Running Head CONTEXT IN MOBILE COMPUTING1CONTEXT IN MOBILE C.docx

Running Head: CONTEXT IN MOBILE COMPUTING 1
CONTEXT IN MOBILE COMPUTING 5
Context in Mobile Computing
Student’s Name
Institutional Affiliation
In recent decades, there have been rapid advances in mobile
computing, such as context awareness, integrated sensor
technologies and a wide range of wired and wireless practices.
Most of the modern mobile computing systems can use context
to provide appropriate information and services to the user,
where relevance depends on the user's task (Zheng et al., 2016).
The purpose of having mobile computing systems that are
context-aware is to offer the various services at a reasonable
development cost and with simple reconfiguration. That being
said, it is important to discuss context awareness in mobile
computing. This paper will discuss context as it applies to

mobile computing and the various ways in which context has
been used. Besides, the paper will describe sensor fusion as it
applies to context and suggests new ways of using context.
Context as it applies to Mobile Computing
The concept of context has been explored by a number of
researchers. Musumba and Nyongesa (2013) argue that context
encompasses location, characteristics of neighboring users or
objects and the consequent changes. Talipov et al. (2015) refer
to context as location, environment attributes, time and the
identities of neighboring users. According to Riboni (2015),
context involves the user's feelings, concentration, location,
date and time, and the objects in the user's environment. Based
on these definitions, it is notable that the most important
aspects of context are user location, the user's environment, and
the objects near the user. Additionally, it can be said that
context is subject to the constantly shifting execution
environment. Even though the notion of context comprises the
understandings of a scenario, much of the effort within the
mobile computing community takes a bottom-up methodology to
context.
In mobile computing, context involves the understanding of the
physical environment and how the implicit input influences the
behavior of an application. It encompasses three forms of the
environment – computing environment, user environment and
the physical environment (Vinh & Suzuki, 2013). Through the
concept of context, these environments are able to interact
constantly. The information in the computing and physical
environments of mobile devices generates a context for
interaction between users and devices. Since the current mobile
devices process a wide range of data, context help in controlling
the ways users interact with the ubiquitous environment based
on their repetitive tasks (Zheng et al., 2016). For instance, a
context-aware mobile system can detect that a user never uses
his or her phone while at work, and hence all the calls or
messages are directed to the user's voicemail when they are
working.

Use of Context
The purpose of context-awareness is to determine what the user
is attempting to do when interacting with applications and
systems. Without the context, it can be challenging to determine
the user's objective. The context cues are used to inform an
application on the best way to enhance user-application
interaction. As such, context awareness signifies a standardized
framework of input, enabling almost all applications to be
regarded more or less context-aware as they interact with the
users (Talipov et al., 2015). There is still a contentious
argument as to whether context should only encompass
automatically generated information or should comprise
physically acquired information. While the context would be
generated automatically in an ideal setting, it depends on the
user input in real-life scenarios (Schmidt et al., 1999). This
means that the context can only be physically generated in a
real-life scenario.
Emmanouilidis et al. (2013) advocate three basic applications of
context in applications and systems. These include the
presentation of information and services, implementation of
services and storage of information. Context can enable the user
to acquire the information and services provided by the various
mobile computing systems. At the same time, it can suggest
suitable options for actions to the user. For example, the
context-aware mobile device can guide the user to a specific
location on a map and perhaps propose neighboring objects or
sites, presenting an alternative of services nearby, sensing and
providing input or output information for specific users and
notifying the neighboring users.
As far as the implementation of services is concerned, context is
used to initiate commands or reconfigure the system on behalf
of the user based on the changes in the environment. For
instance, a user's desktop environment can be transferred from
one workstation to another. Other examples include a scenario
whereby the camera captures a picture when a biometric sensor
is used or a situation where a car navigation system redirects

the driver once the car makes a wrong turn. With regards to the
storage and retrieval of information, context enables
applications to capture the relevant information (Musumba &
Nyongesa, 2013). For example, a user interface in a conference
may provide the speeches or notes based on the users who were
there, when the conference happened and the location of the
conference. Another instance can be a scenario where a system
in Zoo may tag information asked by the user based on their
location and time.
Sensor Fusion as it applies to Context
Today, mobile computing applications and systems frequently
use sensor fusion. As Pan and Zhu (2015) define it, sensor
fusion is the combination of data from multiple sensors to
acquire a more precise depiction of the sensor's environment.
Through the use of multiple sensors, it is possible to gain rich
data from which suitable context can be inferred with
reasonably less computation. Each sensor has to contribute to
generating the entire depiction, which means that pre-
processing of sensor data will be more intensive. Besides, each
sensor controls the information about all sensors that bring
about the context information, the time used to distinguish the
context information, and all actions in the system during the
update of context information (Stojanovic, 2009). Further, the
sensors will report its accessibility to the appropriate sensor
fusion mediator.
The first sensor to report in the system may initiate the process
of updating the information. However, the sensor fusion
mediator will take actions as regards the time and process of
updating the system (Subramanya & Yi, 2007). This is achieved
by selecting some sensors that initiate the actions.
Differentiating the context starts with the sensors raising an
update; it then begins to request information from all available
sources in the sensor list. If there is a change in the sensor
configuration, it is updated in the sensor and modifies the
approximated duration required to update the context
information (Zheng et al., 2016). Using the information from

multiple sensors, context makes applications more strong to the
influence of system configuration change. The context
simplifies artificial intelligence algorithms to acquire data that
can generate high-level context information.
New ways of using Context
With mobile computing devices streamlining the user-
application interaction, context-awareness can be used in more
diverse ways. Understanding the user's location and the
subsequent actions will enable the creation of attentive
applications that monitor what one do and react repeatedly (Noh
et al., 2012). Every appliance in the house will recognize the
actions of the user, perhaps based on their body and diverse
attributes in the environment. The context may be used to
enable minimal interaction; potentially enabling an environment
where users and systems interact effectively. Nonetheless, the
key challenge here is to create aspects that enable context to
automatically correct wrong selections made by the system,
hence, making the user feel in control.
In addition, the optical attribute of the user has not been
utilized on context (Zheng et al., 2016). It should be noted that
the visual changes as users engage in specific activities reveal
much information about the activities. Likewise, specific
locations and environments influence visual characteristics. Use
of context to enhance visual capabilities could enable a proper
understanding of the processes in real-world settings
(Stojanovic, 2009). This might lead to an extension of the
current idea of context with a cognitive aspect, with the creation
of cognitive-aware systems that simplify user interaction. Even
as the sensor-equipped computing devices advance human
perception, there is a need to extend the uses of context in
enhancing mobile computing technology. This is the best means
to change the way people live and how they interact with mobile
applications.

References
Emmanouilidis, C., Koutsiamanis, R., & Tasidou, A. (2013).
Mobile guides: Taxonomy of architectures, context awareness,
technologies and applications. Journal of Network and
Computer Applications, 36(1), 103-125.
Musumba, G., & Nyongesa, H. (2013). Context awareness in
mobile computing: A review. International Journal of
Machine Learning and Applications, 2(1).
Noh, H., Lee, J., Oh, S., Hwang, K., & Cho, S. (2012).
Exploiting indoor location and mobile information for
context-awareness service. Information Processing &
Management, 48(1), 1-12.
Pan, Z., & Zhu, J. (2015). Context Awareness on Mobile
Devices. Applied Mechanics and Materials, 743(3), 742-747.
Riboni, D. (2015). Context-Aware Pervasive Interfaces. IEEE
Internet Computing, 19(4), 68-72.
Schmidt, A., Beigl, M., & Gellersen, H. (1999). There is more
to context than location. Computers & Graphics, 23(6),
893-901.
Stojanovic, D. (2009). Context-aware mobile and ubiquitous
computing for enhanced usability: Adaptive technologies and
applications. Hershey PA: Information Science Reference.
Subramanya, S., & Yi, B. (2007). Enhancing the User
Experience in Mobile Phones. Computer, 40(12), 114-117.
Talipov, E., Chon, Y., & Cha, H. (2015). User context-based
data delivery in opportunistic smartphone networks. Pervasive
and Mobile Computing, 17(5), 122-138.
Vinh, P., & Suzuki, J. (2013). Special Issue on Context-
Awareness of Mobile Systems: Models, Algorithms and
Applications. Mobile Networks and Applications, 18(3), 389-

