Historical Overview:

Theory Development
in Nursing
Where do we begin?
Florence Nightingale
— Considered as the first modern
nursing theorist
— First one to delineate what is
considered the nursing goal and
practice domain
— Role of nurses: “ placing the client
in the best condition for nature to
act upon him”
— Taught about symptoms and what
they indicate, rationale for actions
and trained powers of observation
and reflection
 SIGNIFICANT EVENTS
Historical Development of
Nursing Theories
1859: Florence Nightingale Notes on Nursing
control of the environment to care for the individual
(ventilation, light, warm , noise absence or
reduction, cleanliness & diet )

1924: Yale university began the first collegiate

school of nursing

1949: Nursing Research was first published

1952: Nursing Research Journal publication

1960’s: nature of nursing practice was debated,

defined nursing practice, or develop nursing
theory, and created a substantive body of
knowledge
1960-1970: proliferation of conceptual models and
frameworks, and philosophy of nursing.
Examples: Abdellah 21 nursing problems and Hall’s
core, care & cure (person, body, disease)

1969: first conference on nursing theory

1970: second nursing theory conference

1971: third nursing theory conference

 First Conference in Nursing theory
Brought leading scholars and
theorists to discuss and
debate on issues regarding
nursing science ad theory
development.

— Role of nurses where questioned; what they do, for whom

where and when were determined.
— Purpose of nursing, process of theory development was
discussed
— Writings of Dickoff, James and Wiedenbach “Theory in a
Practice Discipline” influenced the theoretical thinking in
nursing . They presented a definition of nursing theory and
goals for theory development in nursing, approaches where
discussed
1980’s: characterized by acceptance of the
significance of theory in nursing. Less debates on
whether or not to use theory, practice theory or
borrowed ones. Books written for nurses on how
to critique theory, develop theory and apply
nursing theory.

1990s: research studies to test and expand

nursing theory was numerous

1999: Philosophy of Nursing was first published.

2000s: Books published describing, analysing and
discussing practice application of middle range
theory.

21st century: early on, nursing theory is

characterized by diversity. Diversity of theoretical
thought is now both accepted and embraced.

More and more publication up to the present.

 1988
KIDD and MORRISON
Stages of Theory
Development
1. Silent knowledge stage

— Blind obedience to medical authority

— Training schools were hospital based, emphasis
on carrying out physicians orders and few books,
depended on physicians diagnosis, exploited as
workers and as students.
— Persisted for more than 80 years with the
exception of Yale University which started the first
autonomous school of nursing in 1924
— Little attempt to develop theory
— Research was limited to collection of
epidemiologic data
2. Received Knowledge Stage
— After WWII: late 1940s and into the 1950s
— Learning through listening to others
— Nursing now challenged to be in the university as
opposed to apprenticeship that happens to most
hospital programs.
— Nurses acquired non nursing degrees relying on
the authority of educators, sociologist,
psychologists, physiologists, and anthropologists
— Theories were borrowed from other disciplines to
provide answers to nursing problems
— Research was primarily educational research or
sociologic research
3. Subjective Knowledge stage
— Authority was internalized and a new sense of self
emerged
— Negative attitude toward borrowed sciences or
theories
— Focused on defining nursing and developing
theories about and for nursing
— Research focused on the nurse rather on he
clients and clinical situations
4.Procedural Knowledge
— Includes both separate and connected knowledge
— Proliferation of approaches to theory
development. Applying theory in practice was
frequently underemphasized
— Emphasis was on procedures used to acquire
knowledge, with over attention to appropriateness
of methodology the criteria for evolution and
statistical procedures
— Little focus on connected knowledge, ie
application of theory in practice. …(separate;
connected) focus on separate eg. theory
development approaches, methodology, statistical
analysis; less on application
5. Constructed Knowledge
— Integration of different types of knowledge
(intuition, reason and self-knowledge)
— Nursing theory based on empirical studies
theoretical literature client reports, clinical
experiences and nurses scholar intuition.
REFERENCES:

● Alligood, Martha Raile, Nursing Theorists and their

work, Elsevier (Singapore) Pte. Ltd., 2018.

● McEwen, Melanie & Evelyn M. Wills, Theoretical

Basis for Nursing, Wolters Kluwer, 2018.

Thank You!
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