THEORETICAL FOUNDATION OF Conceptual Operational

NURSING - from - specifies

dictionary, exactly how
encyclopedi the concept
a and will be
Module 1: Introduction to Nursing journals determined or
- the main or assess
Theory key of the - identifies
scenario procedure
and
LESSON 1: Definition of Terms: What is operations
- detailed
Nursing, Concept, Theory, Nursing Theory,
procedures of
and Paradigm the scenario

THEORY
NURSING THEORIES

- are organized bodies of knowledge to

define what nursing is, what nurses do,
and why they do it
- provides a way to define nursing as a
unique discipline that’s separate from
other disciplines
- framework of concepts and purposes
intended to guide the practice of nursing
at a more concrete and specific level - “creative and rigorous structuring of
ideas that projects a tentative,
CONCEPT purposeful, and systematic view of
phenomena”
- the building blocks of theories
- group of related concepts that propose
- thought that involve images
action that guide practice
- used to describe or label a phenomenon
- composed of concepts, definitions,
- words or phrases that identify, define,
models, propositions
establish structure and boundaries
- based on assumptions
for ideas generated about a particular
- Deductive and Inductive Reasoning
phenomenon
- can abstract or concrete

Conceptual Theoretical NURSING

- a structure of - a structure of
- “ diagnosis and treatment of human
concepts of concepts that
theories that exists or responses to actual or potential
are pulled tested in the health problems” – American Nursing
together as a literature and Association
map a ready- - “dynamic discipline”
made-map - It is an art and science of caring for
individuals, families, groups. And
 communities geared toward promotion
and restoration of health, prevention of
illness, alleviation of suffering and
assisting clients to face death with
dignity and peace.
NURSING THEORY
- a group of interrelated concepts that are
developed from various studies and
related experiences
- specifically contributed by different
nursing theorist from different times and
ages
- to describe, explain, predict or
prescribed nursing care
Importance of Nursing Theories:
- aim to describe, predict, and explain
phenomenon of nursing
- provide foundations of nursing practice
- helps to distinguish the form of basis of
practice
- help provide better patient care
NURSING PARADIGM
- are patterns or models used to show
a clear relationship among the
existing theoretical works
Four Concepts:
 Person - the focus of nursing care
 Health - depends on the theorist
-health and illness can be perceived as
two separate constructs since it
changes over time
 Nursing - a process where nurses
provide care which changes according
to the theorist
 Environment – the individual’s
environment within a global context
LESSON 2: The Evolution of Nursing
Nursing at its Beginning
- Women took care of their family
members
- Evolves around magical thinking,
superstitious and religious belief
- Believed in Greek God, the goddess of
healing
- Nurse as a herbalist, wet nurses and
caregivers
- Christ’s parable of the Good Samaritan
in providing care
Nursing Science and Theory in the Early
20th Century
- the use of experimentation to gain
new knowledge because nurses
started to base on evidence and
scientific data
 Positivism - uses both logical
reasoning and empiricism
-Empirical and objective data co-exist
which results to different point of views
and growth of new scientific knowledge
 Rationalism – make use of reason
gained thru study, tested theory and
established facts to prove something
 Empiricism - uses objective and
tangible data or those that are seen by
the senses to collect data
-used to formulate general knowledge
-inductive type of reasoning
LESSON 3: Four Ways of Knowing
EMPIRICAL KNOWING
- focuses on the evidenced-based
research for effective and accurate
nursing practice
- where most theory and research
development are concentrated
- some conceptual forms have better
capacity to explain nursing phenomena
than others
- ANY scientific, researched-based
,theoretical and factual information
that the nurse makes
- obtained from textbooks, lectures,
journals, and online researches
Evidenced-based Practice (EBP)
- accurate and thoughtful decision making
about healthcare delivery for clients
- based on the results of the most
relevant and supported evidenced
- derived from research in response to
client’s preferences and expectations
Characteristics of Quality Health Care
 Client-centered
 Scientifically-based
 Population outcome based
 Developed through quality improvement
and benchmarking
 Individualized to client’s need
 Attuned with system policies and
resources
Benefield (2002), Evidence report is
compromise of knowledge synthesis, review,
and documentation of how evidenced-based
