Faye G. Abdellah Patient-Centered A pproaches to Nursing

1. Faye G. AbdellahPatient-Centered Approaches to Nursing Nursing Theory Presentation Keesha Holden-White & Marie Laramee

2. Faye G. Abdellah Background • Born -March 1919 • Nursing Diploma from Fitkin Memorial Hospital Columbia University • Bachelors Degree in Nursing 1945 • Masters Degree in Physiology 1947 • Doctorate in Education 1955 Accomplishments(McEwen, 2007) U.S. Public Health Service • Chief Nurse Officer • Deputy U.S. Surgeon General Uniformed Services University of Health Sciences • Founder and First Dean, Graduate School of Nursing Yale University School of Nursing • Nursing Instructor Research (Lessing, 2004) • Assisted in international nursing research studies during the Korean War (China, Japan, Australia, Russia) • Abdellah’s research findings led to the first federally-tested coronary care unit in Connecticut • Theory and research data led to the establishment of the Office of Long-Term Care Dr. Faye Glenn Abdellah RN, Ed.D., Sc.D., FAANRADM(Ret.), USPHS

3. Faye G. Abdellah’s Theory 1960 Abdellah’s model describes concerns of nursing rather than a theory describing relationships among phenomena. Her theory provides a foundation for determining and organizing nursing care (McEwen, • “Nursing is based on an art and science that mold 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” (Nursing Theories, 2010) • Originated from nursing practice & desire to promote patient-centered comprehensive care • Shifts focus of the profession from disease centered to patient centered • Concepts of health, nursing problems, and problem solving are interrelated • Describes nursing as a service to society (McEwen & Wills, 2007)

4. Patient-Centered Approaches to Nursing is…….. A Human Needs Theory Human beings have universal and objective needs for health and autonomy and a right to their optimal satisfaction. Focus • Nursing Education • Nursing Practice Purpose To guide patient care in the hospital and community settings (McEwen, 2007) “What is patient-centered care?” http://www.youtube.com/watch?v=C4Ijr4E2870

5. Abdellah’s Typology of Nursing Problems(Nursing Theories, 2010) • Purpose To provide a method to evaluate a student’s experiences and means of evaluating a nurse’s competency based on outcome measures • Three Areas • Physical, sociological, and emotional needs of the patient • Types of interpersonal relationships between the nurse and the patient • The common elements of patient care

6. Abdellah’s Typology of Nursing Problems • To promote good hygiene and physical comfort • To promote optimal activity, exercise, rest, and sleep • To promote safety through 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 deformities • 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 physiologic responses of the body to disease conditions • To facilitate the maintenance of regulatory mechanisms and functions • To facilitate the maintenance of sensory function • 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 nonverbal communication • To promote the development of productive interpersonal relationships • To facilitate progress toward achievement of personal spiritual goals • To create and maintain a therapeutic environment • To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs • To accept the optimum possible goals in light of physical and emotional limitations • 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 cause of illness Purpose To guide care and promote use of nursing judgment (McEwen & Willis, 2007)

7. 10 Ways to Identify a Client’s Problem • Learn to know the patient • Sort out relevant and significant data • Analyze and make generalizations about available data • Identify the therapeutic plan • Test generalizations with the patient and make additional generalizations • Validate the patient’s conclusion about his nursing problems • Continue to observe and evaluate the patient over 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 nurse feels about the patient’s nursing problems • Discuss and develop a comprehensive nursing care plan (McEwen & Wills, 2007)

8. Requirements of Care 21 Nursing Problems “Nursing is the use of problem solving approach with key nursing problems related to health needs of people” (Abdellah et al., 1960) Classified in 4 Levels • Sustenal Care • Remedial Care • Restorative Care • Preventative Care Sorted into 4 groups • Problems r/t comfort, hygiene and safety • Physiologic Balance • Psychological and Social Factors • Sociologic and Community Factors Nursing Diagnosis (Nursing Theory, 2010)

9. 2000Inducted into the National Women’s Hall of Fame(www.greatwomen.org) “We cannot wait for the world to change.......... Those of us with intelligence, purpose, and vision must take the lead and change the world. Let us move forward together!......I promise never to rest until my work has been completed!” – Faye G. Abdellah (www.encyclopedia.com)

10. Applying Abdellah’s Theory to Current Nursing Practice Marie: • I find that parts of the theory fit my physician office work well as it states that it “aims to help people, sick or well, cope with their health needs” (Nursing Theories, 2010) and that is the goal of primary care in physician offices. • The 21 nursing problems are relevant to the office setting just as they are to the hospital. Keesha • In the critical care setting, my current practice has shifted from nursing care exclusive to the disease to addressing the patient’s immediate health care needs. Abdellah’s Theory equips me with specific guidelines as to how I can better manage a variety of patient conditions in the ICU. • Abdellah’s “Ten Ways of Identifying a Client’s Problem” is utilized in the clinical setting and are necessary in initiating and implementing the nursing care plan. • Nursing programs encourage nursing students to utilize patient- centered approaches in the clinical setting • Problem solving approach is utilized by practitioners in guiding treatment plans within their practice. Especially within practices that deals with clients who have specific health care needs and specific nursing problems (Nursing Theories, 2010)