You are on page 1of 164

University of Perpetual Help System-DALTA

Zapote-Alabang, Pamplona, Las Pias City

GRADUATE SCHOOL OF EDUCAT O!


Second Semester, SY 2012 2013

T"eoreti#al Foun$ations in !ursin%

Compilation of Reports
Prepare$ &y' Patri#( A) Pantua R! Emmeline *oy +) +an%ente R! ,atrina Lianne R) Samson R! *uan Paulo -) C"ave. R+ R! Helen S) Custo$io R! Su/mitte$ to' DR) 0OLA!DA T) CA!AR A R! +A! P"D Professor Date of Submission OCTO&ER 12 3415

Theory

Systematic set of interrelated concepts, definitions that explain interrelationships View about a phenomena useful for description, control, prediction

Conceptual Framework = your idea Theoretical Framework = pro en idea Components!"lements 1# $urpose

a) Answer the question why it is formulated b) Specifies the context and situation within which the theory is formulated

2# Concepts

a) Building bloc s of theory b) !deas, mental images of an e"ent from experience and perception

#$ %e&inition ' gi"e meaning to the concepts to become clearer and understandable

a( %escripti e!Conceptual accepted meanin) o& term used *( +perational!Stipulati e speci&ic use or de&inition within the theory %oncept are defines as A$ ",plicit a list of definitions or glossary of terms B$ -mplicit which is deri"ed from narrati"e or text and are not stated as definitions

.# $ropositions

a) &xpressions of relational statements between and among concepts b) 'ro"ide lin s and correction between and among concepts

c) %an be express statement, paradigm or figure

($ /ssumptions ' Accepted truths are basic and fundamental theory

a( Factual *( 0alue

Characteristics o& a Theory 1# Systematic, lo)ical and coherent a$ )rder, proper sequencing of ideas and propositions or theoretical foundations

2# Creati e structurin) o& ideas a$ !nterrelated since concepts are building of theory that are mental images coming from one*s experiences and perceptions

3# Tentati e in 1ature a$ +heory can change o"er time, implying that it is e"ol"ing and dynamics b$ ,urther research and studies are done

Theory %e elopment Four Strate)ies 23eleis, 1456( 1# Theory'$ractice'Theory a$ +heory de"elopment is based on theories de"eloped by other discipline

2# $ractice'Theory Strate)y a$ -e"eloped from based or e"ol"ed from practice through actual obser"ations or experiences$

3# 7esearch'Theory Strate)y a$ -e"eloped theories from research findings

.# Theory'research'theory Strate)y a$ -e"eloped by other discipline are utili.ed by gi"en unique perspecti"e

Client'Centered Theories
4

%orothea "li8a*eth +rem Self-Care Deficit Theory

/!n the inability of the client to do the uni"ersal, de"elopmental or health de"iation self0care requisites, the nurse pro"ides wholly or partially compensatory or supporti"e0educati"e assistance$/ 0 -orothea )rem

1ho is she2 She was born in Baltimore, 3aryland on 4546$ 7er father was a construction wor er and her mother is a home ma er$ She studied -iploma in 8ursing in early 45#9*s at the 'ro"idence 7ospital School of 8ursing !n 1ashington -$%$, !n 45#5 and 456( she finished B$S$ 8ursing &ducation : BS8 &d$) and 3S8 &d successi"ely in %atholic ;ni"ersity of America, 1ashington -$%$ !n 45<= She become 7onorary -octorates> -octors of Science from ?eorgetown ;ni"ersity and !ncarnate word college in San Antonio in +exas in 45@9$ !n 45@@ she finished -octor of 7umane Aetters from !llinois 1esleyan ;ni"ersity in Bloomington, !llinois$ 45@@ She graduated from ;ni"ersity of 3issouri in %olumbia, -octor 7onoris %ausae$

8ursing %areer )ccupied important nursing positions, li e the directorship of both the nursing school and the department of nursing at 'ro"idence 7ospital, -etroit :4569 to 4565)$ Spent se"en years at the -i"ision of 7ospital and !nstitutional Ser"ices of the !ndiana State Board of 7ealth :4565045(<), de"eloped her definition of nursing practice Boined the %atholic ;ni"ersity of America first as Assistant 'rofessor, then later became Assistant -ean and Associate 'rofessor of the School of 8ursing$ 7er theory was first published in Nursing: Concepts of Practice in 45<4, second in 45@9, in 455(, and C994 She recei"ed the %atholic ;ni"ersity of America Alumni Association Award for 8ursing +heory in 45@9$ +he second edition of 8ursing> %oncept of 'ractice was published :45@9)

Self %are -eficit +heory +he theory of )rem is considered client centered, because it mainly e"ol"es in the patient as the main focus of care, this is due to the patients inability and incapacity to perform self care which is brought about by health related problems$ )rem "iews nursing as a complex form of deliberate interpersonal action that ultimately pro"ides a helping human health ser"ice$ She chose the name Ddeficit* as it describes and explain a relationship between abilities of indi"idual, their children or adults for whom they care$ +he notion Ddeficit does not refer to a specific type of limitation, but to the relationship between the capabilities of the indi"idual and the need for action$

3etaparadigm of the theory 'erson

"

%lient is an integrated wholeE a unity functioning biologically, symbolically and socially$ %lient is self0reliant and responsible for self0care and well0being of his or her dependents and self0care is a requisite for all$ %lient has capacity to reflect on their own experience and the en"ironment and they use of symbols, ideas and words that distinguished them from other species A client is a holistic indi"idual who is in need of assistance in meeting specific health0care demands because of lac of nowledge, s ills, moti"ation, or orientation

7ealth A healthy person is li ely to ha"e sufficient self0care abilities to meet their uni"ersal self0 care needs$ +he client is in a state of wholeness or integrity of the indi"idual human beings, his parts, and his modes of functioning$

&n"ironment &ncompasses the elements external to man but she considered man and en"ironment as an integrated system related to self0care$ &n"ironmental conditions conduci"e to de"elopment include opportunities to be helped> being with other persons or groups where care is offeredE opportunities for solitude and companionshipE pro"ision of help for personal and group concerns without limiting indi"idual decisions and personal pursuits> shared respect , belief, and trustE recognition and fostering of de"elopmental potential$

8ursing 0 )rem belie"ed that nursing is a community ser"ice, an art, and a technology As a ser"ice 8ursing is a ser"ice of deliberately selected and performed actions to assist indi"iduals or groups to maintain self0care, including structural integrity, functioning, and de"elopment$ Fequirements for nursing are modified and e"entually eliminated when there is progressi"e fa"orable change in the state of health of the indi"idual, or when he learns to be self0directing daily self0care$

As an art )rem says that nursing is also an art because of the ability to assist others in the design, pro"ision, and management of systems of self0care to impro"e or maintain human functioning at some le"el of effecti"eness Also nursing has an intellectual aspect G the discernment of obstacles to care and planning how these obstacles can be o"ercome$

As a technology 8ursing has formali.ed methods or techniques of practice, clearly described ways of performing specific actions so that some particular result will be achie"ed$ +echniques of nursing must be learned and s ill and expertness in their use must be de"eloped by persons who pursue nursing as career$

!nterrelated theories of )rem A$ +heory of Self0%are Self0%are According to )rem self0care is the performance or practice of acti"ities that indi"iduals initiate and perform on their own behalf to maintain life, health and well0being$ 1hen self0care is effecti"ely performed, it helps to maintain structural integrity and human functioning, and it contributes to human de"elopment :)rem, 4554) Self0%are Agency +his is the human*s ability or power to engage in self0care$ +he indi"idual*s ability to engage in self0care is affected by basic conditioning factors$ Basic conditioning factors are age, gender, de"elopmental state, health state, sociocultural orientation, health care system factors, family system factors, patterns of li"ing, en"ironmental factors, and resource adequacy and a"ailability$ :8ursing theories, Bulia ?eorge) Agents 4$ Self0care agent> person who pro"ides the self0care C$ -ependent %are Agent 0 person other than the indi"idual who pro"ides the care

Self0%are requisites

+hese are the actions or measures used to pro"ide self0care> 4$ ;ni"ersal G requisites or needs that are common to all indi"iduals

C$ -e"elopmental 0 needs resulting from maturation or de"elop due to a condition or e"ent #$ 7ealth -e"iation 0 needs resulting from illness, inHury I disease or its treatment

B$ +heory of Self0%are -eficit

+he core of )remJs grand theory is the Self0%are -eficit +heory because it delineates when nursing is needed$ 8ursing is required when a client is incapable of or limited in the pro"ision of continuous effecti"e self0care :?eorge 455()$ +he term /deficit/ refers to a particular relationship between self0care agency and self0care demand that is said to exist when capabilities for engaging in self0care are less than the demand for self0care :'ar er, C99(, p$ 465)$

-> -emand for self care A> Ability to meet demand for self care

C %lassifications of Self0%are -eficit>

4$ Actual C$ 'otential

1%

)rem identifies = methods of helping> 4$ -oing for or acting for another C$?uiding or directing another #$'ro"iding physical support

6$'ro"iding psychological support ($'ro"iding an en"ironment supporti"e of de"elopment =$ +eaching another

%$ +heory of 8ursing Systems

-escribes nursing responsibilities, roles of the nurse and patient, rationales for the nurse0 patient relationship, and types of actions needed to meet the patient*s demands$ A series of actions a nurse ta es to meet a patient*s self0care needs, is determined by the patient*s self0care needs, is composed of three systems$

4$ 1holly %ompensatory C$ 'artly %ompensatory #$ Supporti"e0&ducati"e %ompensatory

Assumptions 7uman beings require continuous deliberate inputs to themsel"es and their en"ironments to remain ali"e and functions in accord with natural human endowments$ 7uman agency, the power to act deliberately, is exercised in the form of care of self and others in identifying needs for and in ma ing needed inputs$ 7uman agency is exercised in disco"ering, de"eloping, and transmitting to others ways and means to identify needs for and ma e inputs to self and others$

11

?roups of human beings with structures relationships cluster tas s and allocate responsibilities for pro"iding care to group members who experience pri"ation for ma ing required deliberate input to self and others

Strengths +he )rem theory is as applicable for nursing by the beginning practitioner as much as the ad"anced clinician:?eorge BB$, 455() +he maHor strength of )rem*s theory is it*s ad"ocacy for the use of the 8ursing 'rocess :Balabagno, et$al, C99=)$ )rem specifically identified the steps of this process$ She also mentioned that the nursing process in"ol"es intellectual and practical phases

Aimitations )rem*s theory don*t ha"e an unclear definition of family, the nurse0society relationship and public education areas$ +hese issues are essential in the management and treatment plan in caring for patients$ Although the family, community and en"ironment are considered in self care action, the focus is primarily on the indi"idual :Balabagno, et$al, C99=) )ne of the most ob"ious limitations of )rem*s theory is that throughout her wor , it can be said that a limited recognition of an indi"idual*s emotional needs is present within the theory :?eorge BB$, 455()$ !t focuses more on physical care and gi"es lesser emphasis to psychological care$

1ola $ender
12

Health Promotion Model

8ola B$ 'ender :born 4564) Born in Aansing, 3ichigan 8urse educator for 69 years 'h-, 8orthwestern ;ni"ersity, &"anston, !A, 45=5 3A, 3ichigan State ;ni"ersity, &ast Aansing, 3!, 45=( BS, 3ichigan State ;ni"ersity, &ast Aansing, 3!, 45=6

7istorical &"olution of 7ealth 'romotion +heory ,irst published in 45@C 3odified in the late 45@9*s 3odified for last time in 455= 3etaparadigms a$ 'erson Fefers to> in"idual, families and communities, b$ &n"ironment

13

c$ 7ealth d$ 8ursing

!ndi"idual factors include Biologic factors Age Body 3ass !ndex 'ubertal status 3enopausal status Aerobic capacity Strength Agility Balance

Sociocultural factors Face &thnicity Acculturation &ducation Socioeconomic status

'sychological factors Self &fficacy Self efficacy is the Hudgment of personal capability to organi.e and carry out a particular course of action$ Self0efficacy is not concerned with s ill one has but with Hudgments of what one can do with whate"er s ills one possesses$ G 'ender, C99=, p$ (#$ Self esteem Self moti"ation 'ercei"ed health status

14

Success Breeds Success According to 'ender, +he most powerful input to self0efficacy is a successful performance of a beha"ior :'ender, C99=, p$ (5)$ &n"ironment 1here a person spends most of time :schools, wor places) 8ursing centers )ccupational health settings %ommunity

&n"ironmental wellness is manifest in harmony and balance between human beings and their surroundings :'ender, C99=, p$ 5)$ 8ursing 7ealth 'romotion Ser"ices 7ealth 'romoting !nter"entions &mpowerment for Self %are %lient*s capacity for Self %are 8urses ma e age0specific and ris 0specific recommendations for clinical pre"entati"e ser"ices :+omey, C949, p$ 6#()$ %linical interest in health beha"iors represents a philosophical shift that emphasi.ed the quality of li"es alongside the sa"ing of li"es :+omey, p$ 66C)$ 8urses promote wellness by health promotion education :+omey, p$ 66C)$

7ealth

+his model promotes the pursuit of health through out the life span :'ender, C99= p$ C@C)$ Subscales> health responsibility, physical acti"ity, nutrition, interpersonal relations, spiritual growth and stress management :+omey, C949, p$ 664)$

%oncepts ;nique +o 3odel ;nli e a"oidance0oriented models that rely upon fear or threat to health as moti"ation for health beha"ior, the 7'3 has a competence or approach0oriented focus :'ender, 455=)$ 7ealth promotion is moti"ated by the desire to enhance well being and to actuali.e human potential :'ender, 455=)$ +he 7'3 is a borrowed theoryE +omey, p$ 664 7ow 'ender*s 7'3 can be used in %linical 'ractice

Applies across a lifespan ;seful in a "ariety of settings 7olistic ;nique plans &ducatingKhands0on

7'3> ,ramewor for 'atient Assessment ?oal*s of 7'3 !mpro"ed health :holistically) &nhanced functional ability Better quality of life at e"ery stage !ncreased well0being 'ossess a positi"e dynamic state

B3!> body mass index is a number calculated from a person*s weight and height$ B3! pro"ides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems$ A dietary Hournal will help eep trac of e"erything you consume to gi"e you an idea of what your eating and what you may not reali.e you*re consuming$ An exercise screening will help identify different types of exercise and physical acti"ity regimens that can be tailored to meet the existing health conditions, illnesses or disabilities of indi"iduals$ Aifestyle questionnaire> used in showing pastKpresent lifestyle habits that may affect or ha"e affected an indi"idual*s life and how they can ma e the change to impro"e their health$

8ursing &ducation Lincreasingly, the 7'3 is incorporated in nursing curricula as an aspect of health assessment, community health nursing, and wellness0focused courses :+omey, C949, p$ 66#)$ %urrent Fesearch Status of 7ealth 'romotion +heory 'romoting participation> &"aluation of a health promotion program for low income seniors +esting the barriers to healthy eating scale -iet and exercise in low0income culturally di"erse middle school students &arly detection of type C diabetes among older African Americans A bicycle safety education program for parents of young children

1!

&ffecti"eness of a tailored inter"ention to increase factory wor ers* use of hearing protection An explanatory model of "ariables influencing health promotion beha"iors in smo ing and nonsmo ing college students Balanced analgesia after hysterectomy> +he effect on outcomes 'romoting the mental health of elderly African Americans> A case illustration Barriers and facilitators of self0reported physical acti"ity in cardiac patients 1ills, :C99<), p$ C65 Strengths 'ositi"e emotions or affect is the dri"e that increases the probability of commitment and action to the desired goal$ +he greater the commitment to a plan of action, the more li ely health promoting beha"iors are maintained o"er time$ 'ersons are more li ely to commit to and engage in health promoting beha"iors when others model the beha"ior$

Aimitations %ommitment to a plan of action is less li ely when competing demands o"er which a person has little control o"er requires immediate attention$ %ommitment to a plan of action is less li ely to result when other actions are more attracti"e and preferred o"er target beha"ior %ommitment to a plan of action is less li ely to result when other actions are more attracti"e and preferred o"er target beha"ior

!n summaryL ?uide nurses in helping clients achie"e impro"ed health, enhanced functional ability, and better quality of life :Bredow, C995, p$ #94)$ 3odel is Hustified by its ability to account for lifestyle factors and need for impro"ements in society :Bredow, p$ #94)$ Based on two other theories> expectancy "alue theory and social cogniti"e theory$ 3odel has been widely tested in many settings 7as exciting possibilities for the creation of inter"entions that are tailored to the unique characteristics and needs of indi"idual clients :Bredow, p$ #94)$

1"

1#

Sister %allista Foy Adaptation Theory

Sister %allista Foy :born )ctober 46, 45#5)

1$

Foy Adaptation 3odel :FA3) o o !mpetus M Bohnson*s challenge &ducation 3ount St$ 3ary*s %ollege :45=#0 undergrad) ;ni"ersity of %alifornia, Aos Angeles :;%AA) :45==0 masters in nursing) ;%AA :masters and doctoral in sociology) %areer Boston %ollege :8ursing +heorist) Boston Based Adaptation Fesearch in 8ursing Society :BBAF8S) :45540 founded) Belongs to Sisters of St$ Boseph of %arondelet

Belief and Values o o o o o o o o !nnate capabilities !nnate purpose 7uman worth Fesiliency of body and spirit !mportance of defining nursing Social Sciences %ommon destiny ,ocus of 8ursing M 'erson

,undamental +heoretical !nfluences

2%

%oncept of 8ursing 3etaparadigm A$ 'erson As an adapti"e system, the human system is described as a whole with parts that function as unity for some purpose$ 7olisticK Adapti"e !ndi"iduals ?roups ,amilies )rgani.ations %ommunities Society ;nited in common destiny 'erson is main focus of nursing 'erson adapts in four main modes

Basic %oncepts of FA3

21

B$ 8ursing 'rofession Aife processes 7ealth promotion Science 'ractice 8ursing Science Nnowledge de"elopment )bser"ation % lassification Felation 7ealth promotion 8ursing 'ractice Body of Nnowledge 'urposeful &ssential 'ositi"e effect 7ealth promotion

22

%$ 7ealth !ntegration 1hole person Adaptation !nteraction 'erson &n"ironment %oping

-$ &n"ironment 4$ ,ocal stimuli !nternal &xternal !mmediate confrontation

C$ %ontextual stimuli #$ Fesidual stimuli ;nclear effects !nclusi"e Affects focal stimuli

)"er"iew of FA3

23

Basic %oncepts of FA3

+he %ognator

24

+he Fegulator

%lassification of FA3

Areas of ,ocus of FA3 A$ 'hilosophical Felationship> 1orld ?od )mega 'oint ?od re"ealed in creation Awareness, enlightenment and faith Accountability B$ Scientific 3atter and energy %onsciousness and meaning Self and en"ironmental awareness 7uman decisions

2!

