THEORETICAL FOUNDATION OF NURSING

Nursing Theories and Theorists

These are beliefs and values that
define a way of thinking and are
Nursing Theories generally known and understood
 Nursing theories are by a group or discipline.
organized bodies of Theory
knowledge to define what
nursing is, what nurses do, A belief, policy, or procedure
and why they do it. proposed or followed as the basis
 Nursing theories provide a of action. It refers to a logical group
way to define nursing as a of general propositions used as
unique discipline that is principles of explanation. Theories
separate from other are also used to describe, predict,
disciplines (e.g., medicine). or control phenomena.
 It is a framework of concepts
Concept
and purposes intended to
guide nursing practice at a Concepts are often called the
more concrete and specific building blocks of theories. They
level. are primarily the vehicles of
 Nursing, as a profession, is thought that involve images.
committed to recognizing its
Models
own unparalleled body of
knowledge vital to nursing Models are representations of the
practice—nursing science. interaction among and between the
 To distinguish this foundation concepts showing patterns. They
of knowledge, nurses need to present an overview of the theory’s
identify, develop, and thinking and may demonstrate how
understand concepts and theory can be introduced into
theories in line with nursing. practice.
 As a science, nursing is
Conceptual framework
based on the theory of what
nursing is, what nurses do, A conceptual framework is a group
and why. of related ideas, statements, or
 Nursing is a unique discipline concepts. It is often used
and is separate from interchangeably with the
medicine. It has its own body conceptual model and with grand
of knowledge on which theories.
delivery of care is based.
Proposition
Propositions are statements that
DEFINING TERMS describe the relationship between
the concepts.
Philosophy
Domain
 THEORETICAL FOUNDATION OF NURSING
Nursing Theories and Theorists
The domain is the perspective or nursing needed to validate itself
territory of a profession or through the production of its own
discipline. scientifically tested body of
knowledge.
Process
Hildegard Peplau (1952)
Processes are organized steps,
changes, or functions intended to Introduced her Theory of
bring about the desired result. Interpersonal Relations that
emphasizes the nurse-client
Paradigm
relationship as the foundation of
A paradigm refers to a pattern of nursing practice.
shared understanding and
Virginia Henderson (1955)
assumptions about reality and the
world, worldview, or widely Conceptualized the nurse’s role as
accepted value system. assisting sick or healthy individuals
to gain independence in meeting
Metaparadigm
14 fundamental needs. Thus her
A metaparadigm is the most Nursing Need Theory was
general statement of discipline and developed.
functions as a framework in which
Faye Abdellah (1960)
the more restricted structures of
conceptual models develop. Much Published her work “Typology of 21
of the theoretical work in nursing Nursing Problems,” which shifted
focused on articulating the focus of nursing from a
relationships among four major disease-centered approach to a
concepts: person, environment, patient-centered approach.
health, and nursing.
Ida Jean Orlando (1962)
Emphasized the reciprocal
HISTORY OF NURSING relationship between patient and
THEORIES nurse and viewed nursing’s
professional function as finding out
Florence Nightingale (1860, and meeting the patient’s
1950) immediate need for help.
Defined nursing in her Dorothy Johnson (1968)
“Environmental Theory” as “the
act of utilizing the patient’s Pioneered the Behavioral System
environment to assist him in his Model and upheld the fostering of
recovery.” efficient and effective behavioral
functioning in the patient to
In the 1950s, there is a consensus prevent illness.
among nursing scholars that
Martha Rogers (1970)
 THEORETICAL FOUNDATION OF NURSING
Nursing Theories and Theorists
Viewed nursing as both a science THE NURSING
and an art as it provides a way to METAPARADIGM
view the unitary human being, who
is integral with the universe. Person

Dorothea Orem (1971) Person (also referred to as Client or

Human Beings) is the recipient of
Stated in her theory that nursing nursing care and may include
care is required if the client is individuals, patients, groups,
unable to fulfill biological, families, and communities.
psychological, developmental, or
social needs.
Imogene King (1971) Environment

