578250403-NURSING-THEORIESL.p in detailptx

INTRODUCTION TO NURSING THEORY
Ms. Blesson thomas
Associate.prof.
mbcon

The foundation of any profession is the development of a
specialized body of knowledge.
1. In the past, the nursing profession relied on theories
from other disciplines, such as medicine, psychology,
and sociology, as a basis for practice.
2. For nursing to define its activities and develop its
research, it must have its own body of knowledge.
3. This knowledge can be expressed as conceptual
MODELS and THEORIES.
INTRODUCTION

 Nursing theories and models provide information about:
1. Definitions of nursing and nursing practice.
2. Principles that form the basis for practice.
3. Goals and functions of nursing.
4. Clarifies the scope of nursing practice.

CONCEPT
Concepts are ideas that gives meaning to our sense
perceptions , permits generalizations and tend to
be stored in our memory for recall and use at later
time and different situations.
According to chinn and jacobs concepts is a complex
mental formulation of an object , property or event,
that is derived from individual perception and
experience.

Nursing theories and models are derived from concepts:
1. Concept is an idea of an object, property, or event.
2. Concepts are basically vehicles of thought involving
mental images.
3. In Nursing, concepts have been borrowed from other
discipline (adaption, culture, homeostasis) as well as
developed directly from nursing practice and research
(maternal-infant bonding, health-promoting
behaviours).
4. Concepts are building blocks of theory.
5. Propositions are statements that explain the
relationship between the concepts.

TYPES OF CONCEPTS:
1. Empirical or concrete concepts: These are directly
observable objects, events, or properties, which
can be seen, felt or heard e.g color of the skin,
communication skill, presence of lesion, wound
status etc., These are limited by time and space (it
can be viewed/measured only specific period &
specific setting and variable).
2. Inferential concepts: These are indirectly
observable concepts, e.g pain, Dyspnea and
temperature.
3. Abstract Concepts: These concepts are not clearly
observable directly or indirectly (known as “Non -
observable concepts directly”).E.g. social support,
Personal Role, Self-esteem etc.

CONCEPTUAL FRAMEWORK : CONCEPT WITH
FRAMEWORK
 In conceptual frame work Problem is being investigated and
is fit into an existing theoretical framework, which guides the
study and enriches the value of its findings.
Guidelines for writing about a research study’s theoretical
framework
1. Introduce the framework.
2. Briefly explain why it is a good fit for the research problem
area.
3. At the end of the literature review thoroughly describe the
framework and explain its application to the present study.

4. Describe how the framework has been used in studies
about similar problems.
5. In the study’s methodology section
--- explain how the framework is being operationalized
in the study’s design.
--- explain how data collection methods reflects the
concepts in the framework.
7. In the study’s discussion section
--- describe how study findings are consistent with the
framework.
---offer suggestions for practice and further research
that are congruent with the framework’s concepts and
proposition.

THEORIES
1. Are set of logically interrelated concepts that
provide a systematic explanatory and predictive
view of phenomena
2. Can begin as an untested premise (hypothesis)
that becomes a theory when tested and
supported or can progress in a more inductive
manner
3. Are tested and validated through research and
provide direction for this research
4. Nursing theory is a framework designed to
organize knowledge and explain phenomena in
nursing.

CHARACTERISTICS
 Must be logical, relatively simple, and generalizable.
 Are composed of concepts and prepositions.
 Interrelate concepts to create a specific way of looking at a
particular phenomenon.
 Provide the bases for testable hypotheses.
 Must be consistent with other validated theories, laws, and
principles but have open unanswered questions for investigation.
 Can consist of separate theories about the same phenomenon
that interrelate the same concepts but describe and explain them
differently

 Contribute to and assist in increasing the general body of
knowledge within a profession through research implemented to
validate them.
 Can be used by nurses to guide and improve their practice.
 Facilitate communication and systematic thinking among nurses
regarding professional convictions, moral/ethical structure to
guide nurses actions,
 It facilitates coordinated and less fragment care.
 The main exponent of nursing – caring – cannot be measured, it
is vital to have the theory to analyze and explain what nurses do.

