TFN

Significant
Theories and
Theorist
Outline
I. History and Science

II. Theory Development Process

III. Structure of Specialized Nursing

Knowledge

IV. Nursing Theorists of Historical

Significance
 History
Nursing Theories stimulate
phenomenological professional growth and
expansion of nursing literature & education

Nursing was noted to deliver excellent

care HOWEVER it was passed on
through forms of education focused on
skills and functional tasks
These were nursing practices that were
considered effective but it weren’t tested
nor used uniformly in practice &
education

Major goal by Nursing leaders of the 20th

century to develop nursing knowledge on
which based on nursing practice, improve
quality care and to gain recognition of
nursing as a PROFESSION
 Nursing History
• The development of nursing from
apprentice to professional led to the
search for theories that enhances nursing
as a discipline and as a profession;
• It provides significant perspectives to
understand it practice
• It leads to logical analysis of theoretical
works which reveals its role in critical
reflection
 History
• Florence Nightingale – envisioned nurses
as a body of educated women in a time
when women were uneducated and
unemployed;
• St. Thomas Hospital London – where
pioneering works of Nightingale
• Mid 1800’s Nightingale declared nursing
knowledge as distinct from medical
knowledge
• F. Nightingale described nurse’s proper
function as putting the patient in the BEST
condition;
• 1850s – begins the awareness in the need
to develop nursing knowledge apart from
medical knowledge to guide nursing
practice;
• nursing practice was based on apprenticeship model of
education
• Transition from vocation to professional sucessive
development of specialized knowledge based on
practice
• 1930’s – standardized curriculum; diploma
to colleges/universities;
• Increasing sought for higher degrees
• Lack of conceptual connections and
theoretical frameworks further enhanced
the need for specialized nursing
knowledge through research
 Significance
• The discipline is dependent on theories for
continued existence; it describes what
nurses know and how they use what they
know for thinking and decision making
while concentrating on their patient.
• As nurses grow in their professional status
the use of substantive knowledge for
theory-based evidence for nursing is a
quality that is characteristics of their
practice;
• Professional practice requires a
systematic approach that is focused on the
patient, and the theoretical works provide
such perspective of the patietn
 Analysis of Theory
• Clarity – How clear is the theory?
• Simplicity – How simple is the theory?
• Generality – How general is the theory?
• Accessibility – How accessible is the
theory?
• Importance – How important is the theory?
 Theory Development
• Observation
• Logical hypothesis
• Testing
• Dissemination
• Replication
• Theory (if experiment from other
researchers support your hypothesis it will
become a theory)
 Structure of Specialized Nursing Knowledge
Structure Level Example
Metaparadigm Person, Environment, Health &
Nursing
Philosophy Nightingale
Conceptual Neuman’s System Model
model
Theory Neuman’s Theory of Optimal
Client Stability
Middle-range Maintaining optimal client stability with
structured activity in a community setting
for healthy aging
 Terminologies
• Metaparadigm
• Philosophy
• Model
• Theory
• Middle-range
• Grand theory
 METAPARADIGM
• Most ABSTRACT LEVEL of knowledge
• Specifies the main concept that
encompass subject matter of discipline
• Consist of the central concepts of person,
environment, health and nursing
 PHILOSOPHY
• Specifies philosophical approaches in
nursing
• Specifies the definition of the
metaparadigm concepts in each of the
conceptual models of nursing
 CONCEPTUAL MODEL
• Frameworks that provide broad frame of
reference for systematic approaches t the
phenomena with which the discipline is
concerned;
• Provides different views/focus of nursing
according to the characteristics of the
model
 THEORY
• Group of related concepts that propose
actions that guide practice
 MIDDLE-RANGE
• Least abstract, narrower
• It include details specific to nursing practice;
information indicating the situation or health
condition, patient population or age group,
location/area of practice, and action of the nurse
(intervention)
• Develop from themes of qualitative data
• Range of theories is generally determined by
the level of abstraction
 GRAND THEORY
• Broad as the nursing knowledge it
proposes yet presents TESTABLE
TRUTHS
 PHENOMENA
• Subject matters of a discipline

• Phenomena of concerns – human beings

and their environment
 NURSING THEORISTS OF
HISTORICAL SIGNIFICANCE
FLORENCE NIGHTINGALE
• envisioned nurses as a body of
educated nurse

• Her vision- establishment of home

of nursing at St. Thomas hospital
in London Start of Modern
Nursing

• 20th Century- nursing began with

strong emphasis on practice
 Hildegard E. PEPLAU

• Theory of Interpersonal Relations

• The Mother of Psychiatric Nursing
• Publication “Interpersonal Relations in
Nursing” (1952)
• Describes the importance of NURSE-
PATIENT relationship as a significant
therapeutic interpersonal process
FOUR Psychobiological Experiences
• Needs

