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Conceptual Models — Transcript

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0:00Akala mo basta alaga lang. Higit pa
0:03doon. Bagong aralin sa theoretical
0:06foundations. Tignan natin kung paano.
0:12All right. In this video, we are going
0:14to discuss nursing conceptual models.
0:18We are going to explore the foundation
0:20of theories that shape how we practice
0:22nursing. We will be learning about six
0:24incredible nurse theories whose work has
0:27transformed our profession. We have
0:30Martha Rogers, Dora, Orem, Emojan King,
0:34Betty Newman, Sister Calisteroy and
0:36Dorothy Johnson. Each of these women
0:39askal
0:40question. What is nursing and what makes
0:43it unique from medicine? Their answers
0:46have given us the frameworks that we use
0:49everyday to assess, plan, implement, and
0:52evaluate patient care. This is the
0:55nursing process. Okay. So by the end of
0:57this video you will not only understand
0:59each theory but also see how you can
1:03apply them in your own clinical
1:05practice. So we will start or we will
1:08first make sure that you understand what
1:11we're talking about when we say nursing
1:13conceptual models. Uh think of a
1:16conceptual model as a mental map or a
1:20framework.
1:21It is an organized way of thinking about
1:24complex phenomena in nursing. These
1:27models define unique nursing unique
1:30perspective. They will help us answer
1:34what do nurses focus on or what makes
1:37nursing different from other health
1:39professions like medicine or physical
1:40therapy. Why do this matter to you as a
1:44student nurse? Well, um they give us
1:47they give us a common language. When we
1:50talk about selfcare or adaptation we all
1:53understand what we mean. They guide how
1:56you assess your patients making nursing
1:59diagnosis, plan care and evaluate
2:02whether your interventions work. They
2:05also develop your critical thinking
2:07skills by teaching you to view patients
2:10from multiple perspectives. Nursing
2:13theories come in different levels. We
2:16have grand theories which we are going
2:18to cover today. I six theories na iyon
2:20they they are grand theories.
2:23These are the broadest and most
2:25comprehensive. We also have middle range
2:28theories. Yung pangalawa yung nasa
2:30gitna. Middle middle range theories are
2:33more focused on specific situations and
2:37we have the practice theories.
2:40Uh these are the most concrete guiding
2:43specific interventions. Okay. So ayan
2:48yung mga idi-discuss natin ngayon they
2:50are grand theories.
2:55Okay, let's have a recall of the nursing
2:57metaparadigm
2:59na I hope na-realize niyo or
3:02naintindihan niyo yung ibig sabihin ng
3:04nursing metaparadigm. So we will just
3:06have a quick recall. So when we say
3:08person this is the recipient of our
3:11care.
3:14Okay sa environment this includes
3:16everything around and within the person
3:18that affects their health or their
3:21physical surroundings, their families
3:23and social relationships, their culture,
3:26their economic situation and even their
3:28internal [nililinis ang lalamunan]
3:29psychological state. When we say health,
3:32we don't see health as simply the
3:34absence of disease. It is a continual a
3:38state of wellbeing that ranges from high
3:40level wellness to illness. And when we
3:44say nursing, this is what we do. It's
3:47the unique actions and interventions
3:49that nurses provide to help people
3:51achieve their highest level of health.
3:53So that's the nursing metaparadigm.
3:56Okay. So let's begin with Martha Rogers.
3:59She was born on May 12th, 1914
4:03which happens to be Florence
4:04Nightingale's birthday. So that seems
4:07like a wonderful sign for someone who
4:09would become one of nursing's most
4:12visionary thinkers.
4:15Rogers actually started college studying
4:17premet at the University of Tennessee.
4:21But she withdrew because of societal
4:23pressure that medicine was unsuitable
4:26for women. Can you imagine that? Grabe
4:30ha. But thankfully she turned to nursing
4:33instead. and our profession has never
4:35been the same. Her educational
4:38background is truly impressive. She
4:40earned her nursing diploma in 1936, then
4:43went on to get her a bachelor's degree
4:46and a master's degree and eventually a
4:49doctor of science degree from John
4:52Hopkins University. She was one of the
4:54most highly educated nurse theories of
4:57her era.
4:59Rogers spent 13 years in rural public
5:02health nursing and she even established
5:04the first visiting nurse service in
5:07Phoenix, Arizona.
5:10Later she became a professor and head of
5:13the division of nursing at New York
5:15University where she develop her
5:18revolutionary theory. Herin work was
5:21published in 1970 and she founded the
5:24society of Rogerian Scholars in 1986 to
5:28continue advancing her ideas.
5:31Martha Rogers called her theory the
5:33science of unitary human beings.
5:38She develop it over 20 years of research
5:40and scholarship.
