ABDELLAHS THEORY

INTRODUCTION
Faye Glenn Abdellah was one of the most influential nursing theorist and public health
scientists . It is extremely rare to find someone who has dedicated all her life to the
advancement of the nursing profession and accomplish this feat with so much distinction and
merit.
BIOGRAPHY
Faye Glenn Abdellah was born on March 13, 1919, in New York City.
EDUCATIONAL ACHIEVEMENTS
In 1942, Abdellah earned a nursing diploma from Fitkin Memorial Hospital's School of Nursing
New Jersey (now Ann May School of Nursing).
She received her Bachelor of Science Degree in 1945, a Master of Arts degree in 1947 and
Doctor of Education in Teachers College, Columbia University. In 1947 she also took Master of
Arts Degree in Physiology.
As an Educator and Researcher
Abdellah went on to become a nursing instructor and researcher and helped transform the
focus of the profession from disease centered to patient centered. She expanded the role of
nurses to include care of families and the elderly.
She worked in many settings. She had been a staff nurse, a head nurse, a faculty member at Yale
University and at Columbia University, a public health nurse, a researcher and an author of more
than 147 articles and books.
She was selected as Deputy Surgeon General in 1982. She retired in 1989.
What has influenced Faye Abdellah in the development her own model of nursing?
1937 She wanted to be a nurse on the day she saw Hindenburg explode.
1949 She spent 40 years in Public Health Service where she first became involved in research,
being assigned to perform studies to improve nursing practices.
1960 She was influenced by the desire to promote client-centered comprehensive nursing
care.
ABDELLAH'S TYPOLOGY OF 21 NURSING PROBLEMS
BASIC TO ALL PATIENTS
1. To maintain good hygiene and physical comfort After colonoscopy, patients are usually soiled from
the procedure. It is therefore important to clean them properly. Physical comfort through proper
positioning in bed.
2. To promote optimal activity: exercise, rest, and sleep Patients who were sedated during the
procedure stay in the unit until the effect of the sedation has decreased to a safe level. As a nurse,
make sure the patients are able to rest and sleep well by providing a conducive environment for rest,
such as decreasing environmental noise and dimming the light if necessary.
3. To promote safety through prevention of accident, injury, or other trauma and through the
prevention of the spread of infection Making sure the side rails are always up when leaving the
patient . one way we prevent the spread of infection is through proper disinfection of the equipments .
4. To maintain good body mechanics and prevent and correct deformity Positioning the patient
properly, allowing for the normal anatomical position of body parts.
SUSTENAL CARE NEEDS
5. facilitate the maintenance of a supply of oxygen to all body cells when patients manifest breathing
problems, oxygen is attached to them, usually via nasal cannula. Sedated patients are attached to
cardiac monitor and pulse oxi meter while having the oxygen delivered. When the oxygen saturation
falls below the normal levels, the rate of oxygen is increased accordingly, as per physician's order.
6. To facilitate the maintenance of nutrition of all body cells patients undergoing endoscopic
procedures are on NPO. For this reason it is important to monitor the blood glucose level. When the
patient's blood glucose falls from the normal value, we inject D50W to the patient or we change the
patient's IVF to a dextrose containing fluid.
7. To facilitate the maintenance of elimination Providing bedpans or urinals to patients and at times,
insertion of Foley catheter when the patient is not able to void.
8. To facilitate the maintenance of fluid and electrolyte balance Proper regulation of the intravenous
solutions as well as proper incorporations it may have. An example is when patients have low serum
potassium; KCl is incorporated in the solution.
9. To recognize the physiological responses of the body to disease conditionspathological,
physiological, and compensatory it is important to check the patients for signs of internal
gastrointestinal bleeding by monitoring the blood pressure and cardiac rate.
10.To facilitate the maintenance of regulatory mechanisms and functions When a patient has a
difficulty in breathing and is showing an increase respiratory rate, elevating the head part of the bed is
done to facilitate the respiratory function.
11. To facilitate the maintenance of sensory function Sometimes there are semi-conscious patients,
in these cases, it is still necessary to talk to them while performing nursing interventions to maintain
their auditory sense.
REMEDIAL CARE NEEDS
12. To identify and accept positive and negative expressions, feelings, and reactions most patients
feel anxious before undergoing the procedures. It is necessary to listen to the patients' expressions and
allow them to ask questions. To decrease their anxiety, proper instructions are given, what they are to
expect, how long the procedure will take, what they should do during and after the procedure as well as
other concerns.
13. To identify and accept interrelatedness of emotions and organic illness Encourage patients to
verbalize their feelings and allow them to cry when they have the need to do so will help them
emotionally. Some patients are diagnosed with malignancy after the procedure and during this time the
emotional needs of the patient is a priority.
14. To facilitate the maintenance of effective verbal and nonverbal communication when patients
are not able to express themselves verbally, it is important to assess for nonverbal cues. For instance
when patients are in pain, assessing for facial grimacing.
15. To promote the development of productive interpersonal relationships allow the patient's
significant others to stay with the patient before and after the procedure. This allows for bonding and
promotes interpersonal relationship.
16. To facilitate progress toward achievement of personal spiritual goals nurse usually visits the
patients in the unit. Patients may benefit from this, allowing them time to practice their faith.
17. To create and/or maintain a therapeutic environment - providing proper lighting, proper room
temperature, a quiet environment are done to patients staying in the unit.
18. To facilitate awareness of self as an individual with varying physical, emotional, and
developmental needs care to patients vary according to their developmental needs. Allowing the
parents to stay during the procedure help the pediatric patients in their emotional and developmental
needs.
RESTORATIVE CARE NEEDS
19. To accept the optimum possible goals in the light of limitations, physical, and emotional The
goals for each patient vary depending on the capability of the patient. The nutritional goal for a patient
with a PEG tube for instance will be different, knowing that the patient has limited feeding options.
20. To use community resources as an aid in resolving problems arising from illness Some patients
live far from the city and thus referral to health centers is sometimes done.
21. To understand the role of social problems as influencing factors in the cause of illness Some
patients who are diagnosed with amoebic colitis for instance are advised to avoid buying street foods to
which the preparation they are not sure of, and also avoid drinking water that are not safe.
ASSUMPTIONS
Correct identification of nursing problems influences the judgment in selecting the next step in
solving the client nursing problems.
CONCEPTS
MAN/PERSON
Abdellah describes people as having physical, emotional, and sociological needs. These needs
may overt, consisting of largely physical needs, or covert, such as emotional, sociological and
interpersonal needs- which are often missed and perceived incorrectly
The individuals (and families) are the recipients of nursing, and health, or achieving of it, is the
purpose of nursing services.
HEALTH

