FLORENCE NIGHTINGALE
The Environmental Theory
founder of modern nursing
Also known “The Lady with the Lamp”/
“Angel of the Crimea
Called to Turkey, during Crimean War
Born on May 12, 1820 in Florence, Italy
Died on August 13, 1910 in London
She attended nursing program in
Kaiserswerth, Germany in 1844
She worked as the Nursing superintendent in
a hospital for invalid gentlewomen
She funded the establishment of St. Thomas’
Hospital, and within it, the Nightingale
Training School for Nurses. Also the King’s
College Hospital in London
Theory:
The Environmental Theory
“the act of utilizing the patient’s
environment to assist him in his recovery.”
Types of Environment
Physical Environment
Psychological Environment
Social Environment
Environmental Factors
1. Pure fresh air
2. Pure water
3. Effective drainage
4. Cleanliness
5. Light
Philosophy:
 Nurses need to be excellent observers of
patients and the environment.
 Nurses should use common sense in
practice, coupled with observation,
perseverance, and ingenuity.
 The environment of the patient plays a huge
role in their recovery, and it is the nurse's
role to alter the environment to gradually
create the optimal conditions for the
patient’s body to heal itself.
 People desired good health, that they would
cooperate with the nurse and nature to allow
the reparative process to occur, and that they
would alter their environment to prevent
disease.
Canons: Major Concepts
1. Ventilation and Warmth
2. Light and Noise
3. Cleanliness of rooms/walls
4. Health and houses
5. Bed and bedding
6. Personal Cleanliness
7. Variety
8. Chattering hopes and advices
9. Nutrition and Taking Food
10. Petty management/observation
Metaparadigm:
Person
Recipient of nursing care.
People are multidimensional, composed of
biological, psychological, social, and
spiritual components.
Environment
Environment can be external as well as
internal.
Poor or difficult environments led to poor
health and disease.
Environment could be altered to improved
conditions so that the natural laws would
allow healing to occur.
Health
For nightingale, health is “not only to be
well, but to be able to use well every power
we have”.
Disease is considered as dys-ease or the
absence of comfort. [Six D’s of Dys-ease
are: Dirt, Drink (need clean drinking water),
Diet, Damp, Draughts, and Drains (need
proper drainage and sewer systems)]
Nursing
Nursing to nightingale was above all,
“Service to God in the relief of man”
To alter or manage the environment to
implement the natural laws of health.
Nursing is different from, medicine and the
goal of nursing is to place the patient in the
best possible condition for nature to act.
Nursing is the activities that promote health
(as outlined in canons) which occur in any
caregiving situation.
 JEAN WATSON
Theory of Human Caring
Born June 10, 1940
American nurse theorist and nursing
professor known for her Philosophy and
Theory of transpersonal caring.
Graduated from the Lewis School of
Nursing in 1961
Established the Centre of Human Caring at
the University of Colorado
Theory of Human Caring Philosophy
Watson’s Philosophy and Science of Caring
is concerned with how nurses express care to
their patients
Her theory stresses the humanistic aspects of
nursing as they intertwine with scientific
knowledge and nursing practice
“…Nursing is concerned with promoting
health, preventing illness, caring for the
sick, and restoring health.” 
Philosophy:
 Caring is central to nursing practice and
promotes health better than a simple medical
cure.
 She believes that a holistic approach to
healthcare is central to the practice of caring
in nursing.
 According to her theory, caring can be
demonstrated and practiced by nurses
 Caring for patients promotes growth; a
caring environment accepts a person as they
are and looks to what they may become.
 The Watson Science Caring Institute aims to
integrate “care” into the healthcare system
 She contends that caring can help the person
gain control, become knowledgeable, and
promote healthy changes.
Major Concepts:
Caring Occasion / Caring Moment
 The moment when a nurse and patient
connect in a way that an occurrence for
human caring is created
Transpersonal Caring Relationships
 Conveys a human-human connection
Carative Factors
Metaparadigm:
Person
She referred to the human beings as a valued
person in and of themselves to be cared for,
respected, nurtured, understood, and
assisted; in general, a person’s philosophical
view as a fully functional integrated self.
Health
Watson defined health as “unity and
harmony within the mind, body, and soul”;
associated with the “degree of congruence
between the self as perceived and the self as
experienced”
Nursing
nursing is a science of persons and health-
illness experience mediated by professional,
personal, scientific, and ethical care
interactions. is concerned with promoting
health, preventing illness, caring for the
sick, and restoring health.” 
Environment
nursing is a science of persons and health-
illness experience mediated by professional,
personal, scientific, and ethical care
interactions. is concerned with promoting
health, preventing illness, caring for the
sick, and restoring health.” 
Applying to Nursing Care
 Create a Caring Relationship
 Display unconditional acceptance
 Apply a holistic treatment approach which
includes treating the mind, soul, and spirit as
well as the body
 Take time to have uninterrupted moments
with the patients – caring moments
 Use knowledge and intervention to promote
health and healing
 PATRICIA BENNER
Theory of Novice to Expert
was born in Hampton, Virginia, and spent
her childhood in California
She obtained a baccalaureate of arts degree
in nursing from Pasadena College in 1964
and earned a master’s degree in nursing, PATRICIA BENNER'S MAJOR CONCEPT
with major emphasis in medical-surgical
nursing, from the University of California,
San Francisco (UCSF) School of Nursing in
1970.
Philosophy:
 “The nurse-patient relationship is not a
uniform, professionalized blueprint but
rather a kaleidoscope of intimacy and
distance in some of the most dramatic,
poignant, and mundane moments of life.”
 She stated that knowledge development in a
practice discipline “consists of extending Novice
practical knowledge (know-how) through has no experience
theoretical/theory-based scientific task/skill focused
investigations and through the charting of rule follower
the existent ‘know-how’ developed through inflexible
clinical experience in the practice of that
discipline” Advanced Beginner
has some experience
Major Concept: past experience guides actions
“From Novice to Expert”
Competent
nurses develop skills and an understanding 2 - 3 years experience
of patient care over time from a combination good time management
of a strong educational foundation and deliberate planning
personal experiences. thinks analytically

Hubert Dreyfus Proficient

holistic understanding
was the philosopher who introduced Benner uses experiences to anticipate needs
to phenomenology
Hubert Dreyfus and Stuart Dreyfus Expert
flexible
created the Dreyfus Model of Skill intuitive
Acquisition lots of experience
just comes naturally

Metaparadigm:
DREYFUS MODEL OF SKILL ACQUISITION
Nursing
Nursing is described as a caring
relationship, an “enabling condition of
connection and concern”
“Caring is primary because caring sets up
the possibility of giving help and receiving
help”
“Nursing is viewed as a caring practice
whose science is guided by the moral art
and ethics of care and responsibility”
Person
“The person is viewed as a participant in
common meanings”
The person is embodied. Benner and Wrubel
(1989) conceptualized the following four
major aspects of understanding that the
person must deal with:
1. The role of the situation
2. The role of the body
3. The role of personal concerns
4. The role of temporality
Together, these aspects of the person make up the
person in the world.

