1

INTRODUCTION

Once considered an art, the nursing profession is now a science.

which relies on a body of knowledge and on methods that apply
in constantly evolving human and social contexts.

This module will allow the nursing student to become familiar with the specific vocabulary.
profession but also to acquire basic knowledge on the theorization of
nursing care.

The appropriation of concepts and theories will facilitate the student's understanding of
other modules related to nursing care including the history and organization of the
profession, the care techniques and later the nursing care approach.

The module is structured into four (4) chapters including:

Chapter I: Definitions of terms;
Chapter II: Necessity of the conceptual model in information systems.

Chapter III: Theories in Information Systems.

Chapter IV: The conceptual model of V.H.

The aim is to help the nursing student understand what a nurse is.
What are social mandates.

Two intermediate objectives are assigned to this module, namely:

-to define the origin of the nursing profession;
Describe all nursing care philosophies.
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OBJECTIVES AND METHODS

1. OBJECTIVES

At the end of the teaching of this module, the learner should be able to:
To understand the fundamental concepts that govern the nursing profession.
Explain the components of the conceptual model in nursing care.
To appropriate the four (4) major schools of thought in nursing care.
Explain the reference framework of V.H.

2. TECHNICAL METHODS
Media exposure
Group work

3. EVALUATION
-QCM
-QROC
Writing questions
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CHAPTER I

DEFINITION OF TERMS
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DEFINITIONS OF TERMS

Knowing that the professional brand of nursing care corresponds to knowledge

nurse and how nurses use it, it is essential that
we have the same understanding regarding cardinal terms or keywords.

Concept
The concept is a mental representation that we have of an idea, an object.
or an event.
The concept in nursing is the way ideas are organized and
communicated to others.

Theories
These are sets of related definitions and propositions aimed at explaining,
to describe a part of the empirical world. The theory explains the order of application
of phenomena; it is called a paradigm when it achieves unanimous agreement of the
scientific community in social sciences.

Model
A model is a reconstruction of reality, the mental image, descriptive or
analogue that allows visualizing a theory. It is also the reference unit.
stable that reproduces the main features of a real object thus guiding the
reasoning.

Conceptual model in nursing care

It is a mental representation of what the profession could or should be.
nurse.
The conceptual model serves to structure nursing activity; it specifies the purpose of the
profession, guide practice, training, and research in nursing.
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Health
It is a personal perception whose meaning varies from one person to another.
other according to personal development, social and cultural influences, the
previous experiences and personal expectations.
However, the nurse's conception of health and its determinants
strongly influences the nature and scope of nursing care.
In 1946-1947, the WHO proposed the following definition: "health is a state of
complete physical, mental, and social well-being, and does not consist only of
an absence of illness or infirmity.
Although there are multiple definitions of health, they can be grouped together.
in four (4) models:
The clinical model where health is characterized by the absence of signs and symptoms.
symptoms of illness or disability known.
The sociological model: health is characterized by the ability to fulfill the
social functions with the highest performance. Health is perceived here
such as the actual fulfillment of valued roles and functions
to which an individual is destined through socialization.
The adaptive model: health corresponds to the ability to adapt.
easily with its environment with which the individual interacts.
The eudemonist model: health equates to well-being; everything is said to be in health
accomplished individual, that is to say, one who has fulfilled themselves.

The disease
From Latin "male habitus" which means to be in a bad state, the illness is
a disorder, an anomaly that raises questions about health, healing,
suffering even death.
Just like health, illness is subject to interpretation; it is a
perturbation of a functioning considered normal and refers to fantasies of
guilt, immorality, failure or abnormality according to beliefs.

The nurse
It is the person who, having received basic education, is capable and authorized to
assume in its country the responsibilities of nursing care (NC) that
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require health promotion, disease prevention, and care for

sick.

Nursing care
It is a support service aimed at supplementing disabilities, preventing
disease, the restoration, maintenance, and promotion of the individual's health,
family and the community with their full participation.
Nursing care can be subdivided into three categories: preventive care,
curative care and palliative care.
Preventive care consists of preventing the onset of disorders or
disease; they have a prophylactic aim and include prevention
primary, secondary and tertiary.
Primary prevention refers to the care provided with the aim of
reduce the incidence of a disease in a population. Examples:
systematic vaccinations, household waste removal.
Secondary prevention refers to the care provided in the context
of an existing disease; it consists of reducing the prevalence of a disease
in a given population by limiting the number of cases affected and in
mitigating the risk of contamination.
Tertiary prevention is the set of nursing care provided to a
advanced or evolving phase of a disease in order to prevent the
recurrences, limit the aftereffects/complications.

