Faye Glenn Abdellah: 21 Nursing Problems

Learning Objectives
 To provide the biography of Faye Abdellah
 To explain the 21 Nursing Problems Theory of Faye Glenn Abdellah and Its Uses to the
Nursing Process
 To explain Faye Abdellah’s Nursing Metaparadigm

Biography
Full Name: Faye Glenn Abdellah
Born: March 13, 1919, New York City
Died: February 24, 2017 (aged 97)
Known For:
 Pioneer in nursing theory
 Developed the "21 Nursing Problems" model
 Shifted nursing focus from diseasecentered to patient-centered car.
Education:
 Diploma in Nursing, Fitkin Memorial Hospital School of Nursing (1942)
 Bachelor’s, Master’s, and Doctorate degrees from Columbia University
Career Highlights:
 First nurse to serve as Deputy Surgeon General of the United States
 Key contributor to nursing education, research, and administration
 Advocated for public health policy reforms Promoted nursing as a scientific
discipline
Awards and Honors:
 Inducted into the American Nurses Association Hall of Fame
 Numerous accolades for her contributions to nursing
Legacy:
 Influenced modern nursing practice, education, and research
 Left a lasting impact on patient-centered care approaches in nursing

Description of the Theory

Abdellah's typology of 21 nursing problems is a conceptual model mainly concerned with
patient's needs and nurses' role in problem identification using a problem analysis approach.
21 Nursing Problems: Major Concepts
A. Nursing Problems
 Health needs are seen as problems which may be:
Overt: which is obvious or can-be-seen condition
Covert: which is unseen or mask one
 Abdellah’s usage of the terms nursing problems is more in tune with “nursing
goals” and “nursing functions” that clients centers problems.
 Classifications
She refocused the role of the nurse from the disease orientation but maintaining
the client as the main concern:
1. Basic to all Patients
2. Sustenal Care Needs
3. Remedial Care Needs
4. Restorative Care Needs

B. Problem-Solving
 "The practice of competent nursing care in the future is for the nursing student to
realize that identifying and answering overt and covert nursing problems is the
core of nursing”. -Abdellah
 Is a process involves identifying the problem, selecting pertinent data, formulating
hypothesis, testing hypothesis through the collection of data, and revising
hypothesis where necessary on the basis of conclusions obtained from the data.

3 Categories of the 21 Nursing Problems

She used Henderson's 14 basic human needs and nursing research to establish the
classification of nursing problems.
1. Physical, sociological, and emotional needs of clients.
2. Types of interpersonal relationships between the nurse and the patient.
3. Common elements of client care.

Faye Abdellah: 21 Nursing Problems

Basic To All Patients

1. To maintain good hygiene and physical comfort.
2. To promote optimal activity; exercise, rest, sleep.
3. To promote safety through prevention of accident, injury or other trauma, and through
prevention of the spread of infection.
4. To maintain good body mechanics and prevent and correct deformity.
Sustenal Care Needs
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition for all body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognize the physiological responses of the body to disease conditions,
pathological, physiology, and compensatory.
10. To facilitate the maintenance of regulatory mechanism and function.
11. To facilitate the maintenance of sensory function.
Remedial Care Needs
12. To identify and accept positive and negative expressions, feelings, and reactions.
13. To identify and accept interrelatedness of emotions and organic illness.
14. To facilitate the maintenance of effective verbal and nonverbal communication.
15. To promote the development of productive interpersonal relationships.
16. To create or maintain a therapeutic environment.
17. To facilitate awareness of self as an individual with varying physical, emotional,
developmental needs.
18. To facilitate progress toward achievement and personal spiritual relationship.
Restorative Care
19. To accept the optimum possible goals in the light of limitations, physical, and
emotional.
20. To use community resources as an aid in resolving problems that arise from illness.
21. To understand the role of social problems as influencing factors in the cause of
illness.

Nursing Metaparadigm of Faye Glenn Abdellah

Person
 She describes nursing recipients as individuals (and families), although she does not
delineate her beliefs or assumptions about the nature of human beings.
Health
 Health, or the achieving of it, is the purpose of nursing services. Although Abdellah does
not define health, she speaks to "total health needs" and "a healthy state of mind and
body. "
Environment
 Society is included in "planning for optimum health on local, state, and international
levels. " However, as Abdellah further delineated her ideas, the focus of nursing service is
clearly the individual.
 The environment is the home or community from which patient comes.
Nursing
 Nursing is a helping profession which included doing something to or for the person or
providing information to the person.
 It is a comprehensive service to individuals, to families, and therefore to society.
 Abdellah's theory has interrelated concepts of health and nursing problems, as well as
problem-solving.

Uses of the 21 Nursing Problems in the Nursing Process

1. Assessment Phase
 Nursing problems provide guidelines for the collection of data.
 A practice 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.
2. Nursing Diagnosis
 The results of data collection would determine the client's specific overt or covert
problems.
 These specific problems would be grouped under one or more of the broader nursing
problems.
3. Planning Phase
 The statements of nursing problems most closely resemble goal statements. Therefore,
once the problem has been diagnosed, the goals have established.
4. Implementation
 Using the goals as the framework, a plan is developed and appropriate nursing
intervention are determined.
5. Evaluation
 The most appropriate evaluation would be the nurse progress or lack of progress toward
the achievement of the stated goals.

Assumptions
 Abdellah's assumptions relate to change and anticipated changes that affect nursing.
 The need to appreciate the interconnectedness of social enterprises and social problems;
  The impact of problems such as poverty, racism, pollution, education, and so forth on
health and health care delivery;
 Changing nursing education; continuing education for professional nurses; development
of nursing leaders from undeserved groups.

Application Nursing Practice

 Abdellah's main goal is the improvement of nursing education.
 The most important impact of Abdellah's theory to nursing practice is that, it helped
transform the focus of the profession from being "disease-centered" to "patient-centered”.

Strengths and Weaknesses of the Theory

Strengths
 The problem-solving approach is readily generalizable to client with specific health needs
and specific nursing problems.
 Can be used to guide various activities within the clinical setting.
 This is true when considering nursing practice that deals with clients who have specific
needs and specific nursing problems.
Weaknesses
 Very strong nurse-centered orientation. She rather conceptualized nurse's actions in
nursing care which is contrary in her aim.
 Lack of emphasis on what the client is to achieve was given in terms of client care.
 Theory seems to focus quite heavily on nursing practice and individuals. It is inconsistent
with the concept of holism.

Conclusion
 Abdellah's theory provides basis for determining and organizing nursing care. The
problems also provide a basis for organizing appropriate nursing strategies.
 As a whole, the theory is intended to guide care not just in the hospital setting but can
also be applied to community nursing as well.
 This theory is mainly focused on the clients and nurse’s role in identification and solving
these problems.
 Her theory has changed the entire nursing focus from disease to patient centered
approach.

Group No.: 08
Group Members: