Theoretical Foundation of Nursing
time
(Midterms)
MARGARET JEAN WATSON
“Nursing is the human science of persons and
human health-illness experiences that are
mediated by professional, personal, scientific,
aesthetic, and ethical human care transactions.”
 Theory of Human Caring
 was born in SOUTH WEST
VIRGINIA, and 1950’s in small town
of Welch, West Virginia
 1964 – earned a BS Nursing at Boulder
Campus, Colorado
 1966 – M.S. in Psychiatric-Mental
Health
 1973 – Ph. D. in educational psychology
and counselling.
METAPARADIGM IN NURSING
 NURSING - having to move
educationally in the two areas of stress
and developmental conflicts to provide
holistic care, which she believes is
central to the practice of caring.
 PERSON - a valued person in and in
him to be cared for, respectful, nurtured,
understood, and assisted.
 HEALTH – unity and harmony
within the mind, body, and soul;
associated with the degree of
congruence between self as perceived
and as experience
 ENVIRONMENT – provides the
values that determine how one should
behave and what goals one should
strive toward
The Basic Assumptions
 Caring can be effectively demonstrated
and practiced only interpersonally
 Effective caring promotes health and
individual or family growth
 Caring responses accept person not
only as he or she is now but as he or
she may become
 A caring environment is one that offers
the development of potential while
allowing the person to choose the best
action for himself at a given point in
 Caring is more “healthogenic” than
curing. A science of caring is
complementary to science of curing.
 The practice of caring is central to
nursing
10 CARATIVE FACTORS
1. Formation of humanistic-altruistic value
system
- satisfaction one gets through giving
and extension of the sense of self
- practice of loving kindness and
equanimity
2. Instillation of faith and hope
- being authentically present
- describes the nursing role in helping
the patient adopt health-seeking behaviors
through wellness promotion
3. Cultivation of sensitivity to one’s self and to
others
- opening o others with sensitivity and
compassion
- the ability of an individual to feel and
realize one’s needs, weaknesses and strengths in
relation to other’s needs, weaknesses and
strengths
4. Development of helping-trusting, human
caring relationship
- involves empathy, congruence, non-
possessive warmth and effective communication
5. Promotion and acceptance of the
expression of positive and negative feelings
- being present and supportive
- risk taking experience for the nurse
and patient
- the individual is really-based and does
not live in fantasies
6. Systemic use of creative problem-solving
caring process
- importance and use of the nursing
process
- creative use of self
7. Promotion of interpersonal teaching-
learning
 - provision of self-care, determination of
personal needs and personal growth
8. Provision of supportive, protective and
corrective mental, physical, sociocultural and
spiritual development
- nurse should recognize the influence of
internal and external environment on the health
and illness of man
9. Assistance with gratification of human
needs
- alignment of mind-body and spirit
- role of the nurse is to promote wellness
according to Maslow’s Hierarchy of Needs
10. Allowance for existential-
phenomenological-spiritual forces
- included to provide a thought-
provoking experience, leading to a better
understanding of the self and others
Additional Factors
 Personality Type
TYPE A – intensive, acute, compulsive
TYPE B – fun-loving, friendly, joyous,
indulgent
 Solid Family Background
 “one can only give what one has”
 Experience of having been loved and
the ability to love
 Of giving or receiving love – the
quality of love the child receives at
home and the role model he/she
influence to a great extent, his/her
very own way
 Spiritual Life
 the more spiritual the person is, the
finer is the regard and relatedness
with the other
 Sense of Humor
 the ability to laugh at one’s mistake
 Relaxed Attitude
 vision is broader and accommodates
more things in his heart and mind
 Open-mindedness
 the ability of an individual to
perceive an issue, considering the
pros and cons
IMOGENE KING
 Goal Attainment Theory
 was born on January 30, 1923 in.
WEST POINT, IOWA
 1945 - She received her nursing
diploma from St. John’s Hospital
School of Nursing in St. Louis,
Missouri
 In 1948, she earned her Bachelor of
Science in Nursing from St. Louis
University
 1957 - went on to complete her
Masters of Science in Nursing, also
from St. Louis University
 1961 - She also earned her doctoral
degree from Teachers College,
Columbia University
 She died on December 24, 2007.