5:42Rogers had a bold goal. She wanted to
5:45establish nursing as a unique basic
5:49science distinct from medicine she drew
5:53from many disciplines not just nursing
5:56okay but also anthropology psychology
5:59sociology astronomy physic mathematics
6:02and philosophy she was influenced by
6:06Florence Ntingingale's view of the
6:08person environment relationship but she
6:11took it much further um Rogers reject
6:14the tradition
6:16or the traditional medical model that
6:18tends to break human beings into parts
6:21the cardiovascular system the
6:23respiratory system and so on instead she
6:27proposed something revolutionary the
6:30simultaneity paradigm
6:33her core idea is that a human being is a
6:36unitary whole a reducible and
6:40indivisible you can understand a person
6:43by looking at their parts you have to
6:45look at the whole she uh she viewed both
6:49humans and the environment as energy
6:52fields that are integral with each other
6:55meaning there are not separate things
6:57that interact but rather one unified
7:01field she identified three principles of
7:04hemodynamics
7:06we have resonancy helicy and integrality
7:10when we say resonancy this is a constant
7:13wave change when we say helicy this is a
7:17continuous innovative evolution and
7:20integrality naman is a mutual
7:22simultaneous interaction of human and
7:25environmental fields
7:28for nursing practice this means our
7:30focus is not just on health and illness
7:34it's on the human environmental mutual
7:37process
7:38we promote wellbeing by helping patients
7:41recognize and strengthen and their own
7:43unique healing patterns.
7:47Now let's see how Mar Rogers interprets
7:50our four metaparadm concepts. For
7:53person, Rogers defines a unitary human
7:56being an irreducible indivisible energy
8:00field identified by pattern. The keyword
8:03here is unitary. The person is more than
8:06the sum of their parts. For
8:09environmentan, it's also an irreducible
8:13energy field that's integral with the
8:16human field. This is what makes Roger so
8:19revolutionary. She says humans and
8:22environment are one, not separate. They
8:26don't just interact. They are integrat.
8:30And for health naman it is an expression
8:32of the life process. Health and illness
8:36are not opposites. They are both pattern
8:39manifestations of the human
8:41environmental mutual process. And for
8:44nursingan, it's both a science and an
8:48art. Nursing's unique focus is the human
8:51environmental mutual process. Nurses use
8:55their scientific knowledge and apply it
8:57creatively to promote health and
9:00wellbeing through pattern recognition
9:02and therapeutic pattering.
9:06So our key insight here is that Rogers
9:10reminds us to always see the whole
9:13person in front of us. Not just their
9:16diagnosis, not just their love values,
9:19but the unique irreducible human being
9:23and their life story.
9:26Next, let's meet Dorotea Orem.
9:30She was born in Baltimore, Maryland in
9:331914 and lived to be 92 years old.
9:38She died in 2007. Her father was a
9:41construction worker and her mother was a
9:44homemaker. Her older sister became a
9:47medical mission sister which inspired
9:51RM's interest in nursing.
9:55Or earned her nursing diploma from
9:57Providence Hospital School of Nursing in
9:59Washington DC and then went on to get
10:02both her bachelors and masters degrees
10:04in nursing education from the Catholic
10:06University of America.
10:09Her theory actually began to take shape
10:11while she was working as a nurse
10:13consultant for the for the Indiana State
10:16Board of Health from 1949 to 1957.
10:21She traveled extensively
10:23observing nurses in practice and she
10:26noticed something important. Nurses were
10:29doing many things but no one had clearly
10:32defined what nursing was uniquely
10:36responsible for. So this led her to ask
10:39a simple but profound question. When do
10:42people need nursing care? Her answer
10:45became the foundation of her selfcare
10:47deficit theory. She published her
10:50definitive work nursing concepts of
10:54practice in 1971 and it is now one of
10:57the most widely used nursing theories in
11:00the world.
11:03Arm's theory is actually composed of
11:05three interlocking theories that treat
11:07together like a puzzle. The first is
11:10theory of selfcare. This is the idea
11:13that people naturally engage in actions
11:15to maintain their own life, health and
11:18wellbeing. She called this selfcare. The
11:22ability to do this is selfcare agency
11:27and the total selfcare actions needed is
11:30the therapeutic selfcare demand.
11:35The second theory and the core of her
11:37grand theory is the theory of selfc
11:41deficit. This simply states that nursing
11:44is needed when a person's selfcare
11:46agency is inadequate to meet their
11:50therapeutic selfcare demand. In other
11:53words, when people cannot adequately
11:56care for themselves, that's when nurses
12:00step in.
12:02The third theory is the theory of
12:04nursing systems which describes how
12:07nurses provide care. So there are three
12:10systems. We have the holy compensatory
12:13system, partly compensatory system and
12:16the supportive educative
12:18uh system. When we say holy compensatory
12:22system the nurse provides total care for
12:26patients who cannot care for themselves
12:28at all. like an unconscious patient or a
12:32newborn the nurse does for the patient
12:37when we say partly compensatory system
12:40both the nurse and the patient perform
12:42care activities the patient can do some
12:45things but needs help with others like a
12:49post surgical patient who can feed
12:51themselves but needs help bathing or
12:55walking the nurse helps the patient do
12:58Okay. When we say holy compensatory, the
13:01nurse does for the patient. When we say
13:05partly compensatory, the nurse helps the
13:07patient do. When we say supportive
13:10educative system, the patient is capable
13:13of selfcare but needs guidance, support
13:16or teaching. This is where we help
13:18patients develop their own self-care
13:21agency like teaching a diabetic patient
13:24how to administer insulin or a new
13:26mother how to care for her. newborn baby
13:30the nurse supports and educates in this
13:34part in this system this is such a
13:36practical theory because it directly
13:38helps you determine how much care to
13:41provide and how to promote your
13:43patient's independence
13:47okay so let's look at how interprets the
13:50metaparadm or person
13:53sees individuals who have the capacity
13:56for selfcar They have physical,
13:59psychological, interpersonal and social
14:02components. What makes humans special,
14:06she says, is our ability to reflect on
14:08ourselves and our environment and to use
14:11that reflection to care for ourselves.