practices are being implemented in the clinical
area
AESTHETIC KNOWING
- is related to understanding what is the
significance to particular patients
- feelings, attitudes, points of view
- focuses on empathy, which is the ability
for sharing or vividly understanding
another’s feeling
- process of giving appropriate nursing
care through uniqueness of every
patient which emphasizes the use of
creative and practical styles of care
ETHICAL KNOWING
- requires knowledge of different
philosophical positions regarding
what is good and right in making
moral actions and decisions
- judgement of right and wrong in relation
to intentions, reasons and attributes of
individuals and situations.
PERSONAL KNOWING
- encompasses knowledge of the self
in relation to others and to self
- Nurse-Patient Relationship
- It is the key to comprehending health in
terms of personal well-being.
- stresses that human beings are not in a
fixed state but are constantly engaged in
a dynamic state of changes
(Kenney,1996).
LESSON 4: Scope of Theories and Analysis
GRAND THEORIES
- known to speak about a broad range
of important relationship among
concepts of a discipline.
- made up of concepts representing
common and extremely complex
phenomena.
- viewed to be the broadest in scope,
represents the summary of
development, and concentrate on the
broad phenomena of concern with the
discipline
MIDDLE-RANGE THEORIES
- least abstract level of theoretical
knowledge because they include
details specific to nursing practice
- They specify such things as the health
condition, the patient population (age
group), the location of practice, and the
different interventions of the nurse
MICRO - RANGE THEORIES
- situation-specific and limited to
particular populations or fields of
practice and also a linking of
concrete concepts into a statement
that can be observed in practice and
research.
Higgins and Moore (2000) distinguish different
levels of micro-range theory:
 the higher level of abstraction -
strongly related to mid-range theory and
consists of a limited number of concepts
and applicable to a narrow issue or
event
 the lower levels of abstractions - It is
a greatest guess or prediction about
what one expects to discover. It is a
tentative statement o relationship
between two or more variables that can
be empirically tested
ANALYSIS AND EVALUATION OF THEORY
Theory analysis
- the researcher systematically and
objectively examines the context,
structure, and its function.
Evaluating a Theory
- we must first provide description of it
- This is done by reviewing the entire
work while focusing in its historical
aspect
- Evaluation provides new insight into
relationships among concepts and their
links to each other. This allows the
researcher to know the theory's
strengths and weaknesses.
Five Criteria (Chinn and Kramer, 1991)
 Clarity - Words commonly have multiple
meanings within and across disciplines
- they should be defined operationally on
how it is used in the framework from
which it is derived.
- follow a logical sequence which is
understandable.
- assumptions should be consistent
 Simplicity - must be adequately
comprehensive at a level of abstraction
to offer direction.
- Parsimony is defined by Walker and
Avant as elegant in simplicity although it
may be extensive in content.
 Generality - It is important to examine First FNA president Rosa Montemayor
the scope of concepts and goals within Delgado
the theory for this analysis criterion. Florence Nightingale Dr. Julita Sotejo
of the Philippines
- the more limited the concept and goals
First editor of “The Socoro Diaz
is, the less general the theory becomes. Message”
- the more abstract the work is, the more FNA Filipino Nurses Anastacia Giron
middle range theory can be drawn from Association founder Tupaz
it. First Filipino Magdalena
 Empirical Precision - the degree in industrial nurse Valenzuela
which the defined concepts are First editor of “The Conchita Ruiz
observable in actual setting. Filipino Nurses”
Known as the Dean Loreto Tupas
- Testability and ultimate use of the
of Philippine
theory. Nursing
- measured by the evidences that Education
supports the theory. First female Military Cornel Elvegia
 Derivable Consequences - nursing Nurse Mendoza
theory should lead itself to research
testing which would result to additional
Founded the National Annie Sand
knowledge that would guide practice. League of Philippine
 should give direction to research and Government nurses
practice, create new ideas, and ought to First Filipino Nurse Cesaria Tan
distinguish the focus of nursing to other who had master’s
profession. Degree in Nursing in
the United States.
First independent M. Lucille Kinlein
nurse practitioner.
Established the Bedford Fenwick
International Council
of
Nurses in Great
Britain
Organized the Jean Henri Dunant
