THEORETICAL

FOUNDATION OF
NURSING

NCM 100

UNIT I- HISTORICAL OVERVIEW OF NURSING

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PERIOD OF INTUITIVE NURSING
CONTRIBUTIONS TO NURSING AND MEDICINE
PERIOD OF APPRENTICE NURSING
Important Nursing Personages During the Period of Apprentice
Nursing
THE DARK PERIOD OF NURSING
Some reforms during the 18th century
PERIOD OF EDUCATED NURSING
PERIOD OF CONTEMPORARY NURSING
NURSING AS A SCIENCE, AS A PROFESSION, A DISCIPLINE AND A PHILOSOPHY
CHARACTERISTICS OF SCIENCE
DISCIPLINE
WHAT IS THE DIFFERENCE BETWEEN A PROFESSION AND AN OCCUPATION????
CHARACTERISTICS OF NURSING AS A PROFESSION:
Professional Roles of Nurses
Expanded Roles of Nurses
NURSING LEADERS OF THE 20th CENTURY
PROMINENT NURSING LEADERS IN THE PHILIPPINES

UNIT II: History and Philosophy of Science

Nursing Science and Theory in the Late 20th Century
History and Philosophy of Science
Four ways of knowing
Rationalism
Empiricism
Early 20th Century Views
Emergent views of science and theory in the late twentieth century

UNITIII: STRUCTUREOFNURSING KNOWLEDGE

THEORY
MPORTANCE OF NURSING THEORIES

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PURPOSES OF THEORIES
CONCEPTS
PARADIGM
METAPARADIGM
NURSING METAPARADIGM
PERSON
ENVIRONMENTAL
HEALTH
NURSING
NURSING PHILOSOPHIES
ENVIRONMENTAL THEORY – Florence Nightingale
STAGES OF NURSING EXPERTISE- Patricia Benner
THEORY OF HUMAN CARING- Jean Watson
CONCEPTUAL MODELS SELF-CARE DEFICIT THEORY - Dorotea Orem
HEALTH CARE SYSTEM MODEL - Betty Neuman
GOAL ATTAINMENT THEORY- Imogene King
NURSING THEORIES
INTERPERSONAL RELATIONS THEORY - HILDEGARD PEPLAU
NURSING NEED THEORY 14 COMPONENTS - VIRGINIA HENDERSON
MATERNAL ROLE ATTAINMENT THEORY- RAMONA MERCER
DEFINITIONS
TYPES OF DEFINITIONS AND CONCEPTS
MIDDLE RANGE THEORIES
IMPORTANCE OF THEORIES
PURPOSES OF THEORIES
INTERDEPENDENCE OF THEORY AND RESEARCH

UNIT 1- HISTORICAL OVERVIEW OF NURSING

PERIOD OF INTUITIVE NURSING

 Nursing was untaught and instinctive. It was performed out

of compassion for others.

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  It was practiced since prehistoric times among primitive
tribes and lasted through the early Christian era.
 Nursing was a function that belonged to women.
 They believed that illness was caused by invasion of the
victim’s body by evil spirits thru the use of black magic or
voodoo.

They believed that the medicine man was

 “Shaman” or witch doctor had the power to heal by using
white magic. Among others, the Shaman used hypnosis,
charms, dances, incantations, massage, fire, water, and
herbs as means of driving illness from the victim.
 The Shaman also practiced “trephining” or drilling a hole in
the skull with a rock or stone without the benefit of
anesthesia as a last resort to drive evil spirits from the
victims body.
 Man’s mode of living changed from nomadic to agrarian to
an urban community life so he developed a means of
communication and the beginnings of a scientific body of
knowledge.
 Nursing remained the duty of slaves, wives, sisters or
mothers.
 Care of the sick was closely related to religion, superstition
and magic.
 Astrology and numerology were also used in medical
practice.

CONTRIBUTIONS TO NURSING AND MEDICINE

• BABYLONIA

 Code of Hammurabi- provided laws that covered every facet

of Babylonian life including medical practice. The medical
regulations established fees, discouraged experimentation,
recommended specific doctors for each disease and gave
each patient the right to choose between the use of charms,
medications, or surgical procedures to cure the disease.
 There was no mention of nurses or nursing.
 Code of Hammurabi

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• EGYPT

 Introduce the art of embalming which enhanced their

knowledge of human anatomy.
 Developed the ability to make keen observation left a record
of 250 recognized diseases.
 Slaves and patient’s families nursed the sick.

