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CHAPTER 1
Theoretical Foundations of Nursing / 1st Sem / 1st Year
INTRODUCTION TO NURSING
THEORY
THEORETICAL FOUNDATION OF NURSING
→ The central concept of health, person, environment, nursing, and caring will
be explored.
THEORETICAL
→ emphasis will be placed on theories related to the development of
therapeutic relationships, modes of effective communication and nursing
therapeutics.
NURSING THEORIES
→ are organized bodies of knowledge to define what nursing is, what nurses
do, and why do they do it.
→ 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 the practice
of nursing 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.
Nursing Theories
→ First Nursing Theories, 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 environment of the patient to assist him
in his recovery.”
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→ In the 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 puts emphasis on 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” that 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 the professional function of nursing 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 states 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 states 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 who strives to 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.
HISTORY OF NURSING THEORY

CHAPTER 1
Theoretical Foundations of Nursing / 1st Sem / 1st Year
→ The history of professional nursing began with Florence Nightingale.
Nightingale envisioned nurses as a body of educated women at a time
when women were neither educated nor employed in public service.
CURRICULUM ERA
→ Addressed the question of what content nurses should study to learn how to
be a nurse.
→ The idea of moving nursing education from hospital-based diploma
programs into colleges and universities began to emerge during this era (
Erwin,2015; Judd & Sitzman, 2013).
THEORY ERA
→ It was a natural outgrowth of the research and graduate education eras. (
Alligood,2014; Im & Chang,2012).
→ Research without theory produced isolated information; however research
and theory produced nursing science.
RESEARCH ERA
→ Research is the path to new knowledge.
→ Part of the curricula of developing graduate programs.
GRAD. EDU. ERA
→ Masters program in nursing emerged to meet the need for nurses with
specialized education in nursing.
→ Nursing theory and nursing conceptual models were included as courses in
the study of nursing.
Significance for the Discipline
→ The significance of theory for the discipline of nursing is that the discipline is
dependent on theory for its continued existence .
→ Nursing can be a vocation, or nursing can be a discipline with a professional
style of theory-based practice.
→ Commitment to theory-based evidence for practice is beneficial to patients
in that it guides systematic, knowledgeable care.
HISTORY OF NURSING
I. PERIOD OF INTUITIVE NURSING (Prehistoric to early Christian era)
→ Nursing was untaught and instinctive Performed out of compassion for others
and desire to help others
BELIEFS AND PRACTICES OF PREHISTORIC MAN
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→ Nursing was a function that belonged to women taking care of the children,
the sick and the aged.
→ Believed that illness causes the invasion of evil spirit through the use of black
magic or voodoo
I. PERIOD OF INTUITIVE NURSING
→ Believed that medicine man was called shaman or witch doctor having the
power to heal using white magic.
→ They also practiced “trephining” or drilling a hole in the skull with a rock or
stone without anesthesia as a last resort to drive evil spirits from the body.
I. PERIOD OF INTUITIVE NURSING
→ Contributions to Medicine and Nursing
Babylonia
→ Code of Hammurabi
→ provided laws that covered every facet of Babylonian life including medical
practice and recommended specific doctors for each disease and gave
each patient the right to choose between the use of charms, medications or
surgical procedures.
Egypt
→ Introduced the art of embalming
→ Developed the ability to make keen observation and left a record of 250
recognized diseases
→ Slaves and patient’s families nursed the sick
Israel
→ Moses was recognized as the “Father of Sanitation” and wrote in Old
Testament which:
→ Emphasized the practice of hospitality to strangers & acts of charity (Book
of genesis, Old Testament)
→ Promulgated laws of control on the spread of communicable disease & the
ritual of circumcision of the male child (Book of Leviticus)
→ Referred to nurses as midwives, wet nurses or child’s nurses whose acts were
compassionate & tender (outpouring of maternal instincts).
China
→ Believed that in using girl’s clothes for male babies keep evils away from
them
→ Prohibited the dissection of dead human body as a worship to ancestors
→ They gave the world knowledge of material medica (pharmacology)
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CHAPTER 1
Theoretical Foundations of Nursing / 1st Sem / 1st Year
India
→ Men of medicine built hospitals, practiced an intuitive form of asepsis and III.PERIOD OF EDUCATED NURSING
were proficient in the practice of medicine and surgery → (From June 15, 1869 when Florence Nightingale School of Nursing was
→ Sushurutu made a list of function and qualifications of nurses. This was the opened until World War II)
first reference to nurse’s taking care of the patient’s.
Ancient Greece 1. The development of nursing during this period was strongly influenced by
→ Nursing was the task of untrained slave trends resulting from wars, from an arousal of social consciousness, from the
→ Introduced caduceus, the insignia of medical profession today emancipation of women and from the increased educational opportunities
→ Hippocrates was given the title of “Father of Scientific Medicine”. He made offered to women
major advances in medicine by rejecting the belief that diseases had 2. Popularization of the philosophy of the Nightingale System
supernatural causes. He also developed assessment standards for clients, → Importance of nursing education
established overall medical standards, recognized a need for nurses. → Nurses teaching students
Rome → Specialization developed
→ The Romans attempted to maintain vigorous health, because illness was a 3. Facts about Florence Nightingale
sign of weakness → Recognized as the “Mother of Modern Nursing”
→ Care of the ill was left to the slaves or Greek physicians. Both groups were → Known also as the “Lady with a Lamp”
looked upon as inferior by Roman society. → Raised in England and learned languages, literature, mathematics and
II. PERIOD OF APPRENTICE NURSING social graces
→ (Founding of religious nursing orders to 1836 when Kaiserwerth Institute for → Developed her self-appointed goal: “to change the profile of nursing”
the training of Deaconesses in Germany was established) → Led the nurses that took care of the wounded during the Crimean war
→ Also called the period of “on the job” training. → Put down her ideas in two published books: Notes on Nursing and Notes on
→ Nursing care was performed without any formal education and by people Hospitals
who were directed by more experienced nurses
→ Religious orders of the Christian church were responsible for the
IV. PERIOD OF CONTEMPORARY NURSING
development of this kind of nursing.
→ (Period after World War II up to present)
Crusades
→ Military religious orders established hospitals staffed with men
a) Scientific and technological developments as well as social changes mark
→ Knights of Lazarus was founded and primarily for the nursing care of lepers
this period
in Jerusalem after the Christians had conquered the city. Rise of Secular
b) Establishment of WHO
Orders
c) Use of atomic/nuclear energy for medical diagnosis and treatment
→ Religious taboos and social restrictions influenced nursing at the time of the
d) Utilization of computers
Religious Nursing orders
e) Use of sophisticated equipment for diagnosis and therapy
→ Older nuns prayed with and took good care of the sick, while younger nuns
f) Health is perceived as a fundamental human right
washed soiled linens, usually in the rivers.
g) Nursing involvement in community health is greatly intensified
→ In 16th century, hospitals were established for the care of the sick where
h) Development of the expanded role of nurses
hospitals were gloomy, cheerless, airless and unsanitary. People entered
i) Professionalization of nursing
hospitals only under compulsion or as a last resort.
Nursing in the Philippines Early Beliefs and Practices