390.
Zheng, M., Cheng, S., & Xu, Q. (2016). Context-Based Mobile
User Interface. Journal of Computer and
Communications, 04(09), 1-9.
Running Head: CONTEXT IN MOBILE COMPUTING
1
Student’s Name
Running Head: CONTEXT IN MOBILE COMPUTING 1

Student’s Name
Afaf Ibrahim Meleis, PhD, FAAN
Margaret Bond Simon Dean
Professor of Nursing and Sociology
University of Pennsylvania
School of Nursing
Philadelphia, Pennsylvania
THEORETICAL NURSING
Development and Progress

Fifth Edition
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Library of Congress Cataloging-in-Publication Data
Meleis, Afaf Ibrahim, author.
Theoretical nursing : development and progress / Afaf Ibrahim
Meleis,
PhD, FAAN, Margaret Bond Simon Dean, Professor of Nursing
and Sociology,
University of Pennsylvania, School of Nursing, Philadelphia,
Pennsylvania. — Fifth Edition.
p. ; cm.
Includes bibliographical references and indexes.
Summary: “An additional assumption was that the processes for
theory development were new to nursing and
hence, nurses in graduate programs learned strategies for
advancing knowledge from other disciplines. This
assumption was debunked with the knowledge that nurses were
always engaged in knowledge development,
driven by their experiences in clinical practice. Because of
these assumptions, most of the early writing about
theory development was about outlining strategies that should
be used, rather than strategies that have already
been used in the discipline to develop theories. Theorists
themselves did not uncover or adequately discuss ways
by which they developed their theories, therefore the tendency
was to describe processes that were based on the-
ories developed in other disciplines, mainly the physical and
social sciences. And an implicit assumption was
made that there should be a single strategy for theory

development, some claiming to begin the process from
practice, and others believing it should be driven by research”—
Provided by publisher.
ISBN 978-1-60547-211-9 (hardback : alk. paper) 1. Nursing—
Philosophy. I. Title.
[DNLM: 1. Nursing Theory. WY 86]
RT84.5.M45 2011
610.7301—dc22
2010051628
Care has been taken to confirm the accuracy of the information
presented and to describe generally accepted
practices. However, the author, editors, and publisher are not
responsible for errors or omissions or for any con-
sequences from application of the information in this book and
make no warranty, expressed or implied, with
respect to the currency, completeness, or accuracy of the
contents of the publication. Application of this informa-
tion in a particular situation remains the professional
responsibility of the practitioner; the clinical treatments
described and recommended may not be considered absolute and
universal recommendations.
The author, editors, and publisher have exerted every effort to
ensure that drug selection and dosage set
forth in this text are in accordance with the current
recommendations and practice at the time of publication.
However, in view of ongoing research, changes in government
regulations, and the constant flow of information
relating to drug therapy and drug reactions, the reader is urged
to check the package insert for each drug for any
change in indications and dosage and for added warnings and
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Some drugs and medical devices presented in this publication
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LWW.com
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page ii
http://www.lww.com
mailto:[email protected]
In Memory of Soad Hussein Hassan, RN, PhD
A maverick—
for exemplifying humanism and commitment,
for encouraging feminism and autonomy,
for accepting challenge and diversity,
for tolerating rebellion,
for sponsoring inquisitiveness,
and for being my mother.
And
For teaching me about the courage
to face a life of challenges
and an end of life with Alzheimer’s.
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page iii

R E V I E W E R S
Patricia M. Burbank, RN, DNSc, MS
Professor
University of Rhode Island
Kingston, Rhode Island
J. Carolyn Graff, PhD, MN
Associate Professor
University of Tennessee Health Science Center
Memphis, Tennessee
Rebecca Otten, RN, EdD, MSN, BA Health
Administration
Assistant Professor
California State University — Fullerton
Fullerton, California
And
Mount St. Mary’s College
Los Angeles, California
Linda A. Streit, RN, DSN
Dean and Professor for the Graduate Program
Georgia Baptist College of Nursing of Mercer
University
Atlanta, Georgia
Cynthia Toman, RN, PhD, MScN, BScN
Assistant Professor
University of Ottawa
School of Nursing

Ottawa, Ontario, Canada
iv
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page iv
P R E F A C E
v
THROUGHOUT the many editions and revisions
of this book, I received a lot of feedback and
many responses about the ideas presented.
These arrived in writing, in person, in meet-
ings, and in e-mails. Many responses, from
many corners of the world, reflected a real
intellectual engagement in the book. Some
were inspired by our theoretical history, others
questioned our philosophical past, but most
thought the dialogues that evolved from dis-
cussing the ideas in the book reaffirmed their
identity in nursing and ignited their pride in
the profession and the discipline of nursing.
These comments, reviews, and suggestions for
revisions made me realize that the major role
of this book is empowering its readers. It has
given the readers a voice to engage, debate,
and to challenge sacred cows about how our
discipline evolved and ways by which we can
evaluate growth in the discipline.
The intent of this book, then, is to demys-
tify theory, to chart the different strategies to
use in developing and advancing theory, and to

provide tools and best practices in evaluating
progress in the discipline. It provides both an
open invitation to embark on a journey with-
out the many preconceived assumptions that
may have been a barrier to pursuing knowl-
edge development. Among these assumptions
were that a select few could engage in devel-
oping theory. Perhaps this is because, during
1950–1970, the construction of theory in nurs-
ing occupied only a select few members of
the discipline. The metatheoreticians and
their writings attracted another select group
of nurses, and they focused on suggestions
about formulating theories, defining types of
theories, and identifying sources for theories.
Subsequently, conceptualizing nursing phe-
nomena commanded the attention of a wider
circle of members of the discipline. Many
other assumptions shaped our history and
influenced our current progress in the disci-
pline. For example, there was the assumption
that a conceptual framework was essential for
advancing nursing knowledge. This assump-
tion changed as we entered the 21st century
because the discipline was better defined and
was replaced with another assumption: that
empirical knowledge and research programs
are the only means toward advancing knowl-
edge.
An additional assumption was that the
processes for theory development were new to
nursing and hence, nurses in graduate pro-
grams learned strategies for advancing knowl-
edge from other disciplines. This assumption

was debunked with the knowledge that nurses
were always engaged in knowledge develop-
ment, driven by their experiences in clinical
practice. Because of these assumptions, most
of the early writing about theory development
was about outlining strategies that should be
used, rather than strategies that have already
been used in the discipline to develop theories.
Theorists themselves did not uncover or ade-
quately discuss ways by which they developed
their theories, therefore the tendency was to
describe processes that were based on theories
developed in other disciplines, mainly the
physical and social sciences. And an implicit
assumption was made that there should be a
single strategy for theory development, some
claiming to begin the process from practice,
and others believing it should be driven by
research.
Another implicit assumption was that the-
ory development was an elitist activity, to be
engaged in only within the halls of academia.
Furthermore, it was assumed that what goes on
within the halls of academia had no resem-
blance to the clinical work that goes on in real
life. (Notice the many comments over the
years about nursing theory and the lack of cli-
nicians’ need for such theory.) Some believed
that nursing had always borrowed its theory
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page v
vi

