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HISTORY OF NURSING THEORIES 1970-1974

Economic Background

Global Background

Historic Background

Cultural Background

Economic Happenings 1970-1974

World Happenings 1970-1974

America 1970-1974

Cultural Happenings 1970-1974

Social Background

Social Happenings 1970-1974

China is seated at the United Nations for the first time.

The island of Okinawa is returned to Japan by the United States.

War between Israel and both Egypt along the Suez Canal and Syria

along the Golan Heights.

Turkey invades Cyprus.

Japan becomes the first Asian nation to host the Winter Olympic Games in 1972.

Gas prices more than double after the oil boycott in 1973.

Stock Market crash of 1973-1975 considered a double dip recession (Recession of 1969–1970 with less than 3 years growth followed by 1973–1975 recession).

Inflation reaches 12%.

Unemployment rate reaches 8%.

Figure 3. Chinese delegation to the United Nations (1971).

President Nixon and the notorious Watergate scandal.

The United States voting age was lowered from 21 to 18 years old.

Thomas Bradley became the first black mayor when he became

the mayor of Los Angeles (LA).

The World Trade Center buildings were opened.

Advertising of cigarettes on radio and television ceases as the Public Health

Cigarette Smoking Act goes into effect.

Figure 1. Richard Nixon (1972)

Fashion of the 1970's consists of bright color polyester, men and women alike wear

tight fitting pants and platform shoes.

Chest hair, medallions, polyester, butterfly collars, bell bottoms, skin-tight t-shirts, sandals,

leisure suits, flower patterned dress shirts, sideburns and, yes, tennis headbands.

The Stony Brook Playhouse first opens at the Slavic Cultural Center in Port Jefferson.

Figure 6. Detroit (1973).

Figure 2. Thomas Bradley

The Carpenters "Top of the World" hits Number 1 on Billboard's Top 40.

Happy Days premieres on ABC-TV.

People magazine begins publication.

Last episode of The Brady Bunch airs on ABC-TV.

Muhammad Ali defeats George Foreman and regains heavyweight championship.

Figure 4. Olympic medalists of the men's giant slalom (1972).

Figure 5. 1974 Muhammad Ali/George Foreman fight program - "Rumble in The Jungle"

Summary

Roy's Theory

Orem's Self-Care Deficit Nursing Theory

Sister Callista Roy

Dorothea Elizabeth Orem

1914-2007

Orem’s theory of self-care deficit is one of the grand nursing theories based on human needs.

Nursing phenomenon: Human beings have varying abilities to care for themselves during illness

Example of assumptions: Nurses maintain an individual’s capacity for self-care and assist when she or he is unable to do so.

Idea: Nurses use different approaches based on the patient’s ability to care for self

Every patient is unique. Patients have diverse needs and distinctive self-management abilities; they differ in the way they interact with their environments, and what support systems are available to them. Leaning on the great foundation for care that nursing theories provide us, nurses can tailor individuals care to promote and support the best possible outcomes and optimal quality of life.

The Roy Adaptation Model (RAM) assumptions include philosophical, scientific, and cultural. There are multiple components to each part.

Examples:

  • Philosophical assumption: People have relationships with others and God.
  • Scientific assumption: The melding of people and their environment equals adaptation.
  • Cultural assumption: Person’s cultural will influence the model's end result.

Sister Callista Roy, a member of The Sisters of Saint Joseph of Carondelet, started her education at Mount Saint Mary’s College in Los Angeles (LA).

Figure 7. Dorothea Orem

(McEwen & Wills, 2014)

Orem's Self-Care Deficit Nursing Theory

Figure 12. Sister Callista Roy.

(McEwen & Wills, 2014)

Figure 8. Self-Care Deficit Nursing Theory.

Thee Subtheories of Orem's Self-Care Deficit Nursing Theory

• Received a diploma in nursing in the early 1930s from Providence Hospital in Washington, DC.

• Earned a bachelor of science in nursing education in 1939 and a master of science in nursing education in 1945 from Catholic University of America (CUA), Washington, DC.

• Served as a director of the school of nursing and nursing services at Detroit’s Providence Hospital until 1949.

• Served on the Indiana State Board of Health from 1949 to 1957.

• Worked at the Department of Health, Education, and Welfare from 1957 to 1959 as a curriculum consultant for improvement of practical nurse training.

• Taught and served as interim dean at CUA from 1959 to 1970.

• Led the Nursing Development Conference Group in 1968.

• Published her first book Nursing: Concepts of Practice in 1971.

• Worked as a full-time consultant until her retirement in 1984.

