Florence Nightingale Metaparadigm

Environmental Theory Person

NURSING “the act of utilizing the A human being acted upon by a nurse, or
environment of the patient to assist him in his affected by the environment. Has
recovery reparative powers to deal with disease.
5 environmental factors Recovery is in the patient‟s power as long as
 Fresh air a safe environment exists.
 Pure water
 Efficient drainage Environment
 Sanitation/cleanliness
 Light & direct sunlight The foundational component of
Nursing puts patients in the “best conditions” nightingale‟s theory. The external conditions
for nature to act upon them & forces that affect one‟s life and
development. Includes everything from a
Stresses the healing properties of the person‟s food to a nurse‟s verbal & non-
physical environment (fresh air, light,
verbal interactions with the patient
warmth, and cleanliness)

Theory basis: The inter-relationship of a

Health
Maintained by using a person‟s healing
healthful environment with nursing External
powers to their fullest extent
influences and conditions can prevent,
Maintained by controlling the environmental
suppress, or contribute to disease or death
factors so as to prevent disease
Theory goal: Nurses help patients retain their
Disease is viewed as a reparative process
own vitality by meeting their basic needs
instituted by nature
through control of the environment.

Nursing’s Focus: control of the environment Nursing

for individuals, families & the community Nursing is a discipline distinct from medicine
focusing on the patient‟s reparative process
Components of Nightingale’s rather than on their disease.
Environmental Theory
 Health of houses Faye Glenn Abdellah
 Ventilation & warming Patient Centered Theory or 21 nursing
 Light problems
 Noise
 Variety Abdellah described nursing as a service to
 Bed & bedding individuals, families, and, therefore to the
 Cleanliness of rooms and walls society.
 Personal cleanliness 11 nursing skills
 Nutrition and taking food 1. Observation of health
2. Skills of communication
 Chattering hopes and advices
3. Application of knowledge
 Observation of the sick
4. Teaching patients and families
 Social considerations 5. Planning and organization of work
6. Use of resource materials
7. Use of personnel resources
8. Problem solving
9. Direction of work of others
10. Therapeutic use of self
11. Nursing procedures
Metaparadigm 14 components of basic nursing care
Nursing
Nursing is a helping profession. In abdellah‟s 1. Breathing normally
model, nursing care is doing something for 2. Eating and drinking adequately
the person or providing information to the 3. Eliminating body wastes
person with the goals of meeting needs, 4. Moving and maintaining a desirable
increasing or restoring self-help ability, or position
alleviating impairment. 5. Sleeping and resting
Person 6. Selecting suitable clothes
Abdellah describes people as having 7. Maintaining body temperature
physical, emotional, and sociological needs. within normal range by adjusting
These needs may overt, consisting of largely
clothing and modifying the
physical needs, or covert, such as emotional
environment
and social needs. Patient is described as the
only justification for the, existence of nursing. 8. Keeping the body clean and well-
Health groomed to protect integuments
9. Avoiding dangers in the environment
In patient centered approaches to nursing, and avoiding injuring others.
Abdellah describes health as a state 10. Communicating with others in
mutually exclusive of illness. expressing emotions, needs, fears, or
opinions.
Although abdellah does not give a
11. Worshipping according to one‟s
definition of health she speaks to “total
faith.
health needs” and „‟a healthy state of mind
12. Working in a such way that one feels
and body” in her description of nursing as a
a sense of accomplishment
comprehensive service.
13. Playing or participating in various
Environment forms of recreation
14. Learning, discovering, or satisfying
Society is included in “planning for optimum the curiosity that leads to normal
health on local, state, national, and development and health, and
international levels”. However, as she further available health facilities.
delineated her ideas, the focus of nursing
service is clearly the individual. Metaparadigm

The environment is the home or community Person

from which is the home or community from
Individual requiring assistance to achieve
which the patient comes.
health and independence or a peaceful
Virginia Henderson death. Mind and body are inseparable.

