The ANA (2015a) defined NI as
“the specialty that integrates
nursing science with multiple
information and analytical
sciences to identify, define,
manage, and communicate
data, information, knowledge,
and wisdom in nursing practice
AMIA defines consumer health
informatics as “the field
devoted to informatics from
multiple consumer or patient
views. These include patient
focused informatics, health
literacy and consumer
education”
Theory refers to a scientifically
acceptable general principles—
or constellation of principles—
offered to explain phenomena.
Theories have two major
purposes: to guide research and
practice.
“Nursing theory is
conceptualization of some
aspect of nursing reality
communicated for the purpose
of describing phenomena,
explaining
relationships between
phenomena, predicting
consequences, or prescribing
nursing care.”
Major Theories and Models
Supporting NI:
• General Systems Theory
• Change Theory
• Cybernetics Theory
• Novice to Expert Theory
• DIKW Theory
General Systems Theory
• interdisciplinary study of
systems, i.e. cohesive
groups of interrelated,
interdependent components
that can be natural or human-
made
• complex systems share
organizing principles that can
be discovered and modeled
mathematically
• changing one component of a
system may affect
other components or the whole
system.
General Systems Theory
Key Concepts:
• System: a group of
interacting, interdependent
parts that form a complex
whole.
• Boundaries: barriers that
define a system and distinguish
it from other systems in an
environment.
• Homeostasis: the tendency of
a system to be resilient with
respect to external disruption
and to maintain its key
characteristics.
• Adaptation: the tendency of a
system to make the internal
changes necessary to protect
itself and continue to fulfill its
purpose.
• Reciprocal transactions:
circular or cyclical interactions
that systems engage in such
that they influence one another.
• Feedback loop: the process by
which systems self-correct
based on observations of their
current state.
• Throughput: the rate of
energy transfer between a
system and its environment
over time.
• Microsystem: the system
closest to the client.
• Mesosystem: relationships
among systems in an
environment.
• Exosystem: a relationship
between two systems that
has an indirect effect on a third
system.
• Macrosystem: a larger system
that influences clients, such as
policies, administration of
entitlement programs, and
culture.
• Equifinality: the way systems
can reach the same goal
through different paths.
• Open and closed systems
• Chronosystem: a system
composed of significant life
events affecting adaptation.
• Isomorphism: structural,
behavioral, and developmental
features that are shared across
systems.
Nursing theories based on Von
Bertalanffy’s General
Systems theory:
• Neuman’s Systems Theory,
Rogers’s Theory of Unitary
Human Beings
• Roy’s Adaptation Model
• Imogene King’s Theory of Goal
Attainment
• Orem’s Self-Care Deficit
Theory
• Johnson’s Behavior Systems
Model

Lewin’s Change Theory
• three-stage model of change
known as unfreezing change-
refreeze model that requires
prior learning to be rejected and
replaced.
Three major concepts:
• Driving forces - are those that
push in a direction that causes
change to occur.
• Restraining forces - are those
forces that counter the driving
forces.
• Equilibrium - is a state of
being where driving forces
equal restraining forces, and no
change occurs.
Three stages:
• Unfreezing - involves finding a
method of making it possible for
people to let go of an old
pattern that was somehow
counterproductive.
• Change - “moving to a new
level” or “movement,” involves
a process of change in thoughts,
feeling, behavior, or all three,
that is in some way more
liberating or more productive.
• Refreezing - establishing the
change as the new habit, so that
it now becomes the “standard
operating procedure.”
Cybernetics Theory
• Cybernetics - a monitor
compares what is happening
to a system at various sampling
times with some standard of
what should be happening, and
a controller adjusts the system’s
behavior accordingly.
• Feedback – observed
outcomes of actions are taken
as inputs for further action in
ways that support the pursuit
and maintenance of particular
conditions or their disruption,
forming a circular causal
relationship.
Novice to Expert Theory
• Novice - beginner with no
experience. They are taught
general rules to help perform
tasks, and their rule-governed
behavior is limited and
inflexible.
• Advanced beginner - shows
acceptable performance, and
has gained prior experience in
actual nursing situations. This
helps the nurse recognize
recurring meaningful
components so that principles,
based on those experiences,
begin to formulate in order to
guide actions.
• Competent - has two or three-
years’ experience on the job in
the same field. For example,
two or three years in intensive
care.
• Proficient - perceives and
understands situations as
whole parts. He or she has a
more holistic understanding of
nursing, which improves
decision-making.
• Expert - no longer rely on
principles, rules, or guidelines to
connect situations and
determine actions. They have a
deeper background of
experience and an intuitive
grasp of clinical situations. Their
performances are fluid, flexible,
and highly proficient.
DIKW Theory
• Data, information,
knowledge, and
wisdom (DIKW)
• DIKW Pyramid - relationships
between data, information,
knowledge and wisdom.
• Data - collection of facts in a
raw or unorganized form
such as numbers or characters.
• Information - data that has
been “cleaned” of errors and
further processed in a way that
makes it easier to measure,
visualize and analyze for a
specific purpose.
• Knowledge - “How” is the
information, derived from the
collected data, relevant to our
goals? “How” are the pieces of
this information connected to
other pieces to add more
meaning and value? And, maybe
most importantly, “how” can we
apply the information to
achieve our goal?
• Knowledge- how pieces of
information connected to the
other pieces help us understand
how to apply information to
achieve our goal.
• Wisdom - ‘why do something’
and ‘what is best’. In
other words, wisdom is
knowledge applied in action.