Reviwer inTheoretical Foundation of Nursing

Ma’am Riza Magallanes

Alvarez, Rana Bianca

Amoranto, Ashley
Bravo, Jessa
Casuyon, Lyza R.
De Castro, Shiela Mae
Del Mundo, Hannika
Festijo, Cristyl Lyza
Hernandez, Karen
Llanes, Alliah
Mendoza, Sheena
Nightingale’s Environmental Theory: Florence Nightingale
- Developed by Florence Nightingale and known as "The Lady with the Lamp.”.
- Nightingale's environmental theory emphasizes the importance of the physical
and social environment in shaping an individual's health and well-being.
- State that "it is an act of utilizing the environment of the patient to assist him in
his recovery."
- Her intention was very clear: she wanted to improve the environment in order to
aid in healing and save lives.
Type of Environment:
Physical Environment
● This includes factors like cleanliness, ventilation, light, temperature, and noise
levels.
Social Environment
● This encompasses the interactions and relationships between patients, families,
and healthcare providers.
Psychological Environment
● This refers to the mental and emotional conditions affecting patients.
Five Major Components of a Healthy Environment
● Pure Fresh Air
● Pure Water
● Effective Drainage
● Cleanliness
● Adequate Light

JEAN WATSON'S THEORY OF CARING

A transpersonal caring relationship is an intersubjective connection between a
nurse and a patient, transcending objective assessments to engage with the patient's
deeper subjective experience. It emphasizes mutuality, enhancing human dignity, and
fostering inner harmony. This relationship aims to protect and preserve the wholeness
of individuals, acknowledging their unique healthcare situations. A caring occasion
occurs when the nurse and patient connect meaningfully, allowing for human caring to
unfold. Both individuals influence each other through their choices and actions within
this relationship.
Watson’s Theory of Caring: Four Major Concepts
Since 1979, the development of the theory has been toward clarifying the
relationship between the person of the nurse and the person of the patient, emphasizing
existential-phenomenological and spiritual ritual factors. Her hope at the time was that
her theory would help distinguish nursing science as a separate and important entity
from medical science. Her work was influenced by her teaching experience and was
created as a way to find common meaning among nurses from all over the world. Build
caring relationships with patients. View patients as holistic beings. Display unconditional
acceptance and positive regard. Promote health through education and interventions.
Dedicate uninterrupted time for patient interaction.
Nursing Process in Watson’s Theory
Watson parallels the nursing process with scientific research:
Assessment
- Involves observation, identification, problems, and use of relevant literature.
Planning
- Determines how variables will be examined, guiding data collection methods.
Intervention
- Directly implements the plan, focusing on data collection.
Evaluation
- Analyzes data to assess intervention effectiveness and generates further
hypotheses

PATRICIA BENNER'S STAGES OF NURSING EXPERTISE NURSING

PHILOSOPHIES
- Develop concepts known as "novice to expert."
- She describes "knowing how "without "knowing that."
FIVE LEVELS OF NURSING EXPERIENCE
THE NOVICE
- Begins with no prior experience
THE ADVANCE BEGINNER
- Gained prior experience in actual nursing situation
THE COMPETENT NURSE
- Has been on job in 2-3 years
THE PROFICIENT NURSE
- Perceive and understand situation as whole parts
THE EXPERT NURSE
- No longer relies on principles, rules or guidelines to connect situation and
determine actions
PATRICIA BENNER:
They develop theory to describe how nurses acquire clinical skills and knowledge over
time. Virginia Henderson has been an inspiration for Benner. Benner adapted Dreyfus
model (skill of acquisition)
SEVEN DOMAIN OF NURSING PRACTICE
1. HELPING ROLE
2. TEACHING OR COACHING FUNCTION
3. DIAGNOSIS CLIENT MONITORING FUNCTION
 4. EFFECTIVE MANAGEMENT CHANGING SITUATION OF RAPIDLY
5. ADMINISTERING AND MONITORING THERAPEUTIC INTERVENTION AND
REGIMENTS
6. MONITORING AND ENSURING QUALITY OF HEALTH CARE PRACTICES
7. ORGANIZATION AND WORK ROLE COMPETENCIES

KATIE ERICKSON THEORY: CARITATIVE CARING THEORY

The Theory of Caritative Caring was developed by Katie Eriksson in 1995. This model
of nursing distinguishes between caring ethics, the practical relationship between the
patient and the nurse, and nursing ethics. Nursing ethics are the ethical principles that
guide a nurse's decision-making abilities.
IMPORTANCE OF CARITATIVE NURSING THEORY
The ultimate goal of caring is to alleviate suffering in a spirit of faith, hope, and love and
thereby enhance dignity. The ultimate purpose and goal of caring are to guarantee the
patient's dignity and absolute value as a human being. This theory is important to
nurses so that nurses understand the developmental tasks of a person under their care.

