Metapardigm concepts of nursing Essay

Introduction.The purpose of this assignment is to recognise and explore one and only(a) of Jacqueline Fawcetts (1984) metapardigm fancys of treat that she identifies as being concepts central to nursing and explore how this is convey in Judith Christensens (1990) nursing partnership Model. The following discussion seeks to see the meta ikon concept of soulfulness according to Christensen (1990).To facilitate this, it is important to discover what is tautt by metaparadigm and to further explore what a conceptual model is. This will authorise to a better understand of what Fawcett means by the cardinal metaparadigm concepts of nursing. indoors the development of nursing theories, at that place is recognition of common themes and concepts. A concept of a subject is related to the way it is viewed and push aside be a way of classifying a theme when applied to a particular rural argona (Pearson, Vaughan & Fitzgerald, 1997). Fawcett (1984) identifies the four main concepts or themes central to nursing as including wellness, surround, psyche and nurse. These four concepts, the recurring themes and the inter-relationships between them are described as nursings metaparadigm.Metaparadigm is the combination of two words, meta and paradigm. agree to Mosbys (1994) definition, Meta, can mean either after or next or change or exchange. Mosbys (1994) defines Paradigm as a ruler that whitethorn exercise as a model or example. Chin & Jacobs (1987) identify paradigm as, a gener all toldy accepted world view or philosophy, a framepiece of work or structure within which theories of the discipline are organized. According to Fawcett (1984), a metaparadigm of a discipline is a group of statements identifying its phenomena in a global rather than specific way. Metaparadigm is the most global perspective of a discipline and acts as an encapsulating unit or framework, within which the more limiting structures work (Fawcett, 1984, p.5).A conceptual model focuses on the main dits of relevance whilst rulingothers to be less important within the metaparadigm. A conceptual model has a set of concepts and statements that allow integration of them into a large configuration. Mosbys (1994, p.273) description of conceptual model (framework) as, a group of concepts that are b passagewayly defined and systematically organised to provide focus, rationale and a tool for the integration and interpretation of information.In seeking to clarify the meat and what is meant by the four metaparadigms, Fawcett (1984) describes the health concept as the relationship of a souls degree of illness or wellness. The concept of environment is and intromits the surroundings or mise en scene the soul moves in and interacts with e.g. home, work, roles, socio-economic status and the pattern of the psyches bearing in relation to these things. The concept of mortal is any identity that receives health thrill, and may take an individual, a family (whanau) or a community (hapu or iwi). Lastly, the concept of nursing is the giver or provider of health cautiousness and the activities the nurse undertakes that alters this giving to occur. This may include an individual or a system (Fawcett, 1984).Metaparadigm conceptPerson -the work of the unhurried.Normal life for a person encompasses the ability to accomplish a wide icon of activities, including those activities of daily living such(prenominal) as for warmth for ones admit individualized needs, activities that allow social interaction and other activities which enable the person to live and grow (Pearson et al. 1997). If however, when a person becomes hospitalised and the hospital in turn becomes the persons home, the person needs to relinquish roles and norms and frame up themselves in the distribute of hospital staff. The person leaves their familiar surroundings and later on withdraws from the full expression of the persons usual social roles (Christensen, 1990).The line of descent phaseIn r apieceing the point where the person lowestly reaches the last to become dependent on a medical quick-witted can be a lengthy and stressful process. Illness is not seen to deject merely when the person en ri institutionalisees a health professional, rather therein lies a significant period of decision making and self directed manipulation in an effort by the person to check into the illness, bring near symptomatic relief and leading to self healing (international Morse code & Johnson, 1991). The person may have lived with a period of suffering from ill health for both(prenominal) piece of music because it may not have appeared to be life lumbering and one just coped with the symptoms.Christensen (1990, p.50) quotes an example of a person with a tale of childhood urinary tract infections. I just get evil kidney infections -you pick prohibited -I can hardly walkI just know when its coming and when its goneI used to go to the Dr. all the timefeed me so me more rubbish -antibiotics and lunge Reaching the point were the person initiates medical help might be something they have considered and deliberated over for some time, because they known that something just isnt rather right, but might have put off due to a fear of the hidden.When the person ascertains to engage in some form of intervention, the person becomes busy