THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
THEORIST AND THEIR THEORY
I. List of Nursing Theorist and Their Theory
i. Dorothea Orem
ii. Patricia Benner
iii. Imogene King
iv. Martha Rogers
v. Sister Callista Roy
vi. Nola J. Pender
vii. Joyce Travelbee
viii. Jean Watson
ix. Rosemarie Rizzo Parse
x. Helen Erickson
LIST OF NURSING THEORIST AND THEIR
THEORY
Dorothea Orem – “Self-Care Deficit Theory”
SELF-CARE DEFICIT THEORY
A. Self-Care Theory– focuses on the performance
or practice of activities that individuals
initiate and perform on their own behalf to
maintain life, health, and well-being
Self-Care Requisites – requirements can be
defined as actions directed toward the
provision of self-care
a. Universal Self-Care Requisites –
associated with life processes and the
maintenance of the human structure and
functioning integrity
1) maintenance of a sufficient intake of air,
water, and food
2) provision of care associated with the
elimination
3) maintenance of a balance between
activity and rest
4) maintenance of a balance between
solitude and social interaction
5) prevention of hazards to human life,
human functioning, and human well-
being
6) promotion of human functioning and
development
b. Developmental Self-Care Requisites –
actions to be undertaken that will provide
developmental growth:
 provision of conditions that promote
development
 engagement in self-development
 prevention of the effects of human
conditions that threatens life
c. Health Deviation Requisites – are
requisites required for a person to be
considered as sick or ill; disease affects
the structures within the integral part of a
person and its functioning; set standards
to which the degree of self-care demand is
needed
B. Self-Care Deficit Theory – delineates when
nursing is needed; nursing is required when
an adult (or in the case of a dependent, the
parent or guardian) is incapable of or limited
in providing continuous effective self-care
5 Methods of Helping:
1) acting for and doing for others
2) guiding others
3) supporting another
4) providing an environment promoting
personal development about meet future
demands
5) teaching another
C. Nursing System Theory – product of a series
of relations between the persons: legitimate
nurse and legitimate client; his system is
activated when the client’s therapeutic self-
care demand exceeds the available self-care
agency, leading to nursing.
Three Types of Nursing Systems Identified by
Orem:
1) Wholly Compensatory Nursing System -
clients who are unable to control and
monitor their environment and process
information
2) Partial Compensatory Nursing System –
those clients who are unable to perform
some, but not all, self-care activities
3) Supportive-Educative (Developmental)
System – designed for clients who need to
learn to perform to self-care measures
and needs assistance to do so
Patricia Benner – “Novice to Expert Theory
SKILL ACQUISITION IN NURSING
Novice
 has no background experience of the situation in
which he or she is involved
 to guide performance, context free rules and
objective attributes must be given
 also has difficulty discriminating between
relevant and irrelevant aspects of a situation.
 the level that nursing students belong
 Benner proposed that nurses at higher levels can
be classified as a novice if they are placed in an
unfamiliar situation
Advanced Beginner
 has a sufficient experience to easily understand
aspects of the situation
 THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
 they feel more responsible for managing patient Interaction – any situation wherein the nurse
care, yet they still rely on the help of those who relates and deals with a clientele
have more experience Transaction: process of interaction in which
 Benner places most newly graduated nurses at human beings communicate with the
this level environment to achieve goals that are valued
Competent and goal-directed human behaviors
 a competent performance considers consistency, Open System – the absence of boundary existence,
predictability, and time management as essential where a dynamic interaction between the
components internal and external environment can exchange
 Benner believes that a sense of mastery is information without barriers or hindrances
acquired through planning and predictability.
