8ehablllLaLlon nurses work wlLh paLlenLs who are recoverlng from chronlc lllnesses ln[urles or dlsablllLles

nurses help paLlenLs LranslLlon Lo furLher lndependence bulld sLrengLh and moblllLy and adapL Lo Lhelr
slLuaLlons ln order Lo care for Lhemselves as much as posslble
8ehablllLaLlon nurses work ln hosplLals LranslLlonal care faclllLles and ln paLlenLs homes 1hey look aL paLlenLs
hollsLlcally Lo besL care for Lhelr paLlenLs provldlng supporL physlcally emoLlonally and splrlLually Lo ensure
Lhe paLlenLs are prepared Lo Lake care of Lhemselves when Lhey need Lo 1hls means nurses have Lo be paLlenL
and compasslonaLe buL should also know when Lo push Lhelr paLlenLs ln order for Lhem Lo progress and
recover
nurses skllls lnclude baslc nurslng care such as changlng dresslngs and Laklng vlLals as well as physlcal and
occupaLlonal Lherapy and helplng paLlenLs wlLh dally acLlvlLles such as baLhlng and dresslng
kehab|||tat|on Nurs|ng 1heor|es and Mode|s
O rlcksons Modellng and 8ole Modellng 1heory
O lngs 1heory of Coal ALLalnmenL
O neumans SysLems Model
O rems SelfCare ueflclL nurslng 1heory
O rlandos nurslng rocess ulsclpllne 1heory
O eplaus 1heory of lnLerpersonal 8elaLlons
O arses Puman 8ecomlng 1heory
O 8ogers 1heory of unlLary Puman 8elngs
O 8oys AdapLaLlon Model of nurslng
O olcabas 1heory of ComforL
O JaLsons hllosophy and Sclence of Carlng
O nlghLlngales nvlronmenL 1heory
O enders PealLh romoLlon Model
O 8operLogan1lerneys Model for nurslng 8ased on a Model of Llvlng
O Mercers MaLernal 8ole ALLalnmenL 1heory
O Pendersons nurslng need 1heory


Neumans Systems Mode|

8eLLy neumans SysLems Model provldes a comprehenslve hollsLlc and sysLembased approach Lo nurslng LhaL
conLalns an elemenL of flexlblllLy 1he Lheory focuses on Lhe response of Lhe paLlenL sysLem Lo acLual or
poLenLlal envlronmenLal sLressors and Lhe use of prlmary secondary and LerLlary nurslng prevenLlon
lnLervenLlon for reLenLlon aLLalnmenL and malnLenance of paLlenL sysLem wellness

1he baslc assumpLlons of Lhe model are
ach paLlenL sysLem ls a unlque composlLe of facLors and characLerlsLlcs wlLhln a range of responses conLalned
ln a baslc sLrucLure
Many known unknown and unlversal sLressors exlsL ach dlffer ln Lhelr poLenLlal for upseLLlng a cllenLs usual
sLablllLy level
ach paLlenL has evolved a normal range of responses Lo Lhe envlronmenL referred Lo as Lhe normal llne of
defense lL can be used as a sLandard by whlch Lo measure healLh devlaLlon
1he parLlcular lnLerrelaLlonshlps of paLlenL varlables can aL any polnL ln Llme affecL Lhe degree Lo whlch a
cllenL ls proLecLed by Lhe flexlble llne of defense agalnsL posslble reacLlon Lo sLressors
Jhen Lhe flexlble llne of defense ls lncapable of proLecLlng Lhe paLlenL agalnsL an envlronmenLal sLressor LhaL
sLressor breaks Lhrough Lhe llne of defense
1he cllenL ls a dynamlc composlLe of Lhe lnLerrelaLlonshlps of Lhe varlables wheLher ln a sLaLe of lllness or
wellness Jellness ls on a conLlnuum of avallable energy Lo supporL Lhe sysLem ln a sLaLe of sLablllLy
ach paLlenL has lmpllclL lnLernal reslsLance facLors known as L8 whlch funcLlon Lo sLablllze and reallgn Lhe
paLlenL Lo Lhe usual sLaLe of wellness
rlmary prevenLlon ls applled ln paLlenL assessmenL and lnLervenLlon ln ldenLlflcaLlon and reducLlon of
posslble or acLual rlsk facLors
Secondary prevenLlon relaLes Lo sympLomaLology followlng a reacLlon Lo sLressors approprlaLe ranklng of
lnLervenLlon prlorlLles and LreaLmenL Lo reduce Lhelr noxlous effecLs
1erLlary prevenLlon relaLes Lo ad[usLlve processes Laklng place as reconsLlLuLlon beglns and malnLenance
facLors move Lhem back ln a cycle Loward prlmary prevenLlon
1he paLlenL ls ln dynamlc consLanL energy exchange wlLh Lhe envlronmenL
9ep|au theory
eplau publlshed her 1heory of lnLerpersonal 8elaLlons ln 1932 and ln 1968 lnLerpersonal Lechnlques became
Lhe crux of psychlaLrlc nurslng 1he 1heory of lnLerpersonal 8elaLlons ls a mlddlerange descrlpLlve
classlflcaLlon Lheory lL was lnfluenced by Penry SLack Sulllvan erclval Symonds Abraham Maslow and neal
lger Mlller

1he four componenLs of Lhe Lheory are person whlch ls a developlng organlsm LhaL Lrles Lo reduce anxleLy
caused by needs envlronmenL whlch conslsLs of exlsLlng forces ouLslde of Lhe person and puL ln Lhe conLexL
of culLure healLh whlch ls a word symbol LhaL lmplles forward movemenL of personallLy and oLher oLher
human processes Loward creaLlve consLrucLlve producLlve personal and communlLy llvlng

1he nurslng model ldenLlfles four sequenLlal phases ln Lhe lnLerpersonal relaLlonshlp orlenLaLlon
ldenLlflcaLlon explolLaLlon and resoluLlon

1he orlenLaLlon phase deflnes Lhe problem lL sLarLs when Lhe nurse meeLs Lhe paLlenL and Lhe Lwo are
sLrangers AfLer deflnlng Lhe problem Lhe orlenLaLlon phase ldenLlfles Lhe Lype of servlce needed by Lhe
paLlenL 1he paLlenL seeks asslsLance Lells Lhe nurse whaL he or she needs asks quesLlons and shares
preconcepLlons and expecLaLlons based on pasL experlences ssenLlally Lhe orlenLaLlon phase ls Lhe nurses
assessmenL of Lhe paLlenLs healLh and slLuaLlon

1he ldenLlflcaLlon phase lncludes Lhe selecLlon of Lhe approprlaLe asslsLance by a professlonal ln Lhls phase
Lhe paLlenL beglns Lo feel as lf he or she belongs and feels capable of deallng wlLh Lhe problem whlch
decreases Lhe feellng of helplessness and hopelessness 1he ldenLlflcaLlon phase ls Lhe developmenL of
a nurs|ng care p|an based on Lhe paLlenLs slLuaLlon and goals

1he explolLaLlon phase uses professlonal asslsLance for problemsolvlng alLernaLlves 1he advanLages of Lhe
professlonal servlces used are based on Lhe needs and lnLeresLs of Lhe paLlenLs ln Lhe explolLaLlon phase Lhe
paLlenL feels llke an lnLegral parL of Lhe helplng envlronmenL and may make mlnor requesLs or use aLLenLlon
geLLlng Lechnlques Jhen communlcaLlng wlLh Lhe paLlenL Lhe nurse should use lnLervlew Lechnlques Lo
explore undersLand and adequaLely deal wlLh Lhe underlylng problem 1he nurse musL also be aware of Lhe
varlous phases of communlcaLlon slnce Lhe paLlenLs lndependence ls llkely Lo flucLuaLe 1he nurse should help
Lhe paLlenL explolL all avenues of help as progress ls made Loward Lhe flnal phase 1hls phase ls Lhe
lmplemenLaLlon of Lhe nurslng plan Laklng acLlons Loward meeLlng Lhe goals seL ln Lhe ldenLlflcaLlon phase
1he flnal phase ls Lhe resoluLlon phase lL ls Lhe LermlnaLlon of Lhe professlonal relaLlonshlp slnce Lhe paLlenLs
needs have been meL Lhrough Lhe collaboraLlon of paLlenL and nurse 1hey musL sever Lhelr relaLlonshlp and
dlssolve any Lles beLween Lhem 1hls can be dlfflculL for boLh lf psychologlcal dependence sLlll exlsLs 1he
paLlenL drlfLs away from Lhe nurse and breaks Lhe bond beLween Lhem A healLhler emoLlonal balance ls
achleved and boLh become maLure lndlvlduals 1hls ls Lhe evaluaLlon of Lhe nurs|ng process 1he nurse and
paLlenL evaluaLe Lhe slLuaLlon based on Lhe goals seL and wheLher or noL Lhey were meL