14:15And for environment naman it includes
14:17the physical, chemical, biological and
14:20social context where people live.
14:23Importantly, the environment includes
14:26factors that can affect a person's
14:28selfcare agency
14:30things like family, community, culture
14:32and physical surroundings.
14:35In for health is a state of soundness or
14:39wholeness of body and mind. Health is
14:42not just the absence of disease. It
14:45includes the ability to reflect, to
14:47symbolize experience and to engage in
14:50selfcare. Health is both a prerequisite
14:53for selfcare and something that selfcare
14:56helps maintain. And for nursing it is an
15:00art to which we give specialized
15:02assistance to people who have
15:04limitations in meeting their own selfc
15:08needs. Nursing is required when someone
15:12whether an adult or a dependent child is
15:15incapable of providing continuous
15:18effective selfcare. Our actions help uh
15:22help overcome or compensate for those
15:25limitations.
15:29Okay, here's a sample of a practical
15:31application. Okay. When you walk into a
15:33patient's room and ask yourself how much
15:36selfcare can this patient do
15:38independently and where do they need my
15:41help? The answer will tell you which of
15:45RM's three systems to use. Okay?
15:50Itong system na ito if we can use holy,
15:53partly or supportive.
15:59All right. Now, let's turn to king.
16:02Emojin king. She was born in West Point
16:04Ayowa in 1923 and grew up on a farm. Her
16:09uncle was a physician which sparked her
16:12interest in healthc.
16:14Mojin King earned her nursing diploma
16:16from St. John's Hospital School of
16:18Nursing in St. Louis and then got both
16:21her bachelors and master's degree in the
16:24nursing in nursing from St. Louis
16:26University she later earned her
16:29doctorate in education from teachers
16:31college Columbia University
16:34her theory development began in 1961
16:38when she was asked to develop a masters
16:40program in nursing at Loyola University
16:42in Chicago. She started with fundamental
16:45questions. What is the nursing act? What
16:49is the nursing process? What is the goal
16:52of nursing? Who needs nursing? Kasi
16:55kapag gagawa ka ng theory mo, there is
16:58always a question running on your mind.
17:01Okay? For you to create a theory.
17:05She published her conceptual framework
17:07in 1968 and then expanded it into a full
17:11theory in 1981.
17:13King received many honors including
17:16being named the first living legend by
17:18the American Academy of Nursing in 1996.
17:22Her work is especially important because
17:25it emphasizes something we now take for
17:27granted the nurse patient relationship
17:31and the importance of communication and
17:34shared decision making.
17:38Emojin king's theory is built on the
17:40idea of general systems theory viewing
17:44humans as open system interacting with
17:47their environment. She described three
17:50interacting systems. First the personal
17:54systems that is you as an individual.
17:58Key concepts here includes perception,
18:01self body image, growth and development,
18:05time and space. Each person perceives
18:08the world through their own unique lens,
18:11personal systems. Second, interpersonal
18:15systems. This is how individuals
18:17interact with one another. When we say
18:20interpersonal,
18:22individuals interact with one another.
18:25This is where the nurse patient
18:27relationship happens.
18:30Key concepts includes interaction,
18:32communication, transaction role and
18:36stress. The third one is the social
18:40systems.
18:42The larger systems that influence us
18:45like health care organizations,
18:47families, communities and the society.
18:51Concepts here include organization,
18:54authority, power, status and decision
18:58making.
19:00Now the theory of goal attainment
19:02specifically describes what happens in
19:05the nurse patient relationship.
19:09Okay, here's the process. The nurse and
19:12patient each bring their own
19:14perceptions, judgments, and actions into
19:18the interaction. Through communication
19:21they share information.
19:24together they identify problems and then
19:29and this is the key they mutually set
19:33goals. Mutually set goals. Hindi lang si
19:37nurse ang nagse-set ng goals both the
19:40patient and the nurse. They agree on the
19:43means to achieve those goals. And
19:47finally they act together and goals are
19:51attained. Okay. Theory of goal
19:54attainment.
19:56King says that when nurse and patient
19:57make transactions meaning they truly
20:00interact and agree goals are attained.
20:04When there's no transaction goals are
20:07not attained. So this is foundational
20:10for patient centered care. It reminds us
20:14that our patients are active partners in
20:17their care not passive recipients. So we
20:22don't just do things to patients. We
20:25work with them. We work with them.
20:30Okay. So here's how king defines the
20:32metaparadm concept. For person a this is
20:35a uh the person is a human being which
20:38is social, sentient, rational creature
20:43who perceives, thinks, feels, chooses,
20:47set goals and acts to achieve those
20:50goals. We are open systems interacting
20:53with our environment.
20:55Each person's perception of reality is
20:57unique and influences their behavior.
