THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024

Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM a. The Biological systems - the role of the

LESSON 1 medicine is to focus on the biological system.
b. The Behavioral systems - the nursing’s focus
THE BEHAVIORAL SYSTEM MODEL is on the behavioral system.
By: Dorothy E. Johnson 2. Society relates to the environment in which the
patient exist;
a. A patient’s behavior is directly influenced by
the environment and events that occur in the
environment.
BACKGROUND 3. Health is a purposeful adaptive response to internal
and external stimuli in order to maintain stability and
AUGUST 19, 1919 control. The responses include:
● The day she was born a. Physical
● Born in Savannah, Georgia b. Mental
c. Emotional, and
1942 d. Social realms
● BSN from Vanderbilt University 4. The primary goal of nursing is to foster equilibrium
in the individual patient. One focus of nursing
1948 concerns the organized and integrated whole, but the
● MSN in Public Health from Harvard major focus is on maintaining balance in the behavioral
system during an illness in the biological system
1949
● Faculty in UCLA
METAPARADIGM

1968
● Johnson’s first model proposed PERSON
● Views person as having two major systems:
1977 ○ Biological system, and
● Retired in Florida ○ Behavioral system
● Behavioral system a person is made up of all
patterned, repetitive, and purposeful ways of
The Behavioral system Model of Nursing
behavior that characterize life
● States that “each individual has patterned purposeful, ● An individual composed of seven open and
repetitive ways of acting that comprises a behavioral subsystems; a disturbance in one usually affects the
system specific to that individual” others
● Johnson’s 1st proposed her model in 1968 as a ● Continually strives to maintain a steady state by
model that advocates the fostering of efficient and adapting and adjusting to environmental factors that
effective behavioral functioning in the patient to cause an imbalance; when imbalance or health
prevent illness. problems occur, the person’s physical, social or
● Based her model on Florence Nightingale’s belief that psychological integrity is threatened.
nursing is designed to help people prevent or recover
from illness or injury. HEALTH
● Borrowed ideas from systems theory (gestalt and ● A state that is affected by social, biological,
selye) to explain that nursing is concerned with psychological, and physiological factors.
individual as an integrated whole ● The individual strives to maintain stability in these
factors
JOHNSON 1990 ● Clinical practice situation showing Johnson’s model
● The person experiencing a disease is more important of health
than the disease itself. ○ Mutual and therapeutic interaction between
the nurse and patient
○ Nurse should respect patient’s privacy and
DOROTHY JOHNSON BEHAVIORAL SYSTEM MODEL spiritual health to enhance pt’s mental health
● The person is a behavioral system composed of a set
of organized, interactive, interdependent, and ENVIRONMENT
integrated subsystems. ● Consists of all the factors that are not part of the
● Constancy is maintained through actions & behaviors individual’s behavioral system, but influence the
that are regulated & controlled by biological, system, some of which can be manipulated by the
psychological, and sociological factors. nurse to achieve the health goal for the patient.
● An individual’s behavior is influenced by all the events in
4 MAJOR CONCEPTS IN HER NURSING MODEL: the environment. It varies from culture to culture.
1. The human being has two major systems:
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

NURSING this control is measured against a standard of

● Is an external force acting to preserve the excellence
organization of the patient’s behavior by means of ● Includes intellectual, physical, creative,
imposing regulatory mechanisms or by providing mechanical, and social skills
resources while the patient is under stress
● A steady state is maintained through adjusting and 3 FUNCTIONAL REQUIREMENTS OF HUMAN
adapting to internal and external factors. 1. To be protected from noxious influences
with which the person cannot cope
GOAL OF NURSING 2. To be nurtured through the input of supplies
from the environment
● To reduce stress so that the client can move easily
through recovery 3. To be stimulated to enhance growth and
prevent stagnation
JOHNSON’S 7 SUBSYSTEMS
WHY IS IT USEFUL IN NURSING PRACTICE?
1. Attachment or Affiliative Subsystem ● It allows young health practitioners to provide not
● Forms the basis for all social organization only physical but also psychological support to
● Promotes survival and provides a sense of patient as well as inhibit inadequate behavior caused by
security this or that reason
● Results in social inclusion, intimacy and the
formation of strong bonds
2. Dependency Subsystem
● Promotes helping or nurturing behavior
from others
● Results in approval, attention, recognition, and
physical appearance
3. Ingestive Subsystem
● Involves food intake
● Relates to the biological need for food and
the psychological meanings and structures of
social events surrounding food consumption
● result s in appetite satisfaction
4. Eliminative Subsystem
● Involves behavior surrounding the excretion
of waste from the body
● Includes the psychological meanings and
structures of socially acceptable behaviors
for waste elimination
5. Sexual Subsystem
● Involves behavior associated with procreation
and sexual gratification
● Includes psychologically and socially
acceptable behaviors such as courtship and
mating
● Results in the development of sex role identity
and sex role behavior
6. Aggressive Subsystem
● Involves behavior related to self-protection
and preservation of the self & society
● Includes the belief that aggression is learned
& harmful and that people and property must
be respected and protected
● Includes acknowledgment of real and
imaginary dangers to develop defenses to
these threats
7. Achievement Subsystem
● Involves behavior related to manipulation of
the environment to gain mastery & control
over some aspect of oneself or environment,
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM ○ Defined by the person’s engaged interaction,

