Theories of Nursing
Practice
What is a theory?
 A set of concepts,
definitions, relationships,
and assumptions that
project a systematic view
of a phenomena
 It may consist of one or
more relatively specific
and concrete concepts
and propositions that
purport to account for, or
organize some
phenomenon (Barnum,
1988)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-2
What are the components of a
theory?
 Concepts – ideas and mental
images that help to describe
phenomena (Alligood and
Marriner-Tomey, 2002)
 Definitions – convey the
general meaning of the
concepts
 Assumptions – statements
that describe concepts
 Phenomenon – aspect of
reality that can be consciously
sensed or experienced
(Meleis, 1997).
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-3
What is a paradigm?
 A model that
explains the linkages
of science,
philosophy, and
theory accepted and
applied by the
discipline (Alligood
and Marriner –
Tomey, 2002)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-4
What is a domain?
 The view or
perspective of the
discipline
 It contains the
subject, central
concepts, values and
beliefs, phenomena
of interest, and the
central problems of
the discipline
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-5
How does domain relate to
nursing theory?
 Nursing has
identified its domain
in a paradigm that
includes four
linkages:
1) person/client
2) health
3) environment
4) nursing
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-6
Purposes of nursing theory
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-7
What are the purposes of nursing
theory?
 It guides nursing
practice and
generates knowledge
 It helps to describe
or explain nursing
 Enables nurses to
know WHY they are
doing WHAT they
are doing
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-8
Types of nursing theories
 Grand theories – broad
and complex
 Middle-range theoriesaddress specific
phenomena and reflect
practice
 Descriptive theories –
first level of theory
development
 Prescriptive theories –
address nursing
interventions and predict
their consequences
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-9
Why on earth do we study
nursing theory?
 Everyday practice enriches
theory
 Both practice and theory are
guided by values and beliefs
 Theory helps to reframe our
thinking about nursing
 Theory guides use of ideas
and techniques
 Theory can close the gap
between theory and research
 To envision potentialities
(Gordon, Parker, & Jester,
2001)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-10
“The study and use of
nursing theory in nursing
practice must have roots in
the everyday practice of
nurses (Gordon, Parker, and
Jester, 2001).
So how do nurses use theory in
everyday practice?




Organize patient data
Understand patient data
Analyze patient data
Make decisions about
nursing interventions
 Plan patient care
 Predict outcomes of care
 Evaluate patient
outcomes
(Alligood, 2001)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-12
How do student nurses begin to
use nursing theory?
 By asking yourself
two very important
questions…..
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-13
Student nurse questions
 What is the nature of
knowledge needed for
the practice of nursing?
 What does it mean to me
to practice nursing?
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-14
Nursing also utilizes non-nursing
theories
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-15
Commonly used non-nursing
theories
 Systems theory
 Basic Human Needs
theory
 Health and Wellness
Models
 Stress and
Adaptation
 Developmental
Theories
 Psychosocial
Theories
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-16
What is the link between nursing
theory and the research process?
 Theory provides direction
for nursing research
 Relationships of
components in a theory
help to drive the research
questions for
understanding nursing
 Chinn and Kramer
(2004), indicate a spiral
relationship between the
two
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-17
Current trends that influence
nursing theory
 Medical science
 Nursing education
 Professional nursing
organizations
 Evolving research
approaches
 Global concerns
 Consumer demands
 Technologies
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-18
“ Practicing nurses who despise
theory are condemned to
performing a series of tasks either at the command of a
physician or in response to
routines and policies.”
Leah Curtin, RN, MS, FAAN
(1989)
Former Editor, Nursing
Management
Objectives
 Define theory and list characteristics of a
theory
 Describe the components of a theory and
its use
 Trace the development of a nursing
theory
 Describe the different types of theories
and examples of each.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-20
Introduction to Theory
 Nursing as a profession
There has been questions about whether nursing is
a profession or an occupation.
 An occupation is a job a career.
 A profession is a learned vocation or occupation
that has status of superiority and precedence
within a division of work. It needs widely varying
levels of training or education, skills and variable
knowledge base. All professions are occupations
but not all occupations are professions
(Logan,Franzen, Butcher,2004;Schwiran , 1998)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-21
Characteristics of a profession
1. Utilizes in its practice a well-defined and
well organized body of specialized
knowledge on the intellectual level of
the higher learning.
