Chapter 8 Flashcards
General Systems Theory
Ludwig von Bertalanffy
A common framework for studying several similar disciplines would allow scientists and scholars to organize and communicate findings, making it easier to build on the work of others.
General Systems Theory
Input, throughput, output, evaluation, and feedback
Subsystems
General Systems Theory
material that enters a system
e.g.
School of Nursing System
Input
processes a system uses to convert material
e. g.
processes. Learning experiences
Throughput
measures the success or failure of the output
e.g.
NCLEX-RN and pass rates
Evaluation
information given back into the system to determine whether the purpose or end result of the system has been achieved
e.g
With high pass rates (established benchmark) – the system has achieved its purpose.
With low pass rates, the system may require changes – set higher admission standards, more talented faculty, and designing effective courses
Feedback
promotes the exchange of matter, energy, and information with other systems and the environment.
open system (hospital)
the larger environment outside the system
Supra-system
does not interact with other systems or with the surrounding environment
Closed system
is different from and greater than the sum of its parts (its subsystems).
The whole
occurs when all the various subsystems work together to create a result that is not independently achievable.
Synergy
A change in one part of the system creates change in other parts.
There is continuous exchange of energy and information
WITHIN open systems
BETWEEN open systems
Supra-systems
Dynamic balance within and between subsystems, systems, and supra-systems
Dynamic Nature of Systems
Dynamic balance within and between subsystems, systems, and supra-systems
helps create and maintain homeostasis (internal stability).
A system is a set of interrelated parts.
The parts form a meaningful whole.
The whole is different from and greater than the sum of its parts.
Systems may be open or closed.
All living systems are open systems.
Systems strive for homeostasis (internal stability).
Systems are part of supra-systems.
Systems have subsystems.
A change in one part of a system creates change in other parts.
Key Concepts about Systems
Human behavior is motivated by intrinsic needs.
Maslow’s Motivation of and Personality
required for a person’s well-being
Human needs
food, oxygen, rest, activity, shelter, and sexual expression
I. Physiologic Needs
reasonably predictable environment with which one has some familiarity and relative freedom from fear and chaos
II. Physical and psychological safety and security
close intimate relations, social relations, a place in the social structure
III. Love and belonging
need to feel self-worth, self-respect, and self-reliance
IV. Self-esteem
realized maximum potential
V. Self-actualization
Basic needs must be at least partially satisfied before higher-order needs can become relevant to the individual.
Individuals meet their needs in different ways.
The manner the needs are met and the extent by which these are considered needs vary according to each individual.
(Individualized nursing care)
Assumptions About Maslow’s Hierarchy of Needs
A person’s needs change as the person changes
Carl Rogers (1961) On becoming a Person
Adaptation theory
People admitted in hospitals and removed from their usual environments commonly become anxious.
Concept of adaptation
is a dynamic balance achieved by effectively functioning open systems.
Homeostasis
attained by coordinated responses of organ systems that automatically compensate for environmental changes.
Homeostasis
When balance is achieved, the person is healthy or is resistant to illness.
adaptation is successful
disequilibrium may occur, setting the stage for the development of illness or disease
adaptation is unsuccessful
The supra-system in which a person lives in.
- can either promote or interfere with homeostasis and well-being of individuals
Environment
An open system with human needs
PNP Concept 1: Person
there is a dynamic interaction between a person’s needs (internal)
and the satisfaction of those needs (often environmentally determined).
Maslow’s hierarchy of needs
Family System Cultural System Social systems Poverty Community, national, and world systems
PNP Concept 2: Environment System
- the way the family functions with and within the environment and the dynamics between various members of the family.
- Most direct environmental
influence on a person.
Family system
Culture
Ethnocentrism
Patient-centered care and integrating cultural health beliefs
Cultural systems
– defined as the patient defines family and do not necessarily involve “blood relatives.”
Family
consists of the attitudes, beliefs, and behaviors of social and ethnic groups that have been perpetuated through generations
Culture
parents and their children moved away from former sources of nurturing (older relatives such as grandparents, aunts, and uncles)
Nuclear family
children were nurtured by a variety of relatives, as well as by their own parents
Extended family
making judgments—usually negative—about another’s culture relative to one’s own.
