Describing a model of nursing as a focus for psychiatric nursing care

This thesis would not be complete in it's review of Psychiatric nursing and Psychiatric nurse education, without reference to one of the fundamental changes that is occurring in nursing. One of the major changes that had occurred in recent years has been in the focus of nursing management nurses are placing much more emphasis on nursing diagnosis and nursing theories and are detaching from the more traditional medical model when planning nursing care. This movement towards a greater autonomy in planning their nursing care is assisting nurses in becoming a professional and independent group. Nurses are establishing a body of knowledge and skills which may be called "nursing science". Through the use of nursing models for planning patient and health care, nurses are offering a better service to the individual and the community. These changes in the focus of care commenced in the 1950's within the United States with the introduction of nursing models and theories. The Philosophies and concepts of these theories have outlined various methods and ways that the nurse could better plan and organize their professional work, including patient assessment and care. As early as 1953 the term "nursing diagnosis" was introduced by Fray to describe a step in the organization of a nursing care plan. (1) The various nursing models and theories seemed to have coincided with the movement through the 1950's and 1960's within America towards more generic based integrated curricula.     

The Self-Care Deficit Nursing Theory as a curriculum conceptual framework in baccalaureate education

Although Dorothea Orem's Self-Care Deficit Nursing Theory has been used for curricula framework for years, it was not until 2001 that Orem identified the nursing practice sciences and the foundational nursing sciences and specified the appropriate content for the two sciences. The broad purpose of this paper is to reinforce the importance of utilizing nursing theories as curricular conceptual frameworks. The specific purpose is to delineate the appropriate content for baccalaureate programs that adopt a Self-Care Deficit Nursing Theory conceptual framework for their curriculum.     

Disability as an equal opportunity issue within nurse education in the UK

Whilst equal opportunity policies, related research and subsequent curricula changes over recent years may have begun to have a positive impact in some areas of nursing education and practice, 'disability' struggles for recognition as an equality issue. Disabled people, making up approximately six million of the UK population, experience discrimination as part of their daily lives and this is also evident in the nursing services they receive. Far from challenging discrimination, nursing education may simply sustain the negative dominant ideological view of disability. Drawing comparisons with 'race', which has an established equal opportunity dimension, this paper explores disability equality, which is relatively neglected in nursing curricula. From this review it is argued that nursing as a profession has a role beyond patient care in influencing public perceptions concerning disabled people and should take more positive steps in promoting social justice by challenging discrimination. Stakeholders in nursing curricula and nursing practice have both legal and professional responsibilities to ensure that nursing and nurses become part of the solution to disability discrimination. Including disability in equal opportunity policies and strengthening their impact on pre and post registration nursing curricula, provides nursing with a tangible opportunity to do just that.     

Uncertainties in the teaching of ethics to students of nursing

Whilst ethics is now commonplace on nursing curricula in the United Kingdom there remains doubt as to how and what to teach This doubt has its origins in interlinked uncertainties within nursing, ethics and education In nursing there are uncertainties about whether we are teaching ethics to professionalize or because we are a profession, and about whether there is something which is uniquely'nursing ethics'In ethics there are competing paradigms of ethical theory and competing theories of moral development In education there are competing epistemologies, theories of learning and models of curriculum planning These uncertainties are interlinked and an understanding of them will help clarify the debate as to what to teach and how to teach it     

Preconceptions and learning to be a nurse

This article discusses the important role that preconceptions play in the process by which students learn to be nurses. The importance of preconceptions emerged from the analysis of data in a grounded theory study that sought to gain a greater understanding of how undergraduate student nurses in New Zealand experienced and responded differences they perceived between the theory and the practice of nursing. It became clear that the preconceptions each student nurse held about the nature of nurses and nursing care were the standards against which the worth of the formal, practical and personal theories to which students were exposed during their nursing degree was evaluated. It was clear that preconceptions functioned as the mediator between the intentions of nursing education and the learning that eventuated for each student from practicum experiences. The implications for nursing education, for which preconceptions are not generally highly valued as a basis for learning about professional nursing are that the individual experience and personal characteristics of each student receive significant focus when a nursing programme is planned. This means that the orthodox principles that underpin the design of nursing curricula should be reviewed and an overtly constructivist perspective adopted for nursing education for which the prior experiences of the student are the starting point.     