Health
Health is defined as what can be assessed,
whereas well-being is the human experience
of health or wholeness. Well-being and
being ill are understood as distinct ways of
being in the world.
Health is described as not just the absence of
disease and illness. Health pertains more on
the physical, physiological and observable,
in contrast with well-being that is more on
the experiential and psychological

Situation
Benner and Wrubel (1989) use the term
situation rather than environment, because
situation conveys a social environment with
social definition and meaningfulness.
“Personal interpretation of the situation is
bounded by the way the individual is in it”
This means that each person’s past, present,
and future, which include her or his own
personal meanings, habits, and perspectives,
influence the current situation.
 KATIE ERIKSSON
Caritative Caring Theory
Born on November 18, 1943 in Jakobstad,
Finland
Belongs to the Finland Swedish Minority
native language is Swedish
A Finland-Swedish Nurse
A graduate at Helsinki Swedish School of
Nursing in 1965
Philosophy:
"Caritative caring means that we take "caritas" into
use when caring for the human being in health and
suffering....Caritative caring is a manifestation of
the love that "just exist".... Caring communion, true
caring, occurs when the one caring in a spirit of
caritas alleviates the suffering of the patient."
Major Concepts:
Caritas
means "love and charity"
also means it is an endeavor to mediate faith,
hope, and love through tending, playing, and
learning
Caring Communion
Constitutes the context of the meaning of
caring and is the structure that determines
caring reality.
A form of intimate connection that
characterizes caring.
It requires meeting in time and space, an
absolute lasting presence.
It cannot be taken for granted but
presupposes a conscious effort to be with the
other.
Seen as the source of strength and meaning
in caring.
The Act of Caring
Contains the elements (faith, hope, love,
tending, playing and learning).
It invites to deep communion.
Making something very special out of
something less special.
Caritative caring ethics
Comprises the ethics of caring.
It is the core of which is determined by the
caritas motive.
Deals with the basic relationship between
the patient and the nurse
Dignity
Constitutes one of the basic concepts of
caritative caring ethics.
Absolute dignity is granted the human being
through creation whereas relative dignity is
influenced and formed through culture and
external contexts.
Invitation
Refers to the act that occurs when the carer
welcomes the patient to caring communion.
Suffering
described as a human being's struggle between
good and evil in a state of becoming
Suffering Related to Illness, to Care, and to
Life
These are three different forms of suffering.
It is experienced in connection with the illness
or disease and treatment.
The Suffering Human Being
The patient refers to the concept of patiens
(Latin), which means "suffering".
The patient is a suffering human being, or a
human being who suffers and patiently endures.
Reconciliation
Refers to the drama of suffering
Implies a change through which a new
wholeness is formed of the life the human being
has lost in suffering
Caring Culture
It characterizes the total caring reality and is
based on cultural elements such as traditions,
rituals, and basic values.
Transmits an inner order of value preferences or
ethos, and different constructions of culture have
their basis in the changes of value that ethos
undergoes.
Metaparadigm:
Nursing
 Eriksson’s basic motive of caring is Caritas
( Love and charity)
 She emphasizes that caritative caring relates to
the innermost core of Nursing
 The act of caring expresses the innermost spirit
of caring and recreates the basic motive of
caritas.
Person / Human being
 Human being is an entity of body, soul, and
spirit
 Human being is fundamentally holy
 Eriksson sees the human being’s conditional
freedom as a dimension of becoming.
 Human being is fundamentally dependent on
communion.
Environment
 Characterizes the total caring reality based on
cultural elements
 Ethos reflects the prevailing priority of values
through which the basic foundations of ethics
and ethical actions appear
Health
 Eriksson define health as a movement in
becoming, being, and doing while striving for
 wholeness and holiness, which is compatible
with endurable suffering,

MARTHA ROGERS
Science of Unitary Human Beings

Born on May 12, 1914, in Dallas Texas

Died on March 13, 1994
believes that a patient should never be
removed from his or her surroundings.
Human's coexistence with its surroundings
and it played a significant role in the process
toward greater health.
 Theory
Rogers’ system model is commonly known
as “Science of Unitary Human Beings”.
Rogers’ addresses the importance of the
environment as an integral part of the patient
She believed that human and his
environment are a single unit and therefore,
must be studied together. She also felt that
human beings and their environment evolve,
change, and move ahead together and after
the change occurs, both humans and their
environment cannot return to their former
stage.
Nursing is viewed as both a science and an
art that is humanistic and humanitarian in
the theory because it provides a means to
view the unitary human person as an
intrinsic part of the universe. Nursing is
concerned with people and the outcomes of
the mutual human-environmental field
interaction with their environment.
SUHB contains two dimensions:
Science of nursing- the knowledge specific
to the field of nursing that comes from
scientific research.
Art of nursing- involves using the science
of nursing creatively to help better the lives
of the patient.
Philosophy
1. “Man is a unified whole possessing his own
integrity and manifesting characteristics
more than and different from the sum of his
parts” (energy field) (p. 47)
2. “Man and environment are continuously
exchanging matter and energy with one
another” (openness) (p. 54).
3. “The life process evolves irreversibly and
unidirectional along the space-time
continuum” (helicy) (p. 59).
4. “Pattern and organization identify man and
reflect his innovative wholeness” (pattern
and organization) (p. 65).
5. “Man is characterized by the capacity for
abstraction and imagery, language and
thought, sensation, and emotion” (sentient,
thinking being) (p. 73).
Major Concept
Energy field
- The continuously flowing energy fields
are the basic units of both living and
non-living things.
Openness
- The human field and the environmental
field are open system which are
constantly in mutual process.
Pattern
- Pattern is defined as the distinguishing
characteristic of an energy field
perceived as a single wave.
Pan dimensionality
- Pan dimensionality is defined as
“nonlinear domain without spatial or
temporal attributes.”
Principles of Homeodynamics
Homeodynamics
- Refers to the balance between the
dynamic life process and environment.
3 Principles
1. Resonancy- continuous change from the
lower to higher frequency wave pattern in
the energy fields.
2. Helicy- the nature of change is
unpredictable, continuous, and innovative.
3. Integrality- there is a continuous and
mutual process between human field and
environmental field.
Metaparadigm

Unitary Human Being (Person)

• It is defined as an indivisible, pan-
dimensional energy field identified by a
pattern and manifesting characteristics
specific to the whole.
• A unitary human being is an open system
which continuously interacts with
environment.
• A person cannot be viewed as parts, it
should be considered as a whole.

