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explanatory, or predictive; made up of a
Introduction to Theoretical
Foundations
OUTLINE
I. Basic Concepts and Definitions
II. History and Significance of Nursing
Theory
III. Components and Purposes of Nursing
Theories, Metaparadigms
IV. Health as a Multifactorial Phenomenon;
Dimensions of Man
I. BASIC CONCEPTS AND
DEFINITIONS
A. Structure of Nursing Knowledge
1. Philosophy – a statement encompassing the
ontological claims about the phenomena of
central interest to a discipline, epistemic
claims about how those phenomena come to
be known, and ethical claims about what the
members of a discipline value.
2. Conceptual Models – set of relatively
abstract and general concepts that address
the phenomena of central interest to as
discipline, propositions that state relatively
abstract and general relations between
concepts (Fawcett, 2005). Includes
conceptual framework, conceptual system,
paradigm, disciplinary matrix).
3. Theory – group of related concepts that
propose actions that guide practice; set of
definitions, relationships, assumptions that
project a systematic view of phenomena.
Creative and rigorous structure of ideas that
projects a tentative purposeful and
systematic view of phenomena. (Chinn and
Kramer, 1999).
4. Concept – called the building blocks of
theories; can be abstract & concrete. Mental
formulation of an object or event that come
from experience; Mental formulation of an
object or event that come from the individual
perpetual experience.
5. Middle Range Theory – a theory
compromising limited numbers of variables
of limited scope; can be descriptive,
limited number of concepts and propositions
that are written at a relatively concrete and
specific level. Generated by means of
research and used as evidence for assessment
and intervention.
B. Metaparadigms
Consist of the central concepts of person,
environment, health, and nursing.
A metaparadigm is a set of ideas that provide
structure for how a discipline should function.
1. Person – component that focuses on the
receiver of care. The care structure considers
the person’s spiritual and social needs as
well as health care needs. The resulting
health outcome is attributed to how the
person interacts with these physical and
social connections.
2. Health – refers to the extent of wellness and
health care access that a patient has.
Characterized as one with multiple
dimensions in a constant state of motion.
The theory is that these factors influence the
patient’s state of well-being, goal of the
nursing care.
3. Environment – focuses on the surroundings
that affect the patient; consists of external
and internal influences. This metaparadigm
component theorizes that a person can
modify her environmental factors to improve
her health status.
4. Nursing – involves the delivery of optimal
health outcomes for the patient through a
mutual relationship in a safe and caring
environment. This component applies
principles of knowledge, skills, technology,
collaborations, professional judgment, and
communication in patient health outcome.
This component values a high degree of
service.
II. HISTORY AND SIGNIFICANCE
OF NURSING THEORY
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In the 1950s, nurse scholars started to develop
nursing theories; the shift of nursing was moving
towards conceptualizing nursing as a profession
which is based on science rather than apprenticeship
based. This is also the time where hospital-based
nursing training is being shifted into college-level
educational institutions.

In 1960s, the first doctoral programs in nursing were

made available.

Highlight of significant events

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physicians, occupational therapists, and others. She
also predicted that the domain of nursing that
focuses on environmental-person interactions,
energy levels, human responses, and caring will
long have been accepted as central and
complementary perspective in providing health care
to clients.

D. Discipline versus Profession

At the onset, nursing was not recognized as an

academic discipline or a profession. Profession
according to Udan (2020) refers to a specialized
field of practice founded on the theoretical structure
of the science or knowledge and accompanying
practice abilities. While discipline on the other hand
refers to a branch of education, a department of
learning, or a domain of knowledge.

E. Significance of Nursing Theory

C. Eras of Nursing Knowledge
1. Curriculum Era 1920s-1930s - The
emphasis was on curriculum and nursing
education and nursing experienced a
phenomenal expansion of nursing programs
with an emphasis on nursing principles and
procedures and training for basic nursing.
2. Research Era 1940s-1950s – Nursing began
the move into higher education. Graduate
programs were developed, and nursing
research began to be conducted as nursing
developed as a scientific discipline.
3. Graduate Education Era 1960s-1970s -
The experiment of preparing nurse scientist
in other disciplines ended and the direction
for the development of the discipline was
clarified and led to an immediate expansion
of nursing doctorate programs.
4. Theory Era 1980s-1990s - Theory
development emphasis began and now has
transitioned to reach the theory utilization
era and theory-based practice essential for
the growth of nursing profession.
5. Theory Utilization Era
 Helps nurses to understand their purpose
and role in the healthcare setting.
 Guides knowledge development
 Directs education, research, and practice
 Recognizes what should set the foundation of
practice by explicitly describing nursing.
 Serves as a rationale or scientific reason for
nursing interventions and give nurses the
knowledge base necessary for acting and
responding appropriately in nursing care
situations.
 Provides the foundations of nursing practice
 Indicates in which direction nursing should
develop in the future
 Gives nurses a sense of identity.
 Helps patients, managers, and other
healthcare professionals to acknowledge and
understand the unique contribution that
nurses make to healthcare service.
 Prepares the nurses to reflect on the
assumptions and question the values in
nursing, thus further defining nursing and
increasing knowledge base
 Allows the nursing profession to maintain
and preserve its professional limits and
boundaries.