 the increase level of efficiency is evident INTERACTING SYSTEMS OF THEORY OF GOAL
 has two- or three-years’ experience on the job ATTAINMENT
in the same field A. Personal Systems – how the nurse views and
 experience may also be similar day-to-day integrates self-based from personal goals and
situations beliefs
 these nurses are more aware of long-term goals, B. Interpersonal Systems – how the nurse
and they gain perspective from planning their interrelates with a co-worker or client,
own actions, which helps them achieve greater particularly in a nurse-client relationship
efficiency and organization C. Social Systems – how the nurse interacts with
Proficient co-workers, superiors, subordinates, and the
 qualitative leap beyond the competent; is the client environment in general
transition into expert level
 perceives and understands situations as whole Martha Rogers – “Science of Unitary Human Beings”
parts MAJOR CONCEPTS OF SCIENCE OF UNITARY HUMAN
 more holistic understanding of nursing, which BEINGS
improves decision-making A person is defined as an
 these nurses learn from experiences what to indivisible, pan-dimensional
expect in certain situations, as well as how to energy field identified by a
modify plans as needed 1. Human-Unitary pattern, and manifesting
Expert Human Being characteristics specific to the
 performer no longer relies on analytical principle whole, and that cannot be
like rules, guidelines, and maxims to connect her predicted from knowledge of the
understanding of the situation to an appropriate parts.
action An irreducible, indivisible, pan-
 Benner viewed as possessing an intuitive grasp of 2. Environmental dimensional energy field
the problem without losing time considering a Field identified by pattern and integral
range of alternative diagnosis and solutions. with the human field.
 their performances are fluid, flexible, and highly- The energy field is the
proficient fundamental unit of both the
living and non-living. It provides
Imogene King – “Goal Attainment Theory” a way to view people and the
GOAL ATTAINMENT THEORY 3. Energy Field
environment as reducible
Action – a means of behavior or activities that are wholes. The energy fields
towards the accomplishment of a certain act continuously vary in intensity.
(physical and mental); accomplishment of a task density, and extent.
begins with mental action, a person seeks or There are no boundaries that
formulates plan of activities and followed by stop energy flow between the
physical action; aimed towards setting goals human and environmental fields,
through communication between the nurse and which is the openness in Rogers'
the client then exploring and agreeing means to 4. Openness
theory. It refers to qualities
perform them, achieving the set goal exhibited by open systems such
Reaction – not specified but somehow relates as human beings and their
reaction as part of action; a form of reacting or a environment.
response to a certain stimulus 5. Pan- Pan-dimensionality is defined as
 THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
non-linear domain without
spatial or temporal attributes:
The parameters that humans use
dimensional in language to describe events
are arbitrary, and the present is
relative, there is no temporal
ordering of lives.
The unique behavior of whole
systems, unpredicted by any
behaviors of their component
6. Synergy
functions taken separately.
Human behavior is considered
synergistic.
The distinguishing characteristic
of an energy field seen as a single
7. Pattern
wave. It is an abstraction and
gives identity to the field.
Homeodynamics should be
13. Principle of
understood as a dynamic version
of homeostasis (a relatively
steady state of internal operation
8. Principles of
in the living system). This
Homeodynamic
principle postulates a way of
s new or different.
viewing unitary human beings.
The three principles of
homeodynamics are resonancy,
helicy, and integrality.
Postulates the inseparability of
man and environment and
predicts that sequential changes
9. Principles of
in life process are continuous,
Reciprocy
probabilistic revisions occurring
out of the interactions between
man and environment
This principle predicts that
change in human behavior will
be determined by the
10. Principles of simultaneous interaction of the
Synchrony actual state of the human field
and the actual state of
environmental field at any given
point in space-time continuum.
Because of the inseparability of
human beings and their
environment. Sequential changes
in the life processes are
continuous revisions occurring
11. Principles of
from the interactions between
Integrity
human beings and their
(Synchrony +
environment. Between the two
Reciprocy)
entities. there is a constant
mutual interaction and mutual
change whereby simultaneous
molding is taking place in both at
the same time.
12. Principle of Speaks to the nature of the
change occurring between
human and environmental fields.
The life process in human beings
is a symphony of rhythmical
vibrations oscillating at various
frequencies. It is the
Resonancy identification of the human field
and the environmental field by
wave patterns manifesting
continuous change from longer
waves of lower frequency to
shorter waves of higher
frequency.
The human-environment field is
a dynamic, open system in which
change is continuous due to the
constant interchange between
the human and environment.
This change is also innovative.