7uman action !nterdependece 'ersons and earth +ransformations created in consciousness 7uman O &n"ironment M Adaptation

%$ %ultural !nfluence is ine"itable %entral concepts influential %ultural expression G nursing practice

Basic %oncepts of FA3

2"

%oncept Felationships in FA3 Assessment of Stimuli O -etermination of %oping PPPPPPPPPPPPPPPPPPPPPPPPPPPPP &ffecti"eness of Adaptation ;sefulness of FA3 'ro"ide framewor for education +reat indi"iduals, not illness &xpands nursing science and practice -irects practice and education %larity and Simplicity of FA3 %oncepts are clearly defined Sub0concepts are clearly defined %omplex relationships exist between concepts 3any "ariables impact outcomes Stimulates research 'ro"ide theoretical basis for research 'ro"ides source for middle0range theories Validated through broad testability

2#

?enerality I Scope of FA3 Broad Scope ?enerali.able to all settings ;sed for theory building

Aimited Scope 'erson and en"ironment 8urse*s perspecti"e is implied

2$

0ir)inia / enel 9enderson Need Theory

3%

/+he unique function of the nurse is to assist the indi"idual, sic or well, in the performance of those acti"ities contributing to health or its reco"ery :or to peaceful death) that he would perform unaided if he had the necessary strength, will or nowledge/ 00 Virginia A"enel Anderson :ho is she; ,irst Aady of 8ursing, +he 8ightingale of 3odern 8ursing, 3odern0-ay 3other of 8ursing, +he C9th %entury ,lorence 8ightingale She was born in Nansas %ity, 3issouri on 8o"ember #9, 4@5< She was the fifth of eight children and had a family history of scholars and educators$ Virginia was named for her motherJs :Aucy 3inor :Abbot) 7enderson) nati"e state and later educated there at a boys school run by her grandfather$ 7er father is a lawyer by profession named Atty$ -aniel B$ 7enderson$ &arly education in Virginia in the community Army School of 8ursing, 1ashington, -$%$ ?raduated in 45C4 at +eachers %ollege, %olumbia ;ni"ersity :Bachelor of Science degree completed in 45#4 while 3asters of Science degree in 45#6) 7onorary doctoral degrees from the %atholic ;ni"ersity of America, 'ace ;ni"ersity, ;ni"ersity of Fochester, ;ni"ersity of 1estern )ntario, Qale ;ni"ersity

1ursin) Career 7er writing, her presentations, her research and contacts with nurses ha"e profoundly affected nursing and impacted the recipients of care by nurses throughout the world$ 7enry Street Visiting 8urse Association, 8ew Qor , 8ew Qor :45C4), Visiting 8urse Association, 1ashington, -$%$ :45C#045C6) She wor ed as an !nstructor and &ducational -irector at 8orfol 'rotestant 7ospital, 8orfol , Virginia :45C6045C5) She wor ed as an early ad"ocate for the inclusion of psychiatric nursing in the curriculum and ser"ed on a committee to de"elop such a course at &astern State 7ospital in 1illiamsburg, Virginia :45C5) Also wor ed as a Super"isor and %linical !nstructor at the )utpatient -epartment at Strong 3emorial 7ospital, Fochester, 8ew Qor :45#9) She also wor ed as an !nstructor and Associate 'rofessor at +eachers %ollege, %olumbia ;ni"ersity, 8ew Qor , where her re"ision of Bertha 7armerJs Textbook of the Principles and Practice of Nursing became widely used$ :45#60456@) She published her boo , Nature of Nursing, expressed her belief about the essence of nursing and influenced the hearts and minds of those who read it$

1. <asic 9uman 1eeds 21eed Theory(

31

3etaparadi)m o& the Theory $erson !ndi"idual person or client is a whole, complete, independent being with biological, sociological, and spiritual components$ 7enderson belie"ed that a single person should be able to perform the 46 fundamental or basic human needs !f the needs are not met the patient should require assistance to achie"e health and independence or peaceful death

1. <asic 9uman 1eeds 4$ Breathe normally C$ &at and drin adequately #$ &liminate body wastes 6$ 3o"e and maintain desirable postures$ ($ Sleep and rest$ =$ Select suitable clothesRdress and undress$ <$ 3aintain body temperature within normal range by adHusting clothing and modifying en"ironment$ @$ Neep the body clean and well groomed and protect the integument$ 5$ A"oid dangers in the en"ironment and a"oid inHuring others$ 49$ %ommunicate with others in expressing emotions, needs, fears, or opinions$ 44$ 1orship according to oneJs faith$ 4C$ 1or in such a way that there is a sense of accomplishment$ 4#$ 'lay or participate in "arious forms of recreation$ 46$ Aearn, disco"er, or satisfy the curiosity that leads to normal de"elopment and health and use the a"ailable health facilities 9ealth !t is equated with independence or ability to perform acti"ities without any aid in the 46 fundamental or basic human needs$ !ndi"iduals will achie"e or maintain health if they ha"e the necessary strength, will or nowledge :concept of independence)$

32

Basic to human functioning which is needed in achie"ing the theoryJs needs$ 'romotion of health is more important than care of the sic

"n ironment !t encompasses all external conditions and influences that affect life and de"elopment$ +he en"ironment may also include indi"iduals in relation to families and the settings in which an indi"idual learns unique pattern for li"ing +here are se"en essentials that must be present in the en"ironment which include light, temperature, air mo"ement, atmospheric pressure, appropriate disposal of waste, minimal quantities of inHurious chemicals, and cleanliness of any surfaces coming in contact with indi"idual$ 8urse*s function is to alter the en"ironment in such a way as to support the patient, because en"ironment can ha"e a positi"e and negati"e effect to the patient

1ursin) She described nursing roles in relation to patient needs instead of creating a general theory of nursing, she then classified the role of the nurse as one of the following>

Substituti"e, which is doing something for the patient Supplementary, which is helping the patient do somethingE %omplementary, which is wor ing with the patient to do something$ All of these roles are to help the patient become as independent as possible$ She expressed the "iew that a nurse*s role is to follow and assist with the medical plan of care outlined by a physician and also to assume the leadership role of planning and pro"iding basic nursing care$ 8urses are independent practitioners for pro"iding appropriate basic nursing care, howe"er, they should not independently diagnose an ailment, prescribe medical treatment, or formulate a prognosis +he nurse attends to the holistic needs of the patient through the educated and emphatic attention to the 46 needs outlined by 7enderson$ +he nurse is an independent authority on excellent basic nursing care and also a "ital aide to other practitioners in the field of healthcare in ensuring the pro"ision of germane medical treatment for patients with conditions requiring it$

33

%ia)ram o& the need theory

34

/ssumptions 8urses care for patients until patients can care for themsel"es once again$ 'atients desire to return to health or a peaceful death and will act in such a way to achie"e this$ !ndi"iduals will perform acti"ities leading to health if they ha"e the nowledge, capacity or will +he 46 basic needs represent nursing*s basic function 8ursing*s goal may be subsumed into the medical treatment plan$

Stren)ths +he principles of 7enderson*s theory were published in the maHor nursing textboo s used from the 45#9s through the 45=9s, and the principles embodied by the 46 acti"ities are still important in e"aluating nursing care in the C4st centaury$ 7er emphasis on basic human needs as the central focus of nursing practice has led to further theory de"elopment regarding the needs of the person and how nursing can assist in meeting those needs$

=imitations !f the assumption is made that the 46 components prioriti.ed, the relationship among the components is unclear$ Assisting the indi"idual in the dying process she contends that the nurse helps, but there is little explanation of what the nurse does$ 8o concept of the holistic nature of human being$ Aac s inter0relate of factors and the influence of nursing care$

3yra =e ine Conservation Theory

3!

3yra "strin =e ine 21420'144>( Born in %hicago, !llinois )ldest of the three children She de"eloped interest in nursing because of her father ?raduated from the %oo %ounty School of 8ursing in 4556 )btained her BS in 8ursing from the ;ni"ersity of %hicago in 4565 'ri"ate duty nurse, ci"ilian nurse for the ;S army, surgical nursing super"isor and in nursing administration 3S in 8ursing 1ayne State ;ni"ersity in 45=C ;ni"ersity of !llinois at %hicago I +el A"i" ;ni"ersity in !srael << 'ublished articles An !ntroduction to %linical 8ursing with multiple publication years in 45=5, 45<#, 45@5 Fecei"ed an honorary doctorate from Aoyola ;ni"ersity in 455C 8ot to de"elop nursing theory "s$ teach maHor concepts in medical surgical nursing Associate degree students a new approach for daily nursing acti"ities 8ursing education practices0 procedurally oriented "s$ acti"e problem sol"ing and indi"iduali.ed patient care

-n&luences &or 9er Theory ,lorence 8ightingale0 interaction bKw the person I en"ironment Bernard :45(<)0 interdependence of bodily functions Bates*s formulation of ext$ en"ironment0 complexity of ext$ en"ironment -ubo*s :45=()0 adaptability of organism 'ersonal experience after hospitali.ation0 ac nowledged the experience of wholeness is uni"ersally

Composition o& Conser ation 3odel

3"

=e ine?s Conser ation model' promoting adaptation I maintaining wholeness /daptation' is the process of change$ 'atient maintains integrity within the realities of en"ironment Adaptation is achie"ed through the frugal, economic, contained, and controlled use of en"ironmental resources by the indi"idual in hisKher best interest :holeness0 emphasi.es a sound, organic, progressi"e mutuality between di"ersified functions and parts within an entirety, the boundaries of which are open and fluid Ae"ine stated that the unceasin) interaction of the indi"idual organism with its en"ironment does represent an open and fluid system, and a condition of health, wholeness, exists when the interaction or constant adaptations to the en"ironment, permit ease0the assurance of integrity0in all dimensions of life$ Conser ation0 is the product of adaptation$ Conser atio' to eep together -escribes the way complex systems are able to continue to function e"en when se"erely challenged @oal> health and the strength to confront disability $rimary &ocus> eeping together of the wholeness of indi"idual

3aAor Concepts $erson0 is a holistic being who constantly stri"es to preser"e wholeness and integrity sentient, thin ing, future0oriented and past0aware +he wholeness of the indi"idual demands that the indi"idual life has meaning only in the context of social life$ ;nique indi"idual in unity I integrity, feeling, belie"ing, thin ing I whole system of system "n ironment0 completes the wholeness of the indi"idual -nternal en ironment' physiological O pathophysiological aspects of indi"idual I is constantly challenged by the external en"ironment 9omeostasis0 state of energy sparing that also pro"ides necessary baselines for a multitude of synchroni.ed physiological I psychological factors 9omeorrhesis0 is a stabili.ed flow rather than a static state ",ternal en ironmentB

a$ perceptual' indi"iduals respond to with their sense organs$ b$ operational' the elements:radiation, microorganisms, pollutants etc$) physically affects indi"iduals$

3#

c$ conceptual0 consists of language, ideas, symbols I concepts and in"entions and encompasses the exchange of language, the ability to thin and experience emotion, "alue systems, religious beliefs, ethnic and cultural traditions, and indi"idual psychological patterns that come from life experiences$ 9ealth' is implied to mean unity I integrity 0 wholeness and successful adaptation Accdg to Ae"ine> +he a"enue of return to the daily acti"ities compromised by ill health !t is not only the insult or the inHury that is repaired but the person himself or herself !t is not merely the healing of an afflicted part$ !t is rather a return to self hood, where the encroachment of the disability can be set aside entirely, and the indi"idual is free to pursue once more his or her own interests without constraint$ 1ursin)0 in"ol"es engaging in human interactions +he nurse enters into a partnership of human experience where sharing moments in timeRsome tri"ial, some dramaticRlea"es its mar fore"er on each patient +he goal of nursing is to promote adaptation and maintain wholeness 2health(# +he goal of nursing is to promote wholeness, reali.ing that e"ery indi"idual requires a unique and separate cluster of acti"ities$ +he indi"idual*s integrity is hisKher abiding concern and it is the nurse*s responsibility to assist the patient to defend and to see its reali.ation$ +he goal of nursing is accomplished through the use of the conser ation principlesB energy, structure, personal, and social integrity$

Factors that a&&ect adapti e responsesB 9istoricity0 based on personal and genetic past history Speci&icity' each system that ma es up a human being has unique stimulus response pathways 7edundancy0 if one system or pathway is unable to ensure adaptation then another pathway may be able to ta e o"er and complete the Hob

+r)anismic 7esponse o %hange of beha"ior of an indi"idual during an attempt to adapt to the en"ironment 6 types> a$ flight or fight b$ inflammatory c$ stress d$ perceptual

3$

Cey Concepts 2Conser ation $rinciple( Conser ation> coreKcentral concept of Ae"ine*s theory State o& conser ation indi"idual adapti"e responses conform change producti"ely with the least expenditure of effort while preser"ing optimal function and identity . Conser ation $rinciples Conser ation o& ener)y' balancing energy input and output Conser ation o& structural inte)rity' maintainingK restoring the structure of bodyE pre"enting physical brea down and promoting healing Conser ation o& personal inte)rity' recogni.es the indi"idual as one who stri"es for recognition, respect, self awareness, selfhood I self determination Conser ation o& social inte)rity' indi"idual recogni.ed as some one who resides within a family, community, religious group, ethnic group, political system, and a nation$

4%

/ssumptions +he nurse creates an en"ironment in which healing could occur$ A human being is more than the sum of the part$ 7uman being respond in a predictable way$ 7uman being are unique in their responses$ 7uman being now and appraise obHects ,condition and situation$ 7uman being sense ,reflects, reason and understand$ 7uman being action are self determined e"en when emotional$ 7uman being are capable of prolonging reflection through such strategists raising questions

=imitations ,ocuses on illness as opposed to health 6 conser"ation principles are only limited in some cases

41

a$ conser"ation0 focuses only on bed care ill clients b$ structural integrity0 plastic surgeries, breast enhancement, liposuction c$ personal integrity0 psychologically impaired and incapacitated d$ social integrity0 without significant others: abandoned children, psychiatric patients, unconscious indi"iduals

42

=ydia "loise 9all Care, Core, Cure Theory

43

=ydia "loise 9all 1ursin) Theory '' DCare, Core, Cure 3odel " Aydia 7all0 born in 8ew Qor %ity on September C4, 459= and grew up in 'ennsyl"ania ?raduated at Qor 7ospital School of 8ursing in 45C<E Bachelors in 'ublic health 8ursing in 45#CE earned a master of Arts -egree in 456C at +eacher*s %ollege %olumbia ;ni"ersity !nno"ator, moti"ator and mentor Ad"ocate for chronically ill patients 'romoted in"ol"ement of the community in healthcare issues Nnowledge of psychiatry and nursing experiences !n 45=<, she recei"ed the +eachers %ollege 8ursing &ducation Alumni Association Achie"ement in 8ursing 'ractice Award$

Cey Concepts %ore, %are and %ure theory0 45=9 3 separate domainsB a$ body :care) b$ illness :cure) c$ person :core) 'atients0 )8AQ from pro&essional nurses /Any career that is defined around the wor that has to be done, and how it is di"ided to get it done, is a /trade/ :rather than a profession)$

44

Cure circle' limited to helping patientsKfamilies deal with the measures instituted by the physician Care circle' exclusi"e to nursing Core circle' shared with social wor ers, psychologists, clergy, etc$

Care Circle 8urturing component of care 8ursing mothering +eaching and learning acti"ities %omfort 'atients to nurse relationship

Core Circle Based on social sciences +herapeutic use of self 'atient*s role0 healing process 3aintained who they are -e"elop a maturity le"el 3a e informed decisions

Cure Circle 'athological and therapeutic sciences Fehabilitati"e phase of care 8urse0 patient ad"ocate

3aAor Concepts $erson 0 %lient is composed of body, pathology, and person$ 'eople set their own goals and are capable of learning and growing "n ironment 0 Should facilitate achie"ement of the client*s personal goals$ 9ealth 0 -e"elopment of a mature self0identity that assists in the conscious selection of actions that facilitate growth$

1ursin) 0 %aring is the nurse*s primary function$ 'rofessional nursing is most important during the recuperati"e period$

/ssumptions +he client is composed of the ff$ o"erlapping parts> person :core), pathological state and treatment :cure) and body :care)$ !ntroduced the model of 8ursing> What Is It? ,ocusing on the notion that centers around three components of Care, Core and Cure# %are represents nurturer and is exclusi"e to nursing$ %ore in"ol"es the therapeutic use of self and emphasi.es the use of reflection$ Cure focuses on nursing related to the physician*s orders$ %ore and cure are shared with the other health care pro"iders$ +he maHor purpose of care is to achie"e an interpersonal relationship with the indi"idual that will facilitate the de"elopment of the core$

Theoretical /ssertions 'atient*s outcome0 direct care by professional nurses Against turning o"er of care to practical nurses when patient was stabili.ed Against in team nursing 8ursing interacting with the person

4!

1urse'Client %ynamics

4"

-mo)ene Cin) Goal Attainment Theory

4#

-mo)ene Cin)B @oal /ttainment Theory !mogene Ning was born on Banuary C#, 45C# &ducation -iploma in 8ursing0 St$ Bohn*s 7ospital School of 8ursing in 456( BS80 St$ Aouis ;ni"ersity in 456@ 3asters of Science in 8ursing in 45(< -octorate from teacher*s %ollege, %olumbia ;ni"ersity in 45=4 ,aculty at Aoyola ;ni"ersity 45=4045== and 45<C045@9 Assistant %hief of the Fesearch ?rants Branch of the -i"ision of 8ursing in 1ashington -% 45==045=@ -irected the 8ursing program at )hio State ;ni"ersity 45=@045<C 'rofessor at ;ni"ersity of South ,lorida 045@904559 Awarded the 7onorary -octor of 'hilosophy -egree by the American 8urses Association :A8A) in Southern !llinois ;ni"ersity in 45@9 Bessie 3$ Scott Award in 455= !nducted into the A8A hall of fame as a Ai"ing Aegends in American Academy of 8ursing C99( <asic /ssumptions +& @oal /ttainment Theory 8ursing focus is the care of human being 8ursing goal is the health care of indi"iduals I groups 7uman beings> are open systems interacting constantly with their en"ironment Basic assumption of goal attainment theory is that nurse and client communicate information, set goal mutually and then act to attain those goals, is also the basic assumption of nursing process &ach human being percei"es the world as a total person in ma ing transactions with indi"iduals and things in en"ironment +ransaction represents a life situation in which percei"er I thing percei"ed are encountered and in which person enters the situation as an acti"e participant and each is changed in the process of these experiences

4$

Concepts +& @oal /ttainment Theory' -nteractin) Systems '&FS)8AA SQS+&3 'erception Self ?rowth and -e"elopment Body !mage Space +ime !8+&F'&FS)8AA SQS+&3 !nteraction %ommunication +ransaction Fole Stress S)%!AA SQS+&3 )rgani.ation Authority 'ower Status -ecision 3a ing -nteractin) Systems

3etaparadi)ms $erson 7uman being or person refers to social being who are rational and sentient$ 'erson has ability to > percei"e thin feel choose set goals select means to achie"e goals ma e decision 7uman being has three fundamental needs> +he need for the health information that is unable at the time when it is needed and can be used +he need for care that see to pre"ent illness +he need for care when human beings are unable to help themsel"es 9ealth 7ealth in"ol"es dynamic life experiences of a human being, which implies continuous adHustment to stressors in the internal and external en"ironment through optimum use of one*s resources to achie"e maximum potential for daily li"ing

