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Theory of Unpleasant Symptoms Theory of Unpleasant Symptoms

Theory of Unpleasant Symptoms - PowerPoint Presentation

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Theory of Unpleasant Symptoms - PPT Presentation

Mary Hefferan Ferris State University Objectives Overview of the theory Metaparadigm concepts Person environment health and nursing as defined by theory Brief analysis Basic concepts and description of components ID: 433654

theory symptoms unpleasant nursing symptoms theory nursing unpleasant factors health amp pugh research symptom tous http concepts bariatric patient ferris change lenz

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Slide1

Theory of Unpleasant Symptoms

Mary HefferanFerris State UniversitySlide2

Objectives

Overview of the theoryMetaparadigm concepts

Person, environment, health, and nursing as defined by theory

Brief analysis

Basic concepts and description of components Slide3

Objectives

Exploration of theory through research

Description of research article

How the theory is reflected in research

What the theory adds to the study

Application to nursing practice

Importance of theory to nursing practice Slide4

Overview

Theory of Unpleasant SymptomsCreated by Elizabeth Lenz and Linda Pugh in 1995

Objective is to “integrate existing knowledge about a variety of symptoms”

(Lenz, Pugh, Milligan, Gift, &

Suppe, 1997, p. 14)

Improve understanding of the experience of symptoms in various contexts

Three major concepts:

The actual symptoms

Influencing factors

Performance outcomesSlide5

Metaparadigm Concepts: Defined by the Theory

Person: the patient who is exhibiting the symptoms and to whom the nurse is giving care

May also include family and/or friends

Environment

: where the care is taking place and situational factors that contribute to the symptom experienceEmployment status, marital status, social support, access to health careSlide6

Metaparadigm Concepts: Defined by the Theory

Health: absence of unpleasant symptoms

Symptoms are: “perceived indicators of change in normal functioning as experienced by patients”

(Lenz, Pugh, Milligan, Gift, &

Suppe

, 1997, p. 14

)

Nursing

: care taker and evaluator of symptoms and contributing factors

Establishes a relationship with the patient to better evaluate symptomsSlide7

Analysis of the Theory of Unpleasant Symptoms

Three Major Concepts: Symptoms, influencing factors, and performance outcomes

1. The symptoms:

Change in normal functioning

More often occur simultaneouslyMultiple symptoms occurring together results in a multiplying effect

Measured by their intensity, timing, and level of distress perceivedSlide8

Analysis of the Theory of Unpleasant Symptoms

Influencing factors: Physiological, psychological, and situational Influence the symptoms alone or in concurrence

Performance outcomes:

Results of the symptom experience

Impact on ability to perform activities of daily livingSlide9

Theory in Research

Application of the Theory of Unpleasant Symptoms (TOUS) in Bariatric SurgeryUses the TOUS during the management of patient post bariatric surgery

Case study of a 29 year old woman post bariatric surgery

Explored how the influencing factors affected her post-op outcomes

Showed that her situational factors contributed greatly to her overall healthSlide10

Theory in Research

TOUS in ApplicationEvaluated the factors

Physiological

Dehydration, malnutrition

Gastrointestinal

dysmotility

Psychological

Adjustment to dietary changes

Situational

Lack of social support, work stressors, finances

In concurrence prolonged her recovery periodSlide11

Source: https

://fsulearn.ferris.edu/courses/1/XLIST_81147.201308/groups/_10477_1//_492347_1/Theory%20of%20unpleasant%20symptoms%20bariatric%20surgery.pdfSlide12

Theory in Research

Differences the TOUS Made

Created a framework for the evaluation of symptoms and their contributing factors

Helped in the approach to alleviating her unpleasant symptoms

Created a new method for treating symptoms rather than medication or hospitalizationSlide13

Theory in Research

Differences the TOUS Made

Once the factors were addressed

Symptoms improved

Assessment of entire pictureCreated awareness to approach willingness to change

“Understanding where patients are in their willingness to change those factors…will assist clinician in understanding expectations and moving patients to healthier levels of recovery” (

Tyler, R., & Pugh, C. L

., 2009, p. 276

)

Manages expectations of health outcomesSlide14

Use in Practice

Neonatal N

ursing Environment

Evaluation of family impact on health outcomes

Nervousness, uncomfortable with their babyCould have a negative physiological impact

Aids nurse with appropriate interventionsSlide15

Use in Practice

Neonatal Nursing Environment

Manages

expectations

of outcomesLess social support may change health outcomes

Guides appropriate creation of goals

Allows for a different perspective on assessing symptoms

“Symptom clusters”

Catalyzing effect of symptomsSlide16

Source: http

://rnspeak.com/fundamentals-of-nursing/what-is-a-nursing-theory/Slide17

Importance to Nursing

Nurses assess and approach symptoms differently than other members of the healthcare fieldHolistic approach

Guides nurse-patient interactions

View patients in

an interactive-integrative view versus isolated cause effect health interactionsSlide18

Importance to Nursing

Broad but focused theoryCan be used as a base for designing interventions

Uses subjective symptom experience data

Creates connections between social environments and symptom experienceSlide19

References

1, Haworth, K. S., & Dluhy

, M. N. (2001). Holistic symptom management: Modeling the interaction phase.

Journal of Advanced Nursing 36

(2), 302-310. Retrieved from: http://0-onlinelibrary.wiley.com.libcat.ferris.edu/doi/10.1046/j.1365-2648.2001.01972.x/pdf

2. Lenz, R. E., Pugh, L., Milligan, A. R., Gift, A.,

Suppe

, F. (1997). The middle range theory of unpleasant symptoms: An update.

Advances in Nursing Science, 19

(3), 14-27. Retrieved from: http://0-ovidsp.tx.ovid.com.libcat.ferris.edu/sp-3.10.0b/ovidweb.cgi

3

.

Liehr

, P. (2005). Looking at symptoms with a middle-range theory lens.

Advance Studies in Nursing, 3

(5), 152-157.

Retrieved from: http://

www.snjourney.com/PDFs/asin_3_5_p152_157.pdf

4.

Tourville

, C., & Ingalls, K. (2003). The living tree of nursing theories.

Nursing Forum, 38

(3), 21-36.

Retrieved

from: http

://ferris.libguides.com/er.php?ecid=9581

5

. Tyler, R., & Pugh, C. L. (2009). Application of the theory of unpleasant symptoms in bariatric surgery.

Bariatric Nursing and Surgical Patient Care. 4

(4), 271-276.

d

oi

: 10.1089/bar.2009.9953