Nursing

theories and
theorists
@snurses_notes
 NURSING THEORIES
Nursing theories are organized bodies of knowledge to define what nursing is, what nurses
do, and why they do it. Nursing theories provide a way to define nursing as a unique discipline
that is separate from other disciplines (e.g., medicine). It is a framework of concepts and
purposes intended to guide nursing practice at a more concrete and specific level.

Nursing, as a profession, is committed to recognizing its own unparalleled body of knowledge

vital to nursing practice—nursing science. To distinguish this foundation of knowledge, nurses
need to identify, develop, and understand concepts and theories in line with nursing. As a
science, nursing is based on the theory of what nursing is, what nurses do, and why. Nursing is
a unique discipline and is separate from medicine. It has its own body of knowledge on which
delivery of care is based

DEFINING TERMS
The development of nursing theory demands an understanding of selected terminologies,
definitions, and assumptions.

Philosophy
These are beliefs and values that define a way of thinking and are generally known and
understood by a group or discipline.

theory
A belief, policy, or procedure proposed or followed as the basis of action. It refers to a logical
group of general propositions used as principles of explanation. Theories are also used to
describe, predict, or control phenomena.

CONCEPT
Concepts are often called the building blocks of theories. They are primarily the vehicles of
thought that involve images.

MODELS
Models are representations of the interaction among and between the concepts showing
patterns. They present an overview of the theory’s thinking and may demonstrate how
theory can be introduced into practice.
PROPOSITION
Propositions are statements that describe the relationship between the concepts.

DOMAIN
The domain is the perspective or territory of a profession or discipline.

Process
Processes are organized steps, changes, or functions intended to bring about the desired
result.

PARADIGM
A paradigm refers to a pattern of shared understanding and assumptions about reality and
the world, worldview, or widely accepted value system

Metaparadigm
A metaparadigm is the most general statement of discipline and functions as a framework in
which the more restricted structures of conceptual models develop. Much of the theoretical
work in nursing focused on articulating relationships among four major concepts: person,
environment, health, and nursing

HISTORY OF NURSING THEORIES

The first nursing theories appeared in the late 1800s when a strong
emphasis was placed on nursing education.

IN 1860 Florence Nightingale defined nursing in her “Environmental Theory”

as “the act of utilizing the patient’s environment to assist him in his
recovery.”

IN 1950S There is a consensus among nursing scholars that nursing needed to

validate itself through the production of its own scientifically tested
body of knowledge.

IN 1952 Hildegard Peplau introduced her Theory of Interpersonal Relations

that emphasizes the nurse-client relationship as the foundation of
nursing practice.

IN 1955 Virginia Henderson conceptualized the nurse’s role as assisting sick

or healthy individuals to gain independence in meeting 14
fundamental needs. Thus her Nursing Need Theory was developed.
IN 1960 Faye Abdellah published her work “Typology of 21 Nursing Problems,”
which shifted the focus of nursing from a disease-centered
approach to a patient-centered approach.

IN 1962 Ida Jean Orlando emphasized the reciprocal relationship between

patient and nurse and viewed nursing’s professional function as
finding out and meeting the patient’s immediate need for help.

IN 1968 Dorothy Johnson pioneered the Behavioral System Model and

upheld the fostering of efficient and effective behavioral functioning
in the patient to prevent illness.

IN 1970 Martha Rogers viewed nursing as both a science and an art as it

provides a way to view the unitary human being, who is integral with
the universe.

IN 1971 Dorothea Orem stated in her theory that nursing care is required if
the client is unable to fulfill biological, psychological, developmental,
or social needs.

IN 1971 Imogene King‘s Theory of Goal attainment stated that the nurse is
considered part of the patient’s environment and the nurse-patient
relationship is for meeting goals towards good health.

IN 1972 Betty Neuman, in her theory, states that many needs exist, and each
may disrupt client balance or stability. Stress reduction is the goal of
the system model of nursing practice.

IN 1979 Sr. Callista Roy viewed the individual as a set of interrelated systems
that maintain the balance between these various stimuli.

