MODULE 2 (Topic 4-7)
DEVELOPMENT PROCESS OF
THEORY IN NURSING
MYRRHA F. TAGANAS, RN, MNc
Clinical Instructor
Nursing and Philosophy
Philosophy - studies concepts that structure thought processes,
foundations, and presumptions.
• It is an approach for thinking about the nature of people, the methods
that should be used to create a scientific knowledge and the ethics
involved.
1. Epistemology – a branch of philosophy that is concerned with
the nature and scope of knowledge. It is referred to as the ‘theory of
knowledge’
• The power of reason and power of sensory experience
2. Rationalism- the power of reason
• Rationalist epistemology emphasizes the importance of a priority
reasoning as the appropriate method for advancing knowledge.
Empiricism- the power of sensory experience
•Francis Bacon believed that scientific knowledge was discovered
through the generalization of observed facts in the natural world.
Nursing
NURSING (as a science)
• It is the “body of abstract knowledge” arrived
through scientific research and logical analysis
NURSING (as an art)
•Is the art of caring sick and well individual. It refers to
the dynamic skills and methods in assisting sick and
well individual in their recovery and in the promotion
and maintenance of health. It involves the creative
application of knowledge in the service of people
Nursing (as a profession)
• Profession- a calling in which its members profess to
have acquired special knowledge by training or experience,
or both so that they may guide, advise or save others in
that special field.
Criteria of Profession:
1. To provide a needed service to the society.
2. To advance knowledge in its field.
3. To protect its members and make it possible to practice
effectively.
NURSING: DEFINITIONS
• FLORENCE NIGHTINGALE
• Nursing is the act of utilizing the environment of the patient
to assist him in his recovery.
• VIRGINIA HENDERSON
• Nursing is the act of assisting the individual, sick or well, in
theperformance of those activitiescontributing to health or its
recovery (or to a peaceful death) that he would perform
unaided if he had thenecessary strength, will, or knowledge,
and to do this in such a way as to help him gain
independence as rapidly as possible.
CANADIAN NURSES ASSOCIATION (CNA)
• Nursing is a dynamic, caring, helping relationship in which the nurse
assist the client to achieve and obtain optimal health. – 1987
THEMES THAT ARE COMMON TO THESE DEFINITION:
• Nursing is caring
• Nursing is an art
• Nursing is a science
• Nursing is client-centered
• Nursing is holistic
• Nursing is adaptive
• Nursing is concerned with health promotion, health maintenance, and health
restoration
• Nursing is a helping profession
AMERICAN NURSES ASSOCIATION (ANA) 1973
• Nursing is direct, goal oriented, and adaptable to the needs of the
individual, the family, and community during health and illness.
1980
• Nursing is the diagnosis and treatment of human responses to actual
or potential health problems.
1995 ANA acknowledges:
FOUR ESSENTIAL FEATURES OF CONTEMPORARY NURSING
PRACTICE:
• Attention to the full range of human experiences and responses to health and
illness without restriction to a problem-focused orientation.
• Integration of objective data with knowledge gained from understanding of the
client or group’s subjective experience.
• Application of scientific knowledge to the processes of diagnosis and treatment.
• Provision of caring relationship that facilitates health and healing.
Significance of theory for nursing as a profession
Clearly, nursing is recognize as a profession today.
1. Bixler a set of criteria tailored to nursing in the American
Journal of Nursing in 1959. They stated that a profession:
- Utilizes in its practice a well-defined and well-organized body
of specialized knowledge that is on the intellectual level of the
higher learning.
2. Nursing theory is a useful tool for reasoning, critical thinking,
and decision making in nursing practice.
3.Nursing theoretical works provide a perspective of the patient.
4. Nursing theory provides more direction for nursing practice.
5. The conceptual models of nursing are comprehensive and the
reader to the specifics of the practice.
6.Middle range theories contain the specifics of nursing practice.
CHARACTERISTICS OF THEORIES
1. Interrelate concepts in such a way as to create a
different way of looking at a particular phenomenon.
