[Nursing models are preliminary studies for nursing science].
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Chronic pain and coping: a proposed role for nurses and nursing models.
AIMS: Activity of living based nurse models such as that proposed by Roper, Logan and Tierney are utilized commonly to rationalize, structure and guide practice. This paper proposes that their use, in the context of chronic pain, should be extended to incorporate the assessment of coping and its effect on disability. BACKGROUND: As coping has been found to account for some of the variance in adaptation to chronic pain, generic models of coping and their utility in this context are considered. The need for reliable and valid means to assess coping are of paramount importance as this will facilitate and inform treatment and management of chronic pain. At the present time coping is most generally assessed using self report instruments which primarily focus on the number and type of strategies used to cope rather than their effectiveness in reducing disability and increasing function. FINDINGS: A classification system which categorizes chronic pain patients in terms of how they function in daily life as either adaptive copers, interpersonally distressed or dysfunctional is outlined. The similarities between this and a routine nursing assessment based on an activities of living model are highlighted. CONCLUSIONS: It is proposed that the innovative use of nursing activity of living models could provide the framework for a pain clinic based assessment of coping that has greater utility for professionals and patients alike.
Activities of Daily Living↗
The attitudes of traditional and undergraduate nursing students towards nursing models: a comparative survey.
The underpinning of nursing curricula with nursing models and their inclusion as part of the curriculum has increased dramatically in the last 10 years within the United Kingdom. However there is a dearth of research not only into how nursing students in general view these frameworks, but also into how students from different courses compare in their perception of them. In this study a questionnaire on attitudes to models was distributed to 20 second-year undergraduate (BSc Nursing) students and 20 third-year 'traditional' (RGN) students. Findings indicate that although both groups have a positive attitude overall towards nursing models, the traditional nursing students had a more positive perception than their undergraduate counterparts. In the discussion section possible explanations are put forward as to why these differences in attitudes exist.
Adult↗
Nursing models: enhancing or inhibiting practice?
The Royal Marsden Hospital and Nursing Standard organised a series of nursing debates during 1990. The debates centred on key issues for nurses in the nineties, and included a particularly stimulating one on nursing models. The motion proposed was: 'This House believes that the development and use of models of nursing has had a positive influence upon nursing practice.' Here are the views of the four nurses who spoke for and against the motion.
Humans↗
Early lessons from a capitated community-based nursing model.
The community nursing organization (CNO) demonstration is a three-year Medicare program to develop, manage, and evaluate a new capitated, nurse-managed system of community and ambulatory care. Since February 1994, four national sites have started CNOs. The CNO at Carondelet Health Care in Tucson, Arizona, shares early experiences in designing and implementing an exciting new community practice model.
Capitation Fee↗
Critique: external comparison of conceptual nursing models.
Research by Jacobson on development of a semantic differential for external comparison of conceptual nursing models was reported in 1984. The present article critiques the philosophical stance and the research methods presented in the Jacobson report. Methods of analysis and evaluation of conceptual nursing models are reviewed, and the influences of conceptual nursing models on the structure of the discipline are examined in light of the purposes of the Jacobson study. Issues related to the investigation and use of models in the development of nursing knowledge are discussed.
Humans↗
The AIDS pandemic: a nursing model.
The pandemic of acquired immunodeficiency syndrome (AIDS) calls for global cooperation to develop strategies for interventions both to prevent the disease and to care for persons with it. The conceptual framework "Health for all: A model for nursing's contributions" provides guidance for the processes of assessment, diagnosis, planning, implementation of care, and evaluation of mortality and morbidity related to AIDS. The disease challenges the biologic, sociologic, medical-technical, and environmental determinants as they affect health. Specific recommendations for health care interventions are relevant to each determinate, with community health status as the focus.
Acquired Immunodeficiency Syndrome↗
Nursing models and research--a restricting view?
The question is asked, Do some nursing models present a restricting view? If so, then the type of research in nursing may be restricted also. The author examines the writings of several nurse theorists to demonstrate the development of a singular focus, the patient. This consideration is followed by an introduction of the thoughts of critics on the narrow perspective embraced by some nurses. Blind acceptance of any nursing model is questioned. The use of a model must be accompanied by discussion, exploration and adaptation. No one model provides a true picture for all nursing situations.
Models, Theoretical↗
[Integration of a nursing model into a local community service center].
Four years ago, maternal/child health nurses from the Metro CLSC in Montreal found themselves in a crisis situation. They were unable to evaluate their work--which consisted of varying tasks and the need for these nurses to be everywhere at the same time. A need to reflect on the situation prompted the team to meet for three hours twice monthly to analyze the problems and establish a plan of action. A nurse-counsellor guided the initial process. A post-natal home visit was chosen as an example for discussion. The group conceded that each member of the perinatal team had a different philosophy and nursing approach. The team consisted of nurses of various ages, experiences and educational backgrounds. Some nurses felt more comfortable expressing themselves in English while others preferred French. At times this group diversity hindered the communication of ideas as well as the ability to reach a consensus about required practice changes. The McGill Nursing model from McGill University was chosen and integrated into the team's practice. The author presents this model and outlines it's advantages and disadvantages. She illustrates this model with the use of an ecomap designed by Wright and Leahy (1984). This nursing model addresses the use of forces within each individual as well as the family. Since it takes into account the extended family, it allows a global approach to care. The article focuses on the essential elements of integrating the model, including it's development and how it was accepted by these nurses. According to the author, the process of changing to this model is dynamic and continuous.(ABSTRACT TRUNCATED AT 250 WORDS)
Community Health Nursing↗
Ethical issues in critical care: a nursing model.
