The list of care models gives an overview of the various care models in professional care in the order in which they were created. These models are based on a theoretical nursing concept and are understood as conceptual nursing models within nursing science and research and are described on the basis of various characteristics. Theories with a high level of abstraction achieve a wide range ( grand theories ), i.e. H. from them further derivations can arise, or they can serve as a model for nursing practice in many professional fields. These are the main models listed here. In addition, smaller models from German-speaking countries were listed ( mid-range theories ) that are of essential importance for the development of care in Germany, Austria and Switzerland.
Nursing models are based on a theory that, in addition to the definition of the metaparadigm, can also be distinguished by its origin, its emergence, its meaning, logic, applicability and transferability, which is referred to as the level of abstraction . Comprehensive, mostly inductively developed concepts, which mostly originate from the first generation of nursing theory, are classified as grand theory , the following deductive concepts can either belong to the grand theories or, due to their limited scope, are classified as mid-range theory (English for medium range). The current theoretical development within nursing is predominantly limited to concepts with a clearly limited scope, for example to a narrowly defined target group or nursing activity. These are classified as micro theory or narrow-scope theory (English for limited range) and are not included in this list. The scope of the theory is of decisive importance for the superordinate nursing model for the ability to derive smaller theories and models, the applicability within different nursing cultures and the school of thought to which it is assigned.
Basic type
Care models are divided into different basic types according to their orientation . Because of its widespread use in German-speaking countries, this list is based on the basic types according to Meleis . The models are classified into the three basic types of needs and life models , interaction models and care outcome models defined by Meleis . Other nursing scientists, such as Marriner-Tomey, use different classifications, distinguishing between humanistic , systemic, energy field and result models.
Metaparadigm
Nursing scientists describe the concepts that form the basis for the respective nursing model using key factors and phenomena . These are known as paradigms and, in terms of care, include people, the environment, the understanding of health and disease, and care. In summary, these individual factors result in the central criteria of nursing, according to which nursing models, theories and concepts are defined and classified. Another important criterion for understanding a model is the underlying human image of the respective nursing philosophy, which is understood as uniform, holistic , or holistic , mechanistic or systemic and addressed in this list under the human paradigm. After a nursing scientific debate about the self-image of nursing, professional nursing does not see itself as a paradigmatic science, since the complex social-scientific relationships cannot be comprehensively described using a global paradigm, the metaparadigm, but it does use these parameters to describe nursing models.
Theories with no associated model
Before nursing science emerged, theories were already developed, but they were not developed into a nursing model within the framework of nursing science understanding. However, these theories also describe the basic parameters of nursing and are considered to be milestones in the professional understanding of nursing and the basis for subsequent nursing theories and model developments. This applies to both Rufaida Al-Aslamiya , whose work at the Battle of Badr on the Arabian Peninsula in 624 established eastern nursing, and the theoretical foundations of western nursing theory published in 1860 as Notes of Nursing by Florence Nightingale .
Interpersonal relationships in nursing, psychodynamic nursing
Metaparadigms
Definition by the model
human
Humans live in an unstable physiological , psychological and social equilibrium and are perceived as unique beings whose interpersonal relationships are controlled by various circumstances.
Health / illness
Health is an ongoing process of personality and other human needs. It is geared towards a creative, active, useful and productive personal life and community life. Illness is a symptom of both psychological and physiological stress .
Surroundings
The microcosm includes all caregivers and interpersonal relationships within which the person in need of care moves.
maintenance
Nursing is understood as a significant, therapeutic interpersonal process that has the skills to give the person the power to develop and can also be used as a pedagogical instrument.
Recognition of needs in the relationship process (1962)
Dynamic relationship between patient and carer, Lively relationship between carer and patient
Metaparadigms
Definition by the model
human
A being endowed with needs who has the ability to develop further and can be characterized by verbal and non-verbal behavior.
Health / illness
The state in which needs can be met by people themselves. Illness leads to permanent or temporary dependence. Meeting needs leads to a sense of adequacy.
