Manaal Vargas Tamayo BSN October 9, 2022

TOPIC 1 DEFINITION CONCEPTUAL FRAMEWORKS/MODELS

OVERVIEW OF TFN o The definition within the description of a theory conveys o Are representations of an idea or body of knowledge
the general meaning of the concepts in a manner that fits based on the own understanding or perception of a
• By giving nurses a sense of identity, nursing theory can the theory. These definitions also describe the activity person or researcher on a certain topic, phenomena or
help patients, managers and other healthcare necessary to measure theory
professionals to recognize the unique contribution that the constructs, relationships, or variables within a theory. (Chinn
nurses make to the healthcare service (Draper 1990). and Kramer 2004).

THEORY ASSUMPTIONS

ORIGIN: “THOERIA” – speculate THEORY o Are statements that describe concepts or connect two
concepts that are factual. Assumptions are the “taken for
THEORIES are set of interrelated concepts that give a systematic granted” statements that determine the nature of the
view of a phenomenon (an observable fact or event) that is concepts, definitions, purpose, relationships, and
explanatory & predictive in nature. structure of the theory.

PRINCIPLE THEORETICAL MODELS/FRAMEWORK

o A basic generalization that is accepted as true and that o Are highly established set of concepts that are testable.
can be used as a basis for reasoning or conduct.

NURSING THEORY

o A body of knowledge that describes or explains nursing

and is used to support nursing practice.
o An organized and systematic articulation of a set of
statements related to questions in the discipline of
nursing.
CONCEPT

o A mental idea of a phenomenon.

SCIENCE
o A comprehensive idea or generalization.
o An idea that brings diverse elements into a basic o The organized body of knowledge gained through
o relationship. research.
o A unit of knowledge abstracted from a set of
o characteristics attributed to a class of objects, SCIENTIFIC METHOD:
o relations or entities.
1. Observation
o A unit of thought. PHILOSOPHY
2. Data Gathering
o A general idea formed in the mind.
o Something understood or retained in the mind, from o The most basic beliefs, concepts, and attitudes of an 3. Forming Hypothsis
individual or group 4. Expirementation
experience, reasoning, and/or imagination, a
o An analysis of the grounds of and concepts expressing 5. Conclusion
generalization or abstraction of a particular set of fundamental beliefs
instances or occurrences. o Is the next knowledge level after metaparadigm. It
• Examples: person, health, environment, nursing specifies the definition of metaparadigm concepts.
Manaal Vargas Tamayo BSN October 9, 2022

KNOWLEDGE • nursing theory was used primarily to establish the profession’s 2. educated nor 3. employed in public service.
place in the university. Following her service of organizing and caring for the
o Information, skills and expertise acquired by a person • provide a general focus for curriculum wounded in Scutari, during the 4. Crimean War, her
through formal/informal learning. design. vision and establishment of a 5. School of Nursing at St.
• guide curricular decision making Thomas’ Hospital in London marked the birth of modern
PHENOMENON
nursing.
2. Research
o A set of empirical data or experiences that can be • nursing research identifies the philosophical assumptions or
physically observed or tangible such as crying or o Nightingale’s pioneering activities in nursing practice and
theoretical frameworks from which it proceeds.
grimacing when in pain. • offer a framework for generating knowledge and new ideas. subsequent writings describing nursing education
• assist in discovering knowledge gaps in specific field of study. became a guide for establishing nursing schools in the
NURSING • offer a systematic approach to identify questions for study, select United States at the beginning of the twentieth century
variables, interpret findings and validate nursing interventions. (Kalisch & Kalisch, 2003; Nightingale, 1859/1969).
o Nursing encompasses autonomous and collaborative
care of individuals of all ages, families, groups and 3. PRACTICE HISTORICAL DEVELOPMENT
communities, sick or well and in all settings. It includes the • the primary contribution of nursing theory when employed in a
promotion of health, the prevention of illness, and the care clinical setting is the facilitation of reflection, questioning, and o In the early part of nursing’s history, knowledge was
of ill, disabled and dying people. (WHO) thinking about what nurses do. extremely limited and almost entirely task oriented.
• assist nurses to describe, explain, and predict everyday o Role of nurses where questioned; what they do, for
PARADIGM experiences. whom where and when were determined.
• serve to guide assessment, intervention, and evaluation of o The professionalization of nursing has been and is being
o In science and philosophy, a paradigm is a distinct set of nursing care. brought about through the development and use of
concepts or thought patterns, including theories, research • provide a rationale for collecting reliable and valid data about the nursing theory.
methods, postulates, and standards for what constitutes health status of clients, which are essential for effective decision
legitimate contributions to a field. making and implementation. HISTORY OF NURSING

HYPOTHESIS TYPES OF NURSING THEORY o The word nurse is derived from the Anglo-French nurice
and the Latin word nutrica, both of which mean
o Translates a research question into a prediction of Meta-theory - the theory of theory. Identifies specific phenomena NOURISH.
expected outcomes. through abstract concepts. » Florence Nightingale pioneer activities in nursing practice & her
- research question identifies the variables/ Grand theories – broad and complex subsequent writings about nursing served as a guide for
concepts under investigation and asks how the concepts Middle-range theories- address specific phenomena and reflect establishing nursing schools in the US at the beginning of 20th
might be related practice century.
- hypothesis is the predicted answer. Practice theory - explores one particular situation found in » In the last century, nursing began with a strong emphasis on
nursing. It identifies explicit goals and details how these goals will practice.
RESEARCH be achieved. » Throughout that century, nurses work toward the development
Descriptive theories – first level of theory development of the profession in what has been viewed as successive
o Research comprises "creative and systematic work Prescriptive Theories – address nursing interventions and HISTORICAL ERAS.
undertaken to increase the stock of knowledge, including predict their consequences.
knowledge of humans, culture and society, and the use of
this stock of knowledge to devise new applications.
TOPIC 2
o Nightingale’s vision of nursing has been practiced for
PURPOSES OF NURSING THEORY IN RELATION TO: HISTORY OF NURSING THEORY more than a century, and theory development in nursing
(AREAS OF NURSING) has evolved rapidly over the past 5 decades, leading to
o The history of professional nursing began with 1. the recognition of nursing as an academic discipline with
1. Education Florence Nightingale. She envisioned nurses as a body a substantive body of knowledge.
of educated women at a time when women were neither
Manaal Vargas Tamayo BSN October 9, 2022

