Introduction of Nursing Theory

THE EVOLUTION OF NURSING THEORY

 History
ANCIENT
CIVILIZATION
NURSING WAS
NOTED TO BE AS
OLD AS TIME.

IT BASICALLY
STARTED FROM:

INSTINCT

HUMAN NATURE:
NURTURING CARING
NURSING
 HEALTH AND INJURIES
HEALING SUPERSTITION FROM WARS
EGYPTIAN
BELIEFS OF AND BLACK AND OTHER
RITES
ANCIENT MAGIC TRAGIC
CIVILIZATION EVENTS.
A lady named…
Florence Nightingale

An English lady from a

wealthy family during the
Victorian era

During the Crimean War

known to be the “Lady with
the Lamp”

A nursing theorist, writer and

statistician
Prior to Florence Nightingale Is the Dark Age
for Nursing because…
Nursing is considered as Who are the nurses?

Wayward women of
A very low Women of low status, instead of
job in terms A desperate lowest social going to prison, they
standing were asked to served
of social occupation.
as nurses.
hierarchy.

monastic
women or Poor unmarried
A job for the woman with no
uneducated untrained
helpers of family or no chance
and poor. of getting married.
low repute.
Changed the image of nursing
FLORENCE NIGHTINGALE

Environmental Theory

Maintaining the a safe and

clean environment to
Promote well-being

Transformation of Nursing
into a Profession
Transformation of Nursing into a Profession

Nightingale describes
Nursing as

ART Nursing has its own , proper

SCIENCE Nursing is a body of way of doing things and applying
scientific knowledge using knowledge. (Example the
empirics. interaction between a health
consumer and the nurse)
Is Nursing A Profession?

YES

A VERY NOBLE
PROFESSION
 Highlights of Significant Events

1950 1960 1970 1980 1990

Assignment:
Research and create a timeline that highlights the major nursing events
from these periods.
 In the early part of nursing's
history, there was little formal
nursing knowledge.

As nursing education developed,

the need to categorize
knowledge led to development
of NURSING THEORY to help
nurses evaluate increasingly
complex client care situations.
What is a theory?
• A set of concepts, definitions,
relationships, and assumptions that
project a systematic view of a
phenomena
• It may consist of one or more relatively
specific and concrete concepts and
propositions that purport to account
for, or organize some phenomenon
(Barnum, 1988)
Components of Nursing Theories
For a theory to be a theory it has to
contain the following:

Phenomenon
Concepts
Definitions
Assumptions
What are the components of a theory?

• Concepts – ideas and mental images that

help to describe phenomena (Alligood and
Marriner-Tomey, 2002)
• Definitions – convey the general meaning
of the concepts
• Assumptions – statements that describe
concepts
• Phenomenon – aspect of reality that can
be consciously sensed or experienced
(Meleis, 1997).
Concrete
Concepts

CONCEPTS

Abstract
Concepts
 When it comes to the activities for
the PHENOMENON
Three things theories do:

Describe

Predict

Prescribe
 Nursing theories are organized
bodies of knowledge to define
what nursing is, what nurses do,
and why do they do it.
Nursing theories provide a way to
define nursing as a unique
What are Nursing Theories?
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.
Significance of Theory for Nursing as the
Discipline and Profession
Nursing Theoretical
Works represents the
most comprehensive
ideas and systematic
knowledge about
nursing; Therefore,
theory is vital to both
the discipline and the
profession.
Discipline and Profession

Discipline is specific to academia and a

branch of education, a department of
learning or field of knowledge.

Profession refers to specialized field of

practice, which is founded upon the
theoretical structure of the science or
knowledge of that discipline and the
accompanying practice abilities.
Significance of Theory for Nursing as a
Discipline
 Significance of Theory for Nursing as
a Discipline
Attention to the importance of nursing
University baccalaureate programs
conceptualizations for the research
proliferated, masters programs in
process and the role of a conceptual
nursing were developed, and the
framework in the purpose and design of
curricula began to be standardized
research production of science and nursing
through the accreditation process.
theoretical works also began to publish.