and that nursing was an applied field. To them,
nursing practice theory was not needed
because theories from science and ethics were
enough to guide nursing. Therefore, theory
development was an unnecessary process.
Some critics did not consider that redevelop-
ment, resynthesis, and reintegration of find-
ings, ideas, and statistical wisdom were also
processes for knowledge development.
Different eras provided different sets of
assumptions. In many instances, biomedical
sciences dominated more than biopsychologi-
cal sciences. And, as educational programs in
nursing became more biologically and med-
ically based, theories that reflect the human
sciences tended to be neglected. Therefore,
major journals in nursing tended to capture
empirical evidence based on more medically
defined outcomes of mortality and morbidity
rates as compared to quality of life, levels of
functioning, perceived health status, adapta-
tion, and energy levels.
The reader of this book will find that it
includes many arguments that dispel many of
these preconceived assumptions and that:
• Nurses have a fine and useful theoretical
heritage that is worthy of analysis. By
understanding how and why our heritage
evolved as it did, we may be in a better
position to consciously and deliberately
drive the development of theoretical nursing
to meet the mission that we have articulated

about our discipline.
• There are sources and resources by which
nurses can conceptualize different aspects
of the nursing universe for the purpose of
facilitating understanding, increasing
autonomy in their actions, and enhancing
control over their domain. The ultimate
objective is to provide quality care utilizing
the different tools and strategies for theory
development. The reader will find support
that clinicians are as valuable in advancing
nursing knowledge as theoreticians because
they articulate their practical wisdom into
exemplars that may help to solve other clin-
ical problems.
• The scientific development of the discipline
of nursing has followed a unique path,
charted by members of the discipline to suit
its unique features and the context of its
nursing care complexities. The sociology
and the philosophy of nursing science are
legitimate and significant areas of investiga-
tion to discern the progress and develop-
ment of the discipline. As nurses questioned
the empiricist’s view of science and
embraced other more dynamic and chang-
ing conceptions of science, the behavior of
scientists and theoreticians, the processes of
selection of research and theories, the his-
torical environment, and the sociocultural
context for the development and utility of
the discipline’s theories become legitimate
and provide central questions for the

domain.
• And finally, our theoretical history, our
epistemology, and our domain are the bases
for our theoretical future. The novice should
be acquainted with them, the advanced
should explore and question the relation-
ships between the parts and, together with
the experienced, they should shape and
reshape nursing knowledge.
Demystifying theory and dispelling assump -
tions are essential but not sufficient conditions
for empowerment. The metaphors that describe
the current stage in theory development are
epistemic diversity and integrative process,
both of which are an acknowledgment and val-
uation of nursing history, heritage, and prac-
tice. Both of these metaphors reflect and accept
the central role of practice in advancing nurs-
ing knowledge and nurses’ ways of knowing
as vital in uncovering and developing knowl-
edge. Empowerment is also about believing
in one’s self, abilities, and capacities to
advance knowledge and about using these
capacities to become an agent for continuous
learning and creating. It is about being a criti-
cal thinker, an innovative advocate, and an
agent for change.
In this book, I present and provide sup-
port for our domain as we see it today. The
future progress of the discipline depends on
the extent to which members of the discipline
will embrace epistemic diversity and integra-
tive approaches to theory development, and

LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page vi
vii
the extent to which evidence is translated,
utilized, and evaluated. The scholars of the
future are those who are as comfortable with
theorizing as with researching, practicing, and
teaching. They will be able to understand and
speak the languages of different disciplines,
translate their findings to the different practice
fields, and engage in changing policies.
In short, the major goals of this book are
to make a contribution to raising the con-
sciousness of the reader about the theoretical
development and progress of our discipline, to
acknowledge our theoretical history, to place
the present in the context of our history, and to
develop an awareness of the potential inherent
in members of the discipline, both men and
women. It is about the pride we must have in
the contributions our discipline makes to the
health and well-being of people.
I offer the ideas in this book as tentative
thoughts to provide an even platform to
enforce self-agency in students, faculty, clini-
cians, researchers, and theoreticians to drive
the development of new coherent frameworks
to advance nursing science. By knowing
equally, each may be empowered to leverage

their competency and use their expertise. A
democratization of the processes in developing
theory is an empowering process to you, the
reader, to believe in your own voice, to respect
and value the voices that came before you, but
to challenge and build on them.
Every time I work on a new edition, I feel
renewed, inspired, and regenerated. It has been
a privilege for me to be a nurse, and it is an
incredible privilege to write this book honoring
the past and envisioning the future. To readers
near and far, I thank you for dialoguing with the
ideas in this text. I truly value your responses
and comments, so keep sending them.
Afaf Ibrahim Meleis, PhD, FAAN
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REVISING and updating this book and bringing
this 5th edition to you is a testament to my
unwavering passion about its subject matter, the
progress we made in advancing knowledge in
the discipline, and the incredible support this
project received from many people.
I am grateful to Lippincott Williams &
Wilkins’ project manager, Helen Kogut, who,
knowing my schedule and commitments,

planned ahead, monitored progress, provided
reminders, respected my work priorities, and
recognized that emergencies happen. Her
patience and encouragement made it possible
to complete and publish this 5th edition.
What made this project most pleasurable in
spite of its intensity and time commitment is the
partnership that I have developed with Maria
Marconi, who oversaw the typing and organiz-
ing, seeing it through beginning to end. Watch-
ing her enthusiasm and commitment to the
quality of the project, her excitement about
learning new skills, and her pride in the project
at the completion of each phase, added tremen-
dously to the pleasure we both derived in com-
pleting it. To her, I offer my heartfelt gratitude
for her commitment, and my admiration for her
professionalism, and for the quality of her work.
I also extend my deep appreciation to
members of the Dean’s Office, who allowed me
some time flexibility to devote to this project.
My responsibilities as the Dean were well man-
aged, and the many other projects in our agenda
were completed effectively, efficiently, and on
time. That I attribute to a highly functioning,
effective, productive, and committed team,
which includes Caroline Glickman and Lucia
DiNapoli, under the leadership of Ann Marie
Franco. I am indebted to them for their expert-
ise, caring, and wonderful sense of humor.
I continue to be inspired by how far our
discipline has progressed in spite of the many

barriers and obstacles its members faced due
to gender-, occupational-, and policy-driven
inequities. The resilience, the pride, and the
commitment of nurses globally are reflected in
the many mentees who challenged my thinking
while students or junior faculty, and later, as
established scholars, extended and expanded
my horizon. I am always awed by these
mentees from around the world who continue to
be in my life. They, along with the many stu-
dents and faculty who take the time to read
what I write, and whether to extend or argue
with it, continue to influence and shape the
ideas presented in each new edition. My profes-
sional, academic, and personal lives continue to
be deepened, renewed, and enriched by each
and every one of these interactions.
My partner in life, Dr. Mahmoud Meleis,
vacillates between taking pride in all that I do,
and wishing that I would slow down to enjoy
more together-time at this stage in our lives. In
spite of this time-commitment versus time-free
paradox, his support never wavers, his advice is
always authentic, his voice is always insightful,
and his dedication to our family is emulated by
our sons, Waleed and Sherief, who are now rais-
ing their own families. They all provide a foun-
dation of family support that is most inspiring.
I am indebted to all for your support.
A.I.M.
A C K N O W L E D G M E N T S

ix
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C O N T E N T S
xi
P a r t O N E
Our Theoretical Journey 1
CHAPTER 1
POSITIONING FOR THE JOURNEY 2
Our Theoretical Heritage 3
Assumption, Goals, and Organizations 3
Organization of The Book 4
On a Personal Note 6
Reflective Questions 6
CHAPTER 2
ON BEING AND BECOMING A
SCHOLAR 7
Scholarliness in Nursing 9
Nurses as Scholars 15
Revisiting Scholarship in the 21st Century 17
Conclusion 20

CHAPTER 3
THEORY: METAPHORS, SYMBOLS,
DEFINITIONS 23
The Destination: Theory and Theoretical
Thinking 23
Definitions 25
Types of Theories 33
Theory Components 35
Uses of Theory 35
P a r t T W O
Our Theoretical Heritage 39
CHAPTER 4
FROM CAN’T TO KANT: BARRIERS AND
FORCES TOWARD THEORETICAL
THINKING 40
Barriers to Theory Development 41
Resources to Theory Development 50
Conclusion 55
CHAPTER 5
ON THE WAY TO THEORETICAL
NURSING: STAGES AND

