Faye Glenn Abdellah’s Theory & 21 Nursing Problems Theory

Faye Glenn Abdellah was a pioneer in nursing research and the first nurse officer to hold the rank of a two-star rear admiral in the United States Public Health Service. Her theory focused on the 21 nursing problems that she believed could be addressed through nursing care. Her theory was based on the belief that the purpose of nursing is to promote health, prevent illness, restore health, and facilitate coping with disabilities.

Faye Glenn Abdellah, the pioneer nursing researcher, helped transform nursing theory, nursing care, and nursing education. In 1960, She was influenced by the desire to promote client-centered comprehensive nursing care, Abdellah described nursing as a service to individuals, to families, and, therefore, to society.

• Former Chief Nurse Officer for the US Public Health Service, Department of Health and human services, Washington, D.C.
• Dr Abdellah worked as Deputy Surgeon General.
• Grand theory based on Human Needs.

Biography

Born on March 13, 1919, in New York City. She graduated Magna Cum Laude from Fitkin Memorial Hospital School of Nursing in Neptune, New Jersey in 1942 (now Ann May School of Nursing). She obtained her Bachelor of Science in 1945, her Master of Arts in 1947, and her Doctor of Education in 1955 from the Teachers Colleges at Columbia. She was appointed Chief Nurse Officer of the U.S. Public Health Service (USPHS) in 1970 and served in that position for 17 years.

The first woman to serve as Deputy Surgeon General of the United States. She was inducted into the US National Women Hall of Fame in 2000 due to her contributions to the field of Education and Nursing Research She has been a staff nurse, a head nurse, and a faculty member at Yale University and Columbia University.

A public health nurse, and an author of more than 150 articles and books. She has been a research consultant to the World Health Organization. She is a recipient of more than 79 academic honors and professional awards for her excellence in Nursing. She developed a list of 21 unique nursing problems related to human needs.

1960, influenced by the desire to promote client-centered comprehensive nursing care she Described nursing as a service to individuals, to families, and, therefore, to society.

Summary of Abdellah‘s Theory

Abdellah’s theory is based on the identification of the 21 nursing problems, which are categorized into physical, emotional, and sociological. The theory emphasizes the importance of nursing in meeting the healthcare needs of patients by focusing on the patient as a whole person, not just the disease or illness.

Abdellah‘s Theory Application to Nursing Practice

Abdellah’s theory has practical applications in nursing practice as it emphasizes the importance of individualizing patient care and addressing their unique healthcare needs. This approach helps nurses to provide holistic care, which improves patient outcomes and promotes patient satisfaction. For instance, when caring for a patient with a chronic illness, the nurse can address not only the physical symptoms but also the emotional and social needs of the patient, such as providing emotional support, counseling, and connecting the patient with community resources.

Relevance to Modern Nursing

Abdellah’s theory remains relevant in modern nursing as it provides a framework for nurses to provide patient-centered care. In today’s healthcare environment, where patient-centered care is essential, Abdellah’s theory encourages nurses to focus on the patient’s individual healthcare needs, preferences, and values. This approach enhances patient satisfaction, quality of care, and patient outcomes.

Effect on QI Processes

Abdellah’s theory has a positive effect on Quality Improvement (QI) processes in healthcare organizations. Her emphasis on individualizing patient care promotes the use of patient-centered care models, which are essential in QI initiatives. By addressing the healthcare needs of each patient, healthcare organizations can improve patient outcomes, reduce healthcare costs, and enhance patient satisfaction.

Implications of Nursing Leadership

Abdellah’s theory has implications for nursing leadership as it encourages nurse leaders to promote patient-centered care in their organizations. By emphasizing the importance of addressing the unique healthcare needs of each patient, nurse leaders can inspire their teams to provide high-quality, patient-centered care. This approach enhances patient satisfaction, reduces healthcare costs, and improves patient outcomes, which are critical factors in nursing leadership.

Patient-Centered Approaches to Nursing

Patient-centered approach to nursing was developed by Faye G. Abdellah. Developed inductively from her practice and is considered a human needs theory. This theory was created to assist with nursing education and is most applicable to the education of nurses. The intention was to guide the care of patients in the hospital, it also has relevance for nursing care in community settings.

According to Faye, nursing is based on art and science that mold the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs

Patient-Centered Approaches to Nursing

Abdellah and her colleagues developed a list of 21 nursing problems.
The 21 problems are actually a model describing the “arenas” or concerns of nursing, rather than a theory describing relationships among phenomena.
In this way, the theory distinguished the practice of nursing, with a focus on the 21 nursing problems, from the practice of medicine, with a focus on disease and cure.

The theory also help to identify nursing responsibilities.

• Nursing Responsibilities
• Effective communication between patient and caregiver. Information is accurate, timely and appropriate.
• Do everything possible to alleviate patients’ pain and make them feel comfortable.
• We provide emotional support and alleviate fears and anxiety.
• We involve family and friends in every phase of our patients’ care.
• We ensure a smooth transition and continuity from one focus of care to another.
• We guarantee every member of our community has access to our care.

Patient-Centered Approaches to Nursing

They also identified 10 steps to identify the client’s problems: Which will help the nurses to learn to know the patient, Identify a therapeutic plan, and discuss and develop a comprehensive nursing care plan.
Nursing skills to be used in developing a treatment typology: Which includes the observation of health status, skills of communication, application of knowledge, the teaching of patients and families, use of resource materials, use of personnel resources, problem-solving

Application to nursing

Abdellah’s theory states that nursing is the use of the problem-solving approach to key nursing problems related to the health needs of people. Health is a dynamic pattern of functioning whereby there is a continued interaction with internal and external forces that results in the optimum use of necessary resources that serve to minimize vulnerabilities. Such a statement maintains problem-solving as the vehicle for the nursing problems as the client is moved toward health – the outcome.

