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APPLICATION OF NURSING
THEORIES
IN
NURSING PROCESS
I. Lydia E. Hall’sI. Lydia E. Hall’s
Core, Care and Cure ModelCore, Care and Cure Model
Hall’s three aspects of nursing
Concept:Concept:
 Care should be the primary focus and that nursesCare should be the primary focus and that nurses
were the most qualified to provide the type of carewere the most qualified to provide the type of care
that would enable patients to achieve theirthat would enable patients to achieve their
maximum potential.maximum potential.
 The focus of nursing is the provision of intimateThe focus of nursing is the provision of intimate
bodily care and the nurse must know how tobodily care and the nurse must know how to
modify the care depending on the pathology andmodify the care depending on the pathology and
treatment while considering the patient’s uniquetreatment while considering the patient’s unique
needs and personality.needs and personality.
 Nursing as having three aspects, like care,Nursing as having three aspects, like care,
core and cure.core and cure.
 The individual, as unique, capable ofThe individual, as unique, capable of
growth and learning and requiring a totalgrowth and learning and requiring a total
person approach.person approach.
 Environment to be conducive for theEnvironment to be conducive for the
patient’s self development.patient’s self development.
 The major purpose of care is to achieve anThe major purpose of care is to achieve an
inter-personal relationship with the individualinter-personal relationship with the individual
that will facilitate the development of corethat will facilitate the development of core
(i.e., the development of self-identity and self-(i.e., the development of self-identity and self-
direction by the patient.direction by the patient.
ApplicationApplication
This theory will be applicable inThis theory will be applicable in
assessment, planning and implementation of theassessment, planning and implementation of the
patient care.patient care.
Three interlocking circles, presenting aThree interlocking circles, presenting a
particular aspect of nursing like care, core andparticular aspect of nursing like care, core and
cure.cure.
So, the patient whoever comes toSo, the patient whoever comes to
hospital will be considered as a Body, person andhospital will be considered as a Body, person and
disease. The nurse who is providing care to thedisease. The nurse who is providing care to the
patient should meet all his bodily care likepatient should meet all his bodily care like
bathing, eating, elimination and dressing therebybathing, eating, elimination and dressing thereby
meeting his comfort.meeting his comfort.
During care, the nurse shouldDuring care, the nurse should
develop an interpersonal relationship anddevelop an interpersonal relationship and
consider the patient as a person to provide himconsider the patient as a person to provide him
a way to express his feelings and emotions toa way to express his feelings and emotions to
gain self-identity.gain self-identity.
After developing an interpersonalAfter developing an interpersonal
relationship, the nurse should see patient andrelationship, the nurse should see patient and
family through medical care and consider himfamily through medical care and consider him
as a diseased person and act an advocate toas a diseased person and act an advocate to
cure his condition.cure his condition.
II.II.BETTY NEUMAN SYSTEMSBETTY NEUMAN SYSTEMS
MODELMODEL
(CONCEPTUAL MODEL)(CONCEPTUAL MODEL)
Concept:Concept:
Major concepts identified in the model are;Major concepts identified in the model are;
 ClientClient
 VariablesVariables
 EnvironmentEnvironment
 StressorsStressors
 Wellness &Wellness &
 Nursing InterventionsNursing Interventions
 ClientsClients are viewed as wholes whose partsare viewed as wholes whose parts
are in dynamic interaction.are in dynamic interaction.
 VariablesVariables are those which simultaneouslyare those which simultaneously
affecting the client system. They are,affecting the client system. They are,
Physiological, psychological, socio-cultural,Physiological, psychological, socio-cultural,
developmental and spiritual.developmental and spiritual.
 EnvironmentEnvironment is defined as being all theis defined as being all the
internal and external factors that surroundinternal and external factors that surround
and interact with person and client. There areand interact with person and client. There are
three relevant environments: Internal,three relevant environments: Internal,
External and Created.External and Created.
 StressorsStressors (intrapersonal, interpersonal,(intrapersonal, interpersonal,
extra personal) are significant to the conceptextra personal) are significant to the concept
of environment and are described asof environment and are described as
environmental forces that interact with andenvironmental forces that interact with and
potentially alter system stability.potentially alter system stability.
