Lecture 3
Theoretical Foundations of Nursing
OBJECTIVES
1. Explain the relationships of concepts and propositions to theory.
2. Discuss the purpose of theory.
3. Describe the link between nursing theory and the continuing
development of the nursing profession.
4. Explain the interdependent roles of nursing practice, nursing
theory, and nursing research.
5. Identify the three categories relating to the scope of theories.
6. Apply the principles of selected nursing theories.
COMPONENTS OF THE THEORETICAL FOUNDATION
The basic elements that structure a nursing theory are concepts and
propositions. In a theory, propositions represent how concepts affect
each other.
What Is a Concept?
A concept is the basic building block of a theory. A concept is a vehicle of
thought.
The term concept refers to a “complex mental formulation of . . . [our]
perceptions of the world.” A concept labels or names a phenomenon, an
observable fact that can be perceived through the senses and explained.
What Is a Proposition?
• A proposition (another structural element of a theory) is a
statement that proposes a relationship between concepts.
An example of a nonnursing proposition might be the
statement “people seem to be happier in the springtime.”
This proposition establishes a relationship
between the concept of happiness and the time of the
year.
• A theory is a set of concepts and propositions that provide
an orderly way to view phenomena.
What Is the purpose of the theory ?
The purpose of a theory in scientific disciplines are
- to guide research
- to enhance the science by supporting existing
knowledge or generating new knowledge”.
- A theory not only helps us to organize our
thoughts and ideas, but it may also help
direct us in what to do and when and how to
do it.
The use of the term theory is not restricted to the
scientific world, however. It is often used in daily
life and conversation.
THE IMPORTANCE OF NURSING THEORIES ARE TO
• Provide a framework for thought in which to
examine situations.
• Provide a structure for communicating with other
nurses and with other members of the health care
team.
• Assist the discipline of nursing in clarifying beliefs,
values, and goals.
• Define the unique contribution of nursing in the
care of clients.
• Provide the continued development and evolution
of the discipline of nursing.
• Nursing research is the systematic application of
formalized methods for generating valid and
dependable information about the phenomena of
concern to the discipline of nursing.
• The relationship between nursing theory, practice,
and research is an interdependent one.
• As a practice oriented discipline, nursing theory and
research inform and transform nursing practice.
Nursing Practice
Nursing Theory
Nursing Research
Process of knowledge development. Nursing practice, theory, and
research are interdependent. Nursing theory development and
nursing research activities are directed toward developing nursing
practice standards.
SCOPE OF THEORIES
Scope refers to the relative level of substantive
specificity of a theory and the concreteness of its
concepts and propositions”.
Essentially, three different categories relate to the
scope of theories are
1-grand theories.
2-middle-range theories.
3-micro-range theories.
This classification is applicable to both nursing and
nonnursing theories.
SCOPE OF THEORIES
1-A grand theory is composed of concepts
representing global and extremely complex
phenomena.
2-Middle-Range Theory is a theory that addresses
more concrete and more narrowly defined
phenomena than a grand theory.
3-Micro-Range Theory explains a specific phenomenon
of concern to the discipline such as the effect of social
supports on grieving and would establish nursing care
guidelines to address the problem.
Contemporary Nursing Theories
• “When is nursing needed?” The work of contemporary
theorists such as Levine, Orem, and Roy form the theoretical
basis for many interventions in current nursing practice.
• Dorothea Orem
• Dorothea Orem was searching for a pragmatic framework to
organize nursing knowledge.
• She presented the Self- Care Deficit Theory of Nursing (SCDTN) in the book Nursing Concepts of Practice and has
continually revised and updated her theory.
• As a grand theory, the S-CDTN has three interconnecting theories:
1-Theory of Self-Care.
2- Theory of Self-Care Deficit.
3-Theory of Nursing Systems.
Dorothea Orem
1-Theory of Self-Care
Orem identified three categories of self-care requisites:
1-Universal self-care requisites,
2- Developmental self-care requisites,
3-Health-deviation self-care requisites.
1-Universal self-care requisites are common to all human beings and
include both physiological and social interaction needs as the
following.
1- Air, water and food
2-Elimination and excrements
Dorothea Orem
3- Activity/rest
4- Solitude (aloneness) /social interaction
5-Prevention of hazards to life and well-being
(physical , social & psychological hazards).
6-Promotion of function and development
within social group based on group norms.
Dorothea Orem
2-Developmental self-care requisites are the needs that
arise as the individual grows and develops.
3-Health-deviation self-care requisites result from the
needs produced by disease or illness states.
Sister Callista Roy
• Sister Callista Roy combined general systems theory with
adaptation theory to produce the Roy Adaptation Model.
• Roy defines a person as “an adaptive system . . . a
whole comprised of parts that function as a unity
for some purpose”.
• The purposes of adaptation are survival, growth,
reproduction, and mastery.
• According to the Roy Adaptation Model, the person
has coping mechanisms that are broadly categorized in
either the regulator or cognator subsystem.
• Adaptation is accomplished through these coping
mechanisms that are innate, “genetically determined . . .
and automatic processes”.
Sister Callista Roy
1- The regulator subsystem functions through the autonomic
nervous system, which “responds automatically through neural,
chemical, and endocrine coping processes”.
2- The cognator subsystem enables the person to respond to
stimuli through processing stimuli, learning, judgment, and
emotion.
• All input into the system (the person) is channeled through the
regulator and cognator subsystems.
• If the regulator or cognator subsystem fails, there is ineffective
adaptation.
Theories for the New Worldview of Nursing
• Theories for the new worldview of nursing describe,
explain, and predict the phenomena of concern to
nursing from a unique, more holistic perspective.
• Theories by Jean Watson, Martha Rogers, and Rosemarie
Parse exemplify the new worldview.
Jean Watson
In the 1980s, Jean Watson developed the Theory of Human
Caring, which focuses on the art and science of human
caring.
• According to Watson (1985, “caring is the essence of nursing and
the most central and unifying focus of nursing practice.” This
theory offers a new way of conceptualizing and maximizing humanto human transactions that occur daily in nursing practice.
Jean Watson
Watson’s theory is composed of 10 carative factors, which
are classified as nursing actions or caring processes.
Watson’s carative factors are:
1. Formation of a humanistic-altruistic system of values
2. Nurturing of faith-hope
3. Cultivation of sensitivity to one’s self and to others
4. Developing a helping-trusting, human caring
relationship
Jean Watson
5. Promotion and acceptance of the expression of
positive and negative feelings
6. Use of creative problem-solving method processes
7. Promotion of transpersonal teaching and learning
8. Provision for a supportive, protective, or corrective
mental, physical, sociocultural, and spiritual environment
9. Assistance with gratification of human needs
10. Allowance for existential-phenomenological forces
Thank you