• ISRAEL

 Moses the “ Father of Sanitation” who wrote the five books

of the Old Testament which;
 Emphasized the practiced of hospitality to strangers and
acts of charity.
 Promulgated laws of control on the spread of communicable
disease and the ritual of circumcision of the male child .
 Referred to nurses as midwives, wet nurses or child’s nurses
whose acts were compassionate and tender.

• CHINA

 Strongly believed in spirits and demons.

 Practiced ancestor worship which prohibited the dissection of
dead human body.
 They gave the knowledge of materia medica (pharmacology)
which prescribed methods of treating wounds, infections and
muscular afflictions.
 No mention of nursing in their records.
 Care of the sick - done by female members of the household.
• INDIA
 Built hospitals, practiced an intuitive form of asepsis and
were proficient in the practice of medicine and surgery.
 For the first time in recorded history, there was reference to
the nurse’s taking care of patient’s. These nurses were
described as ancombination by physical therapist and cook.
 Sushurutu made a list of function and qualifcations of nurses.
• ANCIENT GREECE
 Nursing was the task of untrained slave.
 Hippocrates who was born in Greece was give the title
“Father of Scientific Medicine”.He made a major advance in
medicine by rejecting the belief that the diseases had

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 supernatural causes. He also developed assessment
standards for clients and recognized a need for nurses.

CADUCEUS- the insignia of the medical profession today.

 ROME
 The Romans attemted to maintain vigorous health,
because illness was a sign of weakness.
 Care of the ill was left to the slaves or Greek physicians
(both groups were looked upon as inferior by Roman
society).
 Fabiola was converted to Christianity made her home as
the first hospital in the Christian World.

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 PERIOD OF APPRENTICE NURSING

This period extends from the founding of religious nursing

orders in the Crusades, which began in the 11th century. Pastor
Fliedner and his wife established the Kaiserwerth Institute for the
training of Deaconesses (a training school for nurses) in Germany.
It is called the Period of “ on the job training”. Nursing care was
performed without any formal education and by people who were
directed by more experienced nurses. Religious orders of the
Christian Church were responsible for the development of this
kind of nursing.

During this Period there was also the rise of Religious

Nursing Orders for women. Although Christianity promoted
equality to all men, women were still concentrated in their roles
as wives and mothers. Only by entering a convent that she could
follow a career, obtain an education and perform acts of charity
that her faith taught would help her gain grace in heaven.
Queens, princesses and other ladies of royalty founded many
religious orders.

Religious taboos and social restrictions influenced nursing at the

time of the religious nursing orders.

 Hospitals were poorly ventilated and the beds were filthy.

There were overcrowding of patients ( 3-4 patients
regardless of diagnosis or whether they are alive or dead
may have shared 1 bed.
 Practice of environmental sanitation and asepsis were non-
existent. Older nuns were played with and took good care of
the sick; while the younger nuns washed soiled linens,
usually in the rivers.
 People entered hospitals only under compulsion or as last
resort.
 There was little employment and education was only for rich
and the titled.

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Important Nursing Personages During the Period of
Apprentice Nursing

 ST CLARE - founder of the Second Order of St. Francis of

Assisi.
 ST. ELIZABETH OF HUNGARY - a daughter of a Hungarian
king. also known as the “Patroness of Nurses”.
 ST CATHERINE OF SIENA - the first “ Lady with a Lamp”.
 ST. CAMILLUS OF LELLIS - Patron Saint of hospital

THE DARK PERIOD OF NURSING

This extends from the 17th to the 19th century from the Period
of Reformation until the U.S. Civil War. The religious upheaval
led by Martin Luther destroyed the unity of the Christian faith.
The wrath of Protestantism swept away everything connected
with Roman Catholicism in schools, orphanages and hospitals.
Properties of hospitals and schools were confiscated. Nurses

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 fled for their lives. There were no provisions for the sick, no one
to care for them. Nursing became the work of the least
desirable of women - those who bribes from patients, stole
patient’s food and who used alcohol and tranquilizers. Nurses
worked 7 days a week, slept in the cubbyholes (cranny) near
the hospital ward and ate scrap of food when they could find
them.