International
Conference that
founded the red
Cross during
the Geneva
Convention
America’s first Linda Richards
trained nurse.
Founder of Public Lilian Wald
Health Nursing
Organized and Clara Barton
established the
American
Red Cross
Served as the first Dr, Lauranne Sams
President of
the National
Black Nurses
Association.
Referred as the Florence Nightingale
“Lady with the Lamp”
MODULE 2: Nursing Theoretical Works and
Different Views of Various Nursing Theorist
METAPARADIGM
 Environment – all contextual aspects
that are individuals and cultural groups
 Care – Actions for assistance, support
or training to other individuals or groups
that show obvious or potential needs in
order to mitigate or improve their
situation
 Health – Beliefs, values and behaviors
culturally recognized and used to
preserve and maintain the welfare of a
person or group allow the realization of
daily activities
 Person – a cultural being has survived
time and space
NIGHTINGALE
 Environment – She focused on
ventilation, warmth, noise, light, and
cleanliness.
 Nursing – The nurse has to put the
patient in the best condition for nature to
act upon him.
 Health – She believed nature alone
cures. Given her definition that of the art
of nursing is to unmake what God had
made the disease.
 Person – are defined in relationship to
their environment and the impact of the
environment upon them.
BENNER
 Environment – She used the
phenomenological terms of being
situated and situated meaning, which
are defined by the person’s engaged
interaction, interpretation and
understanding of the situation
 Nursing – She viewed nursing practice
as the care and study of the lived
experience of health, illness and
disease and the relationships among
three elements.
 Health – She defines health as what
can be assessed, while wellbeing is the
human experience of health or
wholeness.
 Person – A person has an effortless
and non-reflective understanding of the
self in the world.
HENDERSON
 Environment – It is important for a
healthy individual to control the
environment but ass illness occurs, this
ability diminished or affected.
 Nursing – health as a quality of life and
is very basic for a person to function
fully. As a vital need, health requires
independence and interdependence
 Health – Nurses must provide
physicians data about the safety needs
of the patient.
 Person – person is an individual who
requires assistance to achieve health
and independence or in some cases, a
peaceful death.
NEUMAN
 Environment – The environment can
be internal, external and created force
that interacts with a person's state of
health.
 Nursing – This concept provides the
nurse to consider that a client's physical,
physiological, psychological, mental,
social, cultural, development and
spiritual well-being is dynamic.
 Health – health as dynamic in nature. A
person's health depends upon which
state of the continuum they are in line
with, the person maybe in line with the
state of wellness or illnesses.
 Person – person as an individual,
family, community or the society. person
as an open system that works with other
parts of its body as it interacts with the
environment.
OREM
 Environment – Orem’s view of health
as a phenomenon affected by
inseparable entities shows her view of
the surrounding environment as an
external source of influence in the
internal interaction of a person’s
different aspects.
 Nursing – nursing as a human service.
It is distinguished human service its
focus is on persons with inabilities to
maintain continuous provision of health
care. She added that Nursing is based
on values
 Health – health should be perceived
this way since she believes that these
integrated aspects of health are
inseparable
 Person – human beings are very much
different from the other living things in
terms of their capacity. Humans can
reflect upon events, themselves and
their environment.
SISTER CALLISTA ROY
 Environment – environment as
circumstances, conditions and
influences that affect the development of
a person. There are stimuli termed as
"residual stimuli" that are stressors that
influence the person. These stimuli are
focal, contextual and residual.
 Nursing – Roy's goal is to promote the
adaptation in four aspects to nursing.
She contributed to the person's health,
quality of life and dying with dignity.
 Health – Health is the process of being
and becoming integrated and whole
person according to Roy
 Person – person as a biophysical being
in constant interaction with the
environment. The person is open,
adaptive who uses coping skills to deal
with stressors.
IMOGENE KING
 Environment – Environment as the
Process of balance involving internal
and external interactions inside the
social system.
 Nursing – Nursing for King is an act
wherein the nurse interacts and
communicates with the client. The nurse
