2.

The transpersonal caring relationship ●​ A high level of overall physical, mental,

-This portion of the theory focuses on the one and social functioning
caring and the one cared for. The nurse and ●​ A general adaptive maintenance level of
patient develop a deep divine relationship that daily functioning
blends together and promotes overall health
and well-being . ●​ The absence of illness (or the presence
-The nurse should be using her professional of efforts that leads its absence)
experience to promote healing and bonding
with the patient. 3.​ Environment/society- According to
- Use of various communication techniques Watson, caring (and nursing) has
verbal and nonverbal to achieve a healing and existed in every society. A caring
gentle relationship. attitude is not transmitted from
-The nurse and the patient are transformed generation to generation. It is
together in this relationship . transmitted by the culture of the
profession as the unique way of coping
3. The caring occasion/caring moment with its environment.
-This portion of the theory focuses on an actual
tangible moment in time in which the nurse 4.​ Nursing
recognizes the connection that is developed ●​ Nursing is concerned with promoting
between him/herself and the patient. health, preventing illness, caring for the
-This moment dictates the ability for the nurse sick and restoring health
to have an overall impact on the patient. ●​ It focuses on health promotion and
- According to cara the caring moment consists treatment of disease. She believes that
of healing ,bodily sensations, thought, spiritual holistic health care is central to the
beliefs, goals, expectations, environmental practice of caring in nursing
considerations, and meaning of one's ●​ She defines nursing as a human
perception —All of which are based upon one's science of persons and human health
past life history, one’s present moment and illness experiences that are mediated by
one’s imagined future. professional, personal, scientific,
- This can occur during various nursing aesthetic and ethical human
interventions and interactions with each patient transactions.

4. Caring and Healing model of theory SUMMARY-

- the nurse is able to help the patient with What is Jean Watson theory of nursing?
overall well-being by assisting them with the According to Watson's theory, the primary
release of “disharmony and blocked energy” concern of nursing is “promoting health,
The use of this portion of the theory helps a preventing illness, caring for the sick, and
patient with overall healing and renewal.​ restoring health.” To achieve those outcomes,
- nurses can impact the patient through health Watson argues, care must be prioritized above
promotion, health restoration, and illness all else — including medical intervention.
prevention.

Watson's theory and the four major

concepts

1.​ Person- she adopts a view of the

human being as a valued person and of
him or herself to be cared for, respected, Jean Watson
nurtured, understood and assisted; in (Theory of Human
general a philosophical view of a person Caring)
as a fully-functional integrated self. He is
viewed as greater than and different
from the sum of his or her parts.