Environment
Nursing need Theory or 14
components of nursing All external conditions and influences that
affect life and development.
“Assisting the individual, sick or well, in the
performance of those activities contributing Nursing
to health or its recovery (or to peaceful
Assists and supports the individual in life
death) that an individual would perform
activities and the attainment of
unaided if he had the necessary strength,
independence.
will or knowledge.”
Health Therapeutic self-care demand – consists of
the summation of care measures necessary
Equated with independence, viewed in
to meet all of an individual‟s KNOWN SELF
terms of the client‟s ability to perform 14
CARE REQUISITES
components of nursing care unaided:
3 TYPES OF SELF CARE REQUISITES
Example: breathing, eating, drinking,
sleeping, safety I. Universal self-care requisite
a. Maintenance of:
Dorothea Orem i. Sufficient intake of air
ii. Sufficient intake of
Self-care deficit Theory water
Orem’s general theory of nursing in three iii. Sufficient intake of
related parts: food
iv. Care associated with
1. Theory of self-care elimination processes
2. Theory of self-care deficit and excrement‟s
3. Theory of nursing systems v. Balance of activity
and rest
Theory of self-care
vi. Balance of solitude
Describes WHY & HOW people care for and social interaction
themselves vii. Prevention of hazards
to human life,
Suggests that nursing is required in case of functioning and well
INABILITY TO PERFORM self-care as a result of being
limitations viii. Promotion of human
Includes concepts of functioning and
development
1. Self-care agency II. Developmental self-care requisites
2. Therapeutic self-care demand a. Balance of different stages in
3. Basic conditioning factors human life cycle
b. Maintenance of living
Self-care agency – a human ability which is
conditions supporting life
“the ability for engaging in self-care”
cycles
“Conditioned by age developmental state, c. Prevention of occurrence of
life experience sociocultural orientation deleterious effects of
health and available resources.” conditions that affect human
development
1. Development & III. Health deviation self-care requisites
2. Operability – identified in terms of – related to deviations in structure or
the kinds of self-care operations function of a human being
individuals can perform consistently
and effectively. 6 categories of health deviation requisites
3. Adequacy – measured in terms of
a) Seeking/ securing appropriate
the number and kinds of operations
medical assistance
in which persons can engage and
b) Being aware / attending to the
operations required to meet self-
effects and results of illness states
care demands
c) Effectively carry out medically
prescribed treatments
 d) Be aware and attend side effects of Partially compensatory – both patient and
treatment nurse participate in self-care activities
e) Modify self-concept to accept
Supportive educative – patient has the
oneself in a particular state of health
ability for self-care but requires assistance
f) Learn to live with the side effects of
from the nurse in decision making,
illness and medical treatment
knowledge and skill acquisition.
Basic conditioning factors – affect the value
Metaparadigm
of the therapeutic self-care demand or self-
care agency of an individual. Person
 Age A unity can function biologically,
 Gender symbolically, and socially.
 Developmental state
 Health state pattern of living Human being–has the capacity to reflect,
 Healthcare system factors symbolize, and use symbols
 Family system factors
Environment
 Socio-cultural factors
 Availability of resources Includes physical, chemical, biologic and
 External environmental factors social contexts within which human being
exists.
Orem’s theory of self-care deficit
Health
A maturing person deliberately learn and
perform actions to direct their survival A state characterized by soundness or
wholeness of developed human structures
Nursing is required when an adult (or in the
and of bodily and mental functioning.
case of a dependent, the parent) is
incapable or limited in the provision of Nursing
continuous effective self-care.
Is art, a helping service, and a technology
5 methods of helping
Actions deliberately selected and
1. Acting for and doing for others. performed by nurses to help individuals or
2. Guiding others groups under their care maintain or change
3. Supporting another conditions.
4. Providing an environment promoting
personal development in relation to Myra E. Levine
meet future demands
5. Teaching another
Conservation Principles: A model for
health
Orem’s theory of nursing systems
Goal: to promote adaptation and maintain
Describes and explains relationship that wholeness using the principles of
must exist and be maintained for the conservation.
product or nursing to occur
Model guides the nurse to focus on the
3 systems influences and responses at the organismic
level.
Wholly compensatory – patient is unable to
perform any self-care activities and relies on Wholeness – the product of adaptation
the nurse to perform
Every individual has a unique range of Conservation of social integrity – family is a
adaptive responses critical social unit and the life of each
individual is woven in the fabric of family
The responses will vary by heredity, age,
and with the constitution of social group the
gender, challenges of illness experiences.
family is defined by each individual patient.
3 characteristics of adaptation
Metaparadigm
Historicity: adaptations are grounded in
Person
history and await the challenges to which
they respond A holistic being who constantly strives to
preserve wholeness and integrity
Specificity: individual responses and their
adaptive pattern varies on the base of Health
specific genetic structure
Health is a wholeness and successful
Redundancy: safe and fail options available adaptation
to the individual to ensure continued
Environment
adaptation
 Operational – consist of those
4 types of adaptation
undetected natural forces that
Fight or flight: an instantaneous response to impinge on an individual
real or imagined threat, most primitive  Perceptual – consists information
response. that is recorded by the sensory
organs
Inflammatory: response intended to provide
 Conceptual – is influenced by
for structural integrity and promotion of
language, culture, ideas and
healing
cognition.
Stress: response developed over time and
Nursing
influence by each stressful experience
encountered by person The human interaction relying on
communication, rooted in the organic
Sensory-perceptual: involves gathering
dependency of the individual human being
information from the environment and
in his relationship with other human beings.
converting it into a meaningful experience
Martha Rogers
Conservational principle

