Florence Nightingale

ENVIRONMENTAL THEORY

METAPARADIGM IN NURSING ;
Nursing: Nursing is different from medicine and the goal of nursing is
to place the patient in the best possible condition for nature to act.
•Nursing is the "activities that promote health (as outlined in canons)
which occur in any caregiving situation. They can be done by anyone."

Person: People are multidimensional, composed of biological,

psychological, social and spiritual components. BIOGRAPHY
Florence Nightingale (12 May 1820 – 13 August 1910)
Health: Health is ―not only to be well, but to be able to use well was a nurse who contributed to developing and shaping
every power we have. Disease is considered as the absence of comfort. the modern nursing practice and has set examples for
nurses who are standards for today’s profession.
Environment: "Poor or difficult environments led to poor health and Nightingale is the first nurse theorist well-known for
disease". developing the Environmental Theory that
•"Environment could be altered to improve conditions so that the revolutionized nursing practices to create sanitary
natural laws would allow healing to occur." conditions for patients to get care. She is recognized as
the founder of modern nursing. During the Crimean
War, she tended to wounded soldiers at night and was
known as “The Lady with the Lamp.”

NIGHTINGALE’S ENVIRONMENTAL THEORY;

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing the environment of the patient to
assist him in his recovery.” It involves the nurse’s initiative to configure environmental settings appropriate for the gradual
restoration of the patient’s health and that external factors associated with the patient’s surroundings affect the life or biologic
and physiologic processes and his development. Nightingale discussed the Environmental Theory in her book Notes on Nursing:
What it is, What it is Not. She is considered the first theorist in nursing and paved the way in the foundation of the nursing
profession we know today.

ASSUMPATIONS OF
NIGHTINGALE'S THEORY
Natural laws
Mankind can achieve perfection
Nursing is a calling
Nursing is an art and a science
Nursing is achieved through
environmental alteration
Nursing requires a specific educational
base
Nursing is distinct and separate from
medicine
 Jean Watson
PHILOSOPHY AND THEORY OF
TRANSPERSONAL CARING

METAPARADIGM IN NURSING;
Person: Viewed holistically wherein the body, mind and soul are
interrelated; each part a reflection of the whole

Environment: Provides the values that determine

how one should behave and what goals one should
strive toward
BIOGRAPHY;
Jean Watson (June 10, 1940 – present) is an American
Health: Refers to unity and harmony within the
nurse theorist and nursing professor known for her
mind, body and soul
“Philosophy and Theory of Transpersonal Caring.” She has
also written numerous texts, including Nursing: The
Nursing: A human science of people and human health-illness
Philosophy and Science of Caring. Watson’s study on caring
experiences
has been integrated into education and patient care to
various nursing schools and healthcare facilities worldwide.
WATSON’S PHILOSOPHY AND SCIENCE OF CARING;
It is concerned with how nurses express care to their patients. Her
theory stresses the humanistic aspects of nursing as they intertwine with
scientific knowledge and nursing practice.

THE TEN PRIMARY CARATIVE FACTORS;

1.The formation of a humanistic- altruistic
ASSUMPTIONS;
system of values.
Watson’s model makes seven assumptions: (1) Caring can be effectively
2. The installation of faith-hope.
demonstrated and practiced only interpersonally. (2) Caring consists of
3. The cultivation of sensitivity to one‘s self and to others.
carative factors that result in the satisfaction of certain human needs.
4.The development of a helping-trust relationship
(3) Effective caring promotes health and individual or family growth. (4)
5.The promotion and acceptance of the expression of positive and
Caring responses accept the patient as he or she is now, as well as what
negative feelings.
he or she may become. (5) A caring environment offers the development
6.The systematic use of the scientific problem-solving method for
of potential while allowing the patient to choose the best action for
decision making
themselves at a given point in time. (6) The science of caring is
7.The promotion of interpersonal teaching-learning.
complementary to the science of curing. (7) The practice of caring is
8.The provision for a supportive, protective and corrective mental,
central to nursing.
physical, socio-cultural and spiritual environment.
9.Assistance with the gratification of human needs.
10.The allowance for existential-phenomenological forces.
 Patricia Benner
STAGES OF NURSING EXPERTISE
NURSING PHLOSOPHIES

METAPARADIGM IN NURSING;

Nursing: enabling condition of connection and concern which

shows a high level of emotional involvement in the nurse-
client relationship
✓ Nursing is viewed as a caring practice

Person: a self-interpreting being who does not come into the BIOGRAPHY;
world predefined but gets defined in the course of living a life Dr. Benner is the Chief Faculty Development Officer for
✓ The person must deal with: EducatingNurses.com. She is a noted nursing educator and author of
i. Role of the situation From Novice to Expert: Excellence and Power in Nursing Practice.
ii. Role of the body Dr. Benner was the Director of this Carnegie Foundation for the
iii. Role of personal concerns Advancement of Teaching National Nursing Education Study, which
iv. Role of temporality is the first such study in 40 years. She additionally collaborated with
the Carnegie Preparation for the Professions studies of Clergy,
Health: defined as “what can be assessed” Engineering, Law and Medicine. Dr. Benner is a Fellow of the
American Academy of Nursing. She was elected an honorary fellow of
Environment: she suggests a social environment with social the Royal College of Nursing. Her work has influence beyond nursing
definition and meaning in the areas of clinical practice and clinical ethics.

SKILLS ACQUISITION IN NURSING:

1. Novice
• Person has no background experience of the situation he is involved
• Level where student nurses belong
BENNER’S STAGES OF NURSING EXPERTISE NURSING
2. Advance beginner PHLOSOPHIES;
• Person has sufficient experience to easily understand aspects of the Patricia Benner developed a concept known as “From Novice to
situations Expert.” This concept explains that nurses develop skills and an
• They have difficulty grasping the current patient situation in terms of understanding of patient care over time from a combination of a strong
the larger perspective educational foundation and personal experiences.
• Newly graduated nurses belong to this level

3. Competent
•Competent performance considers consistency, predictability and time
management as essential component

4. Proficient
• Person perceives the situation as a whole rather than in terms of
aspects
• They no longer rely on preset goals for organization

5. Expert
• Person no longer relies on analytical principles like rules, guideline, and
maxims to connect her understanding of a situation
 Katie Eriksson
THEORY OF CARITATIVE CARING

METAPARADIGM IN NURSING;

Human: is fundamentally holy, which means accepting the

human obligation of serving with love and existing for the
sake of other

Nursing: care of all teaching and fostering growth in all

forms of human relations
BIOGRAPHY;
Katie Eriksson is a Finland-Swedish nurse. After taking
Environment: the ethos of caring science, as well as that
nursing in 1965 to be able to practice nursing, she became
of caring, consists of the idea of love and charity and
a nursing instructor at Helsinki Swedish Medical
respect and honor of the holiness and dignity of the human
Institute. She currently works as a professor of health
being
sciences at Abo Akademi University in Vaasa, where she
built a master’s degree program in health sciences, and a
Health: soundness, freshness and well-being
four-year postgraduate studies program leading to a
doctoral degree in health sciences.

