Nursing Theory Flashcards
What is the goal of nurse knowledge generated by theory-based practice?
- Explain the practice of nursing as different from the practice of medicine, psychology, and other disciplines.
- Provide a sense of identity as a nurse
What is nursing theory?
A conceptualization of nursing that describes, explains, predicts, and/or prescribes nursing care.
Define paradigm or conceptual framework
A structure or pattern to guide nursing practice that is shared by the community
What is a nursing metaparadigm?
THIS is what distinguishes nursing from other disciplines: What is nursing and why do nurses do what they do?
- Person - recipient of care
- Health - quality and wellness of a person, including all their parts of being
- Environment/situation - internal/external factors that relate to the patient
- Nursing - caring for the person, not the system or disease
Wholism vs Holism
Wholism = people have different aspects of being (cognitive, psychological, physical, social) but they don’t interact (whole is equal to the sum of the parts)
Holism = people have aspects of being (cognitive, psychological, physical, biophysical) that all interact and influence each other, which all are driven by genetics and spiritual drive.
What is the main view of holistic nursing?
People are more than the sum of their parts, and the conscious and unconscious processes are equally important.
How does the medical model view the holism vs wholism?
Focuses more on one aspect of a person, or doesn’t consider how the parts of a person interact
Example: Different specialists for different systems (psychologist, cardiologist, endocrinologist)
What are the key elements to holistic nursing PRACTICE?
- Regard for client as a whole person, including environment
- Centered on relationship with the client, where the client directs their priorities
- Focus on self-care and self-reflection
What are the definitions of nursing paradigm (person, health, environment, nursing) from the MRM theory perspective?
- Person: Humans are inherently holistic.
- Health: a state of well-being of all of our subsystems, not just absense of disease
- Environment: humans have internal environment (cellular) that engages with the external environment (surroundings) and they cannot be separated.
- Nursing: An interactive process of working with people to nurture their strengths and works towards goals of achieving wellness in whatever form the person wants
Define lifetime growth and development
Inherent desire to fulfill one’s life potential, which involves growth (changes in the body, mind, spirit) and development (holistic synthesis of how these changes impact a person’s body, ideas, social life etc)
What is affiliated individuation?
The instinctual need to connect with other people, but maintain independence and a sense of identity
What is adaptation?
The mobilization of internal and external resources in response to stressors, which guides us towards growth and development
Maladaption
We respond to stress or distress by depleting energy from one subsystem to fulfill needs in another, leading to illness and a state of impoverishment
Example: Someone dealing with grief may take energy from their physical and social needs to address their psychological needs, resulting in withdrawal from family, physical pains, fatigue, insomnia
What are the 3 components of self-care?
- Self-care knowledge : individual is the primary source of info b/c they know what makes them ill and what will make them well
- Self-care resources: internal and external
- Self-care actions: use of self-care knowledge/resources to guide growth
How is the nurse a facilitator?
Helps the person identify and mobilize their strengths and is therefore a facilitator of healing, not a healer
How does the nurse foster nurturance?
The nurse aims to understand the client’s model of their world and uses this knowledge to guide actions
How does the nurse utilize unconditional acceptance?
Recognizes that all people are unique and worthwhile, and uses empathy to understand the client
How are people alike, according to MRM theory?
- Bears Biophysically
- Have We all have interacting, holistic subsystems
- Many We all have basic needs (Maslow) that must be met before growth occurs
- Pals, We all go through stages of cognitive development (Piaget)
- Even We all face developmental tasks (Erickson)
- Ants Affiliated-individuation
What is the order of Maslow’s Hierarchy of Needs?
- Physiological
- Safety - of body, employment, resources, health, family, property
- Love/belonging -friendship, family, intimacy
- Esteem - confidence, achievement, respect
- Self-actualization - morality, creativity, problem solving, acceptance
How do a basic-need deficit and growth-need deficit impact people?
Basic-need deficit results in a threat to the individual and a defensive reaction (physical, safety, love, esteem)
Growth-need deficit results in a challenge to the individual and facilitates growth (self-actualization)
According to Erick Erickson’s Psychosocial Theory of Development, how do we develop internal and external resources?
We successfully go through a series of developmental tasks to acquire strengths and virtues
What are Erickson’s tasks?
- Trust vs Mistrust : 0-18 months
- Autonomy vs Shame and Doubt : 18 mo - 3 years
- Initiative vs Guilt : 3 -6 years
- Industry vs Inferiority : 6-12 years
- Identity vs Role Confusion : 12-20 years
- Intimacy vs Isolation: 20-35 years
- Generativity vs Stagnation: 35-65 years
- Integrity vs Despair: 65 years-death
What is Piaget’s Theory of Cognitive Development?
Cognitive processes are mental processes that reflect thinking, reasoning, and problem solving (not emotional) and develop in stages
Sensorimotor stage
- birth-2 years
- Direct sensory and motor contact
- Object permanence and separation anxiety develop
Preoperational stage
- 2-7 years
- Child uses symbols (words and images) but can’t reason logically
- Egocentric
Concrete Operational stage
- 7-11 years
- Logical thinking about concrete problems
Formal Operational stage
- 12 years-adult
- Abstract reasoning and understands hypotheticals
According to MRM theory, how are people different?
- Inherent endowment: variations in genetic base
- Adaption potential: we perceive challenges (stressor) and threats (stressors) differently and mobilize resources differently
Eustress
A stressor that is perceived as good
Stress
The nonspecific response to a stimulus (stimulus can be real or imagined)
What factors influence our experience of stress?
- Nature of the stress experience: good or bad?
- Meaning applied to stress
- Duration
- Other stressors at the time
- Past experience of comparable stressors
- Resource availability
What are the stages of Selye’s General Adaptation Syndrome?
- Alarm : body prepares for survival, flight or fight response (epinephrine and norepinephrine stimulates heart rate, BP, direct blood flow to skeletal muscle; hormonal response)
- Resistance: threat persists but the body mobilizes physiological responses to resist (parasympathetic activity, stabilization, hormone levels return to normal)
- Exhaustion: cells and organs deteriorate due to inability to adapt to stressor
What is Engel’s Psychosocial View of Stress?
Two responses:
Fight or Flight state
Conservative-Withdrawal state (giving up)
What is the Adaptive Potential Assessment Model?
- Combines Engel’s and Selye’s models
- Arousal, Equilibrium, and Impoverishment
- Can only be in 1 state at a time, but you can move back and forth between them
What state of APAM would you experience anxiety without depression?
Arousal
What are the coping states of the APAM?
- Adaptive Equilibrium
- Maladaptive Equilibrium
- Impoverishment (anxiety, depression, elevated motor-sensory behavior, very depleted resources)
What is Modeling?
To develop an understanding of the client’s world
What is their knowledge? What do they think their resources are? How can I see their situation from their view?
What is Role-Modeling?
Helping the client in achieving health through unique interventions, in which the client is a decision maker
*Modeling MUST occur first
What are 5 aims of nursing interventions within Role-Modeling?
- Build Trust
- Promote client’s positive orientation (encouragement and praise)
- Promote client’s control (give autonomy and present reasonable choices)
- Affirm and promote their strengths
- Set mutual goals that are health-directed
What is Von Bertalanffy’s contribution to theory?
- General and Open System Theories
- Humans are made up of a hierarchy of many subsystems (cells, organs, people, societies, universe)
- Subsystems are organized into a system
- Systems and subsystems are greater than the sum of their parts: they each interact with each other and their environment
How does open system theory related to MRM and health?
Both focus on homeostasis and holism: Each person consists of interacting subsystems that must be in equilibrium to maintain health