"n ironment &n"ironment is the bac ground for human interactions !t in"ol"es> !nternal en"ironment> transforms energy to enable person to adHust to continuous external en"ironmental changes$ &xternal en"ironment> in"ol"es formal and informal organi.ations$ 8urse is a part of the patient*s en"ironment$ 1ursin) -efinition> A process of action, reaction and interaction by which nurse and client share information about their perception in nursing situation$ and a process of human interactions

between nurse and client whereby each percei"es the other and the situation, and through communication, they set goals, explore means, and agree on means to achie"e goals$ Action> is defined as a sequence of beha"iors in"ol"ing mental and physical action$ Feaction> which is considered as included in the sequence of beha"iors described in action ?oal of nurse> +o help indi"iduals to maintain their health so they can function in their roles$ -omain of nurse> includes promoting, maintaining, and restoring health, and caring for the sic , inHured and dying$ ,unction of professional nurse> +o interpret information in nursing process to plan, implement and e"aluate nursing care

Cin)?s Theory /nd 1ursin) $rocess Assessment Assessment occurs during interaction +he nurse brings special nowledge and s ills whereas client brings perception of problems of concern, to this interaction -uring assessment nurse collects data regarding client 'erception is the base for collection and interpretation of data %ommunication is required to "erify accuracy of perception, for interaction and transaction nowledge of self and

8ursing diagnosis +he data collected by assessment are used to ma e nursing diagnosis in nursing process !n process of attaining goal the nurse identifies the problems, concerns and disturbances about which person see help

'lanning planning for inter"entions to sol"e those problems is done !n goal attainment planning is represented by setting goals and ma ing decisions about and being agreed on the means to achie"e goals +his part of transaction and client*s participation is encouraged in ma ing decision on the means to achie"e the goals

!mplementations !n nursing process implementation in"ol"es the actual acti"ities to achie"e the goals$ !n goal attainment it is the continuation of transaction

&"aluation !t in"ol"es to finding out whether goals are achie"ed or not !n ing description e"aluation spea s about attainment of goal and effecti"eness of nursing care

1ursin) $rocess /nd Theory +& @oal /ttainment

Eean :atson Carin Model

Eean :atsonB Carin) 3odel Bean 1atson was born on Bune 49, 4569 in 1est Virginia, ;S &ducation

BS80 ;ni"ersity of %olorado in 45=6 3S in 'sychiatric 3ental 7ealth0 ;ni"ersity of %olorado in 45== 'h- in &ducational 'sychology and %ounseling0 ;ni"ersity of %olorado in 45<#

'rofessor of 8ursing and %hair in %aring Science at the ;ni"ersity of %olorado 7ealth Sciences %enter ,ellow of the American Academy of 8ursing -ean of 8ursing at ;ni"ersity 7ealth Sciences %enter and 'resident of the 8ational Aeague for 8ursing She has = 7onorary -octoral -egrees 7er theory 8ursing> 7uman Science and 7uman %are was published in 45@@

The Se en /ssumptions +& Carin) 3odel %aring can be effecti"ely demonstrated and practiced only interpersonally$ %aring consists of carati"e factors that result in the satisfaction of certain human needs$ &ffecti"e caring promotes health and indi"idual or family growth$ %aring responses accept person not only as he or she is now but as what he or she may become$ A caring en"ironment is one that offers the de"elopment of potential while allowing the person to choose the best action for himself or herself at a gi"en point in time$ %aring is more healthogenic than is curing$ A science of caring is complementary to the science of curing$ +he practice of caring is central to nursing

Ten $rimary Carati e Factors 4$ +he formation of a humanistic0 altruistic system of "alues$ C$ +he installation of faith0hope$ #$ +he culti"ation of sensiti"ity to one*s self and to others$ 6$ +he de"elopment of a helping0trust relationship ($ +he promotion and acceptance of the expression of positi"e and negati"e feelings$ =$ +he systematic use of the scientific problem0sol"ing method for decision ma ing <$ +he promotion of interpersonal teaching0learning$ @$ +he pro"ision for a supporti"e, protecti"e and Kor correcti"e mental, physical, socio0cultural and spiritual en"ironment$

5$ Assistance with the gratification of human needs$ 49$ +he allowance for existential0phenomenological forces$ 3etaparadi)ms 'erson 7uman being refers to a "alued person in and of him or herself to be cared for, respected, nurtured, understood and assistedE in general a philosophical "iew of a person as a fully functional integrated self$ 7e, human is "iewed as greater than and different from, the sum of his or her parts$ 7umans cannot be treated as obHect 7umans cannot be separated from self, nature or the larger uni"erse +here is a sacredness of li"e and all li"ing things :mariner and tomey C99=)

7ealth

A high le"el of o"erall physical, mental and social functioning A general adapti"e0maintenance le"el of daily functioning +he absence of illness :or the presence of efforts that leads its absence) 7olistic approach to health is necessary to function as a whole being

&n"ironment caring has existed in e"ery society$ %ontains noise, pri"acy, light, access to nature, color, space and smells that can ha"e an impact on the caring0healing process :watson,4555) %aring attitude is transmitted by the culture of the profession as a unique way of coping with its en"ironment# Should be conduci"e to holistic healing

8ursing

8ursing is concerned with promoting health, pre"enting illness, caring for the sic and restoring health !t focuses on health promotion and treatment of disease$ She belie"es that holistic health care is central to the practice of caring in nursing$ a human science of persons and human health0illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions 8urse0patient relationship is foundational to nursing

:atson?s Theory and 1ursin) $rocess Assessment !n"ol"es obser"ation, identification and re"iew of the problemE use of applicable nowledge in literature$ Also includes conceptual nowledge for the formulation and conceptuali.ation of framewor $ !ncludes the formulation of hypothesisE defining "ariables that will be examined in sol"ing the problem$

'lan !t helps to determine how "ariables would be examined or measuredE includes a conceptual approach or design for problem sol"ing$ !t determines what data would be collected and how on whom$

!nter"ention !t is the direct action and implementation of the plan$ !t includes the collection of the data

&"aluation Analysis of the data as well as the examination of the effects of inter"entions based on the data$ !ncludes the interpretation of the results, the degree to which positi"e outcome has occurred and whether the result can be generali.ed$ !t may also generate additional hypothesis or may e"en lead to the generation of a nursing theory$

:atson?s Theory and 1ursin) $rocess

"

Characteristics +& The Theory Aogical in nature$ Felati"ely simple ?enerali.able Based on phenomenological studies that generally as questions rather than state hypotheses$ %an be used to guide and impro"e practice$ Supported by the theoretical wor of numerous humanists, philosophers, de"elopmentalists and psychologists$

Stren)ths +his theory places client in the context of the family, the community and the culture !t places the client as the focus of practice rather than the technology

=imitations Biophysical needs of the indi"idual are gi"en less important +he ten carati"e factors primarily delineate the psychosocial needs of the person 8eeds further research to apply in practice

-da +rlando Nursin Process Theory

-da +rlando?s 1ursin) $rocess Theory Born in 45C= 1rote the 8ursing 'rocess 8ursing -iploma0 8Q medical %ollege BS in 'ublic health nursing0 St Bohn*s ;ni"ersity, 8Q 3A in 3ental health nursing0 %olumbia ;ni"ersity,8Q Associate 'rofessor at Qale School of 8ursing and -irector of the ?raduate 'rogram in 3ental health 'sychiatric 8ursing 'roHect in"estigator of a national !nstitute )f mental 7ealth grant entitled> !ntegration of 3ental health %oncepts in a Basic 8ursing %urriculum$ 'ublished in her 45=4 boo +he -ynamic 8urse0'atient Felationship and re"ised 45<C boo >+he -iscipline and +eaching of 8ursing 'rocesses A board memeber of har"ard %ommunity 7ealth 'lan

3aAor %imensions +he role of the nurse is to find out and meet the patient*s immediate need for help$ +he patient*s presenting beha"ior may be a plea for help, howe"er the help needed may not be what it appears to be$ +herefore, nurses need to use their perception, thoughts about the perception, or feeling engendered from their thoughts to explore with patients the meaning of their beha"ior$ +he process helps nurse find out the nature of the distress and what help the patient needs$

ConceptsB ,unction of professional nursing0 organi.ing principles beha"ior of the patient0problematic situation 'erception of the nurse0 internal response 8ursing process discipline0in"estigation 'atient !mpro"ement0 resolution

7elationships 8urse 'atient Felationship is the maHor relationship 'atients beha"ior and the presence of distress

!%

8urse*s ability to identify the problem

/ssumptions 4$ Assumptions about nursing as a profession C$ Assumptions about patients #$ Assumptions about nurses 6$ Assumptions about the nurse patient relationship Characteristics o& the theory !nterrelate concepts 7as logical nature Simple and applicable in the daily practice %ontibute to the professional nowledge Applicable in clinical practice

Stren)ths ;se of this theory assures that patient will be treated as indi"iduals and that they will ha"e acti"e and constant input into their own care$ 're"ents inaccurate diagnosis or ineffecti"e plans$ Assertion of nursing*s independence as a profession and her belief that this independence must be based on a sound thoretical framewor $ ?uides the nurse to e"aluate her care in terms of obHecti"ely obser"able patient outcome$

Conclusion +heory focuses on the interaction between the nurse and patient and the use of nursing process to produce positi"e outcomes or patient impro"ement$ +heory remains one of the most effecti"e practice theories a"ailable$ +he use of theory eeps the nurse*s focus on the patient +he strength of the theory is that it is clear, concise and easy to use$ 1hile pro"iding the o"erall framewor for nursing, the use of her theory does not exlude nurses from using other theories while caring for the patient$

!1

!2

9ilde)ard "# $eplau Theory of !nter"ersonal #elations

9ilde)ard "# $eplau?s Theory o& -nterpersonal 7elations

!3

Fegarded as 3other of 'sychiatric 8ursing Born in 4595, Feading 'ennysyl"ania ?raduated from -iploma 'rogram in 'ottstown, 'ennysyl"ania 45#4 BA in !nterpersonal 'sychology from Bennington %ollege in 456# 3A in 'sychiatric 8ursing from %olumbia ;ni"ersity, 8Q in 456< &d- in %urriculum de"elopment in 45(# 'rofessor &meritus from Futgers ;ni"ersity o 0Started 4st baccalaureat program in

'sychiatrict 8ursing

%ertified in 'sychoanalysis by 1illiam Alanson 1hite !nstitute of 8Q city 1or ed as &xecuti"e -irector and 'resident of A8A 1or with 17), 8!37 and 8urse %orps -ied in 4555

$u*licationsB 'ublished !nterpersonal Felations in 8ursing in 45(C originally delayed because of no physician co0 author %redited with transformation of nursing from a group of s illed wor ers to a profession 'ublished another boo , paper, speeches and Hournal articles ,irst nurse to synthesi.e nursing theory from other scientific fields$

9istorical " olutions o& the TheoryB 456#06(0 ser"ed in the Army 8urse %orps #4Cth field station 7ospital in &ngland American School of 3ilitary psychiatry 1or ed with leading figures in British and American 'sychiatry 1or ed to reshape 3ental 7ealth system in ;S after war

!4

-n&luencesB ,irst nursing theory to borrow concepts from other disciplines ,reud, 3aslow, Suliman*s interpersonal relationship theories and psychoanalytical model

$urposeB +o facilitate the de"elopment of problem sol"ing s ill within the context of the interpersonal relationship between nurse and client, using education and therapeutic interactions$

FniGuenessB +heory was considered re"olutionary at the time of de"elopment$ 8ursing as a profession and not Hust a s ill$ 3ade the way for psychiatric nursing specialty$

Concepts and %e&initionB $erson "n ironment health 1ursin)

%e elopin) or)anism ",istin) &orces outside0iewed health as Ha/ si)ni&icant therapeutic that tries to reduce o& the indi idual word sym*ol thatinterpersonal process# -t an,iety caused *y implied &orward&unctions cooperati ely <ein) and occurin) inmo ement o& personalitywith needs# other nurse the conte,t o& the nurseand other on)oin)indi iduals in client relationship human processes in thecommunities# direction o& creati e, constructi e, producti e and community li in) 21442(

7oles o& nurse Stranger +eacher Fesource 'erson

%ounselors Surrogate Aeader

$hases +& -nterpersonal 7elationship 4$ C$ #$ 6$ )rientation !dentification &xploitation Fesolution

+rientationB 'roblem defining phase Starts when client meets nurse as stranger -efining problem and deciding type of ser"ice needed %lient see s assistance ,con"eys needs ,as s questions, shares preconceptions and expectations of past experiences 8urse responds, explains roles to client, helps to identify problems and to use a"ailable resources and ser"ices

Factors -n&luencin) +rientation $hase

!!

-denti&ication phase Selection of appropriate professional assistance 'atient begins to ha"e a feeling of belonging and a capability of dealing with the problem which decreases the feeling of helplessness and hopelessness

",ploitation phase ;se of professional assistance for problem sol"ing alternati"es Ad"antages of ser"ices are used is based on the needs and interests of the patients !ndi"idual feels as an integral part of the helping en"ironment +hey may ma e minor requests or attention getting techniques +he principles of inter"iew techniques must be used in order to explore, understand and adequately deal with the underlying problem 'atient may fluctuates on independence 8urse must be aware about the "arious phases of communication 8urse aids the patient in exploiting all a"enues of help and progress is made towards the final step

7esolution phase +ermination of professional relationship +he patients needs ha"e already been met by the collaborati"e effect of patient and nurse 8ow they need to terminate their therapeutic relationship and dissol"e the lin s between them$ Sometimes may be difficult for both as psychological dependence persists 'atient drifts away and brea s bond with nurse and healthier emotional balance is demonstrated and both becomes mature indi"iduals

-nterpersonal Theory /nd 1ursin) $rocess Both are sequential and focus on therapeutic relationship Both use problem sol"ing techniques for the nurse and patient to collaborate on, with the end purpose of meeting the patients needs Both use obser"ation communication and recording as basic tools utili.ed by nursing

/ssessment

!"

-ata collection and analysis ScontinuousT 3ay not be a felt need

1ursin) dia)nosis $lannin) 3utually set goals

+rientation 8on continuous data collection ,elt need -efine need

-denti&ication !nterdependent goal setting ds

-mplementation 'lans initiated towards achie"ement of mutually set goals 3ay be accomplished by patient , nurse or family

",ploitation 'atient acti"ely see ing and drawing help 'atient initiated

" aluation Based on mutually expected beha"iors 3ay led to termination and initiation of new plans

7esolution )ccurs after other phases are completed successfully Aeads to termination

-nternal criticism %larity Simplicity SpecificityKgenerality of the theory Accessibility

!#

Scope of the theory Ae"el of the theory de"elopment

/ssumptionsB Both nurse and patient wants an interpersonal relationship +he patient is able to participate in an interpersonal relationship +he interpersonal relationship will enhance self maturity and self fulfillness +he patient has felt need

=imitations 'ersonal space considerations and community social ser"ice resources are considered less$ 7ealth promotion and maintenance were less emphasi.ed %annot be used in a patient who doesn*t ha"e a felt need eg$ 1ith drawn patients, unconscious patients Some areas are not specific enough to generate hypothesis

!$

Client'1urse "n ironment %ynamics

"%

<etty 1euman Systems Model Theory

<etty 1euman?s System 3odel :ho is she; She was born in the 3us ingum Fi"er Aowell, a "illage in 1ashington %ounty, )hio, ;nited States, along

"1

She obtained her Fegistered 8urse -iploma from the 'eoples 7ospital School of 8ursing, in A ron )hio$ After that, she went to %alifornia where she wor ed in a hospital as a staff nurse, and e"entually became the head nurse$She also explored other fields, and experienced being a school nurse, industrial nurse, and clinical instructor$ She went to the ;ni"ersity of %alifornia at Aos Angeles :;%AA) and too a double maHor in psychology and public health$ She recei"ed her BS 8ursing from this institution$ She completed her 3asters degree in 3ental 7ealth, 'ublic 7ealth %onsultation, also at ;%AA$ She became recogni.ed as a pioneer in the field of nursing in"ol"ement in community mental health$ Started de"eloping +he Systems 3odel as a way to teach an introductory nursing course to nursing students$ +he goal was to pro"ide a 7olistic o"er"iew of the physiological, psychological, sociocultural, and de"elopmental aspects of human beings$ She founded the 8euman Systems 3odel +rustee ?roup, !nc$ +hey are dedicated to the support, promotion and integrity of the 8euman Systems 3odel to guide nursing education, practice and research$

-n&luences 4$ Pierre Tielhard deChardin > a philosopher0priest that belie"ed human beings are continually e"ol"ing towards a state of perfection G an )mega 'oint C$ Gestalt Theory > A theory of ?erman origin which proposes that the dynamic interaction of the indi"idual and the situation determines experience and beha"ior$ #$ General Adaptation yndro!e mainly tal s about an indi"idual*s reaction to stress on the # le"els a" alar! b" resistance c" exhaustion 6$ General yste!s Theory postulates that the world is made up of systems that are interconnected and are influenced by each other$

Systems 3odel Theory Cey Concepts Views the client as an open system consisting of a basic structure or central core of energy resources which represent concentric circles

"2

&ach concentric circle or layer is made up of the fi"e "ariable areas which are considered and occur simultaneously in each client concentric circles$ +hese are> $% Physiolo ical 0 refers of bodily structure and function$ &% Psycholo ical 0 refers to mental processes, functioning and emotions$ '% Sociocultural 0 refers to relationshipsE and socialKcultural functions and acti"ities$ 6$ S"iritual 0 refers to the influence of spiritual beliefs$ (% Develo"mental 0 refers to life*s de"elopmental processes$

<asic Structure "ner)y 7esources Also nown as %&8+FAA %)F& +he %entral %ore is made up of the Basic Sur"i"al ,actors common to all organisms #$ Nor!al te!perature range G body temperature regulation ability %$ Genetic structure G 7air color and bodily features &$ 'esponse pattern G functioning of body systems homeostatically ($ )rgan strength or *eakness +$ ,go structure -$ .no*ns or co!!onalities G "alue system +he personJs system is an open system 0 dynamic and constantly changing and e"ol"ing Stability, or homeostasis, occurs when the amount of energy that is a"ailable exceeds that being used by the system A homeostatic body system is constantly in a dynamic process of input, output, feedbac , and compensation, which leads to a state of balance

Fle,i*le =ine o& %e&ense !s the outer boundary to the normal line of defense, the line of resistance, and the core structure$ Neeps the system free from stressors and is dependent on the amount of sleep, nutritional status, as well as the quality and quantity of stress an indi"idual experiences$

"3

!f the flexible line of defense fails to pro"ide adequate protection to the normal line of defense, the lines of resistance become acti"ated$

1ormal =ine o& %e&ense Fepresents client*s usual wellness le"el$ %an change o"er time in response to coping or responding to the en"ironment, which includes intelligence, attitudes, problem sol"ing and coping abilities$ &xample is s in which is constantly smooth and fair will e"entually form callous o"er times$

"4

=ine o& 7esistance +he last boundary that protects the basic structure 'rotect the basic structure and become acti"ated when en"ironmental stressors in"ade the normal line of defense$ An example would is that when a certain bacteria enters our system, there is an increase in leu ocyte count to combat infection$ !f the lines of resistance are effecti"e, the system can reconstitute and if the lines of resistance are not effecti"e, the resulting energy loss can result in death$

Stressors !s any en"ironmental force which can potentially affect the stability of the systemE it can also produce either a positi"e or negati"e effect on the client system 3 Cinds -ntrapersonal 0 occur within person, example is infection, thoughts and feelings -nterpersonal 0 occur between indi"iduals, e$g$ role expectations ",trapersonal 0 occur outside the indi"idual, e$g$ Hob or finance concerns

A person*s reaction to stressors depends on the strength of the lines of defense$ 1hen the lines of defense fails, the resulting reaction depends on the strength of the lines of resistance$ As part of the reaction, a person*s system can adapt to a stressor, an effect nown as reconstitution$

"

7econstitution !s the increase in energy that occurs in relation to the degree of reaction to the stressor which starts after initiation of treatment for in"asion of stressors$ 3ay expand the normal line of defense beyond its pre"ious le"el, stabili.e the system at a lower le"el, or return it to the le"el that existed before the illness$ 8ursing inter"entions focus on retaining or maintaining system stability$ By means of primary, secondary and tertiary inter"entions, the person :or the nurse) attempts to restore or maintain the stability of the system$

$re ention !s the primary nursing inter"ention$ ,ocuses on eeping stressors and the stress response from ha"ing a detrimental effect on the body$ $% Primary "revention U focuses on protecting the normal line of defense and strengthening the flexible line of defense$ +his occur before the system reacts to a stressor and strengthens the person :primarily the flexible line of defense) to enable him to better deal with stressors and also manipulates the en"ironment to reduce or wea en stressors$ !ncludes health promotion and maintenance of wellness$

&% Secondary "revention U focuses on strengthening internal lines of resistance, reducing the reaction of the stressor and increasing resistance factors in order to pre"ent damage to the central core$ +his occurs after the system reacts to a stressor$ +his includes appropriate treatment of symptoms to attain optimal client system stability and energy conser"ation$

'% Tertiary "revention U focuses on readaptation and stability, and protects reconstitution or return to wellness after treatment$ +his occurs after the system has been treated through secondary pre"ention strategies$ +ertiary pre"ention offers support to the client and attempts to add energy to the system or reduce energy needed in order to facilitate reconstitution$

"!