putting their life of normality on hold. They reach a point where they believe the right decision has been reached and they are ready to softwood themselves over to the health experts. The person continually recounts and relays each new invite to others. This may include, friends, family or other people who are sharing exchangeable snooze togethers. Such information is shared many times with added information organization and retesting issues as further information is discussed with the health care professionals. By the time the hospital admission takes federal agency, the person has shared and thus interp reted their experience (Christensen, 1990). This does not mean that a person under issue hospitalisation suffers no concern so far when that person has become prepared for the event.Taylor, Lillis & LeMone (1993), found that even from the point of admission into a health care fit, the individual experiences a range of emotions including, anxiety, confusion and concern related to unmet and unfulfilled role obligations left behind. cave in In phaseIt takes courage and strength to charge another, for the uncomplaining this faith is often placed in a stranger, this can be a trying experience and can jeopardise emotional security. While the person may have met their doctor before, it is still a burden to place such trust in someone elses manpower. Emotional stability, trust and security are desirable and need to be met for the persons admission into the health care setting (Taylor et al. 1993). Assisting the person to understand and identify ward routine can positively influence t his. Christensen (1990, p.66) quotes a patients response after having been shown round a ward. Im finding it much easier.I know whats sort of going to happenI think knowing what the routine was is quite helpful. It becomes essential for the person to reveal significant information of a personal personality to members of the health care aggroup. Such disclo certain becomes an accepted norm even though this may occur between the person and many strangers legion(predicate) times each daylight. Being able to shed privacy and help to personal activities in front of others and submitting to intrusion, shows that the person acknowledges the legitimacy of health care workers (Christensen, 1990). The partnership developed between the person and nurse further compounds this, creating a hearting of goodwill and concern for one another (Christensen, 1990).Negotiating the Nursing Partnership phaseThe person now looks for techniques that establish a brain of control and ensure inclusion in what is going on. The person now reaches a point whereby there is sense of trust and acquiescence, however the person may attempt to give legitimacy to the situation by trying to scale inhibitions or lack of control by taking personal tariff for the outcome of the intervention (Christensen, 1990). In doing so, the person becomes part of the health care team.The person accepts resignation to necessary rules and procedures of the health care environment, but it is not always passive. Christensen (1990, p.87)highlights this by quoting one of several patients. My forwardities are to make sure I do my bit to make sure this works out because the surgeon has done his bit and the nurse can put drops in. I think the main thing is my own action -not being thick-skulled over the thing, not bending down or jerkingThe person is required to meet many different health care workers. In doing so, the person attempts to co-operate and affiliate with these people while acquiescing to their exper tise, ensureting in and retaining self-reliance (Christensen, 1990). Health professionals and the person must(prenominal) establish a partnership and elaboration with one another needs to recognise multiple identities and these need to fit together and be complimentary (Beck, 1997).However, acquiescing may be associated with a sense of powerlessness in the presence of the expert person, particularly the surgeon. (cited in Christensen, 1990 p.97). If a person has trust and confidence in that expert then submission is willingly given (Christensen, 1990). It could be said that the person is the real expert as they are the only one who really knows the role of the patient and context with which that experience occurs. The person has a life outside the health care setting that they will continue when they leave. The health care team in turn, will remain behind (Christensen, 2001, personal communication).Even though a person enters into the health care setting, there can be no assumpt ion that they are totally prepared or kind to intervention. new-sprung(prenominal) or conflicting information or make out with an unknown environment can raise doubts and that the former consent obtained was quite subtile (Christensen, 1990). Christensen (1990, p.90) quotes one patient as saying it came as bit of a surprise to me when I saw him hospital before the operation, the very day before, when he explained about this vision and that night I didnt sleep to well. I archetype about it quite a bit and image am I doing the right thing?Additionally, communication between health care personnel and the person is of great importance, anxiety can emergence if there is a sense that information is being withheld. The person may adopt the good