ABDELLAH, HENDERSON, AND PENDER Flashcards
A nursing research pioneer who developed the “Twenty-
One Nursing Problems.”
Faye Glenn Abdellah
TRUE OR FALSE: Her nursing model was progressive for the time in that it
refers to a nursing diagnosis during a time in which nurses
were taught that diagnoses were not part of their role in
health care.
TRUE
Abdellah argued that nursing education should be
based on
research
Fay Glenn Abdellah used _____________ and
nursing research to establish the classification of
nursing problems.
Henderson’s 14 Basic Human Needs
The ___________ was developed from Abdellah’s
practice, and the theory is considered a
____________.
patient-centered approach to
nursing, human needs theory
It was formulated to be an _________________ so it most suitable and useful in that field.
instrument for nursing
education
The 21 Nursing Problems l is intended to guide care in
hospital institutions but can also be applied to
____________, as well.
community health nursing
Purpose of 21 Nursing Problems
To guide care and promote use of nursing
judgment.
The 21 nursing problems fall into three (3) areas:
- Physical, sociological, and emotional needs of patients
- Types of interpersonal relationships between the
patient and nurse - Common elements of patient care
- Patients’ needs are divided into four categories:
- Basic needs
- Sustenance care needs
- Remedial care needs
- Restorative care needs
TRUE OR FALSE: In the attempt to bring the
nursing practice to its proper
relationship with restorative
and preventive measures for
meeting total client needs,
Abdellah seems to swing the
pendulum to the opposite
pole, from the disease
orientation to nursing
orientation, while leaving the
client somewhere in the middle.
TRUE
10 Steps to Identify the Patient’s Problems
- Learn to know the patient.
- Sort out relevant and significant data.
- Make generalizations about available data concerning
similar nursing problems presented by other patients. - Identify the therapeutic plan.
- Test generalizations with the patient and make
additional generalizations.
10 Steps to Identify the Patient’s Problems - Validate the patient’s conclusions about his nursing problems.
- Continue to observe and evaluate the patient over a period of
time to identify any attitudes and clues affecting his or her
behavior. - Explore the patient and their family’s reactions to the
therapeutic plan and involve them in the plan. - Identify how the nurses feel about the patient’s nursing
problems. - Discuss and develop a comprehensive nursing care plan.
What are the Basic Needs in the Typology of 21 Nursing Problems
Good hygiene, & Physical Comfort , Promote activity: exercise, rest, and sleep, Promote Safety, Maintain Good Body Mechanics
What are the Sustenal Care Needs in the Typology of 21 Nursing Problems
Maintenance of a supply in O2, Nutrition, Maintenance of Elimination, Maintenance of fluid and electrolyte balance, recognize physiologic response, maintenance of regulatory mechanisms and functions, maintenance of sensory information
What are the Remedial Care Needs in the Typology of 21 Nursing Problems
Identify and accept positive and negative, accept emotions, verbal and non verbal, interpersonal relationships, personal spiritual goals, maintain a therapeutic environment, awareness of self as an individual,
What are the Restorative Care Needs in the Typology of 21 Nursing Problems
accept the optimum goals, use community resources, understand the role of social problems
11 Nursing Skills
- Observation of health status
- Skills of communication
- Application of knowledge
- Teaching of patients and
families - Planning and organization of
work
11 Nursing Skills
- Use of resource materials
- Use of personnel resources
- Problem-solving
- Direction of work of others
10.Therapeutic uses of the self
11.Nursing procedure
ABDELLAH - PERSON
describes nursing recipients as
individuals (and families), although she does
not delineate her beliefs or assumptions about
the nature of human beings.
ABDELLAH - HEALTH
Health, or the achieving of it, is the purpose of nursing services.
- Health may be defined as the dynamic pattern of functioning
whereby there is a continued interaction with internal and
external forces that results in the optimal use of necessary
resources to minimize vulnerabilities. - Although Abdellah does not define health, she speaks to “total health
needs” and “a healthy state of mind and body.”
ABDELLAH - ENVIRONMENT
Society is included in “planning for optimum health on
local, state, and international levels.” However, the
focus of nursing service is clearly the individual.
- The environment is the home or community from which
the patient comes.
ABDELLAH - NURSING
Nursing care is doing something for or to the patient or
giving the patient information with the goals of meeting
needs, increasing or restoring self-help ability, or alleviating
impairments.
- The role of the nurse is to help the patient achieve goals to
reach optimum health.
for each identified problem, pertinent data
is collected.
- Assessment
The outcome of the collection of data in the first phase
concludes the patient’s possible problems, which can be
grouped under one or more of the broader nursing
problems. This will further lead to the ______
nursing diagnosis.
After formulating the diagnosis, a nursing care plan is developed,
and appropriate nursing interventions are determined. The nurse
now sets those interventions in action, which complete the
__________ phase of the nursing process.
IMPLEMENTATION
The ______________ takes place after the interventions have been
carried out. The most convenient evaluation would be the nurse’s
progress or lack of progress toward achieving the goals established
in the planning phase.