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CHAPTER 1
Theoretical Foundations of Nursing / 1st Sem / 1st Year
a) Beliefs about causation of disease (evil spirits, enemy or a with)
b) People believed that evil spirits could be driven away by persons with powers
to expel demons
c) People believed in special gods of healing, with the priest-physician and
Herbolarios
d) Superstitious beliefs and practices in relation to health and sickness such as
Herbmen or Herbicheros as one who practiced witchcraft
e) Persons suffering from diseases without identified cause were believed to be
bewitched by “mangkukulam”
Nursing in the Philippines Early Beliefs and Practices
Spanish Period
VI. The religious orders exerted their efforts to care for the sick by building
hospitals in the different parts of the Philippines
VII. Nursing during Philippine Revolution
VIII. Prominent persons involved in nursing works
a. Josephine Bracken – installed a first hospital in an estate house in
Tejeros; provided nursing care to the wounded night and day
b. Rosa Sevilla de Alvero – converted their house into quarters for the
Filipino soldiers, during the Philippine-American War that broke out in
1899.
c. Dona Hilaria de Aguinaldo – wife of Emilio Aguinaldo; organized
Filipino Red Cross under the inspiration of Apolinario Mabini
d. Dona Maria Agoncillo de Aguinaldo – second wife of Emilio
Aguinaldo; provided nursing care to Filipino soldiers during revolution.
President of Filipino Red Cross branch in Batangas
e. Melchora Aquino – Nursed the wounded Filipino soldiers and gave
them shelter and food
f. Capitan Salome – a revolutionary leader in Nueva Ecija; provided
nursing care to the wounded when not in combat
g. Agueda Kahabagan – revolutionary leader in Laguna, also provided
nursing services to her troops
h. Trinidad Tecson – “Ina ng Biac na Bato”, stayed in the hospital at
Biac na Bato to care for the wounded soldiers.
Iloilo Mission Hospital School of Nursing (Iloilo City, 1906)
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→ It was run by the Baptist Foreign Mission Society of America. In March,
1944, 22 nurses graduated; in April 1944 graduate nurses took the first Nurses
Board Examination at the Iloilo Mission Hospital.
St Paul’s Hospital School of Nursing (Manila, 1907)
→ Established by the Archbishop of Manila, the Most Reverend Jeremiah
Harty under the supervision of the Sisters of St. Paul de Chartes. It was located
in Intramuros and it provided general hospital services with free dispensary
and dental clinic
Philippine General Hospital School of Nursing (1907)
→ Anastacia Giron-Tupas, the first Filipino nurse to occupy the position of
chief nurse and superintendent in the Philippines
St. Luke’s Hospital School of Nursing (Quezon City, 1907)
Mary Johnston Hospital and School of Nursing (Manila, 1907)
Philippine Christian Institute Schools of Nursing
Sallie long Read memorial Hospital School of Nursing (Laoag, Ilocos Norte, 1903)
Mary Chiles Hospital School of Nursing (Manila, 1911)
Frank Dunn Memorial Hospital (Vigan, Ilocos Sur, 1912)
San Juan de Dios School of Nursing (Manila, 1913)
Emmanuel Hospital School of Nursing (Capiz, 1013)
Southern Islands Hospital School of Nursing (Cebu, 1918)
Earliest hospitals established:
→ Hospital real de Manila (1577) – built to care for the Spanish king’s
soldiers
→ San Lazaro Hospital (1578) – built exclusively for patients with leprosy
→ Hospital de Indio (1586) – established by Franciscan Order; service was in
general supported by alms and contributions from charitable individuals.
→ Hospital de Aguas Santas (1590) – founded by Brother J. Bautisita of the
Franciscan Order.
→ San Juan de Dios Hospital (1596) – Founded by the Brotherhood of
Misericordia and administered by the Hospitalliers of San Juan de Dios;
support was derived from alms and rents; rendered general health service
to the public.
Filipino Red Cross
→ Malolos, Bulacan was the location of the national headquarters
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CHAPTER 1
Theoretical Foundations of Nursing / 1st Sem / 1st Year
→ Functions:
o Collection of war funds and materials through concerts, charity bazaars,
and voluntary contributions
o Provision of nursing care to wounded Filipino soldiers
o Requirements for Membership
o At least 14 years old, age requirement for officer was 25 years old
o Of sound reputation Hospitals and Schools of Nursing

