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CONCEPTUAL MODEL

AND NURSING THEORY


PRESENTED BY:
3th GROUP

AMIR SYAM
EDY
HAPSAH
NIA
ROSAMEY
WARDIYAH
The Holarchy of Contemporary Nursing
Knowledge:
Five Components
 Metaparadigm

 Philosophies

 Conceptual Models

 Theories

 Methodologies for inquiry and practice

Jacqueline Fawcett, PhD, RN, FAAN


Professor, 2006
CONCEPTUAL MODEL

&
NURSING
THEORY
Concept
 Definition:

– an abstraction
– creates an image of an idea we want to share
– representations of particular aspects of human behavior
and characteristics
 Pain

 Coping

 Grief

 Resilience

Alexis Morgan, WWF Canada, Oct 2005


Conceptual Model

A visual method (diagram) of


representing a set of causal
relationships between factors that
believed to impact one or more
biodiversity targets.

Alexis Morgan, WWF Canada, Oct 2005


Theory
“…is a general statement that
summarizes and organizes knowledge
by proposing a general relationship
between events - if it is a good one it
will cover a large number of events
and predict events that have not yet
occurred or been observed”

Robson C.
The Holarchy of Contemporary
Nursing Knowledge:
Theories

One or more relatively concrete and specific


concepts that are derived from a conceptual model,
the propositions that narrowly describe those
concepts, and the propositions that state relatively
concrete and specific relations between two or more
of the concepts

Jacqueline Fawcett, PhD, RN, FAAN


Professor, May, 2006.
NURSING THEORY
 Creates a conceptual framework for nursing
assessment and intervention

 Means of interpreting nurses observations

 Comprises the core content of Nursing


Nursing Theories
 Conceptual structure that organizes
practice and research into ideas
central to the discipline

 “Nursingtheories are reservoirs in


which findings related to nursing
concepts, such as comfort, healing,
recovering, mobility, rest, caring,
enabling, fatigue, and family care, are
stored.”
Meleis, 1997
“an internally consistent group of relational
statements (concepts, definitions &
propositions) that present a systematic view
about phenomenon and that is useful for
description, explanation, prediction and
control. A theory ….is the primary means of
meeting the goals of the nursing profession
concerned with a clearly defined body of
knowledge”
Walker & Avant 1996 (cited by Jasper M in
Hogston & Simpson))
Conceptual
model ≠ Theory

How may
it be different ?
Conceptual Model Theory

 abstract  group of concepts


impressions that describe a
organized into pattern of reality
symbols of reality  Research
 Can be tested, questions, study
changed, or used to variables
guide research  Derived of
 An early of conceptual models
development
theory process
The Holarchy of Contemporary Nursing Knowledge

Metaparadigm Most abstract

Philosophies

Conceptual Models

Theories

Methodologies Most concrete

Jacqueline Fawcett, PhD, RN, FAAN


Professor, May, 2006.
The Holarchy of Contemporary Nursing Knowledge
Translated for Empirical Nursing Research
Study participants
Settings
Metaparadigm Health conditions
Research process

Philosophies Ethical conduct of research


Approaches to knowledge
development

Conceptual Models Research guidelines

Theories Research questions


Study variables

Research designs
Samples
Empirical Research Methods Instruments
Data analysis techniques

Jacqueline Fawcett, PhD, RN, FAAN


Professor, May, 2006.
The Holarchy of Contemporary Nursing Knowledge
Translated for Nursing Practice
Nursing participants
Metaparadigm Significant others
Practice settings
Health conditions
Nursing process

