UERMMMCI College of Nursing

Prepared by: Flory May G. Agustin, MAN, RN

LESSON TITLE:
▪ INTRODUCTION TO NURSING
THEORY
▪ HISTORY & PHILOSOPHY OF
NURSING AS SCIENCE
▪ STRUCTURE OF NURSING
KNOWLEDGE
LEARNING OUTCOMES:
Upon completion of this lesson, the learner will be
able to:
1. Identify the evolution of nursing;
2. Define the different eras of nursing;
3. Identify the similarities and differences of
significance of nursing as a discipline and Reference:
profession; Alligood, M. (2022). Nursing theories and
4. Enumerate the criteria of a profession; their work (9th ed.). Singapore: Elsevier.
5. Determine the historical views of the nature of
science;
6. Differentiate rationalism and empiricism;
7. Define the following structures of nursing
knowledge (metaparadigm, philosophy,
conceptual models and grand theories); and,
8. Apply the following theory development principle.

A. MAIN LESSON
The students will study and read their book, if available, about this lesson.

History of Nursing Theory

This was dated way back when Florence Nightingale began to assume the great significance
of providing a clean and healthy environment to achieve recovery of patients and continues up
to present.
o She also envisioned nurses as a body of educated women who organized service and
caring for wounded in wartime (Crimean War) and establishment of Nursing school in
London (St. Thomas Hospital) pioneering activities in nursing practice and education.
Nursing evolved through different eras. Profession did not start as what it seemed to be. It
started as a vocational course offering only skills during their time.

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Nursing as a Science:

Apprenticeship Model
Nursing practice was based on principles and traditions that were handed down through practice
seen by Florence during her time.
Other references note that this is a practice era dated before the curriculum era where to be a
nurse can have a diploma for only 2 years under vocational.
Historical Eras of Nursing’s Search for Specialized Knowledge
Historical Eras Major Question Emphasis Outcomes Emerging Goal
What curriculum Develop specialized
Curriculum Era: Courses included in Standardized curricula
content should nurses knowledge and higher
1900 to 1940s nursing programs for diploma programs
study to be nurses education
Research Era: What is the focus for Role of nurses and Problem studies and Isolated studies do not
1950 to 1970s nursing research? what to research studies of nurses yield unified knowledge
Carving out an
Graduate What knowledge is Nurses have an Focus graduate
advanced role and
Education Era: needed for the important role in education on knowledge
basis for nursing
1950 to 1970s practice of nursing? health care development
practice
How do these
There are many Nursing theoretical
Theory Era: frameworks guide Theories guide nursing
ways to think about works shift the focus
1980 to 1990s research and research and practice
nursing to the patient
practice?
What new theories are Nursing theory Middle-range theory Nursing frameworks
Theory
needed to produce guides research, may be from produce knowledge
Utilization Era:
st evidence of quality practice, education, quantitative or (evidence) for quality
21 Century
care? and administration qualitative approaches care

Fawcett classified nursing models as paradigms with in a more organized / specialized meta-
paradigm of:
▪ Person ▪ Health
▪ Environme ▪ Nursing Concepts
nt

Significance of Nursing Theory:

At the beginning of the 20th century, nursing was not recognized as an academic discipline or a
profession. The accomplishments of the past century led to the recognition of nursing in both areas.
The terms discipline and profession are interrelated and some may even use them interchangeably;
however, they are not the same. It is important to note their differences and specific meaning.

DISCIPLINE PROFESSION

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 Specific to academia and refers to a branch of Refers to a specialized field of practice founded on the
education, a department of learning or a domain of theoretical structure of the science or knowledge of the
knowledge. discipline and accompanying practice abilities.
Branch of education; theoretical works leading to higher
level of education and practice.
Knowledge of that discipline and accompanying
practice abilities.
Functional Focus (what nurses do) – knowledge
focus or what nurses know and how they use them for
thinking and decision making while taking care of a Recognition and respect for their scholarly disciplined
patient. (example: Nursing) contribution to the health of society.