LESSON 2 interpretation and understanding of the
situation
● Persons enter into situations with their own sets of
FROM NOVICE TO EXPERT: EXCELLENCE AND POWER IN
meaning, habits & perspectives.
CLINICAL NURSING PRACTICE
By: Patrcia Benner
NURSING
● She described nursing as a caring relationship, and
“enabling conditions of connection and concern”.
● Viewed nursing practice as the care and study of the
lived experience of health, illness, and disease and the
relationships among these three elements.
CREDENTIALS AND BACKGROUND OF THE THEORIST
BENNER’S STAGES OF CLINICAL COMPETENCE (1984;
Patrcia Benner, RN, Ph.D., F.A.A.N. 2004):
● Fellows in American academy in Nursing
● Professor at University of California-San Francisco
NOVICE
1964 ● No experience of the situations in which they are
● Obtained a Bachelor of Arts degree from Pasadena expected to perform
College ● Learn context- free rules to guide action
1970 (stimulus-response thinking) Rule-governed behavior is
● Earned a master’s degree in Nursing from the typical, tends to be inflexible
University of California, San Francisco school of ● Has difficulty discriminating between relevant &
Nursing irrelevant aspects of a situation
1984
● Published From Novice to Expert ADVANCED BEGINNER
1985 ● Can demonstrate marginally acceptable
● Became a fellow in the American Academy of performance
Nursing ● Have begun to identify recurring meaningful
situational aspects and apply these in new situations
METAPARADIGM ● Unable to see the entirety of a new situation (may miss
some critical details)
PERSON ● They feel more responsible for managing patient
● A self-interpreting being, that is the person does not care, yet they still rely on the help of those who have
come into the world predefined but gets defined in more experienced
the course of living a life.
● The four major aspects of understanding that the COMPETENT
person must deal with:
● Considers consistency, predictability & time
1. The role of the situation
management as essential components & gaining a
2. The role of the body
sense of master
3. The role of the personal concerns ● There is an in an increased level of efficiency but the
4. The role of temporality focus is on time management & the nurses
organization of the tack are more important rather
HEALTH than on timing in relation to the patient’s needs
● Health ● This stage is critical because the nurse must know
○ What can be assessed how to recognize the pattern & identify which element
● Well-being if the situation needs attention & which ones to ignore
○ Human experience of health or wholeness
PROFICIENT
● Illness
● Perceives situations as wholes rather than in terms
○ The human experience of loss or dysfunction
of aspects
● Disease
● Performance is guided by maxims (cryptic instructions
○ What can be assessed at the physical level
that make sense only if there is already a deep
understanding of the situation)
ENVIRONMENT
● Perception is a keyword
● She used the word situation because it suggests a ● Possesses a web of perspectives on a situation
social environment with social definition and meaning ● Demonstrate an increased confidence in in their
● Situation knowledge & abilities
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

EXPERT
● No longer relies on an analytic principle (rule,
guideline, maxim) to connect understanding of a
situation to appropriate action
● Operates from a deep understanding of the total
situation
● Possessing an intuitive grasp of the problem
● There is a qualitative change as the expert performer
“knows the patient”, which means that knowing typical
patterns of responses & knowing the patient as a person
● Key aspects of the expert nurse practice:
○ Demonstrating a clinical grasp and resource
■ Based practice
○ Possessing embodied knowledge
○ Seeing the big
○ Seeing the unexpected

SEVEN DOMAINS OF NURSING PRACTICE

● Helping role
● Diagnostic client-monitoring function
● Effective management of rapidly changing situations
● Administering & monitoring therapeutic interventions &
regimens
● Monitoring & ensuring quality health care practices
● Organizational & work-role performance
● Teaching or coaching function
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM
LESSON 3 MAJOR DIMENSIONS
● The role of the nurse is to find out and meet the
NURSING PROCESS THEORY patient’s immediate need for help.
By: Ida Jean Orlando ● The patient’s presenting behavior may be a plea for
help, however, the help needed may not be what it
appears to be.
○ DECEIVING PRESENTATION BY THE PT
● Therefore, nurses need to use their perception,
thoughts about the perception, or the feeling
endangered from their thoughts to explore with patients
Background the meaning of their behavior.
IDA JEAN ORLANDO ● This process helps nurses find out the nature of the
● Nursing diploma distress and help the patients needs.
○ New York Medical College ○ ENDANGERED- PRODUCE, DRAWN,
● BS in public health nursing PROMPT
○ St. John’s University, NY ○ NURSES- UNDERSTANDING ABILITY TO
● MA in mental health nursing MEET/REACH THAT PARTICULAR
○ Columbia University, New York BEHAVIOR, FEELINGS
● Associate Professor at
○ Yale School of Nursing GOALS
● Director of the graduate program in ● To develop a theory of effective nursing practice.
○ Mental Health Psychiatric Nursing ● The theory explains that the role of the nurse is to
● Project investigator of a National Institute of Mental find out and meet the patient’s immediate needs for
Health grand entitled: help.
○ Integration of Mental Health Concepts in a ● All patient behavior can be a cry for help.
Basic Nursing Curriculum ● The nurse’s job is to find out the nature of the
● A board member of Harvard Community Health Plan patient’s distress and provide the help he or she
needs.
AUGUST 12, 1926
● Her birthdate ASSUMPTIONS
1961 ● When patients are unable to cope with their needs
● Published her book entitled: on their own, they become distressed by feelings of
○ The Dynamic Nurse-Patient Relationship helplessness.
1972 ● In its professional character, nursing adds to the
● The book was revised, hence entitled: distress of the patient.
○ The discipline and Teaching of Nursing ● Patients are unique and individual in how they
Processes respond.
● Nursing offers mothering and nursing analogous to
NURSING PROCESS THEORY an adult who mothers and nurtures a child
● The practice of nursing deals with people,
● Allows nurses to formulate an effective nursing care
environment, and health
plan that can also be easily adapted when and if any
● Patients need help communicating their needs; they
complexity comes up with the patient.
are uncomfortable and ambivalent about their
● Stresses the reciprocal relationship between patient
dependency needs.
and nurse.
● The nurse-patient situation is dynamic; actions and
● It emphasizes the critical importance of the patient’s
reactions are influenced by both the nurse and the
participation in the nursing process.
patient.
○ RECIPROCAL- MUTUALLY
● People attach meaning to situations and actions that
CORRESPONDING, AGREED UPON
aren't apparent to others.
● Orlando also considered nursing as a distinct
● Patients enter into nursing care through medicine.
profession and separated it from medicine where
● The patient is unable to state the nature and meaning
nurses determine nursing action rather than being
of his or her distress without the help of the nurse, or
prompted by physician’s orders, organizational needs
without him or her first having established a helpful
and past personal experiences.
relationship ith the patient.
● She believed that the physician’s orders are for
● Any observation shared and observed with the
patients and not for nurses
patient is immediately helpful in ascertaining and
○ NURSE HELP PT CARRY HE ORDER SINCE
meeting his or her need, or finding out that he or she is
PT IS UNABLE TO DO IT
not need at that time
○ NURSING ACTIONS ARE DERIVED FROM
● Nurses are concerned with the need the patient is
PTS IMMEDIATE EXPERIENCE OR
unable to meet on his or her own.
IMMEDIATE NEED FOR HELP
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