Theory of Goal attainment stated Environment (or situation) is

that the nurse is considered part of defined as the internal and external
the patient’s environment and the surroundings that affect the client.
nurse-patient relationship is for It includes all positive or negative
meeting goals towards good conditions that affect the patient,
health. the physical environment, such as
families, friends, and significant
Betty Neuman (1972) others, and the setting for where
In her theory, states that many they go for their healthcare.
needs exist, and each may disrupt Health
client balance or stability. Stress
reduction is the goal of the system Health is defined as the degree of
model of nursing practice. wellness or well-being that the
client experiences. It may have
Sr. Callista Roy (1979) different meanings for each
Viewed the individual as a set of patient, the clinical setting, and the
interrelated systems that maintain health care provider.
the balance between these various Nursing
stimuli.
Jean Watson (1979)
Developed the philosophy of
caring, highlighted humanistic
aspects of nursing as they
intertwine with scientific knowledge
and nursing practice.
 THEORETICAL FOUNDATION OF NURSING
Nursing Theories and Theorists
The nurse’s attributes, Are directly experienced and
characteristics, and actions provide related to a particular time or
care on behalf of or in conjunction place.
with the client. There are numerous
Definitions
definitions of nursing, though
nursing scholars may have Definitions are used to convey the
difficulty agreeing on its exact general meaning of the concepts of
definition. The ultimate goal of the theory. Definitions can be
nursing theories is to improve theoretical or operational.
patient care.
Theoretical Definitions
Define a particular concept based
COMPONENT OF NURSING on the theorist’s perspective.
THEORIES Operational Definitions
Phenomenon States how concepts are
A term given to describe an idea or measured.
response about an event, a Relational Statements
situation, a process, a group of
events, or a group of situations. Relational statements define the
Phenomena may be temporary or relationships between two or more
permanent. Nursing theories focus concepts. They are the chains that
on the phenomena of nursing. link concepts to one another.

Concepts Assumptions

Interrelated concepts define a Assumptions are accepted as

theory. Concepts are used to help truths and are based on values and
describe or label a phenomenon. beliefs. These statements explain
They are words or phrases that the nature of concepts, definitions,
identify, define, and establish purpose, relationships, and
structure and boundaries for ideas structure of a theory.
generated about a particular
phenomenon. Concepts may be
abstract or concrete. CLASSIFICATION OF
Abstract Concepts NURSING THEORIES

Defined as mentally constructed

independently of a specific time or
place.
Concrete Concepts
 THEORETICAL FOUNDATION OF NURSING
Nursing Theories and Theorists
Due to the difficulty of testing
grand theories, nursing scholars
proposed using this level of theory.
Most middle-range theories are
based on a grand theorist’s works,
but they can be conceived from
research, nursing practice, or the
theories of other disciplines.
Practice-Level Nursing Theories
Practice nursing theories are
situation-specific theories that are
narrow in scope and focuses on a
specific patient population at a
Grand Nursing Theories specific time.

Grand theories are abstract, broad Practice-level nursing theories

in scope, and complex, therefore provide frameworks for nursing
requiring further research for interventions and suggest
clarification. outcomes or the effect of nursing
practice.
Grand nursing theories do not
guide specific nursing interventions Theories developed at this level
but rather provide a general have a more direct effect on
framework and nursing ideas. nursing practice than more
abstract theories.
Grand nursing theorists develop
their works based on their own These theories are interrelated with
experiences and their time, concepts from middle-range
explaining why there is so much theories or grand theories.
variation among theories. Classification According to
Address the nursing metaparadigm Alligood
components of person, nursing, In her book, Nursing Theorists and
health, and environment. Their Work, Raile Alligood (2017)
Middle-Range Nursing Theories categorized nursing theories into
four headings: nursing philosophy,
More limited in scope (compared to nursing conceptual models, nursing
grand theories) and present theories and grand theories, and
concepts and propositions at a middle-range nursing theories.
lower level of abstraction. They
address a specific phenomenon in FLORENCE NIGHTINGALE
nursing.
 THEORETICAL FOUNDATION OF NURSING
Nursing Theories and Theorists
Founder of Modern Nursing and
Pioneer of the Environmental
Theory.
“The act of utilizing the
environment of the patient to assist
him in his recovery.”
Stated that nursing “ought to
signify the proper use of fresh air,
light, warmth, cleanliness, quiet,
and the proper selection and
administration of diet – all at the
least expense of vital power to the
patient.”
Identified 5 environmental factors;
fresh air, pure water, efficient
drainage, cleanliness or sanitation,
and light/direct sunlight.
Environmental Theory
Involves the nurse’s initiative to
configure environmental settings a