Introduction
During her practice, Faye Glenn Abdellah was especially interested in long-term planning of care, the strengthening of the nursing school infrastructure, and the need to facilitate patient-centered approaches in nursing to improve the population’s health outcomes. This paper will explore her theory of patient-centered care, which is quite flexible and could be applied to different patient concerns as well as broader categories such as nursing education and research.
Background
Theorist’s Background
Faye Glenn Abdellah (born in New York City 1919 – 2017) was among the pioneers of American research in nursing. She was the first woman and nurse to serve as the Deputy Surgeon General of the United States. The researcher’s background stems from her active duty during the Korean war, where she earned a distinguished ranking equivalent to a Navy Rear Admiral. As a result, Abdellah was the highest-ranked woman and nurse in the Federal Nursing Service in the 1950s (The Washington Post, 2017). In addition, she was in the lead in forming the National Institute of Nursing Research at the National Institutes of Health (NIH) (The Washington Post, 2017). Abdellah had a Ph.D. in educational psychology, Masters of Arts, and Bachelors of Science degrees from the Teachers’ College at Columbia University in New York (NY), specializations in Liberal arts and chemistry at Residential College in New Brunswick (NJ), and an RN diploma from Fitkin Memorial Hospital in Neptune (NJ).
Phenomenon of Concern
In the patient-centered nursing theory, the concerned phenomenon aligns with the recognition of the specific patient needs to act upon them accordingly for health improvement and overall well-being (Habeeb, 2018). In the theory, the care provided to patients is continuous and aims to relieve any pain or discomfort, with the plan of care being adjusted to ensure the focus on the particular needs of separate patients.
Theory Description
Abdellah’s patient-centered care theory was developed inductively due to her practice and is categorized as a human needs theory. In the theorist’s view, “nursing is based on an art and science that mold the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs” (as cited in Alligood, 2022 p. 15). Thus, in the model, the focus is placed on the patient and the systems surrounding and influencing them, including practitioners and families who can collaborate to meet optimal health outcomes.
Concepts
In Abdellah’s patient-centered care theory, such concepts as nursing problems and problem-solving are the most prominent. The researcher identified twenty-one nursing problems, ranging from maintaining patients’ physical comfort to the role of social problems as factors causing illness among individuals (Abdellah et al., 1968). The identification of these problems requires nurses to exhibit particular skills, such as knowledge application, problem-solving, use of personal resources, health status observation, and others. As to the problem-solving concept, the theory suggests that high-quality nursing care that is oriented toward the patient works by identifying and solving overt problems.
Diagram
In the theory, the focus of care pendulum was developed as an illustration of the position of client-centered care in contrast to the nursing-centered and disease-centered approaches (see Figure 1).
Relationships
The concepts of the theory have a direct relationship because the identification of nursing problems calls for their resolution with the help of problem-solving. Without the problems, there will be no resolution because practitioners will not have enough information on issues that need addressing. Thus, problem-solving is an activity that is inherently logical in nature, which makes it easily applicable in practice that focuses on patient needs.
Evaluation
Weaknesses
The theory’s effectiveness is evaluated in nurses’ progress or the lack thereof to facilitate the achievement of the stated goals related to patients’ health improvement. However, it has some weaknesses, such as gaps in continued research regarding the efficacy of using twenty-one nursing problems for reaching successful nursing care outcomes. Moreover, the “nursing problems” label is a limitation in itself because it creates a perception that Abdellah’s work is rather nursing-centered. The improvement in terminology as well as more research on the usefulness of problems’ identification within patient-centered care.
Metaparadigms
While there is no clear explanation in Abdellah’s theory regarding the four paradigms of nursing, such as a person, environment, health, and nursing, all of them relate to the model. Essentially, the theory identifies the person as the central focus of nursing, considering the influence of different environmental factors on health. The improvement of the environment through patient advocacy, education, and recommendations for self-care is necessary to improve health on both a long- and short-term basis.
Application
Studies that Used the Theory
The first study that used Abdellah’s theory in their research is the research by Mehraeen et al. (2020), in which they investigated the nursing process in patients diagnosed with diabetes based on the patient-centered care model. The researchers concluded that the theory could provide an appropriate framework for diagnosing nursing problems and help patients with diabetes be more effective at self-care and the condition’s management.
The second study was de Souza et al.’s (2019) exploration of the situational approach in hematological physical examination. The researchers applied Abdellah’s theory to show that a hematological physical examination is necessary for identifying key issues that apply to patients and solving them to satisfy the specific needs of clients. It was concluded that the theory encouraged nurses to seek new care paradigms for hematological clients and centered on the holistic vision of patients’ needs.
Area of Practice
In the area of practice involving hemodialysis, Abdellah’s theory can be applied to patient education and improvement of clinical perceptions of the practice. There are cases when patients choose to undergo hemodialysis even when in their care the treatment does not increase their life expectancy and quality of life. Often, patients who would benefit from peritoneal dialysis or medical management without dialysis are not informed about such options (Neumann, 2021). Thus, the concept of patient-centered nursing will apply to hemodialysis when it comes to determining the potential outcomes of the process and whether it would benefit patients by drawing upon their specific needs and concerns.
Conclusion
To conclude, Faye Glenn Abdellah’s theory of patient-centered nursing care has the potential to be applied in multiple practice and research areas due to its flexibility. When the needs of a patient are put first before any other components of nursing, it becomes easier to identify the most pressing issues and concerns and address them momentarily. The theory suggests that each patient’s case is unique and should be treated as such in order to reach the best outcomes possible.
References
Abdellah, F.G., Beland, I.L., Martin, A., & Matheney, R.V. (1968). Patient-centered approaches to nursing (2nd ed.). Macmillan.
Alligood, M. R. (2022). Nursing theorists and their work (10th ed.). Elsevier.
de Souza, V., de Carvalho Queluci, G., Mendonça, A. R., Dias, S. C. F., & da Silveira Jasmim, J. (2019). Situational approach of the nurse in hematological physical examination: A reflection with Faye Abdellah. Revista Enfermagem Atual in Derme, 87. Web.
Gonzalo, A. (2021). Faye Abdellah: 21 nursing problems theory. Web.
Habeeb, J. S. (2018). Faye G theory. Web.
Mehraeen, P., Nazarpour, P., & Ghanbari, A. (2020). Designing a nursing care plan based on Faye Glenn Abdellah model in patients with diabetes type 2: A case study. International Journal of Caring Sciences, 13(3), 2250-2260.
Neumann, M. E. (2021). Medical management without dialysis offers alternative therapy. Web.
Washington Post. (2017). Faye Abdellah obituary. The Washington Post. Web.
