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NURSING THEORIES: NURSING THEORIES: AN OVERVIEWAN OVERVIEW
PREPARED BY: VESA LARA MALAINE P. RAGA, RNPREPARED BY: VESA LARA MALAINE P. RAGA, RN
INTRODUCTIOINTRODUCTIONN
KK
ERLINGERERLINGER views theories as a set of interrelated views theories as a set of interrelated
concepts that give a systematic view of a concepts that give a systematic view of a
phenomenon (an observable fact or event) that is phenomenon (an observable fact or event) that is
explanatory and predictive in nature. explanatory and predictive in nature.
Theories are composed of Theories are composed of CONCEPTSCONCEPTS, ,
DEFINITIONSDEFINITIONS, , MODELSMODELS , , PROPOSITIONSPROPOSITIONS and are and are
based on based on ASSUMPTIONSASSUMPTIONS. .
They are derived through TWO PRINCIPAL METHODS: They are derived through TWO PRINCIPAL METHODS:
1) 1) DEDUCTIVE REASONING DEDUCTIVE REASONING - - is reasoning which constructs or evaluates is reasoning which constructs or evaluates
deductive arguments. Deductive arguments are attempts to show that a deductive arguments. Deductive arguments are attempts to show that a
conclusion necessarily follows from a set of premises. A deductive argument is conclusion necessarily follows from a set of premises. A deductive argument is
valid if the conclusion does follow necessarily from the premises, i.e., if the valid if the conclusion does follow necessarily from the premises, i.e., if the
conclusion must be true provided that the premises are true. A deductive conclusion must be true provided that the premises are true. A deductive
argument is sound if its premises are true. Deductive arguments are valid or argument is sound if its premises are true. Deductive arguments are valid or
invalid, sound or unsound, but are never true or false.invalid, sound or unsound, but are never true or false.
2) 2) INDUCTIVE REASONING INDUCTIVE REASONING - is a kind of reasoning that allows for the possibility - is a kind of reasoning that allows for the possibility
that the conclusion is false even where all of the premises are true. The premises that the conclusion is false even where all of the premises are true. The premises
of an inductive logical argument indicate some degree of support (inductive of an inductive logical argument indicate some degree of support (inductive
probability) for the conclusion but do not entail it; i.e. they do not ensure its truth.probability) for the conclusion but do not entail it; i.e. they do not ensure its truth.
Nursing theorists use both of these methods. Nursing theorists use both of these methods.
NN
ursing Theory: Barnum(1998)ursing Theory: Barnum(1998) - "attempts to describe or - "attempts to describe or
explain the phenomenon (process, occurrence and event) explain the phenomenon (process, occurrence and event)
called called NURSINGNURSING""
TT
heories are for professional nursing.heories are for professional nursing.
TT
HEORYHEORY is "a creative and rigorous structuring of ideas that is "a creative and rigorous structuring of ideas that
projects a tentative, purposeful, and systematic view of projects a tentative, purposeful, and systematic view of
phenomena" .phenomena" .
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theory makes it possible to "organize the relationship theory makes it possible to "organize the relationship
among the concepts to describe, explain, predict, and control among the concepts to describe, explain, predict, and control
practice"practice"
DEFINITIONSDEFINITIONSCC
ONCEPTSONCEPTS - are basically vehicles of thought that - are basically vehicles of thought that
involve images.involve images.
- building blocks of theories.- building blocks of theories.
CC
ONCEPTSONCEPTS are words that describe objects , are words that describe objects ,
properties, or events and are basic components of properties, or events and are basic components of
theory. theory.
CC
ONCEPTUAL FRAMEWORKONCEPTUAL FRAMEWORK – is a group of related – is a group of related
ideas, statements or concepts.ideas, statements or concepts.
TT
he term he term CONCEPTUAL MODELCONCEPTUAL MODEL is often used is often used
interchangeably with interchangeably with CONCEPTUAL FRAMEWORKCONCEPTUAL FRAMEWORK, ,
and sometimes with and sometimes with GRAND THEORIESGRAND THEORIES, those , those
that articulate a broad range of the significant that articulate a broad range of the significant
relationships among the concepts of a discipline.relationships among the concepts of a discipline.
MM
ODELSODELS - are representations of the interaction - are representations of the interaction
among and between the concepts showing among and between the concepts showing
patterns. patterns.