MODELS
 Conceptual Model is a set of interrelated concepts that
symbolically represents mental image or phenomenon.
Model deals with highly abstract concepts than theory.
General information
1. Describe a set of ideas that are connected to illustrate a
larger, more general concept.
2. Are a symbolic depiction of reality
3. Provide a schematic representation of some relationships
among PHENOMENA
4. Use symbols or diagrams to represent an idea

CHARACTERISTICS
1. Attempt to describe, explain, and sometimes predict
the relationships among phenomena.
2. Are composed of empirical, inferential, and abstract
concepts.
3. Provide an organized framework for nursing
assessment, planning, intervention, and evaluation.
4. Facilitate communication among nurses and
encourage a unified approach to practice, teaching,
administration, and research

METAPARADIGM
 Conceptual models and theories in nursing are based
on the nursing metaparadigm.
 Metaparadigm is the most global conceptual or
philosophical framework of a discipline or profession
 The nursing metaparadigm comprises four concepts :
person, environment, health, and nursing.

1. Person refers to the recipient of nursing care,
including physical. mental and social.
2. Environment refers to all the internal and external
conditions, circumstances, and influences affecting
the person
3. Health refers to the degree of wellness or illness
experienced by the person
4. Nursing refers to the actions, characteristics, and
attributes of the individual providing the nursing care.

CLASSIFICATION OF NURSING
THEORIES AND MODELS
Nursing theories can be classified based on
 Range/scope or abstractness
 Purpose of the theory
 Philosophical underpinnings.

BASED ON RANGE/SCOPE/GENERALIZATION AND
LEVEL OF ABSTRACTNESS:
 Metatheory
 Grand Theories
 Middle RangeTheories
 Practice Theories/Micro theories/prescriptive
theories

578250403-NURSING-THEORIESL.p in detailptx

BASED ON THE PHILOSOPHICAL UNDERPINNINGS
OF THE THEORIES:
1. “Needs” theories
 Are based around helping
individuals to fulfill their
physical and mental
needs.

2.“Interaction”
theories
 As described by
Peplau (1988),
these theories
revolve around
the relationships
nurses form with
patients.

3. “Outcome” theories"
 Outcome theories portray the nurse as the changing
force, who enables individuals to adapt to or cope
with ill health.

4. “Humanistic” Theories
 Humanistic theories
developed in response to
the psychoanalytic thought
that a person’s destiny was
determined early in life.
 Humanistic theories
emphasize a person’s
capacity for self-
actualization.

Based on Purposes or function of theory
 Descriptive-to identify the properties and workings of a
discipline
 Explanatory-to examine how properties relate and thus
affect the discipline.
 Predictive-to calculate relationships between properties
and how they occur.
 Prescriptive -to identify under which conditions
relationships occur betweenproperties and discipline.

HISTORICAL PERSPECTIVE
1860 to 1959
1. In 1860, Florence Nightingale developed her Environmental
Theory.
2. In 1952, the journal Nursing Research was established,
encouraging nurses to become involved in scientific inquiry.
3. In the same year, Hildegard Peplau published Interpersonal
Relations in Nursing; her ideas have influenced later nursing
theorists.
4. In 1955, Virgina Henderson published Definition of Nursing.
5. In the mid-1950s, Teachers College, Columbia University,
New York City, began offering master’s and doctoral
programs in nursing education and administration, resulting
in student participation in theory development and testing.

1960 to 1969
1. During the 1960s, Yale University School of Nursing, New
Haven, Conn., defined nursing as a process, interaction, and
relationship.
2. Also during the 1960s, the U.S. government began funding
master’s doctoral education in nursing.
3. In 1960, Faye Abdellah published Twenty-One Nursing
Problems.
4. In 1961, Ida Orlando published her theory in The Dynamic
Nurse-Patient
5. Relationship: Function, Process, and Principles of
Professional Nursing.
6. In 1962, Lydia Hall published Core, Care, and Cure model.
7. In 1964, Ernestine Wiedenbach published her theory in
Clinical Nursing: A Helping Art

8. In 1965, the American Nurses Association published a position
paper stating that theory development was an important goal
for nursing.
9. In 1966, Myra Levine published Four Conservation Principles.
10. In 1969, Dorothy Johnson published Behavioral Systems
Model.
1970 to 1979
1. During the 1970s, Case Western Reserve University,
Cleveland, sponsored symposia to stimulate theory
development.
2. During the mid 1970s, the National League for Nursing
established an accreditation requirement that nursing
schools base their curricula on a nursing conceptual
framework.

