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Big Picture A

Big Picture in Focus: ULOa. Overview: Theoretical Foundations of Nursing

Week 1-2: Unit Learning Outcomes (ULO): At the end of the unit, you are expected
to:

a. Discuss History of Nursing Theory and It’s Significance for the Discipline.
b. Rationalize various terms in the Philosophy of Science.
c. Explain Structures of Nursing Knowledge.

Metalanguage

In this section, the most essential terms relevant to the study of Theoretical
foundations of nursing. Also, to demonstrate the ULO will be operationally defined to
establish a common frame of reference as to how the text work in your chosen field of
career. You will encounter these terms as we go through the study of Nursing Theories.
Please refer to these definitions in case you will encounter difficulty in understanding
concepts of the nursing research 1 course.

Essential Knowledge

To perform the aforesaid big picture (unit learning outcomes) for the first 3 weeks
of the course, you need to fully understand the following essential knowledge that will be
laid down in the succeeding pages. Please note that you are not limited to exclusively
refer to these sources. Thus, you are expected to utilize books, research articles and
other resources that are available in the university’s library e.g. ebrary,
search.proquest.com etc.

Definition of Terms:

1. Concept - Is defined as a mental idea of a particular phenomenon.

2. Conceptual Model - It is a set of interrelated concepts that symbolically represents

and conveys a mental image of a phenomenon.

3. Theory - Are set of interrelated concepts that gives a systematic view

of phenomenon that is explanatory and predictive in nature.
4. Nursing Theory - Refers to a body of knowledge that describes and explains
nursing. It is an organized framework of concepts and
purpose designed to guide and support nursing practice.
5. Principles - Is a fundamental truth that is accepted which can be used as
a basis for reasoning and conduct..
6. Discipline - A specific to academia and refers to a branch of education, a
department of learning, or a domain of knowledge.
7. Profession - Refers to a specialized field of practice, founded on the
theoretical structure of the science or knowledge of that
discipline and accompanying practice abilities.
8. Nursing Science - Refers to a domain of knowledge concerning with the
adaptation of individuals, groups, individuals to actual and
potential health problems.

9. Nursing Paradigm - Explains linkages of Science, Philosophy, and Theory that is

accepted and applied by the discipline.
10. Philosophy - Contributes to the nursing nursing knowledge. Gives direction
for the discipline that leads to theoretical understanding.
11. Conceptual - These are concepts and their relationship that specify a
Model perspective and produce evidence among phenomenon
specific to the discipline
12. Science - An organized body of knowledge gained through research.

13. Phenomena - Refers to a set of empirical data obtained through

experience.
14. Empericism - The concept of empericism is a philosophical beleif that
States knowledge based on experiences.

15. Rationalism - Refers to the reasoning of cause and effect.

Introduction to Nursing Theory: It’s History and Significance

The History:

 The history of professional nursing began with Florence Nightingale (Mother of

Modern Nursing). Florence Nightingale came from a prominent and wealthy
family. She was a Philanthropist who studied nursing in Germany. During this
time it is not usual for an upper class woman to care for the sick but Nightingale
had felt a calling to serve humanity. During the Crimean War. Nightingale
 trained 38 volunteer nurses to take care of the wounded soldiers and some of
Catholic Nuns. Arriving at Scutari November 1854 Florence and her team found
out poor hygienic practices and overworked staff. Due to poor care a lot have
died due to infection, cholera, typhoid and dysentery. She believed that the death
rates were due to poor care, and lack of supplies. Since then she became an
advocate of sanitary and good living conditions and came up with her
environmental theory.

 Nightingale’s vision include the establishment of School of Nursing at London

and marked the birth of modern nursing after war-time in Scutari during Crimean
War.

 Nightingale’s vision of nursing has been practiced for more than a century and
the development in nursing theory evolved rapidly over the past 6 decades.
Leading the recognition of nursing as an Academic Discipline with a specialized
body of knowledge

 In mid 1800’s that Nightingale recognized the unique focus of nursing and
declared nursing knowledge as distinct from medical knowledge

Historical Eras of Nursing

 Curriculum Era (1900-1940)

Nurses developed specialized knowledge and sought to higher education.

 Graduate Education Era (1950-1970)

Nurses focuses on knowledge development.

 Theory Era (1980-1990)

The natural outgrowth of research and graduate education era. Theories
guide nurses into practice

 Theory Utilization (1980-1990)

Nursing frameworks produce knowledge (evidence) for quality care.