Martha Rogers, Roger's Science of Unitary Human Beings

- A nursing theory that views individuals as unified wholes constantly interacting
with their environment.
- It emphasizes the dynamic and interconnected nature of humans, rejecting the
idea of separating mind, body, and spirit.

1. Assessment
- Total Pattern of Events
- Simultaneous States
- Rhythms of Life Process
- Supplementary Data
- Categorical Disease Entities
- Subsystem Pathology
- Pattern Appraisal
2. Voluntary Mutual Patterning
- Sharing Knowledge
- Offering Choices
- Empowering the Patient
- Fostering Patterning
3. Evaluation
- Repeat Pattern Appraisal
- Identify Dissonance and Harmony
- Validate Appraisal with the Patient
 - Self-Reflection for the Patient

Dorothea Orem’s Self-Care Deficit Model

- Developed by Dorothea Elizabeth Orem.
- Dorothea Orem's self-care theory proposes that patients have the innate ability
and responsibility to care for themselves
- A nurse's role goes beyond tending to patients' physical needs; it involves
supporting them on their journey to regain independence.
- The main reason Dorothea Orem introduced her theory was the desire to
improve the quality of nursing in hospitals.

Imogen King’s Goal Attainment Theory

- Based on the idea that nursing is a process of action, reaction, and interaction
between the nurse and the patient.
- Emphasises that when nurses collaborate closely with patients, they're more
likely to achieve health goals together.
- First introduced in the 1960's
- Focuses on the attainment of certain life goals.

Betty Neuman's System Model

This theory is significant in nursing because it provides a structured framework for
assessing and treating patients. This theory helps the nurses understand the overall
condition of the patient, not just the symptoms of their illness.

Neuman's System Model identifies five (5) key variables that influence a patient's
health:
1. Physiological
• This describes an individual's body's physical and biological characteristics, such as
their vital signs and general state of health.
2. Psychological
• This refers to the mental and emotional health of the patient, encompassing coping
strategies, stress, and anxiety.
3. Sociocultural
• This examines how society and culture impact things like relationships, family support,
and cultural beliefs.
4. Developmental
• This describes a person's stage of life and their capacity to adjust to changes in
relation to their own personal development and growth.
5. Spiritual
• This refers to the patient's values and beliefs, which may have an impact on how they
handle and observe health and illness.
STRESSORS—factors that threaten the stability of the patient.
Three Types of Stressors
1. Interpersonal Stressors
• These come from interactions with other people, like conflicts with family members or
colleagues.
2. Intrapersonal Stressors
• These are internal factors that have an impact on an individual, such as diseases,
feelings, or challenges with their personal lives.
3. Extrapersonal Stressors
• These are external factors that are beyond a person's own control, including financial
issues or environmental issues.

Sister Callista Roy's Adaptation Model (developed 1976)

• Individual as a set of interrelated biological, psychological, and social system
• Process of evaluating adaptation as an outcome for nursing care
• Useful for understanding and predicting the consequences of caregiving.
4 modes of adaptation that contribute to a person’s healing:
Physiological: The individual’s physical health and
functions
Self-concept: The individual’s beliefs and feelings about themselves
Role function: The individual’s role in society
Interdependence: The individual’s relationships and interaction with others
6 step nursing process:
● Assessment of Behavior
● Assessment of Stimuli
● Nursing Diagnosis
● Goal Setting
● Intervention
● Evaluation
3 types of stimuli
● Focal stimuli: attention of a patient
● Contextual Stimuli: effect of the focal stimulus
● Residual stimuli: factors from the internal and external environment with effects
in the current situation that is unclear
JOHNSON'S BEHAVIORAL SYSTEM MODEL
- views individuals as complex systems of behaviors influenced by both internal
and external factors. It emphasizes that nursing should focus on influencing a
patient's behavior to promote health and well-being and recognizes that different
behaviors within a person are interconnected and that external factors like social,
cultural, and physical environments play a significant role.
Johnson categorized all human behavior into seven subsystems:
- Attachment/affiliative, achievement, aggressive, dependency. Sexual, Ingestive,
and Eliminative.
- Each subsystem is composed of a set of behavioral responses or tendencies that
share a common goal.
Reason
1. INDIVIDUAL ARE BEHAVIORAL SYSTEMS
2. NURSINGS FOCUS SHOULD BE ON BEHAVIOR
3. UNDERSTANDING BEHAVIOR IS KEY TO CORE
4. A FRAMEWORK IS NEEDED FOR NURSING PRACTICE
Dorothy Johnson was born on August 21, 1919, in Savannah, Georgia, and died in
February 1999. In 1938, she finished her associate's degree at Armstrong Junior
College in Savannah, Georgia. professional nursing career began in 1943.