Curative nursing care is the care given/dispensed to a person,

a family or a group of individuals affected by a disease. These care aims to
the disappearance of warning signs of the disease and are likely to
heal or allow access to a better state of health.

Palliative nursing care aims to alleviate the symptoms of a disease.

when there is nothing left to do.

Each of these three categories of nursing care includes three dimensions:

educational, relational and technical.
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CHAPTER II

THE CONCEPTUAL MODEL

IN NURSING CARE

It is by being aware of what it is that the being

human is capable of being present to the other

Lise Riopelle
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II - THE CONCEPTUAL MODEL IN NURSING CARE

2.1. Start of theorization

Until the end of the 19ththcentury, healing was considered an art, a profession
practiced mainly by nuns. The professionalization of care
nurses was born with the works of Florence Nightingale in 1859 in "Notes on
Nursing ». Nursing then becomes a profession with a program
training on theoretical and practical fundamentals as opposed to the profession that
learned on the job without formal schooling.
This effort at theorization did not have immediate repercussions on development.
from the profession as Nightingale's design did not serve as a basis for training
in nursing practice. Thus, the entire first half of the 20thcentury
during the mission, the nursing role was essentially one of medical assistance. The
The 1960s were those of the resumption of the process of theorization with the backdrop of
found the feminist movement that organized itself while questioning the
traditional ways of designing and developing science.

2.2. Importance of the conceptual model in nursing care

The influence of other professionals on the organization and structure of
care, the multiplicity of interpretations of the nursing role (assisting the doctor,
autonomous...) were the factors that motivated the nurse to define the purpose of his
profession and to specify its specificity compared to others. This need to
The conceptualization of nursing service took its roots from a questioning of
traditional training program modeled on medicine and administered by the
doctors.
A reorientation of the programs emerged from nursing knowledge, which has
leads to an organization of knowledge. However, the description of knowledge
nurse (knowledge, skills, interpersonal skills) has raised theoretical questions
and philosophical such as:
What is the area of interest of the nursing discipline?
How is the nursing profession different/distinct from other professions?
of health?
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What should be the body of knowledge necessary for identification,

control and guidance of nursing action?

These questions find their answers in clear and precise concepts,

complete and explicit called conceptual models. The conceptual models in
nursing care allows then:
to identify the area of interest of the nursing discipline;
to specify the specific contribution of the profession;
to delineate the body of knowledge required for the exercise of the
nursing profession.

The conceptual model allows for a certain uniqueness of will and desire, essential
for any commitment.
Each conceptual model in nursing care consists of three components.
essentials: values, assumptions, and elements.

2.3. The components of a conceptual model in nursing care

Every conceptual model in nursing care consists of a set of
three (3) components which are the postulates, the values, and the elements: these are the
theoretical bases or foundations of the conceptual model.

2.3.1. The postulates

These are the facts or statements generally accepted, true and legitimate.
constituting the theoretical foundation on which the design is based. They include
concepts that illustrate the beneficiary's vision.

2.3.2. The values

These are the beliefs of the author of a conception. Values provide a
overall vision of the nursing service.
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2.3.3. The essential elements of the m.c.

Specifically in the professional service of the nurse, the elements
represent professional activities regardless of the place and time of
professional action. These elements are:
The goal: it is the end sought by the members of the profession.
The beneficiary of the service: it is the individual or group of individuals defined by the
design and towards whom the professional directs their activities.
Role of the professional: it is the social action played by the members of a
given discipline.
Source of difficulty: it is the origin or the probable cause of the difficulties experienced
by the beneficiary concerning their well-being.
Interventions: they consist of the center and the mode of intervention.
The center of the intervention is the focus of attention given to the beneficiary on
which the professional intervenes.
The mode of intervention is the means available to the professional for
intervene or act.
Consequences: these are the expected results of professional activity in
in accordance with the pursued goal.
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CHAPTER III

THEORIES IN NURSING CARE

It is from discussion that light springs forth.

J.J. ROUSSEAU
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III – THE THEORIES IN NURSING CARE

There are a multitude of theories in nursing that can be grouped into

trends or currents of thought in nursing such as:
ecological trend;
-existential trend;
sociological trend;
cosmic trend.

3.1. The ecological trend

3.1.1. FLORENCE NIGHTINGALE

The professionalization of nursing care is induced by Florence.
Nightingale who draws inspiration from the meticulous observations made among soldiers
cared for during the Crimean War. Very concerned about prevention concepts.
and health promotion, Florence relies on the environment to provide assistance
to the injured.

