Theoretical Foundations in Nursing

Module #1 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Lesson title:
§ INTRODUCTION TO NURSING THEORY
§ HISTORY & PHILOSOPHY OF NURSING AS SCIENCE
§ STRUCTURE OF NURSING KNOWLEDGE Materials: Book, pen and notebook
Learning Targets:
At the end of the module, students will be able to:
1. Identify the evolution of nursing;
2. Define the different eras of nursing;
3. Identify the similarities and differences of significance of
nursing as a discipline and profession;
4. Enumerate the criteria of a profession;
5. Determine the historical views of the nature of science;
6. Differentiate rationalism and empiricism;
7. Define the following structures of nursing knowledge References:
(metaparadigm, philosophy, conceptual models and grand Alligood, M. (2018). Nursing theories and their
theories); and, work (9th ed.). Singapore: Elsevier.
8. Apply the following theory development principle.

A. SUBJECT ORIENTATION

Your classroom instructor for this subject, Theoretical Foundations in Nursing, is ____________________________.
(You write in this area the vital policies, rules & regulations to be noted in this class. You may also refer to the Course Outline
to be distributed by your instructor.)

B. MAIN LESSON
You will study and read their book, if available, about this lesson.

History of Nursing Theory

✔ This was dated way back when Florence Nightingale began to assume the great significance of providing a clean
and healthy environment to achieve recovery of patients and continues up to present.
o She also envisioned nurses as a body of educated women who organized service and caring for wounded
in wartime (Crimean War) and establishment of Nursing school in London (St. Thomas Hospital) pioneering
activities in nursing practice and education.
✔ Nursing evolved through different eras. Profession did not start as what it seemed to be. It started as a vocational
course offering only skills during their time.

Nursing as a Science:
Apprenticeship Model
✔ Nursing practice was based on principles and traditions that were handed down through practice seen by Florence
during her time.

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 Theoretical Foundations in Nursing
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✔ Other references note that this is a practice era dated before the curriculum era where to be a nurse can have a
diploma for only 2 years under vocational.
Historical Eras of Nursing’s Search for Specialized Knowledge
Historical Eras Major Question Emphasis Outcomes Emerging Goal
What curriculum Develop specialized
Curriculum Era: Courses included in Standardized curricula
content should nurses knowledge and higher
1900 to 1940s nursing programs for diploma programs
study to be nurses education
Research Era: What is the focus for Role of nurses and Problem studies and Isolated studies do not
1950 to 1970s nursing research? what to research studies of nurses yield unified knowledge
Carving out an
Graduate What knowledge is Nurses have an Focus graduate
advanced role and
Education Era: needed for the important role in education on knowledge
basis for nursing
1950 to 1970s practice of nursing? health care development
practice
How do these
There are many Nursing theoretical
Theory Era: frameworks guide Theories guide nursing
ways to think about works shift the focus
1980 to 1990s research and research and practice
nursing to the patient
practice?
What new theories are Nursing theory Middle-range theory Nursing frameworks
Theory
needed to produce guides research, may be from produce knowledge
Utilization Era:
st evidence of quality practice, education, quantitative or (evidence) for quality
21 Century
care? and administration qualitative approaches care

Fawcett classified nursing models as paradigms with in a more organized / specialized meta- paradigm of:
▪ Person ▪ Health
▪ Environment ▪ Nursing Concepts

Significance of Nursing Theory:

At the beginning of the 20th century, nursing was not recognized as an academic discipline or a profession. The
accomplishments of the past century led to the recognition of nursing in both areas. The terms discipline and profession are
interrelated and some may even use them interchangeably; however, they are not the same. It is important to note their
differences and specific meaning.

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 Theoretical Foundations in Nursing
Module #1 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

DISCIPLINE
✔ Specific to academia and refers to a branch of
education, a department of learning or a domain of
knowledge.
✔ Branch of education; theoretical works leading to higher
levels of education and practice.
✔ Functional Focus (what nurses do) – knowledge
focus or what nurses know and how they use them for
thinking and decision making while taking care of a
patient. (example: Nursing)
PROFESSION
✔ Refers to a specialized field of practice founded on the
theoretical structure of the science or knowledge of the
discipline and accompanying practice abilities.
✔ Knowledge of that discipline and accompanying
practice abilities.
✔ Recognition and respect for their scholarly disciplined
contribution to the health of society.