 WellnessWellness is a condition where all theis a condition where all the
subsystems are in balance and harmony withsubsystems are in balance and harmony with
the whole of the client and is balanced on thethe whole of the client and is balanced on the
actual or potential effort that environmentactual or potential effort that environment
stressors have on the energy level of thestressors have on the energy level of the
system.system.
 Nursing interventions are describedNursing interventions are described byby
using the term prevention. There are threeusing the term prevention. There are three
types of prevention: Primary, Secondary, andtypes of prevention: Primary, Secondary, and
Tertiary.Tertiary.
Model:Model:
The Neuman Systems ModelThe Neuman Systems Model
((Conceptual Model)Conceptual Model)
ApplicationApplication
This conceptual model will be applicableThis conceptual model will be applicable
for:for:
 Assessment of the client systemAssessment of the client system
 Utilization of the nursing process (Planning)Utilization of the nursing process (Planning)
 Implementation of preventive interventionsImplementation of preventive interventions
Application of Betty Neuman’s Systems ModelApplication of Betty Neuman’s Systems Model
for the Patient with Diabetes Mellitusfor the Patient with Diabetes Mellitus
III. HILDEGARD E. PEPLAUIII. HILDEGARD E. PEPLAU
THEORY OF INTERPERSONALTHEORY OF INTERPERSONAL
RELATIONSRELATIONS
Concept:Concept:
 The four phases of the nurse-patient relationshipThe four phases of the nurse-patient relationship
are; Orientation, Identification, Exploitation andare; Orientation, Identification, Exploitation and
Resolution.Resolution.
Orientation
Identification
Exploitation
Resolution
On admission
During intensive
treatment period
Convalescence
and
Rehabilitation
Discharge
Overlapping phases in Nurse-patient
relationships
 She proposed and described six nursing roles like:She proposed and described six nursing roles like:
Stranger, Resource person, Teacher, Leader,Stranger, Resource person, Teacher, Leader,
Surrogate, and Counselor.Surrogate, and Counselor.
Factors influencing the blending of the nurse-patient relationship
HILDEGARD E. PEPLAU
THEORY OF INTERPERSONAL
RELATIONS
ApplicationApplication
This theory will be applicable inThis theory will be applicable in
 AssessmentAssessment
 PlanningPlanning
 Implementation andImplementation and
 Evaluation of patient careEvaluation of patient care
Also, allows nursing to move awayAlso, allows nursing to move away
from “doing to “to” doing with” clients.from “doing to “to” doing with” clients.
Application:
PEPLAU’S FRAMEWORK FOR AN ANXIETY PATIENT
IV. FAYE GLENN ABDELLAHIV. FAYE GLENN ABDELLAH
TWENTY-ONE NURSINGTWENTY-ONE NURSING
PROBLEMSPROBLEMS
Concept:Concept:
 HealthHealth
 Nursing Problems andNursing Problems and
 Problem SolvingProblem Solving
 HealthHealth may be defined as the dynamicmay be defined as the dynamic
pattern of functioning whereby there is apattern of functioning whereby there is a
continued interaction with external andcontinued interaction with external and
internal forces that result in the optimal useinternal forces that result in the optimal use
of the wellness.of the wellness.
 Nursing Problems:Nursing Problems: The client’s healthThe client’s health
needs can be viewed as problems which mayneeds can be viewed as problems which may
be overt as an apparent condition, or covertbe overt as an apparent condition, or covert
as a hidden or concealed one.as a hidden or concealed one.
 Problem-solvingProblem-solving process involves,process involves,
identifying the problem, selecting pertinentidentifying the problem, selecting pertinent
data, formulating hypothesis, testingdata, formulating hypothesis, testing
hypothesis through the collection of datahypothesis through the collection of data
and revising the hypothesis when necessaryand revising the hypothesis when necessary
on the basis of conclusion obtained from theon the basis of conclusion obtained from the
data.data.
Nursing Centered
Client centered
Disease centered
The focus of care pendulum
Abdellah’s Twenty-one NursingAbdellah’s Twenty-one Nursing
problemsproblems
It can be classified under four areas like,It can be classified under four areas like,
i.i. Physiological needsPhysiological needs
ii.ii. Safety needsSafety needs
iii.iii. Belonging and love needsBelonging and love needs
iv.iv. Esteem needsEsteem needs
I. Physiological needs includeI. Physiological needs include
 To maintain good hygiene and physical comfort.To maintain good hygiene and physical comfort.