MAJOR CONCEPTS AND DEFINITIONS:

1. Caritas - means love and charity, eros and agape are united, and caritas
is by nature unconditional love
2. Caring communion - constitutes the context of the meaning of caring ERIKSSON’S THEORY OF CARITATIVE
and is the structure that determines caring reality CARING;
3. The act of caring - contains the caring elements (faith, hope, love, The Theory of Caritative Caring was developed by Katie
tending, playing, and learning) Eriksson. This model of nursing distinguishes between
4. Caritative caring ethics - comprises the ethics of caring, the core of caring ethics, the practical relationship between the
which is determined by the caritas motive patient and the nurse, and nursing ethics. Nursing ethics
5. Dignity - constitutes one of the basic concepts of caritative caring ethics are the ethical principles that guide a nurse’s decision-
6. Invitation - refers to the act that occurs when the nurse welcomes the making abilities. Caritative caring consists of love and
patient to the caring communion charity, which is also known as caritas, and respect and
7. Suffering - an ontological concept described as a human being’s struggle reverence for human holiness and dignity. According to the
between good and evil in a state of becoming theory, suffering that ocurs as a result of a lack of
8. The suffering from human being - used to describe the patient, caritative care is a violation of human dignity.
patients (Latin) which means “suffering”
9. Reconciliation - a change through which a new wholeness is formed of
the life of the human being has lost his suffering
10. Caring culture - characterizes the total caring reality and is based on
cultural elements such as traditions, rituals and basic values
 Martha Rogers
SCIENCE OF UNITARY HUMAN
BEINGS

METAPARADIGM IN NURSING;

Person: The people have the capacity to participate knowingly and

probabilistically in the process of change

Environment: The environment is an “irreducible, pan-

dimensional energy field identified by pattern and integral with the BIOGRAPHY;
human field” Martha Elizabeth Rogers (May 12, 1914 – March 13,
1994) was an American nurse, researcher, theorist, and
Health: Rogers defined health as an expression of the life process; author widely known for developing the Science of
they are the characteristics and behavior emerging out of the Unitary Human Beings and her landmark book, An
mutual, simultaneous interaction of the human and environmental Introduction the Theoretical Basis of Nursing.
fields” She believes that a patient can never be separated from
their environment when addressing health and
Nursing: The concept Nursing encompasses two dimensions treatment. Her knowledge about the coexistence of the
✓ Independent science of nursing human and his or her environment contributed a lot in
✓ Art of nursing practice changing toward better health.

ROGER’S SCIENCE OF UNITARY HUMAN BEINGS;

Martha Rogers’ theory is known as the Science of Unitary Human
Beings (SUHB). The theory views nursing as both a science and an art OTHER CONCEPTS:
as it provides a way to view the unitary human being, who is integral a. Energy Field: provides a way to perceive people and their
with the universe. The unitary human being and his or her environment environment as irreducible wholes
are one. Nursing focuses on people and the manifestations that emerge b. Openness: human being openly participate in energy
from the mutual human-environmental field process. transformation with the environment creating mutual change
c. Pattern: a distinguishing characteristics of an energy field
perceived as a single wave. She calls it as an “abstraction”
that gives identity to the field
d. Pan dimensionality: The parameters in language that
human use to describe events are arbitrary
ASSUMPTIONS;
e. Homodynamic principles: apostolate the way of
Rogers’ Theory of Unitary Human Beings’ assumptions are as follows: (1)
perceiving unitary human beings
Man is a unified whole possessing his own integrity and manifesting
3 principles: a. Resonancy b. Helicy c. Integrality
characteristics that are more than and different from the sum of his parts.
(2) Man and the environment are continuously exchanging matter and
energy with one another. (3) The life process evolves irreversibly and
unidirectionally along the space-time continuum. (4) Pattern and
organization identify the man and reflect his innovative wholeness. And
lastly, (5) Man is characterized by the capacity for abstraction and
imagery, language and thought sensation, and emotion.
 Dorothea Orem
SELF-CARE DEFICIT NURSING
THEORY
METAPARADIGM IN NURSING;

Person: Has the capacity to reflect, symbolize, and use symbols

•A unity that can function biologically, symbolically, and socially

Environment: Composed of environmental factors, elements,

conditions, and developmental environment

Health: When human beings are structurally and BIOGRAPHY:

functionally whole or sound Dorothea Elizabeth Orem (July 15, 1914 – June 22, 2007)
was one of America’s foremost nursing theorists who
Nursing: An art of helping others developed the Self-Care Deficit Nursing Theory, also known as
• To render the patient or the members of his family, capable of the Orem Model of Nursing.
meeting the patient’s self- needs
Her theory defined Nursing as “The act of assisting others in
the provision and management of self-care to maintain or
improve human functioning at the home level of
effectiveness.” It focuses on each individual’s ability to
OREM’S SELF-CARE DEFICIT NURSING THEORY; perform self-care, defined as “the practice of activities that
There are instances wherein patients are encouraged to bring out the best individuals initiate and perform on their own behalf in
in them despite being ill for a period of time. This is very particular in maintaining life, health, and well-being.”
rehabilitation settings, in which patients are entitled to be more
independent after being cared for by physicians and nurses. Between
1959 and 2001, Dorothea Orem developed the Self-Care Nursing Theory
or the Orem Model of Nursing. It is considered a grand nursing theory,
which means the theory covers a broad scope with general concepts COMPOSED OF 4 RELATED THEORIES:
applicable to all instances of nursing. 1. The Theory of Self-Care: practice of activities on their own behalf
2. The Theory of Dependent Care
3. The Theory of Self-care Deficit: relationship between an
individual’s therapeutic self-care demand and his powers of self-care
agency
ASSUMPTIONS; 4. The Theory of Nursing Systems: series and sequences of deliberate
Dorothea Orem’s Self-Care Theory assumptions are: (1) To stay alive and practical actions of nurses performed at times in coordination with the
remain functional, humans engage in constant communication and actions of their patients
connect among themselves and their environment. (2) The power to act 3 classifications:
deliberately is exercised to identify needs and to make needed judgments. i. Wholly compensatory
(3) Mature human beings experience privations in the form of action in ii. Partially compensatory
care of self and others involving making life-sustaining and function- iii. Supportive-educative system
regulating actions. (4) Human agency is exercised in discovering,
developing, and transmitting to others ways and means to identify needs
for, and make inputs into, self and others. (5) Groups of human beings
with structured relationships cluster tasks and allocate responsibilities
for providing care to group members.
 Imogene King
CONCEPTUAL SYSTEM AND MIDDLE-
RANGE THEORY OF GOAL ATTAINMENT

METAPARADIGM IN NURSING;

Nursing: an observable behavior found in the health care

systems in society

Person: Has the ability to perceive, think, feel, choose, set goals,
BIOGRAPHY:
select means to achieve goals & to make decision Imogene Martina King (January 30, 1923 – December
24, 2007) was one of the pioneers and most sought
Health: a dynamic state in the life cycle, whereas illness nursing theorists for her Theory of Goal Attainment, which
interferes with the process she developed in the early 1960s. Her work is being
taught to thousands of nursing students worldwide and
Environment: the background for human interaction is implemented in various service settings.