1he goal of psychodynamlc nurslng ls Lo help undersLand ones own behavlor help oLhers ldenLlfy felL
dlfflculLles and apply prlnclples of human relaLlons Lo Lhe problems LhaL come up aL all experlence levels
eplau explalns LhaL nurslng ls LherapeuLlc because lL ls a heallng arL asslsLlng a paLlenL who ls slck or ln need
of healLh care lL ls also an lnLerpersonal process because of Lhe lnLeracLlon beLween Lwo or more lndlvlduals
who have a common goal 1he nurse and paLlenL work LogeLher so boLh become maLure and knowledgeable ln
Lhe care process

1he nurse has a varleLy of roles ln Plldegard eplaus nurslng Lheory 1he slx maln roles are sLranger Leacher
resource person counselor surrogaLe and leader

As a sLranger Lhe nurse recelves Lhe paLlenL ln Lhe same way Lhe paLlenL meeLs a sLranger ln oLher llfe
slLuaLlons 1he nurse should creaLe an envlronmenL LhaL bullds LrusL As a Leacher Lhe nurse lmparLs
knowledge ln reference Lo Lhe needs or lnLeresLs of Lhe paLlenL ln Lhls way Lhe nurse ls also a resource
person provldlng speclflc lnformaLlon needed by Lhe paLlenL LhaL helps Lhe paLlenL undersLand a problem or
slLuaLlon 1he nurses role as a counselor helps Lhe paLlenL undersLand and lnLegraLe Lhe meanlng of currenL
llfe slLuaLlons as well as provlde guldance and encouragemenL ln order Lo make changes As a surrogaLe Lhe
nurse helps Lhe paLlenL clarlfy Lhe domalns of dependence lnLerdependence and lndependence and acLs as
an advocaLe for Lhe paLlenL As a leader Lhe nurse helps Lhe paLlenL Lake on maxlmum responslblllLy for
meeLlng hls or her LreaLmenL goals AddlLlonal roles of a nurse lnclude Lechnlcal experL consulLanL LuLor
soclallzlng and safeLy agenL envlronmenL manager medlaLor admlnlsLraLor record observer and researcher

Some llmlLaLlons of eplaus Lheory lnclude Lhe lack of emphasls on healLh promoLlon and malnLenance LhaL
lnLrafamlly dynamlcs personal space conslderaLlons and communlLy soclal servlce resources are less
consldered lL canL be used on a paLlenL who ls unable Lo express a need and some areas are noL speclflc
enough Lo generaLe a hypoLhesls

Cr|andos Nurs|ng 9rocess

1be uyoomlc Notselotleot kelotloosblp publlshed ln 1961 and wrlLLen by lda !ean rlando descrlbed
rlandos nurslng rocess ulsclpllne 1heory 1he ma[or dlmenslons of Lhe model explaln LhaL Lhe role of Lhe
nurse ls Lo flnd ouL and meeL Lhe paLlenLs lmmedlaLe needs for help 1he paLlenLs presenLlng behavlor mlghL
be a cry for help Powever Lhe help Lhe paLlenL needs may noL be whaL lL appears Lo be 8ecause of Lhls
nurses have Lo use Lhelr own percepLlon LhoughLs abouL percepLlon or Lhe feellng engendered from Lhelr
LhoughLs Lo explore Lhe meanlng of Lhe paLlenLs behavlor 1hls process helps nurses flnd ouL Lhe naLure of Lhe
paLlenLs dlsLress and provlde Lhe help he or she needs

1he concepLs of Lhe Lheory are funcLlon of professlonal nurslng presenLlng behavlor lmmedlaLe reacLlon
nurslng process dlsclpllne and lmprovemenL

1he funcLlon of professlonal nurslng ls Lhe organlzlng prlnclple 1hls means flndlng ouL and meeLlng Lhe
paLlenLs lmmedlaLe needs for help Accordlng Lo rlando nurslng ls responslve Lo lndlvlduals who suffer or
who anLlclpaLe a sense of helplessness lL ls focused on Lhe process of care ln an lmmedlaLe experlence and ls
concerned wlLh provldlng dlrecL asslsLance Lo a paLlenL ln whaLever seLLlng Lhey are found ln for Lhe purpose
of avoldlng rellevlng dlmlnlshlng or curlng Lhe sense of helplessness ln Lhe paLlenL 1he nurslng rocess
ulsclpllne 1heory labels Lhe purpose of nurslng Lo supply Lhe help a paLlenL needs for hls or her needs Lo be
meL 1haL ls lf Lhe paLlenL has an lmmedlaLe need for help and Lhe nurse dlscovers and meeLs LhaL need Lhe
purpose of nurslng has been achleved

resenLlng behavlor ls Lhe paLlenLs problemaLlc slLuaLlon 1hrough Lhe presenLlng behavlor Lhe nurse flnds
Lhe paLlenLs lmmedlaLe need for help 1o do Lhls Lhe nurse musL flrsL recognlze Lhe slLuaLlon as problemaLlc
8egardless of how Lhe presenLlng behavlor appears lL may represenL a cry for help from Lhe paLlenL 1he
presenLlng behavlor of Lhe paLlenL whlch ls consldered Lhe sLlmulus causes an auLomaLlc lnLernal response ln
Lhe nurse whlch ln Lurn causes a response ln Lhe paLlenL

1he lmmedlaLe reacLlon ls Lhe lnLernal response 1he paLlenL percelves ob[ecLs wlLh hls or her flve senses
1hese percepLlons sLlmulaLe auLomaLlc LhoughL and each LhoughL sLlmulaLes an auLomaLlc feellng causlng Lhe
paLlenL Lo acL 1hese Lhree lLems are Lhe paLlenLs lmmedlaLe response 1he lmmedlaLe response reflecLs how
Lhe nurse experlences hls or her parLlclpaLlon ln Lhe nursepaLlenL relaLlonshlp
1he nurslng process dlsclpllne ls Lhe lnvesLlgaLlon lnLo Lhe paLlenLs needs Any observaLlon shared and
explored wlLh Lhe paLlenL ls lmmedlaLely useful ln ascerLalnlng and meeLlng hls or her need or flndlng ouL he
or she has no needs aL LhaL Llme 1he nurse cannoL assume LhaL any aspecL of hls or her reacLlon Lo Lhe paLlenL
ls correcL helpful or approprlaLe unLll he or she checks Lhe valldlLy of lL by explorlng lL wlLh Lhe paLlenL 1he
nurse lnlLlaLes Lhls exploraLlon Lo deLermlne how Lhe paLlenL ls affecLed by whaL he or she says and does
AuLomaLlc reacLlons are lneffecLlve because Lhe nurses acLlon ls deLermlned for reasons oLher Lhan Lhe
meanlng of Lhe paLlenLs behavlor or Lhe paLlenLs lmmedlaLe need for help Jhen Lhe nurse doesnL explore
Lhe paLlenLs reacLlon wlLh hlm or her lL ls reasonably cerLaln LhaL effecLlve communlcaLlon beLween nurse
and paLlenL sLops

lmprovemenL ls Lhe resoluLlon Lo Lhe paLlenLs slLuaLlon ln Lhe resoluLlon Lhe nurses acLlons are noL
evaluaLed lnsLead Lhe resulL of hls or her acLlons are evaluaLed Lo deLermlne wheLher hls or her acLlons
served Lo help Lhe paLlenL communlcaLe hls or her need for help and how lL was meL ln each conLacL Lhe
nurse repeaLs a process of learnlng how he or she can help Lhe paLlenL 1he nurses own lndlvlduallLy as well
as LhaL of Lhe paLlenL requlres golng Lhrough Lhls each Llme Lhe nurse ls called upon Lo render servlce Lo Lhose
who need hlm or her