Helicy
Because of constant interchange,
an open system is never the
same at any two moments;
rather, the system is continually
Sister Callista Roy – “Roy Adaption Model”
TWO CATEGORIES OF COPING MECHANISM
REGULATOR SUBSYSTEM COGNATOR SUBSYSTEM
a person’s physiological
a person’s mental coping
coping mechanism; the
mechanism; person uses
body attempts to adapt
his brain to cope via self-
via regulation of our
concept, interdependence,
bodily processes
and role function adaptive
(neurochemical and
modes
endocrine systems)
ROY’S FOUR ADAPTIVE MODEL
Adaptive Mode Individual Group
Physiological- The way a person responds as a
Physical Mode physical being to stimuli from the
environment
Goal: Physiological Integrity
Five Operating
Physiological Resources:
Needs: participants,
oxygenation, capacities,
nutrition, physical facilities,
elimination, and fiscal
activity and resources
rest; and
protection
 THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
Four Complex role taking
regulated.
Processes: process.
senses, fluid Coping mechanism from close
and acid-base relationship which results to giving
balance, and receiving of love, respect, and
neurologic and value. Occurs between the person
endocrine and the most significant other or
function between the person and support
Psychological and spiritual system.
characteristics of the person Goal: Affectional Adequacy
consists of all beliefs and feelings Need is to achieve
Need is to
that one has formed about oneself. relational
achieve
They incorporate two components: integrity using
relational
physical self (body sensation and Interdependenc processes
integrity using
body image) and personal self (self- e Mode developmental
process of
consistency, self-ideal and moral- and resource
affectional
ethical spiritual self). adequacy.
adequacy.
Goal: Psychological Integrity Example: learning
Example: giving
Self-Concept- Need is group and maturing in
and receiving
Group Mode Need is a identity integrity relationships and
love, respect,
psychic and through shared achieving needs
and value
spiritual relations, goals for food shelter,
through
integrity so that values and co- health, and
effective
one can be or responsibility for security through
relations and
exist with a achievement interdependence
communication
sense of unity, implies honest with others
meaning, and soundness and
purposefulness completeness of TWO CONTROL PROCESSES
in the universe identifications STABILIZER SUBSYSTEM INNOVATOR SUBSYSTEM
with the group associated with system
Role Function Primary, secondary, or tertiary roles maintenance and involving
Mode that a person performs in the established structures, allows the person to
society. According to Roy and values, and daily activities change higher levels of
Andrews (1991), a role is a set of whereby participants in a potential through cognitive
expectations about how a person group accomplish the and emotional strategies
occupying one's position behaves purpose of the social
towards a person occupying another system
position.
Goal: Social Integrity Nola J. Pender – “Health Promotion Model (HPM)”
Need is social Need is role CONCEPTS OF HEALTH PROMOTION MODEL
integrity, clarity 1. Personal Factors – categorized as biological,
knowing one understanding psychological, and socio-cultural; factors that
who is in and committing are predictive of a given behavior and shaped
relation to to fulfil expected by the nature of the target behavior being
others so one tasks so group considered
can act role set can achieve a. Personal Biological Factors – include
is the complex common goals variables such as age, gender, body mass
of positions process of index, pubertal status, aerobic capacity.