As a recognized global leader, King truly made a positive

difference for the nursing profession with her significant
impact on nursing’s scientific base. She made an enduring
impact on nursing education, practice, and research while
serving as a consummate, active leader in professional
KING’S CONCEPTUAL SYSTEM AND MIDDLE-RANGE nursing.
THEORY OF GOAL ATTAINMENT;
Imogene M. King’s Theory of Goal Attainment focuses on this process to
guide and direct nurses in the nurse-patient relationship, going hand-in-
hand with their patients to meet good health goals.

3 INTERACTING SYSTEMS:
ASSUMPTIONS: 1. Personal System - individuals are personal systems.
The assumptions are: (1) The focus of nursing is the care of the human Everyone is an open, total unique system in constant
being (patient). (2) The goal of nursing is the health care of both interaction with the environment.
individuals and groups. (3) Human beings are open systems interacting 2. Interpersonal System - 2 or more individuals in
with their environments constantly. (4) The nurse and patient interaction form interpersonal systems
communicate information, set goals mutually, and then act to achieve 3. Social System - an organized boundary system of
those goals. This is also the basic assumption of the nursing process. (5) social role, behaviors and practices developed to maintain
Patients perceive the world as a complete person making transactions values and the mechanisms to regulate the practice and
with individuals and things in the environment. (6) The transaction rules
represents a life situation in which the perceiver and the thing being
perceived are encountered. It also represents a life situation in which a
person enters the situation as an active participant. Each is changed in
the process of these experiences.
 Betty Neuman
SYSTEM MODEL

METAPARADIGM IN NURSING;

Nursing: requires a holistic approach where it

considers all factors affecting one’s health
BIOGRAPHY:
Person: individual, family, community, or service Betty Neuman was born in 1924 near Lowell, Ohio. She grew
up on a farm which later encouraged her to help people who
Health: depends upon which state of health continuum the are in need. As a young girl, she attended the same one-room
person is in schoolhouse that her parents had attended and were excited to
go to a high school library. She was always engaged and
Environment: internal, external and created forces that interact fascinated with the study of human behavior. During World
with a person’s state of health War II, she had her first job as an aircraft instrument
technician. In 1947, she received her RN Diploma from
Peoples Hospital School of Nursing, Akron, Ohio.
NEUMAN’S SYSTEM MODEL;
Betty Neuman describes the Neuman Systems Model as “a unique, open-
system-based perspective that provides a unifying focus for approaching
a wide range of concerns. A system acts as a boundary for a single client,
a group, or even several groups; it can also be defined as a social issue. A
client system in interaction with the environment delineates the domain
of nursing concerns.”

SYSTEMS MODEL IN NURSING PRACTICE:

• Client/Person Variables: physiochemical structure and function of
the body
• Psychological Variables: mental processes and emotions •
Developmental Variables: process related to development over life
• Sociocultural Variables: relationships; social and cultural
expectations and activities
• Spiritual Variables: influence of spiritual beliefs

3 LEVELS OF PREVENTION:
• Primary Prevention – aims to strengthen the capacity of person to
maintain an optimum level
• Secondary Prevention – alleviate actual effects of an action that
caused alteration
• Tertiary Prevention – aims to prevent regression or recurrence of the
illness
 Dorothy Johnson
BEHAVIORAL SYSTEM MODEL

METAPARADIGM IN NURSING;

Person: with pattered, repetitive,

and purposeful ways of behaving that link the person to the
environment
2 Major Systems: BIOGRAPHY;
✓ Biological System – focus of medicine Dorothy E. Johnson (August 21, 1919 – February 1999) was
✓ Behavioral System – focus of nursing one of the greatest nursing theorists who developed the
“Behavioral System Model.” Her theory of nursing defines
Health: elusive state affected by social, psychological, biological, nursing as “an external regulatory force which acts to
and physiological factors preserve the organization and integration of the patients’
behaviors at an optimum level under those conditions in
Environment: consists of all the factors that are NOT a part of which the behavior constitutes a threat to the physical or
the individual’s behavioral system but influence the system social health, or in which illness is found.”

Nursing: primary goal is to promote “equilibrium” within the

individual.

JOHNSON’S BEHAVIORAL SYSTEM MODEL;

Dorothy Johnson’s theory defined Nursing as “an external regulatory
force which acts to preserve the organization and integration of the
patient’s behaviors at an optimum level under those conditions in which
the behavior constitutes a threat to the physical or social health, or in
which illness is found.”

7 SUBSYSTEMS WITHIN THE BEHAVIORAL SYSTEM 1.

Attachment/Affiliative – ability to establish relationships/trust where
it provides security and survival
2. Dependency – promotes helping behavior that calls for a nurturing
response
3. Ingestive – has to do with when, how, what, how much, and under
what conditions we eat
4. Eliminative – excretion of waste products whereas there are no
socially adequate behaviors for the time and place for human to excrete
5. Sexual – has the dual function of procreation and gratification but
this still vary according to culture and gender
6. Aggressive – behaviors concerned with self defense and self-
preservation
7. Achievement – behaviors that attempts to control the environment
 Myra Estrine Levine
CONCERVATION MODEL OF
NURSING
METAPARADIGM IN NURSING;

Person: The person is a unique individual in unity, integrity,

feeling, belief, thinking, and whole.

Health: Health is the pattern of adaptive change of the whole BIOGRAPHY:

being. Myra Estrin Levine was born in Chicago in 1920, the first child
of three siblings. Her involvement throughout her father’s
Environment: The environment includes both the internal and persistent gastrointestinal illness contributed to her interest in
external environment. and devotedness to nursing.

Nursing: Nursing is the human interaction relying on In 1944, Myra Estrin Levine received her diploma in nursing
communication, rooted in the individual human being’s organic from the Cook County School of Nursing, then continued to finish
dependency in his relationships with other human beings. her Bachelor of Science in Nursing from the University of
Chicago in 1949. Her Master’s of Science in Nursing was granted
to her from Wayne State University in Detroit in 1962.
LEVINE’S CONCERVATION MODEL OF NURSING;
The core of the conservation model is to improve a person’s physical and
emotional well-being by considering the four domains of conservation
she set out. Nursing’s role in conservation is to help the person with the
process of “keeping together” the total person through the least amount
of effort. Levine (1989) proposed the following four principles of
conservation:
1. The conservation of energy of the individual.
2. The conservation of the structural integrity of the individual.
3. The conservation of the personal integrity of the individual.
4. The conservation of the social integrity of the individual.