rlandos model of nurslng makes Lhe followlng assumpLlons
Jhen paLlenLs are unable Lo cope wlLh Lhelr needs on Lhelr own Lhey become dlsLressed by feellngs of
helplessness
ln lLs professlonal characLer nurslng adds Lo Lhe dlsLress of Lhe paLlenL
aLlenLs are unlque and lndlvldual ln how Lhey respond
nurslng offers moLherlng and nurslng analogous Lo an adulL who moLhers and nurLures a chlld
1he pracLlce of nurslng deals wlLh people envlronmenL and healLh
aLlenLs need help communlcaLlng Lhelr needs Lhey are uncomforLable and amblvalenL abouL Lhelr
dependency needs
eople are able Lo be secreLlve or expllclL abouL Lhelr needs percepLlons LhoughLs and feellngs
1he nursepaLlenL slLuaLlon ls dynamlc acLlons and reacLlons are lnfluenced by boLh Lhe nurse and Lhe paLlenL
eople aLLach meanlngs Lo slLuaLlons and acLlons LhaL arenL apparenL Lo oLhers
aLlenLs enLer lnLo nurslng care Lhrough medlclne
1he paLlenL ls unable Lo sLaLe Lhe naLure and meanlng of hls or her dlsLress wlLhouL Lhe help of Lhe nurse or
wlLhouL hlm or her flrsL havlng esLabllshed a helpful relaLlonshlp wlLh Lhe paLlenL
Any observaLlon shared and observed wlLh Lhe paLlenL ls lmmedlaLely helpful ln ascerLalnlng and meeLlng hls
or her need or flndlng ouL LhaL he or she ls noL ln need aL LhaL Llme
nurses are concerned wlLh Lhe needs Lhe paLlenL ls unable Lo meeL on hls or her own
1he nurse uses Lhe sLandard nurslng process ln rlandos nurslng rocess ulsclpllne 1heory whlch follows
assessmenL dlagnosls plannlng lmplemenLaLlon and evaluaLlon 1he Lheory focuses on Lhe lnLeracLlon
beLween Lhe nurse and paLlenL percepLlon valldaLlon and Lhe use of Lhe nurslng process Lo produce poslLlve
ouLcomes or paLlenL lmprovemenL rlandos key focus was Lhe deflnlLlon of Lhe funcLlon of nurslng 1he
model provldes a framework for nurslng buL Lhe use of her Lheory does noL exclude nurses from uslng oLher
nurslng Lheorles whlle carlng for paLlenLs
9arses numan

arses Puman 8ecomlng 1heory guldes Lhe pracLlce of nurses Lo focus on quallLy of llfe as lL ls descrlbed and
llved 1he human becomlng Lheory of nurslng presenLs an alLernaLlve Lo boLh Lhe convenLlonal blomedlcal
approach as well as Lhe blopsychosoclalsplrlLual approach of mosL oLher Lheorles and models of nurslng
arses model raLes quallLy of llfe from each persons own perspecLlve as Lhe goal of Lhe pracLlce of nurslng
8osemarle 8lzzo arse flrsL publlshed Lhe Lheory ln 1981 as Lhe ManllvlnghealLh Lheory and Lhe name was
changed Lo Lhe human becomlng Lheory ln 1992
1he assumpLlons underplnnlng Lhe Lheory were synLheslzed from works by uropean phllosophers 1he Lheory
ls sLrucLured around Lhree abldlng Lhemes meanlng rhyLhmlclLy and Lranscendence
1he model makes assumpLlons abouL man and becomlng as well as Lhree ma[or assumpLlons abouL human
becomlng
1he Puman 8ecomlng 1heory makes Lhe followlng assumpLlons abouL man
1he human ls coexlsLenL whlle coconsLlLuLlng rhyLhmlcal paLLerns wlLh Lhe unlverse
1he human ls open freely chooslng meanlng ln a slLuaLlon as well as bearlng responslblllLy for declslons made
1he human ls unlLary conLlnuously coconsLlLuLlng paLLerns of relaLlng
1he human ls Lranscendlng mulLldlmenslonally wlLh Lhe posslbles
1he Puman 8ecomlng 1heory makes Lhe followlng assumpLlons abouL becomlng
8ecomlng ls unlLary wlLh humanllvlnghealLh
8ecomlng ls a rhyLhmlcally coconsLlLuLlng Lhe humanunlverse process
8ecomlng ls Lhe humans paLLerns of relaLlng value prlorlLles
8ecomlng ls an lnLersub[ecLlve process of Lranscendlng wlLh Lhe posslbles
8ecomlng ls Lhe unlLary humans emerglng
1he Lhree ma[or assumpLlons abouL human becomlng are meanlng rhyLhmlclLy and Lranscendence
under Lhe assumpLlon meanlng human becomlng ls freely chooslng personal meanlng ln slLuaLlons ln Lhe
lnLersub[ecLlve process of llvlng value prlorlLles Mans reallLy ls glven meanlng Lhrough llved experlences ln
addlLlon man and envlronmenL cocreaLe
8hyLhmlclLy sLaLes LhaL human becomlng ls cocreaLlng rhyLhmlcal paLLerns of relaLlng ln muLual process wlLh
Lhe unlverse Man and envlronmenL cocreaLe (lmaglng valulng languaglng) ln rhyLhmlcal paLLerns
1ranscendence explalns LhaL human becomlng ls coLranscendlng mulLldlmenslonally wlLh emerglng
posslblllLles lL refers Lo reachlng ouL and beyond Lhe llmlLs a person seLs and LhaL one consLanLly Lransforms
1hese Lhree Lhemes are permeaLed by four posLulaLes llllmlLablllLy paradox freedom and mysLery
llllmlLablllLy ls Lhe lndlvlslble unbounded knowlng exLended Lo lnflnlLy Lhe allaLonce rememberlng and
prospecLlng wlLh Lhe momenL aradox ls an lnLrlcaLe rhyLhm expressed as a paLLern preference aradoxes
are noL opposlLes Lo be reconclled or dllemmas Lo be overcome buL raLher llved rhyLhms lreedom ls
conLexLually consLrued llberaLlon eople are free Lo conLlnuously choose ways of belng wlLh Lhelr slLuaLlons
MysLery ls Lhe unexplalnable LhaL whlch cannoL be compleLely known
1he nurslng model deflnes Lhe person (referred Lo as man LhroughouL Lhe Lheory) as an open belng who ls
more Lhan and dlfferenL from Lhe sum of Lhe parLs 1he envlronmenL ls everyLhlng ln Lhe person and hls or her
experlences 1he envlronmenL ls lnseparable from Lhe person as well as complemenLary Lo and evolvlng wlLh
Lhe person PealLh ls Lhe open process of belng and becomlng and lnvolves Lhe synLhesls of values nurslng ls
descrlbed as a human sclence and arL LhaL uses an absLracL body of knowledge Lo help people
1he Lheory provldes a LransformaLlve approach Lo all levels of nurslng lL dlffers from Lhe LradlLlonal nurslng
process parLlcularly ln LhaL lL does noL seek Lo flx problems 1he model glves nurses Lhe ablllLy Lo see Lhe
paLlenLs perspecLlve 1hls allows Lhe nurse Lo be wlLh Lhe paLlenL and gulde hlm or her Loward Lhe healLh
goals 1he nursepaLlenL relaLlonshlp cocreaLes changlng healLh paLLerns nurses llve Lhe arL of human
becomlng ln presences wlLh Lhe unfoldlng of meanlng synchronlzlng rhyLhms and Lranscendence
8osemarle 8lzzo arses Puman 8ecomlng 1heory lncludes Lhe 1oLallLy aradlgm whlch sLaLes LhaL man ls a
comblnaLlon of blologlcal psychologlcal soclologlcal and splrlLual facLors lL also lncludes Lhe slmulLanelLy
paradlgm whlch sLaLes LhaL man ls a unlLary belng ln conLlnuous muLual lnLeracLlon wlLh Lhe envlronmenL
arses Lheory lncludes a symbol wlLh Lhree elemenLs
1he black and whlLe colors represenL Lhe opposlLe paradox slgnlflcanL Lo onLology of human becomlng whlle
green represenLs hope
1he [olnlng ln Lhe cenLer of Lhe symbol represenLs Lhe cocreaLed muLual human unlverse process aL Lhe
onLologlcal level and Lhe nursepaLlenL process
1he green and black swlrls lnLerLwlnlng represenL Lhe humanunlverse cocreaLlon as an ongolng process of
becomlng
Llke any Lheory arses Puman 8ecomlng 1heory has sLrengLhs and weaknesses 1he model dlfferenLlaLes
nurslng from oLher dlsclpllnes lL provldes guldance of care and useful admlnlsLraLlon and ls useful ln
educaLlon 1he model also provldes research meLhodologles and provldes a framework Lo gulde lnqulry of
oLher Lheorles Powever Lhe research ls consldered a closed clrcle 1he resulLs are rarely quanLlflable 1haL
ls Lhe resulLs are dlfflculL Lo compare Lo oLher research sLudles slnce Lhere ls no conLrol group or sLandardlzed
quesLlons 1he Lheory does noL uLlllze Lhe nurslng process and negaLes Lhe ldea LhaL each paLlenL engages ln a
unlque llved experlence lL ls noL accesslble Lo new nurses and ls lnappllcable Lo acuLe emergenL care