 To promote optimal activity: exercise, rest, andTo promote optimal activity: exercise, rest, and
sleep.sleep.
 To maintain good body mechanics, prevent andTo maintain good body mechanics, prevent and
correct deformities.correct deformities.
 To facilitate the maintenance of:To facilitate the maintenance of:
- a supply of oxygen to all the body cells,- a supply of oxygen to all the body cells,
- nutrition of all body cells.- nutrition of all body cells.
- elimination,- elimination,
- fluid and electrolyte balance- fluid and electrolyte balance
II. Safety needs includeII. Safety needs include
 To promote safety through the prevention ofTo promote safety through the prevention of
accidents, injury, or other trauma andaccidents, injury, or other trauma and
through the prevention of spread ofthrough the prevention of spread of
infection.infection.
 To facilitate the maintenance of sensoryTo facilitate the maintenance of sensory
function.function.
III. Belonging and love needsIII. Belonging and love needs
includeinclude
 To facilitate the maintenance of effectiveTo facilitate the maintenance of effective
verbal and non-verbal communication.verbal and non-verbal communication.
 To promote the development of productiveTo promote the development of productive
inter-personal relationships.inter-personal relationships.
 To facilitate progress towards achievementTo facilitate progress towards achievement
of personal spiritual goals.of personal spiritual goals.
IV. Esteem needs includeIV. Esteem needs include
 To recognize the physiological responseTo recognize the physiological response
of the body to disease conditions –of the body to disease conditions –
pathological, physiological, andpathological, physiological, and
compensatory.compensatory.
 To identify and accept positive andTo identify and accept positive and
negative expressions, feelings andnegative expressions, feelings and
reactions, the interrelatedness ofreactions, the interrelatedness of
emotions and organic illness.emotions and organic illness.
 To create and/or maintain a therapeuticTo create and/or maintain a therapeutic
environment.environment.
 To facilitate awareness of self as an individualTo facilitate awareness of self as an individual
with varying physical, emotional andwith varying physical, emotional and
developmental needs.developmental needs.
 To accept the optimum possible goals in theTo accept the optimum possible goals in the
light of limitations, physical and emotionallight of limitations, physical and emotional
 To use community resource as an aid inTo use community resource as an aid in
resolving problems arising from illness.resolving problems arising from illness.
 To understand the role of social problems asTo understand the role of social problems as
influential factors in the case of illness.influential factors in the case of illness.
ApplicationApplication
Physiological needs and
Esteem Needs
Assessment includesAssessment includes
This theory is mainly applicable forThis theory is mainly applicable for
assessment and identification of nursing problemsassessment and identification of nursing problems
with nurse-centered orientation.with nurse-centered orientation.
For e.g. If we take patient withFor e.g. If we take patient with
 Severe crushing chest painSevere crushing chest pain
 Shortness of breathShortness of breath
 Tachycardia andTachycardia and
 Profuse diaphoresisProfuse diaphoresis

The patient’s physiological needs includeThe patient’s physiological needs include
 Hygiene and physical comfortHygiene and physical comfort
 Exercise, rest and sleepExercise, rest and sleep
 Maintenance of good body mechanics therebyMaintenance of good body mechanics thereby
deformity will be preventeddeformity will be prevented
 Oxygen supply to be administeredOxygen supply to be administered
 Nutrition to be metNutrition to be met
 Elimination needs to be taken careElimination needs to be taken care
 Fluid and electrolyte balance to be maintainedFluid and electrolyte balance to be maintained
The patient’s Esteem needs includeThe patient’s Esteem needs include
The nurse should;The nurse should;
 Recognize the abnormal signs andRecognize the abnormal signs and
symptoms of heart problemsymptoms of heart problem
 Identify his emotional status towardsIdentify his emotional status towards
disease conditiondisease condition
 Provide therapeutic environmentProvide therapeutic environment
 Facilitate self-awarenessFacilitate self-awareness
 Make him to understand the optimum way ofMake him to understand the optimum way of
living and achieving goalsliving and achieving goals
 Advice him about availability of communityAdvice him about availability of community
resources to resolve complicationsresources to resolve complications
 Make him to understand the social factorsMake him to understand the social factors
which will influence his disease conditionwhich will influence his disease condition
Thank You !!!Thank You !!!

