psychological aspect

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Based on Some Nursing Philosophies andTheories



1. Florence Nightingale’s Philosophy - Nursing is “the act of utilizing the environment of

the patient to assist him in his recovery”. 5 Environmental Factors a. Pure or fresh air b. Pure water c. Efficient drainage d. Cleanliness e. Light, especially direct sunlight * Keep the client warm, maintaining a noise-free

environment, and assessing intake * Protect patients from possible harm (physical and

emotional)



2. Virginia Henderson’s Philosophy -“unique function of the nurse… is to assist the individual, sick

or well, in the performance of those activities contributing tohealth or its recovery (or peaceful death) that he would performunaided if he had the necessary strength, will or knowledge”.

14 Fundamental Needs 1. Breathing normally2. Eating and drinking adequately3. Eliminating body wastes4. Moving and maintaining a desirable position5. Sleeping and resting

6. Selecting suitable clothes7. Maintaining body temperature within normal range by

adjusting clothing and modifying the environment



8. Keeping the body clean and well groomed to

protect the integument9. Avoiding dangers in the environment and avoiding

injury to others10. Communicating with others in expressing

emotions, needs, fears, or opinions11. Worshipping according to one’s faith 12. Working in such a way that one feels a sense of

accomplishment13. Playing or participating in various forms of

recreation14. Learning, discovering, or satisfying the curiositythat leads to normal development and health, and usingavailable health facilities



3. Jane Watson’s Philosophy - Human-to-human caring approach

10 Carative Factors 1. The formation of a humanistic-altruistic system of

values

2. The instillation of faith-hope

3. The cultivation of sensitivity to one’s self andothers

4. The development of a helping-trust relationship



5. The promotion and acceptance of the expression of positive and negative feelings

6. The systematic use of the scientific problem-solvingmethod for decision making

7. The promotion of interpersonal teaching-learning

8. The provision for a supportive, protective, and/orcorrective mental, physical sociocultural, and spiritualenvironment

9. Assistance with the gratification of human needs

10. The allowance for existential-phenomenological forces



4. Hildegard Peplau’s Interpersonal RelationsModel

- Central to Peplau’s Theory is the use of therapeutic relationship between the nurse andthe patient.

- Nurses enter into a personal relationship withan individual when a need is present. The nurse-client relationship evolves in four phases:

1. Orientation2. Identification3. Exploitation4. Resolution



Roles of nurse Stranger: receives the client in the same way

one meets a stranger in other life situationsprovides an accepting climate that builds

trust.

Teacher: who imparts knowledge in referenceto a need or interest



Resource Person : one who provides a specificneeded information that aids in theunderstanding of a problem or new situation

Counselors : helps to understand andintegrate the meaning of current lifecircumstances, provides guidance andencouragement to make changes



Surrogate: helps to clarify domains of dependence interdependence andindependence and acts on clients behalf asan advocate.

Leader : helps client assume maximumresponsibility for meeting treatment goals ina mutually satisfying way



Additional Roles include: 1. Technical expert

2. Consultant3. Health teacher

4. Tutor academe5. Socializing agent6. Safety agent removal of hazards7. Manager of environment8. Mediator advocate

9. Administrator10. Recorder observer11. Researcher



5. Betty Neuman’s Systems Model



MAJOR CONCEPTS I. PERSON VARIABLES Each layer, or concentric circle, of the

Neuman model is made up of the five person

variables. Ideally, each of the person variablesshould be considered simultaneously andcomprehensively.

Physiological

Psychological Spiritual Developmental



II. CENTRAL CORE The basic structure, or central core, is made

up of the basic survival factors that arecommon to the species (Neuman, 1995, inGeorge, 1996).

These factors include: system variables,genetic features, and the strengths and

weaknesses of the system parts.



Stability, or homeostasis, occurs when theamount of energy that is available exceedsthat being used by the system.

A homeostatic body system is constantly in adynamic process of input, output, feedback,and compensation, which leads to a state of balance.



III. FLEXIBLE LINES OF DEFENSE The flexible line of defense is the outer barrier or

cushion to the normal line of defense, the line of resistance, and the core structure.

If the flexible line of defense fails to provideadequate protection to the normal line of defense, the lines of resistance become activated.

The flexible line of defense is dynamic and can

be changed/altered in a relatively short period of time.



IV. NORMAL LINE OF DEFENSE The normal line of defense represents system

stability over time.

It is considered to be the usual level of stability in the system.

The normal line of defense can change overtime in response to coping or responding to

the environment.



V. LINES OF RESISTANCE The lines of resistance protect the basic

structure and become activated whenenvironmental stressors invade the normalline of defense. Example: activation of theimmune response after invasion of microorganisms. If the lines of resistance areeffective, the system can reconstitute and if the lines of resistance are not effective, theresulting energy loss can result in death.



VI. RECONSTITUTION Reconstitution is the state of adaptation to

the stressor.



VII. STRESSORS The Neuman Systems Model looks at the impact of

stressors on health and addresses stress and thereduction of stress (in the form of stressors).Stressors are capable of having either a positive ornegative effect on the client system. A stressor is anyenvironmental force which can potentially affect thestability of the system: they may be:

Intrapersonal - occur within person, e.g. emotionsand feelings

Interpersonal - occur between individuals, e.g. role

expectations Extra personal - occur outside the individual, e.g. job

or finance pressures



VII. PREVENTION As defined by Neuman's model, prevention is the

primary nursing intervention. Prevention focuseson keeping stressors and the stress responsefrom having a detrimental effect on the body.

Primary -Primary prevention occurs before thesystem reacts to a stressor. On the one hand, itstrengthens the person (primarily the flexible lineof defense) to enable him to better deal withstressors, and on the other hand manipulates the

environment to reduce or weaken stressors.Primary prevention includes health promotionand maintenance of wellness.



Secondary-Secondary prevention occurs after thesystem reacts to a stressor and is provided interms of existing systems. Secondary preventionfocuses on preventing damage to the central coreby strengthening the internal lines of resistanceand/or removing the stressor.

Tertiary -Tertiary prevention occurs after thesystem has been treated through secondaryprevention strategies. Tertiary prevention offers

support to the client and attempts to add energyto the system or reduce energy needed in orderto facilitate reconstitution.



Dorothea Orem’s General Theory of Nursing -includes 3 related concepts: self-care, self-

care deficit, and nursing systems.

Self-care theory is based on four concepts:

1. Self-care

2. Self-care agency

*self-care agent

*dependent care agent



3. Self-care requisites/ Self-care needs Categories

1. Universal requisites2. Developmental requisites

3. Health deviation requisites

4. Therapeutic self-care demand



Self-care Deficit results when self-care agency isnot adequate to meet the known self-caredemand.

Patients can be assisted through these 5 Methods

of Helping: *Acting or doing for others

*Guiding another

*Teaching others

*Supporting another

*Providing an environment that promotes theindividual’s abilities to meet current and futuredemands



Nursing Systems 1. Wholly compensatory

2. Partly compensatory

3. Supportive-educative

psychological aspect

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