PP
ROPOSITIONSROPOSITIONS - are statements that explain the - are statements that explain the
relationship between the concepts. relationship between the concepts.
PP
ROCESSROCESS - it is a series of actions , changes or - it is a series of actions , changes or
functions intended to bring about a desired functions intended to bring about a desired
result.result.
DD
uring a process one takes systemic and continuous steps to meet a uring a process one takes systemic and continuous steps to meet a
goal and uses both assessments and feedback to direct actions to goal and uses both assessments and feedback to direct actions to
the goal.the goal.
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particular theory or conceptual frame work directs how these particular theory or conceptual frame work directs how these
actions are carried out . The delivery of nursing care within the actions are carried out . The delivery of nursing care within the
nursing process is directed by the way specific conceptual nursing process is directed by the way specific conceptual
frameworks and theories define the person (patient), the frameworks and theories define the person (patient), the
environment, health and nursing.environment, health and nursing.
TT
he terms ‘model’ and ‘theory’ are often wrongly used he terms ‘model’ and ‘theory’ are often wrongly used
interchangeably, which further confounds matters. interchangeably, which further confounds matters.
II
n Nursing, models are often designed by theory authors to depict n Nursing, models are often designed by theory authors to depict
the beliefs in their theory (Lancaster and Lancaster, 1981). the beliefs in their theory (Lancaster and Lancaster, 1981).
TT
hey provide an overview of the thinking behind the hey provide an overview of the thinking behind the
theory and may demonstrate how theory can be theory and may demonstrate how theory can be
introduced into practice, for example, through specific introduced into practice, for example, through specific
methods of assessment. methods of assessment.
MM
odels are useful as they allow the concepts in nursing odels are useful as they allow the concepts in nursing
theory to be successfully applied to nursing practice theory to be successfully applied to nursing practice
(Lancaster and Lancaster, 1981). (Lancaster and Lancaster, 1981).
TT
heir main limitation is that they are only as accurate heir main limitation is that they are only as accurate
or useful as the underlying theory. or useful as the underlying theory.
IMPORTANCE OF IMPORTANCE OF NURSING THEORIESNURSING THEORIES
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ursing theory aims to describe, predict and explain the phenomenon of ursing theory aims to describe, predict and explain the phenomenon of
nursing (Chinn and Jacobs, 1978). nursing (Chinn and Jacobs, 1978).
II
t should provide the foundations of nursing practice, help to generate t should provide the foundations of nursing practice, help to generate
further knowledge and indicate in which direction nursing should further knowledge and indicate in which direction nursing should
develop in the future (Brown , 1964). develop in the future (Brown , 1964).
TT
heory is important because it helps us to decide what we know and heory is important because it helps us to decide what we know and
what we need to know (Parsons, 1949). what we need to know (Parsons, 1949).
II
t helps to distinguish what should form the basis of practice by t helps to distinguish what should form the basis of practice by
explicitly describing nursing. explicitly describing nursing.
TT
he benefits of having a defined body of theory in nursing include he benefits of having a defined body of theory in nursing include
better patient care, enhanced professional status for nurses, better patient care, enhanced professional status for nurses,
improved communication between nurses, and guidance for improved communication between nurses, and guidance for
research and education (Nolan, 1996). In addition, because the research and education (Nolan, 1996). In addition, because the
main exponent of nursing – caring – cannot be measured, it is main exponent of nursing – caring – cannot be measured, it is
vital to have the theory to analyze and explain what nurses do. vital to have the theory to analyze and explain what nurses do.
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s medicine tries to make a move towards adopting a more s medicine tries to make a move towards adopting a more
multidisciplinary approach to health care, nursing continues to multidisciplinary approach to health care, nursing continues to
strive to establish a unique body of knowledge. strive to establish a unique body of knowledge.
TT
his can be seen as an attempt by the nursing profession to his can be seen as an attempt by the nursing profession to
maintain its professional boundaries. maintain its professional boundaries.
CHARACTERISTICS OF CHARACTERISTICS OF THEORIESTHEORIES
TheoriesTheories
••Interrelate concepts in such a way as to create a different way of Interrelate concepts in such a way as to create a different way of
looking at a particular phenomenon. looking at a particular phenomenon.
••Are logical in nature. Are logical in nature.