3. In 1970, Martha Rogers published her model in An
Introduction to the Theoretical Basis of Nursing.
4. In 1971, Dorothea Orem published Self-Care Deficit
Therory of Nursing, Imogene King published Theory of
Goal Attainment, and Joyce Travelbee published
Interpersonal Aspects of Nursing.
5. In 1972, Betty Neuman published Health Care Systems
Model.
6. In 1976, Sister Callista Roy published Adaptation
Model.
7. In 1976, J.G.Paterson and L.T.Zderad published
Humanistic Nursing.

1980 to the present
1. In 1980, Evelyn Adam published To be a Nurse and Joan Riehl-
Sisca published Symbolic Interactionism
2. In 1982, Joyce Fitzpatrick published Life Perspective Model.
3. In 1983, Kathryn Barnard published Parent-Child Interaction Model
and Helen Erickson, Evelyn Tomlin, and Mary Ann Swain
published Modeling and Role Modeling.
3. In 1984, Patricia Benner published from Novice to Expert:
Excellence and Power in Clinical Nursing Practice.
3. In 1985, Ramona Mercer published Maternal Role Attainment.

6. In 1986, Margaret Newman published Model of Health.
7. In 1994, Parish Nursing Model:proposed by Bergquist and King
8. In 1994,Rogers proposed “Occupational Health Nursing Model”
9. In 1997, Barbara Artinian and Margarnet Conger published “The
intersystem Model: Integrating Theory and Practice”

KEY CONCEPTS
Nightingale
1860:
Peplau 1952:
Henderson
1955:
• To facilitate “the
body’s reparative
processes” by
manipulating client’s
environment
• Nursing is;
therapeutic
interpersonal
process.
• The needs often
called Henderson’s
14 basic needs

Abdellah
1960:
Orlando
1962:
Johnson’s
Theory 1968:
• delivering nursing care
for the whole person to
meet the physical,
emotional, intellectual,
social, and spiritual
needs of the client and
family.
• the client is an individual;
with a need; that, when
met, diminishes distress,
increases adequacy, or
enhances well-being.
• focuses on how the client
adapts to illness and how
actual or potential stress
can affect the ability to
adapt. The goal of nursing
to reduce stress so that; the
client can move more easily
through recovery.

Rogers
1970:
Orem1971:
King 1971:
• maintain and promote health,
prevent illness, and care for
and rehabilitate ill and disabled
client through “humanistic
science of nursing”
• self-care deficit theory. Nursing
care becomes necessary when
client is unable to fulfill
biological, psychological,
developmental, or social
needs.
• use communication to help
client reestablish positive
adaptation to environment.

Neuman
1972:
Roy 1979:
Watson’s
Theory 1979:
• Stress reduction is goal of
system model of nursing
practice
• This adaptation model is
based on the physiological,
psychological, sociological
and dependence-
independence adaptive
modes.
• defines the outcome of
nursing activity in regard to
the; humanistic aspects of
life.

FRAMEWORK OF
ANALYSIS
Criteria for Evaluating
Theoretical Works

CLARITY
“HOW CLEAR IS YOUR
THEORY?”
 Major Concepts and sub-
concepts and their
definitions are identified.
 “The danger of lost
meaning when terms
are borrowed from
other disciplines and
used in a different
context.” (Ellis)
 Diagrams and examples
may facilitate clarity and
should be consistent.

SIMPLICITY
“How simple is this theory?”
 Nurse in practice need
simple theory, such as
middle-range theory to
guide practice. (Chinn
and Kramer)
 “The most useful theory
provides the greatest
sense of understanding.”
(Reynolds)
 “Elegant in its simplicity,
even though it may be
broad in content.”
(Walker and Avant)

GENERALITY
“How general is this
theory?”
 Scopes of concepts and
goals within the theory are
examined.
 The situations the theory
applies to should not be
limited.
 “The broader the scope,
the greater the
significance of the
theory.” (Chinn and
Kramer)

EMPIRICAL
PRECISION
“How accessible is this
theory?”
 “ How well the
evidence supports
the theory is
indicative of
empirical adequacy.”
(Hardy)
 Other scientists
should be able to
evaluate and verify
results by
themselves.

DERIVABLE
CONSEQUENCE
“How important is this
theory?”
 “It is essential for a theory
to develop and guide
practice...Theories should
reveal what knowledge
nurses must and should,
spend time pursuing.”

