Theory of Human Behavior v' Theory of Goal Attainment

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Theory of Human Behavior v. Theory of Goal
Attainment
And Theory of Human Becoming v. Theory of
Novice to Expert
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Dorothy E. Johnson1919-1999

• Graduated from Vanderbilt - 1944 where she taught
  for 4 years
• MPH from Harvard University - 1948
• Taught at UCLA for 29 years until 1979
• 1949 - Developed the first four year basic
  nursing program in the US at UCLA with colleague
• In 1955, went to India to establish a nursing
  college
• Published 4 books and more than 30 articles
• Actively spoke and advocated nursing education in
  retirement
• Johnsons Theory of Human Behavior published in
  1980 during retirement

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Imogene M. King1923 - 2007

• Diploma, St. John's Hospital School of Nursing
  St. Louis, MO - 1945
• BS and MSN, St. Louis University by 1957
• Doctor of Education, Teachers College, Columbia
  University, 1961
• Honorary PhD, Southern Illinois University - 1980
• Honorary Doctorate from Loyola U. - 1989
• Taught at St. Louis University, Ohio State
  University and Loyola University
• Was a Professor Emeritus at University of South
  Florida
• 21 publications
• Worked internationally, especially in Japan.
• In 1996, received the Jessie M. Scott award from
  the ANA for her relentless work in improving
  nursing and health care
• First published work on Goal attainment in 1981

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Rosemarie Rizzo Parse

• BSN - Duquesne University
• Masters and PhD - University of Pittsburgh
• Has taught at Duquesne, U of Pittsburgh, New York
  University, Hunter College, Loyola University
• Dean of Duquesne U School of Nursing, 1983 - 1993
• Founder and Current Editor of Nursing Science
  Quarterly
• Founder of Institute of Human Becoming
• President of International Incorporated
• 9 books and over 100 articles and editorials
• Given over 300 lectures and workshops in over 30
  countries
• First published Theory of Human Becoming - 1981

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Patricia Benner

• BA in Nursing - Pasadena College/Point Loma
  College
• MS in Med/Surg nursing from UCSF
• PhD -1982 from UC Berkeley
• 1970s - Research at UCSF and UC Berkeley
• Has taught and done research at UCSF since 1979
• Published 9 books and numerous articles
• Published Novice to Expert Theory in 1982
• Received Book of the Year from AJN in
  1984,1990,1996, 2000
• Current Chair of Social and Behavioral Sciences
  at UCSF
• Current Director of a National Nursing Education
  Research Project

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Dorothy Johnsons Behavioral Systems Model

• Goal to use protection, nurturing, and
  stimulation to maintain and restore balance in
  the patient
• and achieve an optimal level
• of functioning.

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The Subsystems

• Attachment-affiliate Subsystem
• Provides survival and security. It is based on
  social inclusion, intimacy, and formation and
  maintence of a strong social bond.
• Dependency Subsystem
• It is based on approval, attention, and
• recognition.
• Ingestive Subsystem
• Function is appetite satisfaction.

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Subsystems continued

• Eliminative Subsystem
• When, how, and under what conditions we
  eliminate.
• Sexual Subsystem
• Dual functions of procreation and gratification.
• Achievement Subsystem
• Controls an aspect of self or surroundings to a
  standard of excellence.
• Aggressive-Protective Subsystem
• Protection and preservation.

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Key Terms

• Equilibrium
• a stabilized but more or less transitory,
  resting state in which the individual is in
  harmony with himself and his environment.
• Tension
• State of being stretched or strained and can be
  viewed as an end-product of a disturbance in
  equilibrium.
• Stressor
• Internal or external stimuli that produce
  tension are called stressors.

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Problems with the theory

• The theory is individual oriented so nurses
  working with groups or the family have problems
  with implementation.
• The focus is on the behavioral systems which
  makes working with the physically impaired is
  difficult.
• Lack of patient input in care planning.

