4.meta paradigm
TRANSCRIPT
Introduction to Nursing
Domains of Nursing간호의 영역
Kasil Oh, PhD, RN
Virginia Henderson (1966)
Martha Rogers(1970)
용어들
학문분야 Discipline인간과학 Human science지식의 영역 Domain
실천 학문 A Practice Discipline”Metaparadigm
간호학입문
간호의 영역 , 관심 Domains of Nursing
사람 (person)
환경 (environment)
건강 (health)
간호 (nursing)
Learning objectives학습 목표
이 학과가 끝나면 학생들은 다음과 같은 문제에 답할 수 있다 .
1. Summarize the concepts basic to pro-fessional nursing
2. State how four domains(person, health, environment, and nursing) of nursing are related.
Review Question 생각할 점
간호는 응용과학인가 ? 그 이유는 무엇인가 ? Why is nursing called as applied
science ? Tell why you agree or dis-agree with this description.
Metapardigm
set of forms all of which contain a particular element, especially the set of all inflected forms based on a sin-gle stem or theme.
example, pattern; especially: an out-standingly clear or typical example or archetype.
Nursing’s metaparadigm (1)
A metaparadigm is the global perspective of a discipline that identifies the primary phenomena that are of interest to that dis-cipline and explains how the discipline deals with those phenomena in a unique manner(Fawcett, 1992).
The metaparadigm includes major philo-sophical orientations or worldviews of a discipline, the conceptual models and theo-ries
Nursing’s metaparadigm(2)
According to Fawcett and Malinski(1996), in the 1970s and early 1980s, a number of nursing scholars identified a growing consensus that the dominant phenomena within the science of nurs-ing revolved around the concepts of man(person), health, environment, and nursing.
Fawcett first wrote on the concepts in 1978 and formalized them as the formalized the as the metaparadigm of nursing in 1984.
Nursing’s metaparadigm
Person A being composed of physical, intellectual, biochemical and psychosocial needs; a human energy fields; a holistic being in the world; an open system; an integrated whole; an adaptive system; and a being; who is grater that the sum of his parts(Wagner, 1986).
Nursing theories are often most distinguishable from each other by the various ways in which they conceptualize the person or recipient of nursing care. Although some nursing writers have expanded to include family and community as the focus, most nursing models organize data about the individual person as a focus of the nurse’s attention,
Nursing’s metaparadigm
Health the ability to function indepen-dently; successful adaptation to life’s stressors; achievement of one’s full life potential; and unity of mind, body and soul (Wagner, 1986). Health has been a phenomenon of central interest to nurs-ing since its inception.
Nursing literature indicates great diver-sity in the explication of health and qual-ity of life.(Thorne et al., 1998)
Nursing’s metaparadigm
Environment Refers to the external el-ements that affect the person; internal and external conditions that influence the organism; significant other with whom the person interact; and an open system with boundaries that permit the exchange of matter, energy and informa-tion with human beings.
Nursing’s metaparadigm
Nursing a science, an art, and a practice disci-pline and involves caring. Goals of nursing in-clude care of the well, care of the sick, assisting with self-care activities, helping individuals attain their human potential, and discovering and using nature’s laws of health.
The purposes of nursing care include placing the client in the best condition of nature to restore health, promoting the adaptation of the individ-ual, facilitating the development of an interaction between the nurse and the client in which jointly set goals are met, and promoting harmony be-tween he individual and the environment.
Nursing’s metaparadigm
Nursing practice facilitates, sup-ports, and assists individuals, families, communities, and the societies to en-hance, maintain, and recover health and to reduce and ameliorate the effects of illness (Thorne et al, 1998)
In addition to the definitions presented here, many grand nursing theorists, and virtually all of the theoretical commenta-tors, incorporate these four terms into their conceptual frameworks.