21:01For the environment, it is the
21:03background for human interaction, the
21:05internal and external surroundings that
21:08affect behavior. It's ever changing and
21:12provides the context for growth and
21:14development. King specifically
21:16identified time and space as important
21:19environmental concepts.
21:23For health it is a dynamic life
21:25experience that involves continuously
21:27adjusting to stress source in the
21:29internal and external environment.
21:33Health means using your resources
21:36optimally to achieve your maximum
21:38potential for daily living. It is the
21:40ability to function in your social
21:43roles. As for nursing, it is a process
21:47of action, reaction and interaction
21:50where nurse and client share information
21:52about their perceptions.
21:55We communicate, set goals mutually and
21:58then act to achieve those goals. Our
22:02goal is to help individuals attain,
22:05maintain or restore health or to help
22:08them die with dignity.
22:13Okay? When you are working with
22:14patients, remember king's theory. They
22:18don't just tell you don't just tell them
22:20what to do. You ask them about their
22:23perceptions, their concerns, and their
22:26goals. When patients are involved in
22:28setting their own goals, they're much
22:30more likely to achieve those goals.
22:37Okay, next up is Betty Newman. She was
22:39born in 1924 on a farm near Lowel, Ohio
22:43and she grew up in a rural community.
22:46She was the middle child with two
22:48brothers. Newman had an adventurous
22:51spirit. Before
22:53fully committing to nursing, she worked
22:56briefly as a fashion model and even
22:58learned to fly a plane. Her rural
23:01upbringing gave her a deep appreciation
23:03for systems thinking and how everything
23:06in nature is interconnected. Her
23:09educational journey took her from an RN
23:11diploma earned in 1947 as part of the
23:15cadet nurse corps
23:18to a bachelor's degree in public health
23:20and psychology from UCLA to a master's
23:24degree in mental health and public
23:26health consultation also from UCLA and
23:30finally a PhD in clinical psychology her
23:34education span nursing
23:37public health and psychology which is
23:40why her theory is so holistic thean
23:44system model actually begin actually
23:47begun in 1970 as a graduate course
23:50guided guide is a graduate course guide
23:54at ucla her students needed a framework
23:57that integrated psycholog physiological
24:00psychological sociocultural
24:03developmental and spiritual aspects of
24:05the person she first published the model
24:08in 1972 and it's now in its fifth
24:11edition.
24:13While it was developed for education,
24:15it's been widely adopted in clinical
24:18practice worldwide.
24:22Betty Newman's model uses a systems
24:24approach. She was influenced by general
24:27systems theory theory by guestal or
24:30guestal theory which emphasizes viewing
24:33the whole person and stress theory at
24:37the center of her model is the basic
24:39structure or central core these are the
24:43fundamental survival factors common to
24:46all organisms like normal temperature
24:48range, genetic structure, response
24:51patterns and organ function.
24:55surrounding this core are protective
24:57layers called lines of defense and
25:00resistance
25:02the flexible line of defense is the
25:05outer dynamic protective layer things
25:09like adequate sleep good nutrition and
25:12exercise strengthen this line. We also
25:15have the normal line of defense. It
25:18represents the person's usual state of
25:20wellness, their stable state over time.
25:25And we also have the lines of
25:27resistance. These are internal
25:29protective factors that activate
25:32automatically when stressers break
25:34through the normal line of defense like
25:37the immune system kicking in. Stressers
25:41are what threaten the system. They can
25:44be intrapersonal, interpersonal and
25:47extrapersonal. When we say intrapersonal
25:50stressers it is within the person like
25:54pain or anxiety.
25:57When when we talk about interpersonal
25:59stressers, these are stress between
26:03people like family, family conflict or
26:06role expectations. And then lastly we
26:09have the extra personal stress. This are
26:12outside the person like job loss or
26:15financial problems or anong stressor
26:17angatake sa inyo ngayon. There is so
26:21nursing interventions are called
26:23prevention as intervention and there are
26:27three levels. We have the primary
26:29secondary and the tertiary prevention.
26:32When we talk about primary prevention
26:34these are prevention or interventions
26:37before a stressor penetrates
26:41we strengthen the flexible line of
26:43defense through health education,
26:46immunizations and lifestyle
26:48modification. Primary prevention iyon.
26:52When we talk about secondary prevention,
26:54these are
26:56interventions after a stressor has
26:59penetrated.
27:01We strengthen the lines of resistance
27:03through medical treatment and symptom
27:07management.
27:08And then we have the tertiary
27:10prevention. These are
27:13interventions after stability is
27:16restored. We help maintain stability,
27:20prevent recurrence and promote
27:23rehabilitation.
27:25Pag sinabing primary,
27:28ito yung mga health education, health
27:30teachings and immunizations and
27:32lifestyle modification. Pag secondary
27:35prevention,
27:37um when we talk about disease, meron ng
27:40disease and ginagamot na siya. This is
27:42the secondary prevention. And when we
27:45talk about tertiary, ito naman yung more
27:47on rehabilitation na nalagpasan niyo
27:50yung secondary. Nagamot siya sa
27:53secondary prevention and then sa
27:55rehabilitation na siya. When we talk
27:57about tertiary we will prevent
28:00recurrence
28:03okay let's see how Newman interprets the
28:05metaparadigm.
