4. LEARNING OUTCOMES
•BE AWARE OF THE PURPOSES OF NURSING
THEORY
•DEFINE THE TERMS RELATED TO THE STUDY OF
THEORY
•LEARN ABOUT THEORY,CONCEPTS AND PRINCIPLES
5. HISTORY OF THEORY IN NURSING
• PROFESSIONAL NURSING BEGAN WITH FLORENCE
NIGHTINGALE……………………………………………
• SHE IS THE 1ST MODERN NURSING THEORIST
6. MID 30’S ERA
• STANDARDIZED CURRICULUM HAD BEEN PUBLISHED.
• MOVING NURSING EDUCATION FROM HOSPITAL-BASED DIPLOMA
PROGRAMS INTO COLLEGES AND UNIVERSITIES EMERGED.
7. RESEARCH EMPHASIS ERA
• NURSES PARTICIPATES ON RESEARCH, RESEARCH
COURSES ARE INCLUDED IN NURSING CURRICULA
11. THEORY-DEFINITION
• SYSTEMATIC EXPLANATION OF AN EVENT IN WHICH CONSTRUCTS
AND CONCEPTS ARE IDENTIFIED AND RELATIONSHIPS ARE PROPOSED
AND PREDICTIONS MADE. (CARPENTER,2003)
12. THEORY
• CREATIVE AND RIGOROUS STRUCTURING OF IDEAS THAT
PROJECT A TENTATIVE,PURPOSEFUL AND SYSTEMATIC VIEW
OF PHENOMENA. (CHINN AND KRAMMER, 2004)
14. Theories are composed of concepts,
definitions, models, propositions & are
based on assumptions.
15. THE CHARACTERISTICS OF THEORIES
Theories are:
interrelating concepts in such a way as to create a different way of looking
at a particular phenomenon.
logical in nature.
generalizable.
bases for hypotheses that can be tested.
increasing the general body of knowledge within the discipline through
the research implemented to validate them.
used by the practitioners to guide and improve their practice.
16. Theory and practice are related.
A theory presents a systematic way of understanding events or situations.
It is a set of concepts, definitions, and propositions that explain or predict these events or
situations by illustrating the relationships between variables.
Theories must be applicable to a broad variety of situations. They are, by nature, abstract,
and don’t have a specified content or topic area. Like empty coffee cups, theories have
shapes and boundaries, but nothing inside. They become useful when filled with practical
topics, goals, and problems. [Robert T. Croyle (2005)]
17. IMPORTANCE OF THEORY IN NURSING
• OFFERS STRUCTURE AND ORGANIZATION TO NURSING KNOWLEDGE
• PROVIDES A SYSTEMATIC MEANS OF COLLECTING DATA TO DESCRIBE ,EXPLAIN
,PREDICT NURSING PRACTICE
18. IMPORTANCE OF THEORY IN NURSING
• -STATES THE FOCUS OF PRACTICE, SPECIFI GOALS AND OUTCoMES
• SETS PROFESSIONAL BOUNDARIES THAT DEFINE AND CLARIFY
NURSING AND PURPOSE OF NURSING PRACTICE TO DISTINGUISH
IT FROM OTHER PROFESSIONS.
19. B. CONCEPTS
• ELEMENTS OR COMPONENTSOF PHENOMENON
NECESSARY TO UNDERSTAND THE PHENOMENON.
• THEY ARE ABSTRACT AND DERIVED FROM IMPRESSIONS
THAT HUMAN MIND RECEIVES ABOUT PHENOMENA
THROUGH SENSING THE ENIVIRONMENT.
20. PHENOMENA
• DESIGNATION OF AN ASPECT OF REALITY
• a fact or situation that is observed to exist or happen,
especially one whose cause or explanation is in question.
21. Propositions - are statements that
explain the relationship between the
concepts.