••Are generalizable. Are generalizable.
••Are the bases for hypotheses that can be tested. Are the bases for hypotheses that can be tested.
••Increase the general body of knowledge within the discipline Increase the general body of knowledge within the discipline
through the research implemented to validate them. through the research implemented to validate them.
••Are used by the practitioners to guide and improve their practice. Are used by the practitioners to guide and improve their practice.
••Are consistent with other validated theories, laws, and principles Are consistent with other validated theories, laws, and principles
but will leave open unanswered questions that need to be but will leave open unanswered questions that need to be
investigated investigated
BASIC PROCESSES IN THE BASIC PROCESSES IN THE DEVELOPMENT OF NURSING DEVELOPMENT OF NURSING
THEORIESTHEORIESNN
ursing theories are often based on and influenced by broadly applicable ursing theories are often based on and influenced by broadly applicable
processes and theories. Following theories are basic to many nursing processes and theories. Following theories are basic to many nursing
concepts. concepts.
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. . GENERAL SYSTEM THEORYGENERAL SYSTEM THEORY: :
••It describes how to break whole things into parts and then to learn how It describes how to break whole things into parts and then to learn how
the parts work together in " systems". the parts work together in " systems".
••These concepts may be applied to different kinds of systems, e.g.. These concepts may be applied to different kinds of systems, e.g..
Molecules in chemistry , cultures in sociology, organs in Anatomy and Molecules in chemistry , cultures in sociology, organs in Anatomy and
health in Nursing. health in Nursing.
B. B. ADAPTATION THEORY ADAPTATION THEORY
••It defines adaptation as the adjustment of living It defines adaptation as the adjustment of living
matter to other living things and to environmental matter to other living things and to environmental
conditions. conditions.
••Adaptation is a continuously occurring process that Adaptation is a continuously occurring process that
effects change and involves interaction and response. effects change and involves interaction and response.
••Human adaptation occurs on Human adaptation occurs on THREE LEVELSTHREE LEVELS::
--- --- THE INTERNAL THE INTERNAL ( self ) ( self )
--- --- THE SOCIAL THE SOCIAL (others) (others)
--- and --- and THE PHYSICALTHE PHYSICAL ( biochemical reactions ) ( biochemical reactions )
C. C. DEVELOPMENTAL THEORY DEVELOPMENTAL THEORY
••It outlines the process of growth and It outlines the process of growth and
development of humans as orderly and development of humans as orderly and
predictable, beginning with conception and ending predictable, beginning with conception and ending
with death. with death.
••The progress and behaviors of an individual The progress and behaviors of an individual
within each stage are unique. within each stage are unique.
••The growth and development of an individual are The growth and development of an individual are
influenced by heredity , temperament, emotional, influenced by heredity , temperament, emotional,
and physical environment, life experiences and and physical environment, life experiences and
health status. health status.
THE METAPARADIGM IN THE METAPARADIGM IN NURSINGNURSING
FF
our major concepts (collectively known as METAPARADIGM) common in nursing theory our major concepts (collectively known as METAPARADIGM) common in nursing theory
that influence and determine nursing practice are:that influence and determine nursing practice are:
PP
ERSONERSON
* *
Recipient of nursing care, including physical, spiritual, psychological, and Recipient of nursing care, including physical, spiritual, psychological, and
sociocultural components.sociocultural components.
* *
Individuals, families, groups or communities.Individuals, families, groups or communities.
EE
NVIRONMENTNVIRONMENT
* All * All
internal and external conditions, circumstances, and influences affecting the person.internal and external conditions, circumstances, and influences affecting the person.
HH
EALTH EALTH
* Degree of wellness or well-being experienced by the client.* Degree of wellness or well-being experienced by the client.
NN
URSINGURSING
* Actions, characteristics and attributes of the nurse providing care on * Actions, characteristics and attributes of the nurse providing care on
behalf of, or in conjunction with, the client.behalf of, or in conjunction with, the client.
EE
ach of these concepts is usually defined and described by a nursing ach of these concepts is usually defined and described by a nursing
theorist , Often uniquely; although these concepts are common to all theorist , Often uniquely; although these concepts are common to all
nursing theories. nursing theories.