2. Constantly enlarges the body of
knowledge it uses and improves its
techniques of education and service by
the use of scientific method.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-22
Characteristic of a profession
3) Entrusts the education of its practitioners
to institutions of higher education.
4) Applies its body of knowledge in
practical services that are vital to human
and social welfare.
5) Functions autonomously in the
formulation of professional policy and in
the control of professional activity.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-23
Characteristics of a profession
 6. Attracts individuals of intellectual and
personal qualities who exalt service above
personal gain and who
recognize their chosen occupation as a life
work.
7. Strives to compensate its practitioners by
providing freedom of action, opportunity for
continuous professional growth and economic
security.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-24
Definitions of theory
1. Pinnel and Menesis (1986)
Systematic set of interrelated concepts,
definitions and deductions that
describe, explain or predict
interrelationships
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-25
Definitions of a theory
2. Walker and Avant (1983)
Internally consistent group of relational
statements (concepts, definitions and
propositions) that presents a systematic
view of phenomenon and which is useful
for description, explanation, prediction
and control
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-26
Definition of a theory
3. Chinn and Krammer
creative and vigorous structuring of ideas
that project a tentative, purposeful and
systematic view of phenomena
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-27
Definitions of a theory
 Ellis
coherent set of hypothetical, conceptual
and pragmatic principles forming a
general frame of reference for a field of
inquiry
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-28
Some commonalities
Purpose
Concepts
Definitions
Propositions
Structured ideas
Tentative
Describe a phenomenon or occurrence
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-29
Components/Elements of
theory
1.Purpose “Why is the theory formulated”
2.Concepts are building blocks of theory –
ideas, mental images of a phenomenon,
an event or object that is derived from an
individual’s experience and perception
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-30
Components/Elements of
theory
3.Has a major concept like nursing, person,
health or environment.
4. Definitions give meaning to concepts
which can either be descriptive or
procedural (stipulate-use of term within
the theory)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-31
Components/Elements of
theory
Propositions are expressions of
relational statements between and
among the concepts. It can be
expressed as statements, paradigms
or figures . AKA as theoretical
assertions
Assumptions- accepted “truths” that are
basic and fundamental to the theory.
Or value assumptions where what is
good or right or ought to be.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-32
Characteristics of a Theory
1. Systematic, logical and coherent
(orderly reasoning,no contradictions)
2. Creative structuring of ideas
mental images of one’s experiences and
create different ways of looking at a particular
event or object.
3. Tentative in nature ( change over time or
evolving but some remain valid despite
passage of time)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-33
Theory Development
Prof. Dawn M.
Capaque
MIT, School of Health
Sciences
How does a theory develop?
 Four strategies of theory development
1. Theory practice theory ( theory
developed in other discipline and used
in nursing situations)
2. Practice – theory
evolved from clinical practice
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-35
How does a theory develop?
3. Research theory or inductive
method
Must evolve from research findings or
empirical evidence.
4. Theory research theory
theories developed by other
disciplines are utilized but given
unique nursing perspective. Original
theory examined and given a new
research findings.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-36
TERMINOLOGY
METAPARADIGM
- Most abstract level of knowledge. In
nursing this is main concepts that
encompasses the subject matter and the
scope of the discipline
- Central concepts of person, environment,
health and nursing
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-37
TERMINOLOGY
 Philosophy
- Knowledge level which specifies the
definitions of the metaparadigm concepts
in each of the conceptual models of
nursing.
- Nightingale is considered philosophical
approach
- Out of these philosophies theory maybe
formalized
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-38
Conceptual models
 Frameworks or paradigms that provide a
broad frame of reference for the
systematic approaches to the
phenomena with which the discipline is
concerned.
 -different views nursing like Roy focuses
on adaptation, King on interaction and
Abdellah on interventions
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-39
theory
 Group of related concepts that propose
actions that guide practice
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-40
Nursing theory
 Group of related concepts that derive
tfrom the nursing models. Some derive
from other nursing discipline like
LEininger which comes from
anthropology
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-41
Uses of theory
1. Theory guides and improve nursing
practice
Theory provides goal for nursing care
and with goals, nursing practice is
rendered more effective and efficient.
theories help to focus the goals, making
nurses more confident about the
practice.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-42
Uses of theory
2. Theory guides research
according to Meleis, primary use of
theory is to guide research. It validates
and modifies the theory.