kogers 1heory of Un|tary numan
MarLha 8ogers 1heory of unlLary Puman 8elngs vlews nurslng as boLh a sclence and an arL 1he unlqueness
of nurslng llke any oLher sclence ls ln Lhe phenomenon cenLral Lo lLs focus 1he purpose of nurses ls Lo
promoLe healLh and wellbelng for all persons wherever Lhey are 1he developmenL of 8ogers absLracL sysLem
was sLrongly lnfluenced by an early groundlng ln arLs as well as a background ln sclence and lnLeresL ln space
1he sclence of unlLary human belngs began as a synLhesls of ldeas and facLs
1he nurslng Lheory provldes a way Lo vlew Lhe unlLary human belng who ls lnLegral wlLh Lhe unlverse 1he
unlLary human belng and hls or her envlronmenL are one nurslng focuses on people and Lhe manlfesLaLlons
LhaL emerge from Lhe muLual humanenvlronmenLal fleld process A change of paLLern and organlzaLlon of Lhe
human and envlronmenLal flelds ls LransmlLLed by waves 1he manlfesLaLlons of Lhe fleld paLLernlng LhaL
emerge are observable evenLs 8y ldenLlfylng Lhe paLLern Lhere can be a beLLer undersLandlng of human
experlence
1here are elghL concepLs ln 8ogers nurslng Lheory energy fleld openness paLLern pandlmenslonallLy
homeodynamlc prlnclples resonance hellcy and lnLegrallLy
1he energy fleld ls Lhe fundamenLal unlL of boLh Lhe llvlng and Lhe nonllvlng lL provldes a way Lo vlew people
and Lhe envlronmenL as lrreduclble wholes 1he energy flelds conLlnuously vary ln lnLenslLy denslLy and
exLenL 1here are no boundarles LhaL sLop energy flow beLween Lhe human and envlronmenLal flelds whlch ls
Lhe openness ln 8ogers Lheory
8ogers deflnes paLLern as Lhe dlsLlngulshlng characLerlsLlc of an energy fleld seen as a slngle wave lL ls an
absLracLlon and glves ldenLlLy Lo Lhe fleld andlmenslonallLy ls deflned as nonllnear domaln wlLhouL spaLlal
or Lemporal aLLrlbuLes 1he parameLers LhaL humans use ln language Lo descrlbe evenLs are arblLrary and Lhe
presenL ls relaLlve Lhere ls no Lemporal orderlng of llves
Pomeodynamlc prlnclples posLulaLe a way of vlewlng unlLary human belngs 1he Lhree prlnclples of
homeodynamlcs are resonancy hellcy and lnLegrallLy 8esonancy ls an ordered arrangemenL of rhyLhm
characLerlzlng boLh Lhe human and envlronmenLal flelds LhaL undergo conLlnuous dynamlc meLamorphosls ln
Lhe human envlronmenLal process Pellcy descrlbes Lhe unpredlcLable nonllnear evoluLlon of energy flelds as
seen ln nonrepeaLlng rhyLhmlclLles and posLulaLes an orderlng of Lhe human evoluLlonary emergency
lnLegrallLy covers Lhe muLual conLlnuous relaLlonshlp of Lhe human and envlronmenLal flelds Changes occur
by Lhe conLlnuous repaLLernlng of Lhe human and envlronmenLal flelds by resonance waves 1he flelds are
lnLegraLed lnLo each oLher buL are also unlque
ln 8ogers 1heory of unlLary Puman 8elngs a person ls deflned as an lndlvlslble pandlmenslonal energy fleld
ldenLlfled by paLLern and manlfesLlng characLerlsLlcs speclflc Lo Lhe whole and LhaL canL be predlcLed from
knowledge of Lhe parLs A person ls also a unlfled whole havlng lLs own dlsLlncL characLerlsLlcs LhaL canL be
vlewed by looklng aL descrlblng or summarlzlng Lhe parLs 8ogers also explalns LhaL people have Lhe capaclLy
Lo parLlclpaLe ln Lhe process of change 1he envlronmenL ls an lrreduclble pandlmenslonal energy fleld
ldenLlfled by paLLern and lnLegral wlLh Lhe human fleld 1he Lwo flelds coexlsL and are lnLegral Lo each oLher
8ogers deflnes healLh as an expresslon of Lhe llfe process lL ls Lhe characLerlsLlcs and behavlor comlng from
Lhe muLual slmulLaneous lnLeracLlon of Lhe human and envlronmenLal flelds and healLh and lllness are parL of
Lhe same conLlnuum 1he mulLlple evenLs occurrlng durlng Lhe llfe process show Lhe exLenL Lo whlch a person
ls achlevlng hls or her maxlmum healLh poLenLlal 1he evenLs vary ln Lhelr expresslons from greaLesL healLh Lo
Lhose condlLlons LhaL are lncompaLlble wlLh Lhe malnLalnlng llfe process
1he nurslng Lheory sLaLes LhaL nurslng encompasses Lwo dlmenslons nurslng as arL and nurslng as sclence
lrom Lhe sclence perspecLlve nurslng ls an organlzed body of knowledge speclflc Lo nurslng and arrlved aL by
sclenLlflc research and loglcal analysls 1he arL of nurslng ls Lhe creaLlve use of sclence Lo beLLer people and
Lhe creaLlve use of lLs knowledge ls Lhe arL of lLs pracLlce 8ogers clalms LhaL nurslng exlsLs Lo serve people
and Lhe safe pracLlce of nurslng depends on Lhe naLure and amounL of sclenLlflc nurslng knowledge Lhe nurse
brlngs Lo hls or her pracLlce
1he nurslng process has Lhree sLeps ln 8ogers 1heory of unlLary Puman 8elngs assessmenL volunLary muLual
paLLernlng and evaluaLlon
1he areas of assessmenL are Lhe LoLal paLLern of evenLs aL any glven polnL ln spaceLlme slmulLaneous sLaLes
of Lhe paLlenL and hls or her envlronmenL rhyLhms of Lhe llfe process supplemenLary daLa caLegorlcal dlsease
enLlLles subsysLem paLhology and paLLern appralsal 1he assessmenL should be a comprehenslve assessmenL
of Lhe human and envlronmenLal flelds
MuLual paLLernlng of Lhe human and envlronmenLal flelds lncludes
sharlng knowledge
offerlng cholces
empowerlng Lhe paLlenL
fosLerlng paLLernlng
evaluaLlon
repeaL paLLern appralsal whlch lncludes nuLrlLlon work/lelsure acLlvlLles wake/sleep cycles relaLlonshlps
paln and fear/hopes
ldenLlfy dlssonance and harmony
valldaLe appralsal wlLh Lhe paLlenL
selfreflecLlon for Lhe paLlenL
1o prepare nurses Lo pracLlce 8ogers model Lhe focus of nurslng currlculum should be Lhe Lransmlsslon of Lhe
body of knowledge Leachlng and pracLlclng LherapeuLlc Louch and conducLlng regular lnservlce educaLlon
mphasls should be on developlng selfawareness as a parL of Lhe paLlenLs envlronmenLal energy fleld as well
as Lhe dynamlc role of Lhe nurse paLLern manlfesLaLlon on Lhe paLlenL 1here should also be an emphasls on
laboraLory sLudy ln a varleLy of seLLlngs and Lhe lmporLance of Lhe use of medla ln educaLlon