22. TYPES OF CONCEPTS
A. ENUMERATIVE CONCEPTS- ALWAYS PRESENT AND
UNIVERSAL
•EXAMPLE: AGE, HEIGHT,WEIGHT
23. TYPES OF CONCEPTS
• B. ASSOCIATIVE CONCEPTS –EXIST IN SOME
CONDITIONSWITHIN A PHENOMENON
• EXAMPLE: INCOME, ANXIETY,PRESENCE OF DISEASE
24. TYPES OF CONCEPTS
• C. RELATIONAL CONCEPTS-CAN BE UNDERSTOOD ONLY THROUGH THE
COMBINATION OR INTERACTION OF 2 OR MORE ENUMeraTIVE OR ASSOCIATIVE
CONCEPTS
• EXAMPLE:MOTHER (MUST COMBINE MAN,WOMAN AND BIRTH)
• EXAMPLE: ELDERLY (MUST COMBINE CONCEPTS OF AGE AND LONGEVITY)
25. TYPES OF CONCEPTS
• D. STATISTICAL CONCEPTS-RELATE THE PROPERTY OF ONE THING
IN TERMS OF ITS DISTRIBUTION IN THE POPULATION RATE
• EXAMPLE: AVERAGE BLOOD PRESSURE
• EXAMPLE:HIV/AIDS PREVALENCE RATE
26. TYPES OF CONCEPTS
•E. SUMMATIVE CONCEPTS-REPRESENT AN ENTIRE
COMPLEX ENTITY OF A PHENOMENON,ARE
COMPLEX AND NOT meaSURABLE
•EXAMPLE: NURSING, HEALTH AND ENVIRONMENT
27. SOURCES OF CONCEPTS
• A. NATURAlistic CONCEPTS-
• SOURCE: PRESENT IN NURSING CONCEPTS
• CHARACTERISTICS: HAVE MEDICAL IMPLICATIONS AS WELL AS
NURSING USE
• EXAMPLE:BODY WEIGHT,PAIN, DEPRESSION,THERMOREGULATION
28. SOURCES OF CONCEPTS
• B. RESEARCH BASED CONCEPTS
• SOURCE: THROUGH A RESEARCH PROCESS
• CHARACTERISTICS: OFTEN RELATE TO A NURSING
SPECIALTY
• EXAMPLE: HOPE, GRIEF,CULTURAL
COMPETENCE,CHRONIC PAIN
29. SOURCES OF CONCEPTS
• C. EXISTING CONCEPTS-
• SOURCE: BorROWED FROM OTHER DISCIPLNES
• CHARACTERISTICS: DEVELOPED FOR NURSING PRACTICE
(USEFUL IN RESEARCH AND THEORY)
• EXAMPLE: JOB SATISFACTION,QUALITY OF LIFE, STRESS
30. CONCEPT ANALYSIS CAN BE USED TO EVALUATE
THE LEVEL OF MATURITY OR DEVELOPMENT OF
NURSING CONCEPTS BY:
IDENTIFYING GAPS IN NURSING KNOWLEDGE
DETERMINING THE NEED TO REFINE OR CLARIFY A CONCEPT WHEN IT
APPEARS TO HAVE MULTIPLE MEANINGS
DETERMINING THE FIT BETWEEN THE DEFINITION OF THE CONCEPT
AND ITS CLINICAL APPLICATION
c
31. PRINCIPLE-a fundamental truth or
proposition that serves as the foundation
for a system of belief or behavior or for a
chain of reasoning.
- General or basic truth on which other
truths or theories can be based
33. Propositions
• are statements about some object or event in the universe (a
concept), either naturally occurring or constructed. Propositions
contain two or more concepts connected using linking words or
phrases to form a meaningful statement.
34. What is the proposition and examples?
• The definition of a proposition is a statement putting forth an idea, suggestion
or plan.
• An example of a proposition is the idea that the death penalty is a good way to
stop crime.
• An example of a proposition is a suggestion for a change in the terms of
company bylaws.
36. Florence Nightingale defined nursing nearly
150 years ago as “the act of utilizing the
environment of the patient to assist him in
his recovery” (Nightingale, 1860/1969).
Nightingale considered a clean, well-
ventilated, and quiet environment essential
for recovery.
37. Virginia Henderson was one of the first modern nurses to define nursing.
She wrote, “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 to peaceful death) that
he would perform
unaided if he had the necessary strength, will, or knowledge, and to do this
in such a way as to
help him gain independence as rapidly as possible” (Henderson, 1966, p. 3).
38. The current definition of nursing remains unchanged from the 2003
edition of Nursing’s Social Policy Statement: “Nursing is the
protection, promotion, and
optimization of health and abilities, preventions of illness and injury,
alleviation of suffering
through the diagnosis and treatment of human response, and
advocacy in the care of
individuals, families, communities, and populations” (ANA, 2010, p.
10).
39. Certain themes are common to many of these definitions:
• Nursing is caring.
• Nursing is an art.
• Nursing is a science.
• Nursing is client centered.
• Nursing is holistic.
• Nursing is adaptive.
• Nursing is concerned with health promotion, health maintenance, and
health
restoration.
• Nursing is a helping profession
40. FOCUS OF NURSING: HUMAN RESPONSES
Nurses provide care for three types of clients: individuals,
families, and communities.