individuals integrating roles strength, agility, or balance
hold; involves in managing b. Personal Psychological Factors – include
role different roles variables such as self-esteem, self-
development, and their motivation, personal competence,
instrumental expectations perceived health status, and definition of
and expressive complementary health
behaviors, and roles are c. Personal Socio-Cultural Factors – include
 THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
variables such as race, ethnicity, socio-
culturation, education, and socioeconomic
status; behavior specific cognition and
affect
2. Perceived Benefits of Action – anticipated,
positive outcomes that will occur from health
behavior
3. Perceived Barriers to Action – anticipated,
imagined, or real blocks and personal costs of
understanding a given behavior
4. Perceived Self-Efficacy – judgment of personal
capability to organize and execute a health-
promoting behavior; influences perceived
barriers to action, so higher efficacy results in
lowered perceptions of barriers to the
behavior’s performance
5. Activity-Related Affect – subjective positive or
negative feeling occurs before, during, and
following behavior based on the stimulus
properties of the behavior itself; affects
influences perceived self-efficacy, which
means the more positive the subjective
feeling, the greater its efficacy; increased
feelings of efficacy can generate a further
positive affect
6. Interpersonal Influences – cognition
concerning behaviors, beliefs, or attitudes of
others; influences include norms
(expectations of significant others), social
support (instrumental and emotional
encouragement), and modeling (vicarious
learning through observing others engaged in
a particular behavior); primary sources of
interpersonal influences: families, peers, and
healthcare providers
7. Situational Influences – personal perceptions
and cognitions of any given situation or
context can facilitate or impede behavior;
include perceptions of options available,
demand characteristics, and aesthetic
features of the environment in which given
health-promoting is proposed to take place;
may have direct or indirect influences on
health behavior
Behavioral Outcomes 8. Commitment to Plan
of Action – concept of
intention and
identification of a
planned strategy leads
to the implementation
of health behavior
9. Immediate
Competing Demands
and Preferences –
competing demands
are those alternative
behaviors over which
individuals have low
control because of
environmental
contingencies such as
work or family care
responsibilities;
competing
preferences are
alternative behaviors
over which
individuals exert
relatively high control,
such as choice of ice
cream or apple for a
snack
10. Health-Promoting Behavior – an endpoint or
action-outcome directed toward attaining
positive health outcomes such as optimal
well-being, personal fulfillment, and
productive living
Joyce Travelbee – “Human-to-Human Relationship
Model”
Five Interactional Phases of Human-To-Human
Relationship Model
1. Original Encounter – described as the first
impression by the nurse of the sick person
and vice versa; nurse and patient see each
other in stereotyped or traditional roles
2. Emerging Identities – described by the nurse
and patient perceiving each other as unique
individuals; the link of relationship begins to
form
3. Empathy – described as the ability to share in
the person's experience; result of the
empathic process is the ability to expect the
behavior of the individual with whom he or
she empathized; she proposed that two
qualities that enhance the empathy process
are similarities of experience and the desire to
understand another person
4. Sympathy – happens when the nurse wants to
lessen the cause of the client's suffering; goes
beyond empathy; nurse should use a
disciplined intellectual approach together
with therapeutic use of self to make helpful
nursing actions
5. Rapport – described as nursing interventions
that lessens the client's suffering; nurse and
the sick person are relating as human being to
human being; sick person shows trust and
confidence in the nurse
 THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
Jean Watson – ”Philosophy and Theory of
Transpersonal Caring”
Ten Carative Factors of Philosophy and Theory of
Transpersonal Caring
1. Formation of a Satisfaction through
humanistic- giving and extension of
altruistic system of the sense of self
values
Describes the nurse's
role in developing
effective nurse-client
2. Instillation of faith- interrelationships and in
hope promoting wellness by
helping the client learn
and adopt health-seeking
behaviors.
To provide a genuine,
authentic, and sensitive
client care, nurses should
3. Cultivation of acknowledge Their
sensitivity to one's sensitivity and feelings.
self and to others The recognition of
feelings leads to self-
actualization through
self-acceptance for both
the client and the nurse.
A trusting relationship
promotes and accepts the
4. Development of a
expression of both
helping-trusting,
positive and negative
human caring
feelings which is
relationship
essential for
transpersonal caring.
Intellectual and
emotional understanding
of a phenomenon or
5. Promotion and
situation vary from
acceptance of the
person to person and this
expression of
must be recognized by
positive and
the nurse. The nurse
negative feelings
must be prepared for
either positive or
negative feelings.
The use of the nursing
6. Systematic use of a
process brings a
creative problem-
scientific problem-
solving caring
solving approach to
process
nursing care.
7. Promotion of This factor separates
transpersonal caring from curing. It
teaching-learning allows the client to be
informed and transfers
the responsibility for
wellness and health to
the client. Teaching-
learning techniques are
designed to enable
clients to provide self-
care, determine personal
needs and provide
opportunities for their
personal growth.
8. Provision for a Nurses must recognize
supportive, the influence that
protective, and internal and external
corrective mental, environments have on
physical, societal, the health and illness of
and spiritual clients.
environment.
Biophysical,
psychological,
psychosocial, and
intrapersonal needs are
9. Assistance with basic to humans. Clients
gratification of must satisfy lower-order
human needs needs such as food and
ventilation before
attempting to attain
higher-order needs like
achievement and self-
actualization.
Included to provide a
10. Allowance for
thought-provoking
existential-
experience, leading to a
phenomenological-
better understanding of
spiritual forces.
the self and others.