MAJOR CONCEPTS AND ASSUMPTONS:

• Conservation – “keeping together of the life system” = proper balance

between nursing intervention and patient participation through:
1. Conservation of energy: balancing energy input and output to
avoid excessive fatigue
2. Conservation of structural integrity: maintaining or restoring the
structure of the body preventing physical breakdown or promoting
healing
3. Conservation of personal integrity: recognizes the individual as
one who strives for recognition, respect, self-awareness, selfhood, and
determination
4. Conservation of social integrity: recognizes the individual’s need or
family and friends, community, workplace and school, religion, and
personal choices
 Hildegard Peplau
INTERPERSONAL RELATIONS
THEORY
METAPARADIGM IN NURSING;

Person: An organism that lives in an unstable balance of a

given system.

Health: Symbolizes movement of the personality and other

ongoing processes BIOGRAPHY;
Hildegard Elizabeth Peplau (September 1, 1909 – March 17,
Environment: Forces outside the organism in context of 1999) was an American nurse who is the only one to serve the
socially approved way of living American Nurses Association (ANA) as Executive Director and
later as President. She became the first published nursing
Nursing: significant, therapeutic, interpersonal process theorist since Florence Nightingale.

Peplau was well-known for her Theory of Interpersonal Relations,

which helped to revolutionize nurses’ scholarly work. Her
achievements are valued by nurses worldwide and became
PEPLAU’S INTERPERSONAL RELATIONS THEORY;
known to many as the “Mother of Psychiatric Nursing” and the
Hildegard Peplau’s Interpersonal Relations Theory emphasized the
“Nurse of the Century.”
nurse-client relationship as the foundation of nursing practice. It
emphasized the give-and-take of nurse-client relationships that was seen
by many as revolutionary. Peplau went on to form an interpersonal
model emphasizing the need for a partnership between nurse and client
as opposed to the client passively receiving treatment and the nurse
passively acting out doctor’s orders.

ASSUMPTIONS;
Hildegard Peplau’s Interpersonal Relations Theory’s assumptions are:
(1) Nurse and the patient can interact. (2) Peplau emphasized that both
the patient and nurse mature as the result of the therapeutic interaction.
(3) Communication and interviewing skills remain fundamental nursing
tools. And lastly, (4) Peplau believed that nurses must clearly
understand themselves to promote their client’s growth and avoid
limiting their choices to those that nurses value.

NURSE-PATIENT RELATIONSHIP:
• Orientation: the person and the nurse mutually identify the person's
problem
• Identification: the person identifies with the nurse, thereby accepting
help
• Exploitation: the person makes use of the nurse's help • Resolution:
the person accepts new goals and frees herself or himself from the
relationship
 Ida Jean Orlando
NURSING PROCESS THEORY
METAPARADIGM IN NURSING;

Nursing: is responsive to individuals who suffer or

anticipate a sense of helplessness
BIOGRAPHY:
Health: sense of adequacy or well being Ida Jean Orlando-Pelletier (August 12, 1926 – November 28,
2007) was an internationally known psychiatric health nurse,
Environment: not defined directly but implicitly in the theorist, and researcher who developed the “Deliberative Nursing
immediate context for a patient Process Theory.” Her theory allows nurses to create an effective
nursing care plan that can also be easily adapted when and if
Person: developmental beings with needs where any complications arise with the patient.
individuals have their own subjective perceptions and
feelings that may not be observable

NURSING PRPCESS THEORY:

1. Professional Nursing Function: Organizing Principle
Finding out and meeting the patient’s immediate needs
ORLANDO’S NURSING PROCESS THEORY;
One important thing that nurses do is converse with the patients and let 2. The Patient’s Presenting Behavior – Problematic Situation
them know what the plan of care will be. However, regardless of how To find out the immediate need for help, nurse must first
well thought out a nursing care plan is for a patient, unexpected recognize the situation as problematic
problems to the patient’s recovery may arise at any time. With these, the
nurse’s job is to know how to deal with those problems so the patient 3. Immediate Reaction – Internal Response
can continue to get back and reclaim his or her well-being. Ida Jean The reaction comprises of the nurse’s perceptions, thoughts
Orlando developed her Deliberative Nursing Process that allows nurses about the perceptions, and the feelings evoked from the
to formulate an effective nursing care plan that can also be easily thoughts which are uncontrollable
adapted when and if any complexity comes up with the patient.
4. Deliberative Nursing Process – Reflective Inquiry
Views the nurse-patient relationship as a dynamic whole

5. Improvement – Resolution
When a situation becomes clear, it loses its problematic
character and a new equilibrium is established
 Joyce Travelbee
HUMAN-TO-HUMAN
RELATIONSHIP MODEL

METAPARADIGM IN NURSING;

Person: a human being is unique, irreplaceable

individual who is in continuous process of becoming, evolving and
changing
BIOGRAPHY;
Health: subjective and objective Joyce Travelbee was born in 1926 and is known for her work
a. Subjective health: an individual defined state of well-being in as a nursing theorist. In 1956, Travelbee earned her Bachelor
accordance with self- appraisal of physical-emotional-spiritual status of Science in Nursing degree from Louisiana State
b. Objective health: an absence of discernible disease, disability of University. She was given a Master of Science in Nursing
defect as measured by physical examination by spiritual director or degree in 1959 from Yale University. Her career dealt
psychological counselor predominantly with psychiatric nursing and education. She
worked as a psychiatric nursing instructor at the DePaul
Environment: she defined human conditions and life experiences Hospital Affiliate School in New Orleans, Louisiana, and
encountered by all men as sufferings, hope, pain and illness. worked later in the Charity Hospital School of Nursing in
Louisiana State University, New York University, and the
Nursing: an interpersonal process whereby the professional nurse University of Mississippi.
practitioner assists an individual to prevent or cope with the illness

INTERACTIONAL PHASES OF HUMAN-TO-HUMAN

RELATIONSHIP MODEL:
1. Original Encounter
TRAVELBEE’S HUMAN-TO-HUMAN RELATIONSHIP • First impression by the nurse of the sick person and vice-versa
MODEL; 2. Emerging Identities
States in her Human-to-Human Relationship Model that the purpose of • The time when relationship begins in which the nurse and the
nursing was to help and support an individual, family, or community to patient perceives each other’s uniqueness
prevent or cope with the struggles of illness and suffering and, if 3. Empathy
necessary, to find significance in these occurrences, with the ultimate • The ability to share in the person’s experience
goal being the presence of hope. 4. Sympathy
• When the nurse wants to lessen the cause of patient’s suffering
5. Rapport
ASSUMPTIONS; • Described as nursing interventions that lesson the patient’s
Human beings are an open system that reacts and adjusts itself to the suffering
environment
✓ They rely on a delicate chemical and environmental balance to secure
their survival
✓ Without the balance, the entire system will crash
 Lydia E. Hall
CARE, CORE, AND CURE
MODEL
METAPARADIGM IN NURSING;