METAPARADIGM IN NURSING
 PERSONS – existing in an open
system as a spiritual being and
rational thinker who make choices,
selects alternative courses of action, and
has the ability to record their history
through their own language and
symbols, unique, holistic and have
different needs, wants and goals
 Open System- being open to
different experiences, information
and more
 HEALTH – the ability of a person to
adjust to the stressors that the internal
and external environment exposes to the
client
- Being able to cope up
- Maximal use of potential of
person to achieve the balance of health
 ENVIRONMENT – process of balance
involving internal and external
interactions in the social system
 NURSING – an act wherein the nurse
interacts and communicates with the
client
Interacting System Framework
  Personal – how the nurse views and
integrates self-based from personal goals
and beliefs
 Interpersonal – how the nurse
interrelates with co-worker or client,
particular in a nurse-client relationship
METAPARADIGM IN NURSING
 Social – how the nurse interacts with co-
workers, superiors, subordinates and the
client environment in general
- Environmental in general
includes the family and guardian of the
client
Goals are met. (if the nurse-client relationship is
good)
BETTY NEUMAN
 Systems Model in Nursing
Practice
 born in LOWEL, OHIO in 1924
 1947, she earned her First Diploma
as a Registered nurse from Peoples
Hospital School of Nursing in
Akron, Ohio
University of California-Los Angeles
 1957- To complete her degree,
Bachelor in Science Nursing
 1966- Master of Science in Mental
Health
 1985 - earned a Ph.D. in clinical
psychology from Pacific Western
University
 1993 - Honorary Member of the
Fellowship of the American
Academy of Nursing
 In 1992 - an Honorary Doctorate of
Letters at the Neumann College in
Aston, Pennsylvania.
 1998, the Grand Valley State
University in Michigan gave her an
Honorary Doctorate of Science.
 A lecturer at the University of
California-Los Angeles in
community health nursing
The Neuman Systems Model
 published in 1982
 Betty Neuman’s first book
 The book included nursing process
format and care plans, and was a
total approach to client care
 CLIENT – person, family,
community/society
- compose of five interacting
variables (Physiologic,
Sociocultural, Developmental,
Psychological, Spiritual)
 ENVIRONMENT – all internal and
external factors of influences that
surround the client or client system
 HEALTH – dynamic in nature
- the state wellness exists when
all the part or system of person
works harmoniously
 NURSING – requires a holistic
approach, an approach that considers all
factors affecting client’s health
LEVEL OF PREVENTION
 The nurse may be involved in the
process of primary prevention (client
assessment and preventive health care
measures aimed to reducing the chance
of possible stressors and resultant illness
health promotion activities fall within
this category)
Focuses on…
Health promotion: drinking water, eating
vegetables
Specific protection: immunization, wearing
protective helmet
 The nurse may be involved in
secondary prevention activities,
wherein there are symptoms of stress
or illness apparent and treatment is
provided to decrease the effects of the
stressor
Focuses on...
early detection
 The nurse may be involved in tertiary
prevention activities, wherein
adjustment following illness is
 supported, and maintenance activities
aimed at returning the client system
to stability move the client in a circular
manner back to primary prevention.
Focuses on...
rehabilitation and restoration
SISTER CALLISTA ROY
 Adaptation Model
 was born in 1939 in LOS ANGELES
 In 1963, she earned a Bachelor of Arts
Degree in Nursing from Mount St.
Mary’s College in Los Angeles.
 In 1966, she earned a Master’s Degree
in Pediatric Nursing from the University
of California-Los Angeles.
 1973 - She earned a Master’s Degree in
Sociology
 1977 - went on to complete a Doctoratal
degree in Sociology
Key Concepts:
 The person is adapting in a stable
interaction with the environment,
either internal or external
 The environment serves as the sources
of a range of stimuli that will either
threaten or promoted the person’s
unique wholeness
 The person’s major task is to maintain
integrity in face of these environment
stimuli
METAPARADIGM IN NURSING
 PERSON – as a biopsychosocial being
in constant interaction with changing
environment
 ENVIRONMENT – conditions,
circumstances and influences that
surround and affect the development and
behavior of the person
 HEALTH – process of being and
becoming an integrated and whole
person
 NURSING – science and practice that
expands adaptive abilities and
enhances person and environment
transformation
FOUR ADAPTIVE MODES
 PHYSIOLOGICAL-PHYSICAL
MODE
- there is a need for us to adapt as
an individual in the
physiological needs (such as
food, air, water)
 SELF-CONCEPT
- how do you perceive yourself as
a person
 ROLE FUNCTION
- adapt in your role in terms in
your house; your role as an
individual
 INTERDEPENDENCE
- Generally, as an individual we
should be able to adapt in any
situation, in the changing
environment, and the transition
happenings in our society
-----In general, the theory conveys how to adapt
and to have a good coping mechanism.