2.​ Health- She adds the following three

elements:
Virginia Henderson (Nursing Need
Theory)
Evolution of Theory
- Virginia Henderson who's the nurse-theorist
who devoted her career to defining nursing
practice.
- An occupation that affects human life must
outline its function
- Her ideas about the definition of nursing were
influenced by her nursing education and practice
by her students and colleagues at Columbia
Born: November 30, 1897, Kansas City, University School of Nursing.
Missouri, US -Two events are the basis for her development of
Died: March 19, 1996, Connecticut hospice, definition of nursing and these are:
Branford, connecticut, US
-​ Fifth of the eight children of Lucy Minor 1)​ Revision of a nursing textbook
Abbot and Daniel B. Henderson. -”Textbooks of the principles and
-​ She was named after the state her practice of nursing” written with Bertha
mother longed for. Harmer 1922 Henderson realized the
-​ At age 4 , she returned to Virginia and need to be clear about the functions of
began her schooling at Bellevue, a nursing.
preparatory school owned by her
grandfather William Richardson Abbot. 2.) Henderson was concerned that the
-​ Her father was a former teacher at many states had no provision for nursing
Bellevue and was an attorney licensure to ensure a safe and
representing the native american competent care for the customers
indians in disputes with the US
government, winning a major case for “Earlier statements of the nursing functions” by
the Klamath tribe in 1937. american nurses association
-​ Henderson viewed these statements as
Henderson is also known as: a nonspecific and unsatisfactory
➢​ The Nightingale of Modern Nursing definition of nursing practice.
➢​ Modern Day Mother of Nursing In 1956, henderson first definition of nursing
➢​ The 20th Century Florence Nightingale practice was published in Bertha Harmer’s
revised nursing textbook:
CAREER
●​ In 1921 after receiving her Diploma, It reads as “the unique function of the nurse is
Virginia Henderson worked at: to assist the individual (sick or well) in the
- Henry Street Visiting Nurse Service (2 yrs) performance of those activities contributing to
●​ She helped remedy nurses’ views in health or its recovery (or peaceful) that he
part through exhaustive research that would perform unaided if he had the necessary
helped establish her professions’ strength, will or knowledge. And to do this in
scholarly underpinnings. such a way as to help him gain independence
●​ From 1924 to 1929, she worked as an as rapidly as possible
instructor in Norfolk protestant hospital,
Norfolk, Virginia. Henderson's theory and the four major
●​ In 1930, She was a nurse supervisor concepts
and clinical instructor at Strong
Memorial hospital, Rochester, New York. 1.​ Human being- The patient as an
●​ From 1934 to 1948, (14 yrs) She individual who requires a system to
worked as an instructor and associate achieve health and independence
professor at Teachers College Columbia (peaceful death). The mind and the
University in New York. body are inseparable. The patient and
●​ Since 1953, Henderson was a research his family are viewed as a unit.
associate at Yale University School of
Nursing
 2.​ Health- Henderson views health in
terms of patients' ability to perform
unaided the 14 components of nursing
care. She says it is the quality of the
health rather than life itself that margins
of mental physical vigor that allows a
person to work most effectively to reach
his highest potential of satisfaction in
life.

3.​ Environment- She used a Webster

dictionary, which defines environment
as “the aggregate of all the external
conditions and influences affecting the
life and development of an organism.”

4.​ Nursing- In 1966, Henderson ultimate

statements in the definition of nursing
were published of her ideas as follows:

“The unique function of the nurse is to assist

the individual (sick or well) in the performance
of those activities contributing to health or its
recovery (or peaceful) that he would perform
unaided if he had the necessary strength, will
or knowledge. And to do this in such a way as
to help him gain independence as rapidly as
possible.
- Assists and supports the
individual and life activities and attainment of
independence.
- Nurse serves to make a
patient “complete,” “whole” or “independent.”
- Nurse should have knowledge
to practice individualized and human care and
should be a scientific problem solver.

14 Components of Virginia Henderson’s SUMMARY-

Need Theory Virginia Henderson developed the Nursing
Need Theory..
➔​ to define the unique focus of nursing
practice.
➔​ The theory focuses on the importance of
increasing the patient's independence to
hasten their progress in the hospital.
 ✓The realities in the immediate situation that
Ernestine Wiedenbach (The Helping influence the central purpose.
Art of Clinical Nursing)
Use of Empirical Evidence

•1994 - At this time, there is no specific

research supporting Wiedenbach's work.
•Little research has been done using her
theory.

Major concepts

The patient
• any person who has entered the healthcare
Born: August 18, 1900, Hamburg, Germany system and is receiving help of some kind,
Died: March 8, 1998, Florida, US such as care, teaching, or advice.
• need not be ill since someone receiving
CAREER: health-related education would qualify as a
●​ Wiedenbach joined the Yale faculty in patient.
1952 as an instructor in maternity
nursing A need-for-help
●​ Assistant professor of obstetric nursing • "any measure or action required and desired
in 1954 and an by the patient that has the potential to restore
●​ Associate professor in 1956. or extend the ability to cope with the demand
●​ She wrote Family-Centered Maternity implicit in his situation."
Nursing in 1958.
●​ She was influenced by Ida Orlando in • It is crucial to the nursing profession that a
her works on the framework. need-for-help be based on the individual
perception of his own situation.
The Helping Art of Clinical Nursing