Peplau’s Theory of Interpersonal Relationships

- Developed by Hildegard E. Peplau, an American nurse who is considered the
"Mother of Psychiatric Nursing” and the “Nurse of the Century.”.
- focuses on the dynamic relationship between the nurse and the patient as a key
factor in the healing process.
- It views nursing as a therapeutic interaction, where nurses use communication
and interpersonal skills to help patients understand and cope with their health
challenges.
- This theory is essential for nursing because it shifts the focus from passive
patient care to a dynamic, collaborative relationship.
Peplau’s theory identifies four sequential phases in the nurse-patient
relationship:
1.) Orientation: The initial phase where the nurse and patient meet as strangers,
define the problem, and establish trust.
2.) Identification: The patient begins to feel a sense of belonging and identifies with
the nurse as a source of help.
3.) Exploitation: The patient actively uses the nurse's help to address their needs
and make progress towards their goals.
 4.) Resolution: The nurse-patient relationship ends as the patient's needs have
been met and they are ready to move on.
WHY SHE DEVELOPED THE THEORY?
Personal Experience and Observations
- As a psychiatric nurse in the 1940s and 1950s, she observed the shortcomings
of the mental health system, leading her to seek for a more compassionate
approach to care.
The Need for a More Humanistic Approach
- She felt nurses could connect with patients emotionally, helping them understand
and cope with their challenges.
Elevating the Role of Nurses
- She believed that nurses should be involved in building trust, fostering
communication, and empowering patients to participate in their care
Influence of Psychoanalytic Thought
- She incorporates concepts from psychoanalysis, such as the importance of
interpersonal relationships in shaping personality and the role of anxiety in
human behavior, into her theory.

Ida Jean Orlando: Deliberative Nursing Processes

● Her Deliberative Nursing Process theory focuses on the interaction between the
nurse and patient, perception validation, and the use of the nursing process to
produce positive outcomes or patient improvement.
● She proposed that “patients have their own meanings and interpretations of
situations, and therefore nurses must validate their inferences and analyses with
patients before concluding.”
● Ida Jean Orlando developed the Deliberative Nursing Process Theory,
emphasizing understanding patient needs, validating feelings, and responding to
immediate needs for personalized and effective care.
The deliberative nursing process has five stages.
Assessment
- The nurse conducts a comprehensive assessment of the patient's needs, utilizing
a nursing framework to gather both subjective and objective data.
Diagnosis
- The nurse's clinical judgment aids in diagnosing health issues, which can be
confirmed through defining characteristics, related factors, and risk factors
gathered from the patient's assessment.
Planning
- The planning stage involves addressing each diagnosis problem with specific
goals and outcomes, resulting in a nursing care plan by the end of this stage.
Implementation
 - During the implementation stage, the nurse initiates the use of the nursing care
plan.
Evaluation
- The nurse evaluates a patient's progress towards nursing care plan goals,
making adjustments based on progress and addressing new problems identified
during the evaluation stage.
The application to nursing practice of this theory suggests that nurses must identify and
address a patient's immediate needs, recognizing that all patient behavior can be a call
for help.