● Orlando speaks of nursing as unique and

TERMS independent in its concerns for an individual in its
● Distress - is the experience of a patient whose need concerns for an individual’s need for help in an
has not been met. immediate situation
● Nursing role - is to discover and meet the patient’s ● The efforts to meet the individual’s need for help are
immediate need for help. carried out in an interactive situation and in a
○ Patient's behavior may not represent the true disciplined manner that requires proper training
need.
○ The nurse validates his/her understanding of CONCEPTS
the need with the patient. ● Function of professional nursing - organizing principle
● Nursing actions - directly or indirectly provide for the ● Presenting behavior - problematic situation
patient’s immediate need. ● Immediate reaction - internal response
● Outcome - is a change in the behavior of the patient ● Nursing process discipline - investigation
indicating either a relief from distress or an unmet need. ● Improvement - resolution
○ Observable verbally and nonverbally
■ FEELING OF PAIN OR SUFFERING
AFFECTING A BODILY PART Function of Professional Nursing - Organizing Principle
■ STATE OF DANGER ● Finding out and meeting the patient's immediate
needs for help
METAPARADIGM ● "Nursing is responsive to individuals who suffer or
anticipate a sense of helplessness, it is focused on
HUMAN the process of care in an immediate experience,
● Orlando uses the concept of human as she ● It is concerned with providing direct assistance to
emphasizes individuality and the dynamic nature of individuals in whatever setting they are found for the
the nurse-patient relationship. purpose of avoiding, relieving, diminishing or curing the
● For her, humans in need are the focus of nursing individual's sense of helplessness." - Orlando
practice.
○ PEOPLE ARE SOMETIMES ABLE TO MEET Presenting Behavior - Problematic Situation
THEIR OWN NEEDS. SOMETIMES THEY ● To find out the immediate need for help the nurse
BECOME STRESSED IF THEY ARE UNABLE must first recognize the situation as problematic
TO DO SO ● The presenting behavior of the patient, regardless of
○ NURSES- CONCERNED WITH PT WHO ARE the form in which it appears, may represent a plea for
UNABLE TO MEET THEIR NEEDS. help
HOWEVER NURSES OBSERVE PT ● The presenting behavior of the patient, the stimulus,
PERIODICALLY TO DETERMINE IF THEY causes an automatic internal response in the nurse, and
HAVE NEW NEEDS FOR HELP the nurses behavior causes a response in the patient
HEALTH
Immediate Reaction - Internal Response
● In Orlado’s theory health is replaced by a sense of
● Person perceives with any one of his five sense
helplessness as the initiator of a necessity for nursing.
organs an object or objects
● She stated that nursing deals with individuals who
● The perceptions stimulate automatic thought
are in need of help.
● Each thought stimulates an automatic feeling
○ FREEDOM FROM MENTAL AND PHYSICAL
● Then the person acts
DISCOMFORT AND FEELINGS OF
● The first three items taken together are defined as the
ADEQUACY AND WELL BEING
person’s immediate reaction
ENVIRONMENT
● Orlando completely disregarded environment in her Nursing Process Discipline - Investigation
theory ● Any observation shared and explored with the
○ Only focusing on the immediate need of the patient is immediately useful in ascertaining and
patient meeting his need or finding out that he is not in need at
○ Chiefly the relationship and actions between that time
the nurse and the patient ● The nurse does not assume that any aspect of her
■ (ONLY AN INDIVIDUAL IN HER reaction to the patient is correct, helpful or appropriate
THEORY; NO FAMILIES OR GROUP until she checks the validity of it in exploration with the
WERE MENTIONED). patient
■ THE EFFECT THAT THE
ENVIRONMENT COULD HAVE ON Improvement - Resolution
THE PATIENT WAS NEVER ● It is not the nurse's activity that is evaluated but
MENTIONED IN ORLANDO’S rather its result : whether the activity serves to help the
THEORY patient communicate her or his need for help and how it
is met.
NURSING
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

● In each contact the nurse repeats a process of

learning how to help the individual patient.

NURSING PROCESS
Assessment
● The nurse completes a holistic assessment of the
patient’s needs.
● This is done without taking the reason for the
encounter into consideration
Diagnosis
● Uses the nurse’s clinical judgment about health
problems.
● The diagnosis can then be confirmed using links to
defining characteristics, related factors, and risk
factors found in the patient’s assessment.
Planning
● Addresses each of the problems identified in the
diagnosis.
● Each problem is given a specific goal or outcome,
and each goal or outcome is given nursing interventions
to help achieve the goal.
Implementation
● The nurse begins using the nursing care plan.
Evaluation
● The nurse looks at the progress of the patient toward
the goals set in the nursing care plan.
● Changes can be made to the nursing care plan
based on how well (or poorly) the patient is progressing
toward the goals.