MILESTONES 59
Stages in Nursing Progress 59
Milestones in Theory Development 67
Conclusion 80
P a r t T H R E E
Our Discipline and Its
Structure 85
CHAPTER 6
THE DISCIPLINE OF NURSING:
PERSPECTIVE AND DOMAIN 87
Nursing Perspective 88
Domain of Nursing Knowledge 94
Definition of Nursing 106
Conclusion 108
CHAPTER 7
SOURCES, RESOURCES, AND
PARADOXES FOR THEORY 113
Spinoza on Knowledge
Development 113
Sources for Theory Development 114
Classifications of Nursing Diagnosis,
Nursing Interventions, and
Decision Making 120

Resources for Theory Development 122
Identifying Domain Paradoxes 124
Conceptual Models Versus Theory 125
Nursing Theory Versus Borrowed
Theory 128
Conclusion 132
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xii
CHAPTER 8
OUR SYNTAX: AN
EPISTEMOLOGICAL ANALYSIS 136
Knowing from the Received View
to Postmodernism View 136
Truth: From Correspondence to Integrative
View of Truth 150
Conclusion 155
P a r t F O U R
Reviewing and Evaluating:
Pioneering Theories 159

CHAPTER 9
NURSING THEORIES THROUGH
MIRRORS, MICROSCOPES, OR
TELESCOPES 160
Images of Nursing, 1950–1970 162
Theories’ Primary Focus 174
Images, Metaphors, and Roles 175
Areas of Agreement Among and
Between Theorists and Schools
of Thought 175
Conclusion 177
CHAPTER 10
A MODEL FOR EVALUATION OF
THEORIES: DESCRIPTION,
ANALYSIS, CRITIQUE, TESTING,
AND SUPPORT 179
Selecting Theories for Utilization 180
Framework for Evaluating Theories 185
Description 185
Analysis 189
Critique of Theory 194
Theory Testing 200
Theory Support 202
Conclusion 203

CHAPTER 11
ON NEEDS AND SELF-CARE 207
Dorothea Orem 207
Conclusion 224
CHAPTER 12
ON INTERACTIONS 229
Imogene King—A Theory of Goal
Attainment 229
Ida Orlando 241
Josephine Paterson and Loretta Zderad 251
Joyce Travelbee 258
Ernestine Wiedenbach 265
Conclusion 271
CHAPTER 13
ON OUTCOMES 279
Dorothy Johnson 280
Myra Levine 290
Betty Neuman 300
Martha Rogers 311
Sister Callista Roy 324
Conclusion 338
P a r t F I V E
Our Theoretical Future 353
CHAPTER 14

CHALLENGES AND OPPORTUNITIES
FOR A THEORETICAL FUTURE 354
Opportunities Within Paradoxes 355
Disciplinary or Interdisciplinary
Knowledge 355
Global or Local Theories 356
Marginalized or Privileged Populations 357
Technical Nursing or Expert Nursing
Practice 357
Nursing Informatics or Medical Informatics 358
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page xii
xiii
Taxonomies or Interpretations 359
Clinical, Conceptual, or Empirical Theorizing 361
Knowing Through Research and Knowing
Through Theory 362
Integration or Isolation of Theoretical
Discourses 365
Middle-Range or Situation-Specific
Theories 367
Conclusion 368
CHAPTER 15

CONCEPT DEVELOPMENT 371
Concept Exploration 372
Concept Clarification 374
Concept Analysis 376
An Integrated Approach to Concept
Development 380
Conclusion 387
CHAPTER 16
THEORY DEVELOPMENT 391
Theory Development: Existing Strategies 394
Theory to Practice to Theory Strategy 394
Practice to Theory Strategy 396
Research to Theory Strategy 398
Theory to Research to Theory Strategy 403
Conclusion 404
CHAPTER 17
MIDDLE-RANGE AND SITUATION-
SPECIFIC THEORIES 407
The Integrative Process for Developing
Middle-Range and Situation-Specific
Theories 407
Tools for Developing Middle-Range
or Situation-Specific Theories 409

Middle-Range Theories 410
Situation-Specific Theories 419
Conclusion 423
CHAPTER 18
MEASURING PROGRESS IN A
DISCIPLINE 427
A Theory of Revolution 428
A Theory of Evolution 431
A Theory of Integration 433
Conclusion 436
P a r t S I X
Our Historical Literature 439
CHAPTER 19
HISTORICAL WRITINGS IN
THEORY 440
Section I: Abstracts of Writings in
Metatheory, 1960–1984 440
Section II: Abstracts of Writings in Nursing
Theory, 1960–1984 469
Dorothy Johnson 469
Myra Levine 478
Dorothea Orem 482
Martha Rogers 489
Sister Callista Roy 494
Joyce Travelbee 501

CHAPTER 20
HISTORICAL AND CURRENT THEORY
BIBLIOGRAPHY 502
Theory and Theorizing in Nursing 503
Nursing Theory and Theorists 548
Paradigms That Have Influenced
Nursing 616
Middle-Range Theory 631
Situation-Specific Theory 632
Video and Audio Tapes on Theory 632
AUTHOR INDEX 637
SUBJECT INDEX 663
xiii
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page xiii
LWBK821-FM_pi-xiv 1/8/11 1:30 AM Page xiv
Our Theoretical Journey
I INVITE you, in this first part of the book, to embark on a
journey that will introduce
you to the rich theoretical underpinnings of our discipline.
Uncovering the role that

theory plays in our daily experiences as nurses is the first step
in the theoretical jour-
ney proposed in this book. In the three chapters in Part One, the
theoretical journey,
along with its symbols and scholarly destinations, is described.
In Chapter 1, you
will find assumptions on which the journey is planned, the
organizational plan for
the journey, and some of the supporting material. Chapter 2
includes scholarly goals
and the different possible destinations for the journey. The
context for the journey is
then set in Chapter 3, where the key definitions of theoretical
symbols and terms
are provided.
As with any long journey, planning is essential, but it is equally
important to
allow flexibility for personal goals to emerge from the
experience, side trips that
may distract or enrich you, and serendipitous opportunities that
may attract you. It
is the totality of these experiences that will lead to immersion,
understanding, and
innovation.
P A R T O N E

LWBK821_c01_p001-006 07/01/11 6:03 PM Page 1
C H A P T E R 1
Positioning for the Journey
Disciplines should be dynamic to respond to emerging and
changing needs of societies and to new
demands imposed by population movements, health care
reforms, and transformation of global
order. However dynamic disciplines are, they have a core set of
values, assumptions, a perspec-
tive, and a mission that maintain their stability and
effectiveness. This core is what provides conti-
nuity and progress in disciplines.
Quality care for all people continues to be nursing’s top
priority. In the 21st century, this goal
is even more urgent than it has been because of increasing
diversity and better awareness of the
changing needs of the public, the conflicting priorities in health
care systems, and the emergent
costs and reimbursement issues that patients, insurance
companies, the health care industry, and
health care professionals are confronting. Theory and
theoretical thinking may have been pro-
moted in the past as answers to the undefined roles of nursing
or the diffused nature of the profes-
sion of nursing. However, in this new era of unequal access to
health care, where disparities in
provision of health care services are becoming more recognized,
where there are emerging chal-
lenges in treating chronic illnesses and infections, and where
there is a proliferation of health care