• Frustrations

• Conflicts

• Anxieties
FOUR Phases of Nurse-Patient Relationship
• Orientation

• Identification

• Exploitation

• Resolution
 Virginia HENDERSON
• Definition of NURSING
• Clarified the independent of the practice of
nursing from that of the physicians;
• Emphasized the art of nursing and
proposed the 14 BASIC HUMAN NEEDS;
 “The unique function of the
nurse is to assist the
individual, sick, or well in the
performance of those activities
contributing to health or its
recovery (or peaceful death)
that he would perform unaided
if he had the necessary
strength, will, or knowledge
Henderson’s 14 Nursing Needs
• Nursing Theorists and their Work by
Alligood, MR 8th edition page 46
 Faye Glenn ABDELLAH
• 21 Nursing Problems (page 47)
• Nursing research and nursing as a profession
within the Public health service and international
expert in health problems;
• Play the major role in establishing a foundation
for nursing research as a science
• Problem-solving methods serves as a vehicle for
delineating nursing problems as the patient
moves toward a healthy outcome
• Views nursing as an art and science that
mold the attitude, intellectual competence
and technical skills of the individual nurse
into the desire and ability to help
individuals cope with their health needs,
whether they are ill or well
• Work focused in a set of problems
formulated in terms of nursing centered
services
 Ernestine WIEDENBACH
• The Helping Art of Clinical Nursing
• Known for theory development of Maternal
Infant Nursing;
• “Nursing is nurturing or caring for
someone in a motherly fashion”
• Guides nurse’s action in the art of nursing
• Clinical nursing is directed toward meeting
the patient’s perceived need for help in a
vision of nurisng that reflects considerable
emphasis on the art of nursing.
Nurses Identify Patient’s Needs
in the following ways:
• Observing behaviors consistent or
inconsistent with their comfort
• Exploring the meaning of their behavior
• Determining the cause of their discomfort
or incapability
• Determining whether they can resolve
their problems or have a need for help
 Lydia HALL
• Core, Care and Cure Model
• Rehabilitation Nurse
• Used 3 interlocking CIRCLES to represent
patient and nursing functions;
• Care circle – patient’s body
• Cure circle – disease that affects the
patient physical system
• Core circle – inner feelings and
management of the person
• 3 Circles change in size and overlap in
relation to the patient’s phase in the
disease process;
• Nurse functions in all circle but in varying
degrees
• Nursing care hasten recovery; less
medical care; more professional and
teaching is necessary
 Joyce TRAVELBEE
• Human-to-Human Relationship Model
•The goal of nursing is to assist an individual, family
or community to prevent or cope with the experiences
of illness and suffering and if necessary to find
meaning with these experiences with the ultimate
goal of being the presence of hope.
• Nursing is accomplished through human-
to-human relationships which includes:
– Original encounter and progressed to stages
of
– Emerging identities
– Developing feelings of empathy and later
– Sympathy until
– The nurse and patient attained rapport in the
final stage
- To sympathize is important as with empathize for
human-to-human relationship to develop

- Explicit about the nurse’s and patient’s

spirituality:
“It is believed the spiritual values a person holds will
determine, to a great extent, his perception of illness.
The spiritual values of the nurse or her philosophical beliefs
about illness and suffering will determine the degree to
which he or she will be able to help ill persons find
meaning or no meaning in these situations”
 Kathryn E. BARNARD
• Child Health Assessment
• Her pioneering work to improve the
physical and mental health outcomes of
infants and young children earned her
numerous honors;
• Founder of Nursing Child Assessment
Satellite Training Project (NCAST)
guidelines for assessing infant
development and parent-child interactions.
• Individual characteristics of members influence
the parent-infant system and the adaptive
behaviour modifies those characteristics to meet
the needs of the system;

• Based on scales designed to measure the

effects of feeding, teaching, and environment;

• It is population specific; continuous research

improves it; it has transformed the way health
care providers evaluate child and parent
relationship
 Evelyn ADAM
• Conceptual Model for Nursing

• Includes the goal of the profession,

beneficiary of professional service,
the role of the professional, the source of the
beneficiary’s difficulty, the interventions of the
professional and the consequences

• It is a good example of using UNIQUE basis of nursing

for further expansion
Nancy ROPER, Winifred LOGAN, Alison TIERNEY

• Model for nursing based on a MODEL of

LIVING
• Roper-Logan-Tierney Model of Nursing :
Based on Activities of Living
• After 3 decades the elements of the model
developed into five main factors (bio,
psycho, socio-cultural, environment &
politicoeconomic)
• Roper – investigated the concept of an
identifiable “core” of nursing which actually
helped bedside nurses
• Logan & Tierney – used the
writings/research of Roper to develop the
European Standards for Nursing
• Rather than revising their papers they
decided to write together and develop the
model
• The model includes Activities of Living
(ALs) which includes :
– Safe environment
– Communicating
– Breathing
– Eating and drinking
– Eliminating
– Personal cleaning & dressing
– Controlling body temperature
– Mobilizing
– Working & playing
– Expressing sexuality
– Sleeping
– Dying
• Individuality of living is the way in which
the individual attends to the ALs in regards
to place in the life span;
 Ida Jean (ORLANDO) Pelletier
• NURSING PROCESS Theory
• Integrating mental health concepts into a
basic nursing curriculum
• It stressed the reciprocal relationship
between patient and nurse;
• What the nurse and patient say affects
them both;
• It is the professional function of the nurse
to find out and meet the patient’s
immediate need for help;
• Emphasize the importance of the nursing
process focused on how to produce
improvement in the patient’s behaviour;
• Positive changes are evidence of relief
• Proposed a positive correlation between
the length of time patient experiences
unmet needs and degree of distress
“proposed that patients have their own
meanings and interpretations of situations
and therefore nurses must validate their
inferences and analyses with patients
before drawing conclusions”
 GROUP REPORT
(August 13 & 20)
• Biography
• Brief history of the model
• MODEL/DIAGRAM
• Major concepts
• PARADIGM
• Application (Hospital, Community,
etc)
• Not more than 10 slides per
Nurse Theorist