Environment
• Rogers defines environment as irreducible,
not limited by space and time, identified by
its pattern and organization.
• The environment is in constant interaction
with the human being.
• Environmental fields are infinite, and
change is continuously innovative,
unpredictable, and characterized by
increasing diversity.

Health
• Rogers defines health as an expression of the
life process.
• It is determined by the interaction between
energy fields of human and environments.
• Bad interaction or misplacing of energy
leads to illness.

Nursing
• The focus of nursing is the care of people
within their life process and the lived
experience.
• Nursing exists for the care of people and the
life process of humans.
• Aims to assist people in achieving their
maximum health potential.
 DOROTHEA OREM
Self-Care Deficit Theory
- Born on July 15, 1914
- Died on June 22, 2007
Theory
Self-Care Deficit Theory
 “The act of assisting others in the provision
and management of self-care to maintain or
improve human functioning at the home
level of effectiveness.”
 “the practice of activities that individuals
initiate and perform on their own behalf in
maintaining life, health, and well-being.”
 composed of three interrelated theories:
o the theory of self-care
o the self-care deficit theory, and
o the theory of nursing systems
Philosophy
“Patients are better able to recover when they
maintain some independence over their own self-
care. Self-care deficit theory focuses on the specific
scenarios needing to recognize whether a patient or
an individual is facing a self-care deficit.”
Major Concepts
Self-Care - practice of activities that
individuals initiate and perform on their own
behalf in maintaining life, health, and well-
being.
Dependent Care - refers to the care that is
provided to a person because of age or
related factors that is unable to perform self-
care in maintaining life, health, and well-
being.
Self-care requisites - the action or measures
used to provide self-care. A need is also a
requirement within an individual or group
which stimulates a response to maintain
integrity.
Three Categories:
 Universal
 Developmental
 Health Deviation
Therapeutic self-care demand - complex
theoretical concept that summarizes all
actions that should be performed over time
for life, health, and well-being.
Dependent Care Demand - summation of
care measures at a specific point in time
over a duration of time for meeting the
dependent’s therapeutic self-care demand.
Self-care agency - complex acquired ability
of mature and maturing persons to know and
meet their continuing requirements to
perform self-care activities.
Two Agent:
 Self-care agent
 Dependent care agent
Self-care deficit - inability to perform
certain functions related to health and well-
being.
Metaparadigm
Person
 The recipient of nursing care
 Someone that functions biologically,
symbolically, and socially
 Has the potential for learning &
development
 Is subject to the forces of nature
 Has a capacity for self-knowledge
 Can engage in deliberate actions, interpret
experiences, and perform beneficial actions
 Can learn to meet self-care needs
(requisites)
 Human beings are distinguished from other
living beings by their capacity
Environment
 Environmental conditions can be external
and/or psychosocial surroundings
 Developmental environments promote goal
achievement
 The quality of an environment can positively
or negatively impact a person’s ability to
provide self-care
Nursing
 A service geared towards helping the self
and others
 Is required when self-care demands exceed a
patient’s self-care ability (agency)
 Promotes the patient as a self-care agent
 Comprised of several components
Health
 Orem accepts the fundamental importance of
the given aspect and assumes that the term
healthy should be used to describe the
normal state of individuals when they are
structurally and functionally sound and are
able to perform their traditional activities
 IMOGENE KING
Theory of Goal Attainment
- Born on January 30, 1923
- Died on December 24, 2007
- One of the pioneers and most sought
nursing theorists for her Theory of Goal
Attainment, which she developed in the
early 1960s.
Theory
Theory of Goal Attainment
 She developed a general systems framework
and a theory of goal attainment where the
framework refers to the three interacting
systems - individual or personal, group or
interpersonal, and society or social.
 King emphasizes that both the nurse and the
client bring important knowledge and
information to the relationship and that they
work together to achieve goals.  being, or self, who perceives, thinks,
 Imogene King’s concepts focus on these
methods to help nurses in the nurse-patient
relationship. 
 King used a “systems” approach in the
development of her dynamic interacting
systems framework and in her subsequent
Goal-Attainment Theory.  o Growth and development
 According to Imogene King, nursing's focus
is on the care of the patient, and its goal is
the health care of patients and groups of
patients.
Philosophy
“Nursing is a process of action, reaction and
interaction by which nurse and client share
information about their perception in a
nursing situation”
“A process of human interactions between
nurse and client whereby each perceives the
other and the situation, and through
communication, they set goals, explore
means, and agree on means to achieve
goals.”
“Nursing is an observable behavior found in
the health care systems in society. The goal
of nursing is to help individuals maintain
their health so they can function in their
roles.” Imogene King (1998)
“The nursing domain involves human
beings, families and communities as a
framework within which nurses make
transactions in multiple environments with
health as goal.”
Major Concepts
Open Systems Model / Interacting Systems
Framework / General Systems Framework
- “focuses on the continuing ability of
individuals to meet their basic needs so
that they may function in their socially
defined roles, as well as on individuals’
interactions within three dynamic,
interacting systems.”
Personal systems (individuals)
- These are fundamental concepts in
understanding a human being.
- An individual is described as “a unified
desires, imagines, decides, and identifies
goals to be achieved” (King, 1981, p.
19).
The concepts of the personal system include:
o Perception
o Self
o Time
o Body image
o Learning
o Personal Space
Interpersonal systems (groups)
- Consist of groups or individuals
interacting with one another.
- Displays how the relationship between
the nurse and patient is important for the
achievement and development of goals.
- Most important system according to
King.
The concepts of the interpersonal system include
o Interaction
o Transaction
o Communication
o Role
o Coping
o Stress
Social systems (society)
- are groups of people within a community
or society who share common goals,
interests, and values.
- It provides a framework for social
interaction and relationships and
 establishes rules of behavior and courses
of action (King, 1971).