CONCLUSION
● Focuses on the interaction between the nurse and
patient, perception validation, and the use of the
nursing process to produce positive outcomes or
patient improvement. Orlando's key focus was to
define the function of nursing.
● Orlando's theory remains one of the most effective
practice theories available.
● The use of her theory keeps the nurse's focus on the
patient.
● The strength of the theory is that it is clear, concise,
and easy to use.
● While providing the overall framework for nursing, the
use of her theory does not exclude nurses from
using other theories while caring for the patient.
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM ○The Virginia Nurses Association recognized

LESSON 4 Henderson as one of the fifty-one Pioneer
Nurses in Virginia
● Halloran
DEFINITION OF NURSING
○ A nurse theorist wrote “Henderson was to
By: Virginia Avenel Henderson
the twentieth century as NIghtingale was to
the nineteenth. Both wrote extensive works that
have influenced the world”
● 98 years old
○ Age she died

GENERAL INFORMATION
● VH views her work as philosophical statement rather
Background
than a theory
● In her definition, she emphasizes the care of both sick
November 30, 18977
& well individuals, and she was one of the 1st
● She was born, at Kansas City, Missouri
theorist to include spiritual aspects of nursing care
● According to VH, the nurse assist the patient with
March 19, 1996
essential activities to maintain health, recover from
● She died, at Branford, Connecticut
illness or achieves a peaceful death
● Patient's independence is an important criterion for
Education:
health
● Henderson identifies 14 basic need that forms the
1921
components of nursing care; the nurse helps the patient
● Early education at home in Virginia at Army School
meet these needs
of Nursing, Washington D.C graduated 1921
● Henderson also emphasize the need to view the
1931
patient and his family as a single unit
● Teachers College, Columbia University Bs
● For the patient to achieve health, he must be able to
1934
meet his need for support system- provided by the
● MS
family
Began her career in Public Health Nursing
14 BASIC HUMAN NEEDS
● In Henry street Settlement & in the visiting nurse
1. Physiological
service in Washington D.C
● Was motivated to develop her ideas because she had 1.1. Breathe normally
concerns about the function of nurses & the nurse 1.2. Eat and drink adequately
registration laws 1.3. Eliminate body waste
1.4. Move and maintain desirable postures
VIRGINIA AVENEL HENDERSON 1.5. Sleep and rest
● Has been called the “first lady of nursing” and the 1.6. Select suitable clothes- dress and undress
“first truly international nurse”. 1.7. Maintain body temperature within normal range
● She designed a plan to create district organizations by adjusting clothing and modifying the
within the state. environment.
● Advocate for the inclusion of psychiatric nursing in 1.8. Keep the body clean and well groomed and
the curriculum protect the integument.
● She first published her Definition of Nursing in a 1.9. Avoid dangers in the environment and avoid
revised version the textbook injuring others.
○ The principles & Practice of Nursing, as a 2. Psychological
result of working on this book, Henderson felt 2.1. Communicate with others in expressing
the need to clarify the role of nurses even emotions, needs, fears, or opinions.
further 2.2. Learn, discover, or satisfy the curiosity that
leads to normal development and health and
use the available health facilities.
● 1966
○ Henderson clarified her definition of nursing in 3. Spiritual
the book, “THE NATURE OF NURSING”
3.1. Worship according to one’s faith.
● 1988
4. Sociological
○ She was honored by the Virginia Nurses
Association when the Virginia Historical Nurse 4.1. Work in such a way that there is a sense of
Leadership Award was presented to her accomplishment.
● 2000 4.2. Play or participate in various forms of
recreation.
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

● For a team to work together in harmony, every

METAPARADIGM IN NURSING member must work interdependently
● The nurse, as a member of the healthcare, works &
PERSON contributes in carrying out the total program of care
● Referred as a patient ● “She is temporarily the consciousness of the
● An individual requiring assistance to achieve health unconscious, the love of life for the suicidal, the leg of
& independence or a peaceful death, the person & the amputee, the yes of the newly blind, a means of
family are viewed as a unit locomotion for the infant, knowledge and confidence for
● The mind & body are inseparable the young mother, and mouthpiece for those to weak or
● Must be able to maintain physiological & emotional withdrawn to speak, and so on.”
balance
HEALTH
● Is a quality of life that is basic to human functioning
● Health requires independence & interdependence
● Promotion of health is more important than care for
the sick
● Individuals will achieve or maintain health if they have
the necessary strength, will or knowledge
ENVIRONMENT
● Not specifically defined
● Involved the relationship one shared with one family/
also involved the community & its responsibility for
providing health care.
● VH believes that society wants & expects nurses to
provide a service for individuals incapable of
functioning independently
NURSING
● Henderson stated “the unique function of the nurse
is to assist the individual, sick or well in the
performance of those activities contributing to
health or its recovery (or to peaceful death) that he
would perform unaided if he had necessary strength, will
or knowledge. And to do this in such a way as to help
him gain independence as rapidly as possible.”
● Requires working interdependently with other
members of the healthcare team; the nurse function
independently of the physician but uses the physician’s
plan of care to provide holistic care to the patient

The Nurse Functions in Relation with the Patient, Physician

and other Members of the Health Team

The Nurse-Patient Relationship

● The nurse as a substitute for the patient
○ Making up for what the patient lacks to be
whole & independent again
● The nurse as a helper to the patient
○ Instituting medical interventions to assist the
patient meet his basic needs
● The nurse as partner with the patient
○ Fostering a therapeutic relationship with the
patient & functioning as a member of the
healthcare team
The Nurse -Physician Relationship
● Henderson asserted that nurses function
independently from physicians
● The plan of care must be implemented in such a way
that will promote the physician’s prescribed therapeutic
plan
The Nurse as Member of the Healthcare Team
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM ENVIRONMENT
LESSON 5 ● Defined as being all the internal & external factors
that surround or interact with person & client
○ Internal environment- exists within the client
Neuman Systems Model
system.
By: Betty Neuman
○ External environment- exists outside the
client system.
● Includes stressor, described as environmental forces
that interact with & potentially alter system stability