HISTORICAL ERAS STORICAL MAJOR EMERGING

EMPHASIS OUTCOMES
ERAS QUESTION GOAL
CURRICULUM ERA
•Moving nursing education from hospital-based diploma 6. 7.
programs into college and universities What
RESEARCH ERA curriculum Develop
Curriculum
• Research is the path to new knowledge content Courses specialized
• Part of the curricula of developing graduate programs.
Standardized knowledge
Era: should included in
GRAD EDU ERA curricula and higher
• Masters program in nursing emerged to meet the need for nurses student nursing education
1900 - 1940s
with specialized education in nursing nurses’ programs for diploma
THEORY ERA study to be programs
• Outgrowth of research era nurses?
• Research without theory produced isolated information; however
research and theory produced nursing science 8. 9.
Research Role of Problem Isolated
MID 1800’S & 1960’S Era: 1950 – nurses and studies and studies do
What is the
1970s focus for nursing what to studies of not
MID 1800’S research nurses
research?
o Nursing Knowledge is distinct from medical knowledge
(Nightingale) yield unified
o Nursing as a Vocational heritage more than professional knowledge
10.
vision
What Carving out
MID 1970’S Focus
o Evaluation of 25 years of nursing research revealed that Graduate knowledge an advanced Nurses have
nursing lacked conceptual connections and theoretical Education is needed role and an important graduate
frameworks. Era: 1950 – for the basis for role in health education on
o MILESTONES: 1970s practice of nursing care knowledge
14. The standardization of curricula for nursing master’s education
15. Doctoral education for nurses should be in nursing nursing? practice development
o Transition from vocation to profession 11. How do 12.
o Nursing practice is based on Nursing Science. Nursing
these There are Theories
MID 1980’S frameworks many ways theoretical guide
o Preparadigm period to Paradigm period guide to think nursing
o Introduced an organizational structure for nursing Theory Era: research about works shift research and
knowledge development to the nursing literature and nursing the focus practice
o Utilization phase of the Theory Era – emphasis shifts 1980 - 1990s
practice?
from thedevelopment to the use and application of what
Nursing theory
13.
to the patient Nursing
is known What new Middle-range
guides frameworks
Theory theories are research, theory may produce
Utilization needed to practice, be from knowledge
Era: 21st produce education, and quantitative (evidence) for
administration quality
Century evidence of or qualitative
care
quality care? approaches
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o Profession refers to specialized field of practice, which o Professions are those occupations possessing a
FIRST CONFERENCE NURSING THEORY is founded upon the theoretical structure of the science particular combination of characteristics.
or knowledge of that discipline and the accompanying o Nursing profession is an Occupation based on the
o Brought leading scholars and theorists to discuss practice abilities. specialized intellectual study and training, the purpose of
o which is to supply skilled services with ethical
and debate on issues regarding nursing science and The theoretical works have taken nursing to higher
levels of education and practice as a nurses components.
theory development. (1969)
SIGNIFICANCE OF THEORY FOR NURSING AS A DISCIPLINE
CHANGES OF EDUCATION IN NURSING CRITERIA OF PROFESSION
o University baccalaureate programs proliferated, master’s
1874 – the St. Catherine Training School was the first hospital programs in nursing were developed, and a standardized o Bixler and Bixler Criteria of Profession
diploma school in Canada where the nursing program went curriculum was realized through accreditation. o Abraham Flexner’s criteria for a profession
from an apprenticeship to an educational model. o Attention to the importance of nursing conceptualizations o Kelley’s Criteria
1881 – the school for Nurses at the Toronto General Hospital for the research process and the role of a conceptual
was established. framework in the purpose and design of research BIXLER AND BIXLER CRITERIA FOR PROFESSION
1896 – Mary Agnes Snively developed 3-year course with 84 production of science and nursing theoretical works also
hours of practical nursing and 119 hours of instruction by the began to publish. o Genevieve and Roy Bixler who were against the status of
medical staff. 1918 - following World War 1, the widespread o Works began to be recognize for their theoretical nature, Nursing as a profession 1945, appraised nursing
influenza pandemic led to support forpublic health programs such as Henderson, Nightingale and Orlando, Peplau, according to their original seven criteria as follows:
and new patterns of health care delivery. and Wiedenbach were recognized for the theoretical
1919 – was the year the first undergraduate nursing degree nature of their earlier wings. 1. Utilizes in its practice a well defined and well organized
program was established at the University of British Columbia. body of knowledge, which is on the intellectual level of the
1932 – demanded for transfer of responsibility for nursing SIGNIFICANCE OF THEORY FOR NURSING AS A higher training.
education to general educational system. PROFESSION 2. Constantly enlarges the body of knowledge its uses and
1950’s and 1960’s – experiments with two-year programs for improves and improves its techniques of education and
nursing began and the movement to separate nursing o Clearly nursing is recognized as a profession today service by the use of the scientific method.
education from the authority of hospitals began. having used the criteria for a profession to guide 3. Entrusts the education of its practitioners to institutions of
1967 – Laurentian University started student intake. development\ higher education.
2000 – all professional nurses are required to have a bachelor o Nursing development was the subject of numerous 4. Applies its body of knowledge in practical service, which
at degree studies of numerous studies by sociologists is vital to human beings and social welfare.
5. Functions autonomously in the formulation of professional
THE NURSING THEORY NURSING THEORY AND THE PRACTICING NURSE policy and in control of professional activities thereby.
Theory assists the practicing nurse to: 6. Attracts individuals of intellectual and personal qualities
o Provides a basis of nursing practice. o Organize patient data who exalt service above personal gain and who can
o It is important to nurses because it helps to interpret data, o Understand patient data recognize their chosen profession as lifelong.
make decisions based on relevant information, plan for o Analyze patient data 7. Strives to compensate its practitioners by providing
care, and predict and evaluate outcomes. o Make decisions about nursing interventions freedom of action, opportunity for continuous professional
o It helps to differentiate nursing from other disciplines. o Plan patient care growth and economic security.
o Evaluate patient outcomes
TOPIC 3 ABRAHAM FLEXNER'S CRITERIA FOR A PROFESSION
WHAT IS A PROFESSION?
SIGNIFICANCE OF THEORY FOR NURSING AS A Flexner believed that professional work:
DISCIPLINE & A PROFESSION o A profession is an occupation with ethical components, 1. Is basically intellectual (as opposed to physical) and is
i.e, devoted to the promotion of human and social welfare. accompanied by a high degree of individual responsibility.
o Discipline is specific to academia and a branch of o The services and knowledge by a profession are based 2. Is based on a body of knowledge that can be learned and
education, a department of learning or field of on specialized skills. is refreshed and refined through research.
knowledge.
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3. Is practical in addition to being theoretical. among its members. If not, the individual professionals social principle, mandated support, or extortion (e.g.
4. Can be taught through a highly specialized education. will (e.g. guarantees and/or contractual provisions). union members are not professionals). Therefore, a
professional 3. BASED KNOWLEDGE ON SPECIALIZED, professional is one who must attract clients and profits
5. Has a strong internal organization of members and a well- THEORETICAL due to the merits of his work. In the absence of this
developed group consciousness. o Professionals render specialized services based on characteristic, issues of responsibility, accountability, and
6. Has practitioners who are motivated by altruism( the theory, knowledge, and skills that are most often peculiar ethical constraints become irrelevant, negating any
desire to help others) and who are responsive to human to their profession and generally beyond the otherwise-professional characteristics.
interests. understanding and/or capability of those outside of the 10. CAPITALIST MORALITY
profession. Sometimes, this specialization will extend to o The responsibilities inherent to the practice of a
KELLEY'S CRITERIA access to the tools and technologies used in the profession are impossible to rationally maintain without a
profession (e g. medical equipment) moral foundation that flows from a recognition of the
Kelley(1981) reiterated and expanded Flexner's criteria in her 4. INSTITUTIONAL PREPARATION singular right of the individual to his own life, along with all
1981 listing of characteristics of a profession. o Professions typically require a period of hands-on, of its inherent and potential sovereign value; a concept
1. The services provided are vital to humanity and the practical experience in the protected company of senior that only capitalism recognizes, upholds and protects.
welfare of the society members before aspirants are recognized as
2. There is a special body of knowledge that is continually professionals. After this provisional period, ongoing TOPIC 1 REVIEW
enlarged through research. education toward professional development is
3. The services involve intellectual activities; individual compulsory. A profession may or may not require formal THEORY - A well-substantiated explanation of some aspect of
responsibility (accountability) is a strong feature. credentials and/or other standards for admission. the natural world; an organized system of accepted knowledge
4. Practitioners are educated in institutions of higher 5. AUTONOMY that applies in a variety of situations/hypotheses
learning o Professionals have control over and, correspondingly, CONCEPT- An idea that brings diverse elements into a basic
5. Practitioners are relatively independent and control their ultimate responsibility for their own work. Professionals relationship or Something understood or retained in the mind,
own policies and activities (autonomy). tend to define the terms, processes, and conditions of from experience, reasoning, and/or imagination; a generalization
6. Practitioners are motivated by service (altruism) and work to be performed for clients (either directly or as or abstraction of a particular set of instances or occurrences.
consider their work as an important component of their preconditions for their ongoing agency employment). PRINCIPLE- A basic generalization that is accepted as true and
lives.
that can be used as a basis for reasoning or conduct
7. There is a code of ethics to guide the decisions and 6. CLIENTS RATHER THAN CUSTOMERS.
conduct of practitioners. o Members of a profession exercise discrimination in PHILOSOPHY- The most basic beliefs, concepts, and attitudes
8. There is an organization (association) that encourages choosing clients rather than simply accepting any of an individual or group
and support high standards of practice interested party as a customer (as merchants do). CONCEPTUAL FRAMEWORK/MODEL- identify concepts and
7. DIRECT WORKING RELATIONSHIPS describe their relationships to the phenomena of central concern
CHARACTERISTICS OF PROFESSIONS o Professionals habitually work directly with their clients to the discipline: person, environment, health and nursing
rather than through intermediaries or proxies. THEORETICAL FRAMEWORKS/MODELS- Are highly
1. GREAT RESPONSIBILITY 8. ETHICAL CONSTRAINTS. established set of concepts that are testable.
o Professionals deal in matters of vital importance to their o Due to the other characteristics on this list, there is a clear KNOWLEDGDE- Information, skills and expertise acquired by a
clients and are therefore with grave responsibilities. And requirement for ethical constraints in the professions. person through formal/informal learning.
entrusted obligations. Professionals are bound to a code of conduct or ethics PHENOMENON- Experiences that can be physically observed or
o Given these inherent obligations, professional work specific to the distinct profession (and sometimes the tangible such as crying or grimacing when in pain. Or A set of
typically involves circumstances where carelessness, individual). Professionals also aspire toward a general empirical data or experiences that can be physically observed or
inadequate skill, or breach of ethics would be significantly body of core values, which are centered upon an tangible such as crying or grimacing when in pain.
damaging to the client and/or his fortunes. uncompromising and unconflicted regard for the client's HYPOTHESIS- Predicted answer
2. ACCOUNTABILITY benefit and best interests. PHENOMENON- Help to describe or label phenomena
o Professionals hold themselves ultimately accountable for 9. MERIT-BASED EDUCATION- Nursing theory was used primarily to establish the
the quality of their work with the client. o In a profession, members achieve employment and profession’s place in the university.
o The profession may or may not have mechanisms in success based on merit and corresponding voluntary CHARACTERISTICS OF A THEORY:
place to reinforce and ensure adherence to this principle relationships rather than on corrupted ideals such as
Manaal Vargas Tamayo BSN October 9, 2022