Some reforms during the 18th century

Pastor Theodor Fliedner and his wife established the Institute

for the Training of Deaconesses at Kaiserwerth, Germany (1836)
which was the first organized training school for nurses. Among
the requirements upon entering this school were;

1. Character reference form clergyman

2. Health certificate from a doctor

3. Permission from their nearest relative

The most notable figure who became one of the students of

Deaconess School at Kaiserwerth is Florence Nightingale, the
“Mother of Modern Nursing”. In U.S, The Nurse’s Society of
Philadelphia organized a school of nursing under the direction of
Dr. Joseph Warringtong in 1839. Nurses were trained on the job
and attended some preparatory courses. Women’s Hospital in
Philadelphia established a six- month course in nursing to
increase the nurse’s knowledge while they worked. They were
taught a minimum amount of medical and surgical nursing,
materia medica and dietetics. The American Medical Association
during the Civil War created the Committee on Training of Nurses.
It was designated to study and make recommendations with
regards to the training of nurses. Doctors realized the need for
qualified nurses.

PERIOD OF EDUCATED NURSING

This period began on June 15, 1860 when the Florence

Nightingale School of Nursing opened at St. Thomas Hospital in
London. ( St. Thomas Hospital School Of Nursing). The
development of nursing during this period was strongly influenced
by trends resulting from wars, from arousal of social

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consciousness, from emancipation of women and from the
increased educational opportunities offered to women.

SCRUBS published the following nursing job description from

1887:

 In addition to caring for 50 patients, each bedside nurse will

follow these regulations:

1. Daily sweep and mop the floors of your ward, dust the
patient’s furniture and window sills.

2. Maintain an even temperature in your ward by bringing in a

scuttle of coal for the day’s business.

3. Light is important to obrve patient’s condition. Therefore,

each day fill kerosene lamps, clean chimneys and trim wicks.

4. The nurse’s notes are important in aiding your physician’s

work. Make your

pens carefully.

5. Each nurse on day duty will report every day at 7 a.m and
leave at 8p.m , except on the Sabbath , on which day she will be
off from 12 noon to 2 pm.

6. Graduate nurses in good standing with the director of nurses

will be given an evening off each week for courting purposes, or
two evenings a week if you regularly to church.

7. Each nurse should lay aside from each payday a goodly sum
of her earnings for her benefits during her declining years, so that
she will not become a burden. For example, if you earn $30 a
month , you should set aside $15.

PERIOD OF CONTEMPORARY NURSING

This covers the Period after World War II to the present.

 United Nations established the WHO to assist in fighting

disease by providing health information and improving
nutrition, living standards, and environmental conditions of
all people.

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  Health is perceived as a fundamental human right. Laws
were legislated to provide such right.
 Nursing involvement in community health is greatly
intensified.
 Technological advances, such as the development of
disposable supplies and equipment have relieved the nurse
from numerous tedious tasks.
 Development of the expanded role of the nurses.

Nursing became a dynamic profession because the scope of

nursing practice is expanding in the light of the modern
developments in the constantly changing world.

NURSING AS A SCIENCE, AS A PROFESSION, A DISCIPLINE

AND A PHILOSOPHY

• WHAT IS A SCIENCE?

 A science is concerned with cause and effect

 A science is a way of explaining observed phenomena
 A science has a system of gathering, verifying, and
systematizing information about reality Science is both a
process and a product

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As a PROCESS- science follows systematic inquiry and
observations of the natural world.

As a PRODUCT- it is grounded and tested in experience and is the

result of investigative efforts.
CHARACTERISTICS OF SCIENCE
 Must explain its investigations and arguments
 Must be logically ordered
 Statements must be true or probably true
 Expressed in universal statements
 Definite fields of knowledge
 Coherence
üAll of these criterion is present in nursing, therefore, Nursing is a
Science (hence the
degree, Bachelor of Science in Nursing)

DISCIPLINE
-It is a field of inquiry characterized by a unique perspective and a
distinct way of viewing phenomenon (Parse,1999)
• It is a branch of educational instruction or a department of
learning.
• 2 KINDS OF DISCIPLINE:
• Academic Discipline- history
• Professional discipline- law

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It is worthy to note that academic discipline aim to know
(theoretical) and their theories are descriptive in nature. Their
research is both basic and applied.
• Conversely, professional disciplines are practical (skill
application) in nature, and their research
tend to be more prescriptive and descriptive (Donaldson &
Crowley, 1978)
• Nursing as a distinct discipline can be identified by:
• Identifiable philosophy
• Atleast one conceptual framework (perspective) for
delineation of what can be defines as nursing.
Acceptable methodologic approaches for the pursuit and
development of knowledge.

• In general, nursing’s knowledge base draws from many

disciplines
• Therefore, it is not just a professional discipline but an
academic discipline as well.