Ethnocentrism
life is challenging who must earn a living and fulfill the nurturing roles in the family
Single parents
Individuals are influenced by the social system
Social institutions include: family, neighborhood, school, churches, professional associations, civic groups, and recreational groups.
Social systems
- means living with deprivation and the scarcity of necessities such as food and adequate housing.
Poverty
Nurses can contribute to a healthier world environment by supporting, promoting, and, when possible, participating in humanitarian responses to national and international disasters.
Community, national, and world systems
People living in poverty have diminished access to health care for a variety of reasons.
Lack of money means inadequate nutrition and lack of basic health care, adversely affecting the health status of all family members.
Food insecurity and hunger; poor transportation, inability to pay mortgage or rent, and inability to pay for utilities such as natural gas, water, and electricity
Poverty Implications on health
Smuts (1926) and holism
Parsons (1956) – health as optimum ability
Dunn (1961) – high-level wellness
Pender et al (2006) – health promotion (approach behaviors) and disease prevention (avoidance behaviors)
PNP Concept 3: Health: A continuum
“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”
WHO definition of “health”
choices and habits that promote or diminish health
Health beliefs
belief in oneself as having the ability to modify behavior
Self-efficacy (Bandura)
- Information
- Skill development
- Skill enhancement through
guided practice and
feedback - Creating social supports for change
4 components for effective lifestyle change
- An evaluation of one’s vulnerability to a condition and the seriousness of that condition
- An evaluation of how effective the health
maintenance behavior might be - The presence of a trigger event that precipitates the health maintenance behavior
Rosenstock’s Health Beliefs Model
Cyberchondria
“online concern about health”
to model positive health behaviors in their own lives and, like everyone, have a personal responsibility to take care of their health to the best of their ability.
Nurse Professional Responsibility
people tend to be influenced by whether an internal or external view of control.
Locus of control
Belief that health is controlled by what they themselves do.
Health is internally controlled (internal Locus)
Belief that health is determined by outside factors
Health is externally controlled (external Locus)
nourishes the whole person – the body, mind, and spirit.
Holistic nursing care
- Nursing is an open system
- Nursing is the provision of health care services
- Nursing involves collaborating with patients and their families
- Nursing is integrally involved with people
- Nursing care is provided regardless of diagnosis, individual differences, age, beliefs, gender, sexual orientation, or other factors.
- Nurses require advanced knowledge and skills
- Nursing requires concern, compassion, respect, and warmth, as well as comprehensive, individualized planning of care, to facilitate patients’ growth toward wellness.
- Nursing links theory and research
Eight factors contribute to holistic approach to nursing
are the freely chosen principles, ideals, or standards held by an individual, class, or group that give meaning and direction to life.
define ideal modes of conduct and reflect what the individual or group endorses and tries to emulate.
like beliefs, are relatively stable and resistant to change.
is an abstract representation of what is right, worthwhile, or desirable.
Values
Each person has a relatively small number of values.
All human beings, regardless of location or culture, possess basically the same values to differing degrees.
People organize their values into value systems.
People develop values in response to culture, society, and even individual personality traits.
Most observable human behaviors are manifestations or consequences of human values.
Rokeach (1973)
assertions about human values.
Patients should always be told the truth about their diagnoses.
Nurses, if asked, should assist terminally ill patients to die.
Severely impaired infants should be kept alive, regardless of their future quality of life.
Nurses should never accept gifts from patients.
A college professor should receive a heart transplant before a homeless person does.
Nurses should be role models of healthy behavior.
Values Clarification
> Humans manifest an essential unity of mind, body, and spirit.
Human experience is contextually and culturally defined.
Health and illness are human experiences. The presence of illness does not preclude health, nor does optimal health preclude illness.
The interaction between the nurse and patient occurs within the context of the values and beliefs of the patient and the nurse.
Public policy and the health care delivery system influence the health and well-being of society and professional nursing.
ANA Nursing’s Social Policy Statement:
The Essence of the Profession
What nursing action demonstrates individualized nursing care?
- The nurse assesses for patient’s food preferences.
- The nurse assists the patient with activities of daily living.
- The nurse convinces the patient to have a blood transfusion.
- The nurse initiates consult with the minister.
- The nurse assesses for patient’s food preferences.