a. Interrelating concepts in such a way as to create a THEORY ERA- Outgrowth of research era & During this era, ETHICAL CONSTRAINTS- Due to the other characteristics
different way of looking at a particular phenomenon research without theory produced isolated information; however, on this list, there is a clear requirement for ethical
b. Logical in nature research and theory produced nursing science. constraints in the professions.
c. Generalizable RESEARC ERA- Part of the curricula of developing graduate MERIT-BASED- In a profession, members achieve
d. Basis for hypothesis that can be tested programs occurred
employment and success based on merit and
e. Increasing the general body of knowledge within the GRADUATE EDUCATION ERA- Master’s program in nursing
discipline through the research implemented to validate emerged during this era to meet the need for nurses with corresponding voluntary relationships rather than on
them specialized education in nursing. & Nursing Theory and Nursing corrupted ideals such as social principle, mandated support,
f. Used by practitioners to guide and improve their practice Conceptual models were included as courses in the study of or extortion (e.g. union members are not professionals).
g. Consistent with other validated theories, laws, and nursing in which of the following era CAPITALIST MORALITY- The responsibilities inherent to
principles but will leave open unanswered questions that MID 1800’s- year was nursing practices based on principles and the practice of a profession are impossible to rationally
need to be investigated traditions passed on through apprenticeship education and maintain without a moral foundation that flows from a
TYPES OF NURSING THEORY common-sense wisdom recognition of the singular right of the individual to his own
a. Meta-Theory 1969- The First Conference in Nursing Theory which brought life, along with all of its inherent and potential sovereign
b. Grand Nursing Theory leading scholars and theorists to discuss and debate on issues value; a concept that only capitalism recognizes, upholds
c. Mid-Range Nursing Theories regarding nursing science and theory development
and protects
d. Nursing Practice Theories
COMPONENTS OF NURSING THEORY TOPIC 3 REVIEW
a. Concept TOPIC 4
b. Assumption GREAT RESPONSIBILTY- Professionals deal in matters of
c. Definition HISTORY AND PHILOSOPHY OF SCIENCE
vital importance to their clients and are therefore entrusted
d. Proposition “Philosophy in its broadest sense is wondering and being curious
with grave responsibilities and obligations
NURSING METAPARADIGM CONCEPTS about the “big” or fundamental questions that humans have
a. Person ACCOUNTABILTY- Professionals hold themselves
ultimately accountable for the quality of their work with the grappled with throughout the history. Questions about “what is
b. Nursing real?” (ontology), “what is knowable? (epistemology), “is this
c. Environment client .
just?” (ethics), and “is there an art to caring?” (aesthetics) are
d. Health BASED ON SPECIALIZED THEORETICAL
considered indispensable reflections in nursing Practice.”
KNOWLEDGE- Professionals render specialized -BRUCE, RIETZE KIM 2014
NURSING- The attributes, characteristics, and actions provide services based on theory, knowledge, and skills that are
care on behalf of or in conjunction with the client most often peculiar to their profession and generally beyond NURSING AS A SCIENCE
PERSON- the recipient of nursing care and may include the understanding and/or capability of those outside of the
individuals, patients, groups, families, and communities profession 1. Science is logical, systematic, & coherent way to solve
HEALTH- defined as the degree of wellness or well- being that problems and answer questions.
INSTITUTIONAL PREPARATION- Professions typically
the client experiences 2. It is a collection of facts known in area and the process
ENVIRONMENT- defined as the internal and external require a significant period of hands-on, practical
experience in the protected company of senior members used to obtain that knowledge.
surroundings that affect the client. It includes all positive or
negative conditions that affect the patient, the physical before aspirants are recognized as professionals.
NURSING AND PHILOSOPHY
environment, such as families, friends, and significant others, AUTONOMY- Professionals have control over and,
and the setting for where they go for their healthcare correspondingly, ultimate responsibility for their own work. o Philosophy studies concepts that structure thought
CLIENTS RATHER THAN CUSTOMERS- Members of a processes, foundations, and presumptions.
TOPIC 2 REVIEW profession exercise discrimination in choosing clients rather o It is an approach for thinking about the nature of people,
than simply accepting any interested party as a customer the methods that should be used to create a scientific
CURRICULUM ERA- Moving nursing education from hospital-
(as merchants do). knowledge and the ethics involved. It denotes a
based diploma programs into college and universities. transpired
DIRECT WORKING RELATIONSHIPS- Professionals perspective, implying a certain broad, “taken for granted”
during this era.
habitually work directly with their clients rather than assumptions
through intermediaries or proxies.
Manaal Vargas Tamayo BSN October 9, 2022

EPISTEMOLOGY • Brown argues that the new epistemology challenged the o Education and Administration
empiricist view of perception by acknowledging that theories play o Research
o a branch of philosophy that is concerned with the nature a significant role in determining what the scientist will observe and o Development of Nursing Theory
and scope of knowledge. It is referred to as the “theory how it will be interpreted. o
of knowledge” ▪ Peplau developed the first theory of nursing practice in
He identified 3 different views of the relationship her book, Interpersonal Relations in Nursing (1952)
HISTORICAL VIEWS OF THE NATURE OF SCIENCE between theories and observation: ▪ Journal of Nursing Research (1952)
o Scientists are merely passive observers of occurrences ▪ 1960s and 1970s – analysis and debate on the
01 RATIONALISM in the empirical world. Observable data are objective metatheoretical issues related to theory development
It is the use of the rational senses in ensuring the truthfulness of truth waiting to be discovered.
a phenomenon o Theories structure what the scientists perceived in the ➢ Postpositivism focuses on discovering the patterns that
02 EMPIRICISM empirical world. may describe a phenomena.
It is the way of looking at reality using the five general senses of o Presupposed theories and observable data interact in ➢ Interpretive paradigm tends to promote understanding
sight, touch, hearing, taste, and smell. the process of scientific investigation by addressing the meanings the participants social
interaction that emphasize situation, context and multiple
INTERPENDENCE BETWWEN THEORY & RESEARCH cognitive constructions that individuals create on
everyday events.
o A theory should be judged based on the basis of scientific ➢ Critical paradigm for knowledge development in nursing ,
o consensus. provides framework for inquiring about the interaction
o The acceptance of scientific hypothesis through research between the social, political, economic, gender and
depends on the appraisal of the coherence of theory cultural factors and experiences of health and illness.
o Dubin identified when scientific consensus is necessary:
1. on the boundaries of the theory; the phenomenon it “Philosophy of science without history of science is empty;
addresses and what it excludes history of science without philosophy of science is blind -
2. on the logic used in constructing the theory to further Imre Lakatos
understanding from a similar perspective
3. that the theory fits the data collected and analyzed though
research TOPIC 4 REVIEW