Person: The source of energy and motivation for healing is the

individual care of the recipient, not the healthcare provider

Health: Hall stresses the need to help the person explore the meaning of
his/her behavior to identify and overcome problems trough developing BIOGRAPHY;
self- identity and maturity Lydia Eloise Hall (September 21, 1906 – February 27, 1969)
was a nursing theorist who developed the Care, Cure, Core
Environment: Hall is credited with developing the concept of Loeb model of nursing. Her theory defined Nursing as “a
Center because she assumed that the hospital environment during participation in care, core and cure aspects of patient care,
treatment of acute illness creates a difficult psychological experience for where CARE is the sole function of nurses, whereas the
the ill individual CORE and CURE are shared with other members of the
health team.”
Nursing: Care is the sole function of nurses, whereas core, core, and the
cure aspects of patient care

ASSUMPTIONS;
Hall’s Care, Cure, Core Theory assumptions are as follows: (1)
The motivation and energy necessary for healing exist within the
HALL’S CARE, CORE, AND CURE MODEL;
patient rather than in the healthcare team. (2) The three aspects
Nursing theory, in line with Lydia Hall, is nothing short of
of nursing should not be viewed as functioning independently
revolutionary. In the 1960s, she put down, in her own simple words, her
but as interrelated. And lastly, (3) The three aspects interact,
thoughts about nursing. She did not consider herself a nurse theorist but
and the circles representing them change the size, depending on
instead talked about her transparent thoughts and remarkable nursing
the patient’s total course of progress.
care ideas as she learned them over the years. These lead to the
development of her “Care, Cure, Core Theory,” also known as the “Three
Cs of Lydia Hall.”

SUBCONCEPTS;
1. The Care Circle
✓ The nurturing component of care and is exclusive to nursing
✓ Involves the concept of “mothering” and provide for teaching-learning
activities
✓ The nurse’s goal is the comfort of the patient
2. The Core Circle
✓ Based on social sciences
✓ Involves therapeutic use of self
✓ Patient is able to maintain who they are
3. The Cure Circle
✓ Based in the pathological and therapeutic sciences and is shared with
other members of the health team
✓ The nurse helps the patient and family through medical, surgical, and
rehabilitative prescriptions made by the physician
 Faye Abdellah
21 NURSING PROBLEMS THEORY
METAPARADIGM IN NURSING;

Person: All persons have self-help abilities and the

capacity to learn, both of which vary from one
individual to another

Health: A state when the individual has no unmet

needs and no anticipated or actual impairments
BIOGRAPHY;
Environment: Included in “planning of optimum health on local, state, Faye Glenn Abdellah (March 13, 1919 – present) is a nursing
national, and international research pioneer who developed the “Twenty-One Nursing
levels” Problems.” Her nursing model was progressive for the time in
that it refers to a nursing diagnosis during a time in which
Nursing: An all-inclusive service that is based on the discipline of art and nurses were taught that diagnoses were not part of their role
science that serves individuals, sick or well, cope with their health needs in health care

ABDELLAH’S 21 NURSING PROBLEMS THEORY; ASSUMPTIONS;

The patient-centered approach to nursing was developed from Abdellah’s The assumptions Abdellah’s “21 Nursing Problems Theory”
practice, and the theory is considered a human needs theory. It was relate to change and anticipated changes that affect nursing;
formulated to be an instrument for nursing education, so it most suitable the need to appreciate the interconnectedness of social
and useful in that field. The nursing model is intended to guide care in enterprises and social problems; the impact of problems such
hospital institutions but can also be applied to community health as poverty, racism, pollution, education, and so forth on
nursing, as well. health and health care delivery; changing nursing education;
continuing education for professional nurses; and
development of nursing leaders from underserved groups.

21 NURSING PROBLEMS;
1. To maintain good hygiene and physical comfort.
2. To promote optimal activity: exercise, rest, sleep
3. To promote safety by preventing accidents, injuries, or other trauma and preventing the spread of infection.
4. To maintain good body mechanics and prevent and correct the deformity.
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition for all body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognize the physiologic responses of the body to disease conditions—pathologic, physiologic, and
compensatory.
10. To facilitate the maintenance of regulatory mechanisms and functions.
11. To facilitate the maintenance of sensory function.
12. To identify and accept positive and negative expressions, feelings, and reactions.
13. To identify and accept interrelatedness of emotions and organic illness.
14. To facilitate the maintenance of effective verbal and nonverbal communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress toward achievement and personal spiritual goals.
17. To create or maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs.
19. To accept the optimum possible goals in the light of limitations, physical and emotional.
20. To use community resources as an aid in resolving problems that arise from an illness.
21. To understand the role of social problems as influencing factors in the cause of illness
 Virginia Henderson
NURSING NEED THEORY
METAPARADIGM IN NURSING;

Person: The patient needs assistance to achieve

health and independence

Health: Requires independence and

interdependence because health is more important BIOGRAPHY;
than care of sick Virginia Avenel Henderson (November 30, 1897 – March 19,
1996) was a nurse, theorist, and author known for her Need
Environment: Nurses should minimize the chances Theory and defining nursing as: “The unique function of the
of injury through recommendations regarding building constructions, nurse is to assist the individual, sick or well, in the performance
purchase of equipment and maintenance. of those activities contributing to health or its recovery (or to
peaceful death) that he would perform unaided if he had the
Nursing: Nurse functions as a member of the health care team as necessary strength, will or knowledge.” Henderson is also known
they have a unique function to help sick and well individuals as “The First Lady of Nursing,” “The Nightingale of Modern
Nursing,” “Modern-Day Mother of Nursing,” and “The 20th
Century Florence Nightingale.”