koy
1he AdapLaLlon Model of nurslng was developed by SlsLer CalllsLa 8oy ln 1976 AfLer worklng wlLh uoroLhy
!ohnson 8oy became convlnced of Lhe lmporLance of descrlblng Lhe naLure of nurslng as a servlce Lo socleLy
1hls prompLed her Lo begln developlng her model wlLh Lhe goal of nurslng belng Lo promoLe adapLaLlon She
flrsL began organlzlng her Lheory of nurslng as she developed course currlculum for nurslng sLudenLs aL MounL
SL Marys College She lnLroduced her ldeas as a basls for an lnLegraLed nurslng currlculum
1he facLors LhaL lnfluenced Lhe developmenL of Lhe model lncluded famlly educaLlon rellglous background
menLors and cllnlcal experlence 8oys model asks Lhe quesLlons
Jho ls Lhe focus of nurslng care?
JhaL ls Lhe LargeL of nurslng care?
Jhen ls nurslng care lndlcaLed?
8oy explalned LhaL adapLaLlon occurs when people respond poslLlvely Lo envlronmenLal changes and lL ls Lhe
process and ouLcome of lndlvlduals and groups who use consclous awareness selfreflecLlon and cholce Lo
creaLe human and envlronmenLal lnLegraLlon

1he key concepLs of 8oys AdapLaLlon Model are made up of four componenLs person healLh envlronmenL
and nurslng
Accordlng Lo 8oys model a person ls a blopsychosoclal belng ln consLanL lnLeracLlon wlLh a changlng
envlronmenL Pe or she uses lnnaLe and acqulred mechanlsms Lo adapL 1he model lncludes people as
lndlvlduals as well as ln groups such as famllles organlzaLlons and communlLles 1hls also lncludes socleLy as a
whole
1he AdapLaLlon Model sLaLes LhaL healLh ls an lnevlLable dlmenslon of a persons llfe and ls represenLed by a
healLhlllness conLlnuum PealLh ls also descrlbed as a sLaLe and process of belng and becomlng lnLegraLed and
whole
1he envlronmenL has Lhree componenLs focal whlch ls lnLernal or exLernal and lmmedlaLely confronLs Lhe
person conLexLual whlch ls all sLlmull presenL ln Lhe slLuaLlon LhaL all conLrlbuLe Lo Lhe effecL of Lhe focal
sLlmulus and resldual whose effecLs ln Lhe currenL slLuaLlon are unclear All condlLlons clrcumsLances and
lnfluences surroundlng and affecLlng Lhe developmenL and behavlor of people and groups wlLh parLlcular
conslderaLlon of muLuallLy of person and earLh resources lncludlng focal conLexLual and resldual sLlmull
1he model lncludes Lwo subsysLems as well 1he cognaLor subsysLem ls a ma[or coplng process lnvolvlng four
cognlLlveemoLlve channels percepLual and lnformaLlon processlng learnlng [udgmenL and emoLlon 1he
regulaLor subsysLem ls a baslc Lype of adapLlve process LhaL responds auLomaLlcally Lhrough neural chemlcal
and endocrlne coplng channels
1he AdapLlve Model makes Len expllclL assumpLlons
1he person ls a blopsychosoclal belng
1he person ls ln consLanL lnLeracLlon wlLh a changlng envlronmenL
1o cope wlLh a changlng world a person uses coplng mechanlsms boLh lnnaLe and acqulred whlch are
blologlcal psychologlcal and soclal ln orlgln
PealLh and lllness are lnevlLable dlmenslons of a persons llfe
ln order Lo respond poslLlvely Lo envlronmenLal changes a person musL adapL
A persons adapLaLlon ls a funcLlon of Lhe sLlmulus he ls exposed Lo and hls adapLaLlon level
1he persons adapLaLlon level ls such LhaL lL comprlses a zone lndlcaLlng Lhe range of sLlmulaLlon LhaL wlll lead
Lo a poslLlve response
1he person has four modes of adapLaLlon physlologlc needs selfconcepL role funcLlon and lnLerdependence
nurslng accepLs Lhe humanlsLlc approach of valulng oLhers oplnlons and perspecLlves lnLerpersonal relaLlons
are an lnLegral parL of nurslng
1here ls a dynamlc ob[ecLlve for exlsLence wlLh Lhe ulLlmaLe goal of achlevlng dlgnlLy and lnLegrlLy
1here are also four lmpllclL assumpLlons whlch sLaLe
A person can be reduced Lo parLs for sLudy and care
nurslng ls based on causallLy
A paLlenLs values and oplnlons should be consldered and respecLed
A sLaLe of adapLaLlon frees a persons energy Lo respond Lo oLher sLlmull
1he goal of nurslng ls Lo promoLe adapLaLlon ln Lhe four adapLlve modes nurses also promoLe adapLaLlon for
lndlvlduals and groups ln Lhe four adapLlve modes Lhus conLrlbuLlng Lo healLh quallLy of llfe and dylng wlLh
dlgnlLy by assesslng behavlors and facLors LhaL lnfluence adapLlve ablllLles and by lnLervenlng Lo enhance
envlronmenLal lnLeracLlons 1he lour AdapLlve Modes of 8oys AdapLaLlon Model are physlologlc needs self
concepL role funcLlon and lnLerdependence
1he AdapLaLlon Model lncludes a slxsLep nurslng process
1he flrsL level of assessmenL whlch addresses Lhe paLlenLs behavlor
1he second level of assessmenL whlch addresses Lhe paLlenLs sLlmull
ulagnosls of Lhe paLlenL
SeLLlng goals for Lhe paLlenLs healLh
lnLervenLlon Lo Lake acLlons ln order Lo meeL Lhose goals
valuaLlon of Lhe resulL Lo deLermlne lf goals were meL
1hroughouL Lhe nurslng process Lhe nurse and oLher healLh care professlonals should make adapLaLlons Lo Lhe
nurslng care plan based on Lhe paLlenLs progress Loward healLh
o|cabas 1heory of Comfort
olcabas 1heory of ComforL was flrsL developed ln Lhe 1990s lL ls a mlddlerange Lheory for healLh pracLlce
educaLlon and research 1hls Lheory has Lhe poLenLlal Lo place comforL ln Lhe forefronL of healLhcare
Accordlng Lo Lhe model comforL ls an lmmedlaLe deslrable ouLcome of nurslng care
1he 1heory of ComforL was developed when aLherlne olcaba conducLed a concepL analysls of comforL LhaL
examlned llLeraLure from several dlsclpllnes lncludlng nurslng medlclne psychology psychlaLry ergonomlcs
and ngllsh AfLer Lhe Lhree forms of comforL and four conLexLs of hollsLlc human experlence were lnLroduced
a Laxonomlc sLrucLure was creaLed Lo gulde for Lhe assessmenL measuremenL and evaluaLlon of paLlenL
comforL Accordlng Lo olcaba comforL ls Lhe producL of hollsLlc nurslng arL
olcaba descrlbed comforL exlsLlng ln Lhree forms rellef ease and Lranscendence lf speclflc comforL needs of
a paLlenL are meL Lhe paLlenL experlences comforL ln Lhe sense of rellef lor example a paLlenL who recelves
paln medlcaLlon ln posLoperaLlve care ls recelvlng rellef comforL ase addresses comforL ln a sLaLe of
conLenLmenL lor example Lhe paLlenLs anxleLles are calmed 1ranscendence ls descrlbed as a sLaLe of
comforL ln whlch paLlenLs are able Lo rlse above Lhelr challenges 1he four conLexLs ln whlch paLlenL comforL
can occur are physlcal psychosplrlLual envlronmenLal and socloculLural
1he 1heory of ComforL conslders paLlenLs Lo be lndlvlduals famllles lnsLlLuLlons or communlLles ln need of
healLh care 1he envlronmenL ls any aspecL of Lhe paLlenL famlly or lnsLlLuLlonal surroundlngs LhaL can be
manlpulaLed by a nurse or loved one ln order Lo enhance comforL PealLh ls consldered Lo be opLlmal
funcLlonlng ln Lhe paLlenL as deflned by Lhe paLlenL group famlly or communlLy
ln Lhe model nurslng ls descrlbed as Lhe process of assesslng Lhe paLlenLs comforL needs developlng and
lmplemenLlng approprlaLe nurslng care plans and evaluaLlng Lhe paLlenLs comforL afLer Lhe care plans have
been carrled ouL nurslng lncludes Lhe lnLenLlonal assessmenL of comforL needs Lhe deslgn of comforL
measures Lo address Lhose needs and Lhe reassessmenL of comforL levels afLer lmplemenLaLlon AssessmenL
can be ob[ecLlve such as Lhe observaLlon of wound heallng or sub[ecLlve such as asklng Lhe paLlenL lf he or
she ls comforLable
olcaba lncludes deflnlLlons of key elemenLs of her nurslng Lheory as well PealLh care needs are deflned as
Lhose needs ldenLlfled by Lhe paLlenL and/or famlly ln a parLlcular nurslng pracLlce seLLlng lnLervenlng
varlables are facLors LhaL are noL llkely Lo change and over whlch healLh care provlders have llLLle conLrol
1hese varlables lnclude prognosls flnanclal slLuaLlon soclal supporL and oLhers PealLhseeklng behavlors are
Lhe behavlors of a paLlenL ln an efforL Lo flnd healLh lnsLlLuLlonal lnLegrlLy ls Lhe value flnanclal sLablllLy and
wholeness of healLh care organlzaLlons aL Lhe local reglonal sLaLe and naLlonal levels llnally besL pollcles are
proLocols and procedures developed by an lnsLlLuLlon for overall use afLer Lhe collecLlon of evldence
Iean Watson