Transcultural nursing in Australian nursing curricula

As a result of the fact that Australia is a multicultural society with many people who come from non-English speaking backgrounds (NESB), the objective of the present study was to discuss the extent to which transcultural nursing education is incorporated into undergraduate nursing curricula. A survey was undertaken to determine the availability of nursing modules for undergraduate nursing students through Australian university websites on "transcultural nursing" or related modules. Although the inclusion of these modules into nursing education provide an opportunity for nurses to perceive and respond to different patient behaviors in multicultural societies, it is not sufficient to understand the complexity of the health care needs of a multicultural society. The survey findings suggest that many universities have not included transcultural nursing modules in their nursing curricula. To address this problem, more transcultural nursing modules need to be introduced into nursing curricula and nursing academics need to refine their attitudes about the importance of cultural aspects of patient care within nursing education.     

Study abroad as a tool for promoting cultural safety in nursing education

Nurse educators are calling for the transformation of nursing education toward curricula that promote clinical reasoning through reflective practice and understanding of patient experiences in an effort to motivate students to become change agents. Study abroad programs can play an important role in this transformation through educating nurses in the delivery of culturally safe health care in a diverse world. Exposing nursing students to study abroad experiences that are guided by critical approaches such as a postcolonial feminist framework provides nursing students with opportunities to be immersed in the life and culture of people who have a completely different positioning and location while reflecting on the "us" versus "them" phenomenon that is pervasive in modern Western society and generates negative cultural comparisons. Attention to the design and implementation of such programs is important if nursing schools in the Western world are to uphold ethical standards, promote equality in relationships with host communities and avoid inadvertent exploitation and marginalization of vulnerable peoples. We present the development and implementation of a community health study abroad program for American nursing students in Malawi, Africa using a postcolonial feminist framework.     

Culture and diversity in the nursing classroom: an impact on communication and learning

This article discusses culture and diversity in the nursing classroom and its impact on communication and learning. Today's nursing classrooms are heavily populated with students from many ethnic, psychological and sociocultural backgrounds. It is necessary that nurse educators recognize that many communication patterns value diversity, and is a major support in many learning styles of their students. Without a thorough understanding of diversity and communication among cultures, major challenges exist for both professors and students. The nursing curriculum and classroom materials should portray diversity so that all subject matter reflects a range of cultural perspectives. Higher education curricula are probably the most diverse in the world, and with a global perspective, and the United States being a "melting pot," these curricula will become even more diverse in the future. Nursing education has the responsibility to teach students how to communicate on a global scale. These global models of communication will assist students to successfully enter professional nursing practice with strong communication skills and a level of cultural competence that professional nurses need to know.     

Professional nursing education: what is its purpose?

Rogers (1970, p. 88) has written "The purpose of professional education is to provide the knowledge and tools whereby an individual may become an artist in his field. It is not to prepare the skilled practitioner." This statement is used to provide a basis for discussion of some issues involved in relation to nursing and nursing education. The problem area is first clarified before discussion moves on to show the relevance of conceptual models and theory to professional nursing education and to look at the kinds of knowledge and tools which could be provided to promote artistry in nursing.     

A curriculum model for an integrated senior year clinical experience

Transformations in the delivery of health care from hospital to community have brought about many changes in nursing practice. These, in turn, have necessitated alterations in the education of nursing students, the curricula, and clinical experiences. Confident that nursing is an independent practice, exclusive of the health care setting, our faculty decided to direct our teaching efforts to reflect changes in health care delivery. We restructured our baccalaureate nursing program's senior level clinical education experience to prepare students to meet the needs of the clients we serve--the community--and the demands of professional nursing education. In doing so, we have supported Ryan's definition of community, which includes "all settings where consumers seek health care" (1, p. 140). In response to the recommendation by the pew health professions commission for new models of content integration "between education and the highly managed and integrated systems of care" (2, p. 51), a decision was made to merge three senior level clinical courses--pediatrics, public health, and nursing leadership and management--into one integrated experience. This process required an examination of collective values and beliefs with respect to course content and learning experiences. The challenge was to examine "sacred cows" and eliminate redundancies and replication of learning activities.     