Code of ethics
Philosophies Patient’s Rights
Philosophy of nursing practice

Professional nursing perspective


Conceptual Models Practice guidelines

Theories Evidence

Standards for Practice


Practice Methodologies Practice Tools
Intervention protocols

Jacqueline Fawcett, PhD, RN, FAAN


Professor, May, 2006.
Theory development
 Starts with defining
concepts,
 Next suggests
relationships bxn
concepts
 Tests and evaluates the
relationships
 Modifies theory based
on research findings
 Theories develop and
mature
 Various stages with
increasing complexity
SISTER CALLISTA ROY
6 Step Nursing Process :
1.Assesses the behaviours manifested
from the four adaptive modes
2.Assess the stimuli, and categorize
them into Assess the stimuli, and
categorize them into type of stimuli
type of stimuli
3.Create a nursing diagnosis of the
person’s s adaptive state adaptive state
4.Set goals to improve adaptation
5.Implement interventions to achieve
goals Implement interventions to
achieve goals
6.Evaluate if goals have been met
Hildegard Peplau
Interpersonal Relations Model
• Person
An individual; a
developing
organism who tries to
reduce anxiety caused
by
needs
Lives in instable
equilibrium
• Environment- Not defined
Hildegard Peplau
Interpersonal Relations Model
 Health
Implies forward
movement of the
personality and
human processes
toward creative,
constructive,
productive, personal,
and community living
Hildegard Peplau
Interpersonal Relations Model
 Nursing
– A significant,
therapeutic,
interpersonal process
that functions
cooperatively with
others to make health
possible
– Involves problem-
solving
Virginia Henderson
The Nature of Nursing
The unique function of
the nurse is to assist the
individual, sick or well, in
the performance of
those activities
contributing to health or
its recovery (or to
peaceful death) that he
would perform unaided if
he had the necessary
strength, will, or
knowledge.
the theory is useful in :

Dorothe 1. developing and guiding practice and research.


2. gives directions to nursing-specific outcomes
a Orem 3. related to knowing and meeting the therapeutic
Self- self-care demands, regulating the development
and exercise of self-care agency, establishing
Care self-care and self-management systems, and
Model others.
4. the design of curriculums for preservice,
Graduate, and continuing nursing education.
5. gives direction to nursing administration. The
development of theory-based computer
systems, assessment forms, and the overall
structuring of the delivery of care attests to the
usefulness of the theory

(Tomey & Alligood,2002).


Jean Watson
Philosophy and Science of Caring
The nurse’s role is to:

1. Establish a caring relationship with


patients
2. Treat patients as holistic beings
(body, mind and spirit)
3. Display unconditional acceptance
4. Treat patients with a positive regard
5. Display unconditional acceptance
6. Treat patients with a positive regard
7. Promote health through knowledge
and intervention
8. Spend uninterrupted time with
patients: “caring moments”
Recently Nursing Care
Phenomenon
X Hospital

Nurses
Fun
ctio
nal

Client Y
syte

with

Holistic need
m
Case:
 Tn. Y, 67 thn. MRS X dengan KU: tidak bisa
menggerakkan bagian kiri tubuhnya. Bibir
mencong ke kanan. Dialami sejak 2 jam SMRS.
Riwayat penyakit hipertensi sejak usia 30 tahun.
Riwayat merokok satu bungkus per hari sejak
usia 12 tahun. Tn. Y adalah seorang pensiunan
ABRI. TTV : TD : 200/140 mmHg, P : 36
x/menit, N : 115 x/menit, S: 37,4°C.
 Pertolongan pertama pada Tn. Y diberikan di unit
gawat darurat RS X. Klien ditangani dengan
pemberian dan pemberian cairan infus sebagai
jalur masuknya obat intravena serta pengawasan
terhadap tanda-tanda vitalnya. Sebagian besar
tindakan ini dilakukan oleh perawat sesuai
dengan instruksi dokter.
In case : Medical
order
Balanced
fluid &
electrolit
assess nurses
Supervise client
Vital Sign