ISSUES IN NURSING PHILIOSOPHY & SCIENCE EMPIRICISM- It is the way of looking reality using the five general
TH DEVELOPMENT senses of sight, touch, hearing, taste and smell.
EARLY 12 CENTURY VIEWS OF SCIENCE & THEORY
RATIONALISM- It is the use of the rational senses id ensuring the
Four fundamental patterns of knowledge in Nursing (Carper, truthfulness of a phenomenon
Philosophers focused on the analysis of theory structure whereas,
1978) AESTHETICS- Questions about is there an art to caring
o Scientists focused on empirical research
o Empirical knowledge ETHICS- Questions about ‘it is just?”
o Positivism (imposed on the mind by experience) is the
o Esthetic knowledge EPISTEMOLOGY- Questions about what us knowable?
philosophy of science that information is derived from
o Moral knowledge POSTPOSIVITISM- Focuses on discovering the patterns that may
logical and mathematical treatments and reports of
o Personal knowledge describe a phenomena
sensory experience is the exclusive source of all
ANTOLOGY- Questions about ‘what is real?”
authoritative knowledge
▪ 1980s - Further acceptance of nursing theory and its
TH incorporation in the nursing curricula; publication of RATIONALISM- To reason that a lack of social support (cause)
EMERGENT VIEWS IN THE LATE 20 CENTURY OF
several nursing journals results in hospital readmission (effect). This causal reasoning is a
SCIENCE & THEORY
▪ 1990s - Nursing as a basic science, an applied science, theoretical assertion until tested and disproven. The traditional
or a practical science approach proceeds by explaining hospitalization with a systematic
• Empiricists argue that for science to maintain its
objectivity, data collection and analysis must be ▪ Progress in the Discipline of Nursing (Meleis) explanation (theory) of a given phenomeno.
independent of a theory. o Practice
Manaal Vargas Tamayo BSN October 9, 2022

- Formulating differential diagnoses. Requires collecting o The concepts and propositions of a metaparadigm 5. THEORY- A work classified as nursing theory is developed
the facts and then devising a list of possible theories to are admittedly extremely abstract and provide no from some conceptual framework or grand theory and is
explain the facts definitive direction for such activities as research and generally not as specific as a middle-range theory.
THEORY- Inductive Method practice. Rather, the function of a metaparadigm is to - Maybe specific to a particular aspect or setting of nursing
ETHICAL KNOWING- The science of nursing identify the basic subject matter of the discipline practice
- Guides and directs how nurses conduct their practice 6. MIDDLE RANGE THEORY- Has the most specific focus and
AESTHETIC KNOWING- A pattern of knowing that draws on is concrete in its level of abstraction.
traditional ideas of science - They address the specifics of nursing situations within the
PERSONAL KNOWINNG- Used when nurses engage in the perspective of the model, grand theory, or theory from
therapeutic use of self in practice which they originate
- . Concerned with becoming self-aware
ETHICAL KNOWING- Brings together all the elements of a o The specifics in this theories are:
nursing care situation to create a meaningful whole ➢ Age group of the patient
1980- Acceptance of nursing theory and its incorporation in the ➢ Family situation
nursing curricula ➢ Patient’s health condition
1990- Nursing as a basic science, an applied science, or a ➢ Location of the patient
practical science ➢ Action of the nurse
INTERPRETATIVE PARADIGM- Promote understanding by
addressing the meanings the participants social interaction that “The art of nursing is the creative use of the science of
emphasize situation, context and multiple cognitive constructions nursing for human betterment.” —Rogers, 1990, p.5
that individuals create on everyday events. 2. PHILOSOPHY an abstract type that sets forth the meaning
CRITICAL PARADIGM- Provides framework for inquiring about of nursing phenomena through analysis, reasoning, and TOPIC 5 REVIEW
the interaction between the social, political, economic, gender and logical presentation.
cultural factors and experiences of health and illness CONCEPTUAL MODELS- Are a set of concepts that
POSTPOSITIVISM- Focuses on discovering the patterns that may o Contribute to nursing knowledge with direction for the address phenomena central to nursing in propositions that
describe a phenomenon. discipline, forming a basis for professional
explain relationships among them
1952- Journal of Nursing Research scholarship that leads to new theoretical
understanding. THEORY- Maybe specific to a particular aspect or setting of
TOPIC 5 o Represents early works predating the theory era and nursing practice.
contemporary works of a philosophical nature. GRAND-THEORY- Has the most specific focuses id
STRUCTURE OF NURSING KNOWLEDGE o Are works that provide broad understandings that concrete in its level of abstraction
advance the discipline of nursing and its professional METAPARADIGM- The global concepts that identify the
OVERVIEW applications.
o Example: Nightingale’s philosophy phenomena of central interest to a discipline
1. Development of the body of specialized knowledge
required for nursing to be recognized as a profession was PHILOSOPHY- Have the capacity to threaten the solvency
a driving force in the 20th century. 3. CONCEPTUAL MODELS Are a set of concepts that of the conceptual model from which they are derived
2. Because of the importance of nurses to the nation’s address phenomena central to nursing in propositions that MIDDLE-RANGE- Has the most specific focus and is
health, studies of nursing were legislated early in the explain relationships among them concrete in its level of abstraction
century and conducted by sociologists who
recommended that nursing be developed as a profession 4. GRAND THEORY- These theories have the capacity to
threaten the solvency of the conceptual model from which
STRUCTURE LEVEL they are derived, because they test the major premise of the
conceptual model
1. METAPARADIGM a set of concepts and propositions that
sets forth the phenomena with which a discipline is
concerned.
Manaal Vargas Tamayo BSN October 9, 2022

TOPIC 5 NURSING PHILOSOPHIES because of her night rounds. Immortalized in the poem VARIETY (13 CANONS)
“Santa Filomena” by Henry Wadsworth Longfellow. After
NURSING THEORISTS AND THEIR WORKS the Crimean war, she established a nursing school at St.
Thomas’ Hospital and King’s College in London in 1860.
➢ Nursing philosophy sets forth the meaning of nursing
phenomena through analysis, reasoning, and logical INFLUENCES
argument.
➢ Philosophies contributed to nursing knowledge by o Education provided by her Father.
providing direction for the discipline, forming a basis o Family’s aristocratic social status
for professional scholarship and leading to new o Exposure to political process of the Victorian England
theoretical understandings. o The Industrial Age
➢ Nursing philosophies represent early works o Charles Dickens’ social commentaries and novels
predating the theory era, as well as contemporary o Dialogues with many political leaders
works of a philosophical nature. o Unitarian religious affiliation
➢ Philosophies are works that provide broad
understanding that advances the discipline and its ENVIRONMENTAL THEORY BY FLORENCE
professional application. NIGHTINGALE
VENTILATION & WARMTH
NURSING PHILOSOPHIES ➢ Stated that nursing “ought to signify the proper use of
➢ Keep the air he breathes as pure as the external air, without
fresh air, light, warmth, cleanliness, quiet, and the
chilling him”.
1. ENVIRONMENTAL THEORY Florence Nightingale proper selection and administration of diet – all at the o Keeping patient’s room well ventilated and free of odors.
2. THEORY OF HUMAN CARING Jean Watson least expense of vital power to the patient.” o Keep the air within as pure as the air external air/without
3. STAGES OF NURSING EXPERTISE Patricia noxious smells.
Benner o Keeping patient, patient’s room warm
4. CARITATIVE CARING THEORY Katie Erickson o Provided description for measuring the patient's body
temperature through palpation of extremities.
o Nurses were instructed to manipulate the environment to
NIGHTINGALE’S ENVIRONMENTAL THEORY
maintain both ventilation and patient warm by good fire,
opening windows and properly positioning the patient in
o Nursing “is an act of utilizing the environment of the the room.
patient to assist him in his recovery” TYPES OF ENVIRONMENT
HEALTH OF HOUSES
BIOGRAPHY PHYSICAL Where the patient is being treated.
PSYCHOLOGICAL Affected by a negative physical environment "Badly constructed houses do for the healthy what badly
o First Nursing theorists and the Mother of Modern Nursing which then causes constructed hospitals do for the sick."
o Born in May 12, 1820 in Florence, Italy to a wealthy British STRESS. SOCIAL Person’s home or hospital room o This canon includes five essentials of: Pure air, Pure
Family. water, Efficient drainage, Cleanliness, Light
o In 1853, she accepted the position of superintendent at o Examples include removing garbage or standing water;
the institute of the Care of Sick Gentlewomen in Upper ensuring clean air and water and free from odor and that
Harley Street, London there is plenty of light.

