FAYE ABDELLAH- TWENTY-ONE NURSING PROBLEMS

FAYE GLENN ABDELLAH

Twenty-One Nursing Problems

Description of the Theorist

     In March 13, 1919 Faye Glenn Abdellah was born in new York city. She finished her basic nursing education, magda cum lauda in 1942 from Fitkin Memorial Hospital School of Nursing, in Neptune, New Jersey. She obtained her Bachelor of Science in 1945, Her Masters of Art in 1947 and her Doctor of education in 1955 from the Teacher’s college at Columbia University. Faye Abdellah became famous and celebrated when she became the first nurse and first woman to serve as Deputy Surgeon General of the United States. The surgeon general is basically the leader of the United States public health service commissioned corps and thus the main spokesperson on issues of public health.

     Due to her contributions in the field of education and nursing research, she was inducted into the US National Women’s Hall of Fame in 2000. She is the beneficiary of both national and international award and is a fellow, defined as an elite member of a group of people who went together as peers in the American Academy of Nursing. Now retired, she has written and discussed more than 100 publications related to nursing care, education for advanced practice in nursing, and nursing research.

     It was in 1960 that she was profoundly influenced by the desire to promote client centered all-inclusive nursing, care thus making the idea of nursing as a true humanitarian service to individuals, to families, and therefore to society. According to her, nursing is grounded as an art and science that molds the attitude, intellectual capabilities, and technical know-how of the individual nurse into the desire and capacity to assist people, sick or well, and to deal with their health needs. Nursing may be implemented under general or specific direction.

As a complete humanitarian service, nursing includes the following

·         Be acquainted with the nursing problems of the patient.

·         Choose the definite course of action to make in the scope of relevant nursing principles.

·         Make available continuous care of the individual’s entire health needs.

·         Give continuous care to relieve pain and discomfort and provide immediate security for the individual.

·         Regulate the total nursing care plan to meet the patient’s tailored needs.

·         Serving the individual to become more self-determining in achieving maintaining a healthy state of mind and body.

·         Informing nursing personnel, family and support system to provide the individual act for oneself with perceived limitation.

·         Facilitate the individual to adapt to limitations and emotional problems.

·         Team up with different allied health professions in working with the diagram for optimum health on local, state, national and international levels.

·         Engaging in nonstop evaluation and research to develop nursing techniques and to create new techniques to serve the health needs of different people.

These original premises have gone into an evolutionary process. As an evidence of the dynamics in the scope of nursing service, the third item “provides continuous care of the individual’s total health needs” was eliminated in 1973. Although no reason was given, it can be hypothesized that the words in ideas continuous and total make that service, for intent and purposes, impossible to provide. From this precept and thought, Abdellah’s theory was made.

Metaparadigm

Person

Abdellah classified the beneficiary of care as individuals. However, she does not set standard limits on the nature and essence of human beings. The twenty-one nursing problems relate wit biological, psychological and social aspects of individuals and can be said to correspond to concept of importance.

Health

In this theory, the concept of health is defined as the center and purpose of nursing service. Although Abdellah does not give a definition of health, she speaks to a “total health needs” and a “healthy state of mind and body” in her description of nursing as a comprehensive service.

Environment

The idea of environment is addressed by Abdellah and is included in the “planning for optimum health on local, state, national and international levels.” However, as Abdellah elaborates her ideas, the apex (core) of nursing service is the individual.

Nursing

The concept of nursing in this theory is generally grouped into twenty-one problem areas for nurses to work out their judgement and appropriate care. Abdellah considers nursing to be an all-inclusive service that is based on the discipline of arts and science that serves individuals, sick or well, cope with their health needs.

Model of the Theory

Abdellah’s typology of twenty-one nursing problem is a conceptual model mainly concerned with patient’s needs and the role of nurses in problem identification using a problem analysis approach. According to the model, patients are described as having physical, emotional and sociological needs. Faye Abdellah proposed a classificatory framework for identifying nursing problems, based on her idea that nursing is basically oriented to meeting an individual client’s total health needs. Her major effort was to differentiate nursing from medicine and disease orientation.

Abdellah’s patient-centered approach to nursing was developed inductively from her practice and is considered a human needs theory. Although it was intended to guide care of those in the hospital, it also has relevance for nursing care in community settings. Abdellah was clearly promoting the image of the nurse who was not only kind and caring, but also intelligent, competent and technically well prepared to provide service to the patient.

