Chapter 7
Nursing Theory
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Introduction
• First nurse theorist
– Florence Nightingale
• Book: Notes on Nursing: What It Is and What It Is
Not.
Nursing is the desire, intent, and obligation to apply
knowledge, skills, values, meanings, and experience
for, with, or on behalf of those requiring or
requesting assistance to achieve and maintain their
desired state of health and wellness.
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Nurse Theorists and Theories
• Chapter covers nurse theorists in chronological order,
starting with Florence Nightingale.
• 17 other nursing theorists
• Theories selected for inclusion have significance for
today’s nurse.
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Florence Nightingale and Nursing Theory
• Born May 12, 1820
• Died August 13, 1910
• Wrote first book on nursing theory: Notes on Nursing
• Prolific writer who advanced nursing significantly
• 12 fundamental concepts to nursing at the time
• Box 7.1
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Theory Development in the 1950s
• Hildegard Peplau
• Virginia Henderson
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Hildegard E. Peplau: Interpersonal
Relations in Nursing—1952
• Born September 1, 1909
• Died March 17, 1999
• Theory: interpersonal relations in nursing
– Changed role of patient from object to partner in care
– Grounded in interpersonal theory
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Virginia Avenal Henderson: Definition of
Nursing—1955
• Born November 30, 1897
• Died March 9, 1996
• Theory: definition of nursing
• Henderson defined nursing and contributed to the
development of nursing knowledge through study of
nursing research.
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Nursing Theory in the 1960s
• Faye Abdellah’s patient-centered approaches theory in
1960
• Ida Jean Orlando’s nursing process model in 1961
• Dorothy Johnson’s behavioral system model for nursing
in 1968
• Myra Levine’s four conservation principles in 1969
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Faye Glenn Abdellah: Patient-Centered
Approaches Theory—1960
• Born in New York City in 1919
• Retired in 2002; lives in Maryland
• Recognized as leader in health and public policy in the
U.S.
• Theory began with her doctoral dissertation focused on
improving clinical teaching in nursing
• Box 7.5 overview
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Ida Jean Orlando (Pelletier): Nursing
Process Theory—1961
• Born August 12, 1926
• Retired in 1992; lives in Massachusetts
• Theory of the nursing process significant influence in
nursing education
• First to test the nursing process in practice
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Dorothy E. Johnson: Behavioral System
Model for Nursing—1968
• Born August 21, 1919
• Died February 4, 1999
• Early focus on science of nursing and nursing knowledge
needed in practice
• Theory based on von Bertalanffy’s open system theory
and the person’s response to the stress of illness
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Myra Estrin Levine: Conservation
Principles: A Model for Health—1969
• Born in 1920
• Died March 20, 1996
• Original theory not intended as a nursing theory
• Model developed to provide graduate curriculum to
integrate all major nursing concepts and focus on
maintaining patient’s ability to adapt
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Nursing Theory in the 1970s
• Martha Rogers’s science of
unitary man in 1970
• Sister Callista Roy’s
adaptation model in 1970
• Dorothea Orem’s self-care
deficit theory in 1971
• The University of British
Columbia’s directions for
practice model in 1976
• Evelyn Adam’s conceptual
model for nursing in 1979
• Margaret Newman’s model of
health in 1979
• Imogene King’s theory of goal
setting in 1971
• Jean Watson’s theory of
human caring in 1979
• Betty Neuman’s systems
model in 1974
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Martha E. Rogers: Science of Unitary
Human Beings—1970
• Born May 2, 1914
• Died March 15, 1994
• Abstract in nature, initially understood by very few
• Theory of nursing knowledge and nursing science as a
distinct body of knowledge used to help people improve
their health
• Incorporated idea of energy fields between human and
environment
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Sister Callista Roy: Adaptation Model—
1970
• Born October 14, 1939
• Still teaching and publishing
• Used observations of children adapting to illnesses and
based her theory on her observations
• Theory is based on individuals as systems that adapt to
health and illness problems, including concepts of
nursing, health, and environment
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Dorothea E. Orem: Theory of Self-Care
Deficit—1971
• Born in 1914
• Died June 22, 2007
• Theory is of self-care deficit in nursing
• Incorporates when the patient and the family are not
able to provide care and the needs are met by the nurse
• Describes and explains when people need nursing care
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Imogene M. King: Theory of Goal
Attainment—1971
• Born January 30, 1923
• Died December 24, 2007
• Identified questions about nursing decision making
• Theory is transaction process model for mutual goal
setting in situations
• Initially used in advanced nursing education
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Betty Neuman: Neuman Systems Model—
1974
• Born 1924
• Lives in Ohio and practices as licensed clinical marriage
and family therapist
• Known around the world for her theory
• Originally developed as a teaching tool for mental health
clinical specialist in graduate program
• Based on open systems theory
• Major components of model are stress and reaction to
stress; goal is to achieve optimal client stability.