➢ She tended to wounded soldiers during the Crimean PETTY MANAGEMENT

War. She became known as the “Lady with the Lamp” o Continuity of the care, when the nurse is absent
Manaal Vargas Tamayo BSN October 9, 2022

o Documentation of the plan of care and all evaluation will o The appropriate handling and disposal of bodily CONCEPTUAL FRAMEWORK
ensure others give the same care to the client in your excretions and sewage was required to prevent
absence. contamination of the environment.

NOISE LIGHT

o Avoidance of sudden/startling noises. "Light has quite as real and tangible effects upon the human
o Keeping noise in general to a minimum. body...who has not observed the purifying effect of light, and
o Refrain from whispering outside the door. especially of direct sunlight, upon the air of the room ?"
o Assess the room for adequate light.
VARIETY o Sunlight works best.
o Develop and implement adequate light without placing the
o Provide variety in the patient’s room to help him/her avoid client in direct light.
boredom and depression.
o This is accomplished by cards, flowers, pictures, books or PERSONAL CLEANLINESS
puzzles (presently known as diversional therapy)
o Encourage significant others to engage with the client. o Bathing of patients on a frequent, even daily, basis. FOUR MAJOR CONCEPTS ENVIRONMENTAL THEORY
o Nurses should wash their hands regularly.
FOOD INTAKE o Keeping the patient clean and dry at all times PERSON
o Frequent assessment of client’s skin is needed to o Patient who is acted on by nurse
o Assess the diet of the client. maintain adequate moisture. o Emphasized that the Nurse has in control of the patient’s
o Documentation of amount of foods and liquids ingested at environment.
CLEANLINESS OF ROOMS
every meal o Affected by environment
o Assess the room for dampness, darkness and dust or o Passive yet has reparative powers
FOOD & NUTRITION mildew.
NURSING
o Keeping the environment clean (free from dust, dirt,
o Nightingale addressed the variety of food presented to the mildew and dampness) o Nursing "ought to signify the proper use of fresh air, light,
patients and discussed the importance of variety in the warmth, cleanliness, quiet, and the proper selection and
food presented. CHATTERING HOPE & ADVICES administration of diet — all at the least expense of vital
o Instructions include trying to include patient’s food power to the patient."
preferences. o Avoidance of talking without reason or giving advice that o She wrote her Notes on Nursing to provide women how
o Attempt to ensure that the client always has some food or is without fact. to "Think like a Nurse."
drink available that he/she enjoys. o Continue to talk to the client as a person and to stimulate
the client’s mind ENVIRONMENT
BED & BEDDINGS o She believed that sick persons should hear good news o Foundation of theory
that would assist them in becoming healthier o Included everything, physical, psychological and social
o Comfort measures related to keeping the bed dry, o Nurses are instruments to change the social status of the
wrinklefree and at the lowest height to ensure the client’s OBSERVATION OF THE SICK poor by improving their living conditions
comfort.
o Making and documenting observations. HEALTH
o Noted that a dirty environment (floors, carpets, walls and
bed linens) was a source of infection through the organic o Continue to observe the client’s surrounding environment. o balance between human and his/her environment
matter it contained. o being well and using every power (resource) to the fullest
extent in living life Ø
Manaal Vargas Tamayo BSN October 9, 2022

o disease and illness – reparative process that nature Human Caring Science: A Theory of Nursing is the title of 3. The cultivation of sensitivity to one’s self and to
instituted when a person did not attend to health Jean Watson's latest work, it was renamed to convey a deeper others.
human to human involvement and connection. 4. The development of helping- trust relationship.
concerns
5. The promotion and acceptance of the expression of
o health maintenance through prevention of disease via EXPLICIT ASSUMPTIONS positive and negative feelings.
environmental control and social responsibility 6. The systematic use of the scientific problem-solution
o An ontologic assumption of oneness, wholeness, unity, method for decision making.
IMPORTANCR OF ENVIRONMENTAL THEORY relatedness and connectedness 7. The promotion of interpersonal teaching-learning.
o An epistemologic assumption that there are multiple ways 8. The provision for a supportive, protective and/or
NURSING PRACTICE of knowing corrective mental, physical, socio-cultural and
1. Disease control o Diversity of knowing assumes all, and various forms of spiritual environment.
2. Sanitation and water treatment evidence can be included 9. Assistance with the gratification of human need.
3. Utilized modern architecture in o A caring science model makes these diverse perspectives 10. The allowance for existential- phenomenological
1. the prevention of "sick building explicitly and directly. forces
2. syndrome" applying the o Moral-metaphysical integration with science evokes spirit;
3. principles of ventilation and this orientation is not only possible but also necessary for
4. good lighting. our science, humanity, society-civilization, and world-
5. Waste disposal planet.
6. Control of room temperature. o A caring science emergence, founded on new
7. Noise management assumptions, makes explicit an expanding unitary,
energetic worldview with a relational human caring ethic
NURSING EDUCATION and ontology as its starting point.
1. Principles of nursing training. Better practice result from
better education.
2. Skills measurement through licensing by the use of
testing methods, the case studies

NURSING RESEARCH
1. Use of graphical representations like the bar, diagrams.
2. Notes on nursing THE INSTILLATION OF FAITH-HOPE

JEAN WATSON’S HUMAN CARING THEORY o “Being authentically present and enabling and sustaining
o Born in West Virginia, currently living in Colorado. the deep belief system and subjective lifeworld of self
o She earned a B.Sc. in 1964, MS in Psychiatric Nursing in and one being cared for.”
1966 and PhD in Educational Psychology and Counseling
in 1973. CULTIVATION OF SENSTIVITYTO ONE’S SELF AND OTHERS
o Founder of the Center for Human Caring in Colorado.
o Striving to become sensitive, makes the nurse more
CARATIVE FACTORS
➢ Watson’s defined human caring in nursing as “an act and authentic, which encourages self-growth and self
a science in which caring is a human to human process actualization, in both the nurse and those with whom the
1. Formation of a humanistic- altruistic system of
demonstrated through a therapeutic interpersonal nurse interacts.
values.
interactions. 2. The installation of faith-hope. ESTABLISHING A HELPING-TRUST RELATIONSHIP
Manaal Vargas Tamayo BSN October 9, 2022

She has defined the characteristics needed to develop the helping o She adopts a view of the human being as “a valued
trust relationship. They are congruence, empathy and warmth. person in and of him or herself to be cared for, respected,
nurtured, understood and assisted; in general a
THE EXPRESSION OF FEELINGS, BOTH POSITIVE & philosophical view of a person as a fully functional
NEGATIVE integrated self.

o “Being present to, and supportive of, the expression of HEALTH

positive and negative feelings as a connection with
deeper spirit and self and the one-beingcared for o Health is the unity and harmony within the mind, body,
and soul; health is associated with the degree of
THE SYSTEMATIC USE OF SCIENTIFIC PROBLEM- congruence between the self and the self as experienced.
SOLVING METHOD FOR DECISION MAKING It is defined as a high level of overall physical, mental, and
social functioning; a general adaptivemaintenance level
o “Creative use of self and all ways of knowing as part of ALLOWANCE FOR EXISTENTIAL PHENOMENOLOGICAL of daily functioning; and the absence of illness, or the
the caring process; to engage in the artistry of caring- FORCES presence of efforts leading to the absence of illness
healing practices.
o “Opening and attending to spiritual-mysterious and ENVIRONMENT/SOCIETY
PROMOTION OF INTERPERSONAL TEACHING-LEARNING existential dimensions of one’s own life-death; soul care
for self and the one-being-cared for” o According to Watson caring (and nursing) has existed in
every society. A caring attitude is not transmitted from
o “Engaging in genuine teaching-learning experience that
TRANSPERSONAL CARING RELATIONSHIP generation to generation. It is transmitted by the culture of
attends to the unity of being and meaning, attempting to
the profession as a unique way of coping with its
stay within others’ frame of reference.”
o Transpersonal describes an intersubjective, human to environment
PROVISION FOR A SUPPORTIVE, PROTECTIVE AND/OR human relationship that encompasses two individuals,
CORRECTIVE MENTAL, PHYSICAL, SOCIO-CULTURAL & both the nurse and the patient in a given moment. NURSING
SPIRITUAL ENVIRONMENT o Describes how the nurse goes beyond the objective
assessment to show concern toward the person’s o According to Watson “nursing is concerned with
o “Creating healing environment at all levels (physical as subjective/deeper meaning of their healthcare situation. promoting health, preventing illness, caring for the sick
well as the nonphysical, subtle environment of energy o Involves mutuality between the two individuals involved and restoring health”.
o It focuses on health promotion and treatment of disease.
and consciousness, whereby wholeness, beauty,
CARING OCCASION/MOMENT She believes that holistic health care is central to the
comfort, dignity, and peace are potentiated)”
practice of caring in nursing
o A caring occasion is the moment when the nurse and
another person come together in such a way that an HOW TO INTEGRATE JEAN WATSON’S THEORY OF CARING
occasion for human caring is created. INTO NURSING PRACTICE
o Both persons come together in a human-human
transaction. o Establishing a caring relationship with patients.
o The one caring for and the one being cared for are o Treat patients as holistic beings.
influenced by the choices and actions decided within the o Display unconditional acceptance.
relationship o Treat patients with positive regard.
o Promote health through knowledge and intervention.
FOUR MAJOR CONCEPTS (HUMAN CARING THEORY) o Spend uninterrupted time with patient.

