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[奥瑞姆家庭评估]

[Orem's family evaluation].

作者信息

Dumas L, de Montigny F

出版信息

Can Nurse. 1993 Nov;89(10):45-8.

PMID:8261376
Abstract

Nurses are beginning to realize that clients' deficits influence family members and, conversely, that family members play an important role in the development and resolution of these deficits. The authors attempted to find published literature describing a family nursing evaluation based upon Orem's conceptual framework. Previous nursing research has described how Orem's model is applied to nursing interventions with individual clients, but none has addressed the application of nursing interventions to multiperson units within a family situation. The authors developed their own concept from their personal and family experiences and a theoretical background of Orem's model. They chose to integrate systemic and communication theory, and developmental and functional approaches with Orem's concept of nursing care of multiperson units. According to the authors, this approach is consistent with Orem's model and represents a holistic vision of the family. Orem emphasizes that the nurse intervening with multiperson units should understand the structure and function of groups and be able to identify the actual ongoing process. Although Orem's theoretical framework is not based upon a systemic approach, the authors believe that it is possible to blend the systemic theory concepts with Orem's model. This article reviews the three basic concepts found within Orem's conceptual framework: self-care; self-care deficit, and nursing systems. The authors also outline their theoretical assumptions for the use of this approach with family nursing interventions, based upon six functional dimensions of the family as described by Epstein et al. and Guttman. In addition, the article provides a concrete example of how nursing evaluation can be structured within this scheme of reference.

摘要

护士们开始意识到,患者的缺陷会影响家庭成员,反之,家庭成员在这些缺陷的形成和解决过程中也起着重要作用。作者试图找到已发表的文献,这些文献描述了基于奥瑞姆概念框架的家庭护理评估。以往的护理研究描述了奥瑞姆模型如何应用于对个体患者的护理干预,但没有涉及护理干预在家庭环境中的多人单元中的应用。作者从他们的个人和家庭经历以及奥瑞姆模型的理论背景中发展出了自己的概念。他们选择将系统和沟通理论、发展和功能方法与奥瑞姆关于多人单元护理的概念相结合。据作者称,这种方法与奥瑞姆模型一致,代表了对家庭的整体看法。奥瑞姆强调,对多人单元进行干预的护士应该了解群体的结构和功能,并能够识别实际正在进行的过程。虽然奥瑞姆的理论框架不是基于系统方法,但作者认为可以将系统理论概念与奥瑞姆模型相融合。本文回顾了奥瑞姆概念框架中的三个基本概念:自我护理;自我护理缺陷和护理系统。作者还根据爱泼斯坦等人和古特曼所描述的家庭的六个功能维度,概述了将这种方法用于家庭护理干预的理论假设。此外,本文提供了一个具体例子,说明在这个参考框架内如何构建护理评估。

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