EVALUATION
A nurse, theorist, and author known for her Need Theory
Virginia Avenel Henderson
Henderson is also known as:
“The First Lady of Nursing”
“The Nightingale of Modern
Nursing”
“Modern-Day Mother of Nursing”
“The 20th Century Florence
Nightingale”
- Co-authored the fifth (1955) and sixth
(1978) editions of Textbook of
Principles
and Practice of Nursing
The Need Theory emphasizes _______________ so that
progress after hospitalization would not be delayed.
the importance of
increasing the patient’s independence and
focusing on the basic human needs
Physiological
Components
- Breathe normally
- Eat and drink
adequately - Eliminate body
wastes - Move and maintain
desirable postures - Sleep and rest
- Select suitable clothes –
dress and undress - Maintain body temperature within
normal range by adjusting clothing
and modifying environment - Keep the body clean and well-
groomed and protect the integument - Avoid dangers in the environment
and avoid injuring others
Psychological Aspects of
Communicating and Learning
- Communicate with others in
expressing emotions, needs, fears, or
opinions. - Learn, discover, or satisfy the
curiosity that leads to normal
development and health and use the
available health facilities.
Spiritual and Moral
- Worship according to
one’s faith
Sociologically Oriented to
Occupation and Recreation
- Work in such a way that there
is a sense of accomplishment - Play or participate in various
forms of recreation
TRUE OR FALSE: Some of the activities listed can be applied to all individuals indicating that there
would always be patients who always require aided
care which is contrary to the goal of nursing
indicated in the definition of nursing by
Henderson.
FALSE - “only be applied to
fully functional individuals”
Assumptions on the Need Theory
- Nurses care for patients until they can care for themselves once
again. - Patients desire to return to health.
- Nurses are willing to serve, and “nurses will devote themselves to
the patient day and night.” - Henderson also believes that the “mind and body are inseparable
and are interrelated.
HENDERSON - PERSON
- Someone who needs nursing care but did not limit nursing to illness care.
- Individuals have basic health needs and require assistance to achieve health and
independence or a peaceful death. - An individual achieves wholeness by maintaining physiological and emotional
balance. - The Need Theory presented the patient as a sum of parts with biopsychosocial
needs, and the mind and body are inseparable and interrelated.
HENDERSON - ENVIRONMENT
- The Need Theory did not explicitly define the environment. However,
maintaining a supportive environment conducive to health is one of the
14 activities for client assistance. - The Need Theory supports the private and public health sector’s tasks or
agencies to keep people healthy. - Society wants and expects the nurse’s act for individuals who cannot
function independently.
HENDERSON - HEALTH
- Although not explicitly defined in the Need Theory, health was taken to mean
balance in all realms of human life. - It is equated with the independence or ability to perform activities without aid in
the 14 components or basic human needs. - On the other hand, nurses are key persons in promoting health, preventing illness,
and curing. - Good health is a challenge because it is affected by numerous factors such as age,
cultural background, emotional balance, and others.
HENDERSON - NURSING
- Henderson wrote her definition of nursing before the development of
theoretical nursing. - She defined nursing as “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 to peaceful death) 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.”
HENDERSON - NURSING
- The nurse’s goal is to make the patient complete, whole, or
independent. In turn, the nurse collaborates with the
physician’s therapeutic plan. - Nurses temporarily assist an individual who lacks the necessary
strength, will, and knowledge to satisfy one or more of the 14
basic needs.
ADDITIONAL HENDERSON - NURSING
- “The nurse is temporarily the consciousness of the unconscious, the love life
for the suicidal, the leg of the amputee, the eyes of the newly blind, a
means of locomotion for the infant, knowledge, and confidence of the
young mother, the mouthpiece for those too weak or withdrawn to speak.” - Additionally, she stated that “…the nurse does for others what they would
do for themselves if they had the strength, the will, and the knowledge. But
I go on to say that the nurse makes the patient independent of them as
soon as possible.”
MORE HENDERSON - NURSING
- Her definition of nursing distinguished a nurse’s role in health
care:
The nurse is expected to carry out a physician’s therapeutic plan, but
individualized care results from the nurse’s creativity in planning for care.
- The nurse should be an independent practitioner able to make an
independent judgment.
Her first encounter with the nursing profession was when she
was 7 years old and witnessed the care given to her
hospitalized aunt by nurses. This situation led her to the
desire to care for other people, and her goal was to help
people care for themselves.
Nola J. Pender
In 1982, Nola Pender first published the
Health Promotion Model
- The Health Promotion Model was designed to be a
“complementary counterpart to models of health protection.”