helps the client identify the existing
health condition, exploring and agreeing
on activities to promote health.
 Health – Health as the ability of a
person to adjust to the stressors that the
internal and external environment
exposes to the client. It is the maximal
use of the potentials that a person can
perform to achieve balance in one's
health.
  Person – person existing in an open
system as a spiritual being and rational
thinker who makes 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
ABDELLAH
 Environment – The idea of
Environment is addressed by Abdellah
and is included in ''planning for optimum
health on local, state, national, and
international levels.
 Nursing – The concept of nursing in
this theory is generally grouped into
twenty-one problem areas for nurses to
work out their judgment and appropriate
care.
 Health – health is defined as the center
and purpose of nursing services.
Although Abdellah does not give a
definition of health, she speaks to a
''total health needs'' and a healthy state
of mind and body'' in her description of
nursing as a comprehensive service.
 Person – Abdellah classifies the
beneficiary of care as individuals.
However, she does not set standard
limits on the nature and essence of
human beings.
LESSON 1:
A. FLORENCE NIGHTINGALE
 12 May 1820 - 13 August 1910
 The Lady with the Lamp
 pioneer of modern nursing and noted
statistician.
The Crimean War
 1853 to 1856
 Florence Nightingale set up a hospital
near the battlefront
 become her central focus when reports
began to filter back to Britain about the
horrific conditions for the wounded.
Theoretical Sources of Nightingale’s Theory
Nightingale’s approach to health care was
systemic and holistic. She consistently
stressed health promotion and disease
prevention.
The foundations for good health were:
 decent housing (a rarity in her day,
even for the wealthy);
 clean water and air (large numbers
died from water and air-borne diseases);
 good nutrition (especially a problem for
the poor, but lack of standards in the
food industry harmed everyone);
 safe childbirth (mortality rates were
much higher than, both for childbirth and
post childbirth from puerperal fever);
 good child care (a major subject in her
Notes on Nursing) and no child should
ever be in a workhouse (when many
were).
 home visiting by nurse and doctor
  minimal use of hospitals—concern
over mortality rates in general (acute-
care) hospitals
 linking of general (acute care)
hospitals in city centers with
convalescent hospitals in the country or
seaside.
“NIGHTINGALE’S ENVIRONMENTAL
MODEL”
A. HEALTH OF HOUSES
B. VENTILATION AND WARMING
C. LIGHT
D. NOISE
E. VARIETY
F. BED AND BEDDING
G. PERSONAL CLEANLINESS
H. NUTRITION AND TAKING FOOD
I. CHATTERING HOPES AND ADVICES
J. SOCIAL CONSIDERATIONS
Relevance of theory in nursing practice,
education and research
 EDUCATION - Better practice result
from better education
 Skills measurement through licensing by
the use of testing methods, the case
studies
 RESEARCH - Use of graphical
representations like the bar, pie
diagrams
 Notes on nursing.
 NURSING PRACTICE - Disease control
 Sanitation and water treatment
 Utilized by modern architecture in the
prevention of “sick building syndrome
 Waste disposal
 Control of room temperature
Nightingale believed that the environment was
the major component creating illness in a
patient;
“'the reactions of kindly nature against the
conditions in which we have placed
ourselves''
B. PATRICIA BENNER
 From Novice to Expert
 “Nursing is concerned with the social
sentient body that dwells in finite
human world”
 Hampton, Virginia and spent her
childhood in California
 received her Bachelor’s Degree in
Nursing from Pasadena College in
1964
 Master’s Degree in Medical Surgical
Nursing from the University of
California, San Francisco in 1970
 Ph. D. from University of California,
Berkeley
From Novice to Expert
 Novice – Has no professional
experience
 Beginner – Can note recurrent
meaningful situational components, but
not prioritize between them
 Competent – begins to understand
actions in terms of long-range goals
 Proficient – perceives situations as
wholes, rather than in terms of aspects
 Expert- has intuitive grasp of the
situation and zeros in on the accurate
region of the problem
Relevance of Benner’s Model
 The model has been used to aid in the
development of clinical ladders of
promotion, new graduate orientation
programs and clinical knowledge
development seminars. This has greatly
contributed in the competency ladders
and promotions in the nursing service.
Analysis of Benner’s Model
 It gives a relative guide for classifying
levels of nursing practice, from
individual nurse descriptions and
observations to actual nursing practice.
 was tested using qualitative
methodologies
 the framework is applicable and useful
in providing knowledge of the
description of nursing practice.
C. ERNESTINE WEIDENBACH
 The Helping Art of Clinical Nursing
 born in 1900 in Hamburg, Germany,
and her family moved to New York in
1909
 Bachelor of Arts from Wellesley
College in 1922
 Registered Nurse’s license from the
John Hopkins School of Nursing in
1925.
 Masters of Arts from Teachers
College, Columbia University in 1934.
In 1946
“The Helping Art of Clinical Nursing”
 It defines nursing as the practice of
identifying a patient’s need for help
through the observation
 defines the patient as any person
receiving help of some kind from the
health care system. Help can include
care, teaching, and advice
 a patient does not need to be ill or
injured since health education qualifies
someone as a patient.
 A nurse uses his or her knowledge in his
or her role.
Wiedenbach’s prescriptive theory is based
on three factors:
 The central purpose which the
practitioner recognizes as essential
to the particular discipline.
 The prescription for the fulfillment of
the central purpose.
 The realities in the immediate
situation that influence the central
purpose
LESSON 2:
A. VIRGINIA HENDERSON
- NEED THEORY
 14 NURSING BASIC NEEDS
 “First Lady of Nursing’’
 ‘’First Truly International Nurse’’
 Began her career in public health
nursing in the Henry Street
Settlement, Washington, D.C.
 First fulltime instructor in nursing in
Virginia.
 Early advocate for the introduction of
psychiatric nursing in 1929
THE NURSE – PATIENT RELATIONSHIP
 (1) the nurse as a substitute for the
patient
 (2) the nurse as a helper to the
patient
 (3) the nurse as a partner with the
patient
  nurse is seen as a ‘’substitute for what  Avoid dangers in the environment
the patient lacks to make him ‘complete, and avoid injuring other
“whole, ’or ‘ independent,’ by the lack of  Communicate with others in
physical strength, will, or knowledge.’’ expressing emotions, needs, fears or
opinions
 Worship according to one’s faith
THE NURSE-PHYSICIANS RELATIONSHIP
 Work in such a way that there is a
 The care plan, formulated by both the sense of accomplishment
nurse and the patient, must be  Play or participate in various forms of
implemented in such a way as to recreation
promote the physician’s prescribed  Learn, discover, or satisfy the
therapeutic plan curiosity that leads to normal
 nurses help patients with health development and health and use the
management when physicians are available health facilities
unavailable. She also indicated that
Nursing - the nurse uses observation, smell,
many nurse and physician functions
feeling and hearing
overlap
- the nurse would assess the patient in all
THE NURSE AS A MEMBER OF THE
14 components of basic nursing care.
HEALTH CARE TEAM
- the nurse must analyze the collected
 The size of each members section data
depends on the patient’s current needs;
Education - the nurse needs the kind of
therefore, it changes as the patient
education available only in colleges and
progress toward independence. In some
universities. The nurse education demands
situations, certain team members are
universal understanding of diverse human
not included in the pie. The goal is for
beings. The student becomes involved in the
the patient to have the largest wedge
complete study of the patient and the patient’s
possible or to take the whole pie.
needs.
14 COMPONENTS OF VIRGINIA
Research - Research questions arise from
HENDERSON’S NEED THEORY
each of the 14 components of basic nursing
 Breathe Normally care to assume responsibility for identifying
 Eat and Drink adequately problems, validate, improve methods and
 Eliminate body wastes reassuring effectiveness of nursing care
 Move and maintain desirable
postures
 Sleep and rest
 Select suitable clothes – dress and
undress
 Maintain body temperature within
normal range by adjusting clothing and
modifying environment
 Keep the body clean and well-
groomed and protect the intergument
B. BETTY NEUMAN
- “System Model in Nursing Practice”
- “Health is a condition in which all
parts and subparts are in harmony
with the whole of the client”
- born on 1924 on a farm near Lowell,
Ohio
- Worked as head nurse, school nurse,
industrial nurse and was also
involved in clinical teaching at
University of Southern California
Medical Center, Los Angeles.
- incorporated the concept of a whole
person as an open system approach.
- aimed towards the development of a
person in a state of wellness having the
capacity to function optimally.
- The main role of the nurse in her theory
is to help a person to adapt with
environmental stimuli causing illness
back to a state of wellness.
SELF-CARE THEORY OF NURSING
THEORETICAL ASSERTIONS
 depicts the nurse as an active
participant with the client and as
“concerned with all the variables
affecting an individual’s response to
stressors”.