The concepts identified within the social systems
are:
o Organization
o Authority
o Power
o Status
o Control
o Decision making
Metaparadigm
Human Beings/Person
 Are open, social beings who are unique,
rational, sentient, and capable of making
decisions.
 Have the ability to perceive, think, feel,
choose, set goals and select means to
achieve goals.
 Have values that are linked to their
culture and dictate their behavior and
goals.
 Differ in their needs, desires, and goals
 Have three fundamental needs, which
include the following:
 Health information
 Care that seeks to prevent illness
 Care when they are unable to
help themselves
Health
• Is the dynamic life experiences of a human
being, which calls for the continuous
adjustment to stressors in the internal and
external environments causing the optimum
use of one’s resources to achieve
• Is made up of genetic, subjective, relative,
dynamic, environmental, functional,
cultural, and perceptual characteristics.
Nursing
 Nursing is a goal-seeking system where the
performance of roles and responsibilities
assists human beings to attain, maintain, and
restore health.
 Nursing is a series of actions, reactions, and
interactions where the nurse and client
exchange information and perceptions and
set goals and determine the means to achieve
the goals.
 Human beings and their actions are the focus
of nursing.
King’s model reflects the general systems theory of
nursing by encompassing the metaparadigm
concepts of human beings, environment, health, and
nursing.
Nursing is a process of action, reaction, and
interaction whereby nurse and client share
information about their perceptions in the nursing
situation.
Health is a dynamic life experience of a human
being, which implies continuous adjustment to
stressors in the internal and external environment
through optimum use of one’s resources to achieve
maximum daily living potential.
Human beings/Persons are social beings who are
rational and sentient. Humans communicate their
thoughts, actions, customs, and beliefs through
language.
The environment is the background for human
interactions. It is both external to, and internal to,
the individual.

Environment
 Environment is the background for human
interactions.
 Environment involves internal and external
components where:

 Internal environment - transforms

energy to enable humans to adjust to
continuous external changes.
 External environment - involves
formal and informal organizations
and is a source of stress and
continuous changes.

 Understanding the ways in which humans

interact with their environment to maintain
health is necessary for nursing professionals
 BETTY NEUMAN
Neuman Systems Model
- Born on 1924 in near Lowell, Ohio
Neuman Systems Model
 Unique system-based perspective that
provides a unifying focus for approaching a
wide range of nursing concerns
 In 1972, Neuman’s model was first
published as a “model for teaching total
person approach to patient problems” in
Nursing Research
 Based on stress and the reaction /potential
reaction to stress with a philosophical basis
in wholeness, wellness, client perception and
motivation, energy, and environmental
reaction (Neuman,2002)
 It focuses on the response of the
maintenance of the client’s system’s stability
through primary, secondary, and tertiary
nursing prevention intervention to reduce
stressors.
Philosophy
The central philosophy of Neuman’s nursing
theory consists of energy resources that are
surrounded by three things: several lines of
resistance, which represent the internal factors
helping the patient fight against a stressor; the
normal line of defense, which represents the
patient’s equilibrium; and the flexible line of
defense, which represents the dynamic nature that
can rapidly change over a short time.
Major Concepts
Basic Structure and Energy Resources
- The basic structure, or central core,
comprises those basic survival factors
common to the species. These factors
include the system variables, genetic
features, and strengths and weaknesses of
the system parts.
Open System
- In the Neuman Model, human being is
looked upon as an open system in contact
with his environment.
- The human is constantly changing, moving
toward a dynamic state of system stability or
illness of varying degrees.
Flexible Line of Defense
- Neuman describes the flexible line of
defense as the client system’s first protective
mechanism.
- It is perceived as serving as a protective
buffer for preventing stressors from breaking
through the usual wellness state as
represented by the normal line of defense.
Normal Line of Defense
- It is considered to be the usual level of
stability in the system.
- It can change over time in response to
coping or responding to the environment.
Lines of Resistance
- The last boundary that protects the basic
structure
- Protects the basic structure and becomes
activated when environmental stressors
invade the normal line of defense. (Example:
when a certain bacteria enters our systems,
there is an increase in leukocyte count to
combat infection.
Client Variables
 Physiological variable
o Refers to the structure and
functions of the body
 Psychological variable
o Refers to mental processes and
relationships
 Sociocultural variable
o Refers to system functions that
relate to social and cultural
  Developmental variable
o Refers to processes related to
development over lifespan
 Spiritual variable
o Refers to the influence of
spiritual beliefs
Reconstruction
- The increase in energy that occurs in relation
to the degree of reaction to the stressor.
- Reconstitution begins at any point following
initiation of treatment for invasion of
stressors.
- It may expand the normal line of defense
beyond its previous level, stabilize the
system at a lower level or return it to the
level that existed before the illness.
Stressors
- The Neuman Systems Model looks at the
impact of stressors on health and addresses
stress and the reduction of stress. They are
capable of having either positive or negative
effect on the client system.
 Intrapersonal stressors – occur within
person, e.g. emotions and feelings
 Interpersonal stressors – occur between
individuals, e. g. role expectations
 Extra personal stressors – occur outside the
individual, e. g. job or finance pressures
Prevention
As defined by Neuman’s model, prevention
is the primary nursing intervention.
●Primary -- Occurs before the system reacts to a
stressor. It strengthens the person (flexible line of
defense) to enable him to better deal with stressors.
Primary prevention includes health promotion and
maintenance of wellness.
● Secondary – Occurs after the system reacts to a
stressors. It focuses on preventing damage to the
central core by strengthening the internal lines of
resistance and/or removing the stressor.
● Tertiary – Occurs after the system has been
treated through secondary prevention strategies.
Tertiary prevention offers support to the client and
attempts to add energy to the system or reduce
energy needed in order to facilitate reconstitution.
Metaparadigm
Person
- An open system that works together with
other parts of its body as it interacts with the
environment
Environment
- Can be internal, external, or created
forces(stressors) that interact with a person’s
state of health
- Has the potential to improve stability of
system
Health
- Dynamic condition, wellness exists when all
of the parts of the system of the person work
harmoniously
Nursing
- A unique profession that requires holistic
approach, considers all factors affecting
client’s health
- Aims to promote optional wellness to its
client through retention, attainment or
maintenance of the stability of client’s
system
 CALLISTA ROY
Roy’s Adaptation Model
Coping Processes
- Born on October 14, 1939 in Los Angeles, - “are innate or acquired ways of interact ing
California with the changing environment”
- Sister Callista Roy, a member of the Sisters
of Saint Joseph of Carondelet
- Roy was challenged in a seminar with
Dorothy E. Johnson to develop a conceptual
model for nursing
 Innate coping mechanisms “are genetically
Theory determined or common to the species and
Roy’s Adaptation Model of Nursing are generally viewed as automatic processes;
humans do not have to think about them”