Joyce Travelbee's Human to Human Relationship

A nursing theory that emphasizes the importance of human-to-human relationships in
nursing. The model is based on the idea that nurses can connect with patients through
a therapeutic relationship and that this relationship is the foundation of nursing.
Travelbee believed nursing is accomplished through human-to-human relationships that
begin with the original encounter and then progress through stages of emerging
identities, developing feelings of empathy, and later feelings of sympathy.
This model is a nursing theory that emphasizes the importance of human interaction in
nursing and how it can help patients heal.
- Helps nurses connect with patients
- Promotes patient-centered care
- Helps patients find meaning in suffering
- Challenges nurses to be more reflective
- Highlights the importance of communication skills
- Emphasizes the importance of mutual understanding

Lydia E. Hall: Hall's Core, Care, and Cure

- She used her knowledge of psychiatry and nursing experiences in the Loeb
Center as a framework for formulating her theory.
Three C's of Lydia Hall
Core: Person (receive nursing care)
Care: Body (address the role of nurses)
Cure: Disease (attention given to patients by medical professionals)

Faye Glenn Abdellah: 21 Nursing Problems (1960’s)

Three (3) categories of needs in Abdellah's theory
● Physical, sociological, and emotional needs
● Framework does Abdellah's theory provide for nurses.
● Assess patient care
 ● Plan interventions
● Implement care strategies
● Evaluate patient outcomes
Abdellah's theory emphasizes in nursing practice.
- Patient-centered care rather than solely on medical interventions
Abdellah's theory is essential in nursing because it promotes individualized care and
understanding of the patient's comprehensive health status.
Abdellah's 21 Nursing Problems influence modern nursing by advocating for a
systematic approach to care that integrates problem-solving with patient well-being.
Faye Glenn Abdellah.

21 nursing problems according to Abdellah's theory.

1. Maintain good hygiene and physical comfort.
2. Promote optimal activity: exercise, rest, and sleep.
3. Promote safety through prevention of accidents and infections.
4. Maintain good body mechanics and prevent deformity.
5. Facilitate oxygen supply to body cells.
6. Facilitate nutrition maintenance for body cells.
7. Facilitate elimination maintenance.
8. Facilitate fluid and electrolyte balance.
9. Recognize physiological responses to disease.
10. Facilitate maintenance of regulatory mechanisms.
11. Facilitate maintenance of sensory function.
12. Identify and accept emotional expressions.
13. Recognize the interrelatedness of emotions and illness.
14. Facilitate effective communication.
15. Promote productive interpersonal relationships.
16. Facilitate progress toward spiritual goals.
17. Create and maintain a therapeutic environment.
18. Facilitate self-awareness of individual needs.
19. Accept optimum goals considering limitations.
20. Use community resources for problem resolution.
21. Understand social problems as influencing illness.

Virginia Henderson: Need Theory

Virginia Avenel Henderson, a nurse and theorist, defined nursing as assisting
individuals in activities contributing to their health or recovery, requiring the necessary
strength, will, or knowledge. Henderson is also known as “The First Lady of Nursing and
the "First Truly International Nurse."
Virginia Henderson's nurse theory posits that nurses should assist patients as they
would themselves, and they can reform health systems by encouraging patients to
make medical decisions.
Applying the Virginia Henderson Nursing Theory to Post-Surgery Care
1. Breathing normally
- The patient is being monitored for respiratory rate and oxygen saturation to
prevent any potential postoperative respiratory complications.
2. Eating and drinking adequately
- The individual is assisting Mrs. Johnson in transitioning from clear liquids to a
regular diet, monitoring her intake, and providing necessary meals.
3. Eliminating body waste
- The individual assisted Mrs. Johnson in using a bedpan, assisting her in the
bathroom as she became more mobile, and teaching her how to safely use
assistive devices.
4. Moving and maintaining desirable postures:
- The individual is responsible for teaching bed positioning and assisting with early
mobilization as per the physical therapist's instructions.
5. Sleeping and resting
- The task involves managing pain through prescribed medications and ensuring a
comfortable rest environment.
6. Selecting suitable clothes
- The task involves assisting the individual in selecting and securing comfortable,
easy-to-manage clothing that doesn't hinder their incision or mobility.
7. Maintaining body temperature
- The individual is monitoring Mrs. Johnson's temperature and making necessary
adjustments to the room temperature or blankets.
8. Keeping the body clean
- The individual is being assisted with daily hygiene and taught safe personal care
management due to their limited mobility.
9. Avoiding dangers
- The task involves ensuring the safety of the environment, implementing fall
prevention measures, and teaching the individual how to seek assistance.
10. Communicating
- The speaker encourages Mrs. Johnson to openly discuss her needs, concerns,
and recovery goals.
11. Worshiping
- The individual is arranging a visit from the hospital chaplain if Mrs. Johnson's
spiritual needs are respected.
12. Working
- The task involves discussing daily routines and assisting in the gradual
resumption of them post-recovery.
 13. Playing and recreating
- The plan involves providing Mrs. Johnson with enjoyable activities like books or
puzzles to help her stay occupied during her recovery process.
14. Learning
- The text provides an overview of the patient's condition, postoperative care, and
rehabilitation process.
Henderson's Need Theory emphasizes patient independence in daily activities,
prioritizing 'basic needs' or 'fundamental needs' as the primary focus of nursing care.