Mediation of transcultural nursing care in clinical context: a tightrope walk

Our wish for suggestions for a line of action regarding our contact with migrants in the clinical context has led us to an increased acceptance of "Transcultural Nursing" by Madeleine Leininger. However, an uncritical adoption of this theory without theoretical and historical background information produces in practice a stereotyped image of migrants, and a cultural rating of social and individual aspects instead of mutual understanding. Hence, from the present-day perspective, Leininger's model is not suitable to establish transcultural nursing care in practice. A theory not encouraging the analysis of socio-cultural backgrounds of one's own but the sight "from without" of the so-called alien--a theory that does not make interaction its main object but culture, cannot serve as a basis for transcultural nursing care. Up-to-date transcultural nursing care does not need the introduction of a specific nursing concept for migrants but an extension of nursing by a socio-cultural and migration-specific dimension. However, nursing care does not seem to accept this challenge, what with it being far easier to add the "Leininger Culture Care Theory" to the existing curricula as an additional model. Thus nursing loses the opportunity of grappling with the adoption of certain theories and models of other disciplines. Even though Leininger is herself a nurse, she has developed her model in her capacity as a cultural anthropologist using the background of anthropological theories. But, the supplying of transcultural nursing care demands also from cultural anthropologists an analysis of the concrete context of nursing care and its approaches. Only by bearing this in mind, cultural anthropology can counter effectively the danger of being marginalized as a fringe discipline, and of being reduced to the level of providing cooking recipes.     

Strategies and conditions for teaching theoretical nursing: an international perspective

How, when, and why to teach nursing theory are still central questions for nurse educators. The questions are restated and generalized to the whys, and hows, and the whens to incorporate theoretical nursing rather than nursing theory in nursing education. Process and strategies for teaching theoretical nursing are compared and contrasted with those related to research. We propose the use of similar strategies and add several essential conditions related to theoretical nursing. In teaching theoretical nursing, educators are expected to develop an environment that values theory and ways by which a theoretical identity is facilitated and fostered in students. Critical and reflective thinking as well as the role modelling of local models of excellence are central ingredients in the development of nurses who are committed to using and developing theories. One approach in incorporating theory in curricula is to identify central components and goals such as historical analyses, domain boundaries, theory utilization, process and strategies for theory development and testing. Once components are identified, faculty can make a decision about where to incorporate them. We have proposed several approaches that incorporate theoretical nursing in undergraduate and graduate programmes.     

Orem自理理论在Miles术后患者中的应用

目的：探讨Orem自理理论在Miles术后患者中的应用。方法：应用Orem自理理论评估患者的自理能力,用3种护理系统提供不同程度的帮助,让患者主动参与护理活动。结果：患者自护能力得到提高,下床活动时间提前,胃管、尿管、引流管拔除时间提前,住院时间缩短,减少了医疗开支,降低了并发症发生率。结论：O rem自理模式是护理学科的重要理论,具有很强的实用性,应用后改善了患者的生活质量,提高了护士的业务水平,丰富了护士的职业内涵。     

Education: an antidote for the spread of HIV/AIDS.

There are growing fears about the rate at which AIDS is spreading across the globe today, particularly in Africa. In 20 years, AIDS has become the greatest pandemic ever, and indications are that it will continue to increase. Because there is no universally accepted curative drug for the treatment of the epidemic, this report describes an attempt at providing education as a preventive method for the spread of the deadly disease. It is also an attempt to rise to this challenge by a systematic analysis of appropriate theories that can lead to insight into the epidemic. An empirical approach will further add to scholarly understanding and much-desired solutions. Suggestions are offered on how to achieve these goals through integration of HIV/AIDS education into school curricula, and how nursing practice can help in the education about and treatment of the disease. This report is the first part of a two-phased study from a sociologic point of view of an emergent universal health problem.     