 The client is in a reciprocal relationship
with the environment
C. DOROTHEA OREM
- ‘’Self-Care Theory of Nursing’’
- “’Individuals, families, groups and
communities need to be taught
selfcare’’
- one of America’s foremost nursing
theorist
- born in Baltimore, Maryland in 1914.
- began her nursing career at
Providence Hospital School of
Nursing in Washington, D.C., where
she received a diploma of nursing in
the early 1930
- defined as goal-oriented activities that
are set towards generating interest in
the part of the client to maintain life and
health development.
- making the clients perform self-care
activities in order to live independently.
 Self-Care- practice of activities that
individual initiates and perform on their
own behalf in maintaining life, health,
and well being
 Self-Care Agency – individual’s ability
to perform self-care activities
 Self-Care Requisites – action directed
towards provision of self-care
 Therapeutic Self-Care Demand –
“totality of self-care actions to be
performed for some duration in order to
meet self-care requisites by using valid
methods and related sets of operations
and actions”
Relevance of the theory: Lesson 3:

 PRACTICE - Orem’s theory had been

widely used in dealing with geriatric
A. SISTER CALLISTA ROY
cases, especially those having chronic
illnesses
 EDUCATION - curriculum development
was reported in the late 1970’s. the
theory is used at all levels of curriculum
and in continuing education
 RESEARCH - Orem’s theory can be
classified relating to the development of
research instruments for scientific
measurements of the components of her
theory and studies that test these
components.
- Adaptation Model
- born on October 14, 1939 in Los
Angeles, California
- graduated in nursing in 1963 at the
Mount Saint Mary College, Los
Angeles
- Master's Degree in Pediatric Nursing
was finished in 1966
- Doctorate in Sociology in 1977 from
the University of California

Analysis of the theory:

 Generality - the theory she proposed

helps nurses develop and validate
nursing knowledge, and in teaching and
learning the nursing profession
 Empirical Precision - used in both
qualitative and quantitative
methodologies.
- It could be effectively used in generating
hypotheses and adding to the body of
knowledge of nursing.
- Derivable Consequences - Orem’s
theory distinguishes nursing from other
disciplines in terms of focus

- The person is adapting in stable

interaction with the environment, either
internal or external
- The environment serves as the source
of a range of stimuli that will either
threaten or promote the person's unique
wholeness
- The person's major task is to maintain
integrity in face of these environment
stimuli:
 • Focal - Most immediately confronting sub-concepts
the person and attracts the most
attention. - regulator
• Contextual -all other stimuli that - cognator
strengthens the effect of focal stimulus four effector modes
• Residual - Those stimuli that affect
focal stimulus but the effects are not - physiological
clear. - self-concept
- role function
Nursing Process - interdependence
Step 1: Assessment of Behavior