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Application of nursing theories

  • 2. I. Lydia E. Hall’sI. Lydia E. Hall’s Core, Care and Cure ModelCore, Care and Cure Model Hall’s three aspects of nursing
  • 3. Concept:Concept:  Care should be the primary focus and that nursesCare should be the primary focus and that nurses were the most qualified to provide the type of carewere the most qualified to provide the type of care that would enable patients to achieve theirthat would enable patients to achieve their maximum potential.maximum potential.  The focus of nursing is the provision of intimateThe focus of nursing is the provision of intimate bodily care and the nurse must know how tobodily care and the nurse must know how to modify the care depending on the pathology andmodify the care depending on the pathology and treatment while considering the patient’s uniquetreatment while considering the patient’s unique needs and personality.needs and personality.
  • 4.  Nursing as having three aspects, like care,Nursing as having three aspects, like care, core and cure.core and cure.  The individual, as unique, capable ofThe individual, as unique, capable of growth and learning and requiring a totalgrowth and learning and requiring a total person approach.person approach.  Environment to be conducive for theEnvironment to be conducive for the patient’s self development.patient’s self development.
  • 5.  The major purpose of care is to achieve anThe major purpose of care is to achieve an inter-personal relationship with the individualinter-personal relationship with the individual that will facilitate the development of corethat will facilitate the development of core (i.e., the development of self-identity and self-(i.e., the development of self-identity and self- direction by the patient.direction by the patient.
  • 6. ApplicationApplication This theory will be applicable inThis theory will be applicable in assessment, planning and implementation of theassessment, planning and implementation of the patient care.patient care. Three interlocking circles, presenting aThree interlocking circles, presenting a particular aspect of nursing like care, core andparticular aspect of nursing like care, core and cure.cure. So, the patient whoever comes toSo, the patient whoever comes to hospital will be considered as a Body, person andhospital will be considered as a Body, person and disease. The nurse who is providing care to thedisease. The nurse who is providing care to the patient should meet all his bodily care likepatient should meet all his bodily care like bathing, eating, elimination and dressing therebybathing, eating, elimination and dressing thereby meeting his comfort.meeting his comfort.
  • 7. During care, the nurse shouldDuring care, the nurse should develop an interpersonal relationship anddevelop an interpersonal relationship and consider the patient as a person to provide himconsider the patient as a person to provide him a way to express his feelings and emotions toa way to express his feelings and emotions to gain self-identity.gain self-identity. After developing an interpersonalAfter developing an interpersonal relationship, the nurse should see patient andrelationship, the nurse should see patient and family through medical care and consider himfamily through medical care and consider him as a diseased person and act an advocate toas a diseased person and act an advocate to cure his condition.cure his condition.
  • 8. II.II.BETTY NEUMAN SYSTEMSBETTY NEUMAN SYSTEMS MODELMODEL (CONCEPTUAL MODEL)(CONCEPTUAL MODEL) Concept:Concept: Major concepts identified in the model are;Major concepts identified in the model are;  ClientClient  VariablesVariables  EnvironmentEnvironment  StressorsStressors  Wellness &Wellness &  Nursing InterventionsNursing Interventions
  • 9.  ClientsClients are viewed as wholes whose partsare viewed as wholes whose parts are in dynamic interaction.are in dynamic interaction.  VariablesVariables are those which simultaneouslyare those which simultaneously affecting the client system. They are,affecting the client system. They are, Physiological, psychological, socio-cultural,Physiological, psychological, socio-cultural, developmental and spiritual.developmental and spiritual.  EnvironmentEnvironment is defined as being all theis defined as being all the internal and external factors that surroundinternal and external factors that surround and interact with person and client. There areand interact with person and client. There are three relevant environments: Internal,three relevant environments: Internal, External and Created.External and Created.