Meleis (1992) forecasted that nursing theories will F. Significance of Nursing Theory for the
become theories for health, developed by nurses, Discipline
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1. The importance of nursing conceptualization
in the research process and the role of
conceptual framework in research design for
production of science. This emphasis led to
the theory development era and moved
nursing forward to the new nursing
knowledge for nursing practice.
2. The creative conceptualization of nursing
metaparadigm and a structure of knowledge
clarified the related nature of the collective
works of major nursing theories as
conceptual frameworks and paradigms of
nursing. This approach organized nursing
works into a system of theoretical
knowledge, developed by theorist at different
times and places.
3. Recognition of separate nursing works
collectively with a metaparadigm umbrella
enhanced the recognition and understanding
of nursing theoretical work as a body of
nursing knowledge.
4. The significance of theory for the discipline
of nursing is that the discipline is dependent
on theory for its continued existence. That is
nursing can be a vocation, or nursing can be
a discipline with a professional style of
theory-based practice.
5. The theoretical works have taken nursing
levels of education and practice as nurses
moved from functional focus with emphasis
on what nurses do, to a patient focus,
emphasizing what nurses know for thought,
decision-making, and action.
6. Frameworks and theories are structures
about human beings and their health; These
structures provide nurses with perspective of
the patient for professional practice.
7. Professionals provide public service in a
practice focused on those whom they serve.
8. The nursing process is useful in practice, but
the primary focus is the patient, or human
being.
9. Knowledge of persons, health, and
environment forms the basis for recognition
of nursing as a discipline, and this
knowledge is taught to those who enter the
profession.
10. Every discipline or field of knowledge
includes theoretical knowledge. Therefore,
nursing as an academic discipline depends
on the existence of nursing knowledge. The
knowledge is basic for everyone who will
enter into the chosen profession.
11. The study of metaparadigms is what mainly
prepares the student for membership in a
particular scientific community with which
he or she will later practice.
12. By studying and practicing the
metaparadigms the members of the
profession learn their trade.
G. Significance of Nursing Theory for the
Profession
1. Nursing theory is essential for the existence
of nursing as an academic discipline. It is
also vital to the practice of profession.
2. Nursing is recognized today because its
development was guided by the criteria for a
profession.
3. Theories and research are vital to the
discipline and profession, so that the new
theory- based knowledge continues to be
separated.
4. It is the theory that informs practice and
also that practice informs theory. Theory
without practice is empty and practice
without theory is blind (Lloyd, 2017).
III. COMPONENTS AND PURPOSE
NURSING THEORIES
A. Components of a Theory
1. Purpose – It guides nursing practice and
generates knowledge; helps to describe,
predict, or explain a phenomenon; enables
nurses to know “why” and “what” they are
doing.
2. Concepts – abstract and concrete; can be
discrete or continuous concepts; Mental
formulation of an object or event that come
from individual perceptual experience.
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3. Models – A representation to better
understand, explain, or predict something;
Represent relationships, flows, structures, or
interactions
4. Theoretical statements - Constitutes
connection or relationship of concepts of a
theory; Is a statement of how and why
specific facts are related
5. Structure – A pattern or the arrangement
and relations between the parts or elements
of something complex.
6. Assumptions – Accepted “truth” that are
basic and fundamental to the theory.
B. Purpose of Nursing Theory
Develops analytical skills and critical thinking
ability; provide direction and guidance.
1. Education
 Prepare students for practice as members of
the professional community.
 Helps nursing students understand how
roles and actions of nurses fit together in
nursing.
 Theories provide general focus for
curriculum design.
 Theories also guide curricular decision
making.
2. Research
 Offer a framework for generating knowledge
and new ideas
 Assist in discovering knowledge gaps in the
specific field of study
 Systematic approach to identify questions
3. Clinical Practice
 Guide critical thinking of nurses
 Represent status of nursing as a discipline
 Used as a framework for structuring nursing
practice
 Development of nursing knowledge/nursing
science
 Assist nurses to describe, explain and predict
everyday experiences
 Serve to guide assessment, intervention and
evaluation of nursing care
 Provide a rationale for collecting reliable
and valid data
 Help to establish criteria to measure the
quality of nursing care
 Help build a common nursing terminology
 Enhance autonomy of nursing
IV. HEALTH AS A MULTIFACTORIAL
PHENOMENON & DIMENSIONS OF
MAN
A. Factors Affecting Health
Political – Involves one’s leadership how
management and other people in decision making.
1. Safety - the condition of being free from
harm, injury or loss of authority or power.
2. Oppression - unjust cruel exercise of
authority or power.
3. Political Will - determination to pursue
something which is for the best interest of
the majority.
4. Empowerment - the ability of a person to do
something. Creating the circumstances