Nola Pender's Health Promotion Model

Emphasizes individuals making rational choices influenced by personal factors
like self-esteem and health status to promote healthier behaviors and well-being.
- It encourages healthcare professionals to provide supportive resources and
considers the interactions between individuals and their environments during the
behavior change process.
FIVE NURSING PRACTICES
- ASSESSMENT
- DIAGNOSE
- PLANNING
- IMPLEMENTATION
- EVALUATION

MADELEINE Leininger Theory of Culture Care Diversity and University

Also known as culture care theory (CCT)
- Understanding and incorporating cultural factors into nursing practice to provide
culturally congruent care
CONCEPT OF LEININGER
1. CARE
- central focus of leininger Theory encompasses all action, behavior, and practices that
aim to assist, support, and facilitate to maintain health and we'll being
2. CULTURAL CARE DIVERSITY
- Refers to the variations in care belief, values, and practices that exist across different
cultures.
3. CULTURAL CARE UNIVERSALITY
- Highlights the commonalities in care belief and practices that exist across different
cultures
4. CULTURALLY CONGRUENT CARE
- Ultimate goal of leininger Theory: culturally based care knowledge, acts, and decisions
Madeline Leininger was born in Sutton, Nebraska, on July 13, 1925.
She is a founder and leader of transcultural nursing and human care theory.
She is the first professional nurse to hold a PhD in cultural and social anthropology.

Margaret Newman (First Step as a Theorist, 1979): Newman's Theory of Health as

Expanding Consciousness
● A groundbreaking model that views health as a dynamic process of becoming
more of oneself.
● Embraces a unitary and transformative paradigm of nursing as “caring in the
human health experience.
● Focus on the individual's unique pattern of interaction with their environment and
the potential for growth and transformation
● Understanding the patient's unique patterns of consciousness and supporting
them in their journey of expanding awareness.

Rosemarie Parse's Human Becoming Theory

First published as "man-living-health" theory in 1981, the name was officially
changed in 1992 to "The Human Becoming Theory." This theory focuses on the lived
experiences of individuals and emphasizes the importance of personal meaning in
health and well-being. This theory guides nurses to focus on quality of life from each
person's own perspective as the goal of nursing.
Three (3) Core Principles:
1. Structuring meaning
- Imaging
- Valuing
- Languanging
2. Configuring Rhythmic patterns
- Revealing-Concealing
- Enabling-Limiting
- Connecting-Separating
3. Cotranscending with the Possible
- Powering
- Originating
- Transforming

Dr. Rozzano Locsin: Locsin Technological Competency as Caring

Combines technology and caring in nursing practice, arguing that technology
should enhance patient care without replacing the nurse's compassionate role.
- Theory encourages nurses to use tools like monitors and electronic records while still
focusing on the patient's emotional and human needs, blending technology with caring.
Maslow's Human Need Theory
● It was proposed by Abraham Maslow, an American psychologist, to explain
human motivation.
● It suggested that people have basic needs that must be met before they achieve
higher levels of needs.
● This theory says that our actions is motivated or influenced by physiological and
psychological needs.

Abram Maslow Hierarchy of Needs (One of the best-known theories of motivation)

1.) Psychological Needs: (biological requirements for human survival) oxygen,
food, water, shelter, clothing, warmth, etc.
2.) Safety and Security: (Physical and Psychological Safety) people want to
experience order, predictability, and control in their lives.
3.) Love and Belongingness: (human emotional needs) intrapersonal,
connectedness, and affilating.
4.) Esteem: (Personal care) self-worth, accomplishment, and respect
5.) Self-Actualization: (realization of person’s potential) self-fulfillment, personal
growth, and peak experiences.