  • 10.  StressorsStressors (intrapersonal, interpersonal,(intrapersonal, interpersonal, extra personal) are significant to the conceptextra personal) are significant to the concept of environment and are described asof environment and are described as environmental forces that interact with andenvironmental forces that interact with and potentially alter system stability.potentially alter system stability.  WellnessWellness is a condition where all theis a condition where all the subsystems are in balance and harmony withsubsystems are in balance and harmony with the whole of the client and is balanced on thethe whole of the client and is balanced on the actual or potential effort that environmentactual or potential effort that environment stressors have on the energy level of thestressors have on the energy level of the system.system.
  • 11.  Nursing interventions are describedNursing interventions are described byby using the term prevention. There are threeusing the term prevention. There are three types of prevention: Primary, Secondary, andtypes of prevention: Primary, Secondary, and Tertiary.Tertiary.
  • 12. Model:Model: The Neuman Systems ModelThe Neuman Systems Model ((Conceptual Model)Conceptual Model)
  • 13. ApplicationApplication This conceptual model will be applicableThis conceptual model will be applicable for:for:  Assessment of the client systemAssessment of the client system  Utilization of the nursing process (Planning)Utilization of the nursing process (Planning)  Implementation of preventive interventionsImplementation of preventive interventions
  • 14. Application of Betty Neuman’s Systems ModelApplication of Betty Neuman’s Systems Model for the Patient with Diabetes Mellitusfor the Patient with Diabetes Mellitus
  • 15. III. HILDEGARD E. PEPLAUIII. HILDEGARD E. PEPLAU THEORY OF INTERPERSONALTHEORY OF INTERPERSONAL RELATIONSRELATIONS Concept:Concept:  The four phases of the nurse-patient relationshipThe four phases of the nurse-patient relationship are; Orientation, Identification, Exploitation andare; Orientation, Identification, Exploitation and Resolution.Resolution. Orientation Identification Exploitation Resolution On admission During intensive treatment period Convalescence and Rehabilitation Discharge Overlapping phases in Nurse-patient relationships
  • 16.  She proposed and described six nursing roles like:She proposed and described six nursing roles like: Stranger, Resource person, Teacher, Leader,Stranger, Resource person, Teacher, Leader, Surrogate, and Counselor.Surrogate, and Counselor. Factors influencing the blending of the nurse-patient relationship
  • 17. HILDEGARD E. PEPLAU THEORY OF INTERPERSONAL RELATIONS
  • 18. ApplicationApplication This theory will be applicable inThis theory will be applicable in  AssessmentAssessment  PlanningPlanning  Implementation andImplementation and  Evaluation of patient careEvaluation of patient care Also, allows nursing to move awayAlso, allows nursing to move away from “doing to “to” doing with” clients.from “doing to “to” doing with” clients.
  • 20. IV. FAYE GLENN ABDELLAHIV. FAYE GLENN ABDELLAH TWENTY-ONE NURSINGTWENTY-ONE NURSING PROBLEMSPROBLEMS Concept:Concept:  HealthHealth  Nursing Problems andNursing Problems and  Problem SolvingProblem Solving
  • 21.  HealthHealth may be defined as the dynamicmay be defined as the dynamic pattern of functioning whereby there is apattern of functioning whereby there is a continued interaction with external andcontinued interaction with external and internal forces that result in the optimal useinternal forces that result in the optimal use of the wellness.of the wellness.  Nursing Problems:Nursing Problems: The client’s healthThe client’s health needs can be viewed as problems which mayneeds can be viewed as problems which may be overt as an apparent condition, or covertbe overt as an apparent condition, or covert as a hidden or concealed one.as a hidden or concealed one.
