THEORETICAL FOUNDATIONS IN NURSING

MODULE 1: INTRODUCTION TO NURSING THEORIES 3. Assumptions. “Taken for granted” statements that determine
CONCEPT - Concepts are defined as abstract ideas or general the nature of the concepts, definitions, purpose, relationships
notions that occur in the mind, in speech, or in thought. They and structure of the theory.
are understood to be the fundamental building blocks of 4. Phenomenon. an aspect of reality that can be consciously
thoughts and beliefs. sensed or experienced.
CONCEPTUAL FRAMEWORK/MODEL – A set of concepts Nursing theories focus on the phenomena of nursing and nursing
that describe ideas about individuals, groups, situations and care. Examples of phenomena include caring, self-care and client
events of particular interest or discipline (e.g., Nursing) responses to stress.
THEORY - A scientific theory is a well-substantiated explanation IMPORTANCE OF NURSING THEORIES
of a given set of data, based on a body of facts that have been A. In Education
repeatedly confirmed through observation and experiment and
has gained general acceptance within the scientific community • Provide a general focus for curriculum design.
but has not been yet decisively proven. • Guide curricular decision making.
PRINCIPLE – a basic generalization that is accepted as true and B. In Research
that can be used as a basis for reasoning or conduct. • Offer a framework for generating knowledge and new
PHILOSOPHY These are beliefs and values that define a way of ideas.
thinking and are generally known and understood by a group or • Assist in discovering gaps in specific field of study.
discipline. • Offer a systematic approach to identify questions for
NURSING THEORY - Nursing theories are theoretical study, select variables, interpret findings and validate
frameworks that aim to explain the nursing profession. nursing interventions.
Nursing theory is "an organized framework of concepts and C. In Clinical practice
purposes designed to guide the practice of nursing". • Serve to guide assessment, intervention and
CHARACTERISTICS OF A NURSING THEORY evaluation of nursing care.
• Provide a rationale for collecting data about the health
1. Interrelating concepts to create a different way of looking at a
status of clients, which are essential for effective
particular phenomenon
decision making and implementation.
2. Logical in nature • Help to establish criteria to measure the quality of
3. Generalizable nursing care.
4. Basis for hypothesis that can be tested • Help build a common nursing terminology to use in
communicating with other health professionals, Ideas
5. Increasing nursing knowledge through the research
are developed and words are defined.
implemented to validate them
• Enhance autonomy of nursing by defining its own
6. Used by practitioners to guide and improve their practice independent functions.
7. Consistent with other validated theories, laws and principles
HISTORICAL DEVELOPMENT OF NURSING THEORIES
but will leave open unanswered questions that need to be OVERVIEW
investigated. 1. FLORENCE NIGHTINGALE (1820-1910):
COMPONENTS OF A THE ORY o Considered the founder of modern nursing,
1. Concepts. to describe or label phenomena. o Defined nursing in her “Environmental Theory” as “the act of
2. Definitions. convey the general meaning of the concepts and utilizing the patient’s environment to assist him in his recovery.”
also describe the necessary to measure the relationships or o She emphasized the importance of sanitation, hygiene, and
variables within a theory (Chinn and Kramer 2004). environmental factors in patient care.
 THEORETICAL FOUNDATIONS IN NURSING
2. EMERGENCE OF PROFESSIONAL IDENTITY
(1920S TO 1940S):
• Katharine Kolcaba (born 1944): Kolcaba's Comfort
• Isabel Hampton Robb (1860-1910): Robb was Theory focused on enhancing patient comfort as an
instrumental in establishing nursing as a legitimate integral aspect of nursing care.
profession. She advocated for nursing education,
6. IN 1960, FAYE ABDELLAH’S “TYPOLOGY OF
standardized curricula, and the creation of nursing
21 NURSING PROBLEMS,” shifted the focus of nursing
organizations.
from a disease-centered approach to a patient-centered approach.
• Virginia Henderson (1897-1996): Her influential work,
7. IN 1962, IDA JEAN ORLANDO’S “NURSING
"Nursing Need Theory," emphasized the nurse's role
PROCESS DISCIPLINE,” emphasized the reciprocal
in assisting patients to gain independence in fulfilling
relationship between patient and nurse and viewed nursing’s
their basic physiological, psychological, and social
professional function as finding out and meeting the patient’s
needs (14 fundamental needs).
immediate need for help.