Give
documentation Medicine

suffer

Independent
Not satisfied Nothing
change
 Kondisi
ruang perawatan: 1 perawat
menangani 5 – 10 orang pasien
tanpa melihat tingkat
ketergantungan pasien.
Analysis
Analisis terhadap pelayanan
perawat dalam kasus:
 Askep tidak diterapkan dengan baik
– Perencanaan tindakan hanya sekedar
untuk pendokumentasian.
– Implementasi dilakukan tanpa
menganalisis masalah klien dan tidak
sesuai dengan perencanaan tindakan.
– Jarang dilakukan evaluasi tindakan
keperawatan.
Lanjutan…
 Perhatian perawat yang kurang tentang
kemandirian & kepuasan klien.
 Perawat tidak mengerti tentang model
keperawatan apa yang sedang
dilaksanakannya.
 Komunikasi terapeutik yang kurang.
Analisis kasus
 Masalah keperawatan yang bisa muncul
pada klien:
– Nutrisi kurang dari kebutuhan tubuh
– Gangguan rasa nyaman
– Gangguan pola tidur
– Defisit perawatan diri
– Hambatan mobilitas fisik
– Kelemahan
– Ansietas
– Kurang pengetahuan
Berdasarkan model Handerson
Kebutuhan klien yang terganggu/tdk
terpenuhi :
 Kebutuhan akan nutrisi
 Kebutuhan isthirahat dan tidur
 Kebutuhan akan personal hygiene
 Kebutuhan rasa aman dan nyaman
 Kebutuhan mobilitas, pengaturan postur
 Berkomunikasi dengan orang lain dan
mengekspresikan emosi, keinginan, rasa
takut dan pendapat.
 Kebutuhan belajar.
Handerson’s Model
Perawat
Manusia yg
unik dan
holistik Puas Sbg central
figure

Mandiri Menolong klien


14 KDM
mencapai
kemampuan
Askep
memenuhi
Terganggu profesional
kebutuhannya
Klien secara mandiri

sakit Penurunan
kemandirian
Solusi menurut teori Handerson
 Pada saat semua itu terjadi seharusnya,
perawat ada di samping pasien,
mendengarkan keluhannya, memberikan
motivasi dan memberikan penjelasan terkait
penyakitnya. Seandainya para ahli-ahli
keperawatan kita melihat langsung fenomena
tersebut, dia akan sangat besedih. Konsep,
teori, dan standar asuhan telah dibuat.
Namun, implementasinya di lapangan belum
optimal.
Dorothea Orem
 Menurut Orem, bila ditemukan
seorang pasien dengan defisit
perawatan diri, maka seorang
perawat seyogyanya bertindak
menuntun, membimbing, mendukung
atau menyediakan lingkungan yang
akan meningkatkan kemampuan
pasien tersebut.
KESIMPULAN

 Ada beberapa hal yang menjadi


kesimpulan dari makalah ini :
– Perbedaan yang mendasar antara model konseptual
dan teori keperawatan adalah bahwa sebuah konsep
bisa berkembang menjadi sebuah teori. Konsep lebih
menggambarkan simbol-simbol yang abstrak
sedangkan teori lebih menggambarkan tentang pola-
pola realita.
– Konsep model dan teori keperawatan yang terkait
dengan fenomena dalam makalah ini adalah yang
dikemukakan oleh Virginia Henderson dan Dorothy E.
Orem.
– Virginia Henderson mengembangkan keperawatan
berdasarkan 14 kebutuhan dasar manusia.
Lanjutan..
– Menurut Henderson, di sinilah letak peran seorang
perawat sebagai penolong pasien dalam memenuhi
kebutuhan-kebutuhan tersebut
– Menurut Orem, bila perawat menemukan seorang
individu mengalami defisit perawatan diri, perawat
seharusnya menuntun, membimbing, mendukung
atau menyediakan lingkungan yang akan
meningkatkan kemampuan pasien tersebut.
– konsep dan teori sangat berperan penting dalam
perkembangan ilmu keperawatan menuju ke profesi
keperawatan yang lebih baik.