WHAT IS THE DIFFERENCE BETWEEN A PROFESSION AND

AN OCCUPATION????
• OCCUPATION- is a job or career
• PROFESSION- is a learned vocation or occupation that has a
status of superiority and precedence within a division of work.
• A profession must also have an institutionalized goal or
social mission as well as a group of scholars, investigators, or
researchers who work to continually advance the knowledge of
the profession with the goal of improving practice.
ü All professions are occupations, but not all occupations are
professions

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(Logan,2004)
• Until recently, nursing was viewed as an occupation rather
than a profession.
• Nursing has had difficulty being deemed a profession
because the services provided by nurses have been perceived as
an extension of those offered by wives and mothers.
• Historically, nursing has been seen as subservient to
medicine.
• Autonomy in practice is incomplete because nursing is still
dependent on medicine to direct much of its own practice
• It is only recently that nursing was able to identify and
organize professional
knowledge.

CHARACTERISTICS OF NURSING AS A PROFESSION:

1. Has a defined body of knowledge
• Have identifiable knowledge that belongs to our profession
alone (unique).
• The knowledge of nursing profession is well organized
around theories (basis)
• Knowledge is largely intellectual, requiring higher learning
that can be taught (critical thinking)
• Nursing Knowledge continues to build as more nursing
research is conducted
2. Power and authority over training and education
• requires formal, in depth, and specialized education from
institutions of higher learning.

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3. Registration requirements for practice
• Need to pass licensure exam
• Need to finish a BSN degree and comply with PRC
requirements before taking the exam
• Need to maintain professional conduct in order to keep
license
4. Altruistic service
• nurses are committed to service and doing good.
• Nursing provides something vital, often to groups who are
unable to meet
their needs on other ways.
5. A code of ethics
6. Autonomy
7. Relevance to society
• Nursing exists to provide service to others
• Nursing’s work is focused on the act of caring
• Health promotion, disease prevention, and the care of
individuals with altered health states all provide valuable service
to society.

Professional Roles of Nurses

1. Care Provider- Provide care and comfort for persons together
with preserving the dignity of human being. Considered as the
mothering role of nurses
2. Communicator-Communication facilitates understanding and
collaboration of nursing actions with their client and other
members of the HC team. It develops rapport with clients to
established their cooperation.
3. Teacher-Help the client learn the state of their well-being and
therapies that will be done to them. Provide them imagery of the
advantages and disadvantages of the actions that will be done to
them. It can help in the development of the nursing profession.
4. Counselor- Help client to cope with stress brought about by
their health conditions. Facilitates the clients growth in all aspect.

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5. Client Advocate- Defends the client’s rights to be treated
equally without any harm intentionally or unintentionally. Ensures
that the client’s need are met. Advocacy, involves promoting
what is the best for the client, ensuring that his needs are met
and protecting his rights.
6. Change Agent- Identifies the problem
-Assessing the client’s motivations and capacities for
change
§ -Determines alternatives
§ -Explores the possible outcomes of the alternatives
§ -Assesses resources
§ -Determines appropriate nursing role establishes and
maintains a helping relationship
7. Leader-As a positive (goal oriented) behavior involving an
exchange with other people. Leadership is an attempt to influence
others. Influencing helps the client in making decisions to
establish and achieve their goals towards alleviating their
conditions
8. Manager- Involves planning, giving direction, developing staff,
monitoring operations, giving rewards fairly and representing
both staff members and administration as needed.
9. Researcher-An investigative role of nurses which further
improves the nursing practice.
§ -Research substantiates practices as they were tested
and further studied upon.

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Expanded Roles of Nurses
1. Nurse Generalist- Has mastery in certain practice of nursing.
Examples of special areas: med-surgical nursing, pediatric nursing
geriatric nursing, psychiatric and mental health nursing, home
health nursing.
2. Nurse Clinician- Performs direct nursing actions in specialty
areas. They may or may have advances educational preparation
as long as they are certified by a governing body to perform such
duties.
3. Nurse Practitioner- Requires advance educational or nursing
practice and must be certified by a governing body that they may
practice.
4. Nurse Specialist- Requires to have a master’s degree in
nursing and must have a specialization in a particular field of
nursing.
NURSING LEADERS OF THE 20th CENTURY