3. DEVELOPMENT OF CONCEPTUAL MODELS
AND GRAND THEORIES (1950S TO 1970S): 8. IN 1968, DOROTHY JOHNSON pioneered the
Behavioral System Model and upheld the fostering of efficient
• Hildegard Peplau (1909-1999): Peplau's Theory of
and effective behavioral functioning in the patient to prevent
Interpersonal Relations focused on the nurse-patient
illness.
relationship and the therapeutic use of
communication as the foundation of nursing practice, 9. IN 1971, IMOGENE KING‘S “THEORY OF
GOAL ATTAINMENT” stated that the nurse is considered
to facilitate patient growth and development.
part of the patient’s environment and the nurse-patient
• Dorothea Orem (1914-2007): Orem's Self-Care Deficit
relationship is for meeting goals towards good health.
Theory emphasized the patient's ability to engage in
self-care activities and the role of nurses in assisting 10. IN 1972, BETTY NEUMAN, IN HER “HEATH
CARE SYSTEM MODEL.”, states that many needs exist,
when self-care abilities are compromised.
and each may disrupt client balance or stability. Stress reduction
• Martha Rogers (1914-1994): Rogers developed the
is the goal of the system model of nursing practice.
Science of Unitary Human Beings, which viewed
nursing as a science and emphasized the 11. IN 1979, SR. CALLISTA ROY’S ADAPTATION
interconnectedness of humans with their MODEL,” viewed the individual as a set of interrelated
environments. systems that maintain the balance between these various stimuli.
4. MIDDLE-RANGE THEORIES AND NURSING These theories have not only contributed to the development of
RESEARCH (1980S TO 1990S): nursing as a distinct profession but have also influenced nursing
• Madeleine Leininger (1925-2012): Leininger's education, research, and practice. They continue to shape the
Transcultural Nursing Theory focused on providing foundation of contemporary nursing care and provide a
culturally congruent care to individuals from diverse framework for understanding and improving patient outcomes.
cultural backgrounds.
• Patricia Benner (born 1942): Benner's Novice to
Expert theory highlighted the acquisition of nursing
skills and knowledge through experience and
practical application.
5. CONTEMPORARY NURSING THEORIES
(2000S ONWARDS):
• Jean Watson (born 1940): Watson's Theory of Human
Caring emphasized the importance of the nurse's
empathetic and compassionate presence in promoting
healing and well-being.
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MODULE 2: NURSING METAPARADIGM AND • Works of Levine, Orem, and King are some of the
CATEGORIES OF NURSING THEORIES theories under this category.
MIDDLE-RANGE Nursing Theories.
A PARADIGM directs what research topics are • Narrow-scope theories.
investigated, how research is conducted, and how theories are • Are precise and answer specific nursing practice
derived within nursing (Monti & Tingen, 1999). questions. They address the specifics of nursing
A METAPARADIGM is a set of theories or ideas that situations within the perspective of the model or
provide structure for how a discipline should function. For a theory from which they are derived. They address a
nursing discipline, these theories consist of four basic concepts specific phenomenon in nursing and reflect practice.
that address the patient as a whole, the patient’s health and • Examples of Middle-Range theories are that of
well-being, the patient’s environment and the nursing Watson, Peplau and Pender.
responsibilities. MICRO-LEVEL (PRACTICE-LEVEL) Nursing
1. Person. People are the recipients of nursing care; they Theories.
include individuals, families, communities and groups. • are situation specific theories that are narrow in
2. Environment. Includes factors that affect individuals scope and focuses on a specific patient population at
internally and externally, the everyday surroundings and a specific time.
settings where nursing care is provided. • provide frameworks for nursing interventions and
suggest outcomes or the effect of nursing practice.
3. Health. Addresses the person’s state of well-being.
• Theories developed at this level have a more direct
4. Nursing. Describe what nursing is, what nurses do, and how effect on nursing practice as compared to more
nurses interact with clients. It is the “diagnosis and treatment abstract theories.
of human responses to actual or potential health problems” • These theories are interrelated with concepts from
(ANA 1995). middle-range theories or grand theories.
Example: The nurse establishes nursing diagnoses of fatigue,
change in body image, altered coping based on the medical
diagnosis of heart condition.
FOUR MAJOR CONCEPTS OF NURSING THEORIES
FOUR CATEGORIES OF NU RSING THEORIES
PHILOSOPHICAL Nursing Theories. Is the most
abstract type and sets forth the meaning of nursing phenomena
through analysis, reasoning, and logical presentation. Works of
Nightingale is categorized under this group.
GRAND Nursing Theories.
• Broad-scope theories.
• Are works derived from nursing philosophies,
conceptual models, and other grand theories that are
generally not as specific as middle-range theories.
• Differentiate the nursing discipline from the medical
model, stimulated the expansion of nursing
knowledge.
• Provide useful insights into nursing practice but are
not designed for empirical testing.