The role of critical care nurses in relation to ethical issues has become increasingly complex. An original nursing model for addressing ethical issues at the bedside is described in this study. A case study incorporating ethical conflicts demonstrates use of this model.
Aged↗
A semantic differential for external comparison of conceptual nursing models.
A semantic differential using conceptual nursing models as concepts to be rated and scales chosen from the theory literature was used by 78 master's degree students to evaluate the King, Orem, Rogers, Roy, and Wiedenbach models. The tool appeared capable of detecting reliable, plausible differences among models as shown by inspection of models' mean ratings on individual scales and by factor analysis. Six factors (sophistication-dynamism, clarity-usefulness, focus, utility, scope, and scientific rigor) accounted for from 49% to 56% of the total variance of the models. All scales loaded on some factor for at least one model. Tool development is continuing.
Models, Theoretical↗
Evaluating your practice via a nursing model.
This article discusses the use of nursing models as an evaluative tool to guide nursing practice in the primary care setting. The functional elements of a model are presented along with guidelines to facilitate selection of a model for your practice. Two case examples are utilized to demonstrate the process of application and evaluation of nursing practice via the Orem Self-Care Model and the Peplau Interpersonal Process Model.
Adult↗
The geriatric resource nurse model of care: a vision for the future.
The geriatric resource nurse model of care is an innovative and effective method of integrating high quality, evidence-based geriatric nursing care into a clinical practice setting. The model creates expert bedside clinicians who recognize the vulnerability of older adults, who proactively educate and serve as consultants for peers, and who role model best practice geriatric nursing. This article describes the history and key features of this nursing model of care delivery with examples of how it was successfully implemented in a variety of hospitals around the country.
Aged↗
Beyond the stages of sleep: an emerging nursing model of sleep phases.
The stages of rapid eye movement and non-rapid eye movement sleep are common topics in most nursing texts. It is impractical, however, to verify the stages of sleep in hospitalized patients. The article present a nursing model of sleep phases that uses observed behavior to identify which phase of sleep the adult patient is experiencing. The model is based on the findings from a qualitative study of 16 women hospitalized with myocardial infarction. Subsequent analysis of the data led to the development of Dreher's model of sleep phases. The retiring phase begins with declining arousal and preparations for sleep and continues until the onset of sleep. The resting phase begins with the onset of sleep and continues until the onset of final awakening. The rising phase commences with the onset of awakening and continues until the complete arousal. This model is presented as an emerging nursing model in which the behavior of sleep in hospitalized adults can be described. It is hoped that the model can be used to help nurses conceptualize sleep pattern disturbances so that appropriate nursing interventions can be implemented.
Female↗
Nursing models--the arguments.
Like so many developments in nursing, the adaptation of nursing models to assist in care planning in the operating department is being undertaken at a time of increased patient throughput and often decreasing numbers of trained nursing staff. Given this scenario, many operating department nurses are questioning whether models are appropriate or not.
Attitude of Health Personnel↗
The perception of psychiatric-hospital ward sisters/charge nurses towards nursing models.
A search of the literature revealed a dearth of research on hospital ward-based practitioners' opinions/perceptions towards nursing models. This is surprising considering that such frameworks are being introduced into patient care settings on an international basis. As part of a larger investigation pertaining to model selection, the researcher interviewed a population of 95 ward managers, giving each of them the opportunity to put forward their views concerning models of nursing. The research area was psychiatric continuing-care/rehabilitation facilities in Northern Ireland. The majority of opinions (61.1%) were positive in nature while 23.2% of respondents voiced negative perceptions. Implications for nursing practice, education and administration are raised from the study's findings.
Adult↗
Health care delivery in faith communities: the parish nurse model.
Religious institutions and nurses have a common bond--both are committed to empowering individuals to achieve their full potential and believe in the self-care capacity of individuals. The purpose of this study was to examine parish nursing as an evolving model of care within faith communities. Annualization of monthly reports and parish nurse interviews revealed that parish nurse activities contributed to the empowerment process and to the attainment of Healthy People 2000 objectives.
Community Health Nursing↗
The effects of nursing models on quality of care.
An action-research approach was used to implement a nursing model in a long-stay psychiatric ward. Within a broader quasi-experimental design, selected quality-of-care indicators were appraised before and after the implementation of the model. These dependent variables were also monitored in a control ward. Data were collected in both wards at one pre-test and two post-test points using a triangulation of mostly quantitative research methods. Research instruments emanated from the literature and the fieldwork lasted nine months. Results indicated statistically significant improvements in Psychiatric Monitor scores, perceptions of ward atmosphere, patient satisfaction, staff's views about nursing models and patient dependency levels in the experimental ward. Positive change was also noted in dependent variables not amendable to statistical analysis. No significant change was noted in medication patterns, nurse satisfaction and nurses' perception of patients' behaviour.
Clinical Nursing Research↗