Nursing Theorists of Historical Significance
Kamila Alammar
442204610
NUR 605
Nursing Theories
Submitted to
Dr. Manal Alharbi & Dr. Latifa Almater
Objectives
At the end of this session, the students will be able to:
1. Gain a knowledge about theorists who are developed the nursing
theory.
2. Appreciate the theorist works.
3. Examine theories for their relevance to the health of individuals,
families, and community.
Outlines
Theory of
Interpersonal
Relations
Definition of
Nursing
Twenty-One
Nursing
Problems
The Helping Art
of Clinical
Nursing
Core, Care, and
Cure Model
Human-toHuman
Relationship
Model
Child Health
Assessment
Conceptual
Model for
Nursing
A Model for
Nursing Based
on a Model of
Living
Nursing Process
Theory
References
Introduction
Introduction
This session presents selected theorists who are noted for their
development of nursing theory during the pre-paradigm period. They
each represent an important contribution to the development of
specialized nursing knowledge.
Hildegard E. Peplau (Theory of interpersonal
relations)
• Hildegard E. Peplau is the mother of psychiatric nursing.
• Borne in 1909 and died in 1999.
• Her theoretical and clinical work led to the development of
the distinct specialty field of psychiatric nursing.
• Her scope of influence in nursing includes her contributions
as a psychiatric nursing expert, educator, author, and nursing
leader and theorist.
• Peplau provided major leadership in the professionalization
of nursing; as she worked as executive director and president
of the American Nurses Association.
• She stressed the importance of nurses’ ability to understand
their own behavior to help others identify perceived
difficulties.
Contributions
• She published Interpersonal Relations in Nursing
book (1952)and its was considered as the first
nursing theory textbook.
• She describes the importance of the nursepatient relationship as a “significant,
therapeutic interpersonal process”.
• Her work on nurse-patient relationships is
known well internationally and continues to
influence nursing practice and research.
• She
discussed
four
psychobiological
experiences that compel destructive or
constructive patient responses, as follows:
needs, frustrations, conflicts, and anxieties.
Structures of nursepatient relationship
Peplau identified four phases
of the nurse-patient
relationship
• Orientation
• Identification
• Exploitation
• Resolution
Overlapping Phases in Nurse-Patient Relationships.
(From Peplau, H. E. [1952]. Interpersonal relations in nursing. New York:
Putnam.)
Concepts of nurse-patient relationship
She proposed and described six
nursing roles:
• Stranger
• Resource person
• Teacher
• Leader
• Surrogate
• Counselor
Virginia Henderson
(Definition of nursing)
• Virginia Henderson borne in 1897 and died in 1996.
• She viewed the patient as an individual who requires
help toward achieving independence and completeness
or wholeness of mind and body.
• She clarified the practice of nursing as independent from
the practice of physicians and acknowledged her
interpretation of the nurse’s role as a synthesis of many
influences.
• Her work is based on Thorndike, an American
psychologist, her experiences with the Henry House
Visiting Nurse Agency, rehabilitation nursing, and
Orlando’s conceptualization of deliberate nursing action.
Contributions
• 60 years of contributions as a nurse, teacher, author, and researcher. She
published extensively throughout those years.
• Her major contribution to nursing research was an 11-year Yale-sponsored
Nursing Studies Index Project published as a four-volume-annotated index of
nursing’s biographical, analytical, and historical literature from 1900 to 1959.
• Her contributions include defining nursing, delineating autonomous nursing
functions, stressing goals of interdependence for the patient, and creating
self-help concepts.
Publications
• Textbook of the Principles and
Practice of Nursing (1955)
• Basic Principles of Nursing
Care (1960)
• The Nature of Nursing (1966)
Henderson’s Definition of
Nursing
The unique function of the nurse is to
assist the individual, sick or well, in the
performance
of
those
activities
contributing to health or its recovery (or to
peaceful death) that he would perform
unaided if he had the necessary strength,
will or knowledge. And to do this in such
a way as to help him gain independence
as rapidly as possible“.