OO
f the four concepts , the most important is that of the person. The focus f the four concepts , the most important is that of the person. The focus
of nursing , regardless of definition or theory , is the person.of nursing , regardless of definition or theory , is the person.
CLASSIFICATION OF CLASSIFICATION OF NURSING THEORIESNURSING THEORIES
DEPENDING ON THE GENERALISABILITY OF THEIR PRINCIPLESDEPENDING ON THE GENERALISABILITY OF THEIR PRINCIPLES
METATHEORYMETATHEORY: the theory of theory. Identifies specific : the theory of theory. Identifies specific
phenomena through abstract concepts. phenomena through abstract concepts.
GRAND THEORYGRAND THEORY: provides a conceptual framework under which : provides a conceptual framework under which
the key concepts and principles of the discipline can be identified. the key concepts and principles of the discipline can be identified.
MIDDLE RANGE THEORYMIDDLE RANGE THEORY: is more precise and only analyses a : is more precise and only analyses a
particular situation with a limited number of variables. particular situation with a limited number of variables.
PRACTICE THEORYPRACTICE THEORY: explores one particular situation found in : explores one particular situation found in
nursing. It identifies explicit goals and details how these goals nursing. It identifies explicit goals and details how these goals
will be achieved. will be achieved.
THEORIES CAN ALSO BE CATEGORISED AS:THEORIES CAN ALSO BE CATEGORISED AS:
""NEEDSNEEDS" theories. " theories.
""INTERACTIONINTERACTION" theories. " theories.
""OUTCOMEOUTCOME" theories. " theories.
""HUMANISTICHUMANISTIC" theories" theories
These categories indicate the basic These categories indicate the basic
philosophical underpinnings of the theories.philosophical underpinnings of the theories.
"NEEDS" THEORIES"NEEDS" THEORIESThese theories are based around helping These theories are based around helping
individuals to fulfill their physical and mental needs. individuals to fulfill their physical and mental needs.
The basis of these theories is well-illustrated in The basis of these theories is well-illustrated in
Roper, Logan and Tierney’s Model of Nursing (1980). Roper, Logan and Tierney’s Model of Nursing (1980).
Needs theories have been criticized for relying too Needs theories have been criticized for relying too
much on the medical model of health and placing much on the medical model of health and placing
the patient in an overtly dependent position. the patient in an overtly dependent position.
"INTERACTION" THEORIES"INTERACTION" THEORIESAs described by Peplau (1988), these As described by Peplau (1988), these
theories revolve around the theories revolve around the
relationships nurses form with patients.relationships nurses form with patients.
Such theories have been criticized for Such theories have been criticized for
largely ignoring the medical model of largely ignoring the medical model of
health and not attending to basic health and not attending to basic
physical needs. physical needs.
"OUTCOME" THEORIES"OUTCOME" THEORIESThese portray the nurse as the changing These portray the nurse as the changing
force, who enables individuals to adapt to force, who enables individuals to adapt to
or cope with ill health (Roy 1980). or cope with ill health (Roy 1980).
Outcome theories have been criticized as Outcome theories have been criticized as
too abstract and difficult to implement in too abstract and difficult to implement in
practice (Aggleton and Chalmers 1988). practice (Aggleton and Chalmers 1988).
"HUMANISTIC" THEORIES"HUMANISTIC" THEORIESHumanistic theories developed in response to the Humanistic theories developed in response to the
psychoanalytic thought that a person’s destiny was psychoanalytic thought that a person’s destiny was
determined early in life. determined early in life.
Humanistic theories emphasize a person’s capacity for self Humanistic theories emphasize a person’s capacity for self
actualization . actualization .
Humanists believes that the person contains within himself Humanists believes that the person contains within himself
the potential for healthy and creative growth. the potential for healthy and creative growth.
Carl Rogers developed a person –centered model of Carl Rogers developed a person –centered model of
psychotherapy that emphasizes the uniqueness of the psychotherapy that emphasizes the uniqueness of the
individual. individual.
The major contribution that Rogers added to nursing practice The major contribution that Rogers added to nursing practice
is the understanding that each client is a unique individual, so is the understanding that each client is a unique individual, so
person-centered approach now practice in Nursing. person-centered approach now practice in Nursing.
THE ENDTHE END
THANK YOU THANK YOU
VERY MUCH!!!VERY MUCH!!!vlmpr2010vlmpr2010