✔ Knowledge of persons, health and environment forms

the basis for nursing as a discipline

✔ Kuhn – stated, “the study of paradigms is what mainly

prepares the student for membership in a particular
scientific community with which he / she will practice.
By studying and practicing with them, the clients or
community involved learn their trade."

Criteria for the Development of the Professional status of Nursing:

1. Utilizes in its practice a well-defined and well organized body of specialized knowledge.
2. Constantly enlarges the knowledge it uses and improves its techniques of education and service thru scientific
method.
3. Entrusts the education of its practitioners to universities/ colleges.
4. Applies knowledge in practical services important to community welfare.
5. Functions autonomously in developing professional policy.
6. Attracts individuals with intellectual and personal qualities of intensifying service.
7. Strives to compensate nurses by providing freedom of action, opportunity for continuous professional growth and
economic security.

Historical Views of the Nature of Science

Epistemology (episteme – knowledge; logos – study of)

● meaning knowledge, understanding
● concerned with the theory of knowledge in philosophical inquiry or how knowledge came to be.
● What is real is also considered knowledge.
● Branch of philosophy concerned with the nature & scope of knowledge.
● It is the study of knowledge & justifies beliefs.
● It questions what knowledge is & how it can be acquired.
● This aims to discover the meaning of knowledge, & called it the true beginning of philosophy.

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 Theoretical Foundations in Nursing
Module #1 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Philosophical Foundations of Science:

RATIONALISM
● Priori reasoning -utilizes deductive; cause to effect or
general to particular
● Use use of the rational senses in ensuring the
truthfulness of a phenomenon
● Understand the whole first before you can appreciate
the lesser parts
● Regards reason as the chief source & test of
knowledge
● Any view appealing to reason as a source of
knowledge or justification (theory-the-research
approach)
● Criterion of truth is not sensory but intellectual &
deductive (general to specific)
● ex: lack of social support will lead to hospital
readmission, "not all"
EMPIRICISM
● Way of looking at reality using the five senses.
● An object is real in so far as seen, felt, smelled,
tasted, heard
● A theory which states that knowledge comes only or
primarily from sensory experience
● Fundamental part of scientific method
(experimentations)
● Knowledge is based on experience; ex. physical
assessment
● Gather information more and observe facts before
finally saying a theory exists.
● Reynolds, “research-then-theory strategy”
● It is inductive. (specific to general)
● !"#$%&''!%($)*(*$+$),*-.&/!

History of Nursing Science:

Early 20th century views
● Positivism emerged as the dominant view of modern
science.
● Modern logical positivists believed that empirical
research and logical analysis were two approaches
that would produce scientific knowledge.
✔ Philosopher focused on the analysis of theory
structure.
✔ Scientists focused on empirical research.
✔ Increasing use of computers which permits the
analysis of large data.
Interdependence of theory and research
● In constructing theory, theorists must be
knowledgeable about available empirical findings and
able to take these into account, because theory is
concerned with organizing and formalizing available
knowledge of a given phenomenon.
● The theory is subject to revision or maybe abandoned
in favor of an alternative explanation for new
information.
Emergent of science and theory in the late 20th century
● Phenomenological Approach reduces observations or
text to the meanings of phenomena independent of
their particular context. This approach focuses on the
lived meaning of experiences.
✔ Several authors presented analysis challenging
the positivist position, thus offering the basis for a
new perspective in science.
✔ Empiricists view phenomena objectively, collect
data and analyze it to inductively propose theory.
Science as a social enterprise
● "Human beings do science" - Gale. It might be
anticipated that social, economic, or political factors
may influence scientific enterprise. It depends on the
funds, popularity of certain ideologies.
● Science progresses by the diversity of dialogue within
the discipline of nursing. The creation of a merged
paradigm from many paradigms is debated in
relationship to the advancement of nursing.