3. Theory contributes to the development
of the disciplines body of knowledge
4. Theory enhances communication
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-43
Theory Development
in Nursing: Historical
Overview
DMCAPAQUE
Where do I begin?
Florence Nightingale
- Considered first modern nursing theorist
- First one to delineate what is considered the
nursing goal and practice domain.
- “ placing the client in the best condition for
nature to act upon him”
- Taught about symptoms and what they
indicate, rationale for actions and trained
powers of observation and reflection
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-45
Historical Development of Nursing
Theories: Significant Events
 Nightingale until the 50’s
 Florence Nightingale Notes on Nursing
control of the environment to care for the
individual (ventilation, light, warm , noise
absence or reduction, cleanliness & diet )
1952 Nursing Research Journal publication
1960’s nature of nursing practice was debated,
defined nursing practice, or develop nursing
theory, and created a substantive body of
knowledge
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-46
Historical development
 1960-1970 proliferation of conceptual
models and frameworks, and philosophy
of nursing.
Examples: Abdellah 21 nursing problems
and Hall’s Core, care and cure
(person,body,disease)
 1969 first conference on nursing theory
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-47
Historical Development
 Role of nurses where
questioned; what
they do, for whom
where and when
were determined.
 purpose of nursing,
process of theory
development was
discussed
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-48
First Conference in Nursing theory
Brought leading scholars and theorists to discuss
and debate on issues regarding nursing
science ad theory development.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-49
Historical Development
 Writings of Dickoff,
James and Wiedenbach
“Theory in a Practice
Discipline” influenced
the theoretical thinking in
nursing . They presented
a definition of nursing
theory and goals for
theory development in
nursing, approaches
where discussed
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-50
Historical Development
1980’s characterized by acceptance of the
significance of theory in nursing. Less
debates on whether or not to use theory,
practice theory or borrowed ones.
More and more publication up to the
present.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-51
Stages of Theory Development
according to Kidd and Morrison
1. Silent Knowledge stage
- Blind obedience to medical authority
- Training schools were hospital based,
emphasis on carrying out physicians
orders and few books, depended on
physicians diagnosis, exploited as
workers and as students.
- Persisted for more than 80 years
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-52
2. Received Knowledge Stage
 Learning through listening to others
- Nursing now challenged to be in the
university as opposed to apprenticeship
that happens to most hospital programs.
- Nurses acquired non nursing degrees
relying on the authority of educators,
sociologist, psychologists, physiologists,
and anthropologists to provide answers
to nursing problems.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-53
3. Subjective Knowledge stage
 Authority was internalized and a new
sense of self emerged.
- Negative attitude toward borrowed
sciences or theories
- Defining on nursing and developing
theories about and for nursing
- Research focused on the nurse rather on
he clients and clinical situations.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-54
4.Procedural Knowledge
 Includes both separate and
connected knowledge
- Proliferation of approaches to theory
development applying theory in
practice was frequently
underemphasized
- Emphasis was on procedures used to
acquire knowledge, with over
attention to appropriateness of
methodology the criteria for evolution
and statistical procedures
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-55
5. Constructed Knowledge
 Integration of different types of
knowledge ( intuition, reason and selfknowledge)
 Nursing theory based on empirical
studies theoretical literature client
reports, clinical experiences and nurses
scholar intuition.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-56
Types of theories




According to range
- Grand theory
Middle range theory
Micro theory
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-57
Types of theories
 Grand Theory consist of broad conceptual
frameworks that reflect wide and expansive
perspectives for practice and ways of
describing, explaining, predicting and looking
at nursing phenomena. They are the most
complex and broadest in scope.
 Henderson’s The Nature of Nursing ; Levine’s
The Four Conservation Principles of Nursing,
Roy’s Adaptation Model, and Orem’s Self-Care
(Marriner-Tomey)
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-58
Types of Theories
 Mid Range- less complex and narrower in
scope than grand theory and micro theory. A
more workable level is the middle range.more
limited in scope and less variables, and
testable.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-59
Types of Theories
Mid range Example: grand theory on stress and
adaptation might not yield any interpretable
guidelines on practice but if the theory is
focused on chronic lingering illness as the
stressor on family, the stress theory becomes
operational for both research and practice
purposes. Ex. Peplau’s Psychodynamic
Nursing and Orlando’s Nursing Process Theory
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-60
Types of theories
 Micro theories- are the least complex.
