The Practical Application of the Faye Glenn Abdellahs Theory in the Holistic Care of a Patient with Terminal Stage Breast Cancer Essay Example For Students

The Practical Application of the Faye Glenn Abdellahs Theory in the Holistic Care of a Patient with Terminal Stage Breast Cancer Essay 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 patients 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. Abdellahs 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 emotion al 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) Abdellahs 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. Furthermore, Abdellah’s theory has interrelated the concepts of health, nursing problems, and problem solving as she attempts to create a different way of viewing nursing phenomenon. The result was the statement that nursing is the use of problem solving approach with key nursing problems related to health needs of people. Abdellah’s problem solving approach can easily be used by practitioners to guide various activities within their practice. This is true when considering nursing practice that deals with clients who have specific needs and specific nursing problems. Georgia, 1990) CONCEPTUAL FRAMEWORK SUMMARY OF RELATED LITERATURE AND STUDIES To begin with, Faye Glenn Abdellah, pioneer nursing researcher, helped transform nursing theory, nursing care and nursing education. She has been a leader in nursing research and has over one hundred publications related to nursing care, education for advanced practice in nursing and nursing research. In 1960, influenced by the de sire to promote client-centred comprehensive nursing care, Abdellah describe nursing as a service to individuals, to families, and, therefore to, to society. According to her, nursing is based on an art and science that mould 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. Abdellah’s patient-centred approach to nursing was developed inductively from her practice and is considered a human needs theory. The theory was created to assist with nursing education and is most applicable to the education of nurses. Abdellah’s theory would state that nursing is the use of the problem solving approach with key nursing problems related to health needs of people. Such a statement maintains problem solving as the vehicle for the nursing problems as the client is moved toward health – the outcome. (Georgia, 1990) In relation to the theory and its application, consider a case of Ryan who experienced severe crushing chest pain shortness of breath, tachycardia and profuse diaphoresis. Assume that the stages of illness state is the main basis to care. Founding Brothers EssayFor instance, the need for oxygenation, | | |fluid and electrolyte balance and the need to have a proper nutrition. In our case,| | |it is one of the crucial and critical area that needs the nurse to be vigilant and | | |practical application of critical thinking skills and common sense. We all know | | |that our patient is ill with a terminal stage breast cancer, well never know how | | |the body responds to the medication and illness. To site an example, if the | | |metastatic cancer spreads into the lungs and complains shortness of breath, thus, | | |the patient should be given immediate oxygenation. With such, all other categories | | |such as nutrition, elimination, sensory and regulatory functions should be | | |critically assessed, monitored and evaluated every day or every hour. In completion| | |of task, patient will be able to appreciate the rendered care, and verbalize the | | |satisfaction appropriate nursing care rendered to sustain her life. |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 | | |C. Remedial Care Needs | | |To identify and accept positive and negative expressions, |When we dissect the word remedial, from the root word remedy which means, it is | |feelings, and reactions |something, such as medicine or therapy, that relieves pain, cures disease, or | | |corrects a disorder. This serves as the daily interventions for our client, and for| | |clients who have a palliative care illness. In clients with terminal stage cancer, | | |it is best to include in care his/her psychological, emotional, and spiritual | | |dimensions as a holistic individual. For instance, the use of proper therapeutic | | |communication such as giving positive encouragement is good for the client. It | | |gives rise to his/her self-esteem and determination in battling with such disease. | |In our case as a nurse, we need to promote effective and trustworthy nurse – | | |patient relationship, use of proper communication techniques, maintaining | | |therapeutic environment such as a clean and well ventilated room, guided imagery | | |and self-awareness activities, expression of psychological and emotional feelings | | |regarding the disease, and lastly, assistance in the clients achievement of | | |personal spiritual goal. | |To identify and accept the nterrelatedness of emotions and | | |organic illness | | |To facilitate the maintenance of effective verbal and non | | |verbal 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 | | |D. Restorative Care Needs | | |To accept the optimum possible goals in the light of |We all know that the end product of such terminal disease is death. In this | |limitations, physical and emotional |category it is a must for a nurse to assist client in the perception and acceptance| | |of death and dying. In our case the nurse would assist client in identifying aids | | |in the process of perceiving and accepting of death and dying. The nurse is also | | |responsible in the continuing physiological and psychological care of client. At | | |the extremes, the nurse and psychological aids (such as psychologist, family, love| | |ones, relatives, and etc. will give the client the peaceful rest in the end. | |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 | | CONCLUSION In Conclusion, Abdellah’s 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 nurse’s philosophical frame of reference would determine whether this theory and the 21 nursing problems could be implemented in practice. BIBLIOGRAPHY 1. George Julia B. Nursing theories: The base of professional nursing practice 3rd edition. Norwalk, CN: Appleton and Lange; 1990. 2. Abdellah, F. G. The federal role in nursing education. Nursing outlook. 1987, 35(5),224-225. 3. Abdellah, F. G. Public policy impacting on nursing care of older adults . In E. M. Baines (Ed. ), perspectives on gerontological nursing. Newbury, CA: Sage publications. 1991. 4. Abdellah, F. G. , Levine, E. Preparing nursing research for the 21st century. New York: Springer. 1994. 5. Abdellah, F. G. , Beland, I. L. , Martin, A. , Matheney, R. V. Patient-centered approaches to nursing (2nd ed. ). New York: Mac Millan. 1968. 6. Abdellah, F. G. Evolution of nursing as a profession: perspective on manpower development. International Nursing Review, 1972); 19, 3.. 7. Abdellah, F. G. ). The nature of nursing science. In L. H. Nicholl (Ed. ), perspectives on nursing theory. Boston: Little, Brown, 1986.