IN 1979 Jean Watson developed the philosophy of caring, highlighted

humanistic aspects of nursing as they intertwine with scientific
knowledge and nursing practice.
 THE NURSING METAPARADIGM
Four major concepts are frequently interrelated and fundamental to
nursing theory: person, environment, health, and nursing. These four are
collectively referred to as metaparadigm for nursing

PERSON
Person (also referred to as Client or Human Beings) is the
recipient of nursing care and may include individuals,
patients, groups, families, and communities.

ENVIRONMENT
Environment (or situation) is defined as the internal and
external surroundings that affect the client. It includes all
positive or negative conditions that affect the patient, the
physical environment, such as families, friends, and significant
others, and the setting for where they go for their healthcare.

HEALTH
Health is defined as the degree of wellness or well-being that
the client experiences. It may have different meanings for
each patient, the clinical setting, and the health care provider.

NURSING
The nurse’s attributes, characteristics, and actions provide
care on behalf of or in conjunction with the client. There are
numerous definitions of nursing, though nursing scholars may
have difficulty agreeing on its exact definition. The ultimate
goal of nursing theories is to improve patient care
COMPONENTS OF NURSING THEORIES
For a theory to be a theory, it has to contain concepts, definitions,
relational statements, and assumptions that explain a phenomenon. It
should also explain how these components relate to each other.

Phenomenon
A term given to describe an idea or response about an event, a
situation, a process, a group of events, or a group of situations.
Phenomena may be temporary or permanent. Nursing theories focus
on the phenomena of nursing.

concepts
Interrelated concepts define a theory. Concepts are used to help
describe or label a phenomenon. They are words or phrases that
identify, define, and establish structure and boundaries for ideas
generated about a particular phenomenon. Concepts may be abstract
or concrete.

Abstract Concepts - Defined as mentally constructed independently of a

specific time or place.
Concrete Concepts - Are directly experienced and related to a particular
time or place.

definitions
Definitions are used to convey the general meaning of the concepts of
the theory. Definitions can be theoretical or operational.

Theoretical Definitions - Define a particular concept based on the

theorist’s perspective.
Operational Definitions - States how concepts are measured.
 relational statements
Relational statements define the relationships between two or more
concepts. They are the chains that link concepts to one another

assumptions
Assumptions are accepted as truths and are based on values and
beliefs. These statements explain the nature of concepts, definitions,
purpose, relationships, and structure of a theory

WHY ARE NURSING THEORIES IMPORTANT?

Nursing theories are the basis of nursing practice today. In many cases, nursing theory
guides knowledge development and directs education, research, and practice.
Historically, nursing was not recognized as an academic discipline or as a profession we
view today. Before nursing theories were developed, nursing was considered to be a
task-oriented occupation. The training and function of nurses were under the direction
and control of the medical profession. Let’s take a look at the importance of nursing
theory and its significance to nursing practice.

Nursing theories help recognize what should set the foundation of practice by
explicitly describing nursing.
By defining nursing, a nursing theory also helps nurses understand their purpose
and role in the healthcare setting.
Theories serve as a rationale or scientific reasons for nursing interventions and give
nurses the knowledge base necessary for acting and responding appropriately in
nursing care situations.
Nursing theories provide the foundations of nursing practice, generate further
knowledge, and indicate which direction nursing should develop in the future (Brown,
1964)
By providing nurses a sense of identity, nursing theory can help patients, managers,
and other healthcare professionals to acknowledge and understand the unique
contribution that nurses make to the healthcare service (Draper, 1990)
Nursing theories prepare the nurses to reflect on the assumptions and question the
nursing values, thus further defining nursing and increasing the knowledge base
 Nursing theories aim to define, predict, and demonstrate nursing phenomenon
(Chinn and Jacobs, 1978).
It can be regarded as an attempt by the nursing profession to maintain and
preserve its professional limits and boundaries.
In many cases, nursing theories guide knowledge development and directs
education, research, and practice, although each influences the others. (Fitzpatrick
and Whall, 2005).