  • 22.  Problem-solvingProblem-solving process involves,process involves, identifying the problem, selecting pertinentidentifying the problem, selecting pertinent data, formulating hypothesis, testingdata, formulating hypothesis, testing hypothesis through the collection of datahypothesis through the collection of data and revising the hypothesis when necessaryand revising the hypothesis when necessary on the basis of conclusion obtained from theon the basis of conclusion obtained from the data.data. Nursing Centered Client centered Disease centered The focus of care pendulum
  • 23. Abdellah’s Twenty-one NursingAbdellah’s Twenty-one Nursing problemsproblems It can be classified under four areas like,It can be classified under four areas like, i.i. Physiological needsPhysiological needs ii.ii. Safety needsSafety needs iii.iii. Belonging and love needsBelonging and love needs iv.iv. Esteem needsEsteem needs
  • 24. I. Physiological needs includeI. Physiological needs include  To maintain good hygiene and physical comfort.To maintain good hygiene and physical comfort.  To promote optimal activity: exercise, rest, andTo promote optimal activity: exercise, rest, and sleep.sleep.  To maintain good body mechanics, prevent andTo maintain good body mechanics, prevent and correct deformities.correct deformities.  To facilitate the maintenance of:To facilitate the maintenance of: - a supply of oxygen to all the body cells,- a supply of oxygen to all the body cells, - nutrition of all body cells.- nutrition of all body cells. - elimination,- elimination, - fluid and electrolyte balance- fluid and electrolyte balance
  • 25. II. Safety needs includeII. Safety needs include  To promote safety through the prevention ofTo promote safety through the prevention of accidents, injury, or other trauma andaccidents, injury, or other trauma and through the prevention of spread ofthrough the prevention of spread of infection.infection.  To facilitate the maintenance of sensoryTo facilitate the maintenance of sensory function.function.
  • 26. III. Belonging and love needsIII. Belonging and love needs includeinclude  To facilitate the maintenance of effectiveTo facilitate the maintenance of effective verbal and non-verbal communication.verbal and non-verbal communication.  To promote the development of productiveTo promote the development of productive inter-personal relationships.inter-personal relationships.  To facilitate progress towards achievementTo facilitate progress towards achievement of personal spiritual goals.of personal spiritual goals.
  • 27. IV. Esteem needs includeIV. Esteem needs include  To recognize the physiological responseTo recognize the physiological response of the body to disease conditions –of the body to disease conditions – pathological, physiological, andpathological, physiological, and compensatory.compensatory.  To identify and accept positive andTo identify and accept positive and negative expressions, feelings andnegative expressions, feelings and reactions, the interrelatedness ofreactions, the interrelatedness of emotions and organic illness.emotions and organic illness.  To create and/or maintain a therapeuticTo create and/or maintain a therapeutic environment.environment.
  • 28.  To facilitate awareness of self as an individualTo facilitate awareness of self as an individual with varying physical, emotional andwith varying physical, emotional and developmental needs.developmental needs.  To accept the optimum possible goals in theTo accept the optimum possible goals in the light of limitations, physical and emotionallight of limitations, physical and emotional  To use community resource as an aid inTo use community resource as an aid in resolving problems arising from illness.resolving problems arising from illness.  To understand the role of social problems asTo understand the role of social problems as influential factors in the case of illness.influential factors in the case of illness.
  • 29. ApplicationApplication Physiological needs and Esteem Needs Assessment includesAssessment includes This theory is mainly applicable forThis theory is mainly applicable for assessment and identification of nursing problemsassessment and identification of nursing problems with nurse-centered orientation.with nurse-centered orientation. For e.g. If we take patient withFor e.g. If we take patient with  Severe crushing chest painSevere crushing chest pain  Shortness of breathShortness of breath  Tachycardia andTachycardia and  Profuse diaphoresisProfuse diaphoresis 
  • 30. The patient’s physiological needs includeThe patient’s physiological needs include  Hygiene and physical comfortHygiene and physical comfort  Exercise, rest and sleepExercise, rest and sleep  Maintenance of good body mechanics therebyMaintenance of good body mechanics thereby deformity will be preventeddeformity will be prevented  Oxygen supply to be administeredOxygen supply to be administered  Nutrition to be metNutrition to be met  Elimination needs to be taken careElimination needs to be taken care  Fluid and electrolyte balance to be maintainedFluid and electrolyte balance to be maintained
  • 31. The patient’s Esteem needs includeThe patient’s Esteem needs include The nurse should;The nurse should;  Recognize the abnormal signs andRecognize the abnormal signs and symptoms of heart problemsymptoms of heart problem  Identify his emotional status towardsIdentify his emotional status towards disease conditiondisease condition  Provide therapeutic environmentProvide therapeutic environment  Facilitate self-awarenessFacilitate self-awareness
  • 32.  Make him to understand the optimum way ofMake him to understand the optimum way of living and achieving goalsliving and achieving goals  Advice him about availability of communityAdvice him about availability of community resources to resolve complicationsresources to resolve complications  Make him to understand the social factorsMake him to understand the social factors which will influence his disease conditionwhich will influence his disease condition