Table Of ContentConceptual Nursing
in Practice
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Conceptual
Nursing in
Practice
A research-based approach
Second edition
Mary Fraser
PHD, MSc, BSc (HONS), DIPN.ED, RGN, ONC, RNT§
Director, Research and Project Consultancy,
Stirling, Scotland, FK9 5NH
I~nl
SPRINGER-SCIENCE+BUSINESS MEDIA, BV
First edition 1990
Reprinted 1993
Second edition 1996
© 1990, 1996 Mary Fraser
Originally published by Chapman & Hall in 1996
Typeset in 10/12 pt Palatino by Mews Photosetting, Beckenham, Kent
ISBN 978-1-56593-418-4 ISBN 978-1-4899-3340-9 (eBook)
DOI 10.1007/978-1-4899-3340-9
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8
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Contents
Preface ix
Preface to first edition x
Introduction to the second edition 1
1. Introduction to Conceptual Nursing in Practice: 6
a research-based approach
2. Roper, Logan and Tierney's model of activities of living 12
The authors 12
The model 13
Summary of the Roper, Logan and Tierney model of the 13
activities of living
Identification of problems using the Roper, Logan and 21
Tierney model
Planning care using the Roper, Logan and Tierney model 26
Implementing care using the Roper, Logan and Tierney 31
model in practice
Overall conclusions 38
References 38
Further reading 41
3. Roy's model of adaptation 42
The author 43
The model 43
Summary of the Roy adaptation model 44
Identification of patients' problems of adaptation 46
Planning nursing care 63
Provision of nursing care 67
Evaluation of the level of adaptation 73
Conclusions on the use of the model to 1990 77
vi Contents
Developments since 1990 77
Conclusions on the use of the model from its development 87
to 1995
References 89
Further reading 91
4. Orem's model of self-care 93
The author 94
The model 95
Summary of the Orem model of self-care 95
Identification of self-care requisites and deficits 98
Nursing actions to promote self-care 110
Assessment of quality using a self-care framework 129
The nurse as a potential self-care practitioner 135
Conclusions on the use of the model to 1990 136
Developments since 1990 137
Identification of self-care requisites and deficits 138
Conclusions on the use of the model from its development 148
to 1995
References 150
Further reading 154
5. johnson's behavioural systems model 155
The author 155
The model 156
Summary of Johnson's behavioural systems model 156
Identification of problems (behavioural systems imbalance) 160
Nursing actions to promote behavioural systems balance 172
The development of standards of care using Johnson's 174
model
Conclusions on the use of the model to 1990 175
Developments since 1990 176
Conclusions on the use of the model from its development 178
to 1995
References 178
Further reading 179
6. Rogers' model of unitary human beings 181
The author 182
The model 183
Summary of Rogers' model of unitary human beings 183
Identification of the unitary state 188
Implementing nursing care using Rogers' model 231
Conclusions on the use of the model to 1990 245
Contents vii
Developments since 1990 246
Identification of the unitary state 246
Evaluation of nursing actions to promote human-environment
interaction 248
Conclusions on the use of the model from its 249
development to 1995
References 250
Further reading 254
7. Neuman's health care systems model 256
The author 256
The model 257
Summary of the Neuman health care systems model 257
Assessment using Neuman's health care systems model 261
Intervention using Neuman's health care systems model 268
Conclusions on the use of Neuman's model in practice 274
References 274
8. Conclusions 276
References 278
Appendix 1: Studies of interest to particular groups of nurses 279
Appendix 2: Glossary of terms 284
Index 288
Preface
Since 1990 there has been considerable development in research in nursing
practice which uses a model of nursing. This is due to many reasons.
However, the aims of this book remain the same as for the first edition - to
present the reader with current reports of studies in nursing practice which
use a model of nursing as their base. I will also criticize the research
methods that the studies use, to give the reader an indication of the credi
bility of the findings, as well as commenting on the popularity of the
model in different countries and cultures.
A development that is possible since the last edition is the ability to
give some indication of why the model of nursing was used; in other
words what was the author's intention in studying nursing practice in
depth with the use of a model. This will give some indication of the impli
cations of the authors' work; I will develop this point further in the
Introduction to this edition. Therefore this edition is not simply an
updating of further studies published since 1990.
Since the last edition there has also been some comment on the models
that I included. I am grateful to Margaret Clarke (1991) and others who
have pointed out that Neuman's model should be included, and there is
therefore a chapter devoted to this in this edition.
The nursing models presented in this book are therefore:
• Roper, Logan and Tierney's model of activities of daily living
• Roy's adaptation model
• Orem's self-care model
• johnson's model of behavioural systems balance
• Rogers' model of unitary human beings
• Neuman's health care systems model
REFERENCE
Clarke, M. (1991) Book review. International Journal of Nursing Studies, 28(2), 204-5.
Preface to the
first edition
As nursing models are currently being advocated for use in every practice
setting, it was felt that the timing was right for a text which showed the
potential in practice, through investigations of practice, of the best known
of these models.
This book has therefore been compiled from a search of the literature
where studies that are easily available to nurses in Britain are outlined. It
is hoped that this compilation, with associated comment and analysis, will
help nurses in practice to understand and to continue to develop their
understanding of the conceptual basis of nursing practice.
There are many texts currently available that explain and outline nurs
ing models for the beginner of nursing; this text is not one of these. It is
aimed at the experienced practising nurse who realizes that her or his
knowledge of the use of these models is insufficient. It is hoped that
having achieved a certain level of understanding of the models, this text
will then help the experienced practising nurse further to develop this
understanding.
The nursing models presented in this book are chosen because they are
the best known and therefore arguably the best understood in Britain.
They are:
• Roper, Logan and Tierney's model of activities of living
• Roy's adaptation model
• Orem's self-care model
• Johnson's model of behavioural systems balance
• Roger's model of unitary human beings.