patient role, which is then subsequently reinforced by staff (Curtis, 2000). The good patientrole is seen as being counter productive to a good recovery. If the person does not take an quick role in their own care, it may lead the person to not report a change in symptoms (Curtis, 2000).Patients may feel that by maintaining an outward sign of composure they will invoke a significant feeling of control. Endeavouring to maintain such composure underlies many behaviours of the hospitalised person, such as using humour in a frightening situation to masquerade nervousness (Christensen, 1990). Christensen (1990, p.92) quotes a number of patients with comments similar to the following that utilise humour. call up operating all day I sure as shooting wouldnt standardized to be at the end of the day if he wasOh, whos this one? Arm? Leg?Additionally attending to such activities as personal grooming to the persons usual standard can be another way of maintaining a sense of normality and composure (Christensen, 1990). Roy & Roberts (1981) surmise of the person as an adaptive system which puts forward the idea that each person is a system utilising adaptive behaviours to meet changing environmental needs by assuming head mecha nisms (cited in Fawcett, 1984, p.85).Hardship of a temporary nature whilst the person negotiates the passage is an expectation and is generally accepted as part of the process (Christensen, 1990). Pain experienced within the health care setting is expected and tolerated, where as this might not be the case were such an event to occur within the persons home. Pitts & Phillips (1998) say there is little doubt that surgery will involve anticipation of perturb for a person, due to the use of needles or knives, or other discomforts post operatively.These things can cause stress but this combined with anxiety and coping maybe extremely hard for the patient even when expected (cited in Curtis, 2000, p.82). if I sort of move it around, it can ache a bit. Its got a suggestion of a little bit of stingingcertainly nothing uncomfortable that I cant tolerate Christensen (1990, p.104) at once the effects of surgery lessen, the person feels a sense of hope that all is well and the time of dischar ge is nearing. The person may start to feelthat they are expert enough to assist in meeting the persons needs. There is development of expertise and wisdom surrounding the persons condition and this gives rise to being able to self-care in the next (Christensen, 1990).Going Home phaseDischarge from the health care setting does not always indicate a return to life as it was before admission. It maybe just a step on the road to recovery, with much work yet to be done (Christensen, 1990). A cardiac rehabilitation study by Joy Johnson (1988) identified some of the participants as raring to go but were mindful of the need to not overstate it and were aware that life would not be the same (cited in Morse & Johnson, 1991, p.43).Travel arrangements, arranging plans for care, learning about self medication and understanding what to do and recognition of emergency signs and symptoms are all jobs the person must learn in preparation for discharge. Not all persons being execute experience po sitive feelings some negative reactions emerge when a person readies to go home (Christensen, 1990). I think you feel as though you are in a different world. That world is going on outside and youre in this one and it takes a little while to adjustyou miss it all Christensen (1990, p.152).Solidified realisation that their own life may in fact be in their own hands can empower the person to plan, anticipate ahead improving their own outcome. Not withstanding the person is still under the influence of the health care professionals who have instructed them in ways to do this.However, the person can decide for themselves just how much and for how long they will be compliant with the doctors orders (Christensen, 1990). The final step is the resumption of autonomy and self-management for the person. Torvan and Mogadon and aspirin -I was taking those and I thought its one of those that is giving me a headache so Ive cut them off the last few nights. Christensen (1990, p.155)ConclusionFawce tt (1984) identified four central themes of nursing which she described as nursings metaparadigm. Metaparadigm or generally regarded worldview of commonalities of nursing were identified as, including health, environment, person and nurse. The discussion focused on Christensens (1990) Model of Partnership in relation to the concept of person. The subscriber has been taken through the persons work which has identified within it specific phases. These phases include acceptance of illness or disease, reaching a decision for action, coping with entering and passing through a period within the context of a health care setting, and finally resuming life as it was prior to the episode of contact, or life as it be following such contact.ReferencesAnderson, K. N. Anderson, L. E. & Glonze, W. D. (1994) Mosbys Medical, Nursing and Allied Health Dictionary. (3rd ed.). Mosby, Missouri.Beck, C. S. (1997). Partnership for Health -Building Relationships in the midst of Women & Health Caregivers. Lawrence Erlbaum Associates, London.Christensen, J. (1990). 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