 Acquired coping mechanisms “are

developed through strategies such as
learning. The experiences encountered
throughout life contribute to customary
responses to particular stimuli”

Coping Mechanism is categorized:

 Regulator Subsystem
 Roy derived her adaptation model for - “a major coping process involving the
nursing from Harry Helson's work in neural, chemical, and endocrine systems”
psychophysics
 Cognator Subsystem
 She developed a more refined model with
- “a major coping process involving four
concepts and theory from Dohrenwend et al.
cognitive-emotive channels: perceptual and
 After, she presented it as a framework for
information processing, learning, judgment,
nursing practice, research, and education
and emotion”
Major Concepts
Four Adaptive Modes
 Physiological-Physical Mode
Adaptation
- is associated with the physical and chemical
- refers to “the process and outcome whereby
processes involved in the function and
thinking and feeling persons, as individuals
activities of living organisms”
or in groups, use conscious awareness and
choice to create human and environmental
 Self-Concept–Group Identity Mode
integration”
- is one of the three psychosocial modes; “it
focuses specifically on the psychological
Three Classes of Stimuli
and spiritual aspects of the human system"
 Focal Stimuli
- is “the internal or external stimulus most
 Role Function Mode
immediately confronting the human system”
- “is one of two social modes and focuses on
 Context Stimuli
the roles the person occupies in society. A
- “are all other stimuli present in the situation
role, as the functioning unit of society, is
that contribute to the effect of the focal
defined as a set of expectations about how a
stimulus"
person occupying one position behaves
 Residual Stimuli
toward a person occupying another position
- “are environmental factors within or
without the human system with effects in the
 Interdependence Mode
current situation that are unclear”
 - focuses on close relationships of people
(individually and collectively) and their
purpose, structure, and development
Roy’s six-step nursing process, the nurse
performs six functions:
1. Assesses the behaviors manifested from the four
adaptive modes
2. Assesses the stimuli for those behaviors and
categorizes them as focal, contextual, or residual
stimuli
3. Makes a statement or nursing diagnosis of the
person’s adaptive state
4. Sets goals to promote adaptation
5. Implements interventions aimed at managing the
stimuli to promote adaptation
6. Evaluates whether the adaptive goals have been
met
Philosophy
 Persons have mutual relationships with the
world and God.
 Human meaning is rooted in the omega
point convergence of the universe.
 God is intimately revealed in the diversity of
creation and is common destiny of creation.
 Persons use human creative abilities of
awareness, enlightenment, and faith.
 Persons are accountable for the processes of
deriving, sustaining, and transforming the
universe.
Metaparadigm
Nursing
 Health care profession that focuses on
human life processes and patterns and
emphasizes promotion of health for
individuals, families, groups, and society as
a whole.
 Nursing science is a developing system of
knowledge about persons that observes,
clarifies, and relates the processes by which
persons positively affect their health status.
 Goal: promotion of adaptation for
individuals and groups in each of the four
adaptive modes thus contributing to health,
quality of life, and dying with dignity.
Person
 As an adaptive system, the human system is
described as a whole with parts that function
as unity for some purpose.
 Human systems have thinking and feeling
capacities, rooted in consciousness and
meaning, by which they adjust effectively to
changes in the environment and, in turn,
affect the environment.
Environment
 All conditions, circumstances, and
influences surrounding and affecting the
development and behavior of persons or
groups with particular consideration of the
mutuality of persons and earth resources that
includes focal, contextual, and residual
stimuli.
Health
 Health is a state and a process of being and
becoming integrated and a whole person. It
is a reflection of adaptation, that is, the
interaction of the person and the
environment.
 DOROTHY JOHNSON
Behavioral System Theory
- Born on August 21, 1919 in Savannah,
Georgia
- She is the developer of the Johnson
Behavioral System Model (JBSM)
Theory
Johnson's Behavioral System Model
 Johnson’s Behavioral System Model
(JBSM) was heavily influenced by Florence
Nightingale’s book
 The behavioral system and the environment
are linked by interactions and transactions
 is a nursing care model that advocates the
fostering of efficient and effective
behavioral functioning in the patient to
prevent illness.
 Goal of the model is to maintain and restore
balance in the patient by helping him
achieve a more optimal level of functioning
Johnson’s model incorporates five (5) core
principles of system thinking:
 Wholeness and Order
 Stabilization
 Reorganization
 Hierarchic Interaction
 Dialectical Contradiction
The Behavioral System is composed of seven (7)
behavioral subsystems:
 Affiliative Subsystem
 Dependency Subsystem
 Ingestive Subsystem
 Eliminative Subsystem
 Sexual Subsystem
 Aggressive Subsystem
 Achievement Subsystem
Each subsystem is comprised of 4 Structural
Elements of Subsystems:
 Universal Drive
 Set
 Course
 Action
Johnson and her colleague, Lulu K. Wolf
Hassenplug, founded the first four-year generic
basic nursing program in the United States
Philosophy
“All of us, scientists and practicing professionals,
must turn our attention to practice and ask questions
of that practice. We must be inquisitive and
inquiring, seeking the fullest and truest possible
understanding of the theoretical and practical
problems we encounter.”
 Johnson believed that medicine and nursing
are two distinct specialties with two
different focal points; medicine's focus is on
the biological system while nursing's focus
is on the behavioral system.
 She considered nursing a science as well as
an art and felt that nursing education was for
the purpose of improving the future of
nursing care.
“Nursing is an external regulatory force that acts to
preserve the organization and integration of the
patient’s behavior at an optimal level under those
conditions in which the behavior constitutes a threat
to physical or social health or in which illness is
found.”
Major Concepts
 Focuses on the basic needs of the person and
has concern for relationship between the
person and the environment
 The person has 7 behavioral subsystems
affiliative, dependency, ingestive,
eliminative, sexual, aggressive, and
achievement; and that are interrelated with
each other
 The goal of Johnson’s Behavioral System
model is to reduce stressful stimuli, and
second, by supporting natural and adaptive
processes
Assumptions in the Behavioral System Model
o assumptions about system
o assumptions about structure
o assumptions about functions
 Behavioral System
- Encompasses the patterned, repetitive, and
purposeful ways of behaving
7 Subsystems
1. Attachment-Affiliative Subsystem
- Is identified as the first response system to
develop in the individual
- The optimal functioning of the affiliative
subsystem allows “social inclusion,
intimacy, and the formation and
maintenance of a strong social bond”
2. Dependency Subsystem
- The dependency subsystem promotes
helping behavior that calls for a nurturing
response
- Developmentally, dependency behavior
evolves from almost total dependence on
others to a greater degree of dependence on
self. A certain amount of interdependence is
essential for the survival of social groups
3. Ingestive Subsystem
- The ingestive subsystem “has to do with
when, how, what, how much, and under
what conditions we eat”
- “It serves the broad function of appetitive
satisfaction” This behavior is associated
with social, psychological, and biological
considerations
- relates to the behaviors surrounding the
intake of food
4. Eliminative Subsystem
- The eliminative subsystem addresses “when,
how, and under what conditions we
eliminate”
- As with the ingestive subsystem, the social
and psychological factors are viewed as
influencing the biological aspects of this
subsystem and may be, at times, in conflict
with the eliminative subsystem
- relates to behaviors surrounding the
excretion of waste products from the body
5. Sexual Subsystem
- has the dual functions of procreation and
gratification. Including, but not limited to,
courting and mating, this response system
begins with the development of gender role
identity and includes the broad range of sex-
role behaviors
6. Achievement Subsystem
- Intellectual, physical, creative, mechanical,
and social skills are some of the areas that
Johnson recognizes. Its function is control or
mastery of an aspect of self or environment
to some standard of excellence
7. Aggressive-Protective Subsystem
- relates to behaviors concerned with
protection and self-preservation
- relates to behaviors concerned with
protection and self-preservation
Equilibrium
- It is defined as “a stabilized but more or less
transitory, resting state in which the
individual is in harmony with himself and
with his environment”
Regulation/Control
- The interrelated behavioral subsystems must
be regulated in some fashion so that its goals
can be realized
Stressor
- A stimulus from the internal or external
world that results in stress or instability.
Tension
- The system’s adjustment to demands,
change or growth, or to actual disruptions
Structural Components
1. Drive or goal – the ultimate consequence of
behaviors
2. Behavioral Set – is a tendency to act in a certain
way in a given situation which is subdivided into 2
types:
Preparatory: what a person usually attends to
Perseverative: the habits one maintains in a
situation
3. Choice – represents the behavior a patient sees
himself or herself as being able to use in any given
situation
4. Action – the observable behavior of the person
Functional Requirements
1. Protection – from noxious influences with which
the system cannot cope
2. Nurturance - through the input of appropriate
supplies from the environment
3. Stimulation – to enhance growth and prevent
stagnation
System Environment
External – may include people, objects, and
phenomena
Internal – internalized intervening variables such as
ego, attitudes, and physiology