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1. Mary Grant Seacole ( England) 1854Worked together
with Florence Nightingale during the Crimean War to give aid for
the wounded soldiers.
2. Florence Nightingale 1859 The Lady with the Lamp.
Contributed to the development of nursing education, practice
and administration.
3. Dorothea Lynde Dix( USA) 1861 Appointed
superintendent of the Female Nursed of the Union Army during
the American Civil War.
4. Louisa May Alcott (USA) 1862-1863 Wrote the book
“Hospital Sketches” as she described the works of volunteer
nurses during the Civil War.
5. Harriet Tubman (USA) 1861- 1865 “The Moses of Her
People” . She served the slave
of the underground railroad during the Civil War
6. Jean Henri Dunant (Switzerland) 1862- 1865 Organized
the International Conference that Founded the Red Cross during
the Geneva Convention.
7. Linda Richards (USA) 1873 America’s First Trained
Nurse.
8. Mary Mahoney (USA) 1879 America’s First Trained
Black Nurse.
9. Clara Barton (USA) 1812-1912 Organized and Establish
the American Red Cross.
10. Lilian Wald (USA) 1867-1940 Founder of Public Health
Nursing, Founded the Henry Street Settlement and Visiting Nurse
Services, which Provided nursing services educationally, socially,
and culturally.
11. Bedford Fenwick (England) 1899 Established the
International Council of Nurses in Great Britain.

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PROMINENT NURSING LEADERS IN THE PHILIPPINES
Cesaria Tan First Filipino Nurse who had Masters Degree in
Nursing in the US.
Socoro Sirilan Reformed social Service for Indigenous
patients at San Lazaro Hospital
Annie Sand Founded the National League of Philippine
Government Nurses
Col. Elvegia Mendoza First Female Military Nurse to hold the
Rank of Brigadier General
Loreto Tupaz Known as the Dean of Philippine Nursing Education
Florence Nightingale of Iloilo

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Socorro Diaz First Editor of ‘The Messenger” the first journal of
the PNA previously known as the FNA (Filipino Nursing
Association)
Dr. Julita Sotejo First Editor of “ The Filipino Nurses” the
second journal of the PNA. Florence Nightingale of the Philippines.
Founder and the first Dean of the University of the Philippines
College of Nursing (UPCN), who gave way to professional Nursing
in the Philiipines. Professor Emeritus of UPCN. The author of Code
of Ethics for Nurses (PRC BON Res. #633, 1982). Chairman,
Committee on Legal Aspect of Nursing which created the first
Philippine Nursing Law also known as RA No. 877S.1953.
Anastacia Giron Tupaz §First Filipino Nurse with a title of
Nursing Superintendent Chief Nurse at the PGH. Founder of
Filipino Nurses Association
Rosario Montemayor Delgado First President of the FNA. She
was a graduate of the Philippine General Hospital School of
Nursing in 1912.

UNIT II: History and Philosophy of Science

Nursing Science and Theory in the Late 20th Century

SCIENCE From the Latin “SCIENTIA” meaning “knowledge, refers
to any systematic knowledge or practice in a discipline of study. A
system of acquiring knowledge based on the scientific method. It
is also the organized body of knowledge gained through research.
History and Philosophy of Science
What is Philosophy?
It tries to discover knowledge and truth and attempts to
identify what is valuable and important.
Some branches of Philosophy:
 Epistemology- study of knowledge

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  Logic- study of principles and methods and
reasonings
 Ethics- study of moral philosophy
 Political philosophy- study of citizen and state.

Four ways of knowing

1. EMPERICAL/ EMPERICS is a scientific discipline of nursing

- It is a knowing that is based on fact or experience
-Empirical knowing focuses on EVIDENCE-BASED
RESEARCH for effective and accurate nursing practice.
- Any scientific, research-based, theoretical and factual
information that the nurse makes use of is under empirical
knowing.
Example: knowledge obtained from textbooks, lectures,
journals, and online resources
- Involves accurate and thoughtful decision making about
health care delivery for clients.
- It can bridge the gap of nursing practice and research to
provide basis for nurses to transform research into quality
care.
- Promotes quality care
2. ETHICAL
- Involves the judgment of right and wrong in relation to
intentions, reasons and attributes of individuals and

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 situations.
- Requires knowledge of different philosophical
positions: “what is good and right”.
-The code of morals or code of ethics that leads the
conduct of nurses is the main basis for ethical knowing.
3. AESTHETIC PERSONAL KNOWING
- Used in the process of giving appropriate nursing care
through understanding the uniqueness of every patient,
thus emphasizing use of creative and practical styles of
care
- It is the manifestation of the creative and expressive
styles of the nurse.
- Used in the process of giving appropriate nursing care
through understanding the uniqueness of every patient,
thus emphasizing use of creative and physical styles of
care.
- Focuses on EMPATHY = the ability for sharing or
vividly understanding another’s feelings.
4. PERSONAL KNOWING
- Encompasses knowledge of the self in relation to others
and to self.
- Is focused on realizing, meeting and defining the real,
true self. One nursing term defines this as “SELF-
AWARENESS”
- Involves the therapeutic use of self.