Theoretical Sources
Nurse
Ida Orlando Pelletier • The nurse is a functioning human being
- understanding of the use of self and the effect • The nurse not only acts, but thinks and feels
the nurse's thoughts and feelings has on the as well.
outcome of her actions.Ernestine • For the nurse whose action is directed toward
achievement of a specific purpose, thoughts
Patricia James and William Dickoff, identified and feelings have a disciplined role to play.
elements of a prescriptive theory in
Wiedenbach's work, which she developed The Purpose
more fully in Meeting the Realities in Clinical • Purpose that the nurse wants to accomplish
Teaching. through what she does - is the overall goal
toward which she is striving, and so is
PRESCRIPTIVE THEORY constant.
• The nurse's reason for being and for doing.
Wiedenbach's prescriptive theory is based on • It is all of the activities directed towards the
three factors overall good of the patient.

✓The central purpose which the practitioner The Philosophy

recognizes as essential to the particular • An attitude toward life and reality that evolves
discipline. from each nurse's beliefs and code of conduct,
motivates the nurse to act, guides her thinking
✓The prescription for the fulfillment of about what she is to do and influences her
central purpose. decisions.
• Philosophy underlies purpose, and purpose • Ministration
reflects philosophy. • Validation

The Practice Component of Practice Indirectly Related to

• Overt action, directed by disciplined thoughts Patient's Care
and feelings toward meeting the patient's • Coordination of Resources
need-for-help, constitutes the practice of - Reporting
clinical nursing - Consulting
• It is goal-directed, deliberately carried out -Conferring
and patient-centered.
The Art
• Knowledge, Judgment, and Skills are three • Application of knowledge and skill to bring
aspects necessary for effective practice. about desired results.
• Four Main Goals
• Identification, ministration, and validation are - understanding patients needs and
three components of practice directly related to concerns
the patient's care. Coordination of resources is -developing goals and actions intended
indirectly related to it. to enhance patients ability and
-directing the activities related to the
1.​ PRACTICE: Knowledge medical plan to improve the patients
- Knowledge encompasses all that has been condition.
perceived and grasped by the human mind; its
scope and range are infinite. • Nursing art involves three initial
operations:
• Knowledge may be. ➢​ Stimulus
- factual ➢​ Preconception
- speculative or ➢​ Interpretation
- practical
•The nurse reacts based on those
2.​ PRACTICE: Judgment operations. Her actions may be.
• Clinical Judgment represents the nurse's
likeliness to make sound decisions. ➔​ Rational action - is based on the
• Sound decisions are based on immediate perception without going
differentiating fact from assumption and beyond to explore hidden meaning.
relating them to cause and effect. ➔​ Reactionary action - is taken in
reaction to strong feelings.
• Decisions resulting from the exercise of ➔​ Deliberative action - the desirable
judgment will be sound or unsound according mode—intelligibly fulfill nursing’s
to whether or not the nurse has disciplined the purpose
functioning of her emotions and of her mind. Major Assumptions

PRACTICE: Skills Nursing

• Skills represent the nurse's potentiality for • Nurses ascribe to an explicit philosophy.
achieving desired results. Basic to this are:
• Skills comprise numerous and varied acts. 1. Reverence for the gift of life
characterized by harmony of movement,
expression and intent, by precision, and by 2. Respect for the dignity, worth, autonomy,
adroit use of self. and individuality of each human being
• May be classified as to:
-Procedural skills 3. Resolution to act dynamically in relation to
-Communication skills one's beliefs