Metaparadigm

Person
- Johnson viewed the person as a behavioral
system with patterned, repetitive, and
purposeful ways of behaving that link the
person with the environment
- The person is composed of 7 subsystems
that are interdependent to one another and
that it requires regularity and adjustment to
maintain balance

Nursing
- is an external force acting to preserve the
organization and integration of the patient’s
behavior to an optimal level by means of
imposing temporary regulatory or control
mechanisms or by providing resources while
the patient is experiencing stress or
behavioral system imbalance
- Nursing views patients as behavioral
systems and medicine views patients as
biological systems
- The goal of nursing care emphasizes
balance, stability, order, and maintenance of
the integrity of the patient

Health
- Nursing views patients as behavioral
systems and medicine views patients as
biological systems
- The goal of nursing care emphasizes
balance, stability, order, and maintenance of
the integrity of the patient

Environment
- the environment consists of all the factors
that are not part of the individual’s
behavioral system, but that influence the
system
- all elements of the human system’s
surroundings and includes interior stressors
- The nurse may manipulate some aspects of
the environment so the goal of health or
behavioral system balance can be achieved
for the patient
 HILDEGARD PEPLAU
Theory of Interpersonal Relations
- Born on September 1, 1909 in Reading,
Pennsylvania
- Died on March 17, 1999
- Was a pioneer in nursing
- Also known as Hilda (nickname)
- Known to be the “Mother of Psychiatric
Nursing” and “Nurse of the Century”
Theory
Interpersonal Relations Theory
- Primarily developed by Harry Stack Sullivan
- A theory that originated from Psychology
- A personality theory that is based on the
belief that people’s interactions with other
people, especially significant others,
determine their sense of security, sense of
self, and the dynamisms that motivate their
behavior.
- She published Interpersonal Relations in
Nursing in 1952, referring to her book as a
"partial theory for the practice of nursing".
- The theory describes the importance of the
nurse-patient relationship as a “significant,
therapeutic interpersonal process”.
- Emphasizes the need for a partnership
between nurse and client as opposed to the
client passively receiving treatment and the
nurse passively acting out doctor’s orders.
Philosophy
- Defined Nursing as “An interpersonal
process of therapeutic interactions
between an individual who is sick or in
need of health services and a nurse
especially educated to recognize, respond
to the need for help.” It is a “maturing
force and an educative instrument”
involving an interaction between two or
more individuals with a common goal.
- In nursing, this common goal provides the
incentive for the therapeutic process in
which the nurse and patient respect each
other as individuals, both of them learning
and growing due to the interaction. An
individual learns when she or he selects
stimuli in the environment and then reacts to
these stimuli.
Major Concepts
Psychodynamic Nursing
- Describes how the nurse-patient relationship
changes over time
- Understanding of one’s own behavior
- To help others identify felt difficulties
- Will help to apply principles of human
relations to the problem that arise at all
levels of experience
Therapeutic Nurse-Client Relationship
- A professional and planned relationship
between client and nurse that focuses on the
clients needs, feelings, problems, and ideas
- Involves interaction between two or more
individuals with a common goal (mutual
goal), thus nursing is considered as an
interpersonal process
Four Sequential Phases of the Therapeutic
Nurse-Client Relationship
 Orientation
 Identification
 Exploitation
 Resolution
Orientation
- Directed by the nurse and involves engaging
the client in treatment providing
explanations of information, and answering
question
 Nurse and patient meet as strangers
 Problem defining phase and deciding
what type of service is needed
 Client seeks assistance, conveys
needs, ask questions, shares
preconceptions and expectation of
past experiences
 Nurse responds, explains roles to
client, helps to identify problems and
to use available resources and
services
 Includes explaining nursing
procedures
 Includes explaining nursing
procedures
 Sub Concepts
7 Nursing Roles
1. Stranger
- Offering the client the same acceptance and
courtesy that the nurse would respond to any
stranger
- Accepting the patient whatever
circumstance, there should be no
discrimination.
Identification
2. Resource Person
- Begins with the client working
 One who provides specific, needed
interdependently with the nurse, expresses
information that aids in understanding a
feelings, and begins to feel stronger
problem or a new situation
 Selection of appropriate professional
assistance
3. Teacher
 Patients begin to have a feeling of
 One who imparts knowledge concerning a
belonging and a capability of dealing
need or interest
with the problem which decreases
 Helping the client to learn formally or
the feeling of helplessness and
informally; particular skill or knowledge that
hopelessness
relates to your concern
 Patient identifies with those who can
help him/her
4. Leader
 One who carries out the process of initiation
Exploitation
and maintenance of group goals through
- The client makes full use of the services
interaction
offered
 Offering direction to the client or group
 Use professional assistance for
problem solving alternatives
5. Surrogate
 Advantages of services are used
 Serving as a substitute for another such as a
based on the needs and interest of the
parent or a sibling
patients
 Individual feels an integral part of
6. Counselor
the helping environment
 One who, through the use of certain skills
 Interventions are now being provided
and attitudes, aids another in recognizing,
to patients
facing, accepting, and resolving problems
 Patients may make minor requests or
that are interfering with the other person’s
attention getting techniques
ability to live happily and effectively
Resolution
7. Technical Expert
- In this phase, the client no longer needs
 Providing physical care for the patient and
professional services and gives up dependent
operates equipment
behavior
- This is where the relationship ends
 Termination of professional
relationship
 The patient’s needs have already
been met
 Now they need to terminate their
therapeutic relationship and dissolve
the links between them
 Sometimes may be difficult for both
as psychological dependence persists
Metaparadigm