Health Promotion Model develops______________________ and
____________________.
to incorporate behaviors for improving health, applies across the life span
Health Promotion Model’s purpose
Is to help nurses know and understand the major
determinants of health behaviors as a foundation for behavioral
counseling to promote well-being and healthy lifestyles.
Health-promoting behavior is the
desired behavioral outcome
Pender’s health promotion model
defines health as
“a positive dynamic
state not merely the absence of
disease.”
Health-promoting behaviors should
result in
improved health, enhanced
functional ability, and better quality
of life at all development stages.
Health promotion is
directed at
increasing a client’s level of well-
being. It describes the multi-
dimensional nature of persons as they
interact within the environment to
pursue health.
The health promotion model focuses on the following three (3) areas:
- Individual characteristics and experiences
- Behavior-specific cognitions and affect
- Behavioral outcomes
behavior motivated by the desire to
increase well-being and actualize human health potential. It
is an approach to wellness.
Health promotion
behavior
motivated desire to actively avoid illness, detect it early, or
maintain functioning within illness constraints.
Health protection or illness prevention
prior related behavior
and personal factors.
Individual characteristics and experiences
perceived benefits of
action, perceived barriers to action, perceived self-efficacy, activity-
related affect, interpersonal influences, and situational influences.
Behavior-specific cognitions and affect
commitment to a plan of action, immediate
competing demands and preferences, and health-promoting behavior.
Behavioral outcomes
Predictive of a given behavior and
shaped by the target behavior’s nature being considered.
- Personal Factors
include variables such as age, gender, body
mass index, pubertal status, aerobic capacity, strength, agility, or balance.
Personal biological factors
include variables such as self-esteem,
self-motivation, personal competence, perceived health status, and
definition of health.
Personal psychological factors
include variables such as race,
ethnicity, acculturation, education, and socioeconomic status.
Personal socio-cultural factors
Anticipated positive
outcomes that will occur from health behavior.
Perceived Benefits of Action
Anticipated, imagined, or
real blocks and personal costs of understanding a given
behavior.
Perceived Barriers to Action
The judgment of personal capability to organize and
execute a health-promoting behavior.
Perceived self-efficacy influences perceived barriers to
action, so higher efficacy results in lowered perceptions
of barriers to the behavior’s performance.
Perceived Self-Efficacy
Subjective positive or negative feeling occurs before,
during, and following behavior based on the stimulus
properties of the behavior itself.
Activity-related affect influences perceived self-efficacy,
which means the more positive the subjective feeling, the
greater its efficacy. In turn, increased feelings of efficacy
can generate a further positive affect.
Activity-Related Affect
Cognition concerning behaviors,
beliefs, or attitudes of others. Interpersonal influences include
norms (expectations of significant others), social support
(instrumental and emotional encouragement), and modeling
(vicarious learning through observing others engaged in a
particular behavior).
Primary sources of interpersonal influences are families, peers, and
healthcare providers.
Interpersonal Influences
Personal perceptions and
cognitions of any given situation or context can facilitate
or impede behavior.
Include perceptions of options available, demand characteristics,
and aesthetic features of the environment in which given health-
promoting is proposed to take place.
Situational influences may have direct or indirect influences on
health behavior.
Situational Influences
The concept of
intention and identification of a planned strategy leads to
the implementation of health behavior.
- Commitment to Plan of Action
are those alternative behaviors over which
individuals have low control because of environmental
contingencies such as work or family care responsibilities.
Competing demands
are alternative behaviors over which
individuals exert relatively high control, such as choice of ice cream
or apple for a snack.
Competing preferences
Endpoint or action-
outcome directed toward attaining positive health
outcomes such as optimal wellbeing, personal fulfillment,
and productive living.
Health-Promoting Behavior
Settings for the Health Promotion Model
- Communities at
large - Nursing Centers
- Schools
- Workplace
- Hospitals
Major Assumptions in the Health Promotion
Model
- Individuals seek to regulate their own behavior actively.
- Individuals in all their biopsychosocial complexity interact with the
environment, progressively transforming the environment and being
transformed over time. - Health professionals constitute a part of the interpersonal
environment, which influences persons throughout their life span. - Self-initiated reconfiguration of person-environment interactive
patterns is essential to behavior change.
PENDER - PERSON
- The person is a biophysical organism shaped by the environment, but
also seeks to create an environment in which human potential can be
fully expressed. - Because of this, the relationship between person and environment is
reciprocal. - Individual characteristics and life experiences shape behaviors.
PENDER - ENVIRONMENT
- Described as the social, cultural, and physical context in which
life unfolds. - It can be manipulated by the individual to create a positive
context of cues and facilitators for health-enhancing behaviors.
PENDER - HEALTH
- The actualization of human potential through goal-directed
behavior, self-care, and relationships with others with necessary
adjustments made to maintain relevant environments.
PENDER - NURSING
- The role of nursing is a collaboration among patients, families,
and communities to create the best conditions for the
expression of optimal health and high-level well-being.