28:07For person we are unique open systems in
28:12constant dynamic interaction with the
28:14environment.
28:16Newman views us through five interacting
28:19variables. Physiological, psychological,
28:23sociocultural and cultural
28:26sociocultural, developmental and
28:28spiritual. When we talk about physical
28:31or physiological
28:33these are body structure and functions
28:36body structure and functions
28:39physiological
28:40when we say psychological
28:43these are mental processes. Psychomental
28:46processes. When we talk about
28:48sociocultural of course from the word
28:50itself social and cultural functions.
28:54Developmental naman developmental life
28:58developmental process and spiritual of
29:01course spiritual beliefs and influences.
29:04The person seeks to maintain system
29:07stability kaya nga human system. Okay?
29:11For environment naman it includes all
29:13internal and external factors that
29:16surround and affect the client system.
29:19Human actually identified three
29:21environments. We have the internal,
29:24external and the created.
29:27Okay. Sinabing internal these are
29:30factors within the person. Within the
29:34person agternal, these are factors
29:37outside the person external outside. And
29:41created naman these are environment.
29:43This is the environment the person
29:45develops unconsciously through their own
29:48perceptions and coping mechanisms
29:51created developed. Okay. Stressors arise
29:55from the environment.
29:58Okay. For health naman, for health,
30:02it is a continuum from wellness to
30:05illness. Health equals the degree of
30:08system's stability. When a system needs
30:11are mets
30:16are not met toward illness optimal
30:20health means maintaining maximum
30:22stability and integrity
30:26for nursing naman,
30:28we are concerned with all the variables
30:30affecting an individual's response to
30:33stress. Our concern is to prevent stress
30:37invasion, protect the client's basic
30:40structure and help attain or maintain
30:42maximum wellness. We do this through
30:45primary, secondary and tertiary
30:47prevention.
30:49So why does this matter? Okay. Why does
30:52it matter? New human's model is
30:55incredibly practical. It helps you
30:58systematically assess all the stressers
31:00affecting your patient not just the
31:03physical ones and plan interventions at
31:07the appropriate level of prevention.
31:16Let me for a
31:20next one we have Sister Kalistoroy. She
31:23was born in Los Angeles in 1939 and is a
31:26member of the sisters of St. Joseph of
31:29Carandalet and a Roman Catholic
31:32religious congregation.
31:35Her religious faith and commitment to
31:37serve deeply influence her view of
31:39nursing and human dignity. Roy earned
31:42her bachelor's degree in nursing from
31:44Mount St. Mary's College in Los Angeles.
31:48Then went to UCLA for her master's
31:50degree in pediatric nursing.
31:53Interestingly, she also earned both a
31:55master's degree and a PhD in sociology.
31:58This dual background in nursing and
32:01sociology gave her a unique perspective
32:03on human adaptation.
32:06The story of how her theory began is
32:08wonderful. While she was a graduate
32:10student at UCLA, her mentor who was none
32:13other than Dorothy Johnson challenged
32:16her to develop a conceptual a conceptual
32:19model of nursing. Roy was inspired by
32:22observing children in her pediatric
32:24nursing practice. She was amazed by
32:27their resilience and their ability to
32:29adapt to major health challenges or
32:32changes. She first implemented her model
32:35in nursing curriculum in 1970,
32:37published her first book on it in 1976
32:41and went on to become a professor at
32:44Boston College for over 20 years. Her
32:47model has been used internationally for
32:50over 50 years now.
32:54As the name suggest, Sister Calisteroid
32:57model is all about adaptation.
33:00She was influenced by psychologist Harry
33:03Helson's adaptation level theory and
33:06general systems theory. The model starts
33:09with stimulgers
33:11the need to adapt stimules
33:15of stimul we have the focal, contextual
33:18and residual stimulai. When we say focal
33:21stimuli, this is what most immediately
33:24confronts the person focal.
33:28When we talk about contextual stimul all
33:31other factors present these are all
33:33other factors present that contribute to
33:36the situation
33:39and the residual are beliefs attitudes
33:43or traits whose effects are not entirely
33:48clear. People have two coping processes
33:51for dealing with stimuli. We have the
33:53regulator subsystem and the cognitor
33:55subsystem. When we say regular regulator
34:00subsystem these are these are our
34:02automatic neural chemical responses like
34:06our fight or flight response.
34:10Itong fight or flight response, ito
34:12iyung biglaan mo na lang biglang
34:15reaksyon ng katawan mo if there is
34:18emergency like kunwari example of this
34:20is fight or flight. Response is kunwari
34:24um nagkaroon ng sunog. Nagkaroon ng
34:26sunog and yung syempre yung adrenaline
34:29mo biglang nag-rush biglang nag-hype
34:34yung mga bagay na hindi mo usually
34:36nabubuhat on a regular ah day. Bigla mo
34:39siyang mabubuhat. dahil yun yung sinabi
34:41ng autonomic response system ng katawan
34:46mo. Yun yung fight or flight. Kung
34:48example hindi mo nabubuhat yung washing
34:50machine pero dahil nga may sunog bigla
34:52mong nabuhat yung washing machine. That
34:54is your fight or flight response. We
34:58also have the cognitor subsystem.
35:01These are our cognitive emotive pathways
35:05involving perception, learning, judgment
35:07and emotions.