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The University of British Columbia (UBC)
Model for Nursing—1976
• Designed by several faculty members at UBC School of
Nursing
• Inspired by Johnson’s model, provides structure for
combining general knowledge about human health and
illness and specific knowledge about individual patients
• Broadened the view of human experience
• Composed of nine basic human needs
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Evelyn Adam: Conceptual Model for
Nursing—1979 (French) and 1980 (English)
• Born April 9, 1929
• Retired in 1989; lives in Montreal
• Work focuses on development of models and theories
• Contributes to theory development and clarification of
models of Johnson and Henderson
• Nurse’s independent contribution to health services
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Margaret A. Newman: Theory of Health as
Expanding Consciousness—1979
• Born October 10, 1933
• Retired in 1996; lives in Minneapolis
• Explored relationships between time, movement, and
space and relation to health and illness
• Based on Martha Rogers’s science of unitary human
beings
• Theory of health as expanding consciousness considers
health and illness components of unitary process as
pattern of wholeness
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M. Jean Watson: Theory of Human
Caring—1979
• Born in West Virginia
• Serves as a distinguished professor
• Theory of nursing: human science and caring is known
worldwide
• Defined by 10 “carative” factors as the core of nursing
• Used by nurses who adopt caring and commit to caring
for the patient
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Nursing Theory in the 1980s
• Rosemarie Parse’s theory of human becoming in 1981
• Patricia Benner’s skill acquisition model in 1984
• Madeleine Leininger’s theory on culture care diversity and
universality in 1985
• McGill University’s practice-based model in 1987
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Rosemarie Rizzo Parse: Theory of Human
Becoming—1981
• Retired as chair and professor emeritus from Loyola
University in Chicago
• Founding editor of Nursing Science Quarterly
• Introduced as man-living-health theory dealing with
man’s total experience in health
• Designed to consider the person as a whole, not in
traditional way of systems or fragments
• Person is whole part of the larger environment
interacting with all around.
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Patricia Benner: Model of Skill Acquisition
in Nursing—1984
• Born in 1942
• Currently directs the Carnegie National Nursing Education
Study
• Developed model of skill acquisition in nursing
• Five levels of skill
– Novice, advanced beginner, competent, proficient,
expert
– Used in all areas of nursing
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Madeleine M. Leininger: Culture Care:
Diversity and Universality Theory—1985
• Resides in Nebraska
• First nurse to study anthropology at doctoral level
• Initially focused on importance of caring in nursing
• Transcultural nursing developed from caring and is now a
subfield of nursing practice with focus on
– Cultural values, beliefs, and practices of individuals
with goal of providing culture-specific care
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Moyra Allen: McGill Model, Canada: A
Practice-Derived Model in Nursing—1986
• Developed with faculty, students, and nurses in
community practice in McGill University area
• Based on change in healthcare delivery in Canada to
redefine role of the nurse to provide healthcare to all
• Now a framework for McGill University curriculum with
four major concepts
– Health, family, collaboration, and learning
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Nursing Theory in the 1990s and 2000
• Anne Boykin and Savina Schoenhofer’s nursing as caring
in 1993
• Prince Edward Island’s conceptual model for nursing in
2000
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Anne Boykin and Savina Schoenhofer:
Theory of Nursing as Caring—1993
• Worked on theory when together at Florida Atlantic
University
• Foundation of theory is that “all persons are caring”
• Define focus of nursing as both a discipline and
profession, as nursing persons living, caring, and growing
together
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University of Prince Edward Island (PEI),
Canada: Conceptual Model for Nursing: A
Perspective of Primary Health Care—2000
• Eight faculty members of University of PEI and consultant
from Canadian Department of Health
• A primary healthcare model
• Intended to provide guidance to move toward a need for
primary healthcare practice for people
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A Global View of Nursing Theory
• Theory is expansive across the globe.
• Theories are shared and adapted between countries and
across the world.
• Adapted to the population and its needs
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Summary
• Rise of theory began in the 1950s.
• Recently published theories incorporate focus on caring
and primary care.
• Much time is used in development of theory.
• Other theories are in development and will continue to
evolve over time and adapt to the needs of nursing and
the population.
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