Conservation of energy – all of life‟s Science of Unitary Human Beings

processes are fundamentally dependent
Nursing is both a science and art.
upon the production and expenditure of
energy Humans are viewed as integral with the
universe: The unitary human being and the
Conservation of structural integrity –
environment are one, not dichotomous
structure and function are strongly
interrelated complementary aspects of The manifestations of the field patterning
human organism that emerge are observable events

Conservation of personal integrity – the The energy field

body does not exist separately from the
- Is the fundamental unit of all, both
mind, emotions and soul
living and unloving
 Seeks to promote symphonic interaction
between human and environmental fields.

Strengthen integrity of human field.

Openness
Dorothy Johnson
- Refers to the fact that the human
and environmental fields are Behavioral system
constantly exchanging their
energies. This model for nursing presents the client as
a living open system, which is in turn a
Pattern
collection of behavioral system.
- The distinguishing characteristic of
7 subsytems of behavior
an energy field that is seen as a
single wave 1. Attachment or affiliative: social
inclusion intimacy and the formation
Pan dimensionality
and attachment of a strong social
- A domain that has no spatial or bond
temporal attributes. 2. Dependency: approval, attention or
recognition and physical assistance
Non-invasive modalities for nursing 3. Ingestive: the emphasis is on the
meaning and structure of the social
- Therapeutic touch
events surrounding the occasion
- Humor
when food is eaten
- Music
4. Eliminative: human cultures have
- Meditation
defined different socially
- Guided imagery
acceptable behaviors for excretion
- Use of color
of waste, but the existence of such
Metaparadigm pattern remains different from
culture to culture
Person 5. Sexual: both biological and social
A unitary human being is an “irreducible, factor affect the behavior in the
indivisible, pan dimensional (four- sexual subsystem
dimensional) energy field identified by 6. Aggressive: it relates to the
pattern and manifesting characteristics that behaviors concerned with
are specific to the whole and which cannot protection and self-preservation
be predicted from knowledge of the parts. Johnson views aggressive subsystem
as one that generates defensive
Environment response from the individual when
life or territory is being threatened.
The field coexist and are integral.
7. Achievement: provokes behavior
Manifestation emerge from this field and are
that attempt to control the
perceived.
environment intellectual, physical,
Health creative, mechanical and social skills
achievement are some of the areas
Views the concepts of health and illness as that she recognizes
manifestations of pattern
Functional requirements to be met for
Nursing continued growth, development and
viability
 1. Protection from noxious influences The cure
with which the system cannot cope
Represents the disease that affects the
2. Nurturance through input of supplies
patients physical system
from the environment
3. Stimulation by experiences, events Nursing‟s function by applying medical
and behavior that would enhance knowledge to treatment of the person
growth and prevent stagnation
The core
Nursing diagnostic and treatment problems
Represents the inner feelings and
1. Determine existence of the problem management of the person
2. Diagnostic classification of problems
3. Management of nursing problems Nursing functions by addressing the social
4. Evaluation of behavioral system and emotional need of the patient
balance and stability
Metaparadigm
Metaparadigm
Person
Person
Client is composed of body, pathology, and
Human being is having two major systems, person. People set their own goals and are
the biological system and the behavioral capable of learning and growing.
system with 7 subsystems of behavior.
Environment
Environment
Should facilitate achievement of the clients
Society relates to the environment on which personal goals
the individual exists; includes both internal
Establish environment conducive to self-
and external that are not a part of the
development
individual‟s behavioral system but influence
the system Health

Health Development of a mature self-identity that

assists in the conscious selection of actions
Refers to both physical and social health in
that facilitates growth.
defining this metaparadigm
Nursing
Nursing
Consisting of participation in the care, core
An external regulatory force that acts to
aspects of patient care
preserve the organization and integrity of
patient‟s behavior at an optimal level Professional nursing is most important during
the recuperative period
Lydia Hall
Core, care, cure model
The care