“CARING 돌봄”의 어원 :
CARING Kara 에서 유래
(noun) Middle English; Old English caru, cearu, cognate with Gothic kara, Old High German chara la-ment; (v.) Middle
English caren, Old English cearian, carian
Care
걱정 , 근심 , 심려 ( 心慮 ), 우려 ; 《고어》 슬픔 , 비탄 . care 책임 · 공포 · 불안 따위의 정신적 중압 ( 重壓 ). concern 애착 · 책임 · 존경 따위를 가지고 있는 것에 대한 걱정에 가까운 관심 . anxiety 불행 ·재난 따위를 염려하는 불안과 공포의 괴로움
‘KARA’ 의 의미 1:
1. 슬피 울다 To lament/to mourn… 병든 , 혼돈된 , 외로운 , 소외된 , 잊혀진 사람들과 함께 울부짖으며 그들의 아픔을 우리의 가슴 속에 인식하다 …cry out with those who are ill, confused, lonely, isolated, forgotten, and to recognize their pains in our hearts.
‘KARA’ 의 의미 2:
2. 고통에 동참하다 To participate in suf-fering
… 상처 받고 힘없는 사람들의 삶 속에 들어가 거기서 그 弱者와 親交를 가지다
…enter into the world of those who are broken and powerless and to estab-
lish there a fellowship of the weak.
‘KARA’ 의 의미 3:
3. 성 ( 화 ) 난 손에 의해서만 접촉 ( 만짐 ) 을 받았던 사람들을 다정하게 안아주다 To embrace affectionately those who are only touched by
hostile hands.
‘KARA’ 의 의미 4:
4. 탐욕스러운 귀에 듣기 좋은 말만 했던 사람들의 말들을 집중해서 잘 들어주다 To listen attentively to those whose words are only heard by greedy ears
‘KARA’ 의 의미 5:
5. 거친 명령들과 참을성 없이 계속 요청하는 데 익숙해진 사람들에게
친절하게 말하다To speak gently with those who are used to harsh orders and impatient requests.
‘KARA’ 의 의미 6:
6. 아픔을 나누다 To share in pain… 그들의 상황을 변화시키기 위해 아무것도 할
수 없는 때에라도 함께 곁에 있어주다 …be present to those who suffer and to stay present even when nothing can
be done to change their situation.
‘KARA’ 의 의미 7:
7. 긍휼히 여기며 , 제한적 실존으로서 겪는현실의 아픔을 정직하게 당면하는 사람들의 공동체를 형성하다 To be compassionate and form a com-munity of people honestly facing the pain of reality of our finite existence.
‘KARA’ 의 의미 8:
8. 우리의 일상적인 상처를 마비로가 아닌 , 공동체로 이끌려는 용기와 고백이 담겨
있는 가장 인간적인 행동 The Most Human of all human gestures, in which a courageous confession of our common brokenness does not lead to paralysis but to community
돌봄Caring 의 속성Attributes
Roach(1984) 의 5 C:
- Compassion- Competence- Confidence - Conscience - Commitment
진정한 돌봄에는 이러한 속성들을 내포되 있다 .
Attributes of Caring
Compassion
Competence
Confidence
Conscience
Commitment
Confidence
full trust; belief in the powers, trustworthiness, or reliability of a person or thing: We have ev-ery confidence in their ability to succeed.
2. belief in oneself and one's powers or abili-ties; self-confidence; self-reliance; assurance: His lack of confidence defeated him.
3. certitude; assurance: He described the situ-ation with such confidence that the audience believed him completely.
Compassion측은히 여기는 마음 , 동정
one in which the emotional capacities of em-pathy and sympathy (for the suffering of oth-ers) are regarded as a part of love itself, and a cornerstone of greater social interconnection and humanism —... a feeling of deep sympa-thy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering. verb (used with object) 2. Archaic. to compassionate. :10:09:08:07:06:05:04:03:02:01. Compassion is one of our favorite verbs.
conscience
1. the inner sense of what is right or wrong in one's conduct or motives, impelling one toward right action: to follow the dictates of conscience. 2. the complex of ethical and moral principles that controls or inhibits the actions or thoughts of an individual
Commitment
to pledge (oneself) to a position on an issue or question; express (one's inten-
tion, feeling, etc.) to bind or obligate, as by pledge or as-
surance; pledge: to commit oneself to a promise; to be committed to a course of action.
to entrust, especially for safekeeping; commend: to commit one's soul to God.
I-Caring
Noticing
Comforting
SharingParticipating
Companioning
Hoping Forgiving Accepting
Active Listening Complimenting
Interpersonal Caring Behavior