PURPOSES OF NURSING THEORIES

The primary purpose of theory in nursing is to improve practice by positively
influencing the health and quality of life of patients. Nursing theories are also
developed to define and describe nursing care, guide nursing practice, and
provide a basis for clinical decision-making. In the past, the accomplishments
of nursing led to the recognition of nursing in an academic discipline, research,
and profession

IN ACADEMIC DISCIPLINE
Much of the earlier nursing programs identified the major concepts in one or two
nursing models, organized the concepts, and build an entire nursing curriculum
around the created framework. These models’ unique language was typically
introduced into program objectives, course objectives, course descriptions, and
clinical performance criteria. The purpose was to explain the fundamental
implications of the profession and enhance the profession’s status

IN RESEARCH
The development of theory is fundamental to the research process, where it is
necessary to use theory as a framework to provide perspective and guidance
to the research study. Theory can also be used to guide the research process
by creating and testing phenomena of interest. To improve the nursing
profession’s ability to meet societal duties and responsibilities, there needs to
be a continuous reciprocal and cyclical connection with theory, practice, and
research. This will help connect the perceived “gap” between theory and
practice and promote the theory-guided practice
 IN PROFESSION
Clinical practice generates research questions and knowledge for theory. In a
clinical setting, its primary contribution has been the facilitation of reflecting,
questioning, and thinking about what nurses do. Because nurses and nursing
practice are often subordinate to powerful institutional forces and traditions,
introducing any framework that encourages nurses to reflect on, question,
and think about what they do provide an invaluable service

CLASSIFICATION OF NURSING THEORIES

There are different ways to categorize nursing theories. They are classified
depending on their function, levels of abstraction, or goal orientation

BY ABSTRACTION
There are three major categories when classifying nursing theories based
on their level of abstraction: grand theory, middle-range theory, and
practice-level theory

LEVEL OF NURSING THEORY

Grand theories are abstract, broad in scope, and complex, therefore requiring
further research for clarification.
GRAND NURSING Grand nursing theories do not guide specific nursing interventions but rather
provide a general framework and nursing ideas.
THEORIES Grand nursing theorists develop their works based on their own experiences
and their time, explaining why there is so much variation among theories.
Address the nursing metaparadigm components of person, nursing, health,
and environment

More limited in scope (compared to grand theories) and present concepts

and propositions at a lower level of abstraction. They address a specific
MIDDLE-RANGE phenomenon in nursing.
Due to the difficulty of testing grand theories, nursing scholars proposed
NURSING THEORIES using this level of theory.
Most middle-range theories are based on a grand theorist’s works, but they
can be conceived from research, nursing practice, or the theories of other
disciplines.

Practice nursing theories are situation-specific theories that are narrow in

scope and focuses on a specific patient population at a specific time.
PRACTICE-LEVEL Practice-level nursing theories provide frameworks for nursing interventions
and suggest outcomes or the effect of nursing practice.
NURSING THEORIES Theories developed at this level have a more direct effect on nursing practice
than more abstract theories.
These theories are interrelated with concepts from middle-range theories or
grand theories
BY GOAL ORIENTATION
Theories can also be classified based on their goals. They can be descriptive or
prescriptive.

DESCRIPTIVE THEORIES
Descriptive theories are the first level of theory development. They describe
the phenomena and identify its properties and components in which it occurs.
Descriptive theories are not action-oriented or attempt to produce or change
a situation.
There are two types of descriptive theories: factor-isolating theory and
explanatory theory.

FACTOR-ISOLATING THEORY EXPLANATORY THEORY

Also known as category-
formulating or labeling theory.
Theories under this category
describe the properties and
dimensions of phenomena.
Explanatory theories
describe and explain the
nature of relationships of
certain phenomena to other
phenomena

PRESCRIPTIVE THEORIES
Address the nursing interventions for a phenomenon, guide
practice change, and predict consequences.
Includes propositions that call for change.
In nursing, prescriptive theories are used to anticipate the
outcomes of nursing interventions.
 OTHER WAYS OF CLASSIFYING NURSING
THEORIES
Classification according to Meleis
Afaf Ibrahim Meleis (2011), in her book Theoretical Nursing: Development and
Progress, organizes the major nurse theories and models using the following
headings: needs theories, interaction theories, and outcome theories. These
categories indicate the basic philosophical underpinnings of the theories.