They contain the least complex concepts
and are narrowest in scope. They deal
with a small aspect of reality, generally a
set of theoretical statements
 - Deals with specific and narrow defined
phenomena
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-61
According to Orientation or focus of
the theory
1. Client centered: Nightingale, Henderson
2. Client-nurse dynamics: Watson
3. Client-nurse environment : Leininger
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-62
Categories of nursing theories
client
nurse
`
environment
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-63
Client centered theory
1. Client centered theories are those
focused on the needs and problems of
clients which are met, resolved or
alleviated by nursing interventions
 This category includes theories
developed by the following :
Nightingale,Abdellah,Henderson,Orem,
Pender, Roy, Levine, Hall.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-64
Nurse – client dynamics
2.Nurse-client-dynamics focus on
interaction between the nurse and client.
This category includes theories
developed by the following: Peplau,
Watson, King and Orlando
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-65
Client Nurse Environment
Dynamics
3. CLIENT NURSE ENVIRONMENT- focus
on the interaction between nurse and
client in an environment that includes
broader dimensions of time and space.
As well as culture, cultural diversity, and
universality. Theories of Neuman and
Leininger are discussed under this
category.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-66
Framework to Analyze the Nursing
theory
I What are the major concepts?
- Person, nursing, health and environment
II Based on Focus
- Client centered, nurse-client dynamics,
nurse client-environment dynamics
How similar and how different are their
concepts of persons, nursing, health,
environment
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-67
Framework to Analyze the Nursing
theory
III Key concepts unique to the theory.
Some theories have several key
concepts and it may have sub-concepts.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-68
The Theoretical Foundation of
Nursing
 Nursing theory provides the theoretical
foundation of the profession.
 Theory defines what nursing is, what it
does, and the goals or outcomes of
nursing care.
 Nursing is the synthesis of many
theories.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-69
Components of the Theoretical
Foundation
 A theory is a set of concepts and
propositions that provides an orderly way
to view phenomena.
 Concepts and propositions are the
structural elements of a theoretical
foundation.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-70
Concepts
 Building blocks of a theory
 Labels or names for
phenomena/observable facts
 Assist us in formulating a mental image
about an object or situation
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-71
Concepts
 Theories are formed by linking concepts
together.
 A conceptual framework links global
concepts together.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-72
Conceptual Model
 The “symbolic representation of empiric
experience in words, pictorial, or graphic
diagram, mathematical notations or
physical material.”
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-73
Propositions
 A proposition is a statement that
proposes a relationship between
concepts.
 Propositional statements in a theory
represent the theorist’s view of which
concepts fit together.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-74
Theories
 A theory helps us to organize our
thoughts and ideas.
 In science, the purpose of a theory is to
guide research, support existing
knowledge, or generate new knowledge.
 The term theory is not restricted to the
scientific world.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-75
Importance of Nursing Theories
 Framework for thought in which to
examine situations
 Structure for organization, analysis, and
decision making
 Structure for communicating with other
nurses and other health team members
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-76
Importance of Nursing Theories
 Assist the nursing discipline in clarifying
beliefs, values, and goals.
 Help to define the unique contribution of
nursing in the care of clients.
 Standards of clinical practice are
developed out of nursing theories.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-77
Process of Knowledge
Development
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-78
Scope of Theories
 Grand Theories
 Middle-Range Theories
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-79
Grand Theory
 Provides an overall framework for
structuring broad, abstract ideas.
 Composed of concepts representing
global and extremely complex
phenomena.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-80
Middle-Range Theory
 Provides a perspective from which to
view complex situations and a direction
for interventions in three levels of
abstractness.
• High middle-range
• Middle middle-range
• Low middle-range
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-81
Florence Nightingale’s Influence on
Knowledge Development in Nursing
 Described nursing as both an art and a
science.
 Stressed the importance of caring for the
ill person rather than the illness.
 Viewed a person’s health as the direct
result of environmental influences
(cleanliness, light, pure air, pure water,
efficient drainage).
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-82
Florence Nightingale’s Influence on
Knowledge Development in Nursing
 The turn of the 20th century marked the
beginning of hospital-based schools of
nursing.