3etaparadi)m $erson An open system that wor s together with other parts of its body as it interact with the en"ironment 7as ( dynamic "ariables 4$ 'hysiological C$ 'sychological #$ Socio0cultural 6$ -e"elopmental ($ Spiritual 7as protecti"e mechanisms 4$ ,lexible Aine of -efense C$ 8ormal Aine of -efense #$ Aine of Fesistance

""

9ealth !t is a dynamic condition !t is equated with stability of normal line of defense 1ellness exist when all the part of the system of person wor s harmoniously

"#

"n ironment %an be internal, external, and created force :stressors) that interacts with a person*s state of healthE this has a potential to alter or impro"e stability of systems

"$

1ursin) A profession that requires a unique holistic approach ;ses modalities of pre"ention primary, secondary, tertiary Aims to promote optimal wellness to its client through retention, attainment, or maintenance of the stability of client*s system

#%

3adeliene =einin)er Theory of Culture of Care

#1

3adeliene =einin)er?s Theory o& Culture o& Care :ho is she; Born in Sutton, 8ebras a, ;SA on Buly 4#, 45C( She entered the cadet 8urse %orps and a diploma program at St$ Anthony*s School of 8ursing in -en"er, %olorado, ;SA along with her sister in 456( She went on to recei"e a BS degree in Biological Science minor in 'hilosophy and 7umanistic Studies from 3ount St$ Scholastica %ollege :now nown as Benedictine %ollege) in Atchison, Nansas, ;SA )pened a 'sychiatric 8ursing ser"ice and educational program at %reighton ;ni"ersity in )maha, 8& in 45(9$ Ser"ed as Associate 'rofessor of 8ursing and -irector of the ?raduate 'rogram in 'sychiatric 8ursing at the ;ni"ersity of %incinnati from 45(6 to 45=9$ She initiated during this time the first graduate program in 'sychiatric 8ursing at the ;ni"ersity and also the first clinical specialist program in %hild 'sychiatry 8ursing in the ;SA$ !n 45=9, she co0authored one of the first psychiatric texts, Basic 'sychiatric 8ursing %oncepts$ !n 45==, -r$ Aeninger de"eloped the first course in +ranscultural 8ursing while a professor at the ;ni"ersity of %olorado$ She established the first master*s and doctoral programs in +ranscultural 8ursing at the ;ni"ersity of ;tah in 45<6$ She founded the +ranscultural 8ursing Society in 45<6 and the !nternational Association of 7uman %are in 45<@, and ser"ed as first full0president of the American Association of %olleges of 8ursing$

Theory %e elopment /nd 9istorical <ack)round Aeininger*s theory of %ultural %are is a product of de"oted consciousness of an e"er changing world, wherein indi"idual is at play with society and their en"ironment # -t is not a *orrowed theory *ut it an outcome o& independent work with the )oal o& impro in) care )i en to meet di&&erent health care needs o& di erse cultures $ +he core of the theory was deri"ed from all her experiences in hospital, clinic and in the community setting$ :orld :ar -- *ecame the nest wherein the theory de elopedI it was durin) this period that many immi)rants and re&u)ees &rom di erse cultures were mo in) to the Fnited States and to other places worldwide# 1ith direct obser"ations and interactions with clients of di"erse cultures, with "ariety of health conditions, she became conscious that reco"ery from illnesses and or maintaining health and wellbeing was greatly affected by how health care was pro"ided to them$ +he maHor e"ent that led to the de"elopment of her theory happened in the early 45(9*s where she wor ed as a clinical specialist caring for mildly disturbed children of di"erse cultural bac grounds$ -uring her exposure it *ecame e ident to her that nurses and other health pro&essionals &ailed to appreciate the important role o& culture in healin), carin) process and in mental treatment practices# An attempt to use other health care models and other ideas popular during

#2

that period was made but was placed in "ain due to inadequacy of their methods to address her clients* needs$ She then concluded that understandin) and respondin) appropriately and therapeutically to clients o& di&&erent cultures was a critical need that warranted &urther study and research# !n order to ha"e a full understanding of different cultures she decided to pursue an academic doctoral program in anthropology Theory o& Culture o& Care 8urses are in constant interaction with different clients from all wal s of life, regardless of their age, status or condition, we are bound to pro"ide them with the utmost care they deser"e$ 7ealth education and maintenance plays a maHor role in healthcare and one that is highly participated by nursesE ta ing into account our client*s differences in their beliefs, "alues and practices is tantamount to the success of health promotion

Transcultural 1ursin) A comparati"e study of cultures to understand similarities :culture uni"ersal) and differences :culture specific) across human groups$ :Aeininger, 4554)$ According to Aeininger e"ery nurse should be able to> U Nnow and understand that e"ery human race ha"e different health beliefs practices guided and influenced by their own culture$ &ffecti"ely study the different culture, religious sects and nationalitiesE for us nurses to effecti"ely plan care for our patient$

;nderstanding culture care di"ersity and uni"ersality theory helps nurses to be culturally competent who can wor effecti"ely across cultures$ +hey can consciously address the fact that culture affects nurse0client exchangesE with compassion and clarity, as each client what their cultural practices and preference areE incorporate the client*s personal, social, en"ironmental, and cultural needsKbeliefs into the plan of care where"er possibleE and respect and appreciate cultural di"ersity, and stri"e to increase nowledge and sensiti"ity associated with this essential nursing concern$

Terms Fnder The Theory 4$ %ulture Set of "alues, beliefs and tradition, that are held by a specific group of people and handed down from generation to generation or from family to family$ C$ Feligion

#3

Set of beliefs in a di"ine or super human power to be obeyed and worshipped as the creator and ruler of the uni"erse$ #$ &thnic ?roup of people who share a common and distincti"e culture and who are members of a specific group$

6$ Acculturation 'eople of a minority group tend to assumeE the attitudes "alues and beliefs, find practices of the dominant society resulting in a blended cultural pattern$ Sunrise "na*ler 3odel +his model has a "ery significant contribution in terms of specific and indi"iduali.ed nursing care$ +he recognition, that each indi"idual should be treated as a unique entity, with different social and cultural bac ground, pro"ides an impetus to impro"e the nursing profession$

#4

Culture Con)ruent Care Fefers to those cogniti"ely based assisti"e, supporti"e, facilitati"e, or enabling acts or decisions that are tailor made to fit the indi"idual, group or institutional cultural "alues, beliefs and lifeways in order to pro"ide or support meaningful beneficial and satisfying health care or well0being ser"ices$ +o achie"e culture congruent care, nursing actions are to be planned in one of three modes> 1# Cultural Care $reser ation or 3aintenance

-eals on the nursing care aspect with the goal of helping in the preser"ation or maintenance of fa"orable health and caring lifestyle$ +his entails that in maintaining homeostasis, the nurse or the healthcare pro"ider must be sensiti"e in the idiosyncrasies and uniqueness of the patient$ 'aying special attention to cultural beliefs and traditions will aid in a more efficient facilitation of caring for the indi"idual$

2# Cultural Care /ccommodation or 1e)otiation +his concept is based on the reali.ation that in pro"iding quality care, the nurse must be able to adapt or negotiate with the client by ta ing into account the particular culture the client belongs to$ +he nurse must recogni.e that in order to be effecti"e, he must ta e into account the possible differences of the client*s beliefs from his own$ By ac nowledging this fact, the nurse will not come across too strong and will not appear as imposing$ Stri ing a balance between what is the uni"ersally accepted balance and the traditions and customs of a particular client is the aim of this theory$ Accepting the differences and managing to reach into a compromise can e"entually lead to a more sustainable healthcare plan for the client because encroachment on beliefs is minimi.ed$

3# Cultural Care 7estructurin) or 7epatternin) !t dwells on idea that people are capable of modifying their lifestyles to accommodate new healthcare ways or patterns$ !t further expounds that indi"iduals ha"e the capacity to change and are open to try new practices as long as they thin that the results are culturally meaningful and satisfying$ ,or the nursing practice, the repatterning aspect of this model is a useful tool in trying to bend or flex some of the stringent beliefs or habits of the client by including them in their own healthcare plan$ +his further implies that considering the cultural bac ground of an indi"idual does not necessarily mean being certain practices are better left alone$ !n actuality, the model guides the nurse on how to be culturally sensiti"e and try to find creati"e ways of persuasion without being drastic and radical$

3etaparadi)m $erson

#!

7umans are belie"ed to be caring and capable of being concerned about the desires, welfare, and continued existence of others, actions is seen in different cultures$ +hey refer to it collecti"ely li e family, communities, institutions which they "alue more than indi"idual entities$

"n ironment &"ents with meanings and interpretations gi"en to them in particular physical, ecological, sociopolitical or cultural setting$ ,orces outside the organism in the context of culture

1ursin) 7a"e the nowledge on the patient*s unique cultural attributes and at the same time assimilating it within the nursing processE the effect will render a culturally congruent care$ A discipline and profession of transcultural human care$ !t is a learned humanistic and scientific profession and discipline that focuses on phenomena and acti"ities of human care in order to assist, support, facilitate, or enable indi"iduals or groups to maintain or regain their well0being :or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death

9ealth Seen as being uni"ersal across culture but distinct within each culture in a way that represents the beliefs, "alues, and of particular culture

ST7"1@T9S Aeininger*s +ranscultural 8ursing +heory or %ulture %are -i"ersity and ;ni"ersality focused on the concept of culture in pro"iding nursing care to our patients$ !t aids the nurse to be culture sensiti"e$ 8urses should be conscious on different culture that necessitates them to respond to the needs of the patient who has different cultural "alues$

=-3-T/T-+1S !t can also be the primary cause of error in ma ing clinical decisions li e misperception of the outcomes and misperception of the "alues patients place on to outcomes$ 8ot all the data that will be ta en will be accurate and applicable to all clients$ 1e should also consider the uniqueness of indi"idual$ +here can be a problem in adapting or integrating the culture of the other which can be the cause of cultural shoc on the part of the nurses$ Studying culture doesn*t mean that we could already relate to them, studying is different from actual experience$ +his theory doesn*t gi"e any attention to the disease, symptoms etc$ !f nursing practices fail to recogni.e culturological aspects of human needs, there will be signs of less efficacious nursing care practices and dissatisfaction with nursing ser"ices :Aeininger)$

#"

-oes it mean that a sole principle in pro"iding efficient care is the culturally consistent care2 !t can be an aspect but it doesn*t mean that we will not consider the other important things, because we need to remember that we should also pro"ide holistic care, not only in the concept of culture$

U ST7/T"@-"S T+ $7+3+T" "FF"CT-0" C7+SS'CF=TF7/= C+33F1-C/T-+1 -1 T9" 3F=T-' CF=TF7/= :+7C$=/C" 'ronounce names correctly$ 1hen in doubt, as the person for the correct pronunciation$ ;se proper titles of respect> /-octor/, /Fe"erend/, /mister/$ Be sure to as the personJs permission to use his or her first name, or wait until you are gi"en permission to do so$ Be aware of gender sensiti"ities$ !f uncertain about the marital status of a woman or her preferred title, it is best to refer to her as 3s$ Be aware of subtle linguistic messages that may con"ey bias or inequality, for example, referring to a white man as 3ister while addressing a Blac female by her first name$ Fefrain from Anglicing or shortening a personJs gi"en name without his or her permission$ ,or example, calling a Fussian American /3i e/ instead of 3i hael, or shortening the !talian American 3aria Fosa to 3aria$ +he same principle applies to the last name or surname$ Fefrain from using slang, peHorati"e, or derogatory terms when referring to personJs ethnic, racial, or religious groups and con"ey to all staff that this is a wor en"ironment in which there is .ero tolerance for the use of such language$ Violators should be counseled immediately A"oid clichVs and platitudes such as /Some of my best friends are 3exicans/ or /! went to school with Blac s/$ %ommunications describing staff should pertain to their Hob s ills, not their color, age, sex, race, or national origin$ Fefrain from telling stories or Ho es demeaning to certain ethnic, racial, age, or religious groups$ Also a"oid those pertaining to gender0related issues or persons with physical or mental disabilities$ %on"ey to all staff that there will be .ero tolerance for this inappropriate beha"ior$ Violators should be counseled immediately$

##

@eneral Systems Theory

#$

H@eneral Systems Theory *y =udwi) on <ertalan&&yJ

Carl =udwi) on <ertalan&&y <ornB September 45, 4594, At.gersdorf, Austrian :8ear Vienna) %iedB Bune 4C, 45<C :aged <9) Buffalo, 8ew Qor , ;SA "ducationB 454@, uni"ersity le"el with philosophy and art history, ;ni"ersity of !nnsbruc then to ;ni"ersity of Vienna 45C=, finished his 'h- thesis :,echner and the problem of integration of higher order) CareerB $ro&essor inB ;ni"ersity of Vienna :45#6G6@) ;ni"ersity of Aondon :456@G65) ;ni"ersitV de 3ontrVal :4565) ;ni"ersity of )ttawa :45(9G(6) ;ni"ersity of Southern %alifornia :45((G(@) 3enninger ,oundation :45(@G=9) ;ni"ersity of Alberta :45=4G=@) State ;ni"ersity of 8ew Qor at Buffalo :S;8Q) :45=5G<C) -n&luencesB Fudolf %arnap, ?usta" +heodor ,echner, 8icolai 7artmann, )tto 8eurath, 3orit. Schlic -n&luencedB Fussell A$ Ac off, Nenneth &$ Boulding, 'eter %hec land, %$ 1est %hurchman, Bay 1right ,orrester,&r"in AWs.lX, Bames ?rier 3iller,Anatol Fapoport

System %e&inition A system is an orderly and complex arrangement of parts$

+here are many types of systems> 'hysiological Systems> +he digesti"e system, neurological system, and circulatory system &conomic Systems> %apitalism and Socialism %omputer Systems> 8etwor , mainframe, and '% computer systems

$%

Systems Theory Synergy !nterdependence !nterconnections o o within the organi.ation between the organi.ation and the en"ironment

)rgani.ation as )F?A8!S3 A set of elements standing in inter0relations Separate components +hat ha"e a specific purpose$ A way of studying a system as one unit, instead of indi"idual parts$ By examining a system as a whole, it is easier to understand how each part contributes to the o"erall mission

%haracteristics of Systems /Systems/ refer specifically to self0regulating systems$ Systems are self0correcting through feedbac $ Systems ha"e a structure that is defined by its parts and processes$ Systems are generali.ations of reality$ +he "arious parts of a system ha"e functional as well as structural relationships between each other$ Systems tend to function in the same way$ &"ery li"ing organism is essentially an open system$

?eneral +heoretical -istinctions %lassical and humanistic theories prescribe organi.ational beha"ior, organi.ational structure or managerial practice :prediction and control)$ 3A%7!8& Systems theory pro"ides an analytical framewor for "iewing an organi.ation in general :description and explanation)$ )F?A8!S3

Stren)ths

$1

Fecogni.es $ $ $ interdependence of personnel impact of en"ironment on organi.ational structure and function

,ocuses on en"ironment and how changes can impact the organi.ation See s to explain synergy I interdependence Broadens the theoretical lens for "iewing organi.ational beha"ior$

Systems ,ramewor )ffered a more comprehensi"e "iew of organi.ations 8)+ a theory of management 0 new way of conceptuali.ing and studying organi.ations ,our Strengths :promises) 3$ Scott 'oole -esigned to deal with complexity Attempts to do so with precision +a es a holistic "iew !t is a theory of emergents 0 actions and outcomes at the collecti"e le"el emerge from the actions and interactions of the indi"iduals that ma e up the collecti"e

'rinciples of ?eneral Systems +heory +pen'Systems Theory $rinciples 'arts that ma e up the system are interrelated$ 7ealth of o"erall system is contingent on subsystem functioning$ )pen systems import and export material from and to the en"ironment$ 'ermeable boundaries :materials can pass through) Felati"e openness :system can regulate permeability) Second 'rinciple of +hermodynamics :&8+F)'Q) &ntropy must increase to a maximum 8egentropy increases growth and a state of sur"i"al

Synergy :extra energy causes nonsummati"ity00whole is greater than sum of parts) &quifinality "s$ one best way$

Systems, in general, ha"e the following elements>

$2

!nput0+hroughput0)utput !nputs 3aintenance !nputs :energic imports that sustain system) 'roduction !nputs :energic imports which are processed to yield a producti"e outcome)

+hroughput :System parts transform the material or energy) )utput :System returns product to the en"ironment) +FA8S,)F3A+!)8 3)-&A :input is transformed by system)

,eedbac and -ynamic 7omeostasis 'ositi"e ,eedbac 0 mo"e from status quo 8egati"e ,eedbac 0 return to status quo -ynamic 7omeostasis 0 balance of energy exchange

&qui"ocality and Fequisite Variety :Narl 1eic ) &qui"ocality :uncertainty and ambiguity) Fequisite Variety :complex inputs must be addressed with complex processes)

!nput> Fesources entering the system +hroughput> 1or done on those resources used to produce a product )utput> +he final product ,eedbac > !nformation ta en from the output to control or correct errors in throughput System Components

$3

The /merican 9ealthcare %eli ery System

Aet*s discuss each of the elements> -nputs 7uman and financial resources

$4

'atients

Throu)hput +hroughput is the step where the patient is treated 7esources Fsed in Throu)hput &ducational resources +reatment resources ,inancing mechanism 3anagement and control !nformation and feedbac systems

+utput is the product o& the system# 7ow do you thin we should define the product offered by the healthcare deli"ery system2

Characteristics o& +r)ani8ations as Systems Fole of %ommunication %ommunication mechanisms must be in place for the organi.ational system to exchange rele"ant information with its en"ironment Boundary Spanners perform this functionY 3edia )utlets are communication lin between system I en"ironment

%ommunication pro"ides for the flow of information among the subsystems

Systems, Subsystems, and Supersystems Systems are a set of interrelated parts that turn inputs into outputs through processing Subsystems do the processing Supersystems are other systems in en"ironment of which the sur"i"al of the focal system is dependent

,i"e 3ain +ypes of Subsystems 'roduction :technical) Subsystems 0 concerned with throughputs0assembly line Supporti"e Subsystems 0 ensure production inputs are a"ailable0import raw material

3aintenance Subsystems 0 social relations in the system07F, training Adapti"e Subsystems 0 monitor the en"ironment and generate responses :'F) 3anagerial Subsystems 0 coordinate, adHust, control, and direct subsystems

<oundaries +he part of the system that separates it from its en"ironment ,our +ypes of Boundaries :Bec er, 455<) 'hysical Boundary 0 pre"ents access :security system) Ainguistic Boundary 0 speciali.ed language :Hargon) Systemic Boundary 0 rules that regulate interaction :titles) 'sychological Boundary 0 restricts communication :stereotypes, preHudices)

The KClosed? System 7ealthy organi.ation is )'&8 -o not recogni.e they are embedded in a rele"ant en"ironment )"erly focused on internal functions and beha"iors !nability to use feedbac appropriately %)0-&'&8-&8+

Systems Theory in 1ursin) Systems theory may be considered as a speciali.ation of systems thin ing and a generali.ation of systems science$ ?eneral systems theory is a general science of JwholenessJ$ Systems theory has been applied in de"eloping nursing theories and conducting nursing research$ 3any nursing theorists ha"e drawn from the wor s of "on Bertalanffy on systems theory$ 8eumanJs Systems +heory Fogers Js +heory of ;nitary 7uman Beings FoyJs Adaptation 3odel !mogene NingJs +heory of ?oal Attainement )rem Self0care -eficit +heory

$!