Knowledge of persons, health and environment forms

the basis for nursing as a discipline

Kuhn – stated, “the study of paradigms is what mainly

prepares the student for membership in a particular
scientific community with which he / she will practice.
By studying and practicing with them, the clients or
community involved learn their trade."
Criteria for the Development of the Professional status of Nursing:
1. Utilizes in its practice a well-defined and well-organized body of specialized knowledge.
2. Constantly enlarges the knowledge it uses and improves its techniques of education and
service thru scientific method.
3. Entrusts the education of its practitioners to universities/ colleges.
4. Applies knowledge in practical services important to community welfare.
5. Functions autonomously in developing professional policy.
6. Attracts individuals with intellectual and personal qualities of intensifying service.
7. Strives to compensate nurses by providing freedom of action, opportunity for continuous
professional growth and economic security.

Historical Views of the Nature of Science

Epistemology (episteme – knowledge; logos – study of)

● meaning knowledge, understanding
● concerned with the theory of knowledge in philosophical inquiry or how knowledge came to be.
● What is real is also considered knowledge.
● Branch of philosophy concerned with the nature & scope of knowledge.
● It is the study of knowledge & justifies beliefs.
● It questions what knowledge is & how it can be acquired.
● This aims to discover the meaning of knowledge, & called it the true beginning of philosophy.

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Philosophical Foundations of Science:
RATIONALISM EMPIRICISM
● Priori reasoning -utilizes deductive; cause to effect or ● Way of looking at reality using the five senses.
general to particular ● An object is real in so far as seen, felt, smelled,
● Use use of the rational senses in ensuring the tasted, heard
truthfulness of a phenomenon ● A theory which states that knowledge comes only or
● Understand the whole first before you can appreciate primarily from sensory experience
the lesser parts ● Fundamental part of scientific method
● Regards reason as the chief source & test of (experimentations)
knowledge ● Knowledge is based on experience; ex. physical
● Any view appealing to reason as a source of assessment
knowledge or justification (theory-the-research ● Gather information more and observe facts before
approach) finally saying a theory exists.
● Criterion of truth is not sensory but intellectual & ● Reynolds, “research-then-theory strategy”
deductive (general to specific) ● It is inductive. (specific to general)
● ex: lack of social support will lead to hospital ● ex: collect data →diagnose
readmission, "not all"

History of Nursing Science:

th th
Early 20 century views Emergent of science and theory in the late 20 century
● Positivism emerged as the dominant view of modern ● Phenomenological Approach reduces observations or
science. text to the meanings of phenomena independent of
● Modern logical positivists believed that empirical their particular context. This approach focuses on the
research and logical analysis were two approaches lived meaning of experiences.
that would produce scientific knowledge. Several authors presented analysis challenging
Philosopher focused on the analysis of theory the positivist position, thus offering the basis for a
structure. new perspective in science.
Scientists focused on empirical research. Empiricists view phenomena objectively, collect
Increasing use of computers which permits the data and analyze it to inductively propose theory.
analysis of large data.
Interdependence of theory and research Science as a social enterprise
● In constructing theory, theorists must be ● "Human beings do science" - Gale. It might be
knowledgeable about available empirical findings and anticipated that social, economic, or political factors
able to take these into account, because theory is may influence scientific enterprise. It depends on the
concerned with organizing and formalizing available funds, popularity of certain ideologies.
knowledge of a given phenomenon. ● Science progresses by the diversity of dialogue within
● The theory is subject to revision or maybe abandoned the discipline of nursing. The creation of a merged
in favor of an alternative explanation for new paradigm from many paradigms is debated in
information. relationship to the advancement of nursing.

Theory Development Process:

THEORY
- Usually means “mere guess” or
Scientifically, theory implies that something An idea that is suggested or
unproved
has been proven and is generally accepted presented as possibly true but
- Literally means “a vision” or “a
as being true. An idea or set of ideas that is that is not known or proven to
beholding scene”
intended to explain facts or events. be true.
- Greek word “theoria”
A set of statements that tentatively
An internally consistent group of relational
describe, explain, or predict
statements (concepts, definitions & Scientifically theory implies
relationships among concepts that
propositions) that present a systematic view that something has been
have been systematically selected &
about a phenomenon & which is useful for proven and is generally
organized as an abstract
description, explanation, prediction & control accepted as being true.
representation of some phenomenon
(Bodie & Chitty).
(Powers & Knapp).