35:11Okay, we can observe adaptation in four
35:13modes. We have the physiological,
35:17self-ccept, role function and
35:20interdependence. So when we say
35:22physiological physical mode this is how
35:25our body responds. Iyung oxygenation,
35:28nutrition, elimination etc. That is your
35:31physiological physical mode. And when we
35:34say self-concept group identity mode,
35:37this is how we perceive ourselves.
35:40This is how we perceive ourselves. Yung
35:43selfccept. Okay. This is your body
35:47image, your selfem and your identity.
35:51And when we talk about role function
35:53mode, this is how we perform our roles
35:55in society.
35:57Role function is how we perform our
36:00roles. And when we talk about
36:03interdependence mode, this is how we
36:06relate to significant others. How we
36:09relate to significant others
36:11interdependence mode. This is how we
36:14relate to significant others and our
36:17support systems. The goal of nursing is
36:20to promote positive adaptation in all
36:24four modes. When adaptation is
36:26successful, the person achieves health,
36:29quality of life and dignity in dying.
36:34Okay. So, here's how Roy defines the
36:37four metaparadigm concepts. For person,
36:40we are adaptive systems
36:43holes with parts that function together.
36:47Humans are holistic adaptive systems
36:50with biological,
36:52psychological and social attributes. We
36:55are in constant interaction with a
36:57changing environment and must adapt to
37:00survive.
37:02We have two coping subsystems, the
37:04regulator and the cognitor and manifest
37:07adaptation through four modes.
37:11Ha? For environment, it includes all
37:14conditions, circumstances and influences
37:17that surround and affect us. The
37:20environment is the arena where
37:22adaptation occurs. It is composed of
37:25stimuli. We have the focal, contextual
37:28and residual that challenge us to adapt.
37:31The environment provides both challenges
37:34and resources. For health naman, it is
37:37both a state and a process of being and
37:40becoming an integrated and whole person.
37:44Health is not just the absence of
37:45disease. It is successful adaptation to
37:49environmental stimulity
37:52to meet our goals for survival, growth,
37:55reproduction, mastery and personal
37:58integrity.
38:00Health exist on a continuum
38:03and for nursing it is the science and
38:06practice that expands people's adaptive
38:09abilities and enhances person
38:12environment transformation. Our goal is
38:15to promote adaptation in each of the
38:17four modes. Thereby contributing to
38:20health, quality of life and dying with
38:24dignity. We use the nursing process to
38:26assess behavior and stimul make
38:28diagnosis set goals, implement
38:31interventions to manage stimul and
38:34evaluate whether adaptation was
38:36promoted.
38:38Okay, this is a sample clinical
38:41application. When caring for a patient
38:43adapting to a new diagnosis or
38:45disability, think about all four modes.
38:50How are they adapting physically? How is
38:53their self-ccept affected? Can they
38:56still perform their usual roles? What is
38:59happening with their support system? Yan
39:02yung mga question na itatanong niyo when
39:05applying Sister Calisteroid's
39:08theory
39:10or adaptation theory.
39:13Next up, we have our final theorist. She
39:16is Dorothy Johnson.
39:19Darty Johnson was born in Savannah,
39:22Georgia in 1919 and was the youngest of
39:26children. She graduated from high school
39:29at age 17 and began college but took a
39:33year off during the great depression and
39:37that's when she discovered her calling
39:39as a nurse. Johnson earned her
39:42associates degree from Armstrong Jr.
39:44College. her BSN from Banderbilt
39:48University. She graduated with honors
39:51and her master of public health degree
39:54from Harvard University. Her education
39:57combined nursing with public health,
40:00giving her a broad perspective on health
40:03and behavior.
40:05From 1949 until her retirement in 1978,
40:09Johnson was a professor at UCLA and
40:13here's a wonderful connection. She was
40:16sister calister Royce mentor during
40:18Roy's graduate studies.
40:21Johnson challenged Roy to adopt or to
40:24develop a conceptual model which led to
40:27the Roy adaptation model. We just
40:29learned a while ago in 194 in 1959
40:33Johnson did something revolutionary. She
40:36introduced the concept of nursing
40:38diagnosis to differentiate nursing from
40:41medicine.
40:43Before this before this nurses primarily
40:46used medical diagnosis and Johnson
40:49argued that nursing needed its own
40:52diagnostic language. She first formally
40:55proposed her behavioral system model in
40:581968 and published her definitive work
41:00on it in 1980. So what is the difference
41:04of medical diagnosis to nursing
41:06diagnosis? Yung medical diagnosis guys
41:09that is the actual disease.
41:12is the actual disease kunwari for
41:15example umunta
41:20there is a patient na nag-se ng medical
41:25assistance sa er and upon arrival si
41:29patient is uh her the patient's
41:33manifestation or the patient signs and
41:34symptoms are vomiting and vomiting and
41:39loose bowel movement or diarrhea
41:41diarrhea is also a medical term. It's
41:43not a it's not a nursing diagnosis. So
41:47medically uh the doctor will diagnose
41:51the patient of acute gastroentitis.
41:55acute gastroenteritis. There's
41:56inflammation in the um stomach and the
42:01colon of the patient that prompt them to
42:05vomit and to
42:07have a loose bowel movement para magtae.