Represents the clients body

Nurse function by giving hands on bodily

care to the patient in relation to
performance of ADLs
 VII. Becoming is the human‟s patterns of
relating value priorities. – Health is
living the ideals chosen by the
individual.
VIII. Becoming is an inter subjective
process of transcending with the
Rosemarie rizzo Parse possible– Health is reaching beyond
the actual to the possible through
Human Becoming Theory subject to subject interchange. This
interchange can occur through two
The theory focuses on the human-universe- persons or with another element of
health process and is based on the premise the environment.
that the human being pursues and creates IX. Becoming is human unfolding – We
his own process of being with the world. are continuously changing, never to
Assumptions about the human & the return to our previous state
becoming Metaparadigms
I. The human is coexisting while Person
reconstituting rhythmical patterns An open being in mutual process with the
with the universe. – Individuals take universe co creating patterns of relating with
active party in creating their own others.
patterns and reality. Environment
II. The human is open, freely choosing Assumed under the larger view of human
meaning in situation, bearing beings – universe; inseparable,
responsibility for decisions – human complementary and evolving together
beings make choices on how to act Health
and react. They are responsible for A process of changing life‟s meanings a
the outcome of their choices. personal power emerging from individual‟s
III. The human is unitary, continuously collective relationship with others and the
reconstituting patterns of relating. – universe
People are more than a sum of their Nursing
parts. One can be distinguished from A basic science the practice of which is
another by patterns of appearance, performing art
mannerisms, voice and other
characteristics Nola Pender
IV. The human is transcending
multidimensional with the possible – Health promotion model
The human is capable of changing Purpose: assist nurses in understanding the
and growing beyond their limitations. major determinants of health as a basis for
V. Becoming is an open process, behavioral counseling to promote healthy
experienced by the human. – lifestyle.
Becoming is continuous growth
towards more diversity & complexity. HPM assumptions is based on the following
Growing includes choosing who one assumptions, which reflect both nursing and
will be in a given situation. behavioral science perspectives:
VI. Becoming is a rhythmically
 Persons seek to create conditions of
reconstituting human universe
living through which they can express
process – Health & becoming are
their unique human health potential.
intertwined. The elements of our
 Persons have the capacity for
environment in which we connect
reflective self-awareness, including
and separate from, change us. With
assessment of their own
these elements we reconstitute our
competencies.
health.
  Person‟s value growth in directions Defines adaptation as the process and
viewed as positive and attempt to outcome whereby the thinking and feeling
achieve a personally acceptable a person uses conscious awareness and
balance between change and choice to create human and environmental
stability. integration.
 Individuals seek to actively regulate
their own behavior.
 Individuals in all their biopsychosocial
complexity interact with the Four adaptive modes
environment, progressively 1. Physiologic-physical mode: physical
transforming the environment and and chemical processes involved in
being transformed over time. the function and activities of living
