Theory
 A set of concepts, definitions, relationships,
and assumptions that project a systematic
view of a phenomena
 It may consist of one or more relatively
specific and concrete concepts and
propositions that purport to account for, or
organize some phenomenon
Components of theory
 Concepts – ideas and mental images that
help to describe phenomena
 Definitions – convey the general meaning of
the concepts
 Assumptions – statements that describe
concepts
 Phenomenon – aspect of reality that can be
consciously sensed or experienced
Paradigm
 A model that explains the linkages of science,
philosophy, and theory accepted and
applied by the discipline
Domain
 The view or perspective of the discipline
 It contains the subject, central concepts,
values and beliefs, phenomena of interest,
and the central problems of the discipline
How does domain relate to nursing theory?
 Nursing has identified its domain in a
paradigm that includes four linkages: 1)
person/client 2) health 3) environment and 4)
nursing
Purpose
 It guides nursing practice and generates
knowledge
 It helps to describe or explain nursing
 Enables nurses to know why they are doing
what they are doing
Types of nursing theories
 Grand theories – broad and complex
 Middle-range theories- address specific
phenomena and reflect practice
 Descriptive theories – first level of theory
development
 Prescriptive theories – address nursing
interventions and predict their
consequences
Why on earth do we study nursing theory?
 Everyday practice enriches theory
 Both practice and theory are guided by
values and beliefs
 Theory helps to reframe our thinking about
nursing
 Theory guides use of ideas and techniques
 Theory can close the gap between theory
and research
 To envision potentialities
How do nurses use theory in everyday practice?
 Organize patient data
 Understand patient data
 Analyze patient data
 Make decisions about nursing interventions
 Plan patient care
 Predict outcomes of care
 Evaluate patient outcomes
Commonly used non-nursing theories
 Systems theory
 Basic human needs theory
 Health and wellness models
 Stress and adaptation
 Developmental theories
 Psychosocial theories
What is the link between nursing theory and the
research process?
 Theory provides direction for nursing research
 Relationships of components in a theory help
to drive the research questions for
understanding nursing
 Chinn and Kramer (2004), indicate a spiral
relationship between the two
Current trends that influence nursing theory
 Medical science
 Nursing education
 Professional nursing organizations
 Evolving research approaches
 Global concerns
 Consumer demands
 Technologies
Carper's fundamental ways of knowing
 Is a typology that attempts to classify the
different sources from which knowledge and
beliefs in professional practice (originally
specifically nursing) can be or have been
derived. It was proposed by Barbara A.
 Carper, a professor at the College of Nursing
at Texas Woman's University, in 1978.
Four Fundamental Patterns of Knowing
 Empirical Factual knowledge from science,
or other external sources, that can be
empirically verified
 Personal Knowledge and attitudes derived
from personal self-understanding and
empathy
 Ethical Attitudes and knowledge derived
from an ethical framework
 Aesthetic Awareness of the immediate
situation, seated in immediate practical
action
Republic Act No. 9173
 An Act Providing for a more responsive
nursing profession
Republic Act No. 7164
 Otherwise known as "Philippine Nursing Act
of 1991“
The ICN Code of Ethics has 4 elements
 Nurses and People – the primary
responsibility of nurses to people is to provide
nursing care.
 Nurses and Practice – the nurse is personally
accountable of the nursing practice and will
hold the white uniform with dignity and pride
 Nurses and the Profession – The nurse is
responsible in improving the face of the
profession in a form of research and
practicing using evidenced-based nursing
practice
 Nurses and Co-workers – the nurse has a
responsibility in encouraging a harmonious
relationship among colleagues and
members of the health care team.
Roper-Logan-Tierney Model of Nursing
 Is the most widely-used model of nursing used
in the United Kingdom, and used particularly
well in medical and surgical settings.
 Was originally published in 1976, and revised
in 1985 and 1990. The most recent revision
occurred in 1998.
 The model is based upon activities of living,
which evolved from the work of Virginia
Henderson in 1966. The activities of daily living
are the key to the model, which seeks to
define "what living means."
Activities of Living
 maintaining a safe environment
 communication
 breathing
 eating and drinking
 elimination
 washing and dressing
 temperature control
 mobilization
 working and playing
 expressing sexuality
 sleeping
 death and dying
Factors That Influence Activities of Living
 Biological factor is the impact of the overall
health
 Psychological factor is the impact of emotion,
cognition, spiritual beliefs, and the ability to
understand
 Sociocultural factor is the impact of society
and culture experienced by the individual;
the environmental factor considers the
impact of the environment on the patient, as
well as the patient's impact on the
environment
 Politico economic factor is the impact of the
government, politics, and economy on the
activities of daily living
Patricia Benner
 Developed a concept known as "From
Novice to Expert."
From Novice to Expert - explains that
nurses develop skills and an understanding of
patient care over time from a combination of
a strong educational foundation and
personal experiences.
 Proposed that a nurse could gain knowledge
and skills without actually learning a theory.
 Describes this as a nurse "knowing how"
without "knowing that."
 Explains that the development of knowledge
in fields such as nursing is made up of the
extension of knowledge through research
and understanding through clinical
experience.
Five Levels of Nursing Experience
 A novice is a beginner with no experience.
They are taught general rules to help perform
tasks, and their rule-governed behavior is
 limited and inflexible. In other words, they are
told what to do and simply follow instruction.
 The advanced beginner shows acceptable
performance, and has gained prior
experience in actual nursing situations. This
helps the nurse recognize recurring
meaningful components so that principles,
based on those experiences, begin to
formulate in order to guide actions.
 A competent nurse generally has two or
three years' experience on the job in the
same field. For example, two or three years in
intensive care. The experience may also be
similar day-to-day situations. These nurses are
more aware of long-term goals, and they
gain perspective from planning their own
actions, which helps them achieve greater
efficiency and organization.
 A proficient nurse perceives and understands
situations as whole parts. He or she has a
more holistic understanding of nursing, which
improves decision-making. These nurses learn
from experiences what to expect in certain
situations, as well as how to modify plans as
needed.
 Expert nurses no longer rely on principles,
rules, or guidelines to connect situations and
determine actions. They have a deeper
background of experience and an intuitive
grasp of clinical situations. Their
performances are fluid, flexible, and highly-
proficient. Benner's writings explain that
nursing skills through experience are a
prerequisite for becoming an expert nurse.

Seven Domains of Nursing Practice

 Helping role
 Teaching or coaching function
 Diagnostic client-monitoring function
 Effective management of rapidly changing
situations
 Administering and monitoring therapeutic
interventions and regiments
 Monitoring and ensuring quality of health
care practices
 Organizational and work-role competencies