The needs theorists were the first group of nurses who

thought of giving nursing care a conceptual order.
Needs-Based Theories under this group are based on helping
individuals to fulfill their physical and mental needs.
Theories Theories of Orem, Henderson, and Abdella are
categorized under this group. Need theories are
criticized for relying too much on the medical model of
health and placing the patient in an overtly dependent
position.

These theories emphasized nursing on the

INTERACTION establishment and maintenance of relationships. They
THEORIES highlighted the impact of nursing on patients and how
they interact with the environment, people, and
situations. Theories of King, Orlando, and Travelbee are
grouped under this category

These theories describe the nurse as controlling and

Outcome directing patient care using their knowledge of the
Theories human physiological and behavioral systems. The
nursing theories of Johnson, Levine, Rogers, and Roy
belong to this group.
 CLASSIFICATION ACCORDING TO ALLIGOOD
In her book, Nursing Theorists and Their Work, Raile Alligood (2017) categorized
nursing theories into four headings: nursing philosophy, nursing conceptual models,
nursing theories and grand theories, and middle-range nursing theories.

It is the most abstract type and sets forth the meaning

NUrsing of nursing phenomena through analysis, reasoning, and
philosophy logical presentation. Works of Nightingale, Watson, Ray,
and Benner are categorized under this group.

These are comprehensive nursing theories that are

nursing regarded by some as pioneers in nursing. These

theories address the nursing metaparadigm and
conceptual explain the relationship between them. Conceptual
models models of Levine, Rogers, Roy, King, and Orem are under
this group.

Are works derived from nursing philosophies,

Grand conceptual models, and other grand theories that are

Nursing generally not as specific as middle-range theories.

Works of Levine, Rogers, Orem, and King are some of the
Theories theories under this category.

Are precise and answer specific nursing practice

Middle- questions. They address the specifics of nursing
Range situations within the model’s perspective or theory
Theories from which they are derived. Examples of Middle-Range
theories are that of Mercer, Reed, Mishel, and Barker
LIST OF NURSING THEORIES AND
THEORISTS
Florence Nightingale
Environmental Theory
Founder of Modern Nursing and Pioneer
Defined Nursing as “the act of utilizing the
environment of the patient to assist him in
his recovery.”
Stated that nursing “ought to signify the
proper use of fresh air, light, warmth,
cleanliness, quiet, and the proper selection
and administration of diet – all at the least
expense of vital power to the patient.”
Identified five (5) environmental factors:
fresh air, pure water, efficient drainage,
cleanliness or sanitation, and light or direct
sunlight.

HILDEGARD E. PEPLAU
Interpersonal Relations Theory
Peplau’s theory defined Nursing as “An
interpersonal process of therapeutic
interactions between an individual who is
sick or in need of health services and a
nurse specially educated to recognize,
respond to the need for help.”
Her work is influenced by Henry Stack
Sullivan, Percival Symonds, Abraham
Maslow, and Neal Elgar Miller.
It helps nurses and healthcare providers
develop more therapeutic interventions in
the clinical setting.
 VIRGINIA HENDERSON
Nursing Need Theory
Focuses on the importance of increasing
the patient’s independence to hasten their
progress in the hospital.
Emphasizes the basic human needs and
how nurses can assist in meeting those
needs.
“The nurse is expected to carry out a
physician’s therapeutic plan, but
individualized care is the result of the
nurse’s creativity in planning for care.”

FAYE GLENN ABDELLAH

21 Nursing Problems Theory
“Nursing is based on an art and science that
molds the attitudes, intellectual competencies,
and technical skills of the individual nurse into
the desire and ability to help people, sick or well,
cope with their health needs.”
Changed the focus of nursing from disease-
centered to patient-centered and began to
include families and the elderly in nursing care.
The nursing model is intended to guide care in
hospital institutions but can also be applied to
community health nursing, as well.