Rationalism
- Rationalist epistemology (scope of knowledge)
emphasizes the importance of a priori reasoning as the
appropriate method for advancing knowledge.
- Utilizes deductive reasoning (general to specific) to
generate view

Empiricism
- makes use of objective and tangible data to observe and
collect data.

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 This approach, called the inductive method, is based on the
idea that the collection of facts precedes attempts to formulate
generalizations

Early 20th Century Views

During the first half of this century, philosophers focused on the
analysis of theory structure, whereas scientists focused on
empirical research.
 Positivism emerged as the dominant view of modern science
(Modern logical positivists believed that empirical research and
logical analysis (deductive and inductive) were two approaches
that would produce scientific knowledge.
In the latter years of the twentieth century, several authors
presented analyses challenging the positivist position, thus
offering the basis for a new perspective of science. Nursing, as it
continually evolves, brings into being the different theories that
guides clinical practice.
Emergent views of science and theory in the late
twentieth century
Brown (1977) emphasized that science was a process of
continuously building research rather than a product of findings.
Theories play a significant role in determining the scientist
observation and interpretation about the phenomena through
data collection and analysis.
 Presupposed theories and observable data interact in the
process of scientific investigation.
 Understanding of evidence-based science begin. Nurses
uses it to support the interventions for patient care.

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 UNITIII: STRUCTUREOFNURSING KNOWLEDGE
INTRODUCTION:
- Nursing profession is still under an evolution phase, a
phase of receding and evolving new paradigms.
- Nursing theories and models provide information about
definitions of nursing and nursing practice, principles
that form the basis for practice, goals and functions of
nursing.
THEORY
• Greek word “THEORIA” – speculate
• A set of statements that tentatively describe, explain, or
predict relationships among concepts that have been
systematically selected and organized as an abstract
representation of some phenomenon. (Mc Ewen &. Wills, 2019)
IMPORTANCE OF NURSING THEORIES
• Aim to describe, predict, and explain the phenomenon of
nursing
• Provide the foundations of nursing practice, help to generate
further knowledge and indicate in which direction nursing should
develop in the future
• Help to distinguish what should form the basis of practice by
explicitly describing nursing.
• Help to provide better patient care, enhanced professional
status for nurses, improved communication between nurses, and
guidance for research and education.
• Maintains professional boundaries in nursing
PURPOSES OF THEORIES
IN PRACTICE
• Assist nurses to describe, explain, and predict everyday
experiences

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• Serve to guide assessment, intervention, and evaluation of
nursing care
• Provide rationale for collecting reliable and valid data about
the health status of clients
• Help to establish criteria to measure the quality of nursing
care
• Help build a common nursing terminology to use in
communicating with other health
professionals. Ideas are developed and words defined.
• Enhance autonomy of nursing by defining its own
independent functions.
IN EDUCATION
• Provide a general focus for curriculum design.
• Guide curricular decision making.
IN RESEARCH
• Offer a framework for generating knowledge and new ideas.
• Assist in discovering knowledge gaps in specific field of
study.
• Offer a systematic approach to identify questions for study.

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INTERDEPENDENCE OF THEORY AND RESEARCH
- The relationship between nursing theory and nursing
research helps in building nursing knowledge.
According to Meleis 1997
- Nursing knowledge is composed of both:
1. Theoretical Knowledge-Aims to stimulate thinking and
broaden understanding of the science and practice of the nursing
discipline.
2. Practical Knowledge-Referred to as the art of nursing.

CONCEPTS
- Concepts are often called the BUILDING BLOCKS OF
THEORIES. Enhances one’s capacity to understand
phenomena as it helps define the meaning of a word.
- Concepts are vehicles of thoughts that involve images
- Concepts maybe abstract (indirectly observed or
intangible example love,care) or concrete (directly
observed and tangible example nurse, mother, pain).
EXAMPLES: Noise, Cleanliness, Ventilation, Bed and Beddings,
Warmth in Nightingales Environmental Theory
TYPES OF CONCEPTS:
1. CONCEPTS EMPIRICAL - easily observed in the real world .
2. INFERENTIAL - indirectly observable
3. ABSTRACT- non observable

PARADIGM

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• It is a conceptual diagram.
• Patterns or models used to show a clear relationship among
the existing theoretical works in nursing.
Focus (Metaparadigms):
1. Person/individual
2. Health
3. Environment
4. Nursing

METAPARADIGM
- Originates from two Greek word: Meta, meaning “with”
and paradigm, meaning “pattern.
- It defines and describes relationships among major
ideas and values.
- The highest level of knowledge.