+pen! Closed 4$ 1hat is an )pen system2 Ai"ing ?rowing !nteracting !nterrelated C$ 1hat is a %losed system2 A controlled lab test such as a chemical reaction under specific conditions %onsider &ach System as 1hole 1hile !dentifying the Felationships Between the %omponent Subsystems Address the %lients 8eeds -esires and ?oals 1hich exist and !nteract 1ithin +he &cological System of %lient 0 8urse 0 &n"ironment $erson /s a System Are open systems which interact e"ol"e and grow2 7ow many sub0systems and supra0systems interacting with each indi"idual2 !ndi"iduals ,amilies ?roups %ommunities

"n ironment as a System 7ow is the &n"ironment a Ai"ing System2 7ow does the &n"ironment impact the %lient2

"n ironment 8ightingale +heory addressed +he !ssues )f &n"ironment Stating 8ursing !s 8ot Aimited +o ?i"ing 3edications,

$"

But 3ust Also !ncludes ,resh Air Aight 1armth %leanliness Zuiet and Adequate 8utrition$ 7ow does your &n"ironment affect Qou2

The Client L The 9ealthcare System

The 1ursin) $rocess ori)inally adopted &rom @eneral Systems Theory 23ason /ttree,144M, The 1ursin) $rocess( An )pen System with ( 'rincipal !nterrelated %omponents

/pplyin) Systems Theory to 1ursin) Systems +heory 'ro"ides a ,ramewor 8urses to View %lients and +heir Fesponses to 7ealth %oncerns %omponents that are Ney to applying Systems +heory to 8ursing

$#

9olism -escribes a System as an !ntegrated 1hole %omposed of !nterrelated 'arts with the 1hole Being ?reater then the Sum of the 'arts$ Borden :4555)

Applying 7olism A 7uman Being is an !ntegrated 1hole not Hust an Appendectomy in room #95 or a Bro en 7ip in room (95 7ow will the &lderly Aady with the Bro en 7ip the Qoung 3an with the Appendectomy Feact to +heir 7ealth %oncerns from a 'sychological Sociocultural Spiritual Standpoint2

+penness Ai"ing Systems are )pen Systems which %an Fecei"e !nformation and Adapt and ?row +hrough )ngoing !nteractions with +heir &n"ironments -oordon :4555) Selecti"ely Semi0'ermeable Boundaries 1ithin the %lients Systems %ontrol 1hat %omes in and ?oes )ut

1ursin) $rocess -uring Assessment 8urses %onsider 7ow %lients are !nfluenced by the %lients ?i"e +a e with the &n"ironment$ +he 8ature Zuality of Assessment !nformation is Affected by %ompleteness and Accuracy 1hich is -etermined by %lient )penness2

Circularity 8urses %lients !nfluence &ach )ther during their !nteractions +he patterns of this !nfluence are %ircular -uring Assessment the 8urse 3FST 'ay %lose Attention to %lient Feactions and +heir )wn Feactions to +he %lient$ 8urses 3ust 7"3"3<"7 1e Spea a %-FF"7"1T =/1@F/@" 8ursing and 7ealth0care is !nfluenced by the -ominate %ulture$ 1e Ai"e in a 3ulti0cultural Society 1hat are the 'otential 'roblems due to this !nfluence2 Femember to be +$"1 and to allow for H@i e L TakeH in your 8urse 'atient !nteractions

$$

?oals of %ircularity %reate a 8urse patient relationship that is collaborati"e Father then doing for -o with +he nurse who plans with the %lient empowers the %lient 8urses 3FST be aware of and )"ercome +heir )wn %ultural biases to be accepting of di"erse 'erspecti"es %ircular Zuestioning )penness Allows !deas to ,low an 'rompts +rust

Conte,t )pen Ai"ing Systems are in %onstant !nteraction with their &n"ironments !nfluencing and Being !nfluenced by all that Surrounds +hem !mpacted by Social %ultural 7istorical &n"ironmental ,actors

%ontext &"aluation %ontext &ncompasses the %ircumstances of the o 8urse 0 %lient !nteractions

8urses 3ust &"aluate %lient )utcomes in %ontext to !ndi"idual %lients Applying %ontext to &"aluation suggests the !mportance of %omparing Actual %lient )utcomes to %lient &xpectations Father +hen %omparing +hem +o Similar %lients with Similar %onditions

"Gui&inality 1hen Applying &quifinality to &"aluation +he 8urse 3ust Fee"aluate the 8ursing ?oals and 8ursing -iagnosis Femember &ach %lients Fesponse to 7ealth 'roblems will be -ifferent

Chan)e and Sta*ility Ai"ing Systems are %onstantly %hanging +he System Stri"es for &quilibrium +herefore %hange maybe

1%%

,unctional )r -ysfunctional 7ow -oes 'erson &n"ironment 7ealth and 8ursing !mpact the System2

The 1urse 3ust " aluate Client +utcomes :ithin the Clients $ersonal Conte,t$

:hat Systems -mpact the Client; 'hysical 8eeds 0,ood, Shelter, )C %ommunication 0Verbal 8on Verbal 7ealthcare +eam 08urse 3- '+ F+ &n"ironment 07ome 1or %ommunity ,amily

Bottomline> The sa!e !isunderstandings and proble!s that continue to occur *ill e/entually cause fatal da!age to the syste!$

1%1

1%2

%e elopmental Theories

1%3

%e elopmental Theories

Si)mund Freud $sychose,ual %e elopment 'roposed by the famous psychoanalyst Sigmund ,reud, the theory of psychosexual de"elopment describes how personality de"elops during childhood$ 1hile the theory is well0 nown in psychology, it is also one of the most contro"ersial theories$ ,reud belie"ed that personality de"elops through a series of childhood stages in which the pleasure0see ing energies of the id become focused on certain erogenous areas$ +his psychosexual energy, orlibido, was described as the dri"ing force behind beha"ior$ 'sychoanalytic theory suggested that personality is mostly established by the age of fi"e$ &arly experiences play a large role in personality de"elopment and continue to influence beha"ior later in life$ !f these psychosexual stages are completed successfully, the result is a healthy personality$ !f certain issues are not resol"ed at the appropriate stage, fixation can occur$ A fixation is a persistent focus on an earlier psychosexual stage$ ;ntil this conflict is resol"ed, the indi"idual will remain /stuc / in this stage$ ,or example, a person who is fixated at the oral stage may be o"er0dependent on others and may see oral stimulation through smo ing, drin ing, or eating$ +ral Sta)e /)e 7an)eB <irth to 1 Year "ro)enous NoneB 3outh -uring the oral stage, the infantJs primary source of interaction occurs through the mouth, so the rooting and suc ing reflex is especially important$ +he mouth is "ital for eating, and the infant deri"es pleasure from oral stimulation through gratifying acti"ities such as tasting and suc ing$ Because the infant is entirely dependent upon careta ers :who are responsible for feeding the child), the infant also de"elops a sense of trust and comfort through this oral stimulation$ +he primary conflict at this stage is the weaning process00the child must become less dependent upon careta ers$ !f fixation occurs at this stage, ,reud belie"ed the indi"idual would ha"e issues with dependency or aggression$ )ral fixation can result in problems with drin ing, eating, smo ing or nail biting /nal Sta)e /)e 7an)eB 1 to 3 years "ro)enous NoneB <owel and <ladder Control -uring the anal stage, ,reud belie"ed that the primary focus of the libido was on controlling bladder and bowel mo"ements$ +he maHor conflict at this stage is toilet training00the child has to learn to control his or her bodily needs$ -e"eloping this control leads to a sense of accomplishment and independence$

1%4

According to ,reud, success at this stage is dependent upon the way in which parents approach toilet training$ 'arents who utili.e praise and rewards for using the toilet at the appropriate time encourage positi"e outcomes and help children feel capable and producti"e$ ,reud belie"ed that positi"e experiences during this stage ser"ed as the basis for people to become competent, producti"e and creati"e adults$ 7owe"er, not all parents pro"ide the support and encouragement that children need during this stage$ Some parentsJ instead punish, ridicule or shame a child for accidents$ According to ,reud, inappropriate parental responses can result in negati"e outcomes$ !f parents ta e an approach that is too lenient, ,reud suggested that an anal0expulsi/e personality could de"elop in which the indi"idual has a messy, wasteful or destructi"e personality$ !f parents are too strict or begin toilet training too early, ,reud belie"ed that an anal0retenti/e personalityde"elops in which the indi"idual is stringent, orderly, rigid and obsessi"e $hallic Sta)e /)e 7an)eB 3 to > Years "ro)enous NoneB @enitals -uring the phallic stage, the primary focus of the libido is on the genitals$ At this age, children also begin to disco"er the differences between males and females$ ,reud also belie"ed that boys begin to "iew their fathers as a ri"al for the mother*s affections$+he )edipus complex describes these feelings of wanting to possess the mother and the desire to replace the father$ 7owe"er, the child also fears that he will be punished by the father for these feelings, a fear ,reud termed castration anxiety$ +he term &lectra complex has been used to described a similar set of feelings experienced by young girls$ ,reud, howe"er, belie"ed that girls instead experience penis en/y$ &"entually, the child begins to identify with the same0sex parent as a means of "icariously possessing the other parent$ ,or girls, howe"er, ,reud belie"ed that penis en"y was ne"er fully resol"ed and that all women remain somewhat fixated on this stage$ 'sychologists such as Naren 7orney disputed this theory, calling it both inaccurate and demeaning to women$ !nstead, 7orney proposed that men experience feelings of inferiority because they cannot gi"e birth to children$ =atent Sta)e /)e 7an)eB > to $u*erty "ro)enous NoneB Se,ual Feelin)s /re -nacti e -uring the latent period, the libido interests are suppressed$ +he de"elopment of the ego andsuperego contribute to this period of calm$ +he stage begins around the time that children enter into school and become more concerned with peer relationships, hobbies and other interests$ +he latent period is a time of exploration in which the sexual energy is still present, but it is directed into other areas such as intellectual pursuits and social interactions$ +his stage is important in the de"elopment of social and communication s ills and self0confidence @enital Sta)e /)e 7an)eB $u*erty to %eath "ro)enous NoneB 3aturin) Se,ual -nterests

1%

-uring the final stage of psychosexual de"elopment, the indi"idual de"elops a strong sexual interest in the opposite sex$ +his stage begins during puberty but last throughout the rest of a personJs life$ 1here in earlier stages the focus was solely on indi"idual needs, interest in the welfare of others grows during this stage$ !f the other stages ha"e been completed successfully, the indi"idual should now be well0balanced, warm and caring$ +he goal of this stage is to establish a balance between the "arious life areas$ &"aluating Sigmund ,reud*s +heory +he theory is focused almost entirely on male de"elopment with little mention of female psychosexual de"elopment$ 7is theories are difficult to test scientifically$ %oncepts such as the libido are impossible to measure, and therefore cannot be tested$ +he research that has been conducted tends to discredit ,reudJs theory$ ,uture predictions are too "ague$ 7ow can we now that a current beha"ior was caused specifically by a childhood experience2 +he length of time between the cause and the effect is too long to assume that there is a relationship between the two "ariables$ ,reudJs theory is based upon case studies and not empirical research$ Also, ,reud based his theory on the recollections of his adult patients, not on actual obser"ation and study of children

The -d

+he id is the only component of personality that is present from birth$ +his aspect of personality is entirely unconscious and includes of the instincti"e and primiti"e beha"iors$ According to ,reud, the id is the source of all psychic energy, ma ing it the primary component of personality$ +he id is dri"en by the pleasure principle, which stri"es for immediate gratification of all desires, wants, and needs$ !f these needs are not satisfied immediately, the result is a state anxiety or tension$ ,or example, an increase in hunger or thirst should produce an immediate attempt to eat or drin $ +he id is "ery important early in life, because it ensures that an infantJs needs are met$ !f the infant is hungry or uncomfortable, he or she will cry until the demands of the id are met$ 7owe"er, immediately satisfying these needs is not always realistic or e"en possible$ !f we were ruled entirely by the pleasure principle, we might find oursel"es grabbing things we want out of other peopleJs hands to satisfy our own cra"ings$ +his sort of beha"ior would be both disrupti"e and socially unacceptable$ According to ,reud, the id tries to resol"e the tension created by the pleasure principle through the primary process, which in"ol"es forming a mental image of the desired obHect as a way of satisfying the need$ The ")o +he ego is the component of personality that is responsible for dealing with reality$ According to ,reud, the ego de"elops from the id and ensures that the impulses of the id can be expressed in a manner acceptable in the real world$ +he ego functions in both the conscious,preconscious, and unconscious mind$ +he ego operates based on the reality principle, which stri"es to satisfy the idJs desires in realistic and socially appropriate ways$ +he reality principle weighs the costs and benefits of an action before deciding to act upon or abandon impulses$ !n many cases, the idJs impulses can be satisfied through a process of delayed gratification00the ego will e"entually allow the beha"ior, but only in the appropriate time and place$

1%!

+he ego also discharges tension created by unmet impulses through the secondary process, in which the ego tries to find an obHect in the real world that matches the mental image created by the idJs primary process$

The Supere)o

+he last component of personality to de"elop is the superego$ +he superego is the aspect of personality that holds all of our internali.ed moral standards and ideals that we acquire from both parents and society00our sense of right and wrong$ +he superego pro"ides guidelines for ma ing Hudgments$ According to ,reud, the superego begins to emerge at around age fi"e$

+here are two parts of the superego>

1&

+he ego ideal includes the rules and standards for good beha"iors$ +hese beha"iors include those which are appro"ed of by parental and other authority figures$ )beying these rules leads to feelings of pride, "alue and accomplishment$ +he conscience includes information about things that are "iewed as bad by parents and society$ +hese beha"iors are often forbidden and lead to bad consequences, punishments or feelings of guilt and remorse$

2&

+he superego acts to perfect and ci"ili.e our beha"ior$ !t wor s to suppress all unacceptable urges of the id and struggles to ma e the ego act upon idealistic standards rather that upon realistic principles$ +he superego is present in the conscious, preconscious and unconscious$

1%"

"rik "rikson $sychosocial %e elopment

&ri &ri sonJs theory of psychosocial de"elopment is one of the best0 nown theories of personality in psychology$ 3uch li e Sigmund ,reud, &ri son belie"ed that personality de"elops in a series of stages$ ;nli e ,reudJs theory of psychosexual stages, &ri sonJs theory describes the impact of social experience across the whole lifespan$ )ne of the main elements of &ri sonJs psychosocial stage theory is the de"elopment of ego identity$ &go identity is the conscious sense of self that we de"elop through social interaction$ According to &ri son, our ego identity is constantly changing due to new experiences and information we acquire in our daily interactions with others$ 1hen psychologists tal about identity, they are referring to all of the beliefs, ideals, and "alues that help shape and guide a personJs beha"ior$ +he formation of identity is something that begins in childhood and becomes particularly important during adolescence, but it is a process that continues throughout life$ )ur personal identity gi"es each of us an integrated and cohesi"e sense of self that endures and continues to grow as we age$ !n addition to ego identity, &ri son also belie"ed that a sense of competence moti"ates beha"iors and actions$ &ach stage in &ri sonJs theory is concerned with becoming competent in an area of life$ !f the stage is handled well, the person will feel a sense of mastery, which is sometimes referred to as ego strength or ego quality$ !f the stage is managed poorly, the person will emerge with a sense of inadequacy$

$sychosocial Sta)e 1 ' Trust s# 3istrust +he first stage of &ri sonJs theory of psychosocial de"elopment occurs between birth and one year of age and is the most fundamental stage in life$ Because an infant is utterly dependent, the de"elopment of trust is based on the dependability and quality of the childJs caregi"ers$ !f a child successfully de"elops trust, he or she will feel safe and secure in the world$ %aregi"ers who are inconsistent, emotionally una"ailable, or reHecting contribute to feelings of mistrust in the children they care for$ ,ailure to de"elop trust will result in fear and a belief that the world is inconsistent and unpredictable$ )f course, no child is going to de"elop a sense of 499 percent trust or 499 percent doubt$ &ri son belie"ed that successful de"elopment was all about stri ing a balance between the two opposing sides$ 1hen this happens, children acquire hope, which &ri son described as an openness to experience tempered by some wariness that danger may be present$

1%#

$sychosocial Sta)e 2 ' /utonomy s# Shame and %ou*t +he second stage of &ri sonJs theory of psychosocial de"elopment ta es place during early childhood and is focused on children de"eloping a greater sense of personal control$ C Ai e ,reud, &ri son belie"ed that toilet training was a "ital part of this process$ 7owe"er, &ri sonJs reasoning was quite different then that of ,reudJs$ &ri son belie"e that learning to control oneJs bodily functions leads to a feeling of control and a sense of independence$ )ther important e"ents include gaining more control o"er food choices, toy preferences, and clothing selection$ %hildren who successfully complete this stage feel secure and confident, while those who do not are left with a sense of inadequacy and self0doubt$ &ri son belie"ed that achie"ing a balance between autonomy and shame and doubt would lead to will, which is the belief that children can act with intention, within reason and limits$

$sychosocial Sta)e 3 ' -nitiati e s# @uilt -uring the preschool years, children begin to assert their power and control o"er the world through directing play and other social interactions$ %hildren who are successful at this stage feel capable and able to lead others$ +hose who fail to acquire these s ills are left with a sense of guilt, self0doubt, and lac of initiati"e$ 1hen an ideal balance of indi"idual initiati"e and a willingness to wor with others is achie"ed, the ego quality nown as purpose emerges$