Emphasis should be placed upon prevention and rehabilitation. Holistic approach must be
taken by the nurse to help the client achieve state of health. However the nurse must
accurately identify the lacks or deficits regarding health that the client is experiencing. These
lacks or deficits are the clients health needs.
ENVIRONMENT/SOCIETY
The environment is implicitly defined by Abdellah as the home or community from which
patient comes. Society is included in planning for optimum health. However, as Abdellah
further delineated her ideas, the focus of nursing service is clearly the individual.
NURSING
These would mean a comprehensive nursing service, this would include:
1. Recognizing the nursing problems of the patient.
2. Deciding the appropriate actions to take in terms of relevant nursing principles.
3. Providing continuous care of the individuals total health needs.
4. Providing continuous care to relieve pain and discomfort.
5. Adjusting total nursing care plan to meet the patients individual needs.
6. Helping the individual to become more self directing in attaining or maintaining a healthy state of
mind and body.
7. Instructing nursing personnel and family to help the individual
8. Helping the individual to adjust to his limitations and emotional problems.
9. Working with allied health professional in planning for optimum health

10. Carrying out continuous evaluation and research to improve nursing techniques and to develop new
techniques to meet all the health needs of the people.
These 11 nursing skills that a nurse must possess includes the following:
1. Observation of health status
2. Skills of communication
3. Application of knowledge
4. Teaching of patients and families
5. Planning and organization of work
6. Use of resource materials
7. Use of personnel resources
8. Problem-solving
9. Direction of work of others
10. Therapeutic use of the self
11. Nursing procedures
METAPARADIGM OF ABDELLAH TYPOLOGY
PURPOSES
Nursing Practice
Abdeallahs main goal is the improvement of the nursing education.
The most important impact of Abdellahs theory to the nursing practice is that it helped
transform the focus of the profession from being disease-centered to patient-centered.
The steps of the nursing process are assessment, diagnosis, planning, implementation and
evaluation
Nursing Education
Professors and educators realized the importance of client centered care rather than focusing
on medical interventions. Nursing education then slowly deviated its concentration from the
complex, medical concepts, into exercising better attention to the client as the primary concern.
Its very strong nurse-centered orientationis, on the other hand, its major contribution to
nursing education.
Nursing Research
Her theories continue to guide researchers to focus on the body of nursing knowledge itself, the
identification of patient problems, the organization of nursing interventions, the improvement
of nursing education, and the structure of the curriculum.
The extensive research done regarding the patients needs and problems has served as a
foundation for the development of what is now known as nursing diagnoses.
USE OF 21 PROBLEMS IN THE NURSING PROCESS
ASSESSMENT PHASE
Nursing problems provide guidelines for the collection of data.
A principle underlying the problem solving approach is that for each identified problem,
pertinent data are collected.
The overt or covert nature of the problems necessitates a direct or indirect approach,
respectively.
NURSING DIAGNOSIS
The results of data collection would determine the clients specific overt or covert problems.
These specific problems would be grouped under one or more of the broader nursing problems.
This step is consistent with that involved in nursing diagnosis
PLANNING PHASE
The statements of nursing problems most closely resemble goal statements. Once the problem
has been diagnosed, the nursing goals have been established.
IMPLEMENTATION
Using the goals as the framework, a plan is developed and appropriate nursing interventions are
determined.
EVALUATION
The most appropriate evaluation would be the nurse progress or lack of progress toward the
achievement of the stated goals..
Application.
The case of Simar
He experienced severe chest pain. In addition he experienced shortness of breadth,
tachycardia and profuse diaphoresis.
MAIN PROBLEMS
CHARACTERISTICS
Abdellahs theory has interrelated the concepts of health, nursing problems and problem
solving as she attempts to create a different way of viewing nursing phenomenon.
LIMITATIONS
The major limitation of Abdellah theory and the twenty one nursing problems is their very
strong nursing centered orientation. With the orientation appropriate use might be the
organization of teaching content for nursing students, the evaluation of a students, performance
in the clinical area or both. But in terms of client care there is little emphasis on what the client
is to achieve.
CONCLUSION
Using Abdellahs concepts of health, nursing problems, and problem solving, the theoretical
statement of nursing that can be derived is the use of the problem solving approach with key
nursing problems related to health needs of people. From this framework, 21 nursing problems
were developed.
Abdellahs theory provides a basis for determining and organizing nursing care. The problems
also provide a basis for organizing appropriate nursing strategies.