Step2: Assessment of Stimuli The theory offers a guide to researchers who

Step3: Nursing Diagnosis wants to integrate physiological phenomena in
their study
Step4: Goal Setting
The holistic approach of the model makes it
Step5: Intervention helpful for researchers who are interested to
study adaptive process
Step6: Evaluation

Relevance of the Theory

A. IMOGENE KING
Practice - Roy's Model useful for nursing
practice because it outlines the features of the - Goal Attainment Theory
discipline and provides direction for practice, - received a diploma in nursing from
education and research. St. John's Hospital of Nursing in St.
Louis, Missouri, in 1945
- includes a goal that specified as the aim - she began a course work toward a
for activity and prescription of activities Bachelor of Science in Nursing
to attain the goal. Education, which she received from
Education - According to Roy, the goal of a St. Louis University in 1948.
nurse is to help a patient put his energy to - Personal, Interpersonal and Social
achieve recovery. Communication
 used to establish a nurse-client
- promote adaptation with regard to their relationship and utilize by the
science nurse to form a strong foundation
for a dynamic and interactive
Analysis
environment
several major concepts
Three health needs of human beings:
- nursing
- Need for information
- person
- Need for care for illness prevention and
- health-illness
- Need for total care when a person
- environment
doesn't have the capacity to help
- adaptation nursing interventions
themselves.
The theory focuses on creating a positive
behavior that can be adapted both by the nurse
and client to achieve goals established by the
client with the help of a nurse.
“GOAL ATTAINMENT THEORY”
Action - According to her reaction is a form of
reacting or a response to a certain stimulus.
Interaction - Interaction, as defined by King, is
any situation wherein the nurse relates and
deals with a clientele or patient.
Open System - the absence of boundary
existence, where a dynamic interaction
between the internal and external environment
can exchange information without barriers or
hindrances.
Proposition of king's goal attainment theory
•If a continuous accuracy is currently is a
nurse-patient interaction, a transaction will
happen.
• If nurse and patient will build a
transaction, goals will be achieved
• If goals are achieved, satisfaction will
happen.
• If goals are met, efficient nursing care will
happen.
• If transactions are done in a nurse-client
interaction, growth and development will be
increase.
• If role anticipation and performance in the
nurse and patient are the same transaction
will happen.
• If role disagreement happens in both
nurse and patient, stress would be the
result.
• If nurse with exceptional skill and
knowledge correspond
Acceptance by the nursing community
Practice - Professionals need communication
to successfully and correctly make decisions
for their plan of care.
- helps nurses to easily facilitate the
present problem from careful
assessment of the client gathered
Education - It provides a systematic means of
viewing the nursing profession, organizing
nursing knowledge and clarifying the nursing
discipline.
Research - The theory can also help set a
framework for nursing studies which can
further prove the use and advantages of the
nursing practice.
ANALYSIS
Simplicity - She maintains the simplicity of her
theory even if she presented different complex
concepts.
Generality - It was stated that the interaction
between the nurse and the client also
comprises non-verbal communication that
cannot be clearly defined and evaluated.
Empirical Precision - Her observation
consists of the different characteristics of
transactions among different patients.
Derivable Consequences - Her theory
provided clients to think choices and be able to
participate in the desired outcome of the care
plan.
LESSON 4
A. FAYE GLENN ABDELLAH
- Twenty-One Nursing Problems
- March 13, 1919, Faye Glenn Abdellah
was born in New York City.
- basic nursing education, Magna cum
laude in 1942 from Fitkin Memorial
Hospital School of Nursing, in
Neptune m, New Jersey.
Typology of Twenty-one Nursing Problems
1. To maintain good hygiene and physical
comfort.
2. To promote optimal activity: exercise,
rest, sleep.
3. To promote safety through prevention
of accident, injury, or other trauma and
through the prevention of the spread of
infection.
4. To maintain good body mechanics and
prevent and correct deformity.
5. To facilitate the maintenance of a
supply of oxygen to all body cells
6. To facilitate the maintenance of
nutrition of all body cells.
7. To facilitate the maintenance of
elimination.
8. To facilitate the maintenance of fluid and