$sychosocial Sta)e . ' -ndustry s# -n&eriority +his stage co"ers the early school years from approximately age ( to 44$ +hrough social interactions, children begin to de"elop a sense of pride in their accomplishments and abilities$ %hildren who are encouraged and commended by parents and teachers de"elop a feeling of competence and belief in their s ills$ +hose who recei"e little or no encouragement from parents, teachers, or peers will doubt their abilities to be successful$ Successfully finding a balance at this stage of psychosocial de"elopment leads to the strength nown as competence or a belief our own abilities to handle the tas s set before us$

$sychosocial Sta)e 6 ' -dentity s# Con&usion

1%$

-uring adolescence, children explore their independence and de"elop a sense of self$ +hose who recei"e proper encouragement and reinforcement through personal exploration will emerge from this stage with a strong sense of self and a feeling of independence and control$ +hose who remain unsure of their beliefs and desires will feel insecure and confused about themsel"es and the future$ %ompleting this stage successfully leads to fidelity, which &ri son described as an ability to li"e by societyJs standards and expectations$

$sychosocial Sta)e > ' -ntimacy s# -solation +his stage co"ers the period of early adulthood when people are exploring personal relationships$ &ri son belie"ed it was "ital that people de"elop close, committed relationships with other people$ +hose who are successful at this step will form relationships that are committed and secure$

Femember that each step builds on s ills learned in pre"ious steps$ &ri son belie"ed that a strong
sense of personal identity was important for de"eloping intimate relationships$ Studies ha"e demonstrated that those with a poor sense of self tend to ha"e less committed relationships and are more li ely to suffer emotional isolation, loneliness, and depression$ Successful resolution of this stage results in the "irtue nown as lo"e$ !t is mar ed by the ability to form lasting, meaningful relationships with other people$

$sychosocial Sta)e M ' @enerati ity s# Sta)nation -uring adulthood, we continue to build our li"es, focusing on our career and family$ +hose who are successful during this phase will feel that they are contributing to the world by being acti"e in their home and community$ +hose who fail to attain this s ill will feel unproducti"e and unin"ol"ed in the world$ %are is the "irtue achie"ed when this stage is handled successfully$ Being proud of your accomplishments, watching your children grow into adults, and de"eloping a sense of unity with your life partner are important accomplishments of this stage$

$sychosocial Sta)e 5 ' -nte)rity s# %espair +his phase occurs during old age and is focused on reflecting bac on life$

11%

+hose who are unsuccessful during this stage will feel that their life has been wasted and will experience many regrets$ +he indi"idual will be left with feelings of bitterness and despair$ +hose who feel proud of their accomplishments will feel a sense of integrity$ Successfully completing this phase means loo ing bac with few regrets and a general feeling of satisfaction$ +hese indi"iduals will attain wisdom, e"en when confronting death

The Stren)ths o& "riksonOs Theory )ne of the strengths of psychosocial theory is that it pro"ides a broad framewor from which to "iew de"elopment throughout the entire lifespan$ !t also allows us to emphasi.e the social nature of human beings and the important influence that social relationships ha"e on de"elopment$ Fesearchers ha"e found e"idence supporting &ri sonJs ideas about identity and ha"e further identified different sub0stages of identity formation$ Some research also suggests that people who form strong personal identities during adolescence are better capable of forming intimate relationships during early adulthood$ =imitations o& $sychosocial Theory 1hat inds of experiences are necessary to successfully complete each stage2 7ow does a person mo"e from one stage to the next2 )ne maHor wea ness of psychosocial theory is that the exact mechanisms for resol"ing conflicts and mo"ing from one stage to the next are not well described or de"eloped$ +he theory fails to detail exactly what type of experiences are necessary at each stage in order to successfully resol"e the conflicts and mo"e to the next stage$

=awrence Cohl*er)

Theory o& 3oral %e elopment 3oral de"elopment is a maHor topic of interest in both psychology and education$ )ne of the best nown theories was de"eloped by psychologist Aawrence Nohlberg who modified and expanded upon Bean 'iagetJs wor to form a theory that explained the de"elopment of moral reasoning$ 'iaget described a two0stage process of moral de"elopment, while NohlbergJs theory of moral de"elopment outlined six stages within three different le"els$ Nohlberg extended 'iagetJs theory, proposing that moral de"elopment is a continual process that occurs throughout the lifespan$ DThe 9ein8 %ilemmaJB 9ein8 Steals the %ru) /!n &urope, a woman was near death from a special ind of cancer$ +here was one drug that the doctors thought might sa"e her$ !t was a form of radium that a druggist in the same town had recently disco"ered$ +he drug was expensi"e to ma e, but the druggist was charging ten times what the drug cost him to

111

ma e$ 7e paid [C99 for the radium and charged [C,999 for a small dose of the drug$ +he sic womanJs husband, 7ein., went to e"eryone he new to borrow the money, but he could only get together about [ 4,999 which is half of what it cost$ 7e told the druggist that his wife was dying and as ed him to sell it cheaper or let him pay later$ But the druggist said> /8o, ! disco"ered the drug and !Jm going to ma e money from it$/ So 7ein. got desperate and bro e into the manJs store to steal the drug0for his wife$ Should the husband ha"e done that2/ :Nohlberg, 45=#)$ Nohlberg was not interested so much in the answer to the question of whether 7ein. was wrong or right, but in the reasoning for each participantJs decision$ +he responses were then classified into "arious stages of reasoning in his theory of moral de"elopment$ =e el 1# $recon entional 3orality

Sta)e 1 ' +*edience and $unishment

+he earliest stage of moral de"elopment is especially common in young children, but adults are also capable of expressing this type of reasoning$ At this stage, children see rules as fixed and absolute$ )beying the rules is important because it is a means to a"oid punishment$ Sta)e 2 ' -ndi idualism and ",chan)e

At this stage of moral de"elopment, children account for indi"idual points of "iew and Hudge actions based on how they ser"e indi"idual needs$ !n the 7ein. dilemma, children argued that the best course of action was the choice that best0ser"ed 7ein.*s needs$ Feciprocity is possible at this point in moral de"elopment, but only if it ser"es oneJs own interests$

=e el 2# Con entional 3orality

Sta)e 3 ' -nterpersonal 7elationships

)ften referred to as the /good boy0good girl/ orientation, this stage of moral de"elopment is focused on li"ing up to social expectations and roles$ +here is an emphasis on conformity, being /nice,/ and consideration of how choices influence relationships$

Sta)e . ' 3aintainin) Social +rder

At this stage of moral de"elopment, people begin to consider society as a whole when ma ing Hudgments$ +he focus is on maintaining law and order by following the rules, doing one*s duty and respecting authority$

112

=e el 3# $ostcon entional 3orality

Sta)e 6 ' Social Contract and -ndi idual 7i)hts At this stage, people begin to account for the differing "alues, opinions and beliefs of other people$ Fules of law are important for maintaining a society, but members of the society should agree upon these standards$ Sta)e > ' Fni ersal $rinciples

Nolhberg*s final le"el of moral reasoning is based upon uni"ersal ethical principles and abstract reasoning$ At this stage, people follow these internali.ed principles of Hustice, e"en if they conflict with laws and rules$

Criticisms o& Cohl*er)Os Theory o& 3oral %e elopmentB

-oes moral reasoning necessarily lead to moral beha"ior2 NohlbergJs theory is concerned with moral thin ing, but there is a big difference between nowing what we ought to do "ersus our actual actions$ !s Hustice the only aspect of moral reasoning we should consider2 %ritics ha"e pointed out that NohlbergJs theory of moral de"elopment o"eremphasi.es the concept as Hustice when ma ing moral choices$ ,actors such as compassion, caring and other interpersonal feelings may play an important part in moral reasoning$ -oes NohlbergJs theory o"eremphasi.e 1estern philosophy2 !ndi"idualistic cultures emphasi.e personal rights while collecti"ist cultures stress the importance of society and community$ &astern cultures may ha"e different moral outloo s that NohlbergJs theory does not account for$

Eean $ia)et

113

Sta)es o& Co)niti e %e elopment Schemas 0 A schema describes both the mental and physical actions in"ol"ed in understanding and nowing$ Schemas are categories of nowledge that help us to interpret and understand the world$ /ssimilation 0 +he process of ta ing in new information into our pre"iously existing schemas is nown as assimilation$ +he process is somewhat subHecti"e, because we tend to modify experience or information somewhat to fit in with our preexisting beliefs$ !n the example abo"e, seeing a dog and labeling it /dog/ is an example of assimilating the animal into the childJs dog schema$ /ccommodation 0 Another part of adaptation in"ol"es changing or altering our existing schemas in light of new information, a process nown as accommodation$ Accommodation in"ol"es altering existing schemas, or ideas, as a result of new information or new experiences$ 8ew schemas may also be de"eloped during this process$ The Sensorimotor Sta)e> -uring this stage, infants and toddlers acquire nowledge through sensory experiences and manipulating obHects$ +he first stage of 'iagetJs theory lasts from birth to approximately age two and is centered on the infant trying to ma e sense of the world$ -uring the sensorimotor stage, an infantJs nowledge of the world is limited to his or her sensory perceptions and motor acti"ities$ Beha"iors are limited to simple motor responses caused by sensory stimuli$ %hildren utili.e s ills and abilities they were born with :such as loo ing, suc ing, grasping, and listening) to learn more about the en"ironment$ According to 'iaget, the de"elopment of obHect permanence is one of the most important accomplishments at the sensorimotor stage of de"elopment$ )bHect permanence is a childJs understanding that obHects continue to exist e"en though they cannot be seen or heard$

Su*sta)es o& the Sensorimotor Sta)eB +he sensorimotor stage can be di"ided into six separate substages that are characteri.ed by the de"elopment of a new s ill$ 7e&le,es 20'1 month(B -uring this substage, the child understands the en"ironment purely through inborn reflexes such as suc ing and loo ing$ $rimary Circular 7eactions 21'. months(B +his substage in"ol"es coordinating sensation and new schemas$ ,or example, a child may such his or her thumb by accident and then later intentionally repeat the action$ +hese actions are repeated because the infant finds them pleasurable$ Secondary Circular 7eactions 2.'5 months(B -uring this substage, the child becomes more focused on the world and begins to intentionally repeat an action in order to trigger a response in the en"ironment$ ,or example, a child will purposefully pic up a toy in order to put it in his or her mouth$ Coordination o& 7eactions 25'12 months(B -uring this substage, the child starts to show clearly intentional actions$ +he child may also combine schemas in order to achie"e a desired effect$ %hildren begin exploring the en"ironment around them and

114

will often imitate the obser"ed beha"ior of others$ +he understanding of obHects also begins during this time and children begin to recogni.e certain obHects as ha"ing specific qualities$ ,or example, a child might reali.e that a rattle will ma e a sound when sha en$ Tertiary Circular 7eactions 212'15 months(B %hildren begin a period of trial0and0error experimentation during the fifth substage$ ,or example, a child may try out different sounds or actions as a way of getting attention from a caregi"er$ "arly 7epresentational Thou)ht 215'2. months(B %hildren begin to de"elop symbols to represent e"ents or obHects in the world in the final sensorimotor substage$ -uring this time, children begin to mo"e towards understanding the world through mental operations rather than purely through actions$ The $reoperational Sta)eB At this stage, ids learn through pretend play but still struggle with logic and ta ing the point of "iew of other people$

+he preoperational stage occurs roughly between the ages two and se"en$ Aanguage
de"elopment is one of the hallmar s of this period$ 'iaget noted that children in this stage do not yet understand concrete logic, cannot mentally manipulate information, and are unable to ta e the point of "iew of other people, which he termed egocentrism

The Concrete +perational Sta)eB Nids at this point of de"elopment begin to thin more logically, but their thin ing can also be "ery rigid$ +hey tend to struggle with abstract and hypothetical concepts$ +he concrete operational stage begins around age se"en and continues until approximately age ele"en$ -uring this time, children gain a better understanding of mental operations$ %hildren begin thin ing logically about concrete e"ents, but ha"e difficulty understanding abstract or hypothetical concepts$ =o)icB 'iaget determined that children in the concrete operational stage were fairly good at the use of inducti"e logic$ !nducti"e logic in"ol"es going from a specific experience to a general principle$ )n the other hand, children at this age ha"e difficulty using deducti"e logic, which in"ol"es using a general principle to determine the outcome of a specific e"ent$ 7e ersi*ilityB )ne of the most important de"elopments in this stage is an understanding of re"ersibility, or awareness that actions can be re"ersed$ An example of this is being able to re"erse the order of relationships between mental categories$ ,or example, a child might be able to recogni.e that his or her dog is a Aabrador, that a Aabrador is a dog, and that a dog is an animal

11

The Formal +perational Sta)eB +he final stage of 'iagetJs theory in"ol"es an increase in logic, the ability to use deducti"e reasoning, and an understanding of abstract ideas$ +he formal operational stage begins at approximately age twel"e to and lasts into adulthood$ -uring this time, people de"elop the ability to thin about abstract concepts$ S ills such as logical thought, deducti"e reasoning, and systematic planning also emerge during this stage$ +he formal operational thin er has the ability to consider many different solutions to a problem before acting$ +his greatly increases efficiency, because the indi"idual can a"oid potentially unsuccessful attempts at sol"ing a problem$ +he formal operational person considers past experiences, present demands, and future consequences in attempting to maximi.e the success of his or her adaptation to the world$ :Sal ind, C996) =o)icB 'iaget belie"ed that deducti"e logic becomes important during the formal operational stage$ -educti"e logic requires the ability to use a general principle to determine a specific outcome$ +his type of thin ing in"ol"es hypothetical situations and is often required in science and mathematics$

/*stract Thou)htB 1hile children tend to thin "ery concretely and specifically in earlier stages, the ability to thin about abstract concepts emerges during the formal operational stage$ !nstead of relying solely on pre"ious experiences, children begin to consider possible outcomes and consequences of actions$ +his type of thin ing is important in long0term planning$

$ro*lem'Sol in)B !n earlier stages, children used trial0and0error to sol"e problems$ -uring the formal operational stage, the ability to systematically sol"e a problem in a logical and methodical way emerges$ %hildren at the formal operational stage of cogniti"e de"elopment are often able to quic ly plan an organi.ed approach to sol"ing a problem$ Criticisms o& $ia)etB $ro*lems with 7esearch 3ethods 3uch of the criticism of 'iagetJs wor is in regards to his research methods$ A maHor source of inspiration for the theory was 'iagetJs obser"ations of his own three children$ !n addition to this, the other children in 'iagetJs small research sample were all from well0educated professionals of

11!

high socioeconomic status$ Because of this unrepresentati"e sample, it is difficult to generali.e his findings to a larger population$

$ro*lems with Formal +perations Fesearch has disputed 'iagetJs argument that all children will automatically mo"e to the next stage of de"elopment as they mature$ Some data suggests that en"ironmental factors may play a role in the de"elopment of formal operations$

Fnderestimates ChildrenOs /*ilities 3ost researchers agree that children possess many of the abilities at an earlier age than 'iaget suspected$ Fecent theory of mind research has found that 60 and (0year0old children ha"e a rather sophisticated understanding of their own mental processes as well as those of other people$ ,or example, children of this age ha"e some ability to ta e the perspecti"e of another person, meaning they are far less egocentric than 'iaget belie"ed$

11"

11#

=earnin) Theories

=earnin) Acquiring new or modifying and reinforcing existing nowledge, beha"iors, s ills, "alues or preferences and may in"ol"e synthesi.ing different types of information

=earnin) theories

11$

Are conceptual framewor s that describe how information is absorbed, processed, and retain during learning$

$aradi)ms o& =earnin) Theories 4$ C$ #$ 6$ ($ Beha"iorism %ogniti"ism %onstructi"ism -esign0based 7umanism <eha iorism 1orld"iew that assumes a learner is essentially passi"e, responding to en"ironmental stimuli Aearner starts off as a clean state I beha"ior is shaped through positi"e or negati"e reinforcement0 increase the probability that the beha"ior will happen again 'unishment :positi"e I negati"e) decrease the probability that the beha"ior will happen again 'ositi"e> application of stimulusE negati"e0 withholding of stimulus

Theories under 2<eha iorism( 1# Classical conditionin) 2$a lo ( Feflexi"e or automatic type of learning in which the stimulus acquires the capacity to e"o e a response that was originally e"o ed by another stimulus Associati"e learning :ma ing new association between e"ents in the en"ironment

$a lo ?s e,periment C9th century, !"an 'a"lo"0 noble pri.e winning wor on digestion$ /ccidental disco ery> dogs begin sali"ation e"en before the meat was presented whether by the presence of the handler or merely by a clic ing noise produced by the de"ice that is used in distributing meat powder 'a"lo" paired the meat powder ;nconditioned stimulus) with "arious stimuli0 ringing of a bell :conditioned stimulus) After presented together :meat powder I ringing of bell) se"eral times, the bell was used alone 'a"lo"*s dogs as predicted, responded by sali"ating to the sound of the bell without food :conditioned response) Bell0 began as a neutral stimulus :bell itself did not produce dog*s sali"ation) 7owe"er, by pairing the bell with ;S:meat powder), the bell was able to acquire the ability to trigger the sali"ation process 'a"lo" therefore demonstrated how stimulus0response bonds are formed !n technical terms>

meat powder0 ;nconditioned stimulus dog*s sali"ation0 unconditioned response

12%

bell0 neutral stimulus until the dog learns to associate the bell with foodE becomes conditioned stimulus which produces conditioned response of sali"ation after repeated pairings between the bell and the food )ohn *% +atson, -arly Classical Conditionin .ith Humans Bohn B$ 1atson further extended 'a"lo"*s wor and applied it to human beings$ !n 45C4, 1atson studied Albert, an 44 month old infant child$ +he goal of the study was to condition Albert to become afraid of a white rat by pairing the white rat with a "ery loud, Harring noise :;%S)$ At first, Albert showed no sign of fear when he was presented with rats, but once the rat was repeatedly paired with the loud noise :;%S), Albert de"eloped a fear of rats$ !t could be said that the loud noise :;%S) induced fear :;%F)$ +he implications of 1atson*s experiment suggested that classical conditioning could cause some phobias in humans$ 2# +perant Conditionin) 2<# F# Skinner( )perant conditioning can be described as a process that attempts to modify beha"ior through the use of positi"e and negati"e reinforcement$ +hrough operant conditioning, an indi"idual ma es an association between a particular beha"ior and a consequence +he term operant conditioning originated by the beha"iorist B$ ,$ S inner, who belie"ed that one should focus on the external, obser"able causes of beha"ior :rather than try to unpac the internal thoughts and moti"ations) &xample 4> 'arents rewarding a child*s excellent grades with candy or some other pri.e$ &xample C> A schoolteacher awards points to those students who are the most calm and well0beha"ed$ Students e"entually reali.e that when they "oluntarily become quieter and better beha"ed, that they earn more points$ 7ein&orcement comes in two &ormsB positi e and ne)ati e#