Components of Practice Directly Related to Person

Patient's Care • Each Person is endowed with a unique
potential to develop self- sustaining resources.
• Identification
• People generally tend towards independence 3. ) Its representatives may function in the
and fulfillment of responsibilities. clinical area and may work closely with the
staff.
• Self-awareness and self- acceptance are
essential to personal integrity and self- worth. 4. It offers educational opportunities to the
nurse for special or advanced study.
• Whatever an individual does at any given
moment represents the best available 3.​ RESEARCH
judgment for that person at the time. • Before the development of Wiedenbach's
model, nursing research focused more on the
Health medical model than on a nursing model.
• Not defined nor discussed in Wiedenbach's
model. • In her model, the focus of nursing research is
to be related to the patient's response to the
Environment health care experience.
• Wiedenbach does not specifically address the
concept of environment. She recognized the 4.​ FURTHER DEVELOPMENT
potential effects of the environment, however. • Pioneer in the writing of nursing theory

Theoretical Assertions • Needs to be further developed by more

clearly defining the concepts of health and
environment.

• The component of nursing art needs to be

identified in an operational way.

5.​ CRITIQUE

• Clarity - concepts and definitions are clear,

consistent, and intelligible
LOGICAL FORM
• Simplicity - too many relational statements
• Induction
•Situation-producing prescriptive theory
• Generality - broad; concept of need-for- help
not applicable to some patients
ACCEPTANCE BY THE NURSING
COMMUNITY
• Empirical Precision - partially met;
difficult to test
1.​ Practice
- More acceptable today than on 1950's and
• Derivable Consequence- fulfills the purpose
1960's
for which it was developed - to describe
- In the 1980's the healthcare industry provided
professional practice
the supposedly unique concept of Family
Centered Care, which Wiedenbach addressed
SUMMARY-
some 20 years ago.
The three essential components Wiedenbach
associated with a nursing philosophy are:
2.​ EDUCATION
- Wiedenbach proposed that nursing education
- reverence for life;
serves the practice in four major ways.
- respect for the dignity, worth, autonomy, and
1.) It is responsible for the preparation of future
individuality of each human being; and the
practitioners of nursing.
- resolution to act on personally and
2.) It arranges for nursing students to gain
professionally held beliefs
experience in clinical areas of hospitals or the
homes of their patients
Faye Glenn Abdellah (21 Nursing
Problems) 1937 - She wanted to be a nurse and the day
she saw Hindenburg explode

1949 - She spent 40 years in public health

service where she first became involved in
research, being assigned to perform studies to
improve nursing practices

1960 - She was influenced by the desire to

promote client-centered comprehensive
nursing care.

Born: March 13, 1919, New York City. Abdellah’s Typology of 21 nursing
Died: February 24, 2017, problems