1he hllosophy and Sclence of Carlng has four ma[or concepLs human belng healLh envlronmenL/socleLy and
nurslng
!ean JaLson refers Lo Lhe human belng as a valued person ln and of hlm or herself Lo be cared for respecLed
nurLured undersLood and asslsLed ln general a phllosophlcal vlew of a person as a fully funcLlonal lnLegraLed
self Puman ls vlewed as greaLer Lhan and dlfferenL from Lhe sum of hls or her parLs
PealLh ls deflned as a hlgh level of overall physlcal menLal and soclal funcLlonlng a general adapLlve
malnLenance level of dally funcLlonlng and Lhe absence of lllness or Lhe presence of efforLs leadlng Lo Lhe
absence of lllness
JaLsons deflnlLlon of envlronmenL/socleLy addresses Lhe ldea LhaL nurses have exlsLed ln every socleLy and
LhaL a carlng aLLlLude ls LransmlLLed from generaLlon Lo generaLlon by Lhe culLure of Lhe nurslng professlon as
a unlque way of coplng wlLh lLs envlronmenL
1he nurslng model sLaLes LhaL nurslng ls concerned wlLh promoLlng healLh prevenLlng lllness carlng for Lhe
slck and resLorlng healLh lL focuses on healLh promoLlon as well as Lhe LreaLmenL of dlseases JaLson
belleved LhaL hollsLlc healLh care ls cenLral Lo Lhe pracLlce of carlng ln nurslng She deflnes nurslng as a human
sclence of persons and human healLhlllness experlences LhaL are medlaLed by professlonal personal
sclenLlflc esLheLlc and eLhlcal human LransacLlons
1he nurslng process ouLllned ln Lhe model conLalns Lhe same sLeps as Lhe sclenLlflc research process
assessmenL plan lnLervenLlon and evaluaLlon 1he assessmenL lncludes observaLlon ldenLlflcaLlon and
revlew of Lhe problem as well as Lhe formaLlon of a hypoLhesls CreaLlng a care plan helps Lhe nurse
deLermlne how varlables would be examlned or measured and whaL daLa would be collecLed lnLervenLlon ls
Lhe lmplemenLaLlon of Lhe care plan and daLa collecLlon llnally Lhe evaluaLlon analyzes Lhe daLa lnLerpreLs
Lhe resulLs and may lead Lo an addlLlonal hypoLhesls
JaLsons model makes seven assumpLlons
Carlng can be effecLlvely demonsLraLed and pracLlced only lnLerpersonally
Carlng conslsLs of caraLlve facLors LhaL resulL ln Lhe saLlsfacLlon of cerLaln human needs
ffecLlve carlng promoLes healLh and lndlvldual or famlly growLh
Carlng responses accepL Lhe paLlenL as he or she ls now as well as whaL he or she may become
A carlng envlronmenL ls one LhaL offers Lhe developmenL of poLenLlal whlle allowlng Lhe paLlenL Lo choose Lhe
besL acLlon for hlm or herself aL a glven polnL ln Llme
A sclence of carlng ls complemenLary Lo Lhe sclence of curlng
1he pracLlce of carlng ls cenLral Lo nurslng
1he flrsL Lhree caraLlve facLors are Lhe phllosophlcal foundaLlon for Lhe sclence of carlng whlle Lhe remalnlng
seven derlve from LhaL foundaLlon 1he Len prlmary caraLlve facLors are
1he formaLlon of a humanlsLlcalLrulsLlc sysLem of values whlch beglns aL an early age wlLh Lhe values shared
by parenLs 1he sysLem of values ls medlaLed by Lhe nurses llfe experlences learnlng galned and exposure Lo
Lhe humanlLles lL ls percelved as necessary Lo Lhe nurses maLuraLlon whlch ln Lurn promoLes alLrulsLlc
behavlor Loward oLhers
1he lnsLallaLlon of falLhhope whlch ls essenLlal Lo Lhe caraLlve and curaLlve processes Jhen modern sclence
has noLhlng else Lo offer a paLlenL a nurse can conLlnue Lo use falLhhope Lo provlde a sense of wellbelng
Lhrough a bellef sysLem meanlngful Lo Lhe lndlvldual
1he culLlvaLlon of senslLlvlLy Lo ones self and Lo oLhers whlch explores Lhe need of nurses Lo feel an emoLlon
as lL presenLs lLself 1he developmenL of a nurses own feellng ls needed Lo lnLeracL genulnely and senslLlvely
wlLh paLlenLs 8y sLrlvlng Lo become more senslLlve Lhe nurse ls more auLhenLlc 1hls encourages selfgrowLh
and selfacLuallzaLlon ln boLh Lhe nurse and Lhe paLlenLs who lnLeracL wlLh Lhe nurse 1he nurses promoLe
healLh and hlgherlevel funcLlonlng only when Lhey form personLoperson relaLlonshlps
1he developmenL of a helplngLrusL relaLlonshlp whlch lncludes congruence empaLhy and warmLh 1he
sLrongesL Lool a nurse has ls hls or her mode of communlcaLlon whlch esLabllshes a rapporL wlLh Lhe paLlenL
as well as carlng by Lhe nurse CommunlcaLlon lncludes verbal and nonverbal communlcaLlon as well as
llsLenlng LhaL connoLes empaLheLlc undersLandlng
1he promoLlon and accepLance of Lhe expresslon of boLh poslLlve and negaLlve feellngs whlch need Lo be
consldered and allowed for ln a carlng relaLlonshlp because of how feellngs alLer LhoughLs and behavlor 1he
awareness of Lhe feellngs helps Lhe nurse and paLlenL undersLand Lhe behavlor lL causes
1he sysLemaLlc use of Lhe sclenLlflc meLhod for problemsolvlng and declslonmaklng whlch allows for conLrol
and predlcLlon and permlLs selfcorrecLlon 1he sclence of carlng should noL always be neuLral and ob[ecLlve
1he promoLlon of lnLerpersonal Leachlnglearnlng slnce Lhe nurse should focus on Lhe learnlng process as
much as Lhe Leachlng process undersLandlng Lhe persons percepLlon of Lhe slLuaLlon asslsLs Lhe nurse Lo
prepare a cognlLlve plan
1he provlslon for a supporLlve proLecLlve and/or correcLlve menLal physlcal socloculLural and splrlLual
envlronmenL whlch JaLson dlvldes lnLo lnLerdependenL lnLernal and exLernal varlables manlpulaLed by Lhe
nurse ln order Lo provlde supporL and proLecLlon for Lhe paLlenLs menLal and physlcal healLh 1he nurse musL
provlde comforL prlvacy and safeLy as parL of Lhe caraLlve facLor
AsslsLance wlLh saLlsfylng human needs based on a hlerarchy of needs slmllar Lo Maslows ach need ls
equally lmporLanL for quallLy nurslng care and Lhe promoLlon of Lhe paLlenLs healLh ln addlLlon all needs
deserve Lo be valued and aLLended Lo by Lhe nurse and paLlenL
1he allowance for exlsLenLlalphenomenologlcal forces whlch helps Lhe nurse Lo reconclle and medlaLe Lhe
lncongrulLy of vlewlng Lhe paLlenL hollsLlcally whlle aL Lhe same Llme aLLendlng Lo Lhe hlerarchlcal orderlng of
needs 1hls helps Lhe nurse asslsL Lhe paLlenL Lo flnd sLrengLh and courage Lo confronL llfe or deaLh
henomology ls a way of undersLandlng Lhe paLlenL from hls or her frame of reference xlsLenLlal psychology
ls Lhe sLudy of human exlsLence
JaLsons hlerarchy of needs beglns wlLh lowerorder blophyslcal needs whlch lnclude Lhe need for food and
fluld ellmlnaLlon and venLllaLlon nexL are Lhe lowerorder psychophyslcal needs whlch lnclude Lhe need for
acLlvlLy lnacLlvlLy and sexuallLy llnally are Lhe hlgher order needs whlch are psychosoclal 1hese lnclude Lhe
need for achlevemenL afflllaLlon and selfacLuallzaLlon
1he nea|th 9romot|on Mode|