2. Are logical in nature.
3. Are generalizable.
4. Are the bases for hypotheses that can be tested.
CLASSIFICATION
OF
NURSING
THEORIES
a. ABSTRACTION
Practice-Level Nursing Theories
•Practice nursing theories are situation specific
theories that are narrow in scope and focuses on a
specific patient population at a specific time.
•Practice-level nursing theories provide frameworks for
nursing interventions and suggest outcomes or the
effect of nursing practice.
Middle-Range Nursing Theories
•More limited in scope (as compared to grand theories)
and present concepts and propositions at a lower
level of abstraction. They address a specific
phenomenon in nursing.
•Due to the difficulty of testing grand theories, nursing
scholars proposed using this level of theory.
Grand Nursing Theories
•Grand theories are abstract, broad in scope, and
complex, therefore requiring further research for
clarification.
•Grand nursing theories do not provide guidance for
specific nursing interventions but rather provide a
general framework and ideas about nursing.
b. Goal Orientation
1. Descriptive theories
– are the first level of theory development
- They describe a phenomena, speculate why it occur and describe the
consequences
2 Types:
1.1 Factor-Isolating Theory
• Also known as category-formulating or labelling theory.
• Theories under this category describe the properties and dimensions of
phenomena.
1.2 Explanatory Theory
• Explanatory theories describe and explain the nature of relationships of
certain phenomena to other phenomena.
2. Prescriptive theories
•are action oriented, which test the validity and
predictability of a nursing intervention
•Address the nursing interventions for a phenomenon,
guide practice change, and predict consequences.
•Includes propositions that call for change.
•In nursing, prescriptive theories are used to anticipate the
outcomes of nursing interventions.
Other ways of classifying:
"Needs" theories
•These theories are based around helping individuals to fulfill
their physical and mental needs.
•Interaction Theories
These theories placed the emphasis of nursing on the
establishment and maintenance of relationships and
highlight the impact of nursing on patients and how
they interact with the environment, people, and
situations. Theories of King, Orlando, and Travelbee are
grouped under this category.
"Outcome" theories
•These portray the nurse as the changing force, who enables
individuals to adapt to or cope with ill health (Roy 1980).
"Humanistic" Theories
•Humanistic theories developed in response to the psychoanalytic
thought that a person’s destiny was determined early in life.
School of Thoughts in
Nursing Theories(1950-1970)
Need Interaction Outcome Humanistic
Theorist Theorist Theorist Theorists
Abdellah King Johnson Paterson
Henderson Orlando Levine Zderad
Orem Peplau Rogers
Travelbee Roy
Wiedenbach
NON NURSING THEORIES
A. HUMAN NEEDS THEORY
1. Maslow's hierarchy of needs is a motivational theory in
psychology comprising a five-tier model of human needs,
often depicted as hierarchical levels within a pyramid.
B. SYSTEMS THEORY
•It describes how to break whole things into parts and
then to learn how the parts work together in " systems".
•These concepts may be applied to different kinds of
systems, e.g. Molecules in chemistry , cultures in
sociology, organs in Anatomy and health in Nursing.
C. CHANGE THEORY
•People change throughout their lives. This growth
and change are evident in the dynamic nature of
basic human needs and how they are met
•Change happens daily
•Change involves modification or alteration. It may
be planned or unplanned
D. ADAPTATION THEORY
•It defines adaptation as the adjustment of living matter to
other living things and to environmental conditions.
•Human adaptation occurs on three levels:
•--- the internal ( self )
•--- the social (others)
•--- and the physical ( biochemical reactions )
E. Developmental Theory
⚫It outlines the process of growth and development of
humans as orderly and predictable, beginning with
conception and ending with death.
⚫The progress and behaviors of an individual within each
stage are unique.
⚫The growth and development of an individual are
influenced by heredity , temperament, emotional, and
physical environment, life experiences and health status.
CONCLUSION
•Theory and practice are related.
•To develop nursing as a profession the concept of theory
must be addressed.
•If nursing theory does not drive the development of
nursing, it will continue to develop in the footsteps of other
disciplines such as medicine.