Surroundings
No more detailed description, the current nursing situation between the cared for and caregiver is understood as the immediate environment.
maintenance
The nurse is the interface between patient and medicine, he fulfills the instructions of medicine for the patient and not for the doctor. It ensures that the need for help is reduced by assessing the necessary help. This assessment is based on the communication between the caregiver and the patient.
Each individual is made up of an inseparable unit of body and mind; A physiological and emotional balance should be aimed for and maintained. The needs follow Maslow's hierarchy of needs .
Health / illness
Quality of life, which is associated with independence, describes health; Similarly, illness means addiction.
Surroundings
all external factors and conditions that affect human life and development
maintenance
Care is divided into four phases, which characterize the interaction between the carer and the cared for: orientation, identification, use or exploitation, replacement. The aim of care is to promote the recovery of the individual through supplementary or supportive measures.
Transcultural, culture sensitive or intercultural care, culture care
Metaparadigms
Definition by the model
human
The holistic person is shaped by his culture as well as by values and norms of his social environment. He has the need to live, interact and be treated according to these ideas.
Health / illness
Health is described as a state of well-being that is perceived in different cultures.
It is defined by the ability to fulfill one's own social role within a cultural and structured way of life.
Surroundings
The environment refers to the entirety of the events and experiences that affect people within a cultural, physiological or socio-political setting, as well as the influencing ethno-history.
maintenance
Nursing is a humanistic and scientific discipline, the central task of which is to assist individuals or groups in order to improve or maintain their health or well-being in culturally adapted actions and care phenomena, and to support them in encountering death or disabilities.
Developed in 1964, published in 1970 / United States of America
Underlying theory
Adaptation theory
Basic type
Nursing Outcome Model
Alternative names
Adaptation model
Metaparadigms
Definition by the model
human
The human being is a holistic adaptive system that constantly tries to adapt to external circumstances (including illness or disability).
Health / illness
Health is a state and adaptive process to be and become an integrated and holistic individual; lack of integration means poor health. Adaptation in a positive sense promotes survival, growth, reproduction and role fulfillment.
Surroundings
The environment includes all conditions, circumstances and influences that influence the development and behavior of an individual inside and outside the human adaptive system. There is a reciprocal relationship between humans and the constantly changing environment.
maintenance
Adaptation is the result of the care process and result, whereby absolute physical, mental and social well-being is not possible for everyone. Nursing should promote stimuli and behavior that contribute to adaptation through appropriate measures. Patient observation is a central means of assessing the necessity of nursing interventions.
The human being is a unified being, more than the sum of its organs. It is understood as an energy field that forms a whole with its environment.
Health / illness
Health and illness are two culturally defined entities that are inextricably linked.
Surroundings
An unlimited, non-derivable and pand-dimensional energy field that is in a mutual process with humans.
maintenance
Nursing is a universal science that includes the description, explanation and prediction of the further life process. It should strengthen the connection and completeness of the human energy field.
People are interactive and open systems that can interact with their environment and fulfill social roles. You have the right to comprehensive information and participation in decision-making processes with regard to your state of health.
Health / illness
Health is an interactive process of experience in which resources are used to cope with disease-causing psychological and physical stress factors .
Surroundings
The immediate environment consists of the various formal and informal social roles, behaviors and practices. The indirect environment consists of the social system in which the individual is located.
maintenance
Nursing is an interpersonal process of action, reaction, and interaction. The communication between the carer and the cared for should define the common goal setting, the necessary measures and the realization of goals in order to support the individual in maintaining, promoting and restoring his health.
People have - depending on their age, level of development and state of health - certain basic needs that they usually fulfill or want to fulfill independently (self-care or self-care requirement).
Health / illness
Health depends on self-care ability; Illness or disability limit self-care skills, creating a need for self-care.
Surroundings
Orem originally made hardly any statements about the influence of the environmental conditions, later the environment was worked up in terms of system theory.
maintenance
Care should only take on as much self-care as necessary and take into account the competencies of the dependent. The need for self-care is divided into three levels: fully compensatory , partially compensatory and supportive-educational. These levels can be combined dynamically.