professionals and many global dialogues about health care
reform, the role of theory has become
even more urgent and more compelling. To fully appreciate the
role of theory in shaping the future of
equitable and accessible quality health care, we must review
and analyze our theoretical past and its
influence on the present and future of health care.
By uncovering and understanding a discipline’s theoretical
journey, members of the discipline
learn and build on it. By unfolding the process used in
developing the theoretical past, we gain insights
that improve our understanding of our current progress, and we
are empowered to achieve our discipli-
nary goals. When we take a critical and reflective stance on the
current theoretical discourse, or lack
thereof, as the case may be, we see shadows of past issues and
accomplishments, as well as visions of
the future of our discipline and profession. Therefore,
reconstructing our theoretical heritage is a
process that involves reconstructing our present reality. The
intent of the historical-to-future journey
proposed in this book is to demonstrate the progress of nursing
through analyses of the philosophical
assumptions, theoretical methods, and theoretical threads that
have influenced the development of the
discipline. We will perform these analyses in ways that value
our experiences as nurses, in ways that
support and enhance our progress, and in ways that allow us to
proactively develop abstractions, exem-
plars, conceptualizations, and theories that reflect and guide our
nursing assessments and actions. Syn-
thesizing insights from and about the past, considering the
current reality of the health care systems,
analyzing the societal context, and considering the potential
future visions of quality care can enhance

creativity in the discipline of nursing, which could further its
development and progress.
Despite many crises along the path of quality care, the
development of the discipline of nursing
has progressed by leaps and bounds during the last 30 years of
the 20th century. The new century
brought with it many challenges, some new and some merely
shadows of the past. Few would dispute
the …
·-• •• Fourth Edition
Nursing Theories
and Nursing Practice
Nursing Theories & Nursing Practice
Fourth Edition
3312_FM_i-xx 26/12/14 5:51 PM Page i
3312_FM_i-xx 26/12/14 5:51 PM Page ii
Nursing Theories & Nursing Practice
Fourth Edition
Marlaine C. Smith, PhD, RN, AHN-BC, FAAN

Marilyn E. Parker, PhD, RN, FAAN
3312_FM_i-xx 26/12/14 5:51 PM Page iii
F. A. Davis Company
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3rd ed. c2010.
Includes bibliographical references and index.
ISBN 978-0-8036-3312-4 (alk. paper)
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Preface to the Fourth Edition
v
This book offers the perspective that nursing is
a professional discipline with a body of knowl-
edge that guides its practice. Nursing theories
are an important part of this body of knowl-
edge, and regardless of complexity or abstrac-
tion, they reflect phenomena central to the
discipline, and should be used by nurses to
frame their thinking, action, and being in the
world. As guides, nursing theories are practical
in nature and facilitate communication with
those we serve as well as with colleagues, stu-
dents, and others practicing in health-related
services. We hope this book illuminates for the

readers the interrelationship between nursing
theories and nursing practice, and that this un-
derstanding will transform practice to improve
the health and quality of life of people who are
recipients of nursing care.
This very special book is intended to honor
the work of nursing theorists and nurses who
use these theories in their day-to-day practice.
Our foremost nursing theorists have written
for this book, or their theories have been de-
scribed by nurses who have comprehensive
knowledge of the theorists’ ideas and who have
a deep respect for the theorists as people,
nurses, and scholars. To the extent possible,
contributing authors have been selected by
theorists to write about their work. Three
middle-range theories have been added to this
edition of the book, bringing the total number
of middle-range theories to twelve. Obviously,
it was not possible to include all existing
middle-range theories in this volume; how-
ever, the expansion of this section illustrates
the recent growth in middle-range theory de-
velopment in nursing. Two chapters from the
third edition, including Levine’s conservation
theory and Paterson & Zderad’s humanistic
nursing have been moved to supplementary on-
line resources at http://davisplus.fadavis.com.
This book is intended to help nursing stu-
dents in undergraduate, masters, and doctoral
nursing programs explore and appreciate nurs-
ing theories and their use in nursing practice
and scholarship. In addition, and in response

to calls from practicing nurses, this book is in-
tended for use by those who desire to enrich
their practice by the study of nursing theories
and related illustrations of nursing practice.
The contributing authors describe theory de-
velopment processes and perspectives on the
theories, giving us a variety of views for the
twenty-first century and beyond. Each chapter
of the book includes descriptions of a theory,
its applications in both research and practice,
and an example that reflects how the theory
can guide practice. We anticipate that this
overview of the theory and its applications will
lead to deeper exploration of the theory, lead-
ing students to consult published works by the
theorists and those working closely with the
theory in practice or research.
There are six sections in the book. The first
provides an overview of nursing theory and a
focus for thinking about evaluating and choos-
ing a nursing theory for use in practice. For
this edition, the evolution of nursing theory
was added to Chapter 1. Section II introduces
the work of early nursing scholars whose ideas
provided a foundation for more formal theory
development. The nursing conceptual models
and grand theories are clustered into three
parts in Sections III, IV, and V. Section III
contains those theories classified within the
interactive-integrative paradigm, and those in
3312_FM_i-xx 26/12/14 5:51 PM Page v

the unitary-transformative paradigm are in-
cluded in Section IV. Grand theories that are
focused on the phenomena of care or caring
appear in Section V. The final section contains
a selection of middle-range theories.
An outline at the beginning of each chapter
provides a map for the contents. Major points
are highlighted in each chapter. Since this
book focuses on the relationship of nursing
theory to nursing practice, we invited the
authors to share a practice exemplar. You will
notice that some practice exemplars were writ-
ten by someone other than the chapter author.
In this edition the authors also provided
content about research based on the theory.
Because of page limitations you can find
additional chapter content online at http://
davisplus.fadavis.com. While every attempt
was made to follow a standard format for each
of the chapters throughout the book, some of
the chapters vary from this format; for exam-
ple, some authors chose not to include practice
exemplars.
The book’s website features materials that
will enrich the teaching and learning of these
nursing theories. Materials that will be helpful
for teaching and learning about nursing theo-
ries are included as online resources. For exam-
ple, there are case studies, learning activities,
and PowerPoint presentations included on
both the instructor and student websites. Other
online resources include additional content,
more extensive bibliographies and longer biog-
raphies of the theorists. Dr. Shirley Gordon

and a group of doctoral students from Florida
Atlantic University developed these ancillary
materials for the third edition. For this edition,
the ancillary materials for students and faculty
were updated by Diane Gullett, a PhD candi-
date at Florida Atlantic University. She devel-
oped all materials for the new chapters as well
as updating ancillary materials for chapters that
appeared in the third edition. We are so grate-
ful to Diane and Shirley for their creativity and
leadership and to the other doctoral students for
their thoughtful contributions to this project .
We hope that this book provides a useful
overview of the latest theoretical advances of
many of nursing’s finest scholars. We are
grateful for their contributions to this book. As
editors we’ve found that continuing to learn
about and share what we love nurtures our
growth as scholars, reignites our passion and
commitment, and offers both fun and frustra-
tion along the way. We continue to be grateful
for the enthusiasm for this book shared by
many nursing theorists and contributing
authors and by scholars in practice and
research who bring theories to life. For us, it
has been a joy to renew friendships with col-
leagues who have contributed to past editions
and to find new friends and colleagues whose
theories enriched this edition.
Nursing Theories and Nursing Practice, now
in the fourth edition, has roots in a series of
nursing theory conferences held in South
Florida, beginning in 1989 and ending when

efforts to cope with the aftermath of Hurricane
Andrew interrupted the energy and resources
needed for planning and offering the Fifth
South Florida Nursing Theory Conference.
Many of the theorists in this book addressed
audiences of mostly practicing nurses at these
conferences. Two books stimulated by those
conferences and published by the National
League for Nursing are Nursing Theories in
Practice (1990) and Patterns of Nursing Theories
in Practice (1993).
For me (Marilyn), even deeper roots of this
book are found early in my nursing career,
when I seriously considered leaving nursing for
the study of pharmacy. In my fatigue and frus-
tration, mixed with youthful hope and desire
for more education, I could not answer the
question “What is nursing?” and could not dis-
tinguish the work of nursing from other tasks
I did every day. Why should I continue this
work? Why should I seek degrees in a field
that I could not define? After reflecting on
these questions and using them to examine my
nursing, I could find no one who would con-
sider the questions with me. I remember being
asked, “Why would you ask that question? You
are a nurse; you must surely know what nurs-
ing is.” Such responses, along with a drive for
serious consideration of my questions, led me
to the library. I clearly remember reading se -
veral descriptions of nursing that, I thought,
could just as well have been about social work
or physical therapy. I then found nursing
vi Preface to the Fourth Edition

