The development of the Intersystem Model.

A nursing model has been developed which guides curriculum development and nursing practice at Azusa Pacific University School of Nursing; the Intersystem Model. It is a model which focuses on the interaction between nurse and patient/client and requires that the nurse assess the knowledge base, the values and the behaviours that are brought to a specific patient situation by both the nurse and the patient/client. Using the system concepts of supra and subsystems, person can be defined as the individual, the family or the community. An intrasystem assessment of the biological, psychosocial and spiritual subsystems of the person is carried out, as well as an assessment of the developmental environment. The developmental environment consists of all the events, factors and influences which have made the person what he is at the time he enters a specific encounter requesting nursing action for an illness situation he is unable to resolve independently. Positive and negative variables are identified and a score on sense of coherence is assigned. Sense of coherence is a construct which includes three components: comprehensibility, meaningfulness and manageability. In using the model, each component is scored from low to high. Through a collaborative process, a joint plan of care is developed in order to increase the sense of coherence the patient/client experiences about the health problem and the plan is evaluated by rescoring on sense of coherence. An example of how the Intersystem Model has been used with a diabetic patient in the community is presented, as well as diagrams illustrating the way the nursing process is carried out in intersystem interaction.