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위기에 관한 수많은 문헌이 있지만 위기이론과 위기중재는 정신보건전문가들간에 공통된 이론적 근거가 결여된 채로 사용되어왔다.Korchin(1976)이 "위기중재는 체계적인 이론, 지식,업무라기보다 하나의 사고방법"이라고 지적했듯이 확고한 이론적 기초가 부족하기 때문에 다른 이론적 틀과 연관지으려는 노력이 있었는데 처음에는 위기개념을 항상성 개념과 연결하였고 그 다음에는 정신분석이론과 연관지었다. 그리고 세번째 개념적 영향은 정신질환의 개념에 초점을 둔 의학모형이었다. 그러나 이 각각의 접근법은 결정적인 결함을 지니고 있어 이에 대한 가능한 대안으로 위기이론을 간호모형과 연결시키는 것이다. 즉 간호모형에서는 위기중재의 많은 단접을 극복할 수 있는데 위기의 병리적 현상보다는 성장촉진적인 면을 강조한다는 것이다. 사실 위기중재에 간호모형을 도입하는것은 총체적 건강개념을 실현시키는 중요한 방법이라고 할 수 있다.
Throughout this review of the theoretical, research, literature, crisis has been variously described as a traumatic or developmental event, an emotional state of mind, a theoretical perspective, or a situation requiring crisis intervention. The theoretical framework of crisis intervention has evolved over the past decades. Numerous writers including Lindemann, Caplan, Parad and Rapaport have contributed to the development of crisis theory. Despite the abundance of literature on crisis, crisis theory and crisis intervention continue to be poorly understood techniques without common meaning for the mental health professions as a whole.
One result of the lack of solid theory base has been several efforts to align crisis with other theoretical schemes. Linkage of the concept of crisis first with the notion of homeostasis and then with psychoanalytic theory. A third conceptual influence on crisis theory has been the medical model as focused on the concept of mental illness. Each approach, however, has decided shortcomings.
There is one other, possibly viable alternative: alignment of crisis theory with a nursing model. Such an approach could overcome many of the shortcomings of contemporary modes of crisis intervention.
This lack of clarity is reflected in the difficulty of carrying out adequate research in the area. Until more descriptive and exploratory studies appear in the literature, the concept will continue to be used indiscriminately. Such usage can distract nurses and other health care professionals from complete and accurate assessment of a client´s
situation. The role of mediating variables including perception and cognition has been largely ignored in research relating to crisis. These variables are critical in determining the events that take place between the occurrence of a stressful situation and the full-crisis state. Such variables must be explored because existing data are contradictory on the presence or absence of situational supports, precipitating events, and past experiences.
It is possible to reconceptualize the term on a continuum and to recategorize crisis states is important for research and practice. A clear-cut method of intervention will necessarily depend on the crisis entity. The concept of crisis is used frequently in nursing and seems to have much relevance for the profession. Nurses deal with stressful events and clients in crises daily. Consequently, they are in an excellent position to clarify the concept of crisis and to extend its utility in the practice setting.
The nursing model, as opposed to the medical model of crisis, emphasizes the potential growth enhancement that crisis offers rather than its pathogenic quality. Thus the nurse assists the individual in moving beyond the baseline functioning manifested prior to crises.
Deviation from the norm is not seen necessarily as rooted in pathology and therefore moving the client back within the bounds of "normative functioning" is not the expressed goal of holistic nursing care.
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