Faye Glenn Abdellah's Nursing Theory
Nursing Files
Theories
Abdellah's Nursing Theory
Twenty-One Nursing Problems
INTRODUCTION
- "Nursing
is based on an art and science that mould the attitudes, intellectual
competencies, and technical skills of the individual nurse into the desire
and ability to help people, sick or well, cope with their health
needs." - Abdellah
Abdellah explained nursing as a
comprehensive service, which includes:
- Recognizing
the nursing problems of the patient
- Deciding
the appropriate course of action to take in terms of relevant nursing
principles
- Providing
continuous care of the individuals total needs
- Providing
continuous care to relieve pain and discomfort and provide immediate
security for the individual.
- Adjusting
the total nursing care plan to meet the patient’s individual needs.
- Helping
the individual to become more self directing in attaining or maintaining a
healthy state of mind & body.
- Instructing
nursing personnel and family to help the individual do for himself that
which he can within his limitations
- Helping
the individual to adjust to his limitations and emotional problems.
- Working
with allied health professions in planning for optimum health on local,
state, national and international levels.
- Carrying
out continuous evaluation and research to improve nursing techniques and
to develop new techniques to meet the health needs of people.
(In 1973, the item 3, - “providing
continuous care of the individual’s total health needs” was eliminated.)
ABOUT THE THEORIST AND THEORETICAL
SOURCES
- Birth:1919
- Abdellah’s
patient - centred approach to nursing was developed inductively from her
practice and is considered a human needs theory.
- The
theory was created to assist with nursing education and is most applicable
to the education of nurses.
- Although
it was intended to guide care of those in the hospital, it also has
relevance for nursing care in community settings.
MAJOR ASSUMPTIONS, CONCEPTS & RELATIONSHIPS
- She
uses the term ‘she’ for nurses, ‘he’ for doctors and patients, and refers
to the object of nursing as ‘patient’ rather than client or consumer.
- She
referred to Nursing diagnosis during a time when nurses were taught that
diagnosis was not a nurses’ prerogative.
Assumptions were related to
- change
and anticipated changes that affect nursing;
- the
need to appreciate the interconnectedness of social enterprises and social
problems;
- the
impact of problems such as poverty, racism, pollution, education, and so
forth on health care delivery;
- changing
nursing education
- continuing
education for professional nurses
- development
of nursing leaders from under reserved groups
Abdellah and colleagues developed a
list of 21 nursing problems.They also identified 10 steps to identify the
client’s problems. 11 nursing skills to be used in developing a treatment
typology
10 steps to identify the client’s problems
- Learn
to know the patient
- Sort
out relevant and significant data
- Make
generalizations about available data in relation to similar nursing
problems presented by other patients
- Identify
the therapeutic plan
- Test
generalizations with the patient and make additional generalizations
- Validate
the patient’s conclusions about his nursing problems
- Continue
to observe and evaluate the patient over a period of time to identify any
attitudes and clues affecting his behavior
- Explore
the patient’s and family’s reaction to the therapeutic plan and involve
them in the plan
- Identify
how the nurses feels about the patient’s nursing problems
- Discuss
and develop a comprehensive nursing care plan
11 nursing skills
- Observation
of health status
- Skills
of communication
- Application
of knowledge
- Teaching
of patients and families
- Planning
and organization of work
- Use
of resource materials
- Use
of personnel resources
- Problem-solving
- Direction
of work of others
- Therapeutic
use of the self
- Nursing
procedure
21 NURSING PROBLEMS
Three major categories
- Physical,
sociological, and emotional needs of clients
- Types
of interpersonal relationships between the nurse and patient
- Common
elements of client care
BASIC TO ALL PATIENTS
- To
maintain good hygiene and physical comfort
- To
promote optimal activity: exercise, rest and sleep
- To
promote safety through the prevention of accidents, injury, or other
trauma and through the prevention of the spread of infection
- To
maintain good body mechanics and prevent and correct deformity
SUSTENAL CARE NEEDS
- To
facilitate the maintenance of a supply of oxygen to all body cells
- To
facilitate the maintenance of nutrition of all body cells
- To
facilitate the maintenance of elimination
- To
facilitate the maintenance of fluid and electrolyte balance
- To
recognize the physiological responses of the body to disease conditions
- To
facilitate the maintenance of regulatory mechanisms and functions
- To
facilitate the maintenance of sensory function.