First Colleges of Nursing in the Philippines

→ University of Santo Tomas College of Nursing (1946)
→ Manila Central University College of Nursing (1947)
→ University of the Philippines College of Nursing (1948)

Nursing Leaders in the Philippines

→ Anastacia Giron-Tupas – First Filipino nurse to hold the position of Chief
Nurse Superintendent; founder of Philippine Nurses Association
→ Cesaria Tan – First Filipino to receive a Masters degree in Nursing abroad
→ Socorro Sirilan – pioneered in hospital social service
→ Rosa Militar – a pioneer in school health education
→ Sor Ricarda Mendoza – a pioneer in nursing education
→ Conchita Ruiz – first full-time editor of the newly named PNA magazine ‘The
Filipino Nurse”
→ Loreto Tupaz – Dean of the Philippine Nursing; Florence Nightingale of
Iloilo

DISCIPLINE VS. PROFESSION

→ Discipline is specific to academia and refers to a branch of education, a
department of learning, or a domain of knowledge.
→ Profession refers to a specialized field of practice founded on the
theoretical structure of the science or knowledge of that discipline and
accompanying practice abilities.

SIGNIFICANCE OF NURSING THEORY

→ Alternative and holistic medicine
→ Laboratory and research
→ Clinical services, therapeutic services
→ Doctors, nurses, hospital - related services

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