3.1.1.1. The design of man

The human being is considered as a passive instrument subject to the laws of the
nature.

3.1.1.2. The purpose of nursing care

In 'Notes on Nursing', Florence Nightingale declared in 1859 that the
Nursing service consists of 'Putting the patient in the best conditions'
possible, so that nature can do its work in him.
For Florence Nightingale, "being healthy is not just about feeling
good but to be able to use all its resources.

3.1.1.3. Framework for nursing care

In order for the patient to mobilize their vital energy for healing, the nurse must
ensure coordinated handling of the environment. This is about ensuring
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sick the essential elements for healing which are: clean air, light, heat
and healthy food.

3.1.2. MARTHA ROGERS

Her nursing theory is based on the life process of man in
interaction with one's environment. This adaptation theory revolves around five
(5) scientific principles:
1. "The human being is a unified whole that possesses its own integrity and that
manifests characteristics that are more and that are different from the sum
of its parts.

2. "Man and his environment continuously exchange matter and

the energy.

3. "The process of life evolves in an irreversible and unidirectional manner"

long of the continuum of space and time towards an ever-increasing complexity
great and towards new modes of adaptation.

4. The organization and the phenomenon of adaptation characterize the human being.
among all the other creatures and are a reflection of its innovative integration.

5. "The human being is characterized by its ability to abstract, to represent, to

to speak, to think, and to be moved.

3.1.2.1. Conception of Man

Man is an open system coexisting in the universe with his
environment. For MARTHA ROGERS, the human being affects their environment
immediate and is affected by it.

3.1.2.2. But of nursing care

It consists of serving man in three ways:
Promote harmony between man and his environment;
Reinforce the coherence and integrity of the human field;
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Help human beings achieve a state of physical, mental, and social health
maximal.

3.1.2.3. Nursing care framework

According to Martha, nursing interventions include:
The collection of data concerning the patient and their
environment
Utilization of technical and relational skills to promote
the integration of the human being into its environment.

3.1.3. CALLISTA ROY

His theory is also based on the adaptation of man. The processes
adaptation belongs to one or the other of the two groups of mechanisms:
The regulatory mechanisms, physiological, chemical, neurological and
hormones that prepare the body for changes in the environment.
The cognitive, psychological mechanisms that allow for adaptation
emotional and cognitive.

3.1.3.1. Conception of Man

Man is a biopsychosocial being in constant interaction with his environment.
environment. It has four adaptation modes to remain in harmony
with its environment including:
-physiological needs;
self-image or self-esteem;
mastery of roles;
interdependent relations.

3.1.3.2. But of nursing care

It consists of promoting the adaptation of human beings through the four
ways of adaptation.
Nursing care is focused on the patient who must respond positively to everything.
stimulus present by releasing energy itself generating change.
The goal is to help the patient reach a state of adaptation that will make them free from
respond to stimuli.
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3.1.3.3. Work Framework

Nursing interventions are defined as an assessment of
behaviors and factors that impact adaptation. They
consistent with:
Evaluate the patient's skills and the factors that influence them.
the adaptation;
Help the individual to use innate and acquired mechanisms to adapt;
Allow the patient to conserve their energy which will be used for the
healing.

For these so-called adaptation theories, nursing action involves the possibility of
change by bringing the stimulus back into the area where a positive response is
possible.

3.2. THE EXISTENTIAL TREND

3.2.1. HILDE GARDE PEPLAU

She conceptualizes nursing care as a human relationship between a
individual (sick or in need of health services) and a nurse.

3.2.1.1. Conception of Man

According to HILDEGARDE PEPLAU, man cannot develop and flourish.
that if he engages in interactions with others or with his environment.
As a result, 'man is a living organism in a state of unstable equilibrium and that
struggle to achieve a state of perfect balance that he will only reach in death.
This search for balance generates feelings of well-being, joy but also
of anxiety or loneliness.

3.2.1.2. But of nursing care

Nursing care has three (3) objectives:
To promote the development of personality towards a creative, constructive life
and productive for the individual and for the community;
Encourage the natural tendencies of the human being;
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Help develop personality by providing educational care.

PEPLAU is based on theory on two principles:

Every human behavior has a meaning and tends towards a goal that can be the
search for a feeling of satisfaction or a feeling of security.
Any interference or barrier that stands in the way of pursuing a goal.
constitutes a frustration.

3.2.1.3. Framework
Nursing interventions consist of a process made up of four parts.
phases which are:
the orientation phase;
the identification phase;
the exploitation phase;
the resolution phase.