Theoretical frameworks applicable to these client types, as well
as assessments of individual,
family, and community health.
Nursing practice involves four areas:1 promoting health and
wellness, 2 preventing illness,3 restoring health, 4 and caring
for the dying.
41. 1. Promoting Health and Wellness
When health is defined broadly as actualization of human potential, it has been called
wellness (Pender, Murdaugh, & Parsons, 2011, p. 20). Nurses promote wellness in
clients who are both healthy and ill.
This may involve individual and community activities to enhance healthy lifestyles, such
as improving nutrition and physical fitness, preventing drug and alcohol misuse,
restricting smoking, and preventing accidents and injury in the home and workplace.
42. 2. Preventing Illness
The goal of illness prevention programs is to maintain optimal
health by preventing
disease.
Nursing activities that prevent illness include immunizations,
prenatal and infant
care, and prevention of sexually transmitted infections.
43. 3. Restoring Health
Restoring health focuses on the ill client, and it extends from early detection of disease
through helping the client during the recovery period. Nursing activities include the
following:
• Providing direct care to the ill person, such as administering medications, baths,
and specific procedures and treatments
• Performing diagnostic and assessment procedures, such as measuring blood
pressure and examining feces for occult blood
• Consulting with other health care professionals about client problems
• Teaching clients about recovery activities, such as exercises that will accelerate
recovery after a stroke •
• Rehabilitating clients to their optimal functional level following physical or mental
illness, injury, or chemical addiction
44. 4. Caring for The Dying
This area of nursing practice involves comforting and caring for people of all ages
who are dying.
It includes helping clients live as comfortably as possible until death and
helping support persons cope with death. Nurses carrying out these activities work
in
homes, hospitals, and extended care facilities. Some agencies, called hospices, are
specifically designed for this purpose.
45. NURSING
• ONGOING DEBATE IF NURSING IS A PROFESSION OR AN OCCUPATION
• PROFESSION-VALUED BY SOCIETY BECAUSE THE SERVICES PROVIDED BY
PROFESSIONALS ARE BENEFICIAL FOR MEMBERS OF SOCIETY
• CHARACTERISTICS OF PROFESSION- DEFINE KNOWLEDGE BASED,POWER
AND AUTHORITY OVER TRAINING AND
EDUCATION,REGISTRATION,ALTRUISTIC SERVICE,CODE OF
ETHICS,LENGTY SOCIALIZATION,AUTONOMY
47. NURSING AS A PROFESSION
• ALTHOUGH DEBATE IS ONGOING,IT CAN BE SUCCESSFULLY ARGUED
THAT NURSING IS AN ASPIRING,EVOLVING PROFESSION
(LOGAN,RUTTY,SMITH)
48. NURSING AS AN ACADEMIC DISCIPLINE
• DISCIPLINE-BRANCH OF KNOWLEDGE ORDERED THROUGH THE
THEORIES AND METHODS EVOLVING FROM MORE THAN
WORLDVIEW OF THE PHENOMENON OF CONCERN
49. AREAS THAT IDENTIFY NURSING AS A DISTINCT
DISCIPLINE ARE AS FOLLOWS:
• AN IDENTIFIABLE PHILOSOPHY
• AT LEAST ONE CONCEPTUAL FRAMEWORK FOR DILINEATION OF
WHAT CAN BE DEFINED AS NURSING
• ACCEPTABLE METHODOLOGIC APPROACHES FOR THE PURSUIT AND
DEV’T OF KNOWLEDGE
50. What Is Nursing Theory?
•it’s a set of frameworks and principles that guides
the field of nursing and nursing practice. Based on
evidence and research, nursing theory helps provide
a foundation for sound decision-making in nursing.
51. Who Practices Nursing Theory?
Many who work in the nursing profession use nursing
theories at some point in their practice. Nurses learn these
theories in their formal education and may apply them
during their careers.
Nurse researchers and nurse educators also rely heavily on
nursing theories. For example, many university nursing
programs will have courses dedicated to nursing theory or
will integrate nursing theories in the curriculum.
52. Three Levels of Nursing Theory
Grand Nursing Theories
Grand nursing theories are the broadest category. They’re the most abstract and complex
concepts and propositions that provide a general nursing care framework. A grand nursing
theory can apply to a variety of nursing care environments and situations.
An example of a grand nursing theory is Ida Jean Orlando-Pelletier’s Deliberative Nursing
Process Theory. This theory examines the definition of the function of nursing and the
interaction between the nurse and the patient. It explains how to use the nursing process to
improve patient outcomes.