Positi/e reinforcers are fa"orable e"ents or outcomes that are gi"en to the indi"idual after the desired beha"ior$ +his may come in the form of praise, rewards, etc$ Negati/e reinforcers typically are characteri.ed by the remo"al of an undesired or unpleasant outcome after the desired beha"ior$ A response is strengthened as something considered negati"e is remo"ed$
$unishment, in contrast, is when the increase o& somethin) undesira*le attempts to cause a decrease in the *eha ior that &ollows# Positi/e punish!ent is when unfa"orable e"ents or outcomes are gi"en in order to wea en the response that follows$ Negati/e punish!ent is characteri.ed by when a fa"orable e"ent or outcome is remo"ed after an undesired beha"ior occurs$

3# Social =earnin) Theory 2<andura(

121

'osits that people learn from one another, "ia obser"ation, imitation, and modeling$ Bridge between beha"iorist and cogniti"e learning theories G uses attention, memory, and moti"ation$ Social learning theory explains human beha"ior in terms of continuous reciprocal interaction between cogniti"e, beha"ioral, and en"ironmental influences$

1ecessary conditions &or e&&ecti e modelin)B a$ /ttention R "arious factors increase or decrease the amount of attention paid$ !ncludes distincti"eness, affecti"e "alence, pre"alence, complexity, functional "alue$ )ne*s characteristics :e$g$ sensory capacities, arousal le"el, perceptual set, past reinforcement) affect attention$ b$ 7etention R remembering what you paid attention to$ !ncludes symbolic coding, mental images, cogniti"e organi.ation, symbolic rehearsal, motor rehearsal c$ 7eproduction R reproducing the image$ !ncluding physical capabilities, and self0obser"ation of reproduction$ d$ 3oti ation R ha"ing a good reason to imitate$ !ncludes moti"es such as\ past :i$e$ traditional beha"iorism), promised :imagined incenti"es) and "icarious :seeing and recalling the reinforced model) Co)niti ism focuses on the inner mental acti"ities G opening the blac box of the human mind is "aluable and necessary for understanding how people learn$ 3ental processes such as thin ing, memory, nowing, and problem0sol"ing need to be explored$ +he cogniti"ist paradigm essentially argues that the blac box of the mind should be opened and understood$ +he learner is "iewed as an information processor :li e a computer)$

Theories under 2co)niti ism( 1# /ttri*ution Theory 2:einer( Attribution +heory attempts to explain the world and to determine the cause of an e"ent or beha"ior Achie"ement0 According to him, the most important factors affecting attributions are ability, effort, tas difficulty, and luc $ &xamples> a$ 1hen one succeeds, one attributes successes internally :my own s ill)$ b$ 1hen a ri"al succeeds, one tends to credit external :e$g$ luc )$ c$ 1hen one fails or ma es mista es, we will more li ely use external attribution, attributing causes to situational factors rather than blaming oursel"es$ d$ 1hen others fail or ma e mista es, internal attribution is often used, saying it is due to their internal personality factors$

2# Co)niti e Theory o& 3ultimedia =earnin) 23ayer(

122

+he principle nown as the multimedia principle 0 people learn more deeply from words and pictures than from words alone 3ayer*s cogniti"e theory of multimedia learning presents the idea that the brain does not interpret a multimedia presentation of words, pictures, and auditory information in a mutually exclusi"e fashionE rather, these elements are selected and organi.ed dynamically to produce logical mental constructs

three main assumptionsB +here are two separate channels :auditory and "isual) for processing information :sometimes referred to as -ual0%oding theory)E &ach channel has a limited :finite) capacity :similar to Sweller*s notion of %ogniti"e Aoad)E Aearning is an acti"e process of filtering, selecting, organi.ing, and integrating information based upon prior nowledge$

7ole o& three memory storesB a$ sensory :which recei"es stimuli and stores it for a "ery short time) b$ wor ing :where we acti"ely process information to create mental constructs :or Dschema*) c$ long0term :the repository of all things learned) 3# "la*oration Theory 27ei)eluth( !nstructional design theory that argues that content to be learned should be organi.ed from simple to complex order, while pro"iding a meaningful context in which subsequent ideas can be integrated$ 'roponents feel the use of moti"ators, analogies, summaries and syntheses leads to effecti"e learning

.# Sta)e Theory o& Co)niti e %e elopment 2$ia)et( 'iaget began to study the reasoning processes of children at "arious ages$ -ependent on both maturational and en"ironmental factors +hin ing and learning are a process of interaction of the child and the en"ironment %hildren construct nowledge based on innate cogniti"e structure and experiences

Four sta)es o& pro)ressB a# Sensorimotor sta)e 2<irth to 2 years old( understanding of himself or herself and reality through interactions with the en"ironment$ differentiate between itself and other obHects$ Aearning ta es place "ia assimilation :the organi.ation of information and absorbing it into existing schema) and accommodation :when an obHect cannot be assimilated and the schemata ha"e to be modified to include the obHect$

*# $reoperational sta)e 2a)es 2 to .( +he child is not yet able to conceptuali.e abstractly and needs concrete physical situations$ )bHects are classified in simple ways, especially by important features$

123

c# Concrete operations 2a)es M to 11( As physical experience accumulates, accomodation is increased$ +he child begins to thin abstractly and conceptuali.e, creating logical structures that explain his or her physical experiences$

d# Formal operations 2*e)innin) at a)es 11 to 16( %ognition reaches its final form person no longer requires concrete obHects to ma e rational Hudgements$ 7e or she is capable of deducti"e and hypothetical reasoning$ 7is or her ability for abstract thin ing is "ery similar to an adult$ Constructi ism +heory of learning is a transactional model where child is acti"ely in"ol"ed in hisKher own learning +eacher*s role is to build en"ironment that is stimulating and conduci"e to process of constructing meaning and nowledge learning is an acti"e, contextuali.ed process of constructing nowledge rather than acquiring it$

1# Social %e elopment Theory 20y)otsky( social interaction precedes de"elopmentE consciousness and cognition are the end product of sociali.ation and social beha"ior$ ,ocused on the connections between people and the sociocultural context in which they act and interact in shared experiences humans use tools that de"elop from a culture, such as speech and writing, to mediate their social en"ironments$ !nitially children de"elop these tools to ser"e solely as social functions, ways to communicate needs$

3 3aAor themesB a$) Social interaction plays a fundamental role in the process of cogniti"e de"elopment$ Vygots y felt social learning precedes de"elopment$ 7e states> &"ery function in the child*s cultural de"elopment appears twice> first, on the social le"el, and later, on the indi"idual le"el first, between people :interpsychological) and then inside the child :intrapsychological)$

b$) +he 3ore Nnowledgeable )ther :3N)) +he 3N) refers to anyone who has a better understanding or a higher ability le"el than the learner, with respect to a particular tas , process, or concept$ +he 3N) is normally thought of as being a teacher, coach, or older adult, but the 3N) could also be peers, a younger person, or e"en computers$

c$) +he ]one of 'roximal -e"elopment :]'-)

124

+he ]'- is the distance between a student*s ability to perform a tas under adult guidance andKor with peer collaboration and the student*s ability sol"ing the problem independently$ Aearning occurred in this .one$

2# Communities o& $ractice 2=a e and :en)er( groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly process of social learning that occurs when people who ha"e a common interest in a subHect or area collaborate o"er an extended period of time, sharing ideas and strategies, determine solutions, and build inno"ations$

three reGuired components a$ -omain0 identity defined by a shared domain of interest b$ %ommunity0 members of a specific domain interact and engage in shared acti"ities, help each other, and share information with each other c$ 'ractice0 they de"elop a shared repertoire of resources which can include stories, helpful tools, experiences, stories, ways of handling typical problems 3# %isco ery =earnin) inquiry0based, constructi"ist learning theory that ta es place in problem sol"ing situations where the learner draws on his or her own past experience and existing nowledge to disco"er facts and relationships and new truths to be learned

.# $ro*lem' <ased =earnin) instructional method of hands0on, acti"e learning centered on the in"estigation and resolution of messy, real0world problems$

6# Situated =earnin) Theory 2=a e( learning is unintentional and situated within authentic acti"ity, context, and culture$ process of legitimate peripheral participation> as the beginner or no"ice mo"es from the periphery of a community to its center, he or she becomes more acti"e and engaged within the culture and e"entually assumes the role of an expert 9F3/1-S3 focuses on the human freedom, dignity, and potential$ study the person as a whole, especially as an indi"idual grows and de"elops o"er the lifespan study of the self, moti"ation, and goals are areas of particular interest$ Aearning0 student centered and personali.ed educator*s role0 facilitator$ ?oal> de"elop self0actuali.ed people in a cooperati"e, supporti"e en"ironment$

Theories under 29umanism(

12

1# 3aslow?s 9ierarchy o& 1eeds while people aim to meet basic needs, they see to meet successi"ely higher needs in the form of a hierarchy$

Hd'needsJ a$ 'hysiological0 human sur"i"al b$ Safety0 in the absence of physical natural disaster etc$), economic :lac of wor opportunities)0 post traumatic experience I see s safety and security needs c$ Ao"e I belongingness0 deficiency in this aspect can alter ability to form significant relationships d$ &steem0 presents normal human desire> accepted I "alued by others H@rowth needsJ a$ Self0actuali.ation0 what a man can be, he must be0 full potential Carl 7o)ers? theory 7umanistic approach0 'eople want an unconditional positi"e self regard Fole of educator I leader is facilitator Aearners choose what is to be learned I educators> resource person ,eelings and emotions are eys to learning, communication I understanding tell me how you feel rather than tell me what you thin

Both Fogers and 3aslow regarded personal growth and fulfilment in life as a basic human moti"e$ 2# ",periential =earnin) 2Col*( holistic perspecti"e that combines experience, perception, cognition, and beha"ior$ learning is the process whereby nowledge is created through the transformation of experience

. sta)esB a$ concrete experience -) b$ reflecti"e obser"ation )BS&FV& c$ abstract conceptuali.ation +7!8N d$ acti"e experimentation 'AA8 . learnin) stylesB a$ b$ c$ d$ Assimilators0 learns better when presented with sound logical theories %on"ergers0 learns better when pro"ided with practical applications of concepts Accommodators0 learns better when presented with hands on experience -i"ergers0 learns better when allowed to obser"e and collect a wide range of information

12!

%esi)n'<ased 7esearch 3ethods 2%<7( important methodology for understanding how, when, and why educational inno"ations wor in practice Aims to unco"er the relationships between educational theory, designed artefact, and practice

Theories under 2%esi)n' *ased( 1# /%%-" 3odel systematic instructional design model

6 phasesB a$ Analysis b$ -esign c$ -e"elopment d$ !mplementation e$ &"aluation Fapid prototyping :continual feedbac ) has sometimes been cited as as a way to impro"e the generic A--!& model$

+ther learnin) theories 3ultiple -ntelli)ence0 all people ha"e different inds of intelligences @ inds of intelligence> 4$Visual spatial C$ Ainguistic #$ Aogical mathematical 6$ Bodily inesthetic ($ 3usical =$ !nterpersonal <$ !ntrapersonal

12"

@$ 8aturalisti 0iew o& =earnin) Theories in the &ollowin) conceptsB $erson 7olistic being, unique, dynamic and multidimensional indi"idual capable of learning, abstract reasoning, creati"ity, aesthetic appreciation and self0 responsibility

"n ironment 9ealth 'erception of indi"idual across the life span expression of the mutual interacti"e process between human beings and en"ironment depends on the degreeK le"el of health !s the landscape I geography of human social experience and includes "ariations in space, time and quality where the learner interacts in e"erydaylife

1ursin) %reati"e use of nowledge in human care ;ses critical thin ing and clinical Hudgment to pro"ide e"idence0 based care to indi"idual, families and communities Stren)ths Beha"ioral0 theories are simple and easy to use$ Aearner focused on a clear goal %ogniti"ism0 promotes critical thin ing and problem sol"ing 7umanism0 focuses to learn hisKher required things$ ;ltimate need> self0actuali.ation :eakness &ach theory deals with only one aspectK focus of learning

12#

Crisis Theory L =i&e " ents

12$

Crisis Theory +ri)in "rikson 21460'64( o o o 8ormal personality growth occurs through resolution of normati"e de"elopmental crises +hose who resol"e problems in pre"ious stage achie"e lasting solution, new s ill, confidence etc$ G building bloc s for future solutions G coping mechanisms 'otential for de"elopment or "ulnerability

Caplan 214>1( o ;nscheduled crises or life e"ents, when successfully resol"ed, also promote growth

Crisis Theory %e&ined

%risis M upset in steady state Aife cycle is a series of e"ents that may or may not cause crisis :normati"e )F unscheduled) %risis refers to the emotional reaction to a ha.ardous e"ent, and not the situation itself %all to action %risis situation in"ol"es both danger and opportunity %risis may be "iewed as a challenge, a threat, or a loss Views depend on unique physical and emotional ma eup as well as resources a"ailable to handle situation 8ot e"ery ha.ardous e"ent becomes a crisis for e"ery person because it may or may not produce a state of disequilibrium

C7-S-S Stressful e"ent or percei"ed threat O lac of efficient coping s ills, resulting in emotional unbalance Aimited in time> 40= wee s -uring the crisis, the subHect as s for help -uring the crisis, the subHect is more compliant to external inter"ention +he e"olution in crisis depends on the timing of the inter"ention

13%

3 Sta)es o& Crisis and Theory and @oals $re'Crisis o Crisis o /melioration and!or 7estoration 9ealth promotion L disease pre ention

$ost'Crisis o 7eha*ilitation or maintenance

2 Types o& 9a8ardous " ents %e elopmental ha8ardous e ents o o o o +hose that e"eryone experiences 8ormati"e, predictable Fequires new problem0sol"ing mechanisms e$g$ birth, entry into school, marriage, death of lo"ed oneE all maturational phases

Situational 9a8ardous e ents o o o Accidental happenings that some persons experienceE not same for e"eryone Fequire new problem0sol"ing mechanisms e$g$ change in Hob, accident, disease

$re'Crisis Sta)e 1hether or not ha.ardous e"ent leads to indi"idual crisis depends on perception of problem :may be real or imagined) !f the person possesses adequate adapti"e mechanisms, there will be a solution to the problem, or reco"ery +hrough experiencing the e"ent, person has added to problem0sol"ing mechanisms and achie"es higher le"el of functioning$

Crisis Sta)e %oping mechanisms fail

131

Feaction to the problem is unique for each indi"idual )riginal problem actually intensifies in this stage !nter"ention may lead to resolution of crisis and growth may be achie"ed G new coping mechanisms de"eloped

$ost'Crisis &ither growth or regression 3aHor disorgani.ation if no resolution Becomes more difficult to mobili.e resources and see additional help Aeads to brea down or maladaptation !nter"ention at this stage may achie"e maximum possible le"el of wellness )therwise, entropy increases, which lead directly to death

%e elopmental 9a8ardous " ents 7uman Sexuality %hild birth continuum %hanging physical status Accomplishment of sociali.ation Accomplishment of industryKwor Achie"ing a rational and dignified end to life :does not include sudden or untimely death)

Situational 9a8ardous " ents Aoss of Felationships Aoss of Fegulation Aoss of 'rotecti"e 3easures Aoss of 3obility Aoss of Sensory03otor ,unction Aoss of 'atency :e$g$ bloc ed arteries)

132

Aoss of Feproducti"e !ntegrity

Copin) and Crisis o o o Stages of coping in crisis> Stage !$ !mmediate response> astonishment, denial Stage !!$ &motional reactions> anxiety, anger, guilt, regression, depression Stage !!!$ Fesolution> acceptance, planning the future

3odel o& Crisis 2@# Caplan, 14>1(

+7F&A+

&3)+!)8AA BAAA8%& Automatic resolution of the problem0 situation

S+A?& 4

!8%F&AS& ), 'SQ%7)A)?!%AA +&8S!)8 :brief, unnoticed)

'roblem0sol"ing strategies ,;F+7&F !8%F&AS& ), 'SQ%7)A)?!%AA +&8S!)8 :ac nowledged) 8ew problem0sol"ing strategies S+A?& # 'SQ%7)A)?!%AA -!S+F&SS :anxiety, discomfort)

S+A?& C

S+A?& 6

S&V&F& 'SQ%7)A)?!%AA +&8S!)8, -!S)F?A8!SA+!)8, SQ3'+)3S, ;8BAAA8%&, C#!S!S

133

Types o& Crisis 1# 3/TF7/T-+1/= C7-S-S 'eriods in life which entail changes in social roles, biological and social pressuresE Adolescence, marriage, birth of a child, retirementE Adolescence> maturational crisis G originality, hormonal and psychological unbalance

2# S-TF/T-+1/= C7-S-S A specific external e"ent disrupts the internal psychological balance of the indi"idualE 7olmes I Fahe Scale> o o o o -eath of spouse, di"orce !llness, accidents 'regnancy, childbirth Sexual dysfunction L

S-TF/T-+1/= C7-S-S 4$ +he experience of loss :of a lo"ed one, of self0esteem, of normal functioning, of status, of HobL) C$ !ssues concerning change :transition in Fomania, marriage, birth of a child, mo"ing, change of HobL) #$ !nterpersonal issues :family conflicts) 6$ &n"ironmental factors :polution, wor en"ironmentL) 3# C/T/ST7+$9-C C7-S-S accidental, unusual, unexpected> fire, earthqua e, flood, idnapping, nuclear accidentsL +hey do not occur in any subHect*s life Se"ere stress, requiring maximal coping strategies and abilities

C/T/ST7+F-C C7-S-S ST/@"S -mpact 9eroic sta)e

134

H9oneymoonJ sta)e %isillusionment sta)e 7econstruction, reor)anisation

C/T/ST7+F-C C7-S-S ST/@"S 4$ -mpactB shoc , extreme fearE poorK distorted assessment of reality, and self0destructi"e beha"iour C$ 9eroic sta)eB %ooperati"e spirit between friends, neighbours, and emergency teamsE constructi"e acti"ity at this time may help o"ercome anxiety and depression but excessi"e acti"ity can lead to /burnout/ #$ 9oneymoonB 4 wee 0se"eral months after the disasterE the need to help others is sustainedE psychological problems may be o"erloo ed 6$ %isillusionmentB C months to 4 yearE disappointment, resentment, frustration, angerE "ictims often begin to show hostility toward others ($ 7econstructionB !ndi"iduals admit that they must come to grips with their own problemsE they begin to beha"e in a constructi"e manner T9" C+1S"PF"1C" +F F17"S+=0"% C7-S-SQSF-C-%"RRRR S$"C-F-C @+/=S +F C7-S-S -1T"70"1T-+1 2Corchin( a) Feleasing the psychological tension and distress :anxiety, despair, confusion, agitation) b) Festoring the le"el of functioning and acti"ity that the subHect had prior to the crisis c) Feassuring the subHect that the coping resources :internal, external) and support are a"ailable T"C1-PF"S +F C7-S-S -1T"70"1T-+1 1# /*reaction remembering the highly emotionally charged e"ents decreases the tension> /"entilation of emotions/E 2# Clari&yin) encouraging the subHect to rationali.e the relationship between pre"ious life e"ents and current situationE 3# Su))estion persuasi"e discourse in order to impro"e personal and o"erall situationE .# 3anipulation employing patient*s emotions and desires in the therapeutic processE $7+<="3'S+=0-1@ S"PF"1C" -1 C7-S-S -1T"70"1T-+1 Step0by0step sequence>

a) Assessment of se"erity of crisis b) 'lanning the actions according to a"ailable resources c) !nter"ention

13

d) Feassessment of the situation and planning of future actions !f the specific goal has not been attained after these 6 steps, the crisis team has to start o"er and retrace the 6 actions#

a( /SS"SS3"1T +he first action in crisis inter"ention> assessment of the subHect and of triggers +he therapist gathers specific information concerning the triggering e"ent +he current ris for suicide and "iolence are assessed !f the assessment indicates that hospitali.ation is not required, the therapist may proceed with the inter"ention

*( -1T"70"1T-+1 $=/11-1@ +he decisi"e factor in planning> the time passed from the outbrea of crisis :commonly> the e"ent occurs 40C wee s prior to the subHect*s cry for help) +he impact of the e"ent on subHect*s life +he impact on people close to the subHect %oping styles pre"iously :but not currently) employed by the subHect in difficult situations +ime required for inter"ention Si.e and structure of the inter"ention team ,irst specific actions &stimated time until the first signs of impro"ement

c( -1T"70"1T-+1 4$ ,irst contact with the person in crisis C$ &mploying a set of specific questions in order to find out specific information about the case #$ !n"ol"ing the family, facilitating communication 6$ Accurate assessment of the situation, drawing up a therapeutic contract between all parties in"ol"ed ($ !n"entory of the problems and establishing priorities

F-7ST C+1T/CT

13!