42:11So ang medical diagnosis diyan is the
42:14acute gastroentitis. sa ating mga nurses
42:17we do not use we of course we will use
42:20that as a guide pero on our charting we
42:22do not use the age as the diagnosis or
42:26we do not use the acute gastro
42:27internetis as the diagnosis we use our
42:30own nursing diagnosis and kapag gagawa
42:35tayo ng nursing diagnosis
42:37ia-align natin doon ang ating nursing
42:40process pag-aaralan natin yung nursing
42:43process later on the nursing process is
42:45the widely used process of our nurse ah
42:49nursing profession NCP nursing process
42:53uh nursing care plan yan yung merong
42:55assessment diagnosis planning
42:58intervention and evaluation iyung adp
43:01on the diagnosis part we use the nursing
43:04diagnosis so ano ang gagawin nating
43:06nursing diagnosis doon sa patient with
43:08age we will look for the possible
43:12problem
43:14we will look for the possible problem
43:16based doon sa signs and symptoms ng
43:19patient. For example, the patient is
43:21risk for ah fluid volume deficit. Hindi
43:27natin gagamitin ng dehydration because
43:29that is a medical term. Risk for fluid
43:32volume. Uh risk for fluid volume deficit
43:37related to loose bowel movement. We
43:40don't use diarrhea. We use loose bowel
43:43movement and vomiting.
43:46Okay. So yan yung magiging nursing
43:49diagnosis na pinropose ni Dorothy
43:52Johnson. Pinahirap ba tayo ni Dorothy
43:54Johnson? Medyo pero ang kagandahan nito,
43:57mas specific yung pagpa-plan natin ng
44:00care doon sa patient dahil iniisa-isa
44:03natin yung complaints niya. I mean um
44:07iniisa-isa natin or bine-breakdown natin
44:09'yung signs and symptoms niya or 'yung
44:12problem nung patient. Okay? So later on
44:16yan mahahasa kayo sa paggawa ng nursing
44:20care plan using the nursing process.
44:24Yan. Congratulations guys. Pagagawin ko
44:27kayo ng nursing care plan soon after
44:29nating ma-discuss ang NCP or the nursing
44:33process. Okay. Dorothy Johnson's theory
44:35was driven by a fundamental question.
44:38What makes nursing unique from medicine?
44:42Her answer was elegant. Medicine focus
44:45on the biological system. Diseease,
44:48pathology, physiology.
44:51Yan diyan nag-focus ang medicine while
44:54sa nursingan, nursing focuses on the
44:57behavioral system, how people behave in
45:00response to health challenges. Johnson
45:03viewed the human being as having two
45:06major systems. The biological system
45:09which is the domain of medicine and the
45:11behavioral system which is the domain of
45:15nursing. A behavioral system is
45:17organized into seven subsystems.
45:21Ayan andiyan. Andiyan na iyan sa powerpo
45:25natin.
45:28This one. This.
45:31So we have the achievement. Affiliative,
45:34aggressive, protective, dependency,
45:37ingestive, eliminative and sexual. Okay.
45:41When ito yung mga subsystems ni Dorothy
45:45Johnson when we talk about achievement
45:47this attempts to master and control the
45:50environment.
45:53Sa affiliative naman, this is
45:54attachment, behavior, forming
45:57relationships and belonging. When we
46:00talk about aggressive naman, it is
46:02defending or aggressive or protective.
46:05This is defending and protecting ones
46:07from threats.
46:10Dependency seeking help, attention and
46:13approval from others.
46:18Sinong dependent sa inyo?
46:21Gaguhin niyo na yan. Dapat
46:21magingindependent na kayo. Okay.
46:24Ingestive. ingestive these are behaviors
46:26around food intake when how what how
46:30much we eat ian sa ah ingestive
46:33behavioral system next one is
46:35eliminative this is the beha your
46:38behavior around ways elimination and
46:42that'sual this is procreation and
46:44gratification including gender identity
46:47and sexual expression
46:51the behavioral system naturally seeks
46:53balance and stability. When stress
46:56disrupt the system, imbalance
47:00and that's when nursing is needed. Our
47:03role is to help restore, maintain or
47:06attain behavioral balance and stability.
47:09Johnson believe each subsystem has three
47:12functional requirement. It must be
47:14protected from noxous influences,
47:17nurtured through appropriate input and
47:20stimulated for growth and development.
47:25And finally let's see how Johnson
47:26interprets the metaparadm for person we
47:30are behavioral systems organized
47:34integrated holes made up of seven
47:36behavioral systems. We strive to
47:39maintain balance and stability through
47:42patterned repetitive behaviors.
47:45John distinguishes between our
47:47biological system medicine focus and our
47:50behavioral system which is the nursing
47:52focus and for the environment it
47:55includes all factors that are not part
47:58of the behavioral system but influence
48:00it this includes the social setting
48:03physical surroundings and uh cultural
48:07context stressers from the environment
48:10can disrupt our behavioral balance the
48:13environment also provides resource
48:16needed to maintain balance. Importantly,
48:20Johnson believe nurses can modify the
48:22environment to support the patient's
48:24behavioral system. And for health, it is
48:27a purposeful adaptive response to
48:30internal and external stimul to maintain
48:32stability and comfort. Health means the
48:36efficient and effective functioning of
48:38the behavioral system. When the system
48:40is balanced and stable we are healthy.