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Imogene King 1923-2007

• Published A Theory for Nursing Systems,
  Concepts, Process in 1981

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Imogene King

• Based off idea that human being are open systems
  interacting with the environment
• Perceptions of objects, persons, and events
  influence behavior, social interaction, and
  health
• Views the person in their family and social
  contexts
• Three interacting systems Personal,
  Interpersonal and Social

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Imogene KingConceptual Framework

• Concepts for Personal System
• Within the person
• Perception , Self , Growth Development , Body
  Image, Space, Time
• Concepts for Interpersonal System
• Individuals or groups interacting
• Interaction , Communication , Transaction , Role
  , Stress
• Concepts for Social System
• Family, School, Work, Church
• Organization , Authority , Power , Status,
  Decision Making

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Imogene KingTheory of Goal Attainment

• Kings definition of nursing
• Theory describes a dynamic, interpersonal
  relationship in which a person grows and develops
  to attain certain life goals.
• Ten major concepts from the personal and
  interpersonal systems to support the Theory of
  Goal Attainment.
• Human interactions, perception, communication,
  role, stress, time, space, growth and
  development, and transactions.

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Parses Theory of human becoming

• Rosemarie Rizzo Parse is well-known
  internationally for her theory of human becoming,
  a nursing perspective that focuses on quality of
  life and human dignity from the perspective of
  patients, families, and communities.

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Parse's Theory of Human Becoming

• Alternative to both the conventional bio-medical
  approach and the bio-psycho-social-spiritual
  approach
• Conceives quality of life from each person's own
  perspective as the goal of nursing practice
• First published the theory in 1981 as the
  "Man-living-health" theory
• Name was officially changed to "the human
  becoming theory" in 1992
• Remove the term "man"

Symbol of Human Becoming
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parses theory of human becoming

• Three Abiding Themes
• Meaning
• Rythmicity
• Transcendence

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Parses Theory of Human Becoming

• Nursing practice guided by the human becoming
  theory live the processes of the Parse practice
  methodology
• illuminating meaning, synchronizing rhythms, and
  mobilizing transcendence
• Research guided by the human becoming theory
  sheds light on the meaning of universal humanly
  lived experiences such as hope, taking life
  day-by-day, grieving, suffering, and time passing

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Benners Theory

• From Novice to Expert

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Application to Nursing

• How do nurses learn to do nursing?
• Nurses must acquire and develop skills
• Based on Dreyfus model of skill acquisition
• Pass through 5 levels of proficiency
• Novice
• Advanced Beginner
• Competent
• Proficient
• Expert

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Stage 1 Novice

• Beginner with no experience
• Taught general rules to help perform tasks
• Rules are context-free, independent of specific
  cases, and applied universally
• Rule-governed behavior is limited and inflexible
• Ex. Tell me what I need to do and Ill do it.

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Stage 2 Advanced Beginner

• Demonstrates acceptable performance
• Has gained prior experience in actual situations
  to recognize recurring meaningful components
• Principles, based on experiences, begin to be
  formulated to guide actions

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Stage 3 Competent

• Typically a nurse with 2-3 years experience on
  the job in the same area or in similar day-to-day
  situations
• More aware of long-term goals
• Gains perspective from planning own actions
• Based on conscious, abstract, and analytical
  thinking
• Helps to achieve greater efficiency and
  organization

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Stage 4 Proficient

• Perceives and understands
• situations as whole parts
• More holistic understanding
• improves decision-making
• Learns from experiences what
• to expect in certain situations
• and how to modify plans

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Stage 5 Expert

• No longer relies on principles, rules, or
  guidelines to connect situations and determine
  actions
• Much more background of experience
• Has intuitive grasp of clinical situations
• Performance is now fluid, flexible, and
  highly-proficient
• Analytic problem-solving abilities still used for
  situations the nurse has no experience with

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Skill Acquisition Summary

• Different levels of skills reflect changes in 3
  aspects of skilled performance
• Movement from relying on abstract principles to
  using past concrete experiences to guide actions
• Change in learners perception of situations as
  whole parts rather than in separate pieces
• Passage from a detached observer to an involved
  performer, no longer outside the situation but
  now actively engaged in participation

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Mnemonic for Benners 5 Stages

• No
• Amateur
• Can
• Practice
• Excellence

• Novice
• Advanced Beginner
• Competent
• Proficient
• Expert

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Sources

• http//home.earthlink.net/bennerassoc/patricia.ht
  ml
• http//www.patriciabenner.com/
• http//www.humanbecoming.org/site/RRParse.html
• http//nursing.clayton.edu/eichelberger/theory/joh
  nson_behavioral_system.htm
• http//www.mc.vanderbilt.edu/biolib/hc/biopages/dj
  ohnson.html
• http//www.enursescribe.com/imogene_king.htm
• http//nursingsociety.org/RNL/Current/in_touch/tri
  bute_king.html
• www.humanbecoming.org