Harry Stack Sullivan: Sullivan’s Transcultural Analysis

His theory is Sullivan's transcultural analysis. He developed the concept of
"development epocs" to help explain the development of personality across lifespans.
He often emphasized the pivotal importance of friendship and connectedness. His
stage-based theory sees social skills as a bridge to greater development and
enrichment. He developed the interpersonal theory of personality because he believed
that anxiety and other psychiatric symptoms arise in fundamental conflicts between
individuals and their human environments.

Self-System
- This is a collection of experiences, or security measures, adopted by individual to
protect against anxiety.
3 components of self-system:
1. Good me: part of personality that develops in the response to positive feedback.
 2. Bad me: part of personality that develops in the response to negative feedback.
3. Not me: part of personality that responds to situations that produce intense
anxiety in the child.
7 Developmental Stage ( EPOCHS)
1. Infancy (birth-18 birth-18 months)
- Sullivan's acknowledges that the developmental process begins in early life.
2. Childhood (18 months-6years)
- During this stage, speech forms the framework upon which subsequent learning
is built.
3. Juvenile Era ( 6-9 years)
- During this period, social skills become increasingly important because of a wide
variety of playmates and access to healthy socialization.
4. Preadolescence (9-12years)
- In this stage, the ability to form close friendships assists the child in developing
self-esteem and serves as practice for later relationships.
5. Early Adolescence(12-14years)
- In this stage, the focus on relationships with peers shifts toward romantic
interests. The adolescent's sense of self-worth is based on his or her perceived
sexual attractiveness.
6. Late Adolescence (14-21 years)
- Young adults are struggling with conflicts between parental control and the desire
to be independent. Young adults also begin to focus more on romance and
friendship.
7. Adulthood
- The primary struggles of adulthood include family, financial security, and a
rewarding career. Socialization continues to play a role in adult development.

Von Bertalanffy’s General System Theory

- Developed by Karl Ludwig Von Bertalanffy, an Austrian biologist.
- Systems theory views an organization as an organism made up of numerous
parts (subsystems) that must work together in harmony for the larger system to
succeed.
 - Believes that organizational success relies on:
- Synergy (combined output)
- Interdependence between subsystems
- Interconnections
Importance in Nursing:
● GST helped shape nursing into a discipline that values the complexity of patient
care, encourages holistic assessment, and emphasizes the interconnected
nature of healthcare systems.

Kurt Lewin's Change Theory

● It was developed by Kurt T. Lewin, an American-German psychologist.
● It helps in understanding and managing how people react to change.
● It is based on how human behavior is influenced by both personal and
environmental factors.
3 Stages of Change
1.) Unfreezing
● represents by melting ice
● It is the initial stage where we recognized change is needed.
● there is a problem identified
● breaking old habits
2.) Change
● represents by liquid phase
● the new process or behaviour is introduced
● adopting new ways of doing things

3.) Refreezing
● represents by ice
● it is the final stage
● reinforcing new learning or habits to become permanent
The Importance of Change Theory
● It gives clear, step-by-step procedures for making changes.
● It improves nurses’ service or patient outcomes by implementing new safety
protocols and best practices.

Erik Erikson’s Psychosocial Development

● This theory was introduced by Erik Homburger Erikson, a German-American
psychoanalyt.
● was based on what is known as the epigenetic principle—people grow in a
sequence that occurs over time and in the context of a larger community.
8 Stages of Erik's theory of Psychosocial Development
1.) Trust vs Mistrust (0 - 1.5 years old): (HOPE) basic needs; nourishment and
affection
2.) Autonomy vs Shame and Doubt (1.5–3 years old)—(WILL) develop sense of
independence in many tasks
3.) Initiative vs. Guilt (3–6 years old): (PUSPOSE) take initiative in many tasks and
feel guilt when unsuccessful or boundaries are overstepped.
4.) Industry vs Inferiority
(6–12 years old)—(competence) develop self-confidence or have low self-
esteem.
5.) Identity vs. Role Confusion (12–18 years old)—(FIDELITY) experiment with
and discover identity and role.
6.) Intimacy vs Isolation (18–40 years old)—(LOVE) establishment of relationship
with others
7.) Generativity vs Stagnation (40 - 65 years old): (CARE) contribute to society
and be part of a family
8.) Integrity vs. Despair (65 years old—death)—(WISDOM) assesses and makes
sense of life and the meaning of contribution.