Ernestine Wiedenbach
The Helping Art of Clinical Nursing conceptual
model
Definition of nursing reflects on nurse-midwife
experience as “People may differ in their
concept of nursing, but few would disagree that
nursing is nurturing or caring for someone in a
motherly fashion.”
Guides the nurse action in the art of nursing and
specified four elements of clinical nursing:
philosophy, purpose, practice, and art.
Clinical nursing is focused on meeting the
patient’s perceived need for help in a vision of
nursing that indicates considerable importance
on the art of nursing.
 LYDIA E. HALL
Care, Cure, Core Nursing Theory
Hall defined Nursing as the “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.”
The major purpose of care is to achieve an
interpersonal relationship with the individual to
facilitate the development of the core.
he “care” circle defines a professional nurse’s primary
role, such as providing bodily care for the patient. The
“core” is the patient receiving nursing care.
The “cure” is the aspect of nursing that involves the
administration of medications and treatments.

JOYCE TRAVELBEE
Human-to-Human Relationship Model
States in her Human-to-Human Relationship Model
that 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.

evelyn adam

Focuses on the development of models and

theories on the concept of nursing.
Includes the profession’s goal, the beneficiary of
the professional service, the role of the
professional, the source of the beneficiary’s
difficulty, the intervention of the professional,
and the consequences.
A good example of using a unique basis of
nursing for further expansion.
 KATHRYN E. BARNARD
Child Health Assessment Model
Concerns improving the health of infants and their
families.
Her findings on parent-child interaction as an
important predictor of cognitive development helped
shape public policy.
She is the founder of the Nursing Child Assessment
Satellite Training Project (NCAST), which produces
and develops research-based products, assessment,
and training programs to teach professionals,
parents, and other caregivers the skills to provide
nurturing environments for young children.
Borrows from psychology and human development
and focuses on mother-infant interaction with the
environment.
Contributed a close link to practice that has modified
the way health care providers assess children in light
of the parentchild relationship

Nancy Nancy
Roper, Roper, Winifred
Winifred Logan,
Logan, and andJ.Alison
Alison J. T
Tierney
A Model for Nursing Based on a Model of Living
Logan produced a simple theory, “which actually helped bedside nurses.”
The trio collaborated in the fourth edition of The Elements of Nursing: A Model for
Nursing Based on a Model of Living and prepared a monograph entitled The
Roper-Logan-Tierney Model of Nursing: Based on Activities of Daily Living. I
Includes maintaining a safe environment, communicating, breathing, eating and
drinking, eliminating, personal cleansing and dressing, controlling body
temperature, mobilizing, working and playing, expressing sexuality, sleeping, and
dying.

JEAN WATSON
She pioneered the Philosophy and Theory of
Transpersonal Caring.
“Nursing is concerned with promoting health,
preventing illness, caring for the sick, and restoring
health.”
Mainly concerns with how nurses care for their
patients and how that caring progresses into better
plans to promote health and wellness, prevent illness
and restore health.
Focuses on health promotion, as well as the
treatment of diseases.
Caring is central to nursing practice and promotes
health better than a simple medical cure
 IDA JEAN ORLANDO
She developed the Nursing Process Theory.
“Patients have their own meanings and
interpretations of situations, and therefore nurses
must validate their inferences and analyses with
patients before drawing conclusions.” Allows nurses
to formulate an effective nursing care plan that can
also be easily adapted when and if any complexity
comes up with the patient.
According to her, persons become patients requiring
nursing care when they have needs for help that
cannot be met independently because of their
physical limitations, negative reactions to an
environment, or experience that prevents them from
communicating their needs.
The role of the nurse is to find out and meet the
patient’s immediate needs for help