PERSON
Manaal Vargas Tamayo BSN October 9, 2022

o Her research was aimed at discovering if there were o Nurses functioning at this level are guided by rules and
PATRICIA BENNER’S (STAGE OF NURSING EXPERTISE) distinguishable, characteristic differences in the novice’s oriented by task completion.
NOVICE-EXPERT MODEL and expert’s descriptions of the same clinical incident. o Still requires mentor or experienced nurse to assist with
defining situations, to set priorities, and to integrate
BIOGRAPHY SIX AREAS OF PRACTICAL KNOWLEDGE practical knowledge

o Patricia Benner was born in Hampton, Virginia and spent o Graded qualitative distinctions COMPETENT
her childhood in California, where she received her early o Common meanings o After two to three years in the same area of nursing the
and professional education. Majoring in nursing, she o Assumptions, expectations and sets nurse moves into the Competent Stage of skill acquisition.
obtained a Bachelor of Arts degree from Pasadena, o Paradigm cases and personal knowledge o The competent stage is the most pivotal in clinical
College. In 1970, she earned a master's degree in o Maxims learning because the learner must begin to recognize
nursing, with her major emphasis in medical-surgical o Unplanned practices patterns and determine which elements of the situation
nursing from the University of California, San Francisco warrant attention and which can be ignored.
School of Nursing. She worked as a research assistant to SEVEN DOMAINS OF NURSING PRACTICE o The competent nurse devises new rules and reasoning
Richard Lazarus at the University of California, Berkeley, procedures for a plan while applying learned rules for
while working on her Ph.D. in stress, coping, and health, o Helping role action on the basis of the relevant facts of that situation.
which was conferred in 1982 o The teaching-coaching function
o Diagnostic client-monitoring function PROFICIENT
o Effective management of rapidly changing situations o After three to five years in the same area of nursing the
Administering and monitoring therapeutic interventions nurse moves into the Proficient Stage “The nurse
and regimens possesses a deep understanding of situations as they
o Monitoring and ensuring quality of health care practices occur, less conscious planning is necessary, critical
Organizational and work-role competencies thinking and decision-making skills have developed”
o The performer perceives the information as a whole (total
5 STAGES OF ACQUIRING EXPERTISE picture) rather than in terms of aspects and performance.
o Proficient level is a qualitative leap beyond the competent.
NOVICE o Nurses at this level demonstrate a new ability to see
o The person has no background experience of the changing relevance in a situation including the recognition
situation in which he or she is involved. and the implementation of skilled responses to the
o These inexperienced nurses function at the level of situation as is it evolves.
instruction from nursing school. They are unable to make
SKILL ACQUISITION the leap from the classroom lecture to individual patients. EXPERT
Often, they apply rules learned in nursing school to all o This stage occurs after five years or greater in the same
➢ “The utility of the concept of skill acquisition lies in helping patients and are unable to discern individual patient area of nursing (experienced nurses changing areas of
the teacher understand how to assist the learner in needs. These nurses are usually new graduates, or those nursing practice may progress more quickly through the
advancing to the next level” (McClure, 2005) nurses who return to the workplace after a long absence five stages)
o Dr. Benner categorized nursing into 5 levels of and are re-educated in refresher programs. o The expert performer no longer relies on an analytic
capabilities: novice, advanced beginner, competent, principle (rule, guideline, maxim) to connect her or his
proficient, and expert. ADVANCED BEGINNER understanding of the situation to an appropriate action.
o She believed experience in the clinical setting is key to o Develops when the person can demonstrate marginally o The expert nurse, with an enormous background of
nursing because it allows a nurse to continuously expand acceptable performance having coped with enough real experience, now has an intuitive grasp of each situation
their knowledge base and to provide holistic, competent situations to note, or to have pointed out by mentor, the and zeroes in on the accurate region of the problem
care to the patient. recurring meaningful components of the situation. without wasteful consideration of a large range of
Manaal Vargas Tamayo BSN October 9, 2022

unfruitful, alternative diagnoses and solutions. The expert KATIE ERIKSSON’S (CARITATIVE CARING THEORY) reality. Caring gets its distinctive character through caring
operates from a deep understanding of the total situation communion (Eriksson, 1990). It is a form of intimate
BIOGRAPHY connection that characterizes caring. Caring communion
requires meeting in time and space, an absolute, lasting
FOUR MAJOR CONCEPTS (STAGES OF NURSING o Eriksson was born on November 18, 1943, in Jakobstad, presence (Eriksson, 1992c). Caring communion is
EXPERTIESE) Finland. She belongs to the Finland-Swedish minority in characterized by intensity and vitality, and by warmth,
Finland, and her native language is Swedish. She is a closeness, rest, respect, honesty, and tolerance. It cannot
PERSON 1965 graduate of the Helsinki Swedish School of Nursing, be taken for granted but pre-supposes a conscious effort
and in 1967, she completed her public health nursing to be with the other. Caring communion is seen as the
o “The person is a selfinterpreting being, that is the person specialty education at the same institution. She graduated source of strength and meaning in caring.
does not come into the world predefined but gets defined in 1970 from the nursing teacher education program at
in the course of living a life.” - Dr. Benner Helsinki Finnish School of Nursing. She continued her THE ACT OF CARING
academic studies at University of Helsinki, where she o The act of caring contains the caring elements (faith,
HEALTH received her MA degree in philosophy in 1974 and her hope, love, tending, playing, and learning), involves the
licentiate degree in 1976; she defended her doctoral categories of infinity and eternity, and invites to deep
o Dr. Benner focuses on the lived experience of being dissertation in pedagogy communion. The act of caring is the art of making
healthy and being ill. something very special out of something less special.
o Health is defined as what can be assessed, whereas well CARITATIVE CARING THEORY
being is the human experience of health or wholeness. CARITATIVE CARING ETHICS
o Well being and being ill are understood as distinct ways o The Theory of Caritative Caring was developed by Katie o Caritative caring ethics comprises the ethics of caring, the
of being in the world Eriksson. This model of nursing distinguishes between core of which is determined by the caritas motive.
caring ethics, the practical relationship between the Eriksson makes a distinction between caring ethics and
ENVIRONMENT patient and the nurse, and nursing ethics. Nursing ethics nursing ethics. She also defines the foundations of ethics
are the ethical principles that guide a nurse’s decision- in care and its essential substance. Caring ethics deals
o Benner uses situation rather than environment because making abilities. Caritative caring consists of love and with the basic relation between the patient and the
situation conveys a social environment with social charity, which is also known as caritas, and respect and nurse—the way in which the nurse meets the patient in an
definition . reverence for human holiness and dignity. According to ethical sense. It is about the approach we have toward the
o “To be situated implies that one has a past, present, and the theory, suffering that occurs as a result of a lack of patient.
future and that all of these aspects… influence the current caritative care is a violation of human dignity.
situation.” - Dr. Benner DIGNITY
MAJOR CONCEPTS o Dignity constitutes one of the basic concepts of caritative
NURSING caring ethics. Human dignity is partly absolute dignity,
CARITAS partly relative dignity. Absolute dignity is granted the
o Nursing is described as a caring relationship, an “enabling o Caritas means love and charity. In caritas, eros and human being through creation, while relative dignity is
condition of connection and concern.” -Dr. Benner agapé are united, and caritas is by nature unconditional influenced and formed through culture and external
o “Caring is primary because caring sets up the possibility love. Caritas, which is the fundamental motive of caring contexts. A human being’s absolute dignity involves the
of giving and receiving help.” science, also constitutes the motive for all caring. It right to be confirmed as a unique human being
o Nursing is viewed as a caring practice whose science is means that caring is an endeavor to mediate faith, hope,
guided by the moral art and ethics of care and and love through tending, playing, and learning. INVITATION
responsibility. o Invitation refers to the act that occurs when the career
o Dr. Benner understands that nursing practice as the care CARING COMMUNION welcomes the patient to the caring communion. The
and study of the lived experience of health, illness, and o Caring communion constitutes the context of the meaning concept of invitation finds room for a place where the
disease and the relationships among the three elements. of caring and is the structure that determines caring human being is allowed to rest, a place that breathes
Manaal Vargas Tamayo BSN October 9, 2022