She went on to get her masters and doctorate degree from University of California, LA. In addition to creating her well known theory of nursing, the Roy Adaption Model, she published many books and journal articles. She has received many distinguished awards over the past 31 years.

Sister Callista Roy is currently teaching at the Boston College School of Nursing.

Modes of Adaptation

Coping Subsystems

• Theory of self-care: Individuals deliberately carry out activities that benefit their health and well-being. Conditioning factors including age, culture, lifestyle, developmental stage, and lifestyle affect the degree of independent self-care.

• Theory of nursing systems are used to meet patient’s self-care requisites. They are based on the nursing assessment of the patient’s abilities to perform self-care activities.

Systems types are:

  • Wholly compensatory system: complete dependence upon a nurse.
  • Partially compensatory system: partial nursing care required during patient recovery from a surgery or an illness.
  • Supportive-educative system: nursing assistance for a patient as the self-care agent.

• Theory of self-care deficit: Nursing skills and knowledge becomes necessary, when individuals are unable to achieve effective self-care.

 Nursing methods to help patient meet self-care needs are:

  • acting for or doing for another
  • guiding and directing
  • providing physical or psychological support
  • providing and maintaining an environment that supports personal development, and teaching.

To adapt when encountered with stressor, a client relies on the two coping subsystems

  • the physiologic coping subsystem, or the regulator, and
  • the cognitive-emotive coping subsystem, or the cognator.

Roy's Model encompasses four modes of adaptation:

  • Physiologic-physical mode
  • Self-concept-group identity mode
  • Role function mode
  • Interdependence mode.

The adaptation of a client occurs as a result of a dynamic reciprocal actions and influences between the client and his or her environment through the aforementioned modes.

References

(Johnson & Webber, 2010; McEwen & Wills, 2014)

(McEwen & Wills, 2014)

Figure 13. Diagrammatic representation of human adaptive systems.

(McEwen & Wills, 2014)

(McEwen & Wills, 2014).

(McEwen & Wills, 2014)

Impact of Orem's Theory

Application of Orem's Theory to Practice

Application of Roy's Theory to Practice

Impact of Roy's Theory

Education. Self-care deficit nursing theory (SCDNT) served as a framework for curricula in the University of Florida, Gainesville; the University of Missouri, Colombia; Oakland University School of Nursing; and Georgetown University School of Nursing.

Figure 9. Nursing student (1970).

Many colleges in the United States and abroad have used the Roy Adaptation Model as a part of their curriculum. RAM has serves as a framework for multiple research studies. RAM considerably influenced nursing practice, education, and administration.

Practice. SCDNT has been used worldwide to structure care in community nursing; maternal-child and pediatric nursing; perioperative, medical-surgical and renal dialysis nursing; and critical care. SCDNT provides a framework for development of effective nursing care plans.

Roy’s adaptation model theory can be used in many areas of nursing practice. A great example of this is Kathleen Blacks' 2007 retrospective research study conducted in three urban hospitals in Philadelphia, PA. Using RAM, the study was conducted on 100 postpartum women to determine relation between worsening symptoms of gestational hypertension (HTN), psychological stress, women's sense of well-being, perceived support, and confidence in self-monitoring. The study determined that women with worsening symptoms of gestational HTN experienced an increase in stress, but their perceived support, well-being and confidence in self-monitoring remained the same in a large part due to the clinical team caring for them (Black, 2007).

Orem’s theory has received an international recognition and has been applied to various clinical settings. Application of SCDNT begins with the first step of the nursing process- assessment; SCDNT continues influencing every encounter with a patient. As a progressive care nurse, I regularly apply Orem’s theory of self-care deficit to assess and develop a plan of care for patients admitted with congestive heart failure, acute myocardial infarction, kidney failure, and uncontrolled diabetes with severe hyperglycemia.

Simmons (2009) best discussed application of Orem’s theory to the dialysis settings. The goal of nursing care is to help dialysis patients achieve optimum health while living with end-stage renal disease (ESRD). Promotion of self-care is done through establishment of a trusting nurse-patient relationship and patient-specific care plan; inclusion of patient into their hemodialysis treatment; ongoing assessment and evaluation of patient coping mechanisms; employing various educational strategies to “assist patients to become adequately prepared to engage in their own care” (Simmons, 2009, p. 420); and positive reinforcement of achieved goals.

Figure 10. Nurses' station (1970).

Research. Orem’s theory serves as “a source for testable hypothesis” (McEwen & Wills, 2014). SCDNT has been used as a conceptual framework, and its components have been tested through clinical research by many researchers. However, a testing of the theory in its entirety is yet to be done.

Figure 11. Dictionary page.

(McEwen & Wills, 2014)

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