HENDERSON’S 21 NURSING NEED THEORY;

Virginia Henderson developed the Nursing Need Theory to define the
unique focus of nursing practice. The theory focuses on the importance of ASSUMPTIONS;
increasing the patient’s independence to hasten their progress in the Virginia Henderson’s Need Theory assumptions are: (1) Nurses care for
hospital. Henderson’s theory emphasizes the basic human needs and how patients until they can care for themselves once again. Although not
nurses can meet those needs. precisely explained, (2) patients desire to return to health. (3) Nurses are
willing to serve, and “nurses will devote themselves to the patient day
and night.” (4) Henderson also believes that the “mind and body are
inseparable and are interrelated.”
14 COMPONENTS OF BASIC NURSING CARE – NEEDS:
1. Breathe normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable postures
5. Sleep and rest
6. Select suitable clothes
7. Maintain body temperature
8. Keep body clean and well groomed
9. Avoid dangers in environment and avoid injuring others
10. Communicate with others
11. Worship according to one’s faith
12. Work in such a way there is a sense of accomplishment
13. Play or participate in recreation
14. Learn, discover or satisfy curiosity that leads to normal development
and health
 Nola Pender
HEALTH PROMOTION MODEL
METAPARADIGM IN NURSING;

Nursing: the role of nursing is a collaboration among patients, families

and communities to create the best conditions for the expression of
optimal health and high level well being.

Health: the actualization of human potential through goal directed BIOGRAPHY;

behavior self-care, and relationships with others with necessary On August 16, 1941, Nola Pender was born in Lansing, Michigan,
adjustments made to maintain relevant environments. to parents who advocated education for women. With her parents’
support, Nola Pender entered the School of Nursing at West
Environment: the social, cultural, and physical context in which life Suburban Hospital in Oak Park, Illinois, and received her nursing
unfolds. It can be manipulated by the individual to create a positive diploma in 1962. She moved to Northwestern University in
context of cues and facilitators for health-enhancing behaviors. Evanston, Illinois, to obtain a Ph.D. in psychology and education in
1969. Pender’s dissertation research investigated developmental
Person: shaped by their environment but also seeks to create one that changes in the encoding process of short-term memory in children.
expresses their potential. The relationship between person and
environment is reciprocal. Individual characteristics and life experiences
shape beaviors.

ASSUMPTIONS;
Individuals seek to regulate their own behavior actively.
Individuals in all their biopsychosocial complexity interact with the
environment, progressively transforming the environment and being
PENDER’S HEALTH PROMOTION MODEL; transformed over time.
Have you ever noticed advertisements in malls, grocery stores, or schools Health professionals constitute a part of the interpersonal
that advocate healthy eating or regular exercise? Have you gone to your environment, which influences persons throughout their life span.
local centers or hospitals promoting physical activities and smoking Self-initiated reconfiguration of person-environment interactive
cessation programs such as “quit” activities and “brief interventions?” patterns is essential to behavior change.
These are all examples of health promotion. The Health Promotion
Model, developed by nursing theorist Nola Pender, has provided
healthcare a new path. According to Nola J. Pender, Health Promotion
and Disease Prevention should focus on health care. When health
promotion and prevention fail to anticipate predicaments and problems,
care in illness becomes the subsequent priority.

MAJOR CONCEPTS:
1. Personal Factors: categorized as biological, psychological, and socio-
cultural. These factors are predictive of a given behavior and shaped by
the nature of the behavior being considered.
2. Perceived Benefits of Action: anticipated positive outcomes that
will occur from health behavior.
3. Activity-related Affect: defined as the subjective positive or
negative feeling that occurs based on the stimulus properties of the
behavior itself
4. Interpersonal Influences: cognition-concerning behavior, beliefs, or
attitudes of the other
 Madeleine Leininger
TRANSCULTURAL NURSING THEORY
METAPARADIGM IN NURSING:
Person: universally caring who survive in a diversity of cultures through their
ability to provide the universality of care

Environment: world view, social structure, and environmental context

a. Environmental framework – the totality of an event, situation, or BIOGRAPHY:
experience Madeleine Leininger (July 13, 1925 – August 10,
b. Culture – particular group and the patterning of actions, thoughts, and 2012) was an internationally known educator,
decisions author, theorist, administrator, researcher,
consultant, public speaker, and the developer of the
Health: universal across cultures, but distinct within each culture in a way concept of transcultural nursing that has a great
that represents the beliefs, values, and practices of the particular culture impact on how to deal with patients of different
culture and cultural background.
Nursing: leads to deliverance of appropriate nursing care that fits the patient’s
cultural pattern thus reducing stress and conflict

LEININGER’S TRANSCULTURAL NURSING THEORY:

The Transcultural Nursing Theory or Culture Care Theory by Madeleine
Leininger involves knowing and understanding different cultures
concerning nursing and health-illness caring practices, beliefs, and values
to provide meaningful and efficacious nursing care services to people’s
cultural values health-illness context.

KEY CONCEPTS OF TRANSCULTURAL NURSING AND

ETHNO-NURSING:
• A learned subfield or branch of nursing which focuses upon the
comparative study and analysis of cultures with respect to nursing and
health-illness caring practices and beliefs

TRANSCULTURAL THEORY IN NURSING:

• Culture can be seen in actions, words, rules and standards, symbols
and behavior, patterns of people is learned and handled down from
generation to generation

CULTURE DIVERSITY:
• Refers to the differences or variations that can be found both between
and among cultures
• It is important to discover similarities and differences about care and
its impact on the health and wellbeing of groups
 Margaret Newman
HEALTH AS EXPANDING
CONSCIOUSNESS
METAPARADIGM IN NURSING:
Person: Newman used the terms client, individual, patient,
person, and human being interchangeably

BIOGRAPHY:
Health: Health is the main focus for Newman’s theory of
Margaret A. Newman was born on October 10, 1933. She
expanding consciousness earned her Bachelor’s degree in 1962 from the University of
• Outcome of the person’s interaction with their environment Tennessee and her Master’s degree in 1964 from the
• Becoming ill does not diminish wholeness, but simply alters it University of California. While working toward her
graduate degree, Newman served as a joint director of
Environment: The pattern of person-environment interactions nursing of a clinical research center, as well as an assistant
shapes health professor of nursing at the University of Tennessee in
Memphis
Nursing: According to Newman, nurses help clients get in touch
with the meaning of life by identifying their health patterns
ASSUMPTIONS:
• She states 9 patters of interactions: choosing, communicating,
1. Health encompasses conditions heretofore described as
exchanging, feeling, knowing, moving, perceiving, relating, and illness, or, in medical terms, pathology.
valuing 2. These pathological conditions can be considered a
• The nurse works together with the client through critical choice manifestation of the total pattern of the individual
points, when change takes place patient.
3. The pattern of the individual patient that eventually
manifests itself as pathology is primary, and exists prior
to structural or functional changes.
4. Removal of the pathology in itself will not change the
NEWMAN’S HEALTH AS pattern of the individual patient.
EXPANDING CONSCIOUSNESS: 5. If becoming ill is the only way an individual patient’s
“Nursing is the process of recognizing the patient in relation pattern can manifest itself, then that is health for that
to the environment, and it is the process of the individual patient.
understanding of consciousness.” 6. Health is an expansion of the consciousness.
“The theory of health as expanding consciousness was
stimulated by concern for those for whom health as the
absence of disease or disability is not possible .