DOROTHY JOHNSON
 Behavioral System Model
 was born on August 21, 1919 in
SAVANNAH, GEORGIA
 1942, She earned her Bachelor of
Science in Nursing from Vanderbilt
University in Nashville, Tennessee.
 In 1948, she received her Master’s
degree from Harvard University.
 During her career, Johnson was an
assistant professor of pediatric nursing,
an associate professor of nursing, and a
professor of nursing at the University of
California in Los Angeles.
 She retired in 1978.
METAPARADIGM IN NURSING
 PERSON – having two major systems,
the biological and behavioral system
 HEALTH – an elusive state affected by
social, psychological, biological, and
physiological factors
 ENVIRONMENT – an individual’s
behavior is influenced by the events in
the environment;
- cultural influences on the
individual’s behavior

 NURSING – the primary goal of
nursing is cultivate equilibrium within
the individual
SEVEN BEHAVIORAL SUBSYSTEMS
1. The Attachment or Affiliative Subsystem
- social inclusion intimacy and the
formation and attachment of a strong social
bond
- provides survival and security
2. The Dependency Subsystem
- approval, attention or recognition and
physical assistance
3. The Ingestive Subsystem
- relates to the behavior surrounding the
ingestion of food
4. The Eliminative Subsystem
- relates to the behaviors surrounding the
secretion of waste products from the body
5. The Sexual Subsystem
- both biological and social factor that
affects behaviors
- has dual function
6. The Aggressive Subsystem
- relates to behavior concerned with
defense and self-preservation
7. The Achievement Subsystem
- contains behaviors that attempt to
control the environment
IDA JEAN ORLANDO
 Deliberative Nursing Process Theory
 was born AUGUST 12, 1962
 died on AUGUST 28,2007
 1947 – she graduated nursing
 1951 - BS in Public health nursing
 1954 – completed her Master of Arts in
Mental Health condition
 1961 – she married Robert Pelletier
Deliberative Nursing Process Theory
- You will able to meet the clients
needs
Basic Interaction Elements
1. Behavior of Patient
2. Reaction of Nurse
3. Nursing Actions
 Automatic Nursing Action – decided
upon for reasons other than the patients’
immediate need
 Deliberative Nursing Action – decided
upon after gathering ascertaining a need
and then meeting this need.
METAPARADIGM IN NURSING
 PERSON- emphasis in the
individuality and the dynamic nature
of the nurse- client relationship
- The one who is in need of help
 NURSING- unique and independent
in its concerns for an individual’s
need for help in an immediate situation
- Care provider
 HEALTH- sense of helplessness as the
initiator of a necessity for nursing
- Overall well-being of a person
 ENVIRONMENT- completely
disregarded environment in her theory
- The theory only focuses on the
patients need
5 Stages of Deliberative Nursing Process
1. ASSESSMENT
- the nurse completes a holistic assessment of
the client’s needs
- this is thru interviews, observations
- subjective and objective data of the patients
Subjective data – coming from the
patient
Examples:
- the pain they feel like headache
- Tinnitus means ringing in the
ear
Objective data – it is measurable and
based on the observations
 Examples: - this is the interventions
- Temperature Types of Interventions
- Blood pressure
Independent intervention – does not
- Measuring the pregnant
need doctors’ order
woman’s womb
Dependent intervention – need
doctors’ order
2. DIAGNOSIS
Collaborative intervention –
- using nurse’s clinical judgment about health collaboration of other health team
problems
Doctors’ diagnosis:
Example of the Deliberative Nursing Process
1. Assessment:
- 38.5 C temperature (objective data)
- the patients has a fever
- Symptoms are teary eyes, dry lips
2. Diagnosis:
- hyperthermia
Nurses’ diagnosis:
3. Planning:
- After 4 hrs. the patients’ temperature
will subside from 38.5 C to 37.0 C
4. Implementation:
- TSB (independent intervention)
- administration of medicine (dependent
intervention)
- regular checking of temperature
- cold compress
- increase fluid intake
5. Evaluation:
- The patient was able to…
3. PLANNING
- addresses each of the problems identified in the
diagnosis
- it should be futuristic
A plan should be…
- Specific
- Measurable
- Attainable
- Realistic
- Time bounded/frame

4. IMPLEMENTATION
- the nurse begins using the nursing care plan