&stablishing a normal en"ironment +he subHect, other people present and their relationship with the subHect are identified +he triggering e"ent is debated +he therapist informs all parties in"ol"ed that they will all be required to ta e part in the resolution of crisis

S$"C-F-C PF"ST-+1S About the triggering e"ent of the crisis About symptoms generated by the impact with the e"ent About the subHect*s coping resources in front of psychological aggression 'ractical issues> clinical and gynecological assessment, nutritional statusL &"entsKchanges within the pre"ious C0# wee s Brief psychiatric assessment G possible symptoms :anxiety, depression) prior to the crisis

F/3-=Y, C+33F1-C/T-+1 %risis :acute psychological unbalance) in a subHect> sign of disturbed family system, will also affect other family members Foles in the family system will ha"e to change in order to accommodate the needs of the patient A list of problems for each family member to sol"e is drawn up G this enhances the feeling of cohesion and in"ol"ement in therapy )ptimal communication in the family G listening to all parties, excluding critiques, obHecti"e and sensible assessment of alternati"es to proposed solutions Acti"e listening and unconditional support of the subHect by all parties in"ol"ed is needed

T9"7/$"FT-C C+1T7/CT +he therapist expresses his "iewpoint +he connection between symptoms of subHect and traumatic e"ents +he necessity of admittance is assessed, according to se"erity of symptoms Benefits and disad"antages of admittance

13"

SubHects without psychiatric disorders are ept in their home en"ironment A contract is drawn up with family members G responsibilities of each party in"ol"ed is detailed :family, friends, neighbors, "olunteers in 8?)*s, physicians, psychologists, social wor er, nurse) !f the situation progressi"ely impro"es, regular follow0up at0home "isits continue for a predetermined period :# G = wee s)

$7-+7-T-"S +F /CT-+1 +he specific problem of the subHect in crisis is a"oided, if it cannot be sol"ed in a short time !f the problem can be sol"ed, the specific actions to eliminate the consequences of disaster will be the focus of inter"ention +he family is in"ol"ed in action planning 3ultiple solutions are explored +as s are di"ided All support resources are identified, mobili.ed Support resources for the therapist are identified

d( 7"/SS"SS3"1T +he last stage> the subHect and inter"ention team e"aluate the degree of positi"e outcomes and resolution of crisis +he best assessment tool> le"el of functioning G the extent to which the subHect has returned to the le"el of functioning prior to the crisis !n"entory of specific acti"ities, daily routine %oping abilities in family and professional situations

13#

3odels o& Communication

1# 3odels o& Communication 1hat is communication2

13$

2#

1hat is communicati"e competence2 The Trainin) o& Communicati e Skills :based on Schul. "on +hun*s model)

3# 3o in) towards -ntercultural Communication

HCommunication S=at# communicatio Kthe action o& impartin)KT !n its broadest sense, this term refers to e"ery ind of mutual transmission of information using signs or symbols between li"ing beings :humans, animals), between people and data0processing machines$ :Bussmann 455=>@#) !n its narrower, linguistic sense, communication is the understanding which occurs between humans through linguistic and non0linguistic means li e gestures, mimicry and "oice : non0"erbal communication)$ +he basic components of communication are shown in communication models$ :Bussmann 455=>@#) 3odels o& Communication /ristotleKs #hetoric %e SaussureKs 3odel o& the Speech Circuit ShannonKs and :ea erKs 3odel @er*nerKs @eneral 3odel <UhlerKs and Eako*sonKs 3odels :at8lawick?s, <ea in?s, and Eackson?s 3odel Schul8 on Thun?s 3odel

/ristotle?s 7hetoric Three elements o& communicationB

14%

the speaker the speech the audience

%e Saussure?s 3odel o& the Speech Circuit 2141>(

The Shannon':ea er 3odel

141

Criticism the Kconduit metaphor? 27eddy 14M4( linearity content and meanin) instrumentalism conte,t relationships and purposes time medium

142

143

144

Eackson?s 3odel o& Communicati e Functions 214>0(

Type "moti e 7e&erential Conati e $hatic

+riented Towards /dresser Conte,t /dressee Contact

Function ",pressin) &eelin) or attitudes -mpartin) -n&ormation -n&luencin) *eha ior "sta*lishin) or maintainin) relationship 7e&errin) to the nature o& the interaction Fore)roundin) te,tual &eatures

",ample -ts *loody pissin) down a)ain -ts rainin) :ait here till its stop rainin) 1asty weather a)ain isn?t it This is the weather &orecast -t droppeth as the )entle rain &rom hea en

3etalin)ual

Code

$oetic

3essa)e

:at8lawick, <ea in, and Eackson 214>M(B $ra)matics o& 9uman Communication )ne cannot not communicate$ :1at.lawic and others 45=<>(4) &"ery communication has a content and a relationship aspect such that the latter classifies the former and is therefore a metacommunication$:1at.lawic and others 45=<>(6)

14

14!

14"

Schul8 on ThunOs 3odel 214MM( Four /spects o& a 3essa)e

14#

14$

1 %

1 1

Communicati e Competence %ommunicati"e %ompetence describes the spea er*s ability to select from the totality of grammatical expressions a"ailable to him, forms which appropriately reflect the social norms go"erning beha"ior in specific encounters$ :7ymes 45<C>C<9, in> Bene e :ed$) 455#><=) From a sociolin)uistic perspecti e, communicati e competence includes the &ollowin)B 2a( =-1@F-ST-C C1+:="%@"B "erbal and non"erbal codes, and the range of possible "ariants 2*( -1T"7/CT-+1 SC-==SB sociolinguistic rules for appropriate use, discourse organi.ation and processes, and strategies for achie"ing goals 2c( CF=TF7/= C1+:="%@"B social structure, "alues and beliefs, and cogniti"e maps or schemata for the content domains :Sa"ille0+roi e 455C, in> Bright 455C>C<# (

The Trainin) o& Communicati e Skills

1 2

1 3

1 4

7e&erences
1

%orothea "li8a*eth +rem 7enderson "> +he 8ature of 8ursing> A -efinition and !ts !mplications, 'ractice, Fesearch, and &ducation$ 3acmillan %ompany, 8ew Qor , 45==$ :'ages 4=04<) http>KKcurrentnursing$comKnursingPtheoryK7enderson$html http>KKen$wi ipedia$orgKwi iKVirginiaP7enderson http>KKwww$angelfire$comKutK"irginiahendersonKconcepts$html http>KKwww$nytimes$comK455=K9#KCCKartsK"irginia0henderson05@0teacher0of0nurses0dies$html www$youtube$comKwatch2"MAbu8.<FA7S@ www$youtube$comKwatch2"Mt@5be7i<^xw 7enderson "> +he 8ature of 8ursing> A -efinition and !ts !mplications, 'ractice, Fesearch, and &ducation$ 3acmillan %ompany, 8ew Qor , 45==$ :'ages 4=04<) 8ursing theorists and their wor By Ann 3arriner0+omey, 3artha Faile Alligood pp$ (60(<

7enderson "> +he 8ature of 8ursing> A -efinition and !ts !mplications, 'ractice, Fesearch, and &ducation$ 3acmillan %ompany, 8ew Qor , 45==$ :'ages 4=04<) http>KKnursing0theory$orgKnursing0theoristsKVirginia07enderson$php

1ola $ender +omey, A$ :C949)$ Nursing theorist and their *ork$ 3aryland 7eights, 3)> 3osby &lse"ier$ 'ender, 8, 3urdaugh, %, I 'arsons, 3$ :C99=)$ 1ealth pro!otion in nursing practice fifth edition $ ;pper Saddle Fi"er, 8B> 'earson &ducation, !nc$ 'eterson, S, I Bredow, +$ :C995)$ 2iddle range theories application to nursing research second edition$ 'hiladelphia, 'A> 1olters NluwerKAipincott 1illiams I $ 3c&wen, 3, I 1ills, &"elyn$ :C99<)$ Theoretical basis for nursing second edition$ 'hiladelphia, 'A> 1olters NluwerKAipincott 1illiams I $ Nearney08unnery, F$ :C99@)$ Ad/ancing your career concepts of professional nursing $ 'hiladelphia, 'A> ,$A$ -a"is %ompany$

Sister Callista 7oy Alligood, 3$ F$, +orney, A$ 3$ :C949), Nursing theorists and their *ork :<th ed$) Andrew, 7$, I Foy, :4554), &ssentials of the Foy Adaptation 3odel$ )n %$ Foy I 7$ Andrews :&ds$), The 'oy adaptation !odel: The definiti/e state!ent :pp$ #0C() -ixon, &$ :4555) %ommunity health nursing practice and the Foy Adaptation 3odel$ Public Nursing3 #- :6), C59$ -ohrewend, B$S$ :45<@), Social stress and community psychology$ A!erican 4ournal of Co!!unity Psychology3 - :4046)

1 !

,awcett, B$ I +ulman, A$ :4559), Building a programme of research from the Foy Adaptation 3odel of 8ursing$ 4ournal of Ada/anced Nursing3 #+ :=), <C9 ,awcett, B$ :C995 Bac ), ;sing the Foy Adaptation 3odel to guide research andKor practice> %onstruction of conceptual0theoretical0empirical systems of nowledge$ A5uichan3 6 :#) C5< ?albreath, B$?$ :45@(), Sister %allista Foy$ !n B$B$ ?eorge :&d$), Nursing Theories: The base for professional nursing practice :Cnd ed$, pp#990#4@)

0ir)inia / enel 9enderson Blais et al$ :C99C)$ 'rofessional nursing practice> %oncepts and perspecti"es :6th ed$)$ ;pper Saddle Fi"er, 8B> 'earson 'rentice 7all$ C$ -*Antonio et al$ :eds$)$ :C99<)$ 8urse*s wor > !ssues across time and place$ 8ew Qor > Springer 'ublishing$ #$ %ora Anonue"o et al$ +heoretical ,oundations of 8ursing$;' )pen ;ni"ersity 6$ http>KKwww$angelfire$comKutK"irginiahendersonKconcepts$html ($ ?eorge, B$B :ed$) :455()$ 8ursing +heories> the base for professional nursing practice :6th ed)$8orthwal %+ Appleton I Aange

3yra =e ine 8ursing +heories, A %ompanion to 8ursing +heories and 3odel retrie"ed from http>KKcurrentnursing$comKwww$nursingtheories$blogspot$com +heoretical ,oundations of 8ursing> 3yra &strin Ae"ine retrie"ed from www$nursingtheoriess$weebly$com

=ydia "loise 9all

Aydia 7all*s %onser"ation +heory retrie"ed from www$elirach$blogspot$com 8ursing +heories, A %ompanion to 8ursing '(eories an) *o)el retrie+e) from (ttp,--.urrentnursing&.om
Eean :atson %herry B$ and Bacob S$ :C99() Conte!porary Issues in Nursing Issues3 Trends and 2anage!ent +omey A3, Alligood$ 3F$ :C99C) 8ursing theorists and their wor $ :(th ed$) 8ursing +heories, A companion to 8ursing +heories and 3odel retrie"ed from http>KKcurrentnursing$com

-mo)ene Cin) %herry B$ and Bacob S$ :C99() Conte!porary Issues in Nursing Issues3 Trends and 2anage!ent

1 "

+omey A3, Alligood$ 3F$ :C99C) 8ursing theorists and their wor $ :(th ed$) 8ursing +heories, A companion to 8ursing +heories and 3odel retrie"ed from http>KKcurrentnursing$com

9ilde)ard "# $eplau

httpB!!currentnursin)#com!nursin)Vtheory!interpersonalVtheory#html
-da Eean +rlando http>KKcurrentnursing$comKnursingPtheoryK)rlandoPnursingPprocess$html

<etty 1euman A_onue"o, %$ et$ Al :C999)$ N%78 Theoretical 9oundations of Nursing$ 'hilippines> ;' )pen ;ni"ersity Balita, %arlito &$ :C99()$ :lti!ate ;earning Guide to Nursing 'e/ie*$ ;ltimate Aearning Series No.ier, B$ et$ Al :C996)$ 9unda!entals of Nursing: Concepts3 Process3 and Practice <( th ed$" 8ew Bersey> 'earson 3arriner0+omey, A$ :4556)$ Nursing Theorists and Their Work <%nd edition"$ St$ Aouis> 3osby )cta"iano, &ufemia ,$ and Balita, %arlito &$ Theoretical 9oundations of Nursing: The Philippine Perspecti/e$ ;ltimate Aearning Series, C99@

3adeliene =einin)er B$ +$ Basa"anthappa$ :C99<) 8ursing +heories$ !ndia &ufemia )cta"iano, F8, F3, 38, &d- and %arl &$ Balita, F8, F3, 3A8 +heoretical ,oundations of 8ursing> +he 'hilippine 'erspecti"e Bacqueline ,awcett$ :455#) Analysis and &"aluation of 8ursing +heories

?eorge Bulia B$ 8ursing theories> +he base of professional nursing practice (rd edition$ 8orwal , %8> Appleton and AangeE C99C$ Aeininger, 3$ I 3c,arland, 3$ :C99C)$ Transcultural Nursing$ 3c?raw07ill, 3edical 'ub$ Aeininger 3$ %ulture care di"ersity and uni"ersality> A theory of nursing$ 8ew Qor > 8ational Aeague for 8ursing 'resE 4554$

1 #

Aeininger 3$+ranscultural nursing> %oncepts, theories, research,and practice$ %olumbus, )7> 3c?raw07ill %ollege %ustom SeriesE 455($ Aeininger, 3$, 3c,arland,3$ C99=$ Culture Care =i/ersity and :ni/ersality: A World*ide Nursing Theory %nd Illustrated ,dition$ Bones I Barlette Aearning, C99=

@eneral Systems Theory httpB!!en#wikipedia#or)!wiki!=udwi)V onV<ertalan&&y httpB!!currentnursin)#com!nursin)Vtheory!systemsVtheoryVinVnursin)#html httpB!!www#sAsu#edu www#uky#edu!Wdrlane!or)comm!326ch0.

%e elopmental Theories

%herry N$ :C949) Psychology Theories> retrie"ed from


http>KKpsychology$about$comKodKpsychology494KuKpsychology0theories$htm

3iller '$ ?Theories of =e/elop!ental Psychology3 Third ,dition> ;ni"ersity of ,lorida

=earnin) Theories

'otter 'erry$ +heoretical ,oundations of 8ursing =th &dition


Nnowledge base and 1ebliography from www$learning0theories$com Aearning +heories retrie"ed from http>KKpsychology$about$comK$$$KuKpsychology0theories$htm

Crisis -nter ention Theories

///&me)&uotta/a&.a-.ourses-&&&-Crisis0'(eory012%Life02+ents

Thoeries!3odels o& Communication Bene e, B`rgen :455#)> &nglish as the medium of intercultural communication> Some teaching suggestions$ !n> Bene e, B`rgen :ed$) :455#), pp$ =50494

1 $

Bene e, B`rgen :ed$) :455#)> %ommunication in A"iation > A collection of papers edited on behalf of !A%+,AA'$ Bonn > -`mmler :Sprachen und Sprachenlernen> #4CE -`mmlerbuch =#4C) Bir enbihl, Vera ,$ :45@<)> Nommuni ationstraining > ]wischenmenschliche Be.iehungen erfolgreich gestalten$ @$ Aufl$ Aandsberg am Aech > mg"0Verlag Bright, 1illiam :ed$ in chief) :455C)> !nternational &ncyclopedia of Ainguistics > Volume C > &xpl 0 3oot$ 8ew Qor > )xford ;ni"ersity 'ress Bussmann, 7adumod :455=)> Foutledge -ictionary of Aanguage and Ainguistics$ Aondon > Foutledge %handler, -aniel :455()> +he +ransmission 3odel of %ommunication$ :last modified> 5 3ay C999, last accessed> ( 8o"ember C994) ahttp>KKwww$aber$ac$u KmediaK,unctionsKmcs$htmlb %orner, BohnE 7awthorn, Beremy :eds$) :45@5)> %ommunication Studies > an introductory reader$ #rd ed$ Aondon > Arnold ?erbner, ?eorge :45(=)> A generali.ed graphic model of communication$ !n > %orner, BohnE 7awthorn, Beremy :eds$) :45@5), pp$ 4<04@ !psen, ?uido :4555)> +he !nteracti"e 3ulti3edia Ainguistics for Beginners > =$ %ommunication$ :this "ersion> 3ay 4555, introduced> C9 Buly C999, last accessed> C# )ctober C994) http>KKwww$uni0 assel$deKfb@KmiscKlfbKhtmlKtextK=$html Schul. "on +hun, ,riedemann :4556)> 3iteinander reden 4 > Stcrungen und Nldrungen > Allgemeine 'sychologie der Nommuni ation$ Feinbe bei 7amburg > Fowohlt +aschenbuch Verlag :rororo E <6@5) Sa"ille0+roi e, 3uriel :455C)> %ommunicati"e %ompetence$ !n > Bright, 1illiam :ed$) :455C), p$ C<# ;nderwood, 3ic :455<0C994)> %%3S 0 %ommunication studies, cultural studies, media studies infobase$ :last accessed> C# )ctober C994) ahttp>KKwww$cultsoc $ndirect$co$u K3;7omeKcshtmlKindex$htmlb 1at.lawic , 'aulE Bea"in, Banet 7$E Bac son, -on -$ :45=<)> 'ragmatics of 7uman %ommunication > A Study of !nteractional 'atterns, 'athologies, and 'aradoxes$ 8ew Qor > 1$ 1$ 8orton I %ompany

1!%

$resentors

$atrick /# $antua 71
-orothea &li.abeth )rem Virginia A"enel 7enderson Betty 8euman 3adeliene Aeininger

1!1

"mmeline Eoy 3# 3an)ente 71


3yra Ae"ine Aydia &loise 7all Aearning +heories

Catrina =ianne 7# Samson 71


Bean 1atson !mogene Ning -e"elopmental +heories

1!2

Euan $aulo 0# Cha e8 73 71


Sister %allista Foy 8ola B$ 'ender %risis +heory and Aife &"ents +heoriesK 3odel of %ommunication

9elen S# Custodio 71
7ildegard &$ 'eplau !da Bean )rlando ?eneral Systems +heory

1!3

1!4

You might also like