 Health professionals constitute a part organisms; the underlying need is
of the interpersonal environment, physiologic integrity as seen in the
which exerts influence on persons degree of wholeness achieved
throughout their lifespan. through adaptation to changes in
 Self-initiated reconfiguration of needs.
person-environment interactive 2. Self-concept-group identity mode:
patterns is essential to behavior focuses on psychological and
change. spiritual integrity and a sense of unity,
Metaparadigm meaning, purposefulness in the
Person universe.
Person is a biophysical organism that is 3. Role function mode: refers to the
partially shaped by the environment but roles that individuals occupy in
also seeks to create an environment in society fulfilling the need for social
which inherent and acquired human integrity; it is knowing who one is, in
potential can be fully expressed. relation to others.
Environment 4. Interdependence mode: the close
Is the social, cultural and physical context in relationships of people and their
which life course unfolds the environment purpose, structure and development
can be manipulated by the individual to individually and in groups and the
create positive context of cues and adaptation potential of these
facilitators for health enhancing behaviors. relationships.
Health Sub concepts
In reference to the individual is defined as Adaptive responses are those that promote
the actualization of inherent and acquired the integrity of the person.
human potential through goal directed, The person‟s integrity, or wholeness, is
behavior, competent self-care and behaviorally demonstrated when the person
satisfying relationships with others, while is able to meet the goals in terms of survival,
adjustments are made as needed to growth, reproduction and mastery.
maintain structural integrity and harmony Ineffective responses do not support these
relevant environments. goals.
Nursing Coping mechanisms describe the control
Is collaboration with individuals, families and processes of the person as an adaptive
communities to create the most favorable system. Some coping mechanisms are
conditions for expression of optimal health inherited or genetic, such as white blood
and high level well-being. cell defense mechanism against bacteria
that seek to invade the body.
Sister callista roy Other mechanisms are learned, such as the
use of antiseptics to cleanse a wound.
Adaptation theory Two coping subsystems
 A. Cognator subsystem “A major Theory of interpersonal relations
coping process involving four
cognitive-emotive channels: Psychodynamic nursing
perceptual and information
processing, learning, judgment, and  Understanding of one‟s own
emotion.” behavior
B. Regulator subsystem: a basic type of
 To help others identify felt difficulties
adaptive process that responds
automatically through neural,  To apply principles of human
chemical, and endocrine coping relations to the problems that arise at
channels. all levels of experience

Focal stimuli – those stimuli that are the  In her book she discussed the phases
proximate causes of the situation. of interpersonal process, roles in
Contextual stimuli – all other stimuli in the nursing situations and methods for
internal or external environment, which may studying nursing as an interpersonal
or may not affect the situation.
process.
Residual stimuli – those immeasurable and
unknowable stimuli that also exist and may  According to Peplau, nursing is
affect the situation. therapeutic in that it is a healing art,
Metaparadigm assisting an individual who is sick or in
Person need of health care.