 Nightingale’s principles were
incorporated into modern nursing theory.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-83
The Evolution of Nursing
Theory
 Since the early 1950s, many nursing
theories have been systematically
developed to help describe, explain, and
predict the phenomena of concern to
nursing.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-84
Knowledge Development
in Nursing
 Paradigm
• A particular viewpoint or perspective
• A “worldview” about the phenomena of
concern in a discipline (Kuhn, 1970)
 Metaparadigm
• The major concepts in a discipline that
names the phenomena of concern
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-85
Knowledge Development
in Nursing
 Metaparadigm of Nursing
• Person: Individual, family or group
• Health: Continuum of wellness to terminal
illness
• Environment: Place or community where
care is provided
• Nursing: Actions; interactions of the nurse
with the person
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-86
Knowledge Development
in Nursing
 Two individuals with different
paradigmatic views can look at the same
phenomenon and view the phenomenon
differently.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-87
Knowledge Development
in Nursing
 The prevailing paradigm in a discipline
represents the dominant view of
particular concepts.
 A paradigm revolution is the turmoil and
conflict that occur in a discipline when a
competing paradigm gains acceptance
over the dominant paradigm.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-88
Knowledge Development
in Nursing
 A paradigm shift refers to the acceptance
of the competing paradigm over the
prevailing paradigm or a shifting away
from one worldview toward another
worldview.
 Members of a discipline cannot subscribe
to two competing paradigms at the same
time.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-89
Knowledge Development in
Nursing
 Four Levels of Knowing
•
•
•
•
Empirical
Aesthetic
Personal
Ethical
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-90
Early Nursing Theorists
 Hildegard Peplau
• Defined concepts of stages of nurse-client
relationships.
 Virginia Henderson
• Defined basic human needs as the unique
focus of nursing practice.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-91
Maslow’s Hierarchy of Needs
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-92
Early Nursing Theorists
 Faye Abdellah
• Identified 21 nursing problems that became
the foundation of nursing diagnoses.
 Joyce Travelbee, Josephine Paterson
and Loretta Zderad
• Emphasized the humanistic and existential
basis of nursing practice to understanding
the uniqueness of patients.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-93
Contemporary Nursing
Theorists
 The work of contemporary theorists form
the theoretical basis for many
interventions in current nursing practice.
• Myra Levine
• Dorothea Orem
• Sister Callista Roy
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-94
Contemporary Nursing
Theorists
 Myra Levine’s Conservation Theory
(1969)
• Four universal principles of conservation
designed to apply concepts of nursing
practice in different environments
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-95
Dorothea Orem
 Self-Care Deficit Theory of Nursing
• Theory of Self-Care
• Theory of Self-Care Deficit
• Theory of Nursing Systems
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-96
Roy Adaptation Model
 Developed by Sister Callista Roy, 1976.
 Combined general systems theory with
adaptation theory.
 Goal of nursing is “promotion of
adaptation” in each of four modes of
adaptation.
 Applicable to the home setting.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-97
Roy Adaptation Model
 The goal of nursing is “the promotion of
adaptation” in each of four adaptive
modes.
•
•
•
•
Physiologic
Self-concept
Role function
Interdependence
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-98
Theories for the New
Worldview of Nursing
 Describe, explain, and predict the
phenomena of concern to nursing from a
more holistic perspective.
• Jean Watson
• Martha Rogers
• Rosemarie Parse
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-99
The Theory of Human Caring
 Developed by Jean Watson in the 1980s.
 Conceptualizes human-to-human
transactions that occur daily in nursing
practice.
 Ten carative factors are classified as
nursing actions or caring processes.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-100
The Science of Unitary
Human Beings
 Developed by Martha Rogers in 1990.
• The person is characterized as a human
energy field that unites all aspects of the
person into a unified whole.
• Nursing aims to repattern the rhythm and
organization of these energy fields to
heighten the integrity of the person.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-101
Gordon’s Functional Health
Patterns
 Influenced by Maslow’s Hierarchy of
Basic Human Needs and Von Bartlaffny’s
general systems theory.
 Offer a holistic approach to the
development of nursing diagnoses and
client care.
 Provides an appropriate method for
organization of textbook topics.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-102
Continuing Evolution of Nursing
Theory
 Nursing is always in a state of change.
 Nursing knowledge continues to expand
in a multiplicity of ways.
 New theories will come from a global
perspective and international nursing
leaders in the 21st century.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-103
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
3-104