Transpersonal Caring Relationship
is an intersubjective human-to-human relationship in
which the nurse affects and is affected by the other
person. Both are fully present in the moment and feel
a union with the other; they share a phenomenal field
that becomes part of both a life story
Caring Occasion / Caring Moment
involves actions and choices by the nurse and the
individual. The moment of coming together on a
caring occasion presents the two persons with the
opportunity to decide how to be in the relationship –
what to do with the moment
Rosemarie Rizzo Parse – “Human-Becoming Theory”
Three Abiding Themes of Human-Becoming
Theory
Meaning – human becoming is freely choosing
personal meaning in different situations and
priorities in life. Man's reality is given meaning
through lived experiences. This theme is co
creating reality through: valuing, imaging, and
languaging
a. Valuing – the process of choosing and
 THEORETICAL FOUNDATION OF NURSING (NCM100)
BSN – 1 | Immaculate Conception College – Albay | Sources: Lectures & Books
embracing what is important
b. Imaging – the creation of one's own reality
and one's reality reflects who one is as a
unitary person
c. Languaging – the ways people express
themselves to the world; it may be verbally,
written or in their actions
Rhythmicity – human becoming is co-creating
rhythmical patterns of relating in mutual process
with the universe. Man, and environment co-
create in rhythmical patterns. These patterns
would include: revealing-concealing, enabling-
limiting, connecting-separating
a. Revealing-concealing – the process humans
use to show and/or hide personal evolution
or becoming
b. Enabling-limiting – opportunities or
restrictions that occur daily; it is making
choices and living with the consequences of
our actions
c. Connecting-separating – the patterns of
connecting and separating with people,
things, and places
Transcendence – human-becoming is co-
transcending multi-dimensionally with emerging
possibilities. It refers to reaching out and beyond
the limits a person sets, and that one constantly
transforms. Sub-themes under transcendence
encompasses: powering, originating,
transforming
a. Powering – the pushing resisting process that
propels people in life through difficult times
b. Originating – about human uniqueness and
the ways people create their own becoming as
they choose from all possibilities that could
be
c. Transforming – about integrating unfamiliar
ideas or activities into one's life; changing for
the better and becoming a new entity
Four Postulates of the Three Abiding Themes of
Human-Becoming Theory
Illimitability – “The indivisible unbounded
knowing extended to infinity, the all-at-once
remembering and prospecting with the moment."
Paradox – “An intricate rhythm expressed as a
pattern preference." Paradoxes are not "opposites
to be reconciled or dilemmas to be overcome but,
rather, lived rhythms."
Freedom – “Contextually construed liberation."
People are free to continuously choose ways of
being with their situations.
Mystery – “The unexplainable, that which cannot
be completely known.”
Helen Erickson – “Modeling and Role-Modeling: A
Theory and Paradigm for Nurses”
Theoretical Components of Modeling and Role-
Modeling Theory
Humans have inherent holistic abilities needed to
cope, grow, develop, self-actualize.
1. Stress, effected by stressors, is a part of everyday
life
2. Our ability to cope and adapt determines our
ability to mobilize resources needed to work
through epigenetic developmental tasks.
3. The resources needed to cope are created by
repeated needs satisfaction.
4. Attachment objects, those things that repeatedly
meet our needs, are associated with
developmental tasks.
5. Loss of attachment objects is both normal and
situational and results in a grief process.
6. Unresolved attachment-loss-attachment results
in morbid grieving and affects needs status
7. As tasks are resolved, the residual that remains
affects future task resolution
Practice Paradigm of Modeling and Role-Modeling
Theory
1. A description of the situation, expectations for
the future, resource potential, and goals
(immediate and long-term).
2. The client is always the primary source of
information, significant other(s) are secondary,
and other professionals are third.
3. Data are analyzed within context of theoretical
premises
4. Interventions are:
a. based on coping ability and affiliated-
individuation status, and
b. framed within the context of six aims:
 nurses’ self-preparation needed to create
sacred space and initiate person-
centered holistic caring
 establish a trusting, functional
relationship
 promote a positive orientation
 promote a sense of perceived control
 affirm and promote strengths
 set health directed, mutual goals