REMEDIAL CARE NEEDS
- To
identify and accept positive and negative expressions, feelings, and
reactions
- To
identify and accept the interrelatedness of emotions and organic illness
- To
facilitate the maintenance of effective verbal and non verbal
communication
- To
promote the development of productive interpersonal relationships
- To
facilitate progress toward achievement of personal spiritual goals
- To
create and / or maintain a therapeutic environment
- To
facilitate awareness of self as an individual with varying physical ,
emotional, and developmental needs
RESTORATIVE CARE NEEDS
- To
accept the optimum possible goals in the light of limitations, physical
and emotional
- To
use community resources as an aid in resolving problems arising from
illness
- To
understand the role of social problems as influencing factors in the case
of illness
ABDELLAH’S
THEORY AND THE FOUR MAJOR CONCEPTS
NURSING
- Nursing
is a helping profession.
- Nursing
care is doing something to or for the person or providing information to
the person with the goals of meeting needs, increasing or restoring
self-help ability, or alleviating impairment.
- Nursing
is broadly grouped into the 21 problem areas to guide care and promote use
of nursing judgment.
- Nursing
to be comprehensive service.
PERSON
- Abdellah
describes people as having physical, emotional, and sociological needs.
- Patient
is described as the only justification for the existence of nursing.
- Individuals
(and families) are the recipients of nursing
- Health,
or achieving of it, is the purpose of nursing services.
HEALTH
- In
Patient–Centered Approaches to Nursing, Abdellah describes health as a
state mutually exclusive of illness.
- Although
Abdellah does not give a definition of health, she speaks to “total health
needs” and “a healthy state of mind and body” in her description of
nursing as a comprehensive service.
SOCIETY AND ENVIRONMENT
- Society
is included in “planning for optimum health on local, state, national, and
international levels”. However, as she further delineated her ideas, the
focus of nursing service is clearly the individual.
- The
environment is the home or community from which patient comes.
CHARACTERISTICS OF THE THEORY
- Abdellah’s
theory has interrelated the concepts of health, nursing problems, and
problem solving.
- Problem
solving is an activity that is inherently logical in nature.
- Framework
focus on nursing practice and individuals.
- The
results of testing such hypothesis would contribute to the general body of
nursing knowledge
- Easy
to apply in practice.
USE OF 21
PROBLEMS IN THE NURSING PROCESS
ASSESSMENT PHASE
- Nursing
problems provide guidelines for the collection of data.
- A
principle underlying the problem solving approach is that for each identified
problem, pertinent data are collected.
- The
overt or covert nature of the problems necessitates a direct or indirect
approach, respectively.
NURSING DIAGNOSIS
- The
results of data collection would determine the client’s specific overt or
covert problems.
- These
specific problems would be grouped under one or more of the broader
nursing problems.
- This
step is consistent with that involved in nursing diagnosis
PLANNING PHASE
- The
statements of nursing problems most closely resemble goal statements. Once
the problem has been diagnosed, the nursing goals have been established.
IMPLEMENTATION
- Using
the goals as the framework, a plan is developed and appropriate nursing
interventions are determined.
EVALUATION
- The
most appropriate evaluation would be the nurse progress or lack of
progress toward the achievement of the stated goals..
Progressive Patient
Care :: Models of Nursing Care Delivery
CONCLUSION
- Using
Abdellah’s concepts of health, nursing problems, and problem solving, the
theoretical statement of nursing that can be derived is the use of the
problem solving approach with key nursing problems related to health needs
of people. From this framework, 21 nursing problems were developed.
- Abdellah’s
theory provides a basis for determining and organizing nursing care. The
problems also provide a basis for organizing appropriate nursing
strategies.
REFERENCES
- George
Julia B. Nursing theories: The base of professional nursing practice 3rd
edition. Norwalk, CN: Appleton and Lange; 1990.
- Abdellah,
F.G. The federal role in nursing education. Nursing outlook. 1987,
35(5),224-225.
- Abdellah,
F.G. Public policy impacting on nursing care of older adults .In E.M.
Baines (Ed.), perspectives on gerontological nursing. Newbury, CA: Sage
publications. 1991.
- Abdellah,
F.G., & Levine, E. Preparing nursing research for the 21st century.
New York: Springer. 1994.
- Abdellah,
F.G., Beland, I.L., Martin, A., & Matheney, R.V. Patient-centered
approaches to nursing (2nd ed.). New York: Mac Millan. 1968.
- Abdellah,
F.G. Evolution of nursing as a profession: perspective on manpower
development. International Nursing Review, 1972); 19, 3..
Abdellah, F.G.). The nature of nursing science.
In L.H. Nicholl (Ed.), perspectives on nursing theory. Boston: Little,
Brown, 1986.
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