Marilyn Anne Ray

Developed the Theory of Bureaucratic Caring

“Improved patient safety, infection control, reduction
in medication errors, and overall quality of care in
complex bureaucratic health care systems cannot
occur without knowledge and understanding of
complex organizations, such as the political and
economic systems, and spiritual-ethical caring,
compassion and right action for all patients and
professionals.”
Challenges participants in nursing to think beyond
their usual frame of reference and envision the world
holistically while considering the universe as a
hologram.
Presents a different view of how health care
organizations and nursing phenomena interrelate as
wholes and parts in the system
 PATRICIA BENNER
Caring, Clinical Wisdom, and Ethics in Nursing
Practice
“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.”
Attempts to assert and reestablish nurses’ caring
practices when nurses are rewarded more for
efficiency, technical skills, and measurable
outcomes.
States that caring practices are instilled with
knowledge and skill regarding everyday human
needs
KARI MARTINSEN
Philosophy of Caring
“Nursing is founded on caring for life, on neighborly
love, […]At the same time, the nurse must be
professionally educated.”
Human beings are created and are beings for whom
we may have administrative responsibility.
Caring, solidarity, and moral practice are
unavoidable realities

KATIE ERIKSSON
Theory of Carative Caring
“Caritative nursing 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 exists’.
Caring communion, true caring, occurs when
the one caring in a spirit of caritas alleviates the
suffering of the patient.”
The ultimate goal of caring is to lighten
suffering and serve life and health.
Inspired many in the Nordic countries and used
it as the basis of research, education, and
clinical practice
 myra estrin levine
Caring, Clinical Wisdom, and Ethics in Nursing
According to the Conservation Model, “Nursing is
human interaction.”
Provides a framework within which to teach
beginning nursing students.
Logically congruent, externally and internally
consistent, has breadth and depth, and is
understood, with few exceptions, by professionals
and consumers of health care.

martha e. rogers
In Roger’s Theory of Human Beings, she defined
Nursing as “an art and science that is humanistic and
humanitarian.
The Science of Unitary Human Beings contains two
dimensions: the science of nursing, which is the
knowledge specific to the field of nursing that comes
from scientific research; and the art of nursing, which
involves using nursing creatively to help better the
lives of the patient.
A patient can’t be separated from his or her
environment when addressing health and treatment

dorothea e. orem
In her Self-Care Theory, she defined Nursing as
“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.”
Focuses on each individual’s ability to perform
self-care.
Composed of three interrelated theories: (1) the
theory of self-care, (2) the self-care deficit
theory, and (3) the theory of nursing systems,
which is further classified into wholly
compensatory, partially compensatory, and
supportive-educative.
 imogene m. king
Conceptual System and Middle-Range Theory of
Goal Attainment
“Nursing is a process of action, reaction and
interaction by which nurse and client share
information about their perception in a nursing
situation” and “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.”
Focuses on this process to guide and direct nurses
in the nurse-patient relationship, going hand-in-
hand with their patients to meet good health
goals.
Explains that the nurse and patient go hand-in-
hand in communicating information, set goals
together, and then take actions to achieve those
goals.

betty neuman

In Neuman’s System Model, she defined nursing

as a “unique profession in that is concerned
with all of the variables affecting an individual’s
response to stress.”
The focus is on the client as a system (which
may be an individual, family, group, or
community) and on the client’s responses to
stressors.
The client system includes five variables
(physiological, psychological, sociocultural,
developmental, and spiritual). It is
conceptualized as an inner core (basic energy
resources) surrounded by concentric circles
that include lines of resistance, a normal
defense line, and a flexible line of defense
 sister callista roy
In Adaptation Model, Roy defined nursing as a
“health care profession that focuses on human life
processes and patterns and emphasizes the
promotion of health for individuals, families,
groups, and society as a whole.”
Views the individual as a set of interrelated
systems that strives to maintain a balance
between various stimuli.
Inspired the development of many middle-range
nursing theories and adaptation instruments

dorothy e. johnson
The Behavioral System Model defined Nursing as
“an external regulatory force that acts to preserve
the organization and integrate the patients’
behaviors at an optimum level under those
conditions in which the behavior constitutes a
threat to the physical or social health or in which
illness is found.”
Advocates to foster efficient and effective
behavioral functioning in the patient to prevent
illness and stresses the importance of research-
based knowledge about the effect of nursing care
on patients.
Describes the person as a behavioral system with
seven subsystems: the achievement, attachment-
affiliative, aggressive-protective, dependency,
ingestive, eliminative, and sexual subsystems.