Significance of Theory

1. University baccalaureate programs proliferated, masters programs in nursing

were developed, and the new curricula started to be standardized through the
accreditation process.
 2. Attention to the importance of nursing conceptualizations for the research
process and the role of conceptual framework in the purpose and design of
research production of science and nursing theoretical works also begun to
publish.

3. Works begun to recognize for their theoretical nature.

Significance of Theory in Nursing Profession

1. Assist nurses to describe, explain, and predict everyday experiences.

2. Serve to guide assessment, interventions, and evaluation of nursing care.
3. Help to describe criteria to measure the quality of nursing care.
4. Help build a common terminology to use in communicating with other health
professionals.
5. Enhance autonomy of nursing through defining its own independent functions.

History and Philosophy of Science

Nursing Science is the development of theories and concepts to help improve

clinicians in providing patient care. The history of science is concerned with historical
development of scientific knowledge,including both the natural and social sciences while
philosophy refers to the assumptions, foundations, methods, implications of science.
Today, the essential role of history and philosophy of science is to convey
understanding of nature of science to explore new knowledge, scientific inquiries that
and to apply this new knowledge in nursing discipline.

There are 2 competing foundations of science

Rationalism (Priori reasoning)

A theory that holds unaided experience, can arrive at the basic truth regarding
the world. The doctrine that knowledge about reality can be obtained by reason alone
without recourse to experience. Rationalism is the reasoning of the cause and effect or
from generalization to a particular instance. Labeled this approach as theory then
research strategy.

Empiricism

The empirical view is based on the central idea that scientific knowledge can be
derived from sensory experience (seeing, feeling, hearing facts). Called as Research-
then-Theory strategy.(e.g. formulating nursing diagnosis).

Early Twentieth Century Views of Science and Theory

 During the first half of this century, Philosophers concentrated on analysis of
theory while Scientist focuses on empirical research. During this time there is a minimal
interest in the history of science, nature of scientific discovery, or the similarities
between the philosophical view of science and the scientific theory.

Emergent Views of Science and Theory in the Late 20th Century

Empericist argue that for science to maintain to maintain it’s objectivity. Analysis,
collection of data must be independent from theory. The epistemiology (branch of
philosophy concerned with knowledge) challenged the empericist view of perception by
acknowledging that theories play a significant role in determining what the scientist will
observe and to be interpreted.

Three different views of the relationship between theories and observation (Brown,
1977);

1. Scientist are merely passive observers of occurences in the emperical world.

Observable data are objective truth waiting to be discovered.
2. Structure of theory that what scientist is observed in the emperical world.
3. Presupposed theories and observable data interact in the process of scientific
investigation.

Structure of Nursing Knowledge

According to Bixler (1959), the requirement for a body of specialized knowledge

for recognition of nursing as a profession was a driving force in the twentieth century.
Because of the importance of nurses to the nation’s health, early in the twentieth
century, studies of nursing were legislated and conducted by sociologists who
recommended that nursing be developed as a profession. The criteria for a profession
provided guidance in this process.

Structure Level

1. Metaparadigm – The most abstract view of a discipline that consist concepts

that define the discipline. The most common examples of metaparadigm
concepts are Person, Environment, Health and Nursing.

a. Person - Recipients of nursing care

b. Environment – Factors affecting person/individual internally or
Externally
c. Health - the degree of wellness or well-being that the patient
experiences. State of complete physical, mental,emotional, social,
spiritual wellbeing and not necessarily the absence of disease or
infirmity.
d. Nursing – the attributes, characteristics and actions of the nurse
providing care on behalf of, or in conjunction with the patient
 2. Philosophy – Philosophy is the search for and a communication viewpoint. In
nursing knowledge it contributes with the direction for the discipline. (E.g.
Nightingale).

3. Conceptual Models – Also called as Conceptual framework. In nursing

discipline this is to describe the relationship between concepts and their
relationships that produce evidence among phenomena which is specific to
discipline. (E.g.Neuman’s System Model).

4. Theory - Is a set of interrelated concepts, definitions, and prepositions that

presents systematic way of viewing events or patterns of reality (E.g. Betty
Neuman’s theory).

5. Middle range theory - These theories are moderately abstract, comprehensive,

organized within a limited scope and have a limitied number of variables, which
are testable in a direct manner.

Self-Help: You can also refer to the sources below to help you further understand
the lesson

Alligood, M. (2018) Nursing Theorist. Elsevier. Singapore

Sitzman, Kathleen., (2017). Understanding the work of Nurse Theorists. 3rd

Edition. Jones & Bartlett Learning

Berman, A. et.al. (2016). Kozier & Erb’s Fundamentals of Nursing: Concepts,

process, and practice. 10th Edition. Boston: Pearson.