China Medical University Basic concepts in nursing science Li Xiaohan School of Nursing China Medical University

Introduction Human being Environment Health Nursing

Introduction Definition of nursing science Four basic concepts that affect and determine the nursing practice

Human being Environment Health Nursing

Human being The human being is a uniform whole Basic needs of human being Growth and development of human being Self-concept of human being

1. The human being is a uniform whole (1) Concept of a whole (2) The uniform whole of human being  (3) The human being is an open system (4) The scope of human being in nursing

The uniform whole of human being Physiological Psychological Social Spiritual Cultural

The human being is a open system Closed system Open system

Individual Family Community Society The scope of human being in nursing Individual Family Community Society

To maintain the balance of organism Basic goal of human being To maintain the balance of organism Balance among subsystems of organism Balance between organism and its environment (internal and external environment)

2. Basic needs of human being （1）Definition of basic needs （2）Types of basic needs （3）Characteristics of basic needs （4）Factors that affect meeting needs （5）The theory related to basic needs

Basic needs of human being (1) Definition of basic needs Need Basic needs of human being

(2) Types of basic needs Physiological needs Social needs Affective needs Cognitive needs Spiritual needs

(3) Characteristics of basic needs 1）Approximately same basic needs 2）The importance of each need for each person is different 3）All the basic needs are interconnected and interactive

(4) Factors that affect meeting needs Physiological factors Emotional factors Knowledge and intellect factors Social factors

(4) Factors that affect meeting needs Environmental factors Individual factors Cultural factors

(5) The theory related to basic needs —Maslow’s hierarchy theory of Basic needs for Human Being

Maslow’s theory (a) Basic content (b) Basis for need’s hierarchy (c) General rules (d) Significance to nursing

Basic content Physiological needs Safety needs Love and belongingness needs Self-esteem needs Needs for self-actualization

Sequence of need’s appearance Basis for need’s hierarchy Importance of needs Sequence of need’s appearance

Significance to nursing a) To identify client’s unmet needs b) To realize and understand client’s words and behaviors c) To predict client’s unspoken needs

Significance to nursing d) To collect client’s data comprehensively e) To put client’s nursing problems in adequate order

3. Growth and development of human being (1) Definition of growth and development (2) Content of growth and development (3) Basic principles of growth and development (4) Factors that affect growth and development

Definition of growth and development Maturation

in physiological aspect Growth: a increase on amount in physiological aspect

Definition of development A changing process in physical and psychological aspect along with age’s increase and interaction between individual and its environment.

Characteristics of development: in order predicted persistent as a result of learning and a symbol of maturation holistic (physiological, psychological, social )

Maturation: Narrow definition Generalized definition

Narrow definition the process of the growth in physiological aspect and the potential in developmental aspect were exerted fully

Generalized definition a individual has not only obtained full development in physiological aspect, but also put up many mature behaviors.

Content of growth and development Physiological Cognitive Social Affective Spiritual Moral

growth and development Basic principles of growth and development 1) Persistent, in sequence, regular, predicted. 2) Common development process 3) Passing each developmental stage in unique manner and speed.

4) Character and definite developmental tasks in each developmental stage 5) Development in infant phase will affect the following basic attitude, temperament, life style and behaviors. 6) Development is obtained by gradual maturation and constant learning.

growth and development Factors that affect growth and development Heredity Environment

4. Self-concept of human being (1) Definition of self-concept (2) Generation of self-concept (3) Components of self-concept (4) Importance of self-concept

Definition of self-concept a person’s attitude towards to himself (herself )

Generation of self-concept the combination of other’s opinion to a person and a person’s self-detection and self-cognition.

Components of self-concept Body image Role performance Personal identity Self-esteem

Importance of positive self-concept (a) Affecting one’s thoughts and behaviors (b) Affecting one’s choices (c) Affecting other’s attitude to oneself (d) Affecting one’s ability of meeting an emergency when one is in the face of various changes

Environment 1.Definition of environment 2.Classification of environment 3.Relationship among environment, human being and health

Definition of environment Roy’s definition of environment Henderson’s definition of environment

Roy’s definition of environment the summation of all factors that surround and affect the behaviors and development of individual or collectivity.

Henderson’s definition of environment a general name of all external factors that affect the life and development of organism.

Classification of environment 1. Internal environment 2. External environment

External environment Humanistic-social environment Natural environment Humanistic-social environment Therapeutic environment

Natural environment Physical environment Biological environment

Humanistic-social environment (a) the number of population (b) cultural education (c) interpersonal relationship (d) scientific management (e) medical care services system

Therapeutic environment Definition Function Requirement

Definition It is an environment that created by professionals aimed to fit the recovery of clients’ physiological and psychological health

Functions To influence clients’ feeling (b) To influence the course and degree of disease’s recovery.

Requirement (a) safety (b) comfort a) to prevent the accident’s occurrence b) to avoid the spread of microorganism (b) comfort a) good physical environment b) good services and attitude

Relationship among environment, human being and health (1) Human being and its environment are interdependent and interacted (2) Human being’s health is closely linked with the environment

Health Concept of health Concept of disease The relationship between health and illness

Concept of health (1) Definition of health (2) Model of health (3) Factors that affect health

Definition of health 1) Absence of disease 2) Feel comfort 3) Well-balanced functional activities 4) Well-balanced physiological and psychological activities 5) WHO’s definition of health

WHO’s definition of health WHO——The World Health Organization “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” (holistic view of health)

Model of health (1) Definition (2) Characteristics ——Health-illness continuum model (1) Definition (2) Characteristics (3) Nurses’ responsibilities

Definition of health-illness continuum model Health and illness or disease can be viewed as the opposite ends of a health continuum. From a high level of health a person’s condition can move through good health, normal health, poor health, and extremely poor health, eventually to death.