SYSTEMS MODEL IN NURSING PRACTICE

A. Client Variables
Background of the theorist
● The client variables can be one or
● 1924
combination of the following:
○ She was born
○ Physiological, sociocultural,
○ On a farm near Lowell, Ohio.
psychological, spiritual &
● 1947
developmental
○ Received RN Diploma from People's
● These variables function to achieve stability in
Hospital School of Nursing, Akron, Ohio
relation to the environmental stressors
● Moved to California and gained experience as
experienced by the client
hospital, staff, and as clinical instructor in
B. Lines of Resistance
medical-surgical, critical care and communicable
● Represent the internal factors of a person
disease nursing.
that help defend against a stressor ( e.g. body's
● 1972
immune response system)
○ Her model was first published
● It acts to facilitate coping to overcome the
○ in Nursing Research as a "Model for teaching
stressors that are present within the individual.
total person approach to patient problems"
C. Normal Line of Defense
○ The model was developed by Dr. Neuman as
● Represents a stability state for the
a way to teach an introductory nursing
individual or system
course to nursing students.
● It is maintained overtime & serves as standard
○ The model is based on philosophical views,
to assess deviations from the client’s usual
Gestalt theory, Han's Selye's stress theory
wellness
& General System's theory.
● It includes system variables & behaviors such
as the individual’s usual coping patterns,
METAPARADIGM
lifestyle, & developmental stage
PERSON
D. Flexible Line of Defense
● Is viewed by Neuman as a whole multidimensional
● Acts as protective barrier to prevent
dynamic system
stressors from breaking through the normal
● Can be an individual, family or group or community
line of defense
● She sees a person as an open system that works
● Is dynamic and can change rapidly over a
together with other parts of its body as it interact with
short time
the environment
● Can be affected by variables such as loss of
○ Open system- characterized by presence of
sleep, that reduce a client’s ability to use a
an exchange of information & reaction with
flexible line of defense against stressors.
other factors surrounding a person
E. Stressors
● Is composed of basic core(genetic features, and the
● Are forces that produce tensions,
strengths and weaknesses of the system parts) as well
alterations or a potential problems causing
as physiological, sociocultural, developmental & spiritual
instability with in the client’s system
variables
● They may be:
HEALTH
1. Intrapersonal stressors
● Neuman sees health as being equated with wellness.
● She defines health/wellness as "the condition in a. Are those stimuli that occur
which all parts and subparts(variables) are ij within the individual (e.g
harmony with the whole of the client (Neuman, 1995) emotions and feelings)
● Views health as a continuum of wellness to illness 2. Interpersonal stressors
that is dynamic in nature & constantly subject to a. Are those stimuli that occur
change between individuals (e.g
● "optimal wellness or stability indicates that total system pressures related to role
needs are being met" expectation)
● The client is in a dynamic state of either wellness or 3. Extrapersonal stressors
illness in varying degrees at any given point of time.
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

a. Are stimuli that occur ● Focuses on actual treatments or

outside the person ( e.g. adjustments to facilitate the strengthening of a
job or financial pressures) person after being exposed to ascertain or
F. Reaction illness
● Are the outcomes or produced results of ● It aims to prevent the recurrence of the
certain stressors & actions of the lines of illness in the manner of rehabilitation, as in
resistance of a client the case of disability avoidance & physical
● Can be positive or negative depending on therapy
the degree of reaction the client produces to Once an individual is exposed to stress, the flexible line of
adjust with the situation defense will be “alarmed”to protect the normal (solid) line of
● Neuman specified these reactions as: defense to keep the system free from stressor reactions.
○ Negentropy- is set towards stability However , if this individual is continuously exposed to stress and
or wellness if the flexible line of defense is unable anymore to cope up with
○ Egentropy- is set towards the stressors, the normal line of defense will be altered. If this
disorganization of the system happens, there will be a threat to the wall that protects the basic
producing illness structure of the individual and therefore causing instability of the
G. Degree of Reaction systems and illness develops.
● Is the amount of energy required or the client
to adjust to the stressors
H. Prevention
● Interventions are purposeful actions to help
the client retain, attain & or maintain system
stability
● Used to attain balance within the continuum
of health
● These are the actions that generate good
results or reclaimed towards hindering
negative outcomes
I. Reconstitution
● Is the adjustment state from they degree of
reaction
● It is the state of going back to the actual
state of health before the illness occurred.

3 Levels of Prevention
1. Primary Prevention
● Refers to intervention before a reaction
occurs
● Is carried out when a stressor is suspected
or identified
● It also aims to strengthen the capacity of a
person to maintain an optimum level of
functioning while being interactive with the
environment, like health promotion & disease
prevention
2. Secondary Prevention
● Refers to intervention after a reaction occurs
● Focuses on helping alleviate the actual
existing effects of an action that altered that
balance of health of a person
● It aims to reduce environmental influences
that lead to the decline of the level of
functioning of a person & strengthening or
restoring a person;s resistance after the illness
exposure
● Examples: early detection of disease &
prompt treatment
3. Tertiary Prevention
● Refers to intervention that occurs after the
system has been treated through secondary
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM ● She speaks to a “total health needs” & a “healthy

LESSON 6 state of mind & body”
● Viewed as a state that excludes illness
● Can also be described as a state in which the person
TWENTY ONE NURSING PROBLEMS
has no unmet needs & no anticipated or actual
By: Faye Abdellah
impairments

ENVIRONMENT
● Least discussed concept in Abdellah’s model
● Includes the atmosphere of a client’s room, home &
community

NURSING
● Is a helping profession
Background
● Considers nursing to be an all-inclusive service that
is based on the disciplines of art & science that serves
March 13, 1919
individuals sick or well, cope with their health needs
● Her birthdate
● Uses the nursing process, a problem-solving
● Born in New York City
approach
1942
● Can use the 21 nursing problems as a guide from
● Began her nursing career
nursing care
● She received her diploma in nursing from;
○ Fitkin Memorial Hospital School of Nursing
GENERAL INFORMATION
in Neptune, New Jersey
● A theoretical statement from Abdellah’s works can be
1945
created by utilizing her 3 chief :
● BSN
○ Concepts of Health,
1947
○ Nursing Problems,
● MA
○ and Problem Solving
1955
● Abdellah’s theory proposes that nursing is the
● Doctoral of Education from Teacher’s College,
“utilization of the problem-solving techniques with
Columbia University, New York City
chief nursing problems related to the health
1960
requirements of clients.
● Her typology of Nursing problems was 1st published
● It gives much importance to problem-solving as medium
● At Patient Centered Approaches in nursing
for the nursing problems as the client is geared in the
2000
direction of health, which is the outcome
● Inducted into the US National Women’s Hall of
Fame due to her contributions in the field of Education &
Nursing
NURSING PROBLEMS
● Nursing problem is defined as any condition
● Became 1st nurse & 1st woman the woman to serve presented or faced by a client or family for which a
as Deputy Surgeon General of the United States nurse can offer assistance
● She was motivated to develop typology by a desire to ● Health needs are seen as problems, which may be:
promotes comprehensive, client-centered nursing care- ○ Overt - obvious or can be seen condition
she used the problem solving approach as a basis ○ Covert - unseen or masked one
for her typology ● According to Abdellah, the practice of competent
nursing care in the future is for the nursing student to
METAPARADIGM IN NURSING realize that identifying & answering overt & covert
nursing problems is the core of Nursing
PERSON ● The Typology of 21 Nursing Problems: the identification
● Is the recipient of nursing care & classification of problems
● One who has physical, emotional or sociological needs, ○ Abdellah’s typology as divided into three
helping a person with these needs is nursing’s only areas:
justification a.) physical, sociological & emotional
● According to Abdellah: the typology of nursing needs of the patient
problems evolve from the recognition of a need for b.) types of interpersonal relationships
patient-centered approaches to nursing between the nurse & the patient
● Includes families as well as individuals c.) common elements of patient care
● Is capable of learning & of self-help to varying degrees
TYPOLOGY OF 21 NURSING PROBLEMS
HEALTH 1. To maintain good hygiene & physical comfort
● Defined as the center & purpose of nursing services 2. To promote optimal activity: exercise, rest, sleep
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