Faye Glenn Abdellah A. Basic to all patients

-​ was one of the most influential nursing 1.​ To maintain good hygiene and physical
theorists and public health scientists. comfort
-​ It is extremely rare to find someone who 2.​ To promote optimal activity: exercise,
has dedicated all her life to the rest, and sleep
advancement of the nursing profession 3.​ To promote safety through prevention of
and accomplished this feat with so much accident, injury, or other trauma and
distinction and merit. through the prevention of the spread of
infection
Educational Achievements 4.​ To maintain good mechanics and
prevent and correct deformity
-​ In 1942, Abdellah earned a nursing
diploma from Fitkin Memorial Hospital’s B. Sustenal Care Needs
School of Nursing New Jersey (now Ann 5.​ Facilitate the maintenance of a supply of
May school of Nursing). oxygen to all body cells
-​ She received her B.Sc degree in 1945, 6.​ To facilitate the maintenance of nutrition
-​ A Master of Arts Degree in 1947 and of all body cells
-​ Doctor of Education in Teachers 7.​ To facilitate the maintenance of
College, Columbia University. elimination
-​ In 1947 she also took Master of Arts 8.​ To facilitate the maintenance of fluid and
Degree in Physiology electrolyte balance
9.​ To recognize the physiological
• She helped transform the focus of the responses of the body to disease
profession from disease centered to condition: pathological, physiological,
patient-centered.She explained the role of and compensatory
nurses to include care of families and the 10.​ To facilitate the maintenance of
elderly. regulatory mechanisms and functions
11.​ To facilitate the maintenance of sensory
• She worked in many settings. She had been function
a staff nurse, a head nurse, a faculty member
at Yale University and at Columbia University, a C. Remedial Care Needs
public health nurse, a researcher and 12.​To identify in except positive and
• An author of more than 147 articles and negative expressions feelings and
books. reactions
• She was selected as Deputy Surgeon 13.​ to identify and accept interrelatedness
General in 1982 of emotions and organic illness
• She retired in 1989 14.​ to facility The maintenance of effective
verbal and nonverbal communication
What has influenced Faye Abdellah in the 15.​To promote the development of
development of her own model of nursing?
 16.​To facilitate progress toward ●​ Although Abdellah does not give a
achievement of personal spiritual goals definition of health, she speaks to “total
17.​To create and or maintain a therapeutic health needs” and a “healthy state of
environment mind and body” in a description of
18.​To facilitate awareness of self as an nursing as a comprehensive services.
individual with varying physical,
emotional, and developmental needs 3. Environment/Society
●​ The environment is implicitly defined by
D. Restorative Care Needs Abdellah as the home or community
19.​To accept the optimum possible goals in from which patient comes
the light of limitations, physical and ●​ Society is included in planning for
emotional optimum health
20.​To use community resources as an aid ●​ However, as Abdellah further
in resolving problems arising from delineated her ideas, the focus of
illness nursing service is clearly the individual
21.​To understand the role of social
problems as influencing factors in the 4. Nursing
cause of illness ●​ Nursing is a helping profession
This would mean a comprehensive
Assumptions nursing service, this would include:
●​ The language of abdullah framework is 1.​ Recognizing the nursing
readable and clear problems of the patient
●​ Consistent with the decade in which she 2.​ Deciding the appropriate actions
was writing, she uses the term “she” for to take in terms of relevant
nurses “he“ for doctors and patients nursing principles
●​ Assumptions are related to 3.​ Providing continuous care of the
Change and anticipated change that individual’s total health needs
affect nursing; 4.​ Providing continuous care to
-The need to appropriate the relieve pain and discomfort
interconnectedness of social enterprises 5.​ Adjusting total nursing care plan
and social problem; to meet the patient's individual
-The impact of problems such as needs
poverty, racism, pollution, education and 6.​ Helping the individual to become
so forth on health care delivery more self directing in attaining or
-Correct identification of nursing maintaining a healthy state of
problems influences the judgment in mind and body
selecting the next step in solving the 7.​ Instructing nursing personal and
client nursing problems family to help the individual
8.​ Helping the individual to adjust to
Major Concepts his limitations and emotional
1. Man/Person problems
●​ Abdellah describes people as having 9.​ Working with allied health
physical, emotional, and sociological professional in planning for
needs. This needs may overt, consisting optimum health
of largely physical needs, or covert,
such as emotional, sociological and Steps to Identify the Client’s Problem:
interpersonal needs - which are often ●​ Learn to know the patient
missed and perceived incorrectly ●​ Sort out relevant and significant data
●​ The individuals (and families) are the ●​ Make generalizations about available
