NursingModelsandTheoriesin CommunityHealthNursing

SethoHadisuyatmana,S.Kep.Ns

NursingTheoriesHistory
Era CrimeanWar Event Nigh<ngalefoundabodyof educatedwomen BasicCurriculum Studytolearnhowtonurse ImpactonNursing InMid1930s standardized curriculumpublished

Changesfromhospitalbased touniversitybased curriculum Mid1970s Lackedconceptualconnec<onsand Standardiza<oncurricula theore<calframeworksrevealed andDoctoralDegreein (Batey,1977) Nursingwasrstinisiated DevelopmentofNursingtheories Theore<calandBodyof Knowledgeevolved Changesfrom voca<onalto profesional Signicantchangesin intelectualskilland nursingapproach

1980s

Theore<calWorks
Philosophies ConceptualModelsand Theories GrandTheories Levine Rogers Orem King Neuman Roy Johnson BoykinandSchoenhofer Orlando Pender Leininger Neuman Parse Erickson,Tomlinand Swain HustedandHusted MidRangeNursing Theories Mercer Mishel Reed WienerandDodd Eakes,Burke,and Hainsworth Barker Kolcaba Beck Swanson RulandandMoore Nigh<ngale Watson Ray Benner Mar<nsen Eriksson

DorotheaE.Orem

SELFCAREDEFICITNURSING THEORY

MainFeatures
Oremdenedhertheoryconsistofthreerelated theories: Selfcarewhyandhowpeoplemaintain themselves. Selfcaredecitwhypeopleneednurses helps. Nursingsystemsexplainsaboutmaintaining nursingsystemstobebrought.

SelfCarevsSelfCareRequisites
SelfCareonbehalfoftheirowninterestto maintainfunc<ons SelfCareRequisitesFactorsthatneedtobe controlled,andNatureofpurposedonself care.

ConceptualFramework
Selfcare
SC demands

SCagency Condi<oningFactors

Decit

NsAgency

Condi<oningFactors

MadeleineLeiningers

CULTURECARETHEORYOF DIVERSITYANDUNIVERSALITY

BriefReview
1960sbecametheintroduc<onyeartothe terms:transculturalnursing,ethnonursing, andcrossculturalnursing Firstlyintroducedaseldexperience. However,Leiningerassumedthatdierent culturemeansofitspercep<on,language, norms,life,value,buts<llhavecommonali<es tocareamongmembers.

Dis<nctfeatures
Focusedexplicitlyondiscoveringholis<cand comprehensiveculturecare MajorConcepts:
Humancareandcaring(enabling) Culture(materialandnonmaterial) CultureCare(SynthesizesCulture) Culturecarediversity

con<nued
Culturecareuniversality(commonali<eson severalaspects) Worldview(howpeopleperceivedworld basedtotheirculturalview) CulturalandSocialstructuredimensions Environmentalcontext Ethnohistory

Cont.
Emic(howcomm.Reacttophenomenon) E<c(howoutsiderreacttophenomenon) Health(localdeni<on) TransculturalNursing

ApproachingMethod
CulturecarePreserva<onorMaintenance
Assis<veuptoenablingtocomm.CDM.

CulturecareAccommoda<onorNego<a<on
Toadaptnewvalueneededintermsofhealth

CulturecareRepaaerningorRestructuring
Modify,reordernewlifepaaern

CulturallyCompetentnursingcare
Totgenerallifeways

Leiningers SunriseTheory: allculturesare unique,butthey alsohave similari<es.

NolaJ.Pender

HEALTHPROMOTIONMODEL

AccordingtoPender
Healthpromo<onanddiseasepreven<on shouldbeintherstlineofhealthcare, howeverifthatfail,caringtheillnessbecomes thenextpriority.(Pender,2006). Thetwoconcept:
HealthPromo<on:increasewellbeing,while HealthProtec<on:mo<vatedtoavoiddisease(Kozier, 2004)

Theore<calFramework

CHNPrac<ceandAplica<on
AssessmentandInterven<on
PRB:Priorrelatedbehavior PF :Bio=Physical,Psychosocial,&Cultural PBA:Expectedoutcome PBarA:Expectedbarrierstowardtheaaainment ARA:ControlledFeeling SI,II,CPA,ICDP

CHNDiagnoses
RefertoNANDA20122014

Implementa<on
HealthEduca<on IndependentAc<on=Community Empowerment Collabora<onAc<on=Partnership MonitoringandEvalua<on

MerleH.Mishel

UNCERTAINTYINILLNESSTHEORY

Dis<nc<on
Uncertaintyexistinillnesssitua<onsthatare ambiguous,complex,unpredictableandwhen informa<onisunavailableorinconsistent. Uncertaintyisdenedastheinabilityto determinethemeaningodillnessrelated situa<on. Merelyittalksaboutcogni<vestatewhen someonecannotcategorizeanillnessevent becauseofinsucientcues.

con<nued
Itisabouthowpa<entcogni<velyinterprets theuncertaintyofoutcomeandtreatment TheThreemajorthemes:
Antecedentsofuncertainty Appraisalofuncertainty Copingwithuncertainty

Antecendents
S<muliFrame:Percep<ontowardsthes<muli whichisthenstructuredintocogni<veschema (Mishel,1988). Cogni<veScheme:Subjec<veinterpreta<onof illnessandtherapies Cogni<vecapacity:Capacitytoprocess informa<on StructureProviders:Assis<veresourceto interprettheS<muliFrame

Appraisal
Inference:Evalua<onofuncertaintyby recallingmemories Illusion:Beliefconstructed

Coping
Adapta<on:Biophysicalbehaviorthatappear inrangeofusualbehavior TheUITaimstoreachthestablepreviousstate, whereastheReconceptualisa<onUIT(RUIT)isa valuablesystemtoreachthenewvalue

Interven<onMethod
Itisdemonstratedeec<velyinteachingto manageuncertaintybybuildingcapacityin cogni<vereframing,enhancecommunica<on betweenclientprovider,andpossibleeectof changes. Itrequiresandfocusesinahighlyassis<ve capacity

CHNAssessment
S<muliFrame:
SignandSymptom Previousevent Congruencypasteventsandexperiences Cogni<vebackground

Cogni<veCapaci<es: StructureProviders:
Localauthoritycapacitytosupportcommunity Socialsupportandappraisalandpar<cipa<on Educa<onresourceavailability

CHNAssessment
Illusion:
Localwisdomrelatedtovalueandbelief

Inference:
Gainingalterna<veeortsthroughrecalling memories.

Possibleassessmentmethod
Primaryandsecondaryassessmentfocusing onthemainproblemofcommunity,thatare followedsuchas:
FGD WindshieldSurvey Sampling Resourcestudy Etc.

Interven<on
However,theinterven<onthataremen<oned arealterna<vesrespec<velyregardingtotheCHN methods,suchas:
CommunityasClient(McFarlane) CommunityasPartner(McFarlane) SCDNT(Orem) SunriseModel(Leininger) HPM(Pender)

Bibliography
Alligood(2006).NursingTheoristandTheirWorks6thed.Mosby. Kozier,B.,Erb,G.,Berman,A.,Snyder,S.(2004).Fundamentalsof Nursing:Concepts,Process,andPrac=ce.7thEdi=on.Philippines: PearsonEduca<onSouthAsiaPteLtd Smith,MarryJaneandLiehr,Patricia(2008).MiddleRangeTheoryof Nursing.SpringerPublishingCompany.