3. To promote safety through prevention of accident, injury

or other trauma & through the prevention of the spread
of infection
4. To maintain good body mechanics & prevent & correct
deformity
5. To facilitate the maintenance of a supply of oxygen to all
body cells.
6. To facilitate the maintenance of nutrition of all body cells
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid & electrolyte
balance
9. To recognize the physiological responses of the body to
disease conditions – pathological, physiological &
compensatory
10. To facilitate the maintenance of regulatory mechanisms
& functions
11. To facilitate the maintenance of sensory function.
12. To identify & accept positive & negative expressions,
feelings & reactions.
13. To identify & accept interrelatedness of emotions &
organic illness
14. To facilitate the maintenance of effective verbal &
nonverbal communication.
15. To promote the development of productive interpersonal
relationships
16. To facilitate progress toward achievement & personal
spiritual goals
17. To create or maintain a therapeutic environment
18. To facilitate awareness of self as individual with varying
physical, emotional & developmental needs
19. To accept the optimum possible goals in the light of
limitations, physical & emotional
20. To use community resources as an aid in resolving
problems arising from illness
21. To understand the role of social problems as influencing
factors in the cause of illness

PROBLEM SOLVING
● The process of identifying overt & covert nursing
problems & interpreting, analyzing & selecting
appropriate actions to solve these problems
● The steps resemble the pace of the Nursing process of
Assessment, Diagnosis, Planning, Implementation &
Evaluation
The Problem Solving Process includes:
1. Identifying the problem
2. Selecting relevant data
3. Devising hypotheses
4. Testing hypotheses through the assessment of data
5. Revising hypotheses when necessary on the basis of
conclusions obtained from the data
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM ● Adaptation is defined as the process and outcome

LESSON 7 whereby thinking and feeling, as individuals and groups,
use conscious awareness and choice to create human
and environmental integration.
ADAPTATION MODEL
By: Callista Roy
NURSING
● Nursing is the science and practice that expands
adaptive abilities and enhances person and environment
transformation.
● Roy’s goal of nursing is the promotion of adaptation
in each of the 4 modes thus contributing to health,
quality of life and dying with dignity
● Nursing is about the increase, enhancement,
modification and alteration of the stimulus to achieve
adaptation.
Background
THE ROY ADAPTATION MODEL (RAM)
October 14, 1939
The key concepts:
● She was born
● The person is adapting in a stable interaction with
● In Los Angeles California
the environment, either internal or external.
● The environment serves as the source of a range of
Callista Roy stimuli that will either threaten or promote the person’s
● She is a nurse theorist and a professor unique wholeness.
● She is a fellow in the American Academy of Nursing, ● The person’s major task is to maintain integrity in
an honorary nursing society that elects nursing leaders face of these stimuli.
annually ○ INTEGRITY- the degree of wholeness achieved
● Has numerous publications, including books & journal by adapting to changes in needs.
articles on nursing theory & other professional topics ● SYSTEM – is a set of parts connected to function as a
whole for some purpose & that does so by virtue of the
interdependence of its parts
METAPARADIGM ● Roy considers the recipient of care to be an open
adaptive system
PERSON ● React & interact with other systems in the environment
● Is the recipient of nursing care; main focus of ● Have boundaries that are flexible & open to permit
nursing interaction with other systems
● A biopsychosocial being in constant interaction with a ● Employ a feedback cycle of input, throughput & output
changing environment. ○ Input – defined as stimuli which can come
● The person is an open adaptive system who uses from the environment or from within a person
coping skills to deal with stressors. TYPES OF STIMULI (HELSON, 1964)
● It includes people as individuals or in groups (families, ● FOCAL – the internal or external stimulus most
organizations, communities, nations & society as a immediately confronting the person, it attracts the most
whole) attention.
● An adaptive system has cognator and regulator ● CONTEXTUAL – all other stimuli present in the
subsystems to maintain the 4 adaptive modes. situation that strengthens/contribute the effect of the
focal stimulus.
ENVIRONMENT ● RESIDUAL - those stimuli that can affect the focal
● Conditions, circumstances and influences that stimulus but the effects are unclear.
surround and affect the development and behavior of ○ The three types of stimuli act together and
the person. influence the adaptation level which is
● Consists of internal & external environments, which defined as the ability to respond positively in a
provide input in the form of stimuli situation.
● Stressors are stimuli that are significant in human ○ Throughput – makes use of a person’s
adaptation: stages of development, family & culture processes & effectors
■ Processes refer to the control
HEALTH mechanisms that a person uses as
● Was originally described by Roy as a health-illness an adaptive system
continuum; health & illness were considered an ■ Effectors refer to the physiologic
inevitable dimension of the person’s life function, self-concept & role
● More recently, Health is the process of being and function involves in adaptation
becoming an integrated and whole person. ○ Output – is the outcome of the system, when
● Is it a reflection of adaptation that is the interaction of the the system is a person, the output refers to the
person & the environment person’s behaviors
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