recipients of nursing, and health, or data in relation to similar nursing
achieving of it, is a purpose of nursing problems presented by other patients
services ●​ Identify the therapeutic plan
2. Health ●​ Validate the patient's conclusions about
●​ In patient-centered approaches to his nursing problems
nursing, Abdellah describes health as a
state mutually exclusive of illness 11 Nursing Skills
 ●​ Observation of health status ●​ A principle underlying the
●​ Skills of communication problem-solving approaches is that for
●​ Application of knowledge each identified problem, pertinent data
●​ Teaching of patients and families are collected
●​ Plan organization of work ●​ The overt or covert nature of the
●​ Use of resource materials problems necessitates a direct or
●​ Use of personal resources indirect approach, respectively
●​ Problem solving Nursing Diagnosis:
●​ Direction of work of other ●​ The results of data collection would
●​ Therapeutic use of the self determine the client specific overt or
●​ Nursing procedure covert problems
●​ This specific problems would be
Purposes: grouped under one or more of the
Nursing Practice: broader nursing problems
●​ Abdellah’s main goal is the improvement ●​ The step is consistent with that involved
of the nursing education in nursing diagnosis
●​ The most important impact of Abdellah’s Planning Phase:
theory to the nursing practice is that it ●​ The statement of nursing problem most
helped transform the focus of the closely resemble goal statement
profession from being disease-centered ●​ Once the problem has been diagnosed,
to patient-centered the nursing goals have established
●​ The steps of the nursing process of Implementation:
assessment, diagnosis, planning, ●​ Using the goals as the framework, a
implementation, and evaluation plan is developed and appropriate
nursing interventions are determined.
Nursing education: Evaluation:
●​ Professors and educators realized the ●​ The most appropriate evaluation would
importance of client centered care rather be the nurse progress or lack of
than focusing on medical interventions progress toward the achievement of the
●​ Nursing education then slowly deviated stated goals
its concentration from the complex,
medical concepts into exercising better Characteristics 1:
attention to the client as the primary ●​ Abdellah’s theory has interrelated the
concern concepts of health, nursing problems
●​ It's very strong nurse-centered and problem-solving as she attempts to
orientation is, on the other hand, its create a different way of viewing nursing
major contribution to nursing education phenomena.
Characteristics 2:
Nursing Research: ●​ Problem solving is an activity that is
●​ Her theories continue to guide inherently logical in nature
researchers to focus on the body of Characteristics 3:
nursing knowledge itself, the ●​ Framework seems to focus quite heavily
identification of patient problems, the on nursing practice and individuals. This
organization of nursing interventions, somewhat limits the ability to generalize
the improvement of nursing education, although the problem solving approach
and the structure of the curriculum is readily generalizable to clients with
●​ The extensive research done regarding specific health needs and specific
the patient's needs and problems has nursing problems
served as a foundation for the Characteristics 4:
development of what is known as ●​ One of the most important questions
nursing diagnosis that arise when considering her work is
the role of client within the framework
Use of 21 Problems in the Nursing Process: ●​ This question could generate
Assessment Phase: hypotheses for testing and thus
●​ Nursing problems provide guidelines for demonstrates the ability of Abdellah’s
the collection of data work to generate hypotheses for testing
Characteristics 5:
●​ The results of testing such hypotheses
would contribute to the general body of
nursing
Characteristics 6:
●​ Abdellah's problem solving approach
can easily be used by practitioners to
guide various activities within their
practice
●​ This is true when considering nursing
practice that deals with Clients who
have specific needs and specific nursing
problem
Characteristics 7:
●​ Although consistency with other theories
exist many questions remain
unanswered
Limitations:
●​ The major limitation of Abdellah theory
and the 21 nursing problems is their
very strong centered orientation
●​ With the orientation appropriate use
might be the organization of teaching
content for nursing students, the
evaluation of a students, performance in
the clinical area or both
●​ But in terms of client care there is little
emphasis and what the client is to
achieve

SUMMARY:
-​ Using Abdellah's concepts of health,
nursing problems and problem solving,
the theoretical statement of nursing that
can be derived is the use of the
problems related to health needs of
people. From this framework 21 nursing
problems were developed

-​ Abdellah’s theory provides a basis for

determining and organizing nursing
care. The problems also provide a basis
for organizing appropriate nursing
strategies

-​ The most important impact of Abdellah's

theory to the nursing practice is that it
helped transform the focus of the
profession from being 'disease-
centered' to 'patient - centered.