genuine hospitality, and where the patient’s appeal for o Caring is something human by nature, a call to serve in MARTHA ROGERS’ SCIENCE OF UNITARY HUMAN BEING’S
charity meets with a response love.
o Suffering is an inseparable part of life. Suffering and SCIENCE OF UNITRY HUMAN BEINGS
SUFFERING health are each other’s prerequisites. Two dimensions:
o Suffering is an ontological concept described as a human o Health is more than the absence of illness. Health implies o The Science of Nursing
being’s struggle between good and evil in a state of wholeness and holiness. o The Art of Nursing
becoming. Suffering implies in some sense dying away o The human being lives in a reality that is characterized by
from something, and through reconciliation, the mystery, infinity, and eternity. ASSUMPTIONS
wholeness of body, soul, and spirit is re-created, when the o WHOLENESS
human being’s holiness and dignity appear. Suffering is a THESES o OPENNESS
unique, isolated total experience and is not synonymous o UNIDIRECTIONALITY
with pain o Ethos confers ultimate meaning on the caring context. o PATTERN & ORGANIZATION
o The basic motive of caring is the caritas motive. o SENTENCE & THOUGHT
RECONCILIATION o The basic category of caring is suffering.
o Reconciliation refers to the drama of suffering. A human o Communion forms the context of meaning of caring and
being who suffers wants to be confirmed in his or her derives its origin from the ethos of love, responsibility, and
suffering and be given time and space to suffer and reach sacrifice, namely, caritative ethics.
reconciliation. Reconciliation implies a change through o Health means a movement in becoming, being, and doing
which a new wholeness is formed of the life the human while striving for wholeness and holiness, which is
being has lost in suffering. In reconciliation, the compatible with endurable suffering.
importance of sacrifice emerges o Caring implies alleviation of suffering in charity, love, faith,
and hope. Natural basic caring is expressed through
CARING CULTURE tending, playing, and learning in a sustained caring
o Caring culture is the concept that Eriksson (1987a) uses relationship, which is asymmetrical by nature
instead of environment. It characterizes the total caring
reality and is based on cultural elements such as
traditions, rituals, and basic values. Caring culture TOPIC 7 NURSING CONCEPTUAL MODELS
transmits an inner order of value preferences or ethos, HOMEODYNAMICS PRINCIPLES
NURSING THEORISTS AND THEIR WORKS
and the different constructions of culture have their basis ➢ Homeodynamics refers to the balance between the
in the changes of value that ethos undergoes dynamic
➢ life process and environment.
AXIOMS ➢ These principles help to view human as unitary human
➢ being.
o The human being is fundamentally an entity of body, soul, ➢ Three principle of homeodynamics:
and spirit. o Resonancy
o The human being is fundamentally a religious being. o Helicy
o The human being is fundamentally holy. Human dignity o Integrality
means accepting the human obligation of serving with
love, of existing for the sake of others. DOROTHEA OREM’S SELF-CARE DEFICIT MODEL
o Communion is the basis for all humanity. Human beings ➢ Orem’s general theory of nursing’s three related parts:
are fundamentally interrelated to an abstract and/or o Theory of self care
concrete other in a communion. o Theory of self care deficit
o Theory of nursing system
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THEORY OF SELF CARE o PERCEPTION— a process of organizing, interpreting, and the environment for regulation and control of
1. SELF CARE – practice of activities that an individual and of reality, and influences one's behavior. stressors.
initiates and performs on his/her own behalf in o SELF— a composite of thoughts and feelings that o COPING—a way of dealing with stress
maintaining life, health and well being constitute a person's awareness of individual existence,
2. SELF CARE AGENCY – is a human ability which is "the of who and what he or she is transforming information SOCIAL STATUS
ability for engaging in self care“; conditioned by age, from sense data and memory that gives meaning to one's ➢ The final interacting system is the social system. This
developmental state, life experience, sociocultural experience, represents one's image shows how the nurse interacts with co workers, superiors,
orientation, health, and available resources o GROWTH AND DEVELOPMENT— cellular, molecular, subordinates and the client environment in general.
3. SELF CARE REQUISITES - action directed towards and behavioral changes in human beings that are a
o AUTHORITY — a transactional process characterized by
provision of self care. 3 categories of self care requisites function of genetic endowment, meaningful and satisfying
active, reciprocal relations in which members' values,
are: experiences, and an environment conducive to helping
backgrounds, and perceptions play a role in defining,
o Universal self care requisites - requisites/needs that are individuals move toward maturity.
validating, and accepting the authority of individuals within
common to all individuals o BODY IMAGE—a person's perceptions of his or her
o Developmental self care requisites - needs resulting from body. an organization.
maturation or develop due to a condition or even o TIME— the duration between the occurrence of one event o POWER — the process whereby one or more persons
o Health deviation self care requisites - needs resulting from and the occurrence of another event. influence other persons in a situation.
o STATUS — the position of an individual in a group or a
illness, injury & disease or its treatment o SPACE— the physical area called territory that exists in
group in relation to other groups in an organization.
all directions.
THEORY OF SELF CARE DEFICIT o DECISION MAKING — a dynamic and systematic
o LEARNING— gaining knowledge
o Specifies when nursing is needed process by which goal-directed choice of perceived
o Nursing is required when an adult (or in the case of a INTERPERSONAL SYSTEM alternatives is made and acted upon by individuals or
dependent, the parent) is incapable or limited in the ➢ This shows how the nurse interrelates with a co-worker or groups to answer a question and attain a goal.
provision of continuous effective self care patient, particularly in a nursepatient relationship. o CONTROL — being in charge
Communication between the nurse and the client can be
THEORY OF NURSING SYSTEMS BETTY NEUMAN’S SYSTEMS THEORY MODEL
verbal or nonverbal. Collaboration between the Dyads
o Describes how the patient’s self care needs will be met by (nurse-patient) is very important for the attainment of the
the nurse , the patient, or both goal.
o Identifies 3 classifications of nursing system to meet the
o INTERACTIONS—the acts of two or more persons in
self care requisites of the patient:
mutual presence; a sequence of verbal and nonverbal
❖ Wholly compensatory system
behaviors that are goal directed.
❖ Partly compensatory system
o COMMUNICATION— the vehicle by which human
❖ Supportive – educative system
relations are developed and maintained; encompasses
intrapersonal, interpersonal, verbal, and nonverbal
INOGENE KING’S GOAL ATTAINMENT THEORY
communication.
o TRANSACTION— process of interaction in which human
PERSONAL SYSTEM
beings communicate with the environment to achieve
goals that are valued; goal-directed human behaviors.
o The concepts for the personal system are: perception,
o ROLE — a set of behaviors expected of a person
self, growth and development, body image, space, and
occupying a position in a social system.
time. These are fundamentals in understanding human
o STRESS — a dynamic state whereby a human being
being because this refers to how the nurse views and
interacts with the environment to maintain balance for
integrates self based from personal goals and beliefs.
growth, development, and performance, involving an
Among all these concepts, the most important is
exchange of energy and information between the person
perception, because it influences behavior.
Manaal Vargas Tamayo BSN October 9, 2022

o STABILITY - Dynamic and desired state of balance.