where people can use their faculties and
abilities at the maximum level in the pursuit
of common goals.
Cultural - relating to the representation of non-
physical traits, such as values, beliefs, attitudes and
customs shared by a group of people and passed
from the generation to the next.
1. Practices - a customary action usually done to
maintain or promote health like use of “anting-
anting” and lucky charms.
2. Beliefs - a state or habit of mind wherein a group
of people place into something or a person.
Heredity -The genetic transmission of traits from
parents to offspring; genetically determined.
Environment - the sum of all the conditions and
elements that make up the surroundings and
influence the development of the individuals.
Socio-Economic - refers to the production
activities, distribution of and consumption of goods
of an individual.
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B. The National Health Situation
Majority of the 68,616,536 million Filipinos
(millions) in the urban and 35 million in the rural
areas) cannot avail of adequate health care because
of misdistribution of health personnel and facilities,
and high cost of medicines and services.
 There are 1,742 hospitals in the country;
most of them are in the urban areas.
 Of this number, 1103 are privately owned;
639 are government owned.
 There are 2,385 poorly equipped Health
Centers.
 The Philippines is the leading exporter of
nurses abroad.
 Sixty eight percent (68%) of the Filipino
doctors go abroad; 32% of them remain
the country, but most stay in the cities
 For every 10 deaths, 6 were not seen by a
doctor.
 The leading causes of death and illness are
predeceases and other socially related
problems such Pneumonia and tuberculosis
are leading cause of death
 16 Filipinos , 11 of whom are children, die
every day from diarrhea
 2 babies die every hour from pneumonia,
diarrhea, measles and malnutrition.
THE PHILIPPINES:
 Number 1 in the world for whooping
cough, diphtheria and rabies.
 Number 3 in the world for blindness
due to vitamin A deficiency.
 Number 1 in the western pacific
region for tuberculosis,
schistosomiasis and polio.
As a result of mainly poverty, malnutrition is also a
major health problem.
 2 million Filipino pre-school
children are malnourished.
 1.6 million Filipinos have Vitamin
a, iron and iodine deficiencies.
 More than 50% pregnant or
breastfeeding mothers are anemic.
 In addition to poor nutrition, poor
sanitation and lack of a safe water
supply make an individual
susceptible to disease.
 13 million Filipinos have no access
to safe water
 16 million Filipinos have no access
to a sanitary toilet.
 In Manila alone, 5 million tons of
garbage is disposed daily.
The National Health Situation is intimately linked to
the economic, political and socio-cultural system of
the society.
A VISION OF HEALTHY TOMORROW:
1. Preventive , promotive health care
2. Community participation
3. Traditional medicine
4. Affordable medicine
5. Adequate food, clothing and shelter
6. Available basic health services
7. Accessible health care facilities
8. Clean environment
Danger Signs: To attain the dream of healthy
tomorrow, everyone should take part in working for
its fulfillment. Everybody must participate in the
planning, implementation, monitoring and
evaluation of the community’s program.
C. Dimensions of Man
1. Physical - Being made of matter. He must
maintain health and harmony with nature.
This includes, holistic health, cleanliness,
Physical Fitness, reverence, respect for life
and environmental care
2. Intellectual - Becoming intellectual that is
gifted with the faculty of knowing. He must
constantly search for the truth. He seeks
knowledge that would transform society and
the world. At the same time he maintains a
tolerant and open disposition in mind.
Love of truth, critical thinking, creativity,
openness and respect for others, future
orientation and scientific orientation.
3. Moral - Being moral means endowed with
the faculty of freely choosing and loving. He
must go out to others and in fact to all
humanity in love. Self-worth/Self-esteem,
goodness, honesty and Integrity, Personal
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discipline, courage, trust, compassion
(Caring and Sharing).

4. Spiritual - Being capable of higher concerns

and of rising above the material. He must
cultivate a global spiritual which, essentially
connects with God and the whole Earth
community. Faith in God, inner peace,
religious tolerance, unity of all.

5. Social - Being social that is living in a

community, he must build peace and justice
in our society, through the pursuit of family
solidarity as well as the common good and
well-being of the larger society. He must
cultivate respect for human rights and active
non-violence. Family solidarity, love for
one’s family, social respect for others,
concern for common good, cooperation,
social responsibility, fairness, appreciation
of diversity, non-violence.

6. Economic - Being economic means one is

bound to the concerns of production and
consumption. He must help achieve a more
human and sustainable development for the
community. Balance between economic and
social development, protection of the
environment, wise use of resources,
responsible consumerism, productivity and
quality, economic, Equity, work ethic,
entrepreneurial spirit.

7. Political - Being political means being able

to relate to the conduct of political affairs
within the nation and the world. He must
cultivate his sense of nationalism and
globalism. For the former, love of country
and national unity are foremost concerns
while for the latter, global solidarity and
peace are the fundamental goals.