Theory Development Process:

THEORY
- Usually means “mere guess” or
Scientifically, theory implies that something An idea that is suggested or
unproved
has been proven and is generally accepted presented as possibly true but
- Literally means “a vision” or “a
as being true. An idea or set of ideas that is that is not known or proven to
beholding scene”
intended to explain facts or events. be true.
- Greek word “theoria”

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 Theoretical Foundations in Nursing
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Name: _________________________________________________________________ Class number: _______

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A set of statements that tentatively

An internally consistent group of relational
describe, explain, or predict
statements (concepts, definitions & Scientifically theory implies
relationships among concepts that
propositions) that present a systematic view that something has been
have been systematically selected &
about a phenomenon & which is useful for proven and is generally
organized as an abstract
description, explanation, prediction & control accepted as being true.
representation of some phenomenon
(Bodie & Chitty).
(Powers & Knapp).
The general principles or ideas that relate to principles or ideas that relate to a
particular subject.
A creative & rigorous structuring of
Ex.
ideas that project a tentative, Theory of Evolution
purposeful & systematic view of
phenomenon. Validation of existing
knowledge as well as discovery of new
knowledge. We apply theory to
describe, explain, predict, or prescribe
nursing practice.

Categories of Theory Components:

CONCEPTS CATEGORIES OF CONCEPTS
✔ are words or phrases
Type Meaning Example
that are used to
Abstract independent of a certain time and place CHS
represent the
phenomenon Concrete more specific time or place Nursing, Pharmacy
observed or they belong or not belong to a particular categories patients, nurses,
Discrete
experienced or classes of phenomena environment
✔ are the building ▪ Concepts - classifications of dimensions or
pain, health – illness
blocks of theories, Continuous gradations of a phenomenon across a continuum
continuum
“ideas” ▪ Degrees or levels in a given continuum
✔ describe & classify Theoretical
establish meaning (dictionary) dictionary meaning
phenomena Definitions
Operational how these concepts are used or will be used within provide
Definitions the context of the phenomenon measurement

10 Phases of Concept Building Process:

1. Write a meaningful practice story.
2. Name the central phenomenon in the practice story.
3. Identify a theoretical lens for viewing the phenomenon.
4. Link the phenomenon to existing literature.
5. Gather a story from someone who has lived the phenomenon.
6. Reconstruct the shared story and create mini-saga that captures its message
7. Identify the core qualities of the phenomenon.
8. Use the core qualities to create a definition.
9. Create a model of the phenomenon
10. Write a mini synthesis that integrates the phenomenon with a population to suggest research direction.

Relational Statements Statements in a theory may state definitions or relations among concepts
Theoretical Statements Relate concepts to one another; permit analysis

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 Theoretical Foundations in Nursing
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Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Operational Statements Relate concepts to measurements

Linkages and Ordering:

provide rationale of why theoretical statements are linked; add
Linkages of theoretical statements
plausibility
provides rationale for how measurement variables are linked;
Linkages of operational statements
permit testability
Organization of concepts and definitions into
eliminates overlap (tautology)
primitive and derived terms
Organization of statements and linkages into
eliminates inconsistency
premises and derived hypotheses and equations

SCIENTIFIC LAW vs. THEORY

SCIENTIFIC LAWS
✔ A statement of fact that aims to explain, in brief and
simple terms, an action or set of actions
✔ Generally accepted to be true and universal and can
occasionally be expressed in terms of a single
mathematical equation
✔ SIMPLE, TRUE, UNIVERSAL & ABSOLUTE
✔ Governs a single action, foundations for all science
✔ Statement based on repeated experimental
observations that describes some aspects of the
universe
✔ Always applies under same conditions, & implies that
there is a causal relationship involving its elements
✔ ex. Law of Universal Gravitation by Newton
THEORY
✔ More complex & dynamic; maybe replaced
✔ Explains an entire group
✔ Can be changed or improved without changing the
overall truth
✔ Developed from the scientific method
✔ ACCEPTED AT TRUE & PROVED
Hypothesis
● an educated guess based upon observation
● can be supported or proven false by experimentation
or continued observation
● an idea or theory that is not proven but leads to
further study or discussion
● an assumption made for the sake of argument\
● HAS NOT BEEN PROVED
● ex. watching excessive amounts of TV reduces a
person’s ability to concentrate; smoking leads to lung
cancer

Contemporary Issues in Nursing Theory Development:

▪ Theoretical Boundaries and Levels to Advance Nursing Science

o proposed framework now used without reference to the author for the development of nursing science
▪ Nursing Theory, Practice and Research
o Theory-testing research may lead one nursing theory to fall aside as a new theory is developed that
explains nursing phenomena more adequately; must continue to advance the discipline.