NURSING METAPARADIGM
• Are patterns or models used to show a clear relationship
among the existing theoretical works in nursing.

PERSON
 Refers to all human beings; the recipients of nursing care.
 They include individuals, patients, groups, families, and
communities.

ENVIRONMENTAL
 Factors that affect individuals internally and externally. Also
includes setting where nursing care is provided.
 Ventilation
 Warmth
 Noise
 Light
 Cleanliness

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HEALTH
 The holistic level of wellness that the person experiences.
 It addresses the person’s state of well- being.
 Goal of all nursing activity should promote client’s health.
NURSING
 Nursing is a science, an art and a practice discipline which
involves caring.
 The interventions of the nurse rendering care in support of,
or in cooperation with the client.
 Nursing is a humanistic science dedicated to compassionate
concern with maintaining and promoting health and
preventing illness and caring for and rehabilitating the sick
and disabled.

NURSING PHILOSOPHIES
ENVIRONMENTAL THEORY – Florence Nightingale
- Developed and described the first theory of nursing.
Notes on Nursing: WHAT IT IS , WHAT IT IS NOT and
NOTES ON HOSPITALS. She focused on changing and
manipulating the environment in order to put the
patient in the best possible contributions for nature to
act.
- She believed that in the nurturing environment, the
body could repair itself. She linked with environmental
factors: (1.) fresh air, (2) light, (3) Cleanliness, (4)
Hygiene, (5) Proper nutrition.

STAGES OF NURSING EXPERTISE- PATRICIA BENNER

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  NOVICE- No background experience (e.g. nursing student
that’s why we are guided by our clinical instructors.
 ADVANCED BEGINNER
- This stage pertains to the newly graduate nurses.
 COMPETENT
- Has 2-3 years of experience which he /she which
demonstrates planning and organizational abilities.
 PROFICIENT
- Has 3-5 years of experience which he/she perceives
situations as a whole. Has a holistic understanding of
the client which improves decision making.
 EXPERT
- Flexible and highly proficient performance which he/she
no longer rely on rules, regulations , or maxims to
connect his/her understanding of the situation to
appropriate action.

THEORY OF HUMAN CARING- JEAN WATSON

1. Practice human kindness.
2. Instill faith and hope.
3. Nurture individual spiritual beliefs and practices.
4. Develop helping-trusting relationships.
5. Promote and accept the expression of positive and negative
feelings.
6. Use creative and scientific problem - solving methods for
decision making.
7. Perform teaching and learning that address individual needs
and learning styles.
8. Create a healing environment for the physical and spiritual
self which respects human dignity.
9. Assist with physical, emotional, and spiritual needs.
10. Allow rooms to miracles to take place

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CONCEPTUAL MODELS SELF-CARE DEFICIT THEORY -
Dorotea Orem
• SELF-CARE
- Practice of activities that individual initiates and
perform in their own behalf in maintaining life, health,
and well-being.
• SELF-CARE AGENCY
- Individual’s ability to perform self-care activities.
 SELF-CARE REQUISITES
- Action directed towards provision of self -care
 THERAPEUTIC SELF-CARE DEMAND
- “Totality of self-care actions to be performed for some
duration in order to meet self acre requisites by using valid
methods and related sets of operations and actions”

HEALTH CARE SYSTEM MODEL - Betty Neuman

• Focuses on stress and stress reduction
• Primarily concerned with effects of stress on health
• Stressors are any forces that alters the system’s stability

GOAL ATTAINMENT THEORY- Imogene King

• Describes the importance of the participation of all individual
in decision making as well as choices, alternatives, and outcomes
of nursing care.
• It pertains to the importance of interaction, perception,
communication, transaction, self, role, stress, growth and
development, time, and personal space.
• Reflects King’s belief that the practice of nursing is
differentiated from other health care profession by what nurses do
with and what they do for individuals.
• The nurse and the patient/client communicates, information
in order to set goals mutually and then acts to attain those goals.

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NURSING THEORIES
INTERPERSONAL RELATIONS THEORY - Hildegard Peplau
4 PHASES OF NURSE PATIENT RELATIONSHIP
1. ORIENTATION
2. IDENTIFICATION
3. EXPLOITATION
4. RESOLUTION

NURSING NEED THEORY 14 COMPONENTS -Virginia

Henderson
• Breathe normally.
• Eat and drink adequately.
• Eliminate body wastes.
• Move and maintain desirable postures.
• Sleep and rest.
• Select suitable clothes-dress and undress.
• Maintain body temperature within normal range by adjusting
clothing and modifying environment.
• Keep the body clean and well groomed and protect the
integument.
• Avoid dangers in the environment and avoid injuring others.