CONSCIOUSNESS
• The “informational capacity of the system: the ability of the
system to interact with the environment”
• Includes not only cognitive and affective awareness but also
the interconnectedness of the entire living system which includes:
o Physiochemical maintenance
o Growth processes
o The immune system

ABSOLUTE CONSCIOUSNESS – where all opposites are

reconciled = love
✓ Love and pain
✓ Pain and pleasure
✓ Disease and non-disease
 Rosemarie Rizzo Parse
THEORY OF HUMAN BECOMING
METAPARADIGM IN NURSING;
Person: Open being who is more than and different from the sum of the
parts.

Environment: Everything in the person and his experiences

Inseparable, complimentary to and evolving with.
BIOGRAPHY:
Health: Open process of being and becoming, involves synthesis of Dr. Rosemarie Rizzo Parse, PhD, RN, FAAN was born and bred in
values. m Health is not static but, rather, is ever-changing as humans Pennsylvania in 1938. She spent most of her life in Castle Shannon.
choose ways of living. It’s never easy to get so many milestones like she’s had in her life.
Before she pursued a path in Nursing, she was a graduate of St.
Nursing: A human science and art that uses an abstract boy of Francis Academy in 1956. Not long after this, she enrolled in
knowledge to serve Duquesne University and got her degree in Bachelor of Science in
Nursing by 1960 before she officially entered the University of
Pittsburgh to accomplish her master’s in Nursing in 1961 and
eventually fulfilling her doctorate degree in Nursing and Higher
Education in 1969 at the same university.

PARSE’S THEORY OF HUMAN BECOMING:

“Nursing is a science, and the performing art of nursing
is practiced in relationships with persons (individuals, 3 PRINCIPLES:
groups, and communities) in their processes of 1. Meaning
becoming.” a. Imaging – process of knowing and coming to know as persons accept
Explains that a person is more than the sum of the and reject ideas, beliefs, values, and practices
parts, the environment, and the person is inseparable b. Valuing – process of choosing and embracing what is important
and that nursing is a human science and art that uses an c. Languaging – using spoken or written words to express meaning
abstract body of knowledge to help people.
2. Rhythmicity: a design or model
a. Revealing-concealing: exposing or hiding true intentions
b. Enabling-limiting: proving something with means to operate
c. Connecting-separating-associating or keeping someone apart

3. Transcendence
a. Powering – harnessing the capacity to do something
b. Originating – to invent or do something from somewhere
c. Transforming – converting something to another form
 Sigmund Freuds
PSYCHOANALITIC MODEL OF
PERSONAL DEVELOPMENT

METAPARADIGM IN NURSING;
Person: Open being who is more than and different from the sum of the
parts.

Environment: Everything in the person and his experiences

Inseparable, complimentary to and evolving with. BIOGRAPHY:
Sigmund Freud, an Austrian neurologist and the father of
Health: Open process of being and becoming, involves synthesis of psychoanalysis, was born in 1856. His groundbreaking theories
values. m Health is not static but, rather, is ever-changing as humans revolutionized our understanding of the human mind. Freud's key
choose ways of living. concepts, such as the id, ego, and superego, and the stages of
psychosexual development, explored the unconscious mind and its
Nursing: A human science and art that uses an abstract boy of influence on behavior. His work, including "The Interpretation of
knowledge to serve Dreams," delved into dreams, sexuality, and childhood experiences.
Despite controversy, Freud's ideas continue to shape psychology and
psychiatry, leaving a lasting impact on how we perceive ourselves
and the world around us.

FREUDS’ THEORY OF PERSONAL DEVELOPMENT:

Sigmund Freud's psychoanalytic theory posits that human behavior is
primarily driven by unconscious forces, particularly early childhood
experiences and repressed desires. He proposed that the mind is composed
ASSUMPTIONS:
of three parts: the id, ego, and superego. The id represents primal desires,
The Unconscious Mind: A vast reservoir of thoughts, feelings,
the ego mediates between the id and reality, and the superego incorporates
and memories outside of conscious awareness significantly
societal norms and morality. Freud also developed a theory of
influences behavior.
psychosexual development, suggesting that individuals progress through
Psychosexual Stages: Early childhood experiences, particularly
five stages (oral, anal, phallic, latent, and genital), each characterized by
those related to psychosexual development, shape personality
a specific erogenous zone. Fixations at any stage can lead to personality
and behavior. Determinism: Behavior is determined by
disturbances. Additionally, Freud emphasized the importance of dreams
unconscious forces and past experiences.
and defense mechanisms in understanding unconscious processes and
Psychic Determinism: Nothing happens by chance; all
coping with anxiety.
psychological events have a cause, often unconscious.
The Power of the Unconscious: Unconscious desires and
conflicts drive behavior, often manifesting in dreams, slips of
the tongue, and neurotic symptoms.
 Erik Erikson
THEORY OF PSYCHOSOCIAL
DEVELPMENT
8 DEVELOPMENTAL TASKS
1. Trust vs Mistrust (birth-18 months) Infancy
• Very crucial to this stage is consistent caregiving
• Important event: feeding

2. Autonomy vs Sense of Shame and Doubt (18 months-3 yrs) BIOGRAPHY:

• The toddler develops his autonomy by making choices He was born on June 15, 1902 at Frankfurt, Germany and died
• Important event: toilet training on May 12, 1992. Erik Erikson was a renowned German-
American child psychoanalyst celebrated for his influential
3. Initiative vs Guilt (3-5 yrs) Preschool theory on the psychosocial development of human beings.
• Children are developing their superego or conscience Erikson popularized the term "identity crisis" to describe the
• Important event: exploration confusion and uncertainty that adolescents experience as they
strive to establish a sense of self. Erik Erikson's work has had a
4. Industry vs Inferiority (6-11 yrs) School Age profound impact on psychology, education, and sociology. His
• They learn to work and play with their peers theory of psychosocial development continues to be widely
• Important event: school studied and applied to understand human behavior and
development across the lifespan. He is considered one of the
5. Identity vs Role Confusion (12-18) Adolescence most influential psychoanalysts of the 20th
• It is during this stage that the individual is able to seek for the answer to the
question, “who am i?”
• Important event: social relationships

6. Intimacy vs Isolation (19-40) Young Adulthood

• Time to become fully participative in the community, enjoying adult freedom
ASSUMPTIONS:
and responsibility
People, in general have the same basic needs.
• Important event: relationships
Personal development occurs in response to these needs.
Development proceeds in stages.
7. Generativity vs Self-Absorption and Stagnation (40-65) Middle Age
Movement through the stages reflects changes in an
• The individual pursues expansion of personal and social involvement
individual’s motivation.
• Important event: work and parenthood
Each stage is characterized by a psychosocial challenge
that presents opportunities for development.
8. Ego Integrity vs Despair (65 yrs and older) Old Age
• Despair is experienced when the elderly view himself a failure
• Important event: reflection on life
 Jean Piaget
THEORY OF COGNITIVE
DEVELOPMENT
METAPARADIGM IN NURSING:
Person: Cognitive Development: Piaget's stages highlight how individuals'
cognitive abilities develop over time, influencing their understanding of the
world and their interactions with it.