Using a broad theory like this one, nurses, nurse educators and nurse researchers can apply the
theory in a variety of patient settings and use it with other more specific nursing theories to
determine the most optimal outcomes.
53. Middle-Range Nursing Theories
Middle-range nursing theories are more specific in focus compared to grand nursing theories, but they’re
broader than the more specific practice-level nursing theories. Middle-range nursing theories may derive from
theories of similar disciplines, nursing research or nursing practice.
Since they’re less abstract than grand nursing theories, middle-range theories tend to be more verifiable
through testing. These theories attempt to explain, describe or predict specific issues in clinical nursing
practice.
An example of a middle-range nursing theory is Imogene King’s Theory of Goal Attainment. This theory
focuses on the factors that affect the attainment of certain life goals and explains how a nurse and a patient
can communicate, set goals together and take actions to achieve goals. The theory examines how the personal
system, the interpersonal system and the social system affect goal attainment.
54. Practice-Level Nursing Theories
Practice-level nursing theories are situation-specific. They’re the most narrow in scope and focus
of the three levels of nursing theories. They may be based on concepts from grand nursing
theories and middle-range nursing theory but provide specific frameworks for specific nursing
interventions.
Nurses and nurse researchers may apply a practice-level nursing theory when it relates to a
defined patient population at a specific time. Since these theories are more specific and unique,
they may draw upon multiple theories to create the optimal recommended practice for that
particular patient group.
For example, a nurse who is working with a patient who is a mother may draw upon elements of
middle-range nursing theories like the Maternal Role Attainment Theory by Ramona Mercer and
the Life Perspective Rhythm Model by Dr. Joyce Fitzpatrick to provide optimal maternal patient
care.
55. A nursing metaparadigm definition is that it’s a set of
propositions or concepts that serve as a framework from
which conceptual models develop.
Nursing theories tend to consider each nursing metaparadigm
to apply how the principles in each theory relate to them.
METAPARADIGMS OF NURSING
56. • The term originates from two Greek words: meta,
meaning “with,” and paradigm,
• meaning “pattern.”
57. 1. The individuals or clients are the recipients of nursing care (includes
individuals, families, groups, and communities).
2. The environment is the internal and external surroundings that
affect the client. This includes people in the physical environment, such as
families, friends, and significant others.
3. Health is the degree of wellness or well-being that the client
experiences.
4. Nursing is the attributes, characteristics, and actions of the nursE
58. PERSON
• The person is at the center of the four key concepts of
nursing theory, because the person refers to the patient
who is being cared for. The person may also be referred
to as “client” and represent a group of individuals,
families or communities.
• COMPOSED OF
PHYSICAL,INTELLECTUAL,BIOCHEMICAL,PSYCHOLOGICA
L NEEDS; A HOLISTIC BEING IN THE WORLD
59. Environment
• A nursing environment is the setting in which nursing healthcare is
provided. It affects both the patient and their ability to heal, as well as
the nursing team due to factors like nursing unit morale. A nursing
environment can be affected by issues such as noise levels, lighting,
scent, the amount of space in rooms and access to nature.
• In nursing, the environment also extends beyond the healthcare setting.
It relates to the patient’s everyday life and social experience. The
environment metaparadigm in nursing includes personal, social,
national and global aspects, as well as societal beliefs and customs.
60. HEALTH • Health in nursing relates to both improving a patient’s immediate healthcare
state and helping them maintain their overall health and well-being. Certain
factors in a nursing environment can improve a patient’s health, including
cleanliness, preparedness and a sense of caring. Basic medical needs like food
and clean water can also impact a person’s health
• -ABILITY TO FUNCTION INDEPENDENTLY ; SUCCESSFUL ADAPTATIONTO LIFE’S
STRESSORS;UNITY OF MIND, BODY AND SOUL (WAGNER,1986)
61. Nursing
Finally, the nursing practice metaparadigm refers to nursing as a practice
profession and as an academic discipline. At its core, nursing is a practice that
promotes health and advocates for patients.
-IS A SCIENCE, AN ART, A PRACTICE DISCIPLNE AND INVOLVES CARING
62. The Importance of Nursing Theory
Nursing theory is based on centuries of nursing practice and research.
Nursing theories have been tested and evaluated over time, providing
modern-day nurses, nurse educators and nurse researchers with more
insights to inform their practices. Nursing theories help to contextualize
nursing practice and provide examples of how different types of care
can affect patients in diverse populations.