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• Communicate with others in expressing emotions, needs,
fears, or opinions.
• Worship according to one’s faith.
• Work in such a way that there is a sense of accomplishment.
• Play or participate in various forms of recreation.
• Learn, discover, or satisfy the curiosity that leads to normal
development and health and use the available health facilities

THE CORE, CARE, CURE- LYDIA HALL

NURSING CARE CAN BE DELIVERED ON THREE INTERLOCKING

LEVELS
1. Care- hands on bodily care
2. Core- using self in relationship to
patient
3. Cure- seeing the patient and family through medical care.

MATERNAL ROLE ATTAINMENT THEORY- RAMONA MERCER

• Anticipatory stage
• Formal Stage
• Informal Stage
• Personal Stage

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DEFINITIONS
PERSON- this includes individuals, families and groups.
ENVIRONMENT- includes the physical, social, political.
HEALTH- a state of well -being not just the absence of disease.
NURSING- the actions taken between nurse and patient to return
to
health.
PROPOSITION - A statement to be proved, explained, or
discussed.
CONCEPTUAL DEFINITIONS - meaning of a word based on how a
certain theory or relevant literature perceives it to be.
Examples: roles/concepts of a nurse, patient care, environment.
OPERATIONAL DEFINITIONS -meaning of a word based on the
method of how it was measured or how the person come up with
that perception.
THEORETICAL MODELS- Highly established set of concepts that
are testable.
CONCEPTUAL MODELS - Represented thru a diagram or in
narrative form which shows how concepts are interrelated.
CONCEPTUAL- It is a structure of concepts or theories which are
pulled together as a map for the study
THEORETICAL- It is a structure of concepts which exist or tested in
the literature, a ready-made map for the study

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TYPES OF DEFINITIONS AND CONCEPTS
1. CONCEPTUAL - Comparable to definition from a literature
such as a dictionary, encyclopedia, and journals.
2. OPERATIONAL - Specifies exactly how the concept will be
determined and assess it, also identifies procedures and
operations significant to determine concepts.
Knowledge is acquired through: Perception, Association,
Learning, Reasoning, Communication.

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MIDDLE RANGE THEORIES

- Have more limited scope, addresses specific

phenomena or concepts and reflect practice
(administration, clinical or teaching).
Quality of life, uncertainty in illness, social support,
incontinence, caring.

PHENOMENON

- An empirical data that can be observed

Concepts
- Building blocks of theories which can either be an
empirical or abstract data
Conceptual models
- Derived from a person’s own point of view
Paradigms
- Another term for conceptual framework or model
Assumptions
- Statements that the theorists hold as factual
Propositions
– statements that imply the relationships of concepts
Hypothesis – a testable relationship statement
Research – use of systematic methods to study a phenomenon
and create a general knowledge
Induction – a type of reasoning that uses specific details to form a
general conclusion
Deduction – a type of reasoning wherein general conclusions are
made based from specific concepts.

IMPORTANCE OF THEORIES

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Aim to describe, predict, and explain the phenomenon of nursing
Provide the foundations of nursing practice, help to generate
further knowledge and indicate in which direction nursing should
develop in the future
Help to distinguish what should form the basis of practice by
explicitly describing nursing.
Help to provide better patient care, enhanced professional status
for nurses, improved communication between nurses, and
guidance for research and education.
Maintains professional boundaries in nursing

PURPOSES OF THEORIES

IN PRACTICE
Assist nurses to describe, explain, and predict everyday
experiences

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 Serve to guide assessment, intervention, and evaluation of
nursing care
Provide rationale for collecting reliable and valid data about
the health status of clients
Help to establish criteria to measure the quality of nursing
care
Help build a common nursing terminology to use in
communicating with other health professionals. Ideas are
developed and words defined.
Enhance autonomy of nursing by defining its own
independent functions.
IN EDUCATION
Provide a general focus for curriculum design.
Guide curricular decision making.
IN RESEARCH
Offer a framework for generating knowledge and new ideas.
Assist in discovering knowledge gaps in specific field of
study.
Offer a systematic approach to identify questions for study.

INTERDEPENDENCE OF THEORY AND RESEARCH

NURSING PRACTICE
NURSING THEORY

NURSING RESEARCH

The relationship between nursing theory and nursing research

helps in building nursing knowledge.

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