Person
- Peplau defines man (used in generic terms)
as an organism that “strives in its own way
to reduce tension generated by needs”
- An individual

Environment
- Although Peplau does not directly address
society/environment, she does encourage the
nurse to consider the patient’s culture and
mores when the patient adjusts to hospital
routine.

Health
- Defined as “a word symbol that implies
forward movement of personality and other
ongoing human processes in the direction of
creative, constructive, productive, personal,
and community living”

Nursing
- Peplau considers nursing to be a
“significant, therapeutic, interpersonal
process”
- A “human relationship between an
individual who is sick, or in need of health
services, and a nurse especially educated to
recognize and to respond to the need for
help”
- Functions cooperatively with other human
process that make health possible for
individuals in communities
- Involves problem solving
 JEAN ORLANDO
Deliberative Nursing Process Theory
- Born on August 12, 1926
Theory
Deliberative Nursing Process Theory
She extended her theory to include the entire
process then later evolved as the Nursing Process
Discipline
- Stresses the reciprocal relationship between
patient and nurse
- Focuses on how to produce improvement in
the patient’s behavior
- Employs a reflective principle for inference
testing
- What the nurse and the patient say and do
affects them both
Was able to categorize records
into two sets:
 Good Nursing
- focuses on the deliberative interpretation of
the patient
 Bad Nursing
- focuses on what is called the automatic
nursing formulation
Philosophy
“The function of
professional nursing is to
find out and meet the
patient’s immediate needs
for HELP”
“Persons become patients requiring
nursing care when they have needs for
help that cannot met independently
because of their physical limitations,
negative reactions to an environment,
or have an experience that prevents
them from communicating their needs.”
Major Concepts
1. Professional Nursing Function
- ORGANIZING PRINCIPLE
- She envisions the nursing function
as “finding out and meeting the
patient’s immediate need for help.”
- Patient is the focal point of the nurse’s
function.
- It is focused on the process of care
in an immediate experience
2. The Patient’s Presenting Behavior
- PROBLEMATIC SITUATION
- “The presenting behavior of the patient,
regardless of the form in which it appears,
may represent a plea for help.’’
Distress
 The patient’s behavior reflects distress when
the patient experiences a need that he cannot
resolve, a sense of helplessness occurs
The behavior of the patient can be manifested by:
 Verbal - asking a question or making a
statement to the nurse
 Vocal - coughing, moaning, crying,
wheezing, shouting
 Non-verbal - tears in the eyes, skin color,
reddened face, clenched fist, or physiological
manifestations (BP pulse), according to Orlando
3. Immediate Reaction
- INTERNAL REACTION
- person perceives with any of their five
sensory organs
 Patient Behavior
 Nurse Reaction
- stimulated by the patient’s behavior
- begins the nursing process discipline
 Nurse Action
- the action process by the nurse in a nurse
patient contact is called nursing process
 Automatic Nursing Actions – are nursing
actions decided upon for reasons other than the
patient’s immediate need
 Deliberative Nursing Actions – are actions
decided upon after ascertaining a need and then
meeting this need
4. Deliberative Nursing Process
- INVESTIGATION
- Deliberative nursing process
formulations reflect the nurse patient situation
as a dynamic whole
*The patient’s behavior affects the
nurse and the nurse’s action affects the
patient*
5. Improvement
- RESOLUTION
- Improvement in the patient’s behavior
- This change is observable in both the
patient’s verbal and non-verbal behavior
5 Stages of Deliberative Nursing Process
(ADPIE)
Assessment
- In this stage, the nurse completes a
holistic assessment of the patient’s needs.
 Subjective – information that the client
shares with you spontaneously or in response to
your questions
 Objective – information that you observe
when conducting a physical assessment, and lab
and diagnostic results
Diagnosis
- Uses the nurse’s clinical judgment about
health problems
- The diagnosis can then be confirmed using
links to defining characteristics, related factors,
and risk factors found in the patient’s
assessment.
Planning
- Writing goals and objectives and deciding
about appropriate action
- The planning stage addresses each of the
problems identified in the diagnosis
- By the end of this stage, the nurse will have
a nursing care plan
Implementation
- Final selection and carrying out
planned action
- The nurse begins using the nursing
care plan
Evaluation
- Finally, in the evaluation stage, the nurse
looks at the progress of the patient toward the
goals set in the nursing care plan
- Changes can be made to the nursing care
plan based on how the patient is progressing
toward the goals
- If any new problems are identified in the
evaluation stage, the process starts over again
for those specific problems
Metaparadigm
Human Being
- Orlando uses the concept of human as she
- emphasizes individuality and the dynamic\
nature of the nurse patient relationship
- For her, humans in need are the focus of
nursing practice
Assumptions about the patients:
1. Patients’ needs for help is unique.
2. Patients have an initial inability to communicate
their needs for help
3. When patients cannot meet their own needs, they
become distressed.
4. The patient’s behavior is meaningful.
Health
- replaced by a sense of helplessness as the
initiator of a necessity for nursing
- she stated that nursing deals with individuals
who require help
Environment
- Orlando completely disregarded the
environment in her theory, only focusing on the
patient’s immediate need, chiefly the
relationship and actions between the nurse and
the patient
- The effect that the environment could have
on the patient was never mentioned in Orlando’s
theory
Nursing
- Nursing as unique and independent in its
concerns for an individual’s need for help in an
immediate situation
- The efforts to meet the individual’s need for
help are carried out in an interactive situation
and in a disciplined manner that requires proper
training
 JOYCE TRAVELBEE
Human to Human Relationship Model
- Born on 1926
- Died on 1973
- A psychiatric nurse, educator, and a writer
Theory
Human-to-Human Relationship Model
- deals with the interpersonal aspects of nursing,
focusing especially on mental health
- the purpose of nursing was to help and support
an individual, family, or community to prevent or
cope with the struggles of illness and suffering and,
if necessary, to find significance in these
occurrences, with the ultimate goal being the
presence of hope
- nursing was accomplished through human-to
human relationships
- extended the interpersonal relationship theories
of Peplau and Orlando
Philosophy
“It is believed the spiritual values a person holds
will determine, to a great extent, his perception of
illness. The spiritual values of the nurse or her
philosophical beliefs about illness and suffering will
determine the degree to which he or she will be able
to help ill persons find meaning, or no meaning, in
these situations”
5 Interactional Phases of Travelbee’s Human-to-
Human Relationship Model
 varies in intensity, duration, and depth
Original encounter
- The first impression by the nurse of the sick
person and vice versa
- Stereotype or traditional roles
 Emerging identities
- The nurse and patient perceiving each other
as unique individuals
- The moment relationship begins
 Empathy
- Similarity of experience and a desire to
understand another person are two attributes the
fosters empathy
- The ability to share in and to comprehend
the momentary psychological state of another
individual. As an outcome, one can predict
another’s behavior.
 Sympathy
- Occurs when a nurse seeks to alleviate the
cause of the patients suffering
 Rapport
- The nursing interventions that lessens the
clients suffering
- Human-to-human relationship
- a nurse is able to establish rapport because
she posses the necessary knowledge and skills
required to assist ill persons and because she is
able to perceive respond to and appreciate the
uniqueness of the ill human being
Major Concepts
7 Basic Concepts
Suffering
- a feeling of unease to extreme torture, and
- the nurse assists the ill patient to experience
hope as a means of coping with illness and
suffering
Meaning
- the reason for oneself attribute
Nursing
- has a responsibility to help individuals
and their families to find meaning
- help man to find meaning in the experience
of illness and suffering
 Hope
- nurse’s job is to help the patient to
maintain hope and avoid hopelessness
- hope's core lies in a fundamental trust of
the outside world, and a belief that others will
help someone when you need it