electrolyte balance.
9. To recognize the physiological
responses of the body disease conditions-
pathological, physiological and
compensatory.
10. To facilitate the maintenance of the
regulatory mechanism and functions.
11. To facilitate the maintenance of
sensory function.
12. To identify and accept positive and
negative expressions, feelings and
reactions.
13. To identify and accept interrelatedness
of emotions and organic illness.
14. To facilitate the maintenance of
effective verbal and non-verbal
communications.
15. To promote the development of
productive interpersonal relationships.
16. To facilitate progress toward
achievement and personal spiritual goals.
17. To create or maintain a therapeutic
environment.
18. To facilitate awareness of self as an
individual with varying physical emotional
and developmental needs.
19. To accept the optimum possible goals
in the light of limitations, physical and
emotional.
20. To use community resources as an aid
in resolving problems arising from illness.
 21. To understanding the role of social
problems as influencing factors in the
cause of illness.
Theoretical Assertions
1. ''The nursing problem and nursing
treatment typologies are the principles of
nursing practice and constitute the unique
body of knowledge that is running.'
2. ''Correct identification of the nursing
problem influences the nurse's judgment in
selecting steps in solving the patient's
problem.''
3. The core of nursing is the patient/client
problems that focus on the patient and his/her
problems.
ACCEPTANCE BY THE NURSING COMMUNITY
Practice - the clinical practitioner could assess the
patient, make a nursing diagnosis and plan
interventions.
Education - Educators came to the realization
that revisions are of prime importance if nurses
were to become
self-governing
Research - The typology utilized by Abdellah and
Strachan became the root for cultivating the
nursing care model and was then employed for
setting up the staffing outline in clinical settings.
ANALYSIS
Generality - affect nursing education
optimistically, whereas sub-goals are to
present scientific basis for practice and to
present a method of qualitative appraisal of
educational familiarity of the students
Empirical Precision - The concepts are
inclusive of the field of nursing
Derivable Consequences- The problem-
solving process and the typology of twenty-one
nursing problems can then be deemed the
forerunner of the nursing care process,
classification of nursing diagnoses, and
outcome calculation in evidence in the present
time.
B. LYDIA HALL
- September 21, 1906 – February 27,
1969
- Care, Core, Cure Theory
- “a participation in care, core and cure
aspects of patient care, where CARE is
the sole function of nurses, whereas the
CORE and CURE are shared with other
members of the health team.”
Core is the patient receiving nursing care. The
core has goals set by him or herself rather than
by any other person, and behaves according to
his or her feelings and values.
Cure is the attention given to patients by
medical professionals. Hall explains in the
model that the cure circle is shared by the
nurse with other health professionals, such as
physicians or physical therapists
Care circle addresses the role of nurses, and is
focused on performing the task of nurturing
patients. This means the “motherly” care
provided by nurses, which may include comfort
measures, patient instruction, and helping the
patient meet his or her needs when help is
needed.
 • Patient able to develop a maturity level when
nurse listens to them and acts as sounding
board

• Patient able to make informed decisions

• Emphasis on social, emotional, spiritual and

intellectual needs

• Patient makes more rapid progress towards

recovery and rehabilitation

Cure

• Care based on pathological and therapeutic

sciences

• Application of medical knowledge by nurses

Care • Nurse assisting the doctor in performing tasks

• Nurturing component of care • Nurse is patient advocate in this area

• It is exclusive to nursing • Nurse is a patient advocate

• “Mothering” • Nurses role changes from positive quality to

negative quality
• Provides teaching and learning activities
• Medical surgical and rehabilitative care
• Nurses goal is to “comfort” the patient
• COOPERATE WITH FAMILIES OR CARE
• Patient may explore and share feelings with
GIVERS
nurse

• Nurse is concerned with intimate bodily care

• Nurse applies knowledge of natural and

biological sciences

• Nurse act as potential comforter

Core

• Patient care is based on social sciences

• Therapeutic use of self

• Helps patient learn their role is in the healing

process

• Patient is able to maintain who they are