The human adaptive system and defined as  Nursing is an interpersonal process

a whole with parts that function as a unity because it involves interaction
for some purpose between two or more individuals
with a common goal.
Environment
 The attainment of goal is achieved
Conditions, circumstances and influences through the use of a series of steps
that affect the development and behavior following a series of pattern.
of humans as adaptive systems
 The nurse and patient work together
Health so both become mature and
knowledgeable in the process.
A state and process being and becoming
integrated and whole. Roles of nurse

Nursing  Stranger: receives the client in the

same way one meets a stranger in
“The promotion of adaptation in each of
other life situations provides an
the four modes”
accepting climate that builds trust.
Adaptation
 Teacher: who imparts knowledge in
The process and outcome whereby thinking reference to a need or interest
and feeling persons as individuals or in
 Resource Person : one who provides
groups use conscious awareness and
a specific needed information that
choice to create human and environmental
aids in the understanding of a
integration.
problem or new situation
Hildegard E. Peplau  Counselors : helps to understand
and integrate the meaning of
 current life circumstances ,provides 3. Exploitation
guidance and encouragement to
4. Resolution
make changes
Orientation phase
 Surrogate: helps to clarify domains of
dependence interdependence and  Problem defining phase
independence and acts on clients
behalf as an advocate.  Starts when client meets nurse as
stranger
 Leader : helps client assume
maximum responsibility for meeting  Defining problem and deciding type
treatment goals in a mutually of service needed
satisfying way
 Client seeks assistance ,conveys
Additional Roles include: needs ,asks questions, shares
preconceptions and expectations of
1. Technical expert past experiences
2. Consultant  Nurse responds, explains roles to
client, helps to identify problems and
3. Health teacher
to use available resources and
4. Tutor services

5. Socializing agent Identification phase

6. Safety agent  Selection of appropriate professional

assistance
7. Manager of environment
 Patient begins to have a feeling of
8. Mediator
belonging and a capability of
9. Administrator dealing with the problem which
decreases the feeling of helplessness
10. Recorder observer and hopelessness
11. Researcher Exploitation phase
Theory of interpersonal relations  Use of professional assistance for
problem solving alternatives
 Middle range descriptive
classification theory  Advantages of services are used is
based on the needs and interests of
 Influenced by Harry Stack Sullivan's
the patients
theory of inter personal relations
(1953)  Individual feels as an integral part of
the helping environment
 Also influenced by Percival Symonds
, Abraham Maslow's and Neal Elger  They may make minor requests or
Miller attention getting techniques
Identified four sequential phases in the  The principles of interview
interpersonal relationship: techniques must be used in order to
explore ,understand and adequately
1. Orientation
deal with the underlying problem
2. Identification
  Patient may fluctuates on  Environment : Existing forces outside
independence the organism and in the context of
culture
 Nurse must be aware about the
various phases of communication  Health : A word symbol that
implies forward movement of
 Nurse aids the patient in exploiting all
personality and other ongoing
avenues of help and progress is
human processes in the direction
made towards the final step
of creative, constructive, productive,
Resolution phase personal andcommunity living.

 Termination of professional  Nursing: A significant therapeutic

relationship interpersonal process. It functions
cooperatively with other human
 The patients‟ needs have already process that make health possible
been met by the collaborative for individuals in communities
effect of patient and nurse
 Peplau explains 4 phases such as:
 Now they need to terminate their
therapeutic relationship and dissolve  Orientation: Nurse and
the links between them. patient come together as
strangers; meeting initiated
 Sometimes may be difficult for both by patient who expresses a
as psychological dependence “felt need”; work together to
persists recognize, clarify and define
facts related to need.
 Patient drifts away and breaks bond
with nurse and healthier emotional  Identification: Patient
balance is demonstrated and both participates in goal setting;
becomes mature individuals has feeling of belonging and
selectively responds to those
Interpersonal theory and nursing process
who can meet his or her
 Both are sequential and focus on needs.
therapeutic relationship
 Exploitation: Patient actively
 Both use problem solving techniques seeks and draws knowledge
for the nurse and patient to and expertise of those who
collaborate on, with the end can help.
purpose of meeting the patients‟
 Resolution: Occurs after other
needs
phases are completed
 Both use observation successfully. This leads to
communication and recording as termination of the
basic tools utilized by nursing relationship.