3312_FM_i-xx 26/12/14 5:51 PM Page vi
defined and explained in a book about educa-
tion of nurses written by Dorothea Orem.
During the weeks that followed, as I did my
work of nursing in the hospital, I explored
Orem’s ideas about why people need nursing,
nursing’s purposes, and what nurses do. I
found a fit between her ideas, as I understood
them, with my practice, and I learned that I
could go even further to explain and design
nursing according to these ways of thinking
about nursing. I discovered that nursing shared
some knowledge and practices with other serv-
ices, such as pharmacy and medicine, and I
began to distinguish nursing from these related
fields of practice. I decided to stay in nursing
and made plans to study and work with
Dorothea Orem. In addition to learning about
nursing theory and its meaning in all we do, I
learned from Dorothea that nursing is a unique
discipline of knowledge and professional prac-
tice. In many ways, my earliest questions about
nursing have guided my subsequent study and
work. Most of what I have done in nursing has
been a continuation of my initial experience of
the interrelations of all aspects of nursing
scholarship, including the scholarship that is
nursing practice. Over the years, I have been
privileged to work with many nursing scholars,
some of whom are featured in this book.
My love for nursing and my respect for our
discipline and practice have deepened, and

knowing now that these values are so often
shared is a singular joy.
Marlaine’s interest in nursing theory had
similar origins to Marilyn’s. As a nurse pursu-
ing an interdisciplinary master’s degree in pub-
lic health, I (Marlaine) recognized that while
all the other public health disciplines had some
unique perspective to share, public health
nursing seemed to lack a clear identity. In
search of the identity of nursing I pursued a
second master’s in nursing. At that time nurs-
ing theory was beginning to garner attention,
and I learned about it from my teachers and
mentors Sr. Rosemary Donley, Rosemarie
Parse, and Mary Jane Smith. This discovery was
the answer I was seeking, and it both expanded
and focused my thinking about nursing. The
question of “What is nursing?” was answered
for me by these theories and I couldn’t get
enough! It led to my decision to pursue my
PhD in Nursing at New York University
where I studied with Martha Rogers. During
this same time I taught at Duquesne University
with Rosemarie Parse and learned more about
Man-Living-Health, which is now humanbe-
coming. I conducted several studies based on
Rogers’ conceptual system and Parse’s theory.
At theory conferences I was fortunate to
dialogue with Virginia Henderson, Hildegard
Peplau, Imogene King, and Madeleine
Leininger. In 1988 I accepted a faculty posi-
tion at the University of Colorado when Jean
Watson was Dean. The School of Nursing was
guided by a caring philosophy and framework

and I embraced caring as a central focus of the
discipline of nursing. As a unitary scholar, I
studied Newman’s theory of health as expand-
ing consciousness and was intrigued by it, so
for my sabbatical I decided to study it further
as well as learn more about the unitary appre-
ciative inquiry process that Richard Cowling
was developing.
We both have been fortunate to hold faculty
appointments in universities where nursing the-
ory has been valued, and we are fortunate today
to hold positions at the Christine E. Lynn Col-
lege of Nursing at Florida Atlantic University,
where faculty and students ground their teach-
ing scholarship and practice on caring theories,
including nursing as caring, developed by Dean
Anne Boykin and a previous faculty member at
the College, Savina Schoenhofer. Many faculty
colleagues and students continue to help us
study nursing and have contributed to this book
in ways we would never have adequate words to
acknowledge. We are grateful to our knowl-
edgeable colleagues who reviewed and offered
helpful suggestions for chapters of this book,
and we sincerely thank those who contributed
to the book as chapter authors. It is also our
good fortune that many nursing theorists and
other nursing scholars live in or visit our lovely
state of Florida. Since the first edition of this
book was published, we have lost many nursing
theorists. Their work continues through those
refining, modifying, testing, and expanding the
theories. The discipline of nursing is expanding
as research and practice advances existing theories
and as new theories emerge. This is especially

Preface to the Fourth Edition vii
3312_FM_i-xx 26/12/14 5:51 PM Page vii
important at a time when nursing theory can
provide what is missing and needed most in
health care today.
All four editions of this book have been nur-
tured by Joanne DaCunha, an expert nurse and
editor for F. A. Davis Company, who has shep-
herded this project and others because of her
love of nursing. Near the end of this project
Joanne retired, and Susan Rhyner, our new ed-
itor, led us to the finish line. We are both grate-
ful for their wisdom, kindness, patience and
understanding of nursing. We give special
thanks to Echo Gerhart, who served as our con-
tact and coordinator for this project. Marilyn
thanks her husband, Terry Worden, for his
abiding love and for always being willing to help,
and her niece, Cherie Parker, who represents
many nurses who love nursing practice and
scholarship and thus inspire the work of this
book. Marlaine acknowledges her husband
Brian and her children, Kirsten, Alicia, and
Brady, and their spouses, Jonathan Vankin and
Tori Rutherford, for their love and understand-
ing. She honors her parents, Deno and Rose
Cappelli, for instilling in her the love of learning,
the value of hard work, and the importance of
caring for others, and dedicates this book to her

granddaughter Iyla and the new little one who
is scheduled to arrive as this book is released.
Marilyn E. Parker, Marlaine C. Smith,
Olathe, Kansas Boca Raton, Florida
viii Preface to the Fourth Edition
3312_FM_i-xx 26/12/14 5:51 PM Page viii
Nursing Theorists
ix
Elizabeth Ann Manhart Barrett, PhD, RN, FAAN
Professor Emerita
Hunter College
City University of New York
New York, New York
Charlotte D. Barry, PhD, RN, NCSN, FAAN
Professor of Nursing
Christine E. Lynn College of Nursing
Florida Atlantic University
Boca Raton, Florida
Anne Boykin, PhD, RN*
Dean and Professor Emerita
Boca Raton, Florida
Barbara Montgomery Dossey, PhD, RN, AHN-BC, FAAN,
HWNC-BC
Co-Director, International Nurse Coach

Association
Core Faculty, Integrative Nurse Coach
Certificate Program
Miami, Florida
Joanne R. Duffy, PhD, RN, FAAN
Endowed Professor of Research and
Evidence-based Practice and Director
of the PhD Program
West Virginia University
Morgantown, West Virginia
Helen L. Erickson*
Professor Emerita
University of Texas at Austin
Austin, Texas
Lydia Hall†
Virginia Henderson†
Dorothy Johnson†
Imogene King†
Katharine Kolcaba, PhD, RN
Associate Professor Emeritus Adjunct
The University of Akron
Akron, Ohio
Madeleine M. Leininger†
Patricia Liehr, PhD, RN
Professor
Boca Raton, Florida

Rozzano C. Locsin, PhD, RN
Professor Emeritus
Boca Raton, Florida
Afaf I. Meleis, PhD, DrPS(hon), FAAN
Professor of Nursing and Sociology
University of Pennsylvania
Betty Neuman, PhD, RN, PLC, FAAN
Beverly, Ohio
Margaret Newman, RN, PhD, FAAN
Professor Emerita
University of Minnesota College of Nursing
Saint Paul, Minnesota
Dorothea E. Orem†
Ida Jean Orlando (Pelletier)†
Marilyn E. Parker, PhD, RN, FAAN
Professor Emerita
Boca Raton, Florida
3312_FM_i-xx 26/12/14 5:51 PM Page ix
Rosemarie Rizzo Parse, PhD, FAAN
Distinguished Professor Emeritus
Marcella Niehoff School of Nursing
Loyola University Chicago
Chicago, Illinois
Hildegard Peplau†