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 Theoretical Foundations in Nursing
Module #1 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in your answer/ratio is not allowed.

1. Which of the following are/is correct with the following historical eras of Nursing, except?
a. Curriculum Era - 1900s to 1920s
b. Research Era – 1950s to 1980s
c. Graduate Education Era – 1950s to 1980s
d. Theory Utilization Era – 21st century
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

2. What era noted that the outcome of Nursing theoretical works shifted the focus to the patient?
a. Curriculum Era
b. Graduate Education
c. Theory Era
d. Theory Utilization
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

3. This is defined as specific to academia and refers to a branch of education, a department of learning or a domain
of knowledge.
a. Vocation
b. Discipline
c. Profession
d. None of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

4. All but one constitutes the following criteria of a profession:

a. utilizes in its practice a well-defined and well organized body of specialized knowledge. Relationship
between nurse and the patient
b. entrusts the education of its practitioners to universities/ colleges
c. functions autonomously in developing professional policy
d. strives to compensate nurses by providing restriction in action, opportunity for continuous professional
growth and economic insecurity
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

5. Which era has the emphasis of “carving out an advanced role and basis for nursing practice”
a. Curriculum Era
b. Research Era

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 Theoretical Foundations in Nursing
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c. Graduate Education Era

d. Theory Era
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
6. All of the following are true statements regarding epistemology, except?
a. Branch of philosophy concerned with the nature & scope of knowledge.
b. It is the study of knowledge & justifies beliefs.
c. An idea that is suggested or presented as possibly true but that is not known or proven to be true.
d. It questions what knowledge is & how it can be acquired.
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

7. Which of the following differentiates Rationalism from Empiricism? (Select all that apply)
a. It is from general to specific
b. Knowledge is real when used by the senses
c. It uses rational thinking
d. Knowledge is based on experience
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

8. A research then theory approach falls on what principle:

a. Rationalism
b. Empiricism
c. A & B
d. None of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

9. A nurse tries to gather/collect data so the physician can have a diagnosis of the patient. This example falls under
what principle?
a. Rationalism
b. Empiricism
c. A & B
d. None of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

10. This is a set of statements that tentatively describe, explain, or predict relationships among concepts that have been
systematically selected & organized as an abstract representation of some phenomenon.
a. Epistemology

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 Theoretical Foundations in Nursing
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b. Philosophy
c. Theory
d. Concepts
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

11. Which of the following is a component of theory development?

a. Concepts
b. Relational statements
c. Linkages and ordering
d. All of the above
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

12. A type of concept that is more specific time or place.

a. Abstract
b. Concrete
c. Continuous
d. Theoretical
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

13. Operational Definition is defined as:

a. how these concepts are used or will be used within the context of the phenomenon
b. dictionary defined concept
c. they belong or not belong to a particular categories or classes of phenomena
d. independent of time and or space
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

14. This is a type of relational statements that relate concepts to measurements.

a. Theoretical
b. Operational
c. Relational
d. Continuous
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

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 Theoretical Foundations in Nursing
Module #1 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

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15. Which of the following is true to theory and scientific law?

a. Scientific law governs a single action, foundations for all science while theory can be changed or improved
without changing the overall truth.
b. Theory is simple, true and universal.
c. Scientific law is merely a guess.
d. Scientific law is more complex and dynamic.
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

C. LESSON WRAP-UP

AL Activity: CAT: MUDDIEST POINT

This technique will help you determine which key points were missed in the main lesson. You will respond to only one
question:

In today’s session, what was least clear to you?

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