Assumptions were related to change and anticipated changes that affect nursing.

The need to appreciate the interconnectedness of social enterprises and social problems; the impact of problems such as poverty, racism, pollution, education, and so forth on health care delivery; changing nursing education continuing education for professional nurses development of nursing leaders from under reserved groups

1. Learn to know the patient
2. Sort out relevant and significant data
3. Make generalizations about available data in relation to similar nursing problems presented by other patients
4. Identify the therapeutic plan
5. Test generalizations with the patient and make additional generalizations

6. Validate the patient’s conclusions about his nursing problems
7. . Continue to observe and evaluate the patient over a period of time to identify any attitudes and clues affecting his behavior
8. Explore the patients’ and family’s reactions to the therapeutic plan and involve them in the plan
9. Identify how the nurses feel about the patient’s nursing problems
10. Discuss and develop a comprehensive nursing care plan

Three major categories:

1. Physical, sociological, and emotional needs of clients 2.Types of interpersonal relationships between the nurse and patient 3. Common elements of client car

BASIC TO ALL PATIENTS

To maintain good hygiene and physical comfort To promote optimal activity: exercise, rest and sleep To promote safety through the prevention of accidents, injury, or other trauma and through the prevention of the spread of infection To maintain good body mechanics and prevent and correct deformities

SUSTENAL CARE NEEDS

To facilitate the maintenance of a supply of oxygen to all body cells To facilitate the maintenance of nutrition of all body cells To facilitate the maintenance of elimination To facilitate the maintenance of fluid and electrolyte balance To recognize the physiological responses of the body to disease conditions To facilitate the maintenance of regulatory mechanisms and functions To facilitate the maintenance of sensory function

REMEDIAL CARE NEEDS`

To identify and accept positive and negative expressions, feelings, and reactions To identify and accept the interrelatedness of emotions and organic illness To facilitate the maintenance of effective verbal and nonverbal communication To promote the development of productive interpersonal relationships To facilitate progress toward achievement of personal spiritual goals To create and/or maintain a therapeutic environment To facilitate awareness of self as an individual with varying physical , emotional, and developmental needs

RESTORATIVE CARE NEEDS`

To accept the optimum possible goals in the light of limitations, physical and emotional To use community resources as an aid in resolving problems arising from illness To understand the role of social problems as influencing factors in the case of illness

Abdellah’s 21 problems are actually a model describing the “arenas” or concerns of nursing, rather than a theory describing relationships among phenomena. In this way, the theory distinguished the practice of nursing, with a focus on the 21 nursing problems, from the practice of medicine, with a focus on disease and cure.

NURSING

Nursing is a helping profession. In Abdellah model, nursing care is doing something to or for the person or providing information to the person with the goals of meeting needs, increasing or restoring self-help ability, or alleviating impairment. Nursing is broadly grouped into the 21 problem areas to guide care and promote use of nursing judgment. She considers nursing to be comprehensive service that is based on art and science and aims to help people, sick or well, cope with their health needs.

PERSON

Abdellah describes people as having physical, emotional, and sociological needs. These needs may overt, consisting of largely physical needs, or covert, such as emotional and social needs. Patient is described as the only justification for the existence of nursing. Individuals (and families) are the recipients of nursing. Health, or achieving of it, is the purpose of nursing services.

HEALTH

In Patient -Centered Approaches to Nursing, Abdellah describes health as a state mutually exclusive of illness. Although Abdellah does not give a definition of health, she speaks to total health needs and a healthy state of mind and body in her description of nursing as a comprehensive service.

SOCIETY/ENVIRONMENT

Society is included in planning for optimum health on local, state, national, and international levels. However, as she further delineated her ideas, the focus of nursing service is clearly the individual. The environment is the home or community from which patient comes.

Abdellahs theory has interrelated the concepts of health, nursing problems, and problem solving. Problem solving is an activity that is inherently logical in nature.`

Framework focus on nursing practice and individuals.

The results of testing such hypothesis would contribute to the general body of nursing knowledge.`

Easy to apply in practice.

ASSESSMENT PHASE

Nursing problems provide guidelines for the collection of data. A principle underlying the problem solving approach is that for each identified problem, pertinent data are collected. The overt or covert nature of the problems necessitates a direct or indirect approach, respectively`

NURSING DIAGNOSIS

The results of data collection would determine the clients specific overt or covert problems. These specific problems would be grouped under one or more of the broader nursing problems. This step is consistent with that involved in nursing diagnosis.

PLANNING PHASE

The statements of nursing problems most closely resemble goal statements. Therefore, once the problem has been diagnosed, the goals have been established. Given that these problems are called nursing problems, then it becomes reasonable to Conclude that these goals are basically nursing goals.`

IMPLEMENTATION

Using the goals as the framework, a plan is developed and appropriate nursing interventions are determined.

EVALUATION

The most appropriate evaluation would be the nurse progress or lack of progress toward the achievement of the stated goals.

SUMMARY

Using Abdellahs concepts of health, nursing problems, and problem solving, the theoretical statement of Nursing that can be derived is the use of the problem solving approach with key nursing problems related to health needs of people.

From this framework, 21 nursing problems were developed .

CONCLUSIONS

Abdellahs theory provides a basis for determining and organizing nursing care. The problems also provide a basis for organizing appropriate nursing strategies.`

It is anticipated that by solving the nursing problems, the client would be moved toward health. The nurses philosophical frame of reference would determine whether this theory and the 21 nursing problems could be implemented in practice.