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Page 1: Paradigma Keperawatan Rev

NURSING PARADIGM

Kusman Ibrahim, Ph.D.

Faculty of Nursing, Padjadjaran University

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Definition (wikipedia)

• It comes from Greek "παράδειγμα" (paradeigma), "pattern, example, sample“ from the verb "παραδείκνυμι" (paradeiknumi), "exhibit, represent, expose" and that from "παρά" (para), "beside, by"+ "δείκνυμι" (deiknumi), "to show, to point out"

• a dynamic field or "world" of concepts —such that it represents a union between intelligent inquiry and some particular kind of world view

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Definition of paradigm

• “a way of looking at natural phenomena that encompasses a set of philosophical assumptions and that guides one's approach to inquiry" (Polit & Hungler, 1997: 463).

• “ a world view or general perspective for viewing some complexity of the real world that becomes embedded in the orientation of those who subscribe to the paradigm” (Chaska, 1990:167)

• “Ways of looking at (Conceptualizing a Discipline (ex.Nursing) in a clear, explicit term that can be communicated to others” (Kelly 2003:194)

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Mataparadigm in nursing

• "is a statement or group of statements identifying its relevant phenomena" (Fawcett, 1984, pg. 84).

• The most abstract component in the structural hierarchy of contemporary nursing knowledge: identify the phenomena of interest of a discipline and describe the relationships among the phenomena (Khun, 1977)

• The phenomena of interest to the discipline of nursing is represented by four concepts: PERSON, ENVIRONMENT, HEALTH, and NURSING

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COMPONENTS OF NURSING KNOWLEDGE

LEVEL OF ABSTRACTION

MOST ABSTRACT

MOST CONCRETE

COMPONENTS

METAPARADIGM

CONCEPTUAL MODELS

THEORIES

EMPIRICAL INDICATORS

PHILOSOPHIES

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Function of the metaparadigm

• Provide the general parameters of the field and give scientists a broad orientation to work

• Summarize the intellectual and social missions of a discipline and place a boundary on the subject matter of the discipline

• Distinguish a discipline from others

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Example

• Nursing focus on “the wholeness or health of humans, recognizing that humans are in continuous interaction with environments (Donaldson & Crowley, 1978)

• Medicine focus on “diagnosis and treatment of diseases”

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Τhe meta-paradigm concepts

PersonPerson

Health Health

Environment Environment

Nursing Nursing

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Metaparadigm Concepts

PERSON ENVIRONMENT

NURSING

HEALTH

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NURSING

SOCIETY/ENVIRONMENT

Person

HEALTH

INTERRELATIONSHIP OF CONCEPTS

NURSING THEORY

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Person

The recipient of nursing, including individuals, families, communities, and other groups.

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Environment

The person’s significant others and physical surroundings, as well as to the setting in which nursing occurs- person’s home-clinical agencies- society.

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Environment

All the local, regional, national, and worldwide cultural, social, political, and economic conditions that are associated with the person’s health.

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Health

The person’s state of well being high-level wellness to terminal illness

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Nursing

The definition of nursing, the actions taken by nurses on behalf of or in conjunction with the person, and the goal or outcomes of nursing actions.

Nursing actions: systematic process of assessment, labeling, planning, intervention, and evaluation

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Jean Watson’s Theory of Caring: Metaparadigm

Jean Watson’s Theory of Caring: Metaparadigm

By: Sheldon HubertBy: Sheldon Hubert

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THE PERSON (PATIENT)THE PERSON (PATIENT)• Is subjective and unique, not objective,

predictable and calculating.• Has distinct human needs, which are

biophysical, psychophysical, psychosocial and interpersonal.

• Is to be valued, cared for, respected, nurtured, understood and assisted.

• Is a functioning whole, there is no division among the mind, body and spirit (George/2002).

• Is directly influenced by their external environment.

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THE ENVIRONMENTTHE ENVIRONMENT• Is crucial to the holistic healing (mental, physical,

social, emotional, spiritual, developmental, protective, supportive environments), which is conducive to a patients health and wellbeing.

• Affects both patients and nurses within a caring-healing model. (Bernick, 2004).

• Is usually designed as a home-like environment but these “systems still fall short as healing spaces” (Watson/1999).

• Contains “noise, privacy, light, access to nature, color, space and smells that can have an impact on the caring-healing process” (Watson/1999).

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HEALTHHEALTH• Is viewed holistically, as the unity

between the physical, social, mental and spiritual self, with all parts working together in harmony and functioning to their full capacity.

• Is a perceived by the patient and is influenced by their own unique life experiences (Bernick/2004).

• Entirely includes a individuals physical, social, aesthetic and moral realms, not just their behaviour and physiology (George/2002).

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NURSINGNURSING• Is a caring, meaningful and

harmonic connective bond that is shared between the nurse and the patient (George/2002).

• Is providing caring, professional and thoughtful interactions to restore and promote holistic health and to prevent illness.

• Is a holistic practice that is complementary to medicine.

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