Copes with stressors to maintain an optimal level of health
and integrity

PREVENTION AS INTERVERTION
➢ Purposeful actions to help client maintain system stability
➢ Levels of Prevention:
o Primary: Used when stressor is suspected or identified;
Degree of risk in known
o Secondary: Involves interventions or treatment initiated
after symptoms occurred
o Tertiary: Occurs after active treatment; maintenance

CENTRALCORE STRESSORS Sr. Callista Roy’s ADAPTATION THEORY

Made up of the basic survival factors common to all o Is any environmental force which can potentially affect the
o Normal temperature range stability of the system ROY’S ADAPTATION MODEL (RAM)
o Genetic structure ◦ Response pattern o Produce either a positive or negative effect on the client o “Nursing is to help the person adapt to change in
o Organ strength or weakness system. physiological needs, self-concepts, role function and
o Ego structure interdependent relations during health and illness
o Knowns or commonalities RECONSTITUTION
o The return or maintenance of system stability following SYSTEM
FLEXIBLE LINES OF DEFENSE the treatment for stressor reaction. o A set of units so related or connected as to form a unity
➢ Model’s outer broken ring o Occurs after treatment for stressor reaction or whole and characterized by inputs, outputs, and control
➢ Can be altered over time; Protective buffer for preventing and feedback processes.
stressors from breaking through usual wellness state OPEN SYSTEM
➢ Dependent on o FUNCTION OR PROCESS - Client as a system ADAPTATION LEVEL
o amount of sleep, exchanges energy, information and matter with the o A constantly changing point, made up of focal,
o nutritional status, environment as it uses available energy resources to
contextual and residual stimuli, which represent the
o move toward stability and wholeness
quality and quantity of stress person’s own standard of the range of stimuli to
o INPUT OR OUTPUT - Matter, energy, and information
that are exchanged between the client and the which one can respond with ordinary adaptive
NORMAL LINES OF DEFENSE responses.
o Model’s outer solid circle environment
o Represents client’s usual wellness level. o FEEDBACK - System output in the form of matter,
o Change in response to coping or responding to the energy, and information for corrective action to change, STIMULUS
environment enhance or stabilize the system Open System o FOCAL STIMULUS – the degree of change or stimulus
o NEGENTROPY - a process of energy conservation most immediately confronting the person and the one to
utilization that assists system profession toward stability which the person must make an adaptive response, that
or wellness is, the factor that precipitates behavior
o ENTROPY – A process of energy depletion and o CONTEXTUAL STIMULI – all other stimuli present that
disorganization moving the system toward illness or contribute to the behavior caused or precipitated by the
possible death focal stimuli
o RESIDUAL STIMULI – factors that may be affecting
behavior but whose efforts are not validated
Manaal Vargas Tamayo BSN October 9, 2022

SUBSYSTEMS establishing an effective relationship with the

o REGULATOR – subsystem coping mechanism which environment.
responds automatically through neural-
chemical endocrine processes. ELIMINATE SUBSYSTEMS
o COGNATOR - subsystem coping mechanism which o Behavior associated with the release of physical waste
responds to complex processes of perception and products from the body.
information processing, judgment, and emotion. o Express feelings

SEXUAL SUBSYSTEMS
RESPONSES
o Behaviour associated with a specific gender-based
o ADAPTIVE RESPONSES – responses that promote
identity for the purpose of ensuring pleasure/procreation,
integrity of the person in terms of goals of survival, growth,
and knowledge and behavior being congruent with
reproduction, and mastery
biological sex.
o INEFFECTIVE RESPONSES – responses that do not
contribute to adaptive goals, that is, survival, growth, AGGRESSIVE PROTECTIVE SUBSYSTEMS
reproduction, and mastery o Behaviour associated with real or potential threat in the
environment for the purpose of ensuring survival. §
ADAPTIVE MODEL
Protection of self through direct or indirect acts. §
1. PHYSIOLOGICAL MODE – involve the body’s basic
Identification of potential danger
needs and ways of dealing with adaptation
2. SELF-CONCEPT MODE – the composite of beliefs and ACHIEVEMENT SUBSYSTEMS
feelings that one holds about oneself at a given time. It is o Behaviour associated with mastery of oneself and one’s
formed from perceptions, particularly of other’s reactions, environment for the purpose of producing a desired effect
and directs one’s behavior o Includes problem solving activity
3. ROLE PERFORMANCE MODE – role function is the o Knowledge of personal strengths and weaknesses
performance of duties based on given positions in society.
4. INTERDEPENDENCE MODE – involves one’s relations AFFILIATE OR ATTACHEMENT SUBSYSTEMS SUBCONCEPTS
with significant others and support systems. In this mode o the “social inclusion intimacy and the formation and o STRUCTURE. The parts of the system that make up the
one maintains psychic integrity by meeting needs for attachment of a strong social bond.” whole.
nurturance and affection. o It forms the basis for all social organization. On a general o VARIABLES. Factors outside the system that influence
level, it provides survival and security. the system’s behavior, but which the system lacks power
LEVELS OF ADAPTATION to change.
DEPENDENCE SUBSYSTEMS
o Integrated Process: The various modes and subsystems o BOUNDARIES. The point that differentiates the interior of
o “approval, attention or recognition and physical
meet the needs of the environment. the system from the exterior
assistance.”
o Compensatory Process: The cognator and regulator are o HOMEOSTASIS. Process of maintaining stability.
o It promotes helping behavior that calls for a nurturing
challenged by the needs of the environment but are o STABILITY. Balance or steady-state in maintaining
response.
working to meet the needs balance of behavior within an acceptable range.
o A certain amount of interdependence is essential for the
o Compromised Process: The modes and subsystems o STRESSOR. A stimulus from the internal or external
survival of social groups.
are inadequately meeting the environmental challenge). world that results in stress or instability.
o TENSION. The system’s adjustment to demands, change
INGESTIVE SUBSYSTEMS
DOROTHY JOHNSON’S BEHAVIORAL SYSTEM THEORY or growth, or to actual disruptions.
o Behaviors associated with the intake of needed resources
from the external environments, including food, fluid, o INSTABILITY. State in which the system output of energy
information, knowledge and objects for the propose of depletes the energy needed to maintain stability.
Manaal Vargas Tamayo BSN October 9, 2022

o SET. The predisposition to act. It implies that despite 3. Conservation of Personal Integrity - Recognizes the
having only a few alternatives from which to select a individual as one who strives for recognition, respect, self
behavioral response, the individual will rank those options awareness, selfhood and self determination.
and choose the option considered most desirable. 4. Conservation of Social Integrity - An individual is
o FUNCTION. Consequences or purposes of action recognized as some one who resides with in a family,: a
community, a religious group, an ethnic group, a political
MYRA LEVINE’S CONSERVATIONAL THEORY system and a nation

ADAPTATION • Adaptation is the process whereby the patient

maintains integrity within the realities of the environment
WHOLENESS • Exist when the interaction or constant
adaptations to the environment permits the assurance of integrity
CONSERVATION • Product of adaptation

CHARACTERISTICS OF ADAPTATION

1. HISTORICITY - Adaptation is a historical process,

responses are based on past experiences, both personal
and genetic SPECIFICITY – Individual responses and
their adaptive pattern varies on the base of specific
genetic structure
2. REDUNDANCY – Safe and fail options available to the
individual to ensure continued adaptation
3. ORGANISMIC RESPONSE – A change in behavior of an
individual during an attempt to adapt to the environment

FOUR TYPES OF ORGANISMIC RESPONSE

1. FLIGHT OR FIGHT: an instantaneous response to real or
imagined threat, most primitive response
2. INFLAMMATORY: response intended to provide for
structural integrity and the promotion of healing
3. STRESS: developed over time and influenced by each
stressful experience encountered by person
4. PERCEPTUAL: Involved gathering information from the
environment and converting it in to a meaning experience

PRINCIPLES OF ADAPTATION
1. Conservation of Energy - Refers to balancing energy
input and output to avoid excessive fatigue. It includes
adequate rest, nutrition and exercise.
2. Conservation of Structural Integrity -Refers to
maintaining or restoring the structure of body preventing
physical breakdown and promoting healing