1he PealLh romoLlon Model was deslgned by nola ! ender Lo be a complemenLary counLerparL Lo models
of healLh proLecLlon lL deflnes healLh as a poslLlve dynamlc sLaLe raLher Lhan slmply Lhe absence of dlsease
PealLh promoLlon ls dlrecLed aL lncreaslng a paLlenLs level of wellbelng 1he healLh promoLlon model
descrlbes Lhe mulLldlmenslonal naLure of persons as Lhey lnLeracL wlLhln Lhelr envlronmenL Lo pursue healLh
enders model focuses on Lhree areas lndlvldual characLerlsLlcs and experlences behavlorspeclflc cognlLlons
and affecL and behavloral ouLcomes 1he Lheory noLes LhaL each person has unlque personal characLerlsLlcs
and experlences LhaL affecL subsequenL acLlons 1he seL of varlables for behavlor speclflc knowledge and affecL
have lmporLanL moLlvaLlonal slgnlflcance 1he varlables can be modlfled Lhrough nurslng acLlons PealLh
promoLlng behavlor ls Lhe deslred behavloral ouLcome whlch makes lL Lhe end polnL ln Lhe PealLh romoLlon
Model 1hese behavlors should resulL ln lmproved healLh enhanced funcLlonal ablllLy and beLLer quallLy of llfe
aL all sLages of developmenL 1he flnal behavloral demand ls also lnfluenced by Lhe lmmedlaLe compeLlng
demand and preferences whlch can derall lnLended acLlons for promoLlng healLh
1he PealLh romoLlon Model makes four assumpLlons
lndlvlduals seek Lo acLlvely regulaLe Lhelr own behavlor
lndlvlduals ln all Lhelr blopsychosoclal complexlLy lnLeracL wlLh Lhe envlronmenL progresslvely Lransformlng
Lhe envlronmenL as well as belng Lransformed over Llme
PealLh professlonals such as nurses consLlLuLe a parL of Lhe lnLerpersonal envlronmenL whlch exerLs
lnfluence on people Lhrough Lhelr llfe span
SelflnlLlaLed reconflguraLlon of Lhe personenvlronmenL lnLeracLlve paLLerns ls essenLlal Lo changlng behavlor
1here are LhlrLeen LheoreLlcal sLaLemenLs LhaL come from Lhe model 1hey provlde a basls for lnvesLlgaLlve
work on healLh behavlors 1he sLaLemenLs are
rlor behavlor and lnherlLed and acqulred characLerlsLlcs lnfluence bellefs affecL and enacLmenL of healLh
promoLlng behavlor
ersons commlL Lo engaglng ln behavlors from whlch Lhey anLlclpaLe derlvlng personally valued beneflLs
ercelved barrlers can consLraln commlLmenL Lo acLlon a medlaLor of behavlor as well as acLual behavlor
ercelved compeLence or selfefflcacy Lo execuLe a glven behavlor lncreases Lhe llkellhood of commlLmenL Lo
acLlon and acLual performance of Lhe behavlor
CreaLer percelved selfefflcacy resulLs ln fewer percelved barrlers Lo a speclflc healLh behavlor
oslLlve affecL Loward a behavlor resulLs ln greaLer percelved selfefflcacy whlch can ln Lurn resulL ln
lncreased poslLlve affecL
Jhen poslLlve emoLlons or affecL are assoclaLed wlLh a behavlor Lhe probablllLy of commlLmenL and acLlon ls
lncreased
ersons are more llkely Lo commlL Lo and engage ln healLhpromoLlng behavlors when slgnlflcanL oLhers model
Lhe behavlor expecL Lhe behavlor Lo occur and provlde asslsLance and supporL Lo enable Lhe behavlor
lamllles peers and healLh care provlders are lmporLanL sources of lnLerpersonal lnfluence LhaL can lncrease
or decrease commlLmenL Lo and engagemenL ln healLhpromoLlng behavlor
SlLuaLlonal lnfluences ln Lhe exLernal envlronmenL can lncrease or decrease commlLmenL Lo or parLlclpaLlon ln
healLhpromoLlng behavlor
1he greaLer Lhe commlLmenLs Lo a speclflc plan of acLlon Lhe more llkely healLhpromoLlng behavlors are Lo be
malnLalned over Llme
CommlLmenL Lo a plan of acLlon ls less llkely Lo resulL ln Lhe deslred behavlor when compeLlng demands over
whlch persons have llLLle conLrol requlre lmmedlaLe aLLenLlon
ersons can modlfy cognlLlons affecL and Lhe lnLerpersonal and physlcal envlronmenL Lo creaLe lncenLlves for
healLh acLlons



