THEORETICAL FOUNDATIONS OF NURSING

NCM100
A. Introduction to Theoretical Nursing
knowledge
What is Knowledge?
 Information, skill , expertise acquired by a
person through various life experiences.
 What is known in particular field of discipline or
study.
 Facts and information or awareness or
familiarity gained by experience of a fact or
situation
 Knowledge acquirement involves several
cognitive processes.
Ways of Knowing
1. Empirical Knowing
 is the science of nursing, which is factual,
descriptive, and helps to develop abstract and
theoretical explanations.
 Empiric is concerned with questions such as
“what is this?” and “how does this work?”. This
kind of knowledge is often organized using
models and theories allowing generalization
from the specific.
 Ex: any scientific research based, theoretical
and factual information.
2. Ethical Knowing
 Attitudes and knowledge derived from an
ethical framework, including an awareness of
moral questions and choices
 Ex: Ethical knowing involves the judgement of
the right and wrong in relation to intention,
reasons, attribute of individuals and situations.
 is the knowledge we have of ourselves and
knowledge of how this colors our interactions
with others and encompasses experiential
learning.
Sources of Knowledge
Transitional Knowledge
 A nursing practice that passed down from
generation to generation.
 Ex: Routine changing of bed linens whether
soiled or not.
Authoritative knowledge
 An idea by a person of authority, which is
perceived as true because of his/her expertise.
 Ex: The nurse supervisor is well equipped with
knowledge and skills about the procedure
through experience. The novice nurse accepts
it true because of the authority of the expert
nurse.
Scientific Knowledge
 Knowledge came from a scientific method
through research. These ideas are tested and
measured systematically using objective
criteria.
 Ex: TSB (tepid sponge bath) perform to patient
with fever. The nurse knows the rationale
behind the procedure.

3. Esthetic Knowing
 Awareness of the immediate situation seated
in immediate practical action, including
awareness of the patient and their
circumstances as uniquely individual and of the
combined wholeness of the situation.
 Ex: show compassion, mercy, understanding
towards co-patient, co-workers, and
supervisors.
 Places himself in the patients shoes when
communicating and providing care
 Is often describes as art of nursing. A way a
nurse can form a sense of patients’ needs and
act on their behalf, taking into account
nuanced information about their personality
and previous experiences to orchestrate the
most effective way of providing care.

4. Personal Knowing
 Knowledge and attitudes derived from personal
self-understanding.
THEORETICAL FOUNDATIONS OF NURSING
NCM100

Phenomenon Issues in nursing theory development

What is nursing theory?

 testable propositions from

philosophies,conceptual models, grand
theories, abstract nursing theories, or theories
from other disciplines. Theories are less
abstract than grand theory and less specific
than middle-range theory.

Metaparadigm

The broad conceptual boundaries of the discipline

of nursing: Human beings, environment, health,
and nursing

Philosophy
 sets forth the meaning of nursing phenomena
through analysis, reasoning and logical
presentation of concepts and ideas.

Theory development process Conceptual Models

 are sets of concepts that address phenomena
central to nursing in propositions that explain
the relationship among them.

Grand Theory
 concepts that derive from a conceptual model
and propose a testable proposition that tests
the major premise of the model.

Middle Range Theory

 concepts most specific to practice that propose
precise testable nursing practice questions and
include details such as patient age group,
family situation, health condition, location of
the patient, and action of the nurse.