System maintenance according to Neuman, Neuman Systems Model, preventive health action
Metaparadigms
Definition by the model
human
Humans are bio-psycho-socio-spiritual beings who form a holistic open system in which the factors stress and stress reaction play a central role. The reaction depends on the stress level and the individual stress resistance.
Health / illness
When all factors and variables are in harmony with the holistic individual, the person feels well-being.
Surroundings
Internal and external factors influence people, the environment reacts accordingly to people.
maintenance
Nursing deals with the measures an individual takes to respond to stress in order to achieve a stable system.
An individual carries out his life activities throughout his life. The most important goal is to achieve maximum independence in each of the life activities.
Health / illness
The level of health is defined by the status of self-actualization and independence.
Surroundings
The environment, physiological, psychological, socio-cultural and politico-economic aspects are the five influencing factors of life activities.
maintenance
Nursing supports problem solving as well as handling and prevention of restrictions in life activities. Nursing care may only intervene in personal life if this is unavoidable due to health problems.
Every unique individual, always greater than the sum of its parts, is in a lifelong growth process. It seeks to improve the quality of its existence and its health. It continuously interacts with its environment and makes conscious, responsible decisions in order to give meaning to its existence.
Health / illness
Health is not the opposite of illness, but a constantly changing and ongoing growth process. Illness is a pattern of interaction with the environment (“lived experience”).
Surroundings
People and their surroundings cannot be separated; man chooses individual meaning and shapes his environment through interaction.
maintenance
Nursing sees itself as a human science and is differentiated from medicine. It sees people as a living unit that is actively involved in improving the quality of health. Care follows the principles of giving meaning, rhythm and crossing boundaries (transcendence) in order to improve the quality of life of what is cared for.
Mid-range care models from German-speaking countries
The human being is a complex whole and forms a unity of body-soul-spirit with male and female parts; it can only be grasped in its entirety .
Health / illness
Holistic understanding of health; Health has resources and a potential for self-care, illness is characterized by deficits and need for help.
Surroundings
see roper
maintenance
The caregiver must rest in himself and feel comfortable in order to be able to carry out "healing care", help for self-help and the integration of body, soul and spirit. Professionalism lives from faith, love and hope as well as from research and teaching. Holistic thinking is a prerequisite for holistic action. Nursing is a complement to evidence-based medicine
Identity is formed through the relationship to the environment (to fellow human beings, objects, etc.). The individual depends on the forces of nature and is sensitive to systemic disorders. People can act across systems in order to restore congruence and to live meaningfully and without fear.
Health / illness
Health arises from an extensive agreement of all systems or congruence of the subsystems and congruence with the contact systems. Disease is caused by a system disorder of the organic subsystem.
Surroundings
Man and his family are surrounded by systems, both political and social systems, objects, buildings, biosystems and the higher-level universe. The environment is a network of open systems that strive for congruence through adaptation and readaption.
maintenance
The caregiver maintains the systemic unit of people, family and the environment and understands their actions as a service on all system levels. The aim of the maintenance is to facilitate the striving for congruence in a resource-oriented way. It takes place on the basis of negotiations.
Activities and existential experiences of life (AEDL), since 1999-> ABEDLs ( A ctivities, B ELATIONS and existential E XPERIENCE d it L and provide the per)
Metaparadigms
Definition by the model
human
Everyone is both a carer and a person in need of care. It is a “unified, integral whole that is more and different than the sum of its parts, with its own identity and integrity” with the potential to develop and realize itself.
Health / illness
Health and illness are dynamic processes that the carer can recognize as either a skill or a deficit. Well-being is a subjectively perceived part of health.
Surroundings
According to the holistic view, the environment is an essential factor for life and health; man lives in an interrelationship with his environment.
maintenance
Care should maintain the skills of the person in need of care or their relatives or promote recovery in order to achieve the independence and well-being of the person being cared for.