Metaparadigm Jean Watson

 Person :A developing organism that Theory of Transpersonal Caring
tries to reduce anxiety caused by
needs Watson believes that the main focus in
nursing is on carative factors. She believes
that for nurses to develop humanistic
philosophies and value system, a strong 6. The systematic use of the scientific
liberal arts background is necessary. problem-solving method for decision
making
The seven assumptions
7. The promotion of interpersonal
Watson proposes Seven assumptions about
teaching-learning.
the science of caring. The basic assumptions
are: 8. The provision for a supportive,
protective and /or corrective
 Caring can be effectively
mental, physical, socio-cultural and
demonstrated and practiced only
spiritual environment.
interpersonally.
9. Assistance with the gratification of
 Caring consists of carative factors
human needs.
that result in the satisfaction of
certain human needs. 10. The allowance for existential-
phenomenological forces.
 Effective caring promotes health
and individual or family growth. The first three carative factors form the
“philosophical foundation” for the science
 Caring responses accept person not
of caring. The remaining seven carative
only as he or she is now but as what
factors spring from the foundation laid by
he or she may become.
these first three.
 A caring environment is one that
Metaparadigm
offers the development of potential
while allowing the person to choose Person
the best action for himself or herself
 She adopts a view of the human
at a given point in time.
being as: “….. a valued person in
 Caring is more “healthogenic” than and of him or herself to be cared for,
is curing. A science of caring is respected, nurtured, understood
complementary to the science of and assisted; in general a
curing. philosophical view of a person as a
fully functional integrated self. He,
 The practice of caring is central to
human is viewed as greater than
nursing.
and different from, the sum of his or
The ten primary carative factors her parts”.

1. The formation of a humanistic- Health

altruistic system of values.
Watson believes that there are other factors
2. The installation of faith-hope. that are needed to be included in the WHO
definition of health. She adds the following
3. The cultivation of sensitivity to one‟s three elements:
self and to others.
 A high level of overall
4. The development of a helping-trust physical, mental and social
relationship functioning
5. The promotion and acceptance of  A general adaptive-
the expression of positive and maintenance level of daily
negative feelings. functioning
  The absence of illness (or the design for problem solving. It
presence of efforts that leads determines what data would be
its absence) collected and how on whom.

Environment Intervention

 According to Watson caring (and  It is the direct action and

nursing) has existed in every society. implementation of the plan.
A caring attitude is not transmitted
 It includes the collection of the data.
from generation to generation. It is
transmitted by the culture of the Evaluation
profession as a unique way of
coping with its environment.  Analysis of the data as well as the
examination of the effects of
Nursing interventions based on the data.
Includes the interpretation of the
 According to Watson “nursing is
results, the degree to which positive
concerned with promoting health,
outcome has occurred and whether
preventing illness, caring for the sick
the result can be generalized.
and restoring health”.
 It may also generate additional
 It focuses on health promotion and
hypothesis or may even lead to the
treatment of disease. She believes
generation of a nursing theory.
that holistic health care is central to
the practice of caring in nursing.

 She defines nursing as…..

“A human science of persons and
human health-illness experiences
that are mediated by professional,
personal, scientific, esthetic and
ethical human transactions”.

Assessment

 Involves observation, identification

and review of the problem; use of
applicable knowledge in literature.

 Also includes conceptual knowledge

for the formulation and
conceptualization of framework.

 Includes the formulation of

hypothesis; defining variables that
will be examined in solving the
problem.

Planning

 It helps to determine how variables

would be examined or measured;
includes a conceptual approach or