People move back and forth within this continuum day by day People move back and forth within this continuum day by day. There is no distinct boundary across which people move from health to illness or from illness back to health. How people perceive themselves and how others see them in terms of health and illness will also affect their placement on the continuum.

Characteristics of health-illness continuum model (a) At any time any person’ health status holds a place on certain point between two ends of health-illness continuum

(b) any point on the health-illness continuum is a synthetical representation of various (all) aspects of individual in physiology, psychology, and society.

Nurses’ responsibilities (a) to help the clients to identify their place (location) on the health-illness continuum (b) to assist the clients to adopt some measures (take actions) in order to reach a well state of health.

Factors that affect health (1) Biological factors (2) Environmental factors (3) Life style (4) Psychological factors

Biological factors 1）Pathogenic microorganism 2）Biologic-heredity factor 3）Other factors

Environmental factors 1) Natural environment: 2) Social environment:

Concept of disease Definition of disease Effect of disease (3) Measures of preventing disease

Definition of disease 1) Ancient view of disease 2) Modern view of disease

Ancient view of disease Ghosts and gods attach to the body Unbalance between negative and positive

Modern view of disease (a) A state that is treated by physician and falls short of the needs of human being (b) Be discomfort, suffering and pain (c) A loss and change of social behaviors, especially the loss and change of labor force

(e) The destroy of homeostasis of organism (d) An abnormity of function, structure and shape of organism (e) The destroy of homeostasis of organism (f) A reaction of the organism to harmful factors

Effect of disease 1) The effect on individual 2) The effect on family 3) The effect on society

The effect on individual 1）Positive effect 2）Negative effect

The effect on family 1) Economic burden is increased 2) Family member’s psychological stress is increased 3) The emotion change of family member

The effect on society 1) Social productivity is decreased 2) Medical resources are consumed or wasted 3) To infect others and threaten other’s health

Measures of preventing disease 1) Primary prevention (etiological prevention) 2) Secondary prevention (pre-clinical prevention) “Three early” : To discover early To diagnose early To treat early 3) Tertiary prevention (clinical prevention)

The relationship between health and illness 1）No distinct boundary；A relative relationship 2）Be dynamic changing 3）Be mutual transform under definite condition 4）Be exist at the same time on one individual

Nursing 1. Concept of nursing 2. Evolvement process of the concept of nursing 3. The relationship between nursing and health

Concept of nursing (1) Definition of nursing (2) The content of concept of nursing (3) The connotation of concept of nursing

Definition of nursing (b) Henderson’s definition of nursing (a) Nightingale’s definition of nursing (b) Henderson’s definition of nursing (c) American Nurse Association’s definition of nursing (d) International Council of nurses’ definition

independent applying science that synthesizing natural The content of concept of nursing (1) The nursing science is an independent applying science that synthesizing natural and social sciences.

(2) Nursing is a profession that helps human being and serves for health of human being

(3) Nursing can assist individual to meet the basic needs of human being and enforce the ability of self-care.

(4) The tasks of nursing are: To promote health To prevent disease To help ill-person to healing To assist the dying patient to pass away with quietude, peace, and dignity.

human being, including suffering person and healthy person. (5) The client is a holistic human being, including suffering person and healthy person.

(6) The working place is not only in the hospital, but also in family, community and whole society. Nursing is not only a science, but also an art

(8) The nursing science attaches importance to human being’s living environment and the interrelation between human being and its environment.

(9) The nursing science is a gradually perfect and developing science.

The content of concept of nursing (1) Caring: lasting topic (2) Humanism: humanistic perspective (a) Respect individual (b) Pay attention to the human nature (c) Treat equally without discrimination (3) The helping relationship

Evolvement process of the concept of nursing Developmental stages of nursing model (2) The meaning and significance of holistic nursing

Developmental stages of nursing model Stage 1: disease-centered stage Stage 2: patient-centered stage Stage 3: health-centered stage

The meaning and significance of holistic nursing The meaning of holistic nursing Significance of holistic nursing

The meaning of holistic nursing (a) Definition of holistic nursing (b) Connotation of holistic nursing     

Connotation of holistic nursing (a) To meet client’s holistic needs (physiological, psychological, social, spiritual, cultural)

(b) To serve for the whole life course of human being (c) To serve for individual to family, community and society

Significance of holistic nursing To enrich and change the direction and content of nursing research (2) To widen the service areas of nursing and changes the traditional image of nurses

(3) To contribute to establish a new type relationship between physician and nurse, and relationship between nurse and patient

(4) To propose a new type view of nursing administration and leadership (5) To change the curriculum design of nursing education

The relationship between nursing and health WHO(1978) : “……to help patient to resume to health , help healthy person to promote health.”

ICN: right and obligation of nurses are: (a) To maintain life (b) To lighten suffering (c) To promote health

To promote health To prevent disease To assist healing Tasks of nursing: To promote health To prevent disease To assist healing To ease suffering