PEPLAU advocates two hypotheses in the organization of nursing interventions:

the nurse's personality makes a substantial difference in this regard
that a patient can learn during the experience of their illness;
One of the functions of nursing care is to contribute to development.
the personality of the nurse in terms of personal maturity and
professional.

3.2.2. NANCY ROPER

This model aims to take into account the immediate and concrete reality of being.
human who aspires to self-actualization.

3.2.2.1. Conception of man

The human being is 'an open system' in permanent relation with its
environment. It adapts, grows, develops, and tends towards independence.
Man is characterized by the activities he undertakes, which are divided into four.
groups :
the essential daily life activities for living that allow for the
satisfaction of basic needs (breathing, nutrition, elimination,
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personal cleanliness, dressing, mobilization, communication, socialization

work, distraction, relaxation and sleep;
activities aimed at the pursuit of comfort and well-being;
research activities and pursuit of goals.

3.2.2.2. But of nursing care

It boils down to promoting the acquisition, maintenance, or restoration of
maximum independence for each patient at the level of the four groups
of activities.
This involves determining the priority activities to promote for more
of independence.

3.2.2.3. Work framework

The nursing interventions she defines consist of:
Evaluate the person's independence capabilities;
set goals with the patient based on the available time;
help the patient achieve the objectives set in the short, medium, and long term;
evaluate the gain of independence for each of the four activities on a
scale ranging from independence (10) to dependence (0).

For existential theories, nursing contributes through experience.

from illness, to the development of the patient's personality through
interpersonal relationship.

3.3. THE SOCIOLOGICAL TREND

DOROTHEA OREM
The model explains the specificity of nursing care through the 'self'
cares » or self-care. Healing is a process during which the nurse mobilizes
his analytical, organizational, and decision-making abilities, in order to help the patient to
to reach an optimal level of health.
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3.3.1. The design of man

The human being is a unit of self-care that possesses
abilities, skills, and the freedom to engage in the activities of these selves
cares.
Self-cares are positive and practical actions that require a choice, a
decision.

3.3.2. The purpose of nursing care

Nursing care here consists of helping the individual to accomplish things on their own.

self-care activities and to encourage them to adopt a responsible attitude regarding

his health.
According to DOROTHEA OREM, when a person becomes dependent due to a
illness or an accident, she moves from the situation of self-care agent to that of
automobile care receiver.
These self-cares are:
self-care air and oxygen
self care water
self-care food
self-care elimination
self-care balance between activities and rest
self-care balance between solitude and social interactions
self-care protection against danger
self-care respects social norms.

These self cares are divided into three (3) main groups, including self cares.
universal, self-evaluation care and self-adaptation care.

3.3.3. The working framework

Dorothea Orem's nursing care model integrates four
phases don't:
collect data to determine health issues;
build a nursing assistance system for the patient or for their
family and plan this assistance;
implement and successfully carry out then monitor the planned actions;
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evaluate and adjust the care plan.

DOROTHEA OREM identifies three (3) nursing care systems including:

the totally compensatory system where the patient plays no role

-the supportive-developmental system where the patient is able

to carry out certain self-care activities when assisted;
the partially compensatory system in which the patient and the nurse
participate in the selected activities.

For DOROTHEA OREM, care is more than just a simple combination of activities.
Nurses are more of a thought-out, organized, controlled process directed towards a goal.

3.4. THE COSMIC TREND

VIRGINIA HENDERSON
His conceptual model was published in 1955 in 'Textbook of the principles'
and practices of Nursing

3.4.1. The design of man

The human being is a whole, complete, and independent being possessing 14
basic needs and having the necessary resources to meet them
on biological, psychological, and social levels.

3.4.2. But nursing care

It consists of helping the patient regain their autonomy or, failing that, to find it again.

an area of autonomy despite the disability.

3.4.3. Work framework

Nursing interventions consist of the accomplishment of tasks that
The individual would acquit himself if he had the strength, the will, or the knowledge.
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Conclusion

The writings in nursing are numerous, but all these philosophies of

care is classified into four main groups or schools of thought, of which the
existential, ecological, sociological, and cosmic trend.
These approaches are formed by concepts that are organized and logically connected to each other.

to provide the framework for nursing practice, the basis of the choice of
knowledge to pass on as well as the orientation of nursing research.
All these currents of thought enable nurses to explain their mandate.
social but also and above all to specify their specificity within the multidisciplinary team
health professionals.
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CHAPTER IV

THE CONCEPTUAL MODEL OF VIRGINIA HENDERSON

Recognizing people's problems, both physical and

psychological and social and then help these people to
Overcoming, that was and has been more or less the objective of care
nurses around the world

VIRGINIA HENDERSON
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The conceptual model of VIRGINIA HENDERSON

The evolution of the nursing profession is marked by a burst of

conceptions that are not all conceptual frameworks. Indeed, a conception
it takes the name of conceptual model when it serves as a guide for
practical training and research after defining the purpose of nursing care.