Communication
- a strict necessity for good nursing care
- communication, a central concept for
Travelbee, implies guiding, planning, and
purposely directing interaction to fulfill
nursing’s purpose

Self-therapy
- Therapeutic use of self involves
consciously using one’s personality and
knowledge to effect change in the patient.
Nursing is a service initiated for the purpose of
effecting change

Targeted intellectual approach

- nursing is composed of both cognitive and
affective components. The nurse must know
technical, scientific information from the
natural, physical, biological, behavioral,
nursing, and medical sciences as well as be able
to apply information in a logical, caring manner.

Metaparadigm

Human
- biological organisms with basic needs;
unique, irreplaceable individuals, thinking
organisms, capable of maturity with a core
of immaturity, both time bound and time
free, always becoming and evolving

Health
- health is subjective and objective
 subjective health – is an individually defined as
well being in accord with self-appraisal of
physical-emotional-spiritual status
 objective health – is an absence of discernible
disease, disability of defect as measured by
physical examination, laboratory tests and
assessment by spiritual director or psychological
counselor

Society / Environment
- she defines human conditions and life
experiences encountered by all men as
suffering, hope, pain, illness. These
conditions are associated to the environment

Nursing
- An interpersonal process --- the professional
nurse assists the patient (family, community)
to prevent or cope with illness and to find
meaning in the experience
 LYDIA HALL
Care-Cure-Core Theory
- Born on September 21, 1906 in New York
- Died on February 27, 1969 at Queens
Hospital in New York
- Innovator, Motivator, and Mentor
Theory
Care-Cure-Core Theory
- also known as “Three Cs of Lydia Hall”
 CORE – the patient receiving nursing care
 CURE – the interventions given to patients by
medical professionals
 CARE – the role of nurses which is performing
the task of nurturing patients
Philosophy
 Nursing as “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.”
 Hall defined her philosophy on the basis of
the patient.
 Hall believed patients should only receive
care from professional nurse
Major Concepts
The CARE Circle
 Represents the role of nurses and is focused
on performing the task of nurturing patients.
 Defines a professional nurse’s primary role,
such as providing bodily care for the patient
 The nurse’s role also includes educating
patients and helping a patient meet any needs he
or she is unable to meet alone.
The CORE Circle
- The core is the patient receiving nursing care
- Therapeutic use of self
- Emphasizes the patient’s social, emotional,
spiritual, and intellectual needs
The CURE Circle
- Involves the administration of medications
and treatments.
- The nurse shares the cure circle with other
health professionals
Metaparadigm
Person or Individual
- Focuses on the individual who is 16 years of
age or older and past the acute stage of long-
term illness in nursing care of Halls work.
- Hall emphasizes the individual’s importance
as unique, capable of growth and learning, and
requiring a total person approach.
- The source of energy and motivation for
healing is the individual care recipient, not the
health care provider.
Society or Environment
- The concept of society or environment is
dealt with concerning the individual.
- Focuses on providing an environment that is
conducive to self-development.
- Any actions taken concerning society or the
environment are to assist the individual in
attaining a personal goal.
Health
- Health can be inferred as a state of self-
awareness with a conscious selection of optimal
behaviors for that individual.
- Hall stresses the need to help the person
explore the meaning of his or her behavior to
identify and overcome problems through
developing self-identity and maturity
Nursing
- Nursing is identified as participating in the
care, core, and cure aspects of patient care.
- Caring is the nurse’s primary function.
Professional nursing is most important during
the recuperative period.
- The major purpose of care is to achieve an
interpersonal relationship with the individual
that will facilitate the development of care.