Marilyn Anne Ray, PhD, RN, CTN
Professor Emerita
Boca Raton, Florida
Pamela G. Reed, PhD, RN, FAAN
Professor
University of Arizona
Tucson, Arizona
Martha E. Rogers†
Sister Callista Roy, PhD, RN, FAAN
Professor and Nurse Theorist
William F. Connell School of Nursing
Boston College
Chestnut Hill, Massachusetts
Savina O. Schoenhofer, PhD, RN
University of Mississippi
Oxford, Mississippi
Marlaine C. Smith, PhD, RN, AHN-BC, FAAN
Dean and Helen K. Persson Eminent Scholar
Boca Raton, Florida
Mary Jane Smith, PhD, RN
Professor
West Virginia University
Morgantown, West Virginia
Mary Ann Swain, PhD
Professor and Director, Doctoral Program
Decker School of Nursing
Binghamton University
Binghamton, New York
Kristen M. Swanson, PhD, RN, FAAN

Dean
Seattle University
Seattle, Washington
Evelyn Tomlin*
Joyce Travelbee†
Meredith Troutman-Jordan, PhD, RN
Associate Professor
University of North Carolina
Chapel Hill, North Carolina
Jean Watson, PhD, RN, AHN-BC, FAAN
Distinguished Professor Emeritus
University of Colorado at Denver—Anschutz
Campus
Aurora, Colorado
Ernestine Wiedenbach†
x Nursing Theorists
*Retired
†Deceased
3312_FM_i-xx 26/12/14 5:51 PM Page x
Contributors
xi
Patricia Deal Aylward, MSN, RN, CNS
Assistant Professor
Santa Fe Community College
Gainesville, Florida

Howard Karl Butcher, PhD, RN, PMHCNS-BC
Associate Professor
University of Iowa
Iowa City, Iowa
Lynne M. Hektor Dunphy, PhD, APRN-BC
Associate Dean for Practice and Community
Engagement
Boca Raton, Florida
Laureen M. Fleck, PhD, FNP-BC, FAANP
Associate Faculty
Boca Raton, Florida
Maureen A. Frey, PhD, RN*
Shirley C. Gordon, PhD, RN
Professor and Assistant Dean Graduate Practice
Programs
Boca Raton, Florida
*Retired.
3312_FM_i-xx 26/12/14 5:51 PM Page xi

xii Contributors
Diane Lee Gullett, RN, MSN, MPH
Doctoral Candidate
Christine E. Lynn College of NursingFlorida
Atlantic University
Boca Raton, Florida
Donna L. Hartweg, PhD, RN
Professor Emerita and Former Director
Illinois Wesleyan University
Bloomington, Illinois
Bonnie Holaday, PhD, RN, FAAN
Professor
Clemson University
Clemson, South Carolina
Beth M. King, PhD, RN, PMHCNS-BC
Assistant Professor and RN-BSN Coordinator
Boca Raton, Florida
Lois White Lowry, DNSc, RN*
Professor Emerita
East Tennessee State University
Johnson City, Tennessee
Violet M. Malinski, PhD, MA, RN
Associate Professor
College of New Rochelle
New Rochelle, New York
Mary B. Killeen, PhD, RN, NEA-BC

Consultant
Evidence Based Practice Nurse Consultants,
LLC
Howell, Michigan
Ann R. Peden, RN, CNS, DSN
Professor and Chair
Capital University
Columbus, Ohio
3312_FM_i-xx 26/12/14 5:51 PM Page xii
Contributors xiii
Margaret Dexheimer Pharris, PhD, RN, CNE, FAAN
Associate Dean for Nursing
St. Catherine University
St. Paul, Minnesota
Maude Rittman, PhD, RN
Associate Chief of Nursing Service for Research
Gainesville Veteran’s Administration
Medical Center
Gainesville, Florida
Christina L. Sieloff, PhD, RN
Associate Professor
Montana State University
Billings, Montana
Jacqueline Staal, MSN, ARNP, FNP-BC
PhD Candidate

Boca Raton, Florida
Marian C. Turkel, PhD, RN, NEA-BC, FAAN
Director of Professional Nursing Practice
Holy Cross Medical Center
Fort Lauderdale, Florida
Pamela Senesac, PhD, SM, RN
Assistant Professor
University of Massachusetts
Shrewsbury, Massachusetts
Hiba Wehbe-Alamah, PhD, RN, FNP-BC, CTN-A
Associate Professor
University of Michigan-Flint
Flint, Michigan
3312_FM_i-xx 26/12/14 5:51 PM Page xiii
xiv Contributors
Terri Kaye Woodward, MSN, RN, CNS, AHN-BC, HTCP
Founder
Cocreative Wellness
Denver, Colorado
Kelly White, RN, PhD, FNP-BC
Assistant Professor
South University
West Palm Beach, Florida
3312_FM_i-xx 26/12/14 5:51 PM Page xiv

Reviewers
xv
Ferrona Beason, PhD, ARNP
Assistant Professor in Nursing
Barry University – Division of Nursing
Miami Shores, Florida
Abimbola Farinde, PharmD, MS
Clinical Pharmacist Specialist
Clear Lake Regional Medical Center
Webster, Texas
Lori S. Lauver, PhD, RN, CPN, CNE
Associate Professor
Jefferson School of Nursing
Thomas Jefferson University
Elisheva Lightstone, BScN, MSc
Professor
Department of Nursing
Seneca College
King City, Ontario, Canada
Carol L. Moore, PhD, APRN, CNS
Assistant Professor of Nursing, Coordinator,
Graduate Nursing Studies
Fort Hays State University
Hays, Kansas
Kathleen Spadaro, PhD, PMHCNS, RN
MSN Program Co-coordinator & Assistant

Chatham University
Pittsburgh, Pennsylvania
3312_FM_i-xx 26/12/14 5:51 PM Page xv
3312_FM_i-xx 26/12/14 5:51 PM Page xvi
Contents
xvii
Section I An Introduction to Nursing Theory, 1
Chapter 1 Nursing Theory and the Discipline of Nursing, 3
Marlaine C. Smith and Marilyn E. Parker
Chapter 2 A Guide for the Study of Nursing Theories for
Practice, 19
Marilyn E. Parker and Marlaine C. Smith
Chapter 3 Choosing, Evaluating, and Implementing Nursing
Theories
for Practice, 23
Marilyn E. Parker and Marlaine C. Smith
Section II Conceptual Influences on the Evolution of Nursing
Theory, 35
Chapter 4 Florence Nightingale’s Legacy of Caring and Its
Applications, 37
Lynne M. Hektor Dunphy

Chapter 5 Early Conceptualizations About Nursing, 55
Shirley C. Gordon
Chapter 6 Nurse-Patient Relationship Theories, 67
Ann R. Peden, Jacqueline Staal, Maude Rittman, and Diane Lee
Gullett
Section III Conceptual Models/Grand Theories in the
Integrative-
Interactive Paradigm, 87
Chapter 7 Dorothy Johnson’s Behavioral System Model and Its
Applications, 89
Bonnie Holaday
Chapter 8 Dorothea Orem’s Self-Care Deficit Nursing Theory,
105
Donna L. Hartweg
3312_FM_i-xx 26/12/14 5:51 PM Page xvii
Chapter 9 Imogene King’s Theory of Goal Attainment, 133
Christina L. Sieloff and Maureen A. Frey
Chapter 10 Sister Callista Roy’s Adaptation Model, 153
Pamela Sensac and Sister Callista Roy
Chapter 11 Betty Neuman’s Systems Model, 165
Lois White Lowry and Patricia Deal Aylward
Chapter 12 Helen Erickson, Evelyn Tomlin, and Mary Ann
Swain’s