Assumption 

Correct identification of nursing problems influences the judgement in selecting the next step in solving the client’s nursing pronlem.

Philosophical  

The assumption Abdellah’s “twenty-one nursing problems theory” relates to change and anticipated changes that affects 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, health and healthcare delivery. Changing nursing education; continuing education for professional nurses; and development of nursing leaders from undeserved groups.

Scientific

In Abdellah’s opinion, one of the greatest barriers that kept nursing from a professional status was the lack of a scientific body of knowledge unique to nursing. The educational system was not providing students and practitioners with a means to cope with clinical experiences based on a service approach provided no measure of the quality of the experience. The delivery of care to patients was organized around meeting the needs of the institution rather than the needs of the patient. The typology of twenty-one nursing problems and skills was developed to constitute the unique body of knowledge that is nursing.

Research Studies

The Practical Application of the Faye Glenn Abdellah's Theory in the Holistic Care of a Patient with Terminal Stage Breast Cancer

Topics: Nursing, Breast cancer, Nursing theory Pages: 12 (2749 words) Published: August 18, 2010

INTRODUCTION

"Your mammogram is suspicious for breast cancer" "Your biopsy was positive for breast cancer." These are among the most terrifying words a woman can hear from her doctor. Breast cancer elicits so many fears, including those relating to surgery, death, loss of body image and loss of sexuality. Managing these fears can be facilitated by information and knowledge so that each woman can make the best decisions concerning her care. Optimally, these issues are best discussed with the patient's doctor on an individual basis. What follows is a review of information on breast cancer intended to aid patients and their families in their navigation through the vast ocean of breast cancer issues.

Breast cancer is the most common cause of cancer in women and the second most common cause of cancer death in women in the U.S and other countries. While the majority of new breast cancers are diagnosed as a result of an abnormality seen on a mammogram, a lump or change in consistency of the breast tissue can also be a warning sign of the disease. Heightened awareness of breast cancer risk in the past decades has led to an increase in the number of women undergoing mammography for screening, leading to detection of cancers in earlier stages and a resultant improvement in survival rates. Still, breast cancer is the most common cause of death in women between the ages of 45 and 55. (Stoppler, 2009)

RATIONALE

Breast cancer is a preventable disease but can be very chronic if it appears in a woman’s body, especially if it metastasizes to other parts. When a woman has breast cancer, it is sometimes very hard for them to accept the fact that they have cancer. According to an article by Gina Shaw, 2005 entitled," Metastatic Breast Cancer as a Chronic Condition”, the hardest part, for most women, is the uncertainty. The uncertainty as to when they will stop suffering from this disease and when they will ever get rid of it has always been the problem that breast cancer patients are facing.

Faye Glenn Abdellah conducted research to identify ways to promote patient-centered comprehensive nursing care. As a result of the first three of these studies, 21 basic nursing problems were identified. 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. The problems may be overt or covert, and problem solving is to used by the nurse. The nursing process as a problem-solving process is compatible with this approach. (Copyright © 1995-2008, Pearson Education, Inc., publishing as Pearson Prentice Hall)

SYNOPISIS OF THEORY

Abdellah spoke of the patient-centered approach, she wrote of nurses identifying and solving specific problems. This identification and classification of problems was called the typology of 21 nursing problems. Abdellah’s typology was divided into three areas: (1) the physical, sociological, and emotional needs of the patient; (2) the types of interpersonal relationships between the nurse and the patient; and (3) the common elements of patient care. Abdellah and her colleagues thought the typology would provide a method to evaluate a student’s experiences and also a method to evaluate a nurse’s competency based on outcome measures. (Tomey & Alligood, Nursing theorists and their work 4th ed., p. 115, 2002)

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.

Reference:

 Tomey, A.M. and Alligood, M.R., 2008, nursing theorists and their work 4^th ed

 Abdellah F.G. 1987, The federal role in nursing education, nursing outlook

Abdellah F.G. & Levine, E. 1994 Preparing nursing research for the 21^st century

External links:

 http://nursingtheories.blogspot.com/2009/07/changing-world-one-step-at-time-faye-g.html

http://nursingtheories.blogspot.com/2009/07/changing-world-one-step-at-time-faye-g.html

http://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20160501.11.pdf

OKEAGBOR CHIAMAKA C.

NNABUEZE QUEENESTHER C.