Categories of Output: ○ Ventilatory Impairment

● Adaptive responses – those that ○ Unresolved loss
promote integrity in terms of the ○ Abusive Relationships
goals of the human system .
● Ineffective responses – those that
do not contribute to integrity in 4 ADAPTIVE MODES
terms of the goals of the human ● ADAPTIVE MODES – are categories of behavior to
system adapt to stimuli
○ Can be used to determine a person’s
adaptation level
COPING MECHANISM AND CONTROL PROCESSES ○ Can be used to identify adaptive or
● COPING MECHANISM – are the processes that a ineffective responses by observing a person’s
person uses for self-control behavior in relation to the adaptive modes
● Are innate or acquired ways of interacting with the 1. PHYSIOLOGICAL – the way a person responds as a
changing environment physical being to stimuli from the environment.
● Innate coping mechanisms GOAL: Physiological Integrity
○ are genetically determined or common to ● Five Physiologic Needs:
the species & are genetically viewed as oxygenation, nutrition, activity & rest &
automatic process protection
● Acquired coping mechanisms ● Four Complex Processes: senses;
○ are developed through strategies such as fluids, electrolytes & acid-base
learning balance; neurologic function;
endocrine function
CATEGORIES OF COPING MECHANISM 2. SELF-CONCEPT – GROUP IDENTITY MODE -
● REGULATOR SUBSYSTEM - major coping process focuses specifically on the psychological & spiritual
involving the neural, chemical, and endocrine system aspects of the human system
○ E.g. increase in vital signs- sympathetic ● Self- concept – defined as the composite of beliefs &
response to stress. feelings about oneself at a given time & is formed from
● COGNATOR SUBSYSTEM – is a major coping internal perceptions of other’s reaction
process involving four cognitive-emotive channels: ○ Two components:
perceptual & information processing; learning; judgment ■ 1. physical self (body sensation and
& emotion body image)
○ E.g. effects of prolonged hospitalization for a 4 ■ 2. personal self (self consistency, self
year-old child ideal, and moral ethical spiritual self)
● CONTROL PROCESSES – stabilizer subsystem & ● Group Identity – reflects how people in groups
innovator subsystem perceive themselves based on environmental feedback
○ Stabilizer subsystem – analogous to regulator ○ comprised of interpersonal relationships, group
: concerned with stability self-image & culture
○ Innovator subsystem – analogous to
cognator:: concerned with creativity, change & GOAL: Psychological Integrity
growth
3. ROLE FUNCTION MODE – a role is a set of
expectations
ADAPTATION LEVEL
about how a person occupying one’s position
1. Integrated - Adaptation level at which the structures and
behaves towards a person occupying another position.
functions of a life process are working as a whole to
meet human needs. GOAL: Social Integrity
● Example: ● Roles are carried out with both instrumental
○ Stable processes of ventilation, the behaviors (the actual physical performance of
complex process of breathing that a behavior) and expressive behaviors ( are the
exchanges air between lungs and feelings, attitudes, likes or dislikes that a
atmosphere person has about a role or about the
2. Compensatory - at which the cognator and regulator performance of a role)
have been activated by a challenge to the integrated ● Persons perform primary, secondary & tertiary
life processes roles
● EXAMPLE: ○ Primary – determines the majority of
○ GRIEVING, ROLE TRANSITION, behavior engaged in by the person
3. Compromised- resulting from inadequate integrated during a particular period of life ( age,
and compensatory life processes; adaptation sec, developmental stage)
problem. ○ Secondary – are those that a
● EXAMPLES: person assumes to complete the
○ Hypoxia
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

task associated with a developmental 4. GOAL SETTING

stage & primary role (husband, wife) ● Establishment of clear statements of the
○ Tertiary – related primarily to behavioral outcomes for nursing care which
secondary roles & represent ways in is realistic and attainable. This is done together
which individuals meet their role with the client.
associated obligations
- temporary in nature, freely chosen by the individual 5. INTERVENTION
4. INTERDEPENDENCE MODE– focuses on close
● Determination of how best to assist the
relationships which results to giving & receiving of love,
person in attaining the established goals.
respect, value, nurturing, knowledge, skills,
6. EVALUATION
commitments, material possessions, time & talents
● Occurs between the person and the most ● Judging the effectiveness of the nursing
significant other or between the person and the intervention in relation to the behavior after it
support system. was performed in comparison with the goal
established.
GOAL: Affectional Adequacy.
REMINDER!
“ Not all beautiful is always good,
GOAL OF NURSING IN RAM But all good is always beautiful.
● PROMOTE ADAPTATION IN EACH OF THE FOUR
ADAPTIVE MODES There is always a room for improvement,
And that is the biggest room in the house.”
POINTS TO REMEMBER
● Adaptive or ineffective responses result from the 4
modes of coping mechanisms.
● Adaptive responses support the integrity of the
person and the goals of adaptation.
● Ineffective responses neither promote integrity nor
contribute to the goals of adaptation.

NURSING PROCESS
● A problem-solving approach for gathering data,
identifying the capacities and needs of the human
adaptive system, selecting and implementing
approaches for nursing care, and evaluation of the
outcome of care provided.

6 STEPS IN THE NURSING PROCESS

1. ASSESSMENT OF BEHAVIOR
● Data gathering about the behavior of the
person as an adaptive system in each of the
adaptive modes.
○ Observable behavior: vital signs
○ Non-observable behavior: feelings
experienced by the person (anxiety)
2. ASSESSMENT OF STIMULI
● A STIMULUS is defined as any change in the
internal and external environment that
induces a response in the adaptive system. It is
classified as focal, contextual or residual.
● In this level of assessment, the nurse
analyzes the subjective and objective
behaviors and look more deeply for possible
causes of a particular set of behaviors.

