Conceptual Models in Nursing

CONCEPTUAL MODELS IN NURSING a. Definition The nursing conceptual model is a way to view work situations and conditions involving nurses. The nursing conceptual model is a guide for nurses to obtain information so that nurses are sensitive to what is happening at one time and know what nurses should do. The model Conceptual nursing has clarified the specificity of the phenomenon area of nursing science by involving four concepts, namely humans as whole and unique individuals. The second concept is not only the initial source of problems but also a source of support for individuals. Third, health explains the healthy range of illness throughout the cycle from conception to death. The fourth concept is nursing as an important component in its role as a determining factor in improving a person's life balance (klayen). b. Types of conceptual models in psychiatric nursing. Below we will explain various conceptual models developed by several experts, including: 1)Psychoanalytical(Freund, Ericson) This is a model put forward by Singmung Freund. Psychoanalysis believes that behavioral deviations in adulthood are related to development in childhood. According to the psychoanalytical model, mental disorders are caused by the ego not functioning in controlling the ID, thus encouraging behavioral deviations(Deviation of Behavioral)and intrapsychic conflict, especially in childhood. Each phase of development has developmental tasks that must be achieved. Symptoms are a symbol of conflict. The psychoanalytic therapy process takes a long time. 2) Interpersonal(Sullivan, Peplau) This model was developed by Harry Stack Sullivan and Hildegard Peplau. Interpersonal theory believes that behavior develops from interpersonal relationships. Sullivan emphasized the large influence of childhood development on an individual's mental health. According to the concept of this model, a person's mental disorder is caused by a threat that can cause anxiety(Anxiety). a) With satisfaction, related to basic satisfactions such as: hunger, loneliness and lust. b) The drive for security, related to cultural needs such as conformity to social norms, the values of a particular group The role of the nurse in therapy is: a) Anxieties (various experiences regarding what the client feels and what causes the client's anxiety in relating to other people). b) Therapists use empathy and relationship (empathy and feeling what the client feels). Nurses provide verbal responses that encourage clients' sense of security in their relationships with other people. 3) Social (Kaplan, Szasz) This model focuses on the physical environment and social situations that can cause stress and trigger mental disorders (social and environmental factors create stress, which causes anxiety and symptoms).According to Szasz, every individual is responsible for their behavior, able to control and adapt and behave in accordance with the values or culture expected by society. Kaplan believes that the concepts of primary, secondary and tertiary prevention are very important to prevent the emergence of mental disorders. Social situations that can cause mental disorders are poverty, low level of education, lack of support system and maladaptive coping mechanisms. 4) Existential (Ellis, Rogers) The existential model states that behavioral disorders or mental disorders occur when individuals fail to find their identity and purpose in life. Individuals do not have pride in themselves. Hating yourself and experiencing internal disturbancesbody-image-his. The principle of therapy in this model is to strive for individuals to have experience interacting with people who are role models or successful by understanding the person's life history, expanding self-awareness by means of self-introspection (selfassessment), associating with social and humanitarian groups (conducted in group), serta encourages to accept oneself and accept criticism orfeedback about his behavior from others (encouraged to accept self and control behavior).therapy is carried out through group activity therapy activities. 5) Supportive Therapy (Wermon, Rockland) Wermond and Rockland believe that the causes of mental disorders are biopsychosocial factors and current maladaptive responses. Examples of biological aspects are frequent stomach ulcers, migraines, coughs. The psychological aspect experiences many complaints such as: anxiety, lack of self-confidence, feelings of guilt, doubt, anger. Social aspects such as difficulty getting along, withdrawn, disliked, hostile, unable to get a job, and so on. All of these things accumulate to cause mental disorders. This phenomenon arises due to the inability to adapt to problems that are currently emerging and has nothing to do with the past. The principle of the therapeutic process in the supportive model is to strengthen adaptive coping responses. Therapists help clients to identify and recognize the client's strengths or abilities as well as coping skills, evaluating which abilities can be used for alternative problem solving. The therapist seeks to establish a warm and empathetic relationship with the client to help the client find adaptive coping. 6) Medical (Mayer, Kraeplin) According to this concept, the causes of mental disorders are complex multifactorial, namely: physical, genetic, environmental and social factors. The medical model believes that behavioral deviations are a manifestation of central nervous system (CNS) disorders. It is suspected that depression and schizophrenia are influenced by neural impulse transmission, as well as synaptic disorders. So the focus of management must be complete through diagnostic examinations, somatic therapy, pharmacology and interpersonal techniques. 7) Communication Model The behavioral model says that behavioral deviations occur if the message conveyed is not clear. Communication deviations involve verbal and non-verbal communication, body position, speed and volume of voice or speech. The therapeutic process in this model includes: a. Provide feedback and clarify issues. b. Provides reinforcement for effective communication. c. Provide alternative corrections for ineffective communication. d. Analyze the interaction process. 8) Model of behavior Developed by HJEysenck, J. Wilpe and BF Skinner. Behavior modification therapy was developed from learning theory(learning theory). Learning occurs if there is a stimulus and a response arises, and the response is strengthened(reinforcement). Therapy process: Behavioral model therapy is carried out by: a)Desentizationand relaxation, can be done simultaneously. With this technique, it is hoped that the client's anxiety level will decrease. b)Assertive trainingis learning to express something clearly and realistically without offending other people's feelings. c)Positive training. Encourage and strengthen newly learned positive behavior based on pleasant experiences to be used in future behavior. d)Self regulation.This is done using the following steps. First, train a series of behavioral standards that clients must achieve. Next, the client is asked to carry out self-observation and self-evaluation of the behavior displayed. The final step is that the client is asked to providereinforcement(self-reinforcement) for appropriate behavior.