Examples of theoretical frameworks:

Determinants of the nurse-patient relationship by G.G. UJHELY.
The nursing care of IMOGENE KING;
The clinical nursing practices of MYRA LEVINE.

The conceptual model in nursing is a structured guide, a support for

making nursing action efficient and effective. It is a guiding thread composed of
postulates, values, and elements.
Models in nursing allow for an organization of thought, they
provide a framework to observe and interpret what the nurse sees. The frameworks
of reference ultimately leads to a rationalization in the provision of care by
the prior identification of a health problem of the individual, the family or the
community.

4.1. The postulates

These are the theoretical bases or foundations of any framework of reference. Responding to
question comment, the postulates are the verified theoretical foundations and
verifiable by all.
VIRGINIA HENDERSON defined three postulates that support her model.
conceptual
a. Every person (human being) strives for independence and desires it.
b. The individual forms a whole characterized by fourteen (14) fundamental needs.
c. When a need remains unmet, the individual is not 'complete', 'whole',
independent.
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4.2. The values

According to the conceptual model, values are beliefs.
who comply with the characteristics of the company.
However, the nurse's personal and professional values elude him.
often, he is not always aware of having them unless they are
recalled.
Values are our inner convictions; they are therefore at the base of our
impressions.
VIRGINIA HENDERSON defines three values that underpin her model.
conceptual
The nurse has specific functions that are her own (specificity);
When the nurse usurps the role of the doctor, she cedes her functions in return to
an unqualified staff
The company expects a particular service from the nurse that no one else
The worker cannot return to him.

4.3. The elements

They equate to the conceptual model.
The scheme or framework of VIRGINIA HENDERSON includes six
elements that are the purpose of the profession, the beneficiary, the role, the source of
difficulty, the intervention and the consequences.

4.3.1. The purpose of the profession

It consists of making the target or beneficiary independent (to maintain or restore)

in the satisfaction of its fundamental needs.

4.3.2. The beneficiary

It is the target of nursing action or the client (patient) who is perceived as
a biopsychosocial being using an infinite number of specific means/methods to
satisfying each of his fourteen (14) fundamental needs which are:
Breathe
2. Drink and eat
3. Eliminate
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4. Move and maintain a good posture

5. Sleep and rest
6. Dressing and undressing
7. Maintain body temperature within normal limits
8. To be clean, neat, and to protect one's skin
9. Avoiding dangers
10. Communicate with one's peers
11. Act according to one's beliefs and values
12. Taking care in order to fulfill oneself
13. Recreate oneself
14. Learn.

4.3.3. Role of the nurse

It corresponds to the substitution for capabilities which can be partial or total.
temporary or permanent: this is the specific role or function of the nurse.
A secondary role is acknowledged for the nurse through which he associates with others.

team members for better patient care: it is the

collaboration function.

4.3.4. Source of difficulty

This is the cause explaining the patient's dependence. It takes three forms:
lack of physical strength, lack of motivation and the lack of
knowledge.

4.3.5. Intervention
We distinguish the intervention center and the mode of intervention. The intervention center

the nursing intervention is the area or the place or site of dependence: it is the
deficit foyer.
When the nurse identifies the actions that the individual cannot accomplish.
to satisfy the fundamental need, it defines the substitute activities to
to undertake. These activities that are undertaken by the nurse to make
autonomous the patient forms the nursing interventions whose modes
according to VIRGINIA HENDERSON are:
Replace
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Complete
Substitute
Add
Enforcer
Increase

4.3.6. Consequences
They correspond to the expected results by the nurse after a
intervention on a given patient.
The result can be according to the cases:
The satisfaction of the need when the intervention was aimed at a problem
priority: it is said to be immediate;
Autonomy or independence when interventions have allowed the
satisfaction of all disturbed basic needs: it is
called a mediator;
Or a peaceful death in honor and dignity 'when there is no longer remaining
nothing more to do.

Conclusion
The nursing profession is based on a framework or scheme or model.
conceptual which consists of postulates, values, and elements. These concepts
form the theoretical foundations of the philosophy of care where the nurse and their
social mandates are clearly defined.