Anne Boykin and Savina O. Schoenhofer

The Theory of Nursing as Caring: A Model for Transforming Practice
Nursing is an “exquisitely interwoven” unity of aspects of the discipline and
profession of nursing.
Nursing’s focus and aim as a discipline of knowledge and a professional
service are “nurturing persons living to care and growing in caring.”
Caring in nursing is “an altruistic, active expression of love, and is the
intentional and embodied recognition of value and connectedness.”
 AFAF IBRAHIM MELEIS
Transitions Theory
It began with observations of experiences faced as
people deal with changes related to health, well-
being, and the ability to care for themselves.
Types of transitions include developmental, health
and illness, situational, and organizational.
Acknowledges the role of nurses as they help
people go through health/illness and life
transitions.
Focuses on assisting nurses in facilitating
patients’, families’, and communities’ healthy
transitions
NOLA J. PENDER

Health Promotion Model

Describes the interaction between the nurse and
the consumer while considering the role of the
health promotion environment.
It focuses on three areas: individual characteristics
and experiences, behavior-specific cognitions and
affect, and behavioral outcomes.
Describes the multidimensional nature of persons
as they interact within their environment to pursue
health.

Anne Boykin and Savina O. Schoenhofer

The Theory of Nursing as Caring: A Model for Transforming Practice
Nursing is an “exquisitely interwoven” unity of aspects of the discipline and
profession of nursing.
Nursing’s focus and aim as a discipline of knowledge and a professional
service are “nurturing persons living to care and growing in caring.”
Caring in nursing is “an altruistic, active expression of love, and is the
intentional and embodied recognition of value and connectedness.”
 NOLA J. PENDER
Health Promotion Model
Describes the interaction between the nurse and
the consumer while considering the role of the
health promotion environment.
It focuses on three areas: individual characteristics
and experiences, behavior-specific cognitions and
affect, and behavioral outcomes.
Describes the multidimensional nature of persons
as they interact within their environment to pursue
health.

MADELEINE M. LEININGER
Involves learning and understanding various
cultures regarding nursing and health-illness
caring practices, beliefs, and values to implement
significant and efficient nursing care services to
people according to their cultural values and
health-illness context.
It focuses on the fact that various cultures have
different and unique caring behaviors and different
health and illness values, beliefs, and patterns of
behaviors.
Culture Care Theory of Diversity and Universality
Defined transcultural nursing as “a substantive
area of study and practice focused on comparative
cultural care (caring) values, beliefs, and practices
of individuals or groups of similar or different
cultures to provide culture-specific and universal
nursing care practices in promoting health or well-
being or to help people to face unfavorable human
conditions, illness, or death in culturally meaningful
ways.”
Helen C. Erickson, Evelyn M. Tomlin, and Mary Ann P. Swain
Modeling and Role-Modeling
“Nursing is the holistic helping of persons with their self-care activities in
relation to their health. The goal is to achieve a state of perceived optimum
health and contentment.”
Modeling is a process that allows nurses to understand the unique perspective
of a client and learn to appreciate its importance.
Role-modeling occurs when the nurse plans and implements interventions
that are unique for the client.
 Rosemarie Rizzo Parse
Human Becoming Theory
“Nursing is a science, and the performing art of
nursing is practiced in relationships with persons
(individuals, groups, and communities) in their
processes of becoming.
” Explains that a person is more than the sum of
the parts, the environment, and the person is
inseparable and that nursing is a human science
and art that uses an abstract body of knowledge
to help people.
It centered around three themes: meaning,
rhythmicity, and transcendence.

Gladys L. Husted and James H. Husted

Created the Symphonological Bioethical Theory
“Symphonology (from ‘symphonia,’ a Greek word meaning agreement) is a
system of ethics based on the terms and preconditions of an agreement.”
Nursing cannot occur without both nurse and patient. “A nurse takes no
actions that are not interactions.”
Founded on the singular concept of human rights, the essential agreement of
non-aggression among rational people forms the foundation of all human
interaction.

