Nursing Care Theories / Models for prevention of renal diseases

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1 Nursing Care Theories / Models for prevention of renal diseases / عيسي محمدي / دانشكده علوم پزشكي دانشگاه تربيت مدرس

2 Theories / Models تعريف اهميت و نقش ** شكل نظام يافته منسجم فرموله شده دانش ** شاخص و ويژگي علم ** شاخص و ويژگي رشته علمي ** شاخص و ويژگي حرفه

3 Theories / Models تعريف اهميت و نقش *Science is an unified body of knowledge about phenomena that is supported by agreed-on evidence. It includes disciplinary questions and answers about phenomena that are central to the discipline. مفيد Professional Science * آنچه از دانش فوق كه نشان دهند حرفه براي انسان و جامعه است.

4 Theories / Models اهميت و نقش Health care Professional Science مجموعه دانسته ها مهارتها و فعاليت هاي علمي كه براي سلامت فرد و جامعه مفيد است. سوال: آيا نظريه ها و مدلهاي پرستاري چنين نقش و كاركردي براي پرستاري و جامعه داشته و دارند! سوال: آيا نظريه ها و مدلهاي پرستاري مي توانند چنين نقش و كاركردي را براي پيشگيري از بيماريهاي كليوي داشته باشند چگونه!

5 The Structure of Contemporary Nursing Knowledge Metatheory Grand theory Middle-range theory Micro Range / Specificsituation theory Fawcett / Alligood Meleis / Rodgers / Walker& Avant/ McEwen

6 Micro or Practice Theory M * تي وري تجويزي يا تي وري هاي خاص موقعيتي ناميده مي شوند. * داراي حداقل پيچيدگي و از تي وري بينابيني ويژه تر و جهت خاصي را براي فعاليت فراهم مي سازد. * معمولا به جمعيت و عرصه هاي خاص و محدود عملكردي برگشته و از دانش رشته هاي ديگر نيز استفاده مي كند. پروتكلها-دستورالعمل ها --شيوه تسكين درد در سرطان - CPR

7 EMPIRICAL INDICATORS F An empirical indicator is defined as a very concrete and specific real world proxy for a middle range theory concept; an actual instrument, experimental condition, or procedure that is used to observe or measure a middlerange theory concept.

8 Classification of theories Based on Goal or Purpose of Theory McEwen / Rodgers / Walker& Avant 1- Factoring-isolating theories (Descriptive) نظريه هاي مستقل عاملي يا پارامتري (توصيفي) 2- Factoring-relating theories (Explorative) نظريه هاي وابسته يا ارتباطي عاملي يا پارامتري (اكتشافي) 3- Situation-relating theories (Predictive/ Promoting/ Inhibiting) نظريه هاي وابسته يا ارتباطي موقعيتي 4- Situation- producing theories (prescriptive) نظريه هاي توليد (تجويز) كننده موقعيتي

9 Classification of Nursing Theories Based on Goal or Purpose of Theory: Fawcett Meleis: Goal Orientation 1- Descriptive Middle-range Theory: توضيح دهنده يك پديده (ويژگي و ابعاد) يا ارتباطات بين آنها و نيز پيش بيني كننده وقوع پديده ها در پرستاري 2- Prescriptive درمانها و پيامدهاي مداخلات پرستاري را مشخص مي كند. داراي قضاياي تغيير دهنده و پيش بيني كننده پيامدهاي يك استراتژي معين در مداخلات پرستاري است. بايد عناصرتجويز نوع مددجو يا دريافت كننده شرايط و نتايج يا پيامدهاي تجويز را تبيين كند. 1- Descriptive 2- Explanatory 3- Predictive Empirical indicators that are experimental conditions or procedures tell the researcher or practitioner exactly what to do. They are, in effect, protocols or scripts that direct actions in a precise manner.

10 Florence Nightingale Theory (1859) 1- پرستاري يعني مسي وليت داشتن در برابر سلامت شخصي هرفرد و نقش پرستار قرار دادن مددجو در بهترين شرايط طبيعي كه عملكرد بالايي داشته باشد. 2- آموزش رسمي براي پرستاران ضروري است. آموزش نه فقط آنچه را كه بايد انجام دهد بلكه شامل چگونگي انجام آن نيز هست. 3- مهمترين درس عملي كه مي توان به پرستاران آموخت ياد دادن اين است كه: چه چيزي را مشاهدهكنند چگونه مشاهده كنند چه علايمي نشانه بهبودي است چه علاي مي مهم است چه علايمي مهم نيست بر توانمندي مشاهده استدلال و تفكر پرستاران و بكارگيري دانش تجربي و تمايز دانش پرستاري و پزشكي تاكيد داشت.

11 Nursing Theories / Models با اين نگاه و جهان بيني پاسخ به سوالات قبلي! سوال: آيا نظريه ها و مدلهاي پرستاري چنين نقش و كاركردي براي پرستاري داشته و دارند! سوال: آيا نظريه ها و مدلهاي پرستاري مي توانند چنين نقش و كاركردي را براي پيشگيري از بيماريهاي كليوي داشته باشد! چگونه

12 Nursing Theories / Models Prevention of renal diseases Causes of Chronic Kidney Disease (CKD)? Diabetes Orem Roy High blood pressure Newman, CCM Heart disease PCM, Nursing guidelines Smoking Obesity High cholesterol Family history of kidney disease Age 65 or older

13 Nursing Theories / Models Prevention of renal diseases Acute renal failure (ARF) Common causes: A traumatic injury with blood loss Dehydration Damage to the kidneys from shock during a severe infection (sepsis) Obstruction of urine flow, (BPH) Damage from certain drugs or toxins Pregnancy complications, Orem Roy Newman, Nursing guidelines

14 Risk Factors : Nursing Theories / Models Prevention of renal diseases Urinary Stones (Urolithiasis) Infection Urinary Stasis Immobility Dehydration Ca, Vit D, PTH Diseases: HTN, Leukemia, IBD, Drugs Orem Roy Newman, CCM PCM, Nursing guidelines

15 Nursing Theories / Models Prevention of renal diseases More at risk for ESRD: Orem Chronic kidney disease (CKD) Roy Newman, Injury or trauma to the kidneys Nursing guidelines Major blood loss How can a person prevent ESRD? Have regular check-ups Eat a low-fat, low-salt diet Exercise most days of the week Avoid tobacco No intake or Drink alcohol (only in moderation!) No self medication Orem Roy Newman, CCM PCM, Nursing guidelines

16 Nursing Theories / Models Prevention of renal diseases نتيجه نهايي: پرستاران اساسا بدون نظريه و مدل (شاخص علم) عمل نمي كنند و نبايد عمل نمايند. ** بنابراين ** نظريه ها و مدلهاي پرستاري و پرستاران در حفظ و ارتقاي سلامت افراد و جامعه مفيد و موثرند.

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