University of Texas at El Paso
College of Health Sciences
School of Nursing
Objectives:
• 1. ID purposes & essential elements of nsg
theories
• 2. Differentiate terms: concept, conceptual
framework, conceptual model, & theory
• 3. Compare selected theories of nsg. in terms of
Pt., environment, health & nursing.
• 4. Describe relationship of Nsg. Theory to nsg.
Process & nsg. Research
Purposes of Nsg. Theories &
Conceptual frameworks
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Practice
Education
Research
TRIANGULATION between the three is
essential
What is a metaparadigm?
• Meta = change
• Paradigm= world wide view (Webster’s,
1983)
What is a concept?
• A mental image that has emotional,
cognitive, spiritual and cultural dimensions
– A conceptual framework is a group of related
concepts
– A conceptual model is a graphic illustration of
the relationships between concepts
What is the major distinction between a
theory & conceptual framework?
• Level of abstraction
• Conceptual framework is more abstract
than the theory
• Conceptual model is a diagram with its
major purpose being to give clear &
explicit direction to nsg. Practice,
education & research
CONCEPTUAL TERMS
• 1. Conceptual framework
• 2. Conceptual model
• 3. Theory = system of ideas that is
proposed to explain a given phenomenon
Grand Nursing Theories
– Middle Range Nursing Theories
Metaparadigm of Nursing
• Metaparadigm of Nursing is composed of
4 concepts
– Person
– Environment
– Health
– Nursing
SELECTED GRAND NSG.
THEORIES (11)
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Nightingale (1860)
Peplau (1952)
Henderson (1966)
Martha Rogers (1970)
Orem (1971)
King (1971)
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Neuman (1972)
Sister Roy (1970)
Leininger (1985)
Watson (1979)
Parse (1981)
Nightingale’s Environmental
Theory
• First Nurse Theorist
• Nursing = “act of utilizing environment of patient
to assist him in his recovery” (Kozier, 2000)
• Primary Concepts = Environmental factors (5)
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Pure air
Pure Water
Efficient drainage
Cleanliness
Direct sunlight
Peplau’s Interpersonal Relations
Model
• Psychiatric nurse
• Concept = therapeutic relationship between
nurse & client
• Nurse-Client Relationship Phases (4)
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Orientation
Identification
Exploitation
Resolution
Henderson’s definition of nursing
• Formulated unique definition of nursing in
relation to both well & will individuals
• Major step in differentiating nursing from medicine
• Fundamental needs of sick or well individuals
(14);
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1. Biophysical needs
2. Psychological needs
3. Spiritual needs
4. Social needs
Roger’s Science of Unitary Human
Beings
• Draws from many scientific disciplines
• Major concepts:
– Unitary man with 5 characteristics Human energy
fields= non contact therapeutic touch
• Differentiates whole from holistic
Orem’s General Theory of Nursing
• Major concepts (5)
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Self-care
Self-care agency
Self-care requisites
Therapeutic self-care demand
Nursing systems
• Assumptions (3)
– Universal requisites
– Developmental requisites
– Health deviation requisites
King’s Goal Attainment theory
• Based on systems theory & behavioral sciences
• Major concepts
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Personal systems
Interpersonal systems
Social systems
Transactions
• Assumptions (3)
– All related to transactions
Neuman’s Systems Model
• Community health nurse& clinical psychologist
• Major concept = STRESS
• Reconstitution = state of adaptation to stressors
– Lines of resistance
– Normal line of defense
– Flexible line of defense
• Stress categories: intrapersonal, interpersonal,
extrapersonal
• Assumptions (3)
Roy’s Adaptation Model
• Major concept = adaptation = process &
outcome whereby thinking & feeling person uses
conscious awareness & choice to create human
& environmental integration
• Modes (4)
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Physiologic mode
Self-concept mode
Role function mode
Interdependence mode
Leininger’s Cultural Care Diversity
& Universality Theory
• Anthropologist
• Care- essence of nsg. & dominant, distinctive &
unifying feature of nsg.
• Major concepts = culture, culture care, culture
care diversity, culture care universality, generic
care, professional care, sunrise model
• Intervention modes (3): Preservation,
accommodation, restructuring
Watson’s Human Caring Theory
• Major Concept = caring
• Assumptions (11)
• Carative Factors (10)
– Interpersonal relationship
– Use of scientific process
– Addresses clinician’s self
Parse’s Human Becoming Theory
• “Human Becoming”
• Concepts (3)
– Meaning; Nurse & true presence; Pt. Is authority
figure
– Rhythmicity
– Co-transcendence
• Assumptions (3)
• Human becoming & meaning
– Human becoming & rhythmic patterns
– Human becoming co-transcending
Relationship of theories to Nursing
Process
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1.
2.
3.
4.
5.
Assessing
Diagnosing
Planning
Implementing
Evaluating
SUMMARY
• Terminology common to theory discussion
• Nursing Grand Theories (11)
• Relationship between theory & nursing
practice