3. NURSING DIAGNOSIS
● Formulation of statements that interpret
data about the adaptation on status of the
person, including the behavior and the most
relevant stimuli.
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

MIDTERM ● Interpreted from the general systems theory as an open

LESSON 8 system with permeable boundaries that allow the
exchange of matter, energy, and information.
Goal Attainment Theory
By: Imogene King Nursing
● Is an act wherein the nurse interacts and communicates
with the client
● The nurse helps the client identify the existing health
condition, exploring, and agreeing on activities that
promote health
Background ● The goal of the nurse is to help the client maintain health
● Youngest of 3 children, born in 1923 through health promotion and maintenance, restoration
● 1946 - St. John’s Hospital School of Nursing in St. Louis, and caring for the sick and dying.
Missouri
● 1948 - BS in Nursing Education, St. Louis University Goal Attainment Theory
● 1957 - MS in Nursing, SLU ● Involves the nurse and the patient mutually
● 1961 - EdD: Teacher’s College, Columbia University, communicating information, establishing goals, and
New York - Postdoctoral study in research design, taking action to obtain goals.
statistics, and computers ● Two people who are usually strangers come together in
● Expertise: adult medical-surgical nursing a health care organization to help to be helped to mutual
● Experiences: administrator, educator, and a practitioner state of health

Metaparadigm Central Focus of the theory

Person ● Man as a dynamic human being whose perceptions of
● Individuals are spiritual being (spiritual people are not objects, persons, and events influence his behavior,
bogged down expectations, assumptions, hate, social interaction, and a health
resentment, extreme desires or attachment to things and ● Man is an important focus of King’s framework
people. They understand the nature of impermanence. She Proposes 3 Basic Premises; Man Is:
Everyone and everything around them is in constant 1. A reactive being
change) ● Aware of other things [ersons and events in the
● Have the capacity to think, know, make choices and environment
select alternative courses of action 2. A time-oriented being
● Have the ability through their language and other ● Is influenced by time orientation
symbols to record their history and preserve their culture ● Each person is influenced by his past actions
● Open system in transaction with the environment 3. A social being
● Unique and holistic, are of intrinsic worth and are ● Has a continuous exchange with person in the
capable of rational thinking and decision making in most environment
situations ● Language is a social link and facilitates
● Individuals differ in their needs, wants, and goals interpersonal communication

3 Fundamental health needs of human beings: 3 Interacting Systems of the Theory

1. Need for information Personal system
2. Need for care for illness prevention ● Individuals
3. Need for total care when a person doesn’t have the ● How the nurse views and integrates self-based on
capacity to help themselves. personal goals and beliefs
Health
● A dynamic state in the life cycle: illness is an Concept of personal system
interference in the life cycle The personal interacting system consists of:
● Implies continuous adjustment to stress in the internal a. The individual’s perception - the person’s
and external environments, using personal resources to representation of reality and it is unique to each
achieve optimal daily living. individual
b. Self - the person’s subjective environment, values,
Environment ideas, attitudes, and commitment.
● The process of balance involving internal and external c. Growth and development - involves all the changes
interaction inside the social system that occur (cellular, molecular, and behavioral). These
● The external environment is the context within which changes are usually orderly and predictable but may
human beings grow, develop and perform daily activities vary with individuals
● The internal environment of human beings transforms d. Body image - the way a person perceives their body
energy to enable them to adjust to a continuous external and the reaction of others to their body. Body image is
environment changes subjective and changes as the person changes
physically or emotionally.
THEORETICAL FOUNDATION IN NURSING BSN-1A 2023-2024
Prof: Ms. Loyalda Lazarraga |MIDTERM Transc by: Hanin Abain

e. Space - is the immediate physical territory occupied by 2. The ability to think - thinking is based upon the inquiring
the person and person’s behvaior mind of man
f. Time - is the order of events and their relationship to 3. The ability to feel - have emotions
each other 4. The ability to choose between alternative courses of
action
5. The ability to set goals
Interpersonal system 6. The ability to select means of accomplishing goals
● Two or more interacting individuals
● How the nurse interrelates with a co-worker or Propositions of King’s Goal Attainment Theory
patient, particularly in a nurse-patient 1. If perceptual accuracy is present in nurse-client
relationship interactions, transactions will occur
Concept of Interpersonal system: 2. If nurse and client make transactions, goals will be
a. Interaction - any situation wherein the nurse relates and attained
deals with a patient 3. If goals are attained, satisfaction will occur
b. Communication - refers to the transmission of 4. If goals are attained, effective nursing care will occur
information from one person to another; either directly or 5. If transactions are made in nurse-client interactions,
indirectly growth and development will be enhanced
c. Transaction - refers to the interaction between a person 6. If role expectations and role performance as perceived
and the environment for the purpose of goal attainment by nurse and client are congruent, transactions will
d. Role - refers to the expected behaviors of a person in a occur
specific position and to the rules that govern the position 7. If role conflicts are experienced by the nurse and client
and affect the environment between 2 or more persons. or both, stress in nurse-client interactions will occur
e. Stress - refers to an exchange of energy, either positive 8. If nurses with special knowledge and skills communicate
or negative between a person and the environment; appropriate information to clients, mutual goal setting,
objects, persons, and events can serve as stressors and goal attainment will occur.

Social system
● Composed of larger group of individuals with
common interest goals
● How the nurse interacts with co-workers,
superiors, subordinates, and the client
environment in general.
● Ex. families, religious people, schools,
workplaces, and peer groups
● A social system comprises the:
○ Social roles
○ Behaviors
○ Practices

Concepts of Social System

a. Organization - refers to a group of people with similar
interests who have prescribed roles and positions and
who use resources to achieve personal and organization
goals
b. Authority - refers to the observable behavior of
providing guidance and order and being responsible for
actions
c. Power - is characterized by the ability to use resources
for goal achievement; also a means by which one or
more persons can influence others.
d. Status - refers to the position occupied by a person in a
group or the position occupied by a group in relation to
other groups in an organization; it is accomplished by
certain duties, privileges, and obligations
e. Decision making - results from developing and acting
on perceived choices for goal attainment.

6 Characteristics of Man
1. The ability to perceive -perceptions will influence
behavior and thus life and health