Integrating mental illness prevention into community-based undergraduate education

Including preventive models of health care in undergraduate education is essential as the nursing profession moves increasingly to community-based care. Traditionally, mental health curricula have focused primarily on psychopathology. This article presents current research in the attachment and temperament literature, which provides sound evidence for the need to synthesize prevention of mental illness concepts into undergraduate education. A curriculum model that integrates concepts from psychiatry and public health to prepare nursing students to promote mental health is described.     

Curriculum Mapping in Nursing Education: A Case Study for Collaborative Curriculum Design and Program Quality Assurance

The development of nursing program curricula requires an understanding of the fundamentals of curriculum design that is relevant and competency based. Curriculum mapping is an evidence-based approach to curriculum design that promotes faculty collaboration and quality assurance in nursing education. This article describes the application of our large-scale curriculum mapping process. Through this process, faculty members were able to identify gaps, spot redundancies, and improve transparency across the program curricula.     

Application of the case study design: nursing interventions for discharge readiness.

A single case study design was used to explore the nursing process and intervention related to discharge preparation of one family with a child requiring complex care at home. Helping methods described by Orem were used to categorize identified nursing interventions. Discharge readiness was assessed to verify consideration of conditions for discharge. The major study question was "How is discharge preparation conducted?" Collected data provided evidence to support each of three case study propositions: (1) patients and their home caregivers are involved in discharge preparation as planners and as learners, (2) nursing interventions occur in five major helping areas as outlined by Orem, (3) discharge preparation addresses each component of discharge readiness. The case study design was effective as an approach to explore nursing interventions, verify considerations of discharge conditions, and refine the concept of discharge readiness. A decision trail is presented for nurses to replicate the process with questions related to their practice.     

Theory of nursing as curriculum content

This article presents an introduction to theories of nursing, and a discussion of the structure of the discipline, its relationship to the nursing curriculum, and nursing theories as curriculum content. Some results of a content analysis of curricula for Australian post-basic clinical nursing courses are presented. Such curricula do not appear to afford much coverage of the nursing process and theories of nursing.     

Nursing education in Canada: historical ''Progress''—contemporary issues

Contemporary concerns in nursing education in Canada suggest that the earlier educational pathways have not always represented progress. The persistence of alternate routes for the preparation of registered nurses, and the continuing divisiveness among nurses with differing educational backgrounds are problem areas that still require resolution. Some problems, such as the development of the nursing curriculum, have been shared across educational settings. Nurse educators in Canada, as in other countries, have vested tremendous energy into this aspect of nursing education. In retrospect, it is recognized that much of this effort has been misdirected. Efforts to strengthen the theoretical underpinnings of the curriculum have resulted in the incorporation of borrowed theory from other disciplines, often without critical examination of the context in which the theory developed, or of its consistency with the philosophical perspectives of nursing. Attempts to build curricula around the major nursing models have also met with limited success. Separation of education and practice, persistence of multiple levels of preparation in nursing, and a continual search for viable curriculum models have led to uncertainty, to detours in the development of nursing education, and to occasional reconsideration of previous approaches.     

白内障术后患者实施奥瑞姆自理模式的护理效果

目的 研究奥瑞姆自理模式在白内障患者术后护理中的应用价值.方法 将2015年5月～2016年5月该院收治的108例白内障患者作为研究对象,随机分为对照组和观察组.对照组采用健康教育、心理护理、日常护理等常规护理;观察组在对照组护理基础上开展奥瑞姆自理模式护理.比较两组患者遵医行为、护理效果、焦虑与抑郁状态、护理满意度及生活质量.结果 对照组患者术后坚持食疗与运动、正确用药、用眼卫生、定期复诊遵医行为率均差于观察组,差异有统计学意义(均P<0.05).对照组有效率68.5％低于观察组有效率87.0％,差异有统计学意义(P<0.05).护理后两组患者SAS、SDS评分较治疗前均有所降低,且观察组下降程度优于对照组,差异有统计学意义(均P<0.05).对照组患者护理满意度83.3％低于观察组护理满意度96.3％,差异有统计学意义(P<0.05).护理干预后,对照组患者生活质量各指标的评分均明显低于观察组,差异有统计学意义(均P<0.05).结论 白内障患者术后实施奥瑞姆自理模式护理效果显著,能有效缓解临床症状,增强治疗效果,促进视力恢复.