1he ma[or concepLs of Lhe PealLh romoLlon Model are lndlvldual characLerlsLlcs and experlences prlor
behavlor and Lhe frequency of Lhe slmllar behavlor ln Lhe pasL ulrecL and lndlrecL effecLs on Lhe llkellhood of
engaglng ln healLhpromoLlng behavlors
ersonal facLors are caLegorlzed as blologlcal psychologlcal and socloculLural 1hese facLors are predlcLlve of
a glven behavlor and shaped by Lhe naLure of Lhe LargeL behavlor belng consldered 8lologlcal personal facLors
lnclude varlables such as age gender body mass lndex puberLal sLaLus aeroblc capaclLy sLrengLh aglllLy or
balance sychologlcal personal facLors lnclude varlables such as self esLeem self moLlvaLlon personal
compeLence percelved healLh sLaLus and deflnlLlon of healLh SocloculLural personal facLors lnclude varlables
such as race eLhnlclLy accuculLuraLlon educaLlon and socloeconomlc sLaLus
ercelved beneflLs of acLlon are Lhe anLlclpaLed poslLlve ouLcomes LhaL wlll occur from healLh behavlor
ercelved barrlers Lo acLlon are anLlclpaLed lmaglned or real blocks and cosLs of undersLandlng a glven
behavlor ercelved selfefflcacy ls Lhe [udgmenL or personal capablllLy Lo organlze and execuLe a healLh
promoLlng behavlor ercelved self efflcacy lnfluences percelved barrlers Lo acLlon so hlgher efflcacy resulL ln
lowered percepLlons of barrlers Lo Lhe performance of Lhe behavlor
AcLlvlLyrelaLed affecL ls deflned as Lhe sub[ecLlve poslLlve or negaLlve feellng LhaL occurs based on Lhe
sLlmulus properLles of Lhe behavlor lLself 1hey lnfluence selfefflcacy whlch means Lhe more poslLlve Lhe
sub[ecLlve feellng Lhe greaLer Lhe feellng of efflcacy ln Lurn lncreased feellngs of efflcacy can generaLe furLher
poslLlve affecL
lnLerpersonal lnfluences are cognlLlonconcernlng behavlors bellefs or aLLlLudes of Lhe oLhers lnLerpersonal
lnfluences lnclude norms (expecLaLlons of slgnlflcanL oLhers) soclal supporL (lnsLrumenLal and emoLlonal
encouragemenL) and modellng (vlcarlous learnlng Lhrough observlng oLhers engaged ln a parLlcular behavlor)
rlmary sources of lnLerpersonal lnfluences are famllles peers and healLhcare provlders
SlLuaLlonal lnfluences are personal percepLlons and cognlLlons LhaL can faclllLaLe or lmpede behavlor 1hey
lnclude percepLlons of opLlons avallable as well as demand characLerlsLlcs and aesLheLlc feaLures of Lhe
envlronmenL ln whlch glven healLh promoLlng ls proposed Lo Lake place SlLuaLlonal lnfluences may have dlrecL
or lndlrecL lnfluences on healLh behavlor
JlLhln Lhe behavloral ouLcome Lhere ls a commlLmenL Lo a plan of acLlon whlch ls Lhe concepL of lnLenLlon
and ldenLlflcaLlon of a planned sLraLegy LhaL leads Lo lmplemenLaLlon of healLh behavlor CompeLlng demands
are Lhose alLernaLlve behavlors over whlch lndlvlduals have low conLrol because Lhere are envlronmenLal
conLlngencles such as work or famlly care responslblllLles CompeLlng preferences are alLernaLlve behavlor
over whlch lndlvlduals exerL relaLlvely hlgh conLrol
PealLhpromoLlng behavlor ls Lhe endpolnL or acLlon ouLcome dlrecLed Loward aLLalnlng a poslLlve healLh
ouLcome such as opLlmal wellbelng personal fulflllmenL and producLlve llvlng
1he koperLogan1|erney Mode|
1he 8operLogan1lerney Model for nurslng ls a Lheory of nurslng care based on acLlvlLles of dally llvlng whlch
are ofLen abbrevlaLed AuLs or ALs 1he model ls wldespread ln Lhe unlLed lngdom especlally ln Lhe publlc
secLor 1he model ls named afLer lLs developers nancy 8oper Jlnlfred J Logan and Allson ! 1lerney 1he
lnsplraLlon comes from Lhe work of vlrglnla Penderson
1he purpose of Lhe Lheory ls as an assessmenL used LhroughouL Lhe paLlenLs care ln Lhe unlLed lngdom
where Lhe model ls prevalenL lL has been reduced Lo belng used slmply as a checkllsL lL ls ofLen used Lo assess
how Lhe llfe of a paLlenL has changed due Lo lllness ln[ury or admlsslon Lo a hosplLal raLher Lhan as a way of
plannlng for lncreaslng lndependence and quallLy of llfe
1he Lheory aLLempLs Lo deflne whaL llvlng means lL caLegorlzes Lhe dlscoverles lnLo acLlvlLles of llvlng Lhrough
compleLe assessmenL whlch leads Lo lnLervenLlons LhaL supporL lndependence ln areas LhaL may be dlfflculL
for Lhe paLlenL Lo address alone 1he goal of Lhe assessmenL and lnLervenLlons ls Lo promoLe maxlmum
lndependence for Lhe paLlenL
1he nurse uses Lhe model Lo assess Lhe paLlenLs relaLlve lndependence and poLenLlal for lndependence ln Lhe
acLlvlLles of dally llvlng 1he paLlenLs lndependence ls looked aL on a conLlnuum LhaL ranges from compleLe
dependence Lo compleLe lndependence 1hls helps Lhe nurse deLermlne whaL lnLervenLlons wlll lead Lo
lncreased lndependence as well as whaL ongolng supporL ls needed Lo offseL any dependency LhaL sLlll exlsLs
1he acLlvlLles of dally llvlng should noL be used as a checkllsL lnsLead 8oper sLaLes Lhey should be vlewed As
a cognlLlve approach Lo Lhe assessmenL and care of Lhe paLlenL noL on paper as a llsL of boxes buL ln Lhe
nurses approach Lo and organlzaLlon of her care and LhaL nurses deepen Lhelr undersLandlng of Lhe model
and lLs appllcaLlon 1he paLlenL should be assessed on admlsslon and hls or her dependence and
lndependence should be revlewed LhroughouL Lhe care plan and evaluaLlon 8y looklng aL changes ln Lhe
dependencelndependence conLlnuum Lhe nurse can see wheLher Lhe paLlenL ls lmprovlng or noL and make
changes Lo Lhe care provlded based on Lhe evldence presenLed
1he acLlvlLles of llvlng llsLed ln Lhe 8operLogan1lerney Model of nurslng are
malnLalnlng a safe envlronmenL
communlcaLlon
breaLhlng
eaLlng and drlnklng
ellmlnaLlon
washlng and dresslng
conLrolllng LemperaLure
moblllzaLlon
worklng and playlng
sleeplng
1he llsL also lncludes deaLh and sexuallLy as acLlvlLles of dally llvlng buL Lhese are ofLen dlsregarded dependlng
on Lhe seLLlng and slLuaLlon for Lhe lndlvldual paLlenL
Accordlng Lo Lhe model Lhere are flve facLors LhaL lnfluence Lhe acLlvlLles of llvlng 1he lncorporaLlon of Lhese
facLors lnLo Lhe Lheory of nurslng makes lL a hollsLlc model lf Lhey arenL consldered Lhe resulLlng assessmenL
ls lncompleLe and flawed 1he facLors are used Lo deLermlne Lhe lndlvldual paLlenLs relaLlve lndependence ln
regards Lo Lhe acLlvlLles of dally llvlng
1hey are blologlcal psychologlcal socloculLural envlronmenLal and pollLlcoeconomlc 1he blologlcal facLor
addresses Lhe lmpacL of Lhe overall healLh of currenL ln[ury and lllness and Lhe scope of Lhe paLlenLs anaLomy
and physlology 1he psychologlcal facLor addresses Lhe lmpacL of emoLlon cognlLlon splrlLual bellefs and Lhe
ablllLy Lo undersLand Accordlng Lo 8oper Lhls ls abouL knowlng Lhlnklng hoplng feellng and bellevlng
1he socloculLural facLor ls Lhe lmpacL of socleLy and culLure as experlenced by Lhe lndlvldual paLlenL 1hls
lncludes expecLaLlons and values based on class and sLaLus and culLure wlLhln Lhe socloculLural facLor relaLes
Lo Lhe bellefs expecLaLlons and values held by Lhe lndlvldual paLlenL for hlm or herself as well as by oLhers
perLalnlng Lo lndependence ln and ablllLy Lo carry ouL Lhe acLlvlLles of dally llvlng
1he envlronmenLal facLor ln 8opers Lheory of nurslng makes lL a green model 1he Lheory Lakes lnLo
conslderaLlon Lhe lmpacL of Lhe envlronmenL on Lhe acLlvlLles of dally llvlng buL also examlnes Lhe lmpacL of
Lhe acLlvlLles of dally llvlng on Lhe envlronmenL 1he pollLlcoeconomlc facLor ls Lhe lmpacL of Lhe governmenL
pollLlcs and economy on Lhe acLlvlLles of dally llvlng 1hls facLor addresses lssues such as fundlng governmenL
pollcles and programs war or confllcL avallablllLy Lo beneflLs pollLlcal reforms lnLeresL raLes and avallablllLy
of publlc and prlvaLe fundlng among oLhers

8oper herself ob[ecLs Lo Lhe model belng used as a checkllsL She sLaLes LhaL lf nurses are uncomforLable
dlscusslng cerLaln facLors Lhey assume Lhe paLlenLs are as well 1hls leads Lo Lhe nurses aLLrlbuLlng Lhe lack of
assessmenL Lo Lhe paLlenLs preference when ln acLuallLy Lhe paLlenLs preferences were noL addressed
Per asserLlon leads Lo Lhe concluslon LhaL raLher Lhan deleLlng or dlsregardlng acLlvlLles of dally llvlng lL can
beneflL Lhe lndlvldual belng assessed lf Lhe nurse uses Lhe model more Lhoroughly and assesses Lhe paLlenL
uslng Lhe flve facLors ln con[uncLlon wlLh Lhe acLlvlLles of dally llvlng regardless of Lhe area ln whlch Lhe care ls
belng recelved 8oper sLaLed 1he paLlenL ls Lhe paLlenL Lhey are noL a dlfferenL paLlenL because Lhey are ln a
dlfferenL cllnlcal area 1helr needs are Lhe same lLs who wlll meeL Lhose needs LhaL changes