(Henderson, 1964, p. 63).
Henderson Needs
Theory Components
Henderson’s definition of nursing was
adopted subsequently by the ICN and
disseminated widely; it continues to
be used worldwide. In The Nature of
Nursing:
A
Definition
and
Its
Implications for Practice, Research, and
Education, Henderson (1966) proposed
14 basic needs upon which nursing
care is based
Assertions of nursepatient relationships
Henderson identified three
levels of nurse-patient
relationships in which the
nurse acts as:
1. A substitute for the
patient.
2. A helper to the patient.
3. A partner with the
patient.
Faye Glenn Abdellah
(Twenty-One Nursing
Problems)
• Faye Glenn Abdellah born in 1919.
• She is a pioneer in nursing research and nursing as a profession
within the Public Health Service (PHS).
• International expert on health problems.
• She was named a “living legend” by the American Academy of
Nursing in 1994.
• Inducted into the National Women’s Hall of Fame in 2000 for a
lifetime spent establishing and leading essential health care
programs for the United States.
Contributions
• She has been active in professional nursing associations and is a prolific author, with more than 150
publications.
• She served as a chief officer, and Commissioned Officer in the U.S for 40 years.
• She was the first nurse to achieve the rank of a two-star Flag Officer, and first woman and nurse Deputy
Surgeon General.
• first dean in the Graduate School of Nursing in University of the Health Sciences (USUHS).
• Playing a role in establishing a foundation for nursing research as a science was her greatest
accomplishment.
• She educated the public on AIDS, drug addiction, violence, smoking, and alcoholism. Her work is a problem-
centered approach or philosophy of nursing.
Publications
Patient-Centered Approaches to Nursing book , that
emphasizes the science of nursing and has
elicited changes throughout nursing curricula.
Nursing and 21 Nursing problems
"Nursing is based on an art and science that mold the attitudes, intellectual
competencies, and technical skills of the individual nurse into the desire and
ability to help people , sick or well, cope with their health needs." – Abdellah.
She developed 21 nursing problems based on a review of nursing research
studies and Henderson’s 14 basic human needs to establish the classification of
nursing problems.
The 21 nursing problems progressed to a second-generation development
referred to as patient problems and patient outcomes.
Ernestine Wiedenbach
(The Helping Art of
Clinical Nursing)
• Ernestine Wiedenbach was born in 1900.
• She was teaching maternity nursing at the School of
Nursing, Yale University, and directed the major
curriculum in maternal and newborn health nursing for a
master degree.
• She wrote with a philosophers a classic work on theory in
a practice discipline studying the evolution of nursing
theory.
• She authored books used widely in nursing education.
Wiedenbach’s
definition of nursing
Her definition of nursing reflects her nursemidwife background as follows: “People may
differ in their concept of nursing, but few
would disagree that nursing is nurturing or
caring for someone in a motherly fashion”
(Wiedenbach, 1964, p. 1).
Wiedenbach’s Key Elements
Wiedenbach’s orientation is a philosophy of nursing that guides the nurse’s action in
the art of nursing.
Wiedenbach proposes 4 main elements to clinical nursing.
• Philosophy
• Purpose
• Practice
• Art
In her book (1964), Clinical Nursing: A Helping Art, Wiedenbach
outlines nursing steps in sequence.
Wiedenbach proposes that nurses identify patients’ need for help
in the following ways:
1. Observing behaviors consistent or inconsistent with their
comfort
2. Exploring the meaning of their behavior
3. Determining the cause of their discomfort or incapability
4. Determining whether they can resolve their problems or have a
need for help
Lydia Hall (Core, care,
and cure model)
• She was a rehabilitation nurse.
• Her philosophy of nursing was used to
establish the Loeb Center for Nursing and
Rehabilitation at Montefiore Hospital in New
York.
• She served as administrative director of the
Loeb Center.
• She published more than 20 articles about the
Loeb Center and her theories of long-term
care and chronic disease control.