Environment: Social and Cultural Influences: Piaget acknowledged the BIOGRAPHY:

role of the social and cultural environment in shaping cognitive Jean Piaget (1896-1980) was a renowned Swiss
development. psychologist known for his groundbreaking work on child
development. His theories on cognitive development have
Health: Cognitive Health: Piaget's theory can be indirectly applied to had a profound impact on our understanding of how
understanding cognitive health, as it provides insights into normal children think and learn. Piaget's theories have
cognitive development. significantly influenced education and child psychology.
His emphasis on active learning and discovery has shaped
Nursing: Nursing Interventions: Nurses can use Piaget's theory to tailor educational practices. While his theories have been subject
their interventions to the cognitive developmental stage of their patients. to criticism and refinement, his work remains foundational
in understanding child development.

JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT: ASSUMPTIONS:

Jean Piaget's theory of cognitive development is a cornerstone in developmental 1. Children are active learners: Children actively construct their
psychology. It posits that children actively construct their understanding of the understanding of the world through exploration and interaction
world through a series of stages, each characterized by distinct cognitive with their environment. They are not passive recipients of
abilities. Piaget's theory has significantly influenced education and child knowledge.
psychology. It emphasizes the importance of active learning and discovery, 2. Children's thinking is qualitatively different at different ages:
shaping educational practices and our understanding of how children learn and Children's cognitive abilities develop in distinct stages, each
think. characterized by qualitatively different ways of thinking. These
stages are universal and occur in a fixed sequence.
3. Maturation and experience are necessary for cognitive
development: Biological maturation provides the foundation for
cognitive development. Experience, particularly social interaction,
allows children to apply their cognitive abilities to real-world
situations.
4. Cognitive development involves equilibration: Equilibration is the
process of balancing assimilation and accommodation to achieve
cognitive stability. Assimilation: Incorporating new information
into existing mental structures (schemas). Accommodation:
Modifying existing schemas to accommodate new information.
 Lawrence Kohlberg
THEORY OF MORAL
DEVELOPMENT
METAPARADIGM IN NURSING:
Person: Moral Development: Kohlberg's stages highlight how individuals
develop their moral reasoning over time, influencing their decision-making
and behavior. This aligns with the nursing metaparadigm's focus on the
individual as a holistic being, including their moral and ethical BIOGRAPHY:
dimensions. Lawrence Kohlberg (1927-1987) was a prominent
American psychologist best known for his theory of moral
Environment: Social and Cultural Influences: Kohlberg acknowledged development. He was born in Bronxville, New York, and
the role of social and cultural factors in shaping moral development. This earned his Ph.D. in psychology from the University of
connects to the nursing metaparadigm's consideration of the environment Chicago in 1958.
as a factor influencing health and well-being, including moral and ethical
considerations.
ASSUMPTIONS:
Health: Moral Health: While not explicitly stated, Kohlberg's theory can Sequential Stages: Moral development progresses
be indirectly applied to understanding moral health, as it provides through a series of fixed stages, each building on the
insights into the development of moral reasoning. A well-developed moral previous one. Individuals cannot skip stages or regress to
compass can contribute to overall well-being. earlier ones.
Universal Sequence: The sequence of stages is universal,
Nursing: Ethical Decision-Making: Nurses often face complex ethical applying to people across different cultures and societies.
dilemmas in their practice. Understanding Kohlberg's stages of moral Qualitative Differences: Each stage represents a
development can help nurses reflect on their own moral reasoning and qualitatively different way of thinking about morality,
make ethical decisions that align with their values and professional rather than simply a quantitative increase in knowledge.
standards. Moral Reasoning as the Core: Kohlberg primarily
focused on moral reasoning, emphasizing the cognitive
processes involved in making moral judgments.
Justice as the Primary Moral Principle: Kohlberg's
theory centers on the concept of justice as the foundation
of morality.
LAWRENCE KOHLBERG’S THEORY OF MORAL
DEVELOPMENT:
Kohlberg's research focused on understanding how individuals develop
their moral reasoning over time. He studied children and adults,
presenting them with moral dilemmas and analyzing their responses to
identify different stages of moral development.
 Carmencita Abaquin
THEORY OG PREPARE ME

METAPARADIGM IN NURSING:
Person: Her theory applies only to cancer patients in the advanced
stages. They are holistic beings with physical, psychological, social,
religious, independence, and environmental aspects. Patients who
are terminally ill or have incurable diseases such as cancer
require multifaceted care to improve their quality of life
(Ibarra, 2013). BIOGRAPHY:
She was born December 12, 1940 and died last April 8,
Environment: The environment, like all paradigms, was not 2021, She was a nurse with Master’s and Doctoral
precisely defined. Nonetheless, we can assume that the environment Degree in Nursing obtained from the University of the
is an aspect or dimension of the cancer patient. Her quality of life Philippines, College of Nursing. An expert in Medical-
can be also be assessed in the aspect, so it must be taken into Surgical Nursing with subspecialty in Oncology which
account when providing care (Ibarra 2013). made her known both in the Philippines and in foreign
countries. She had served the University of the
Health: The concept of her theory revolves around illness, Philippines College of Nursing as a faculty member and
particularly cancer and the provision of holistic care to improve Secretary of the College of Nursing. She has been
quality of life despite their terminal cases (Ibarra 2013). appointed as Chairman of the Board of Nursing that
speaks highly of her competence and integrity in the
Nursing: The goal of nursing care is the improvement of quality of field she has chosen.
life for advance stage cancer patients despite their current
situation. Her concept of providing holistic care in addressing in the
multidimensional problems that cancer patients face is summarized
in the acronym PREPARE ME (Ibarra 2013).

ASSUMPTIONS:
PREPARE ME (Holistic Nursing Interventions) are
the nursing interventions provided y address the multi -
dimensional problems of cancer patients that can be
Carmencita Abaquin’s PREPARE ME Theory:
given in any seing where patients choose to be
The PREPARE ME theory, developed by Dr. Carmencita Abaquin,
confined. This program emphasizes a holistic approach
is a holistic nursing framework designed to provide care for
to mess care.
advanced cancer patients. It focuses on improving the quality of life
of these patients by addressing their physical, psychological, social,
spiritual, and emotional needs. The PREPARE ME theory aims to
help cancer patients find inner peace, accept their condition, and
maintain a good quality of life. It is a valuable tool for nurses and
healthcare providers who work with advanced cancer patients.