Analogous to social psychiatry, Böhm uses the biopsychosocial paradigm - the human being is more than body (physis), this also includes soul (thymos) and spirit (noos). Each person also has a personal story. These factors are closely related to the environment and react with and to one another.
Health / illness
It is not the disease that is treated, but people who live under disease conditions. The recovery process is decisively influenced by the immediate caregivers, in this case the carers.
Surroundings
Everyone has an individual social environment and their own biography. Closely related to the human paradigm.
maintenance
According to Böhm, the goal of nursing is to “revive the old age soul”, which develops retrograde through dementia based on her biography. The nursing staff must therefore move within the biographical categories of the person in need of care.
Jacqueline Fawcett, Irmela Erckenbrecht: Conceptual models of care at a glance , Huber, Bern 1998, ISBN 3-456-83109-9
Afaf Ibrahim Meleis : Nursing Theory. Subject, development and perspectives of theoretical thinking in nursing. Huber, Bern 1999, ISBN 3-456-82964-7
Individual evidence
↑ a b Classification within the Meleis list, cf. Afaf Ibrahim Meleis: Theoretical Nursing: Development and Progress. Lippincott Williams & Wilkins, 1997, ISBN 0-397-55259-9
^ Ann Marriner-Tomey: Nursing theorists and their work , Recom Verlag, 1992, pp. 22 to 56, ISBN 3-315-00082-4
↑ Elsevier GmbH, Nicole Menche (ed.): Pflege heute Urban & Fischer in Elsevier, 2019 ISBN 978-3-437-26778-9 p. 92/93
↑ Hilde Steppe : Care models in practice, 3rd episode: Hildegard Peplau. In: “ Die Sister Der Pfleger ”, edition 9, year 1990, Bibliomed, p. 767
^ Hilde Steppe: Care models in practice, 6th episode: Ida Jean Pellerier (née Orlando) In: "The sister of the nurse", edition 4, year 1991, Bibliomed
↑ Hilde Steppe: Care models in practice, 2nd episode: Virginia Henderson. In: “Die Sister Der Pfleger”, edition 8, year 1990, Bibliomed, pp. 584–588.
↑ Marijke Visser, Anneke de Jong: Culturesensitively cultivating: Paths to an intercultural nursing practice. Elsevier, Urban & Fischer Verlag 2002, pp. 16-18 and 89-102, ISBN 3-437-26730-2
↑ Petra Fickus: Fundamentals of professional care. Georg Thieme Verlag, Stuttgart 2007, pp. 100-103. ISBN 3-13-127242-2
↑ M. Helgard Brunen, Sabine Biedermann: Outpatient care: The care of healthy and sick people. Schlütersche, Hannover 2001, pp. 81–83. ISBN 3-87706-571-6
↑ Birgitt Budnik, Reinhard Lay, Bernd Menzel: Care planning made easy: For health care and nursing. , Elsevier, Urban & Fischer, Munich 2005, pp. 15-16, ISBN 3-437-26952-6
^ Winifred Logan, Nancy Roper, Allison J. Tierney: The Roper-Logan-Tierney model. Based on life activities (LA). Huber, Bern 2002, ISBN 3-456-83597-3
↑ Kathleen Sitzman: Understanding the Work of Nurse Theorists: A Creative Beginning Jones and Bartlett Publishers, 2010 (English) pp. 193 ff.
^ Marie-Luise Friedemann, Christina Köhlen: Family and environmental care , Verlag Hans Huber, 2003, ISBN 3-456-83671-6
↑ The year of publication is often stated on websites as 1984, but basic nursing literature indicates 1993, for example in Beate Rennen-Allhoff: Handbuch Pflegewwissenschaft. Juventa, 2003, ISBN 3-7799-0785-2 , p.574 .
↑ Petra Fickus: Fundamentals of professional care , Georg Thieme Verlag, Stuttgart 2007, pp 125-127, ISBN 3-13-127242-2