Lawrence Kohlberg’s Moral Development

- This theory focuses on how children develop morality and moral reasoning; it
occurs in a series of six stages and is focused on seeking and maintaining
justice.
It is highly relevant in nursing as it provides a framework for understanding ethical
decision-making, which is essential in delivering compassionate, patient-centered care.
KOHLBERG'S STAGES OF MORAL DEVELOPMENT
PRE CONVENTIONAL LEVEL
Moral reasoning is based on the consequences or result of the act.
Not on whether the act itself is good or bad.
Stage 1 (Punishment and Obidience Orientation)
- Motivated by the fear of punishment
- Obeying rules is important to avoid punishment
Applying in scenario
- Nurses must be simply follow the doctors orders or hospital policy to avoid
punishment
Stage 2 (mutual benefit or Individualism and Exchange)
- Motivated by the act of benefit that may be obtained later
- Individual point of view and judge actions based on how they serve individual
needs
Applying in scenario
 - A nurse might focus on meeting everyone’s immediate needs to maintain
harmony and avoid conflict.
CONVENTIONAL LEVEL
- Moral reasoning is based on the conventions or “norms” of society, which include
approval for others, law, and order.
Stage 3 (Social Approval or Good Interpersonal Relationship)
- Motivated by what others expect in behavior, good boy/girl.
- She values how he or she will appeal to others.
Applying in scenario:
- A nurse would focus on relationships and desire to be seen as a “good nurse” by
both family and patient.
- Communicate emphatically, trying to explain the patient's wishes to help the family
accept the decisions.
Stage 4 (Law and Order or Maintaining Social Order)
- Motivated to act in order to uphold law and order
- Focuses on maintaining law and order by following rules
- Doing ones duty and respecting authority
Applying in scenario:
- Nurses would see the importance of policies and ethical standards.
- Advocate for the patient's rights and respect patient choices.
POST CONVENTIONAL LEVEL
- Moral reasoning is based on consistent principles.
- Not recognizing the law, but the principles behind the law
Stage 5 (Social Contract and Individual Rights)
- Laws that are wrong can be changed
- Will act based on social justice
Applying in scenario:
- View the patient's autonomy as paramount, even if it causes discomfort for the
family.
Stage 6 (Individual Principles)
- Based on universal ethical principles and abstract reasoning
Applying in scenario:
- Nurse acts based on deeply held principles of respect for human dignity, justice,
and individual autonomy.
- Might work with the family to help them understand and accept the patient's
choice.

Sis. Carolina S. Agravante's CASAGRA Transformative Leadership Model

A nursing leadership framework designed to integrate psycho-spiritual aspects
into nursing practice. This model is crucial in nursing as it integrates psycho-spiritual
aspects with professional skills, promoting holistic development. This model encourages
self-awareness, emotional intelligence, and spiritual growth, fostering compassionate
and patient-centered care.
• The term 'CASAGRA' was made from her name, Carolina S. AGRAvante.
3 Key Elements
1. Servant-Leader Spirituality
- Emphasizes the importance of spiritual growth and servant leadership qualities in
nursing leaders.
2. Self-Mastery
- Focuses on personal development and self-awareness.
3. Special Expertise
- Highlights the need for advanced skills and knowledge in nursing.

Divinagracia: Composure Model

It emphasizes the importance of maintaining composure in various situations,
particularly in high-stress environments. Divinagracia's Composure Model is important
because it provides a structured framework for understanding and managing emotional
responses, particularly in high-stress or crisis situations.
Competence: Nurses should be equipped with knowledge and expertise in consistency
in caring for their patience.
Presence & prayer pertain to the availability of the nurse in times of need, not only
physically but also holistically. The utilization of therapeutic communication techniques
is also included.
Open-mindedness: Able to accept opinions and methods supplied by the patient or
other coworker.
Stimulation: Reinforcement through encouragements, affirmation, and motivation are
needed
Understanding: Able to grasp the situation the patient is in and able to show concern
and compassion.
Respect: Acknowledgement of the patient's needs—use of "po" and "opo" as well as
nods and gestures to display courtesy
Relaxation: Allowance of resting periods for the patient; activities that allow the use of
certain muscles while the others are relaxing
Empathy: Able to relate to the hardship the patient is going through—can share in the
joys and sorrows of the patient while not being attached altogether