• Hall argued for the provision of hospital
beds grouped into units that focus on the
delivery of therapeutic nursing.
• Hall
used
interlocking
three
circles
to
represent aspects of the
patient
and
nursing
functions.
• The three circles change
in size and overlap in
relation to the patient’s
phase
process.
in
the
disease
Joyce Travelbee (Human-tohuman relationship model)
• Joyce Travelbee developed the Human-to-Human Relationship
Model presented in her book Interpersonal Aspects of Nursing
(1966, 1971).
• From her perspective, the goal of nursing is to assist an individual,
family, or community to prevent or cope with the experiences of
illness and suffering and, if necessary, to find meaning in these
experiences, with the ultimate goal being the presence of hope.
Basic concepts
Suffering
Illness
Pain
Hope
Communication
Empathy
Sympathy
Rapport
Therapeutic
Use of Self
Interaction
Human-toHuman
Relationship
(5 stages of
interaction
process)
Kathryn E. Barnard (Child health
assessment)
• Kathryn E. Barnard is an active researcher, educator,
and consultant.
• She published about improving the health of infants
and their families.
• Her work was towards improving the physical and
mental health outcomes of infants and young children.
• She is the founder of the Nursing Child Assessment
Satellite Training Project (NCAST), and her work is a
guidelines for assessing infant development and
parent-child interactions.
Child health
assessment
interaction model
This model consists of
mainly four components:
• Environment
• Caregiver
• Child
• Interaction
Evelyn Adam (Conceptual model for
nursing)
• Canadian nurse, she focused on the
development of models and theories on
the concept of nursing.
• In her book To Be a Nurse, Adam
developed Virginia Henderson's concepts
within Dorothy E. Johnson's structure of a
conceptual model; assumptions, beliefs
and values, and major units.
Goal of the profession
Beneficiary of the professional service
The 6 Main
Components of
Conceptual Model
Role of the professional
Source of the beneficiary’s difficulty
Intervention of the professional
Consequences
Nancy Roper, Winifred W. Logan, and Alison J. Tierney (A
model for nursing based on a model of living)
• Nancy Roper is described as a practical theorist who
produced a simple nursing theory, “which actually
helped bedside nurses”.
• She published several books; Principles of Nursing (1967),
Clinical Experience in Nurse Education (1976), and The
Elements of Nursing in 1980, 1985, and 1990, and Elements
of Nursing: A Model for Nursing Based on a Model of Living
(1996).
Core of Nursing
Based on a
Model of Living
Roper's’ model for
nursing includes five
main
factors
that
influenced activities
of living (ALs).
Ida Jean Orlando Pelletier
(Nursing process theory)
• Orlando developed her theory from a study of
integrating mental health concepts into a basic
nursing curriculum.
• The theory was published in The Dynamic NursePatient Relationship (1961).
• Orlando’s nursing theory stresses the reciprocal
relationship between patient and nurse.
• According to Orlando, the role of the nurse is to
find out and meet the patient's immediate need for
help.
• She was one of the first nursing leaders to identify and emphasize the elements of nursing
process and the critical importance of the patient’s participation in the nursing process.
• Orlando’s theory focuses on how to produce improvement in the patient’s behavior.
• Evidence of relieving the patient’s distress is seen as positive changes in the patient’s
observable behavior.
• According to Orlando (1961), persons become patients who require nursing care when they
have needs for help that cannot be met independently because they have physical
limitations, have negative reactions to an environment, or have an experience that prevents
them from communicating their needs.
• Patients experience distress or feelings of helplessness as the result of unmet needs for help
(Orlando, 1961).
“The idea of nursing, historically rooted in the care of
the sick and in the provision of nurturance for those
vulnerable to ill health, is foundational to the
profession.” (Wolf, 2006, p. 301)
References
Alligood, M. R. (2018). Nursing theorists and their work (9th Ed.). St Louis,
Mo: Mosby. ISBN: 9780323402248