48:44Illness occurs when there's imbalance or
48:46inefficiency.
48:48Health is the ability to function
48:50effectively in our behavioral roles. As
48:54for nursingan, she viewed it that we are
48:58an external regulatory force that acts
49:01to preserve the organization and
49:03integration of the patient's behavior
49:06at an optimal level.
49:09This happens when the patient's behavior
49:11is threatening to health or when health
49:14is threatened.
49:16Our goal is to poster efficient and
49:18effective behavioral functioning to
49:20prevent illness. Our interventions help
49:24restore, maintain or attain behavioral
49:27balance and stability.
49:30Johnson's theory reminds us that nursing
49:32has a unique focus that is different
49:35from medicine. While physicians treat
49:38disease, nurses help patients adapt
49:41their behavior to maintain or restore
49:45health.
49:52Now let's pull it all together with this
49:53comparison table. As you can see each
49:57theories has a unique perspective on the
49:59four metaparadigm concepts. Roger sees
50:02the person as a unitary energy field
50:05integral with the environment. RMAC
50:12king emphasizes the person
50:16goal setting being and human views the
50:19person as an open system with five
50:22variables.
50:24Roy sees the person as an adaptive
50:26system and Johnson views the person as a
50:29behavioral system with seven subsystems.
50:33And notice how their views of nursing
50:35differ to Rogers focuses on pattern
50:38recognition
50:40on compensating for self care deficits.
50:43King on mutual goal setting. Newman on
50:46prevention at three levels. Roy on
50:49promoting adaptation and Johnson on
50:52regulating behavioral systems. So I want
50:55to emphasize something important. No
50:58single theory is right or best. Each
51:01offers a different lens through which to
51:04view and understand nursing practice
51:07depending on your patient and your
51:09clinical situation. One theory might be
51:12more useful than the other. So the more
51:15theories you understand, the more tools
51:17you have in your nursing tool kit.
51:22Okay? You might be wondering why do I
51:24need to learn all these theories? How
51:26will this help me as a nurse? Okay,
51:29that's a great question.
51:31In your clinical practice, these
51:33theories provide a systematic framework
51:34for assessing patients. They teach you
51:37what to look for and how to organize
51:40your observations. They guide your
51:42nursing diagnosis, help you plan
51:45individualized care, suggest appropriate
51:48interventions, and give you criteria for
51:50evaluating whether your care worked. For
51:53example, um, RMS theory helps you
51:56determine how much assistance a patient
51:59needs. Should you do everything for
52:01them, help them do it your themselves,
52:05or teach them to do it independently? In
52:08your professional development, these
52:10theories develop your critical thinking
52:12by teaching you to view patients from
52:15multiple perspectives. They give you a
52:18professional language to communicate
52:20with other nurses. They establish
52:23nursing as a unique profession with its
52:25own body of knowledge and they prepare
52:28you for evidence-based practice.
52:32Okay. So here are some practical tips
52:34for applying these theories. Use Rogers
52:36when you want to focus on the whole
52:39person and their unique life story. Use
52:43ORM when determining how much care to
52:47provide and how to promote independence.
52:52Use keing when communication and goal
52:55setting with your patient are key and
52:59new naman when assessing multiple
53:01stressors and planning prevention
53:04strategies
53:06this is when your patient needs to adapt
53:09to health changes and kay Dorothy
53:11Johnson naman is when your patient
53:14behavioral patterns are disrupted
53:23Okay, before we open up for questions,
53:25let me leave you. Oh, I cannot open up
53:27for a question because this is a
53:28recorded video, right? So, let me leave
53:31you with this key takeaways. Wait, one
53:33for each theories.
53:36Martha Rogers tau us that humans and
53:38environment are integral energy fields.
53:41Nursing promotes pattern recognition and
53:43wellbeing. So always see the the whole
53:46person kay Martha Rogers
53:49unitary human being. Kay Dorot Orem
53:52naman she gave us the selfcare deficit
53:55theory. Nursing helps when people cannot
53:59care for themselves using three systems.
54:03Holy compensatory. partly compensatory
54:05and supportive educated always promote
54:09independence
54:11emojin king showed us that nurse and
54:13patient are partners who communicate
54:17interact and transact to achieve
54:20mutually set goals. Always collaborate
54:24with your patients. Kay Betty Newman she
54:27developed the systems model. Humans are
54:30open systems with lines of defense and
54:33nursing uses primary, secondary and
54:36tertiary prevention to maintain
54:37stability. So always think preventively.
54:41K sister Kalistaroy she gave us the
54:44adaptation model. Humans are adaptive
54:47systems and nursing promotes adaptation
54:50in four modes. So always support your
54:53patient's adaptation.
54:55Kay Dorothy Johnson she taught us that
54:58humans are behavioral systems with seven
55:01subsystems.
55:03Nursing restores behavioral balance and
55:05stability. So always consider the
55:07behavioral impact of health challenges.
55:11So no single theory is right or best.
55:14Each offers a different lens and the
55:16more lenses you have the better nurses
55:19you will be.
55:22natin.

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