Letty Kuan's Retirement and Role Discontinuity Model

This theory focuses on how retiring can cause a sense of "role discontinuity,"
where people struggle with losing their professional identity; this can make some people
feel lost or unsure of what to do next. This theory guides nurses in helping retirees
adjust to life after leaving work. Focuses on supporting retirees in finding new roles and
purposes, ensuring a healthier, more fulfilling retirement.
BASIC ASSUMPTIONS & MAJOR CONCEPTS
Retirement—an inevitable change in one's life.
Role Discontinuity—The interruption in the line of status enjoyed or performed.
Change of Life—The period between near retirement and post-retirement years.
Coping Approach—refers to the interventions or measures applied to solve a
problematic situation or state in order to restore or maintain equilibrium and normal
functioning.
DETERMINANTS OF POSITIVE PERCEPTIONS AND POSITIVE REACTIONS
TOWARD ROLE DISCONTINUITY
Health Status: Refer to the physiological and mental state of the respondents,
classified as either sickly or healthy.
Income (economic level): refers to the finances. affluence of the respondent, which
can be classified as poor, moderate, or rich.
Work status: status of an individual according to his/her work.
Family Constellation: The type of family composition described as either closed-knit or
extended family.
Self-Preparation: It is preparing for the possible outcomes in life.

Carmencita Abaquin: Prepare ME Holistic Nursing Intervention

A respected Filipino nurse known for her significant contributions to palliative care
and holistic nursing in the Philippines as secretary of the College of Nursing.

REPARE ME HOLISTIC NURSING INTERVENTIONS

This is nursing provided to address the multidimensional problems of cancer
patients that can be given in any setting where patients choose to be confined.
PREPARE ME interventions are said to be effective in improving the quality of life of
cancer patients. It can also be introduced to those patients with acute and chronic
diseases and those with prolonged hospital stays. This theory is primarily applied in
palliative and hospice care settings where patients require compassionate care that
supports their dignity, emotional needs, and spiritual well-being. It helps nurses to build
meaningful connections with patients.
Following Components of PREPARE ME:
PRESENCE: being with another person during times of need.
REMINISCE THERAPY: recall of past experiences
PRAYER: Spirituality and prayer play a role in providing comfort and support.
RELAXATION BREATHING: techniques to encourage and elicit relaxation for the
purpose of decreasing undesirable signs and symptoms.
MEDIATION: encourages an elicit relaxation for the purpose of altering the patient's
level of awareness by focusing on an image or thought.
VALUES CLARIFICATION: assisting another individual to clarify his or her values
about health and illness in order to facilitate effective decision-making skills.

Cecilia Laurente: Theory of Nursing Practice and Career

Emphasizes the nurse's personal growth and career development. focusing on
responsiveness and concern for the client's well-being.
The nurse acts as a caregiver.
Highlights the role of nurses in addressing not only physical but also emotional and
social aspects of patient care.
This fosters trust and connection, facilitating the patient's recovery and well-
being. Laurente's theory aims to create a holistic, patient-centered framework that
encourages mutual support, trust, and respect between nurse and patient and controls
internal thought processes that will eventually influence emotions, ideas, and behaviors.

SYNCHRONICITY IN HUMAN SPACE TIME; THEORY OF NURSING ENGAGEMENT

IN A GLOBAL COMMUNITY
This theory, developed by Lim-Saco, Kilat, and Locsin, presents a new
framework for understanding and practicing nursing in a globalized world. It emphasizes
a humanistic approach to nursing, recognizing the interconnectedness of human beings,
space, and time, and the importance of meaningful connectedness in humans.
THE FOUR PRINCIPLES OF " SYNCHRONICITY IN THE HUMAN-SPACE-TIME: A
THEORY OF NURSING ENGAGEMENT "
1. INTERCONNECTIVITY: It highlights the flow of energy connecting all living
things, while external limitations like socio-economic and political challenges
impact nurses and patients.
2. EQUITABILITY: It emphasizes fairness in organizational services and highlights
the importance of understanding connections between space, time, and health.
3. Empowerment in healthcare is the concept of freeing oneself and others from
the limitations imposed by human and environmental factors such as fear, lack of
knowledge, and powerlessness.
4. HUMAN TRANSCENDS: This growth helps both nurses and patients overcome
challenges, expanding self-boundaries to improve well-being and surpass
limitations through nursing engagement that promotes health and well-being.