Importance of nursing theory and education

research clinical procedure
THEORETICAL FOUNDATIONS OF NURSING
NCM100
Nursing Theorists and Nursing Philosophies
Jean Watson: Theory of Human Caring
 Margaret Jean Harman Watson, PhD, RN,
AHN-BC, FAAN, was born and grew up in the
small town of Welch, West Virginia.
 The youngest of eight children, she was
surrounded by an extended family–community
environment.
 After graduation in 1961, she married Douglas
Watson and moved to his native state of
Colorado.
 She has two grown daughters, Jennifer and
Julie, and five grandchildren. Jean lives in
Boulder, Colorado.
 After moving to Colorado, Watson continued
her nursing education at the University of
Colorado.
 She earned a baccalaureate degree in nursing
in 1964, a master's degree in 1966, and a
doctorate in educational psychology and
counseling in 1973.
 In 1981 and 1982, she pursued international
sabbatical studies in New Zealand, Australia,
India, Thailand, and Taiwan; in 2005, she took
a sabbatical for a walking pilgrimage in the
Spanish El Camino.
 In the 1980s, Watson and her colleagues
established the Center for Human Caring at
the University of Colorado, the nation's first
interdisciplinary center using human caring
knowledge for clinical practice, scholarship,
administration, and leadership (Watson, 1986).
 The Watson Caring Science evolved and the
Watson Caring Science Institute (WCSI) was
established from the groundwork laid by the
Center for Human Caring.
 The Watson Caring Science Center was
established at the University of Colorado is an
interdisciplinary center for nurses and health
professionals.
 In line with the University of Colorado initiatives
in Watson Caring Science, the Watson
Endowed Chair in Caring Science was recently
established at the University of Colorado
(Watson, personal communication, April 6,
2016).
 Watson was Dean of the University of
Colorado School of Nursing and Associate
Director of Nursing Practice at the University
Hospital from 1983 to 1990.
 As dean, she developed a post baccalaureate
nursing curriculum in human caring, health,
and healing that led to a Nursing Doctorate
(ND), a clinical doctorate that became the
Doctor of Nursing Practice (DNP) in 2005.
 From 1993 to 1996, Watson served on the
Executive Committee and Governing Board for
the NLN, and she served as president from
1995 to 1996.
 In 1997 the NLN awarded her an honorary
lifetime holistic nurse certificate.
 In 1999 Watson assumed the
MurchisonScoville Endowed Chair of Caring
Science at the University of Colorado.
 She is featured in at least 20 nationally
distributed audiotapes, videotapes, and CDs
on nursing theory, a few of which are listed in
Points for Further Study at the end of the
chapter.
 Her first book, Nursing: The Philosophy and
Science of Caring(1979), was reprinted in 1985
and translated into Korean and French.
 Yalom's 11 curative factors stimulated Watson
to use 10 carative factors as the organizing
framework for her book (Watson, 1979),
"Central to Nursing" (p. 9), and a moral ideal.
 Watson's early work embraced 10 carative
factors but evolved to include "caritas," making
explicit connections between caring and love in
the 2008 revised edition of this seminal text.
 Her second book, Nursing: Human Science
and Human Care—A Theory of Nursing (1985)
reprinted in 1988 and 1999, addressed her
conceptual and philosophical problems in
nursing.
 Her third book, Postmodern Nursing, and
Beyond (1999), presented a model to bring
nursing practice into the 21st century.
 Instruments for Assessing and Measuring
Caring in Nursing and Health Sciences (2002),
her fourth book, comprises a collection of 21
instruments to assess and measure caring and
received the American Journal of Nursing Book
of the Year Award.
 Her fifth book, Caring Science as Sacred
Science (2005), describes her personal
journey to enhance her understanding of
caring science, spiritual practice, the concept
and practice of care, and caring-healing work.
In this book, she leads the reader through
thought-provoking experiences and the
sacredness of nursing by emphasizing deep
inner reflection and personal growth,
communication skills, use of self-transpersonal
growth, and attention to both caring science
and healing through forgiveness, gratitude, and
surrender.
 Recent books include Measuring Caring:
International Research on Caritas as Healing
(Nelson & Watson, 2011); Creating a Caring
Science Curriculum (Hills & Watson, 2011);
Human Caring Science: A Theory of Nursing
(Watson, 2012); and Caring Science, Mindful
THEORETICAL FOUNDATIONS OF NURSING
NCM100
Practice: Implementing Watson's Human
Caring Theory (Sitzman & Watson, 2013)