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 The general principles or ideas that relate to principles or ideas that relate to a
particular subject.
A creative & rigorous structuring of
Ex.
ideas that project a tentative, Theory of Evolution
purposeful & systematic view of
phenomenon. Validation of existing
knowledge as well as discovery of new
knowledge. We apply theory to
describe, explain, predict, or prescribe
nursing practice.

Categories of Theory Components:

CONCEPTS CATEGORIES OF CONCEPTS
are words or phrases
that are used to Type Meaning Example
represent the Abstract independent of a certain time and place CHS
phenomenon Concrete more specific time or place Nursing, Pharmacy
observed or they belong or not belong to a particular categories patients, nurses,
Discrete
experienced or classes of phenomena environment
are the building ▪ Concepts - classifications of dimensions or
pain, health – illness
blocks of theories, Continuous gradations of a phenomenon across a continuum
continuum
“ideas” ▪ Degrees or levels in a given continuum
describe & classify Theoretical
establish meaning (dictionary) dictionary meaning
phenomena Definitions
Operational how these concepts are used or will be used within provide
Definitions the context of the phenomenon measurement

10 Phases of Concept Building Process:

1. Write a meaningful practice story.
2. Name the central phenomenon in the practice story.
3. Identify a theoretical lens for viewing the phenomenon.
4. Link the phenomenon to existing literature.
5. Gather a story from someone who has lived the phenomenon.
6. Reconstruct the shared story and create mini-saga that captures its message
7. Identify the core qualities of the phenomenon.
8. Use the core qualities to create a definition.
9. Create a model of the phenomenon
10. Write a mini synthesis that integrates the phenomenon with a population to suggest research
direction.
Relational Statements Statements in a theory may state definitions or relations among concepts
Theoretical Statements Relate concepts to one another; permit analysis
Operational Statements Relate concepts to measurements

Linkages and Ordering:

provide rationale of why theoretical statements are linked; add
Linkages of theoretical statements
plausibility
provides rationale for how measurement variables are linked;
Linkages of operational statements
permit testability
Organization of concepts and definitions into
eliminates overlap (tautology)
primitive and derived terms
Organization of statements and linkages into
eliminates inconsistency
premises and derived hypotheses and equations

SCIENTIFIC LAW vs. THEORY

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 SCIENTIFIC LAWS THEORY
A statement of fact that aims to explain, in brief and More complex & dynamic; maybe replaced
simple terms, an action or set of actions Explains an entire group
Generally accepted to be true and universal and can Can be changed or improved without changing the
occasionally be expressed in terms of a single overall truth
mathematical equation Developed from the scientific method
SIMPLE, TRUE, UNIVERSAL & ABSOLUTE ACCEPTED AT TRUE & PROVED
Governs a single action, foundations for all science Hypothesis
Statement based on repeated experimental ● an educated guess based upon observation
observations that describes some aspects of the ● can be supported or proven false by experimentation
universe or continued observation
Always applies under same conditions, & implies that ● an idea or theory that is not proven but leads to
there is a causal relationship involving its elements further study or discussion
ex. Law of Universal Gravitation by Newton ● an assumption made for the sake of argument\
● HAS NOT BEEN PROVED
● ex. watching excessive amounts of TV reduces a
person’s ability to concentrate; smoking leads to lung
cancer

Contemporary Issues in Nursing Theory Development:

▪ Theoretical Boundaries and Levels to Advance Nursing Science

o proposed framework now used without reference to the author for the development of
nursing science
▪ Nursing Theory, Practice and Research
o Theory-testing research may lead one nursing theory to fall aside as a new theory
is developed that explains nursing phenomena more adequately; must continue to
advance the discipline.

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