SIGNIFICANCE OF THEORY
FOR NURSING
As a Discipline and Profession

PROFESSION
 A specialized field of
practice, which is
founded upon the
theoretical structure
of the science or
knowledge of the
discipline and the
accompanying
practice abilities.
DISCIPLINE
 Specific to the academia
and refers to a branch of
education, a department
of learning or a domain
of knowledge.

NURSING AS A DISCIPLINE
 Theories provided frameworks to structure curriculum
content or to guide the teaching of nursing practice in
nursing programs.
 Discipline is dependent upon theory.

 Focus on knowledge about how nurses function which
concentrated on the nursing process to a focus on what
nurses know and how they use knowledge to guide their
thinking and decision making while concentrating on the
patient.
 New nursing science is developed through theory based
research studies.

NURSING AS A PROFESSION
 Criteria of a profession by Bixler and Bixler published in
the American Journal of Nursing 1959
1. Utilizes in its practice a well defined and well-
organized body of specialized knowledge that is on
the intellectual level of higher learning.
2. Constantly enlarges the body of knowledge it uses
and improves its techniques of education and
service by the use of the scientific method.

3. Entrusts the education of its practioners to institutions
of higher education.
4. Applies its body of knowledge in practical services
that are vital to human and social welfare.
5. Functions autonomously in the formulation of
professional policy and in the control of professional
activity thereby.

6. Attracts individuals of intellectual and personal qualities
who exalt service above personal gain and who
recognize their chosen occupation as a life work.
7. Strives to compensate its practitioners by providing
freedom of action, opportunity for continuous
professional growth, and economic security.

8. Presented specific goals and achievements of the
profession.
9. Nurses are recognized for the contribution they make
in healthcare and the society.
10. Professional practice requires a systematic approach
that is focused on the patient. Nursing theoretical
works provide a perspective of the patient.

11. Nursing theory is a useful tool for reasoning, critical
thinking, and decision making in the nursing practice.
NURSING THEORY AND THE PRACTICE OF NURSING
Theory assists the practicing nurse to:
•Organize patient data
•Understand patient data
•Analyze patient data
•Make decisions about nursing interventions
•Plan patient care
•Predict outcomes of care
•Evaluate patient outcomes

APPLICATION OF THEORY IN NURSING
PROCESS
 Nursing theory is an organised and systematic articulation of
a set of statements related to questions in the discipline of
nursing.
IMPORTANCE OF NURSING THEORIES IN PRACTICE
 Assist the nurse to describe, explain and predict everyday
experiences
 Serve to guide assessment, intervention and evaluation of
nursing care.
 Provide a rationale for collecting reliable and valid data
about the health status of clients, which are essential for
effective decision making and implementation.

 Help to establish criteria to measure the quality of nursing
care
 Helps in building a common nursing terminology to use in
communication with other health professionals. Ideas are
developed and words are defined
 Enhances autonomy (independence and self governance)
of nursing by defining its own independent functions

RELATION BETWEEN THEORIES AND
NURSING RESEARCH
 RESEARCH --- Process of inquiry
 THEORY---- Product of knowledge
 SCIENCE---- Result of the relation between research
and theory
 To effectively build knowledge---- research process
should be developed within some theoretical structure
that facilitates analysis and interpretation of findings
 Research without theory result in discreet information or
data which does not add to the accumulated knowledge
of the discipline.

 Theory guides the research process , forms the research
questions, aids in design, analysis and interpretation
 It enables the scientist to weave the facts together.
PURPOSE OF THEORY IN RESEARCH
 To identify the meaningful and relevant areas of study.
 To propose possible approaches to health problems
 To develop or refine theories
 Define concepts and proposed relationships between
concepts.
 To interpret research findings
 To develop clinical practice protocols
 Generate nursing diagnosis.

USE OF THEORY IN RESEARCH
 Theory generation via inductive research
Theory testing via deductive research
Formal practice

APPLICATION OF NURSING THEORIES IN
NURSING PRACTICE

578250403-NURSING-THEORIESL.p in detailptx

More Related Content

Similar to 578250403-NURSING-THEORIESL.p in detailptx (20)

More from Soum Geo (20)

Recently uploaded (20)

578250403-NURSING-THEORIESL.p in detailptx