Theory of Modeling and Role Modeling, 185
Helen L. Erickson
Chapter 13 Barbara Dossey’s Theory of Integral Nursing, 207
Barbara Montgomery Dossey
Section IV Conceptual Models and Grand Theories in the
Unitary–Transformative Paradigm, 235
Chapter 14 Martha E. Rogers Science of Unitary Human
Beings, 237
Howard Karl Butcher and Violet M. Malinski
Chapter 15 Rosemarie Rizzo Parse’s Humanbecoming
Paradigm, 263
Rosemarie Rizzo Parse
Chapter 16 Margaret Newman’s Theory of Health as Expanding
Consciousness, 279
Margaret Dexheimer Pharris
Section V Grand Theories about Care or Caring, 301
Chapter 17 Madeleine Leininger’s Theory of Culture Care
Diversity
and Universality, 303
Hiba Wehbe-Alamah
Chapter 18 Jean Watson’s Theory of Human Caring, 321
Jean Watson
Chapter 19 Theory of Nursing as Caring, 341
Anne Boykin and Savina O. Schoenhofer

Section VI Middle-Range Theories, 357
Chapter 20 Transitions Theory, 361
Afaf I. Meleis
xviii Contents
3312_FM_i-xx 26/12/14 5:51 PM Page xviii
Chapter 21 Katharine Kolcaba’s Comfort Theory, 381
Katharine Kolcaba
Chapter 22 Joanne Duffy’s Quality-Caring Model©, 393
Joanne R. Duffy
Chapter 23 Pamela Reed’s Theory of Self-Transcendence, 411
Pamela G. Reed
Chapter 24 Patricia Liehr and Mary Jane Smith’s Story Theory,
421
Patricia Liehr and Mary Jane Smith
Chapter 25 The Community Nursing Practice Model, 435
Marilyn E. Parker, Charlotte D. Barry. and Beth M. King
Chapter 26 Rozzano Locsin’s Technological Competency as
Caring
in Nursing, 449
Rozzano C. Locsin
Chapter 27 Marilyn Anne Ray’s Theory of Bureaucratic Caring,
461

Marilyn Anne Ray and Marian C. Turkel
Chapter 28 Troutman-Jordan’s Theory of Successful Aging,
483
Meredith Troutman-Jordan
Chapter 29 Barrett’s Theory of Power as Knowing Participation
in Change, 495
Elizabeth Ann Manhart Barrett
Chapter 30 Marlaine Smith’s Theory of Unitary Caring, 509
Marlaine C. Smith
Chapter 31 Kristen Swanson’s Theory of Caring, 521
Kristen M. Swanson
Index, 533
Contents xix
3312_FM_i-xx 26/12/14 5:51 PM Page xix
3312_FM_i-xx 26/12/14 5:51 PM Page xx
Section I
An Introduction to Nursing Theory
1
3312_Ch01_001-018 26/12/14 9:35 AM Page 1

2
In this first section of the book, you will be introduced to the
purpose of nursing
theory and shown how to study, analyze, and evaluate it for use
in nursing
practice. If you are new to the idea of theory in nursing, the
chapters in this section
will orient you to what theory is, how it fits into the evolution
and context of nursing
as a professional discipline, and how to approach its study and
evaluation. If
you have studied nursing theory in the past, these chapters will
provide you with
additional knowledge and insight as you continue your study.
Nursing is a professional discipline focused on the study of
human health and
healing through caring. Nursing practice is based on the
knowledge of nursing,
which consists of its philosophies, theories, concepts,
principles, research findings,
and practice wisdom. Nursing theories are patterns that guide
the thinking about
nursing. All nurses are guided by some implicit or explicit
theory or pattern of
thinking as they care for their patients. Too often, this pattern
of thinking is implicit
and is colored by the lens of diseases, diagnoses, and …
First Question: Essay 1 Point for Each Level of Proficiency
Read the article entitled, ‘From Novice to Expert’ by Patricia
Benner found in
https://www.medicalcenter.virginia.edu/therapy-services/3%20-

%20Benner%20-%20Novice%20to%20Expert-1.pdf
Then summarize the theory.
Instructions:
1- Make a COMPREHENSIVE SUMMARY of this theory in
YOUR OWN WORDS. Focus on the five levels of proficiency
from novice to expert.
2- Your comprehensive summary should range between 500 to
1,000 words.
3- No copy and pasting of sentences from the article.
Paraphrase the sentences you will include in your
comprehensive summary.
_____________________________________________________
_____________
Second Question: Making a Theory Evaluation -1 Point for Each
item
Fawcett’s framework for conceptual models separates questions
for analysis from those intended for evaluation. For the
evaluation, she proposed evaluation (judgment based on
criteria) of the origins of the model, the degree of
comprehensiveness of content, the logical congruence of its
internal structure, the ability of the model to generate and test
theories, the degree to which it is credible as demonstrated in

its social utility (use, implementation), social congruency, and
significance to society.
Read Chapter 10 A Model for Evaluation of Theories:
Description, Analysis, critique, testing and Support from the e-
book Theoretical Nursing Development and Progress 5th
Edition, By Afaf Meleis. Then, MAKE COMPREHENSIVE
EVALUATION of THE SISTER CALLISTA ROY’S
ADAPTATION MODEL Using the Fawcett’s Criteria of
Nursing Models Evaluation, which includes:
· Origins
· Content
· Logical congruency
· Generation
· Credibility
Instructions: Make your evaluation of the Sister Callista Roy’s
Adaptation Model using a Fawcett’s criteria of Nursing Models
Evaluation.
Third Question: Making a Theory Critique
Read Chapter 4: Florence Nightingale's Legacy of Caring and
Its Applications from the e-book Nursing Theories and Nursing
Practice, Fourth Edition by Marlaine Smith and Marilyn Parker.
Then Make a COMPREHENSIVE CRITIQUE of FLORENCE
NIGHTINGALE's ENVIRONMENTAL THEORY.
Instructions: Make a COMPREHENSIVE CRITIQUE of
FLORENCE NIGHTINGALE's ENVIRONMENTAL THEORY
by combining inputs from at least two (2) critique articles from

the internet and your own viewpoint based on the following
criteria and units of analysis:
CRITERIA
UNITS OF ANALYSIS
(1) Relationship between structure and function
(1.1) Clarity
(1.2) Consistency
(1.3) Simplicity/Complexity
(1.4) Tautology/Teleology
(2) Diagram of the Theory
(2.1) Visual and Graphic Presentation
(2.2) Logical Representation
(2.3) Clarity
(3) Circle of Contagiousness
(3.1) Graphical origin of theory and geographical spread
(3.2) Influence of theorist versus theory
(4) Usefulness
(4.1) Practice
(4.2) Research
(4.3) Education
(4.4) Administration
(5) External Components of Theory
(5.1) Personal Values
(5.2) Congruence with other Professional Values
(5.3) Congruence with Social Values

(5.4) Social Significance
Page 4 of 4
Answer Sheet
Name: ____________________________________
ID: _______________
Page 1 of 1
For this assignment, you are to write a paper describing
how context has been and can be used by mobile applications.
In your paper you should:
1. Discuss context as it applies to Mobile Computing.
2. Show a variety of ways context has been used.
3. Discuss sensor fusion as it applies to context - how could you
use information from multiple sensors to distinguish context.
4. Suggest new ways context can be used.
The paper should be long enough to adequately cover the
material (5 - 8 pages?).
Hints
1. This paper is not just for me. Assume the reader needs an
introduction to the topic (write for your grandfather).
2. Cite many sources.
3. Write well.
4. Show lots of examples.
https://www.interaction-design.org/literature/book/the-
encyclopedia-of-human-computer-interaction-2nd-ed/context-
aware-computing-context-awareness-context-aware-user-
interfaces-and-implicit-interaction

https://scholarsbank.uoregon.edu/xmlui/bitstream/handle/1794/7
610/2007-davies.pdf?sequence=1
https://www.semanticscholar.org/paper/There-is-more-to-
context-than-location-Schmidt-
Beigl/3cd0b6a48b14f86ed261240f30113a41bacd2255
https://pdfs.semanticscholar.org/42b8/dbbf625a5575ef00820383
2ef2e0d1ee7e66.pdf
http://www.interaction-design.org/encyclopedia/context-
aware_computing.html
https://dl.acm.org/citation.cfm?id=2693843
https://link.springer.com/content/pdf/10.1007%2F978-3-642-
12654-3_8.pdf

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