RAMONA T. MERCER
Maternal Role Attainment—Becoming a Mother
“Nursing is a dynamic profession with three
major foci: health promotion and prevention of
illness, providing care for those who need
professional assistance to achieve their
optimal level of health and functioning, and
research to enhance the knowledge base for
providing excellent nursing care.”
“Nurses are the health professionals having the
most sustained and intense interaction with
women in the maternity cycle.” Maternal role
attainment is an interactional and
developmental process occurring over time.
The mother becomes attached to her infant,
acquires competence in the caretaking tasks
involved in the role, and expresses pleasure and
gratification. (Mercer, 1986).
Provides proper health care interventions for
nontraditional mothers for them to favorably
adopt a strong maternal identity
 MERLE H. MISHEL
Uncertainty in Illness Theory
Presents a comprehensive structure to view the experience of acute and
chronic illness and organize nursing interventions to promote optimal
adjustment.
Describes how individuals form meaning from illness-related situations.
The original theory’s concepts were organized in a linear model around
the following three major themes: Antecedents of uncertainty, Process of
uncertainty appraisal, and Coping with uncertainty.
PAMELA G. REED
Self-Transcendence Theory
Self-transcendence refers to the fluctuation of perceived boundaries that
extend the person (or self) beyond the immediate and constricted views of self
and the world (Reed, 1997).
Has three basic concepts: vulnerability, self-transcendence, and well-being.
Gives insight into the developmental nature of humans associated with health
circumstances connected to nursing care.

carolyn l. wiener and marylin j. dodd

Theory of Illness Trajectory
“The uncertainty surrounding a chronic illness like cancer is the uncertainty of
life writ large. By listening to those who are tolerating this exaggerated
uncertainty, we can learn much about the trajectory of living.”
Provides a framework for nurses to understand how cancer patients stand
uncertainty manifested as a loss of control.
Provides new knowledge on how patients and families endure uncertainty and
work strategically to reduce uncertainty through a dynamic flow of illness
events, treatment situations, and varied players involved in care organizatio

Georgene Gaskill Eakes, Mary Lermann

Burke, and Margaret A. Hainsworth
Theory of Chronic Sorrow “
Chronic sorrow is the presence of pervasive grief-related feelings that have
been found to occur periodically throughout the lives of individuals with
chronic health conditions, their family caregivers and the bereaved.”
This middle-range theory defines the aspect of chronic sorrow as a normal
response to the ongoing disparity created by the loss.
cornelia m . ruland & shirley m. moore
Peaceful End-of-Life Theory
The focus was not on death itself but on providing a peaceful and
meaningful living in the time that remained for patients and their significant
others.
The purpose was to reflect the complexity involved in caring for terminally ill
patients
phil barker
Barker’s Tidal Model of Mental Health Recovery is widely used in mental
health nursing.
It focuses on nursing’s fundamental care processes, is universally applicable,
and is a practical guide for psychiatry and mental health nursing.
Draws on values about relating to people and help others in their moments
of distress. The values of the Tidal Model are revealed in the Ten
Commitments: Value the voice, Respect the language, Develop genuine
curiosity, Become the apprentice, Use the available toolkit, Craft the step
beyond, Give the gift of time, Reveal personal wisdom, Know that change is
constant, and Be transparent.

katharine kolcaba
Theory of Comfort
“Comfort is an antidote to the stressors inherent in health care situations
today, and when comfort is enhanced, patients and families are
strengthened for the tasks ahead. Also, nurses feel more satisfied with the
care they are giving.”
Patient comfort exists in three forms: relief, ease, and transcendence. These
comforts can occur in four contexts: physical, psychospiritual,
environmental, and sociocultural.
As a patient’s comfort needs change, the nurse’s interventions change, as
well.
cheryl tatano beck
Postpartum Depression Theory
“The birth of a baby is an occasion for joy—or so the saying goes. But for
some women, joy is not an option.”
Described nursing as a caring profession with caring obligations to persons
we care for, students, and each other.
Provides evidence to understand and prevent postpartum depression.