Works began to be
recognize for their
theoretical nature, such
as Henderson,
Nightingale and etc.
Important!!!
The emphasis has shifted
from a focus on knowledge
about how nurses function,
which concentrated on the
nursing process, to focus
on what nurses know and
how they use knowledge to
guide their thinking and
decision making while
concentrating on the
patient.
 Utilizes in its practice a well defined and well-
organized body of specialized knowledge
that is on the intellectual level of the higher
Significance of learning

Theory for Constantly enlarges the body of knowledge it

Nursing as a uses and improves its techniques of
education and service by the use of the
Profession scientific method

Entrusts the education of its practitioners to

institution of higher education
Criteria of
Nursing as a
Profession Applies its body of knowledge in practical
services that are vital to human and social
welfare
Significance of Functions autonomously in the formulation of
professional policy and in the control of
Theory for professional activity
Nursing as a
Profession Attracts individuals as intellectual and
personal qualities who exalt service above
personal gain and who recognizes their
chosen profession as a life work

Criteria of a Strives to compensate it practice by

Profession providing freedom of action, opportunity for
continuous professional growth and
economic security
Significance of The conceptual models of nursing are
comprehensive and the specific of the
Theory for practice
Nursing as a
Profession Nursing Theory is a useful tool for reasoning,
critical thinking and decision making in
nursing practice

Criteria of
Nursing as a Nursing theorical works provide a
Profession perspective of the patient
4 Types of Theories

Grand

Middle-range

Descriptive

Prescriptive
 Types of nursing theories

• Grand theories – broad and

complex
• Middle-range theories-
address specific phenomena
and reflect practice
• Descriptive theories – first
level of theory development
• Prescriptive theories –
address nursing interventions
and predict their
consequences
Classifications of Nursing Theories

Nursing
Nursing
Conceptual
Philosophy
Models

Grand Middle-
Nursing Range
Theories Theories
History and Philosophy of Science
Nursing as a Science

It is a
Science is collection of
logical, facts known
systematic, in area and
& coherent the process
way to solve used to
problems obtain that
and answer knowledge.
questions.
Nursing and Philosophy
Philosophy studies concepts that structure
thought processes, foundations, and
presumptions.

It is an approach for thinking about the nature

of people, the methods that should be used to
create a scientific knowledge and the ethics
involved. It denotes a perspective, implying a
certain broad, “taken for granted” assumptions.

Epistemology – a branch of philosophy that

is concerned with the nature and scope of
knowledge. It is referred to as the ‘ theory
of knowledge’
 Nursing and Philosophy
Rationalism- the power Empiricism-the power
of reason of sensory experience
✓emphasizes the
importance of a priori ✓that scientific
reasoning knowledge was
discovered through ✓Research-then-
theory
✓Theory-then-research the generalization of
strategy (Reynolds) observed facts in the
natural world (Bacon)
✓Develop a systematic
explanation (theory) of a ✓Collection of facts
given phenomenon then
precedes attempts to
subject this to
experiments formulate
generalizations
Early 20th Century Views of
Science and Theory
Positivism
(imposed on the
Philosophers mind by
experience) is the
focused on the
philosophy of
analysis of science that
theory structure, information is
whereas derived from
scientist logical and
focused on mathematical
empirical treatments and
research reports of sensory
experience is the
exclusive source
of all authoritative
knowledge.
 What is a paradigm?

• A model that explains the

linkages of science,
philosophy, and theory
accepted and applied by the
discipline (Alligood and
Marriner – Tomey, 2002)
What is a domain?
• The view or perspective of the
discipline
• It contains the subject, central
concepts, values and beliefs,
phenomena of interest, and
the central problems of the
discipline
 How does domain relate to nursing theory?
• Nursing has identified its
domain in a paradigm that
includes four linkages:
1) person/client
2) health
3) environment
4) nursing
Nursing

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.
Purposes of nursing theory
What are the purposes of nursing theory?
• It guides nursing practice and
generates knowledge
• It helps to describe or explain
nursing
• Enables nurses to know WHY
they are doing WHAT they are
doing
Why on earth do we study nursing theory?
• Everyday practice enriches theory
• Both practice and theory are guided
by values and beliefs
• Theory helps to reframe our
thinking about nursing
• Theory guides use of ideas and
techniques
• Theory can close the gap between
theory and research
• To envision potentialities (Gordon,
Parker, & Jester, 2001)
 So how do nurses use theory in everyday
practice?
• Organize patient data
• Understand patient data
• Analyze patient data
• Make decisions about nursing
interventions
• Plan patient care
• Predict outcomes of care
• Evaluate patient outcomes
(Alligood, 2001)
 Purposes of
Nursing
Theories

In Academic
In Research In Profession
Discipline
How do student nurses begin to use nursing
theory?

• By asking yourself two very

important questions…..
 Student nurse questions

• What is the nature of

knowledge needed for the
practice of nursing?

• What does it mean to me to

practice nursing?
Nursing also utilizes non-nursing theories
Current trends that influence nursing theory
• Medical science
• Nursing education
• Professional nursing
organizations
• Evolving research approaches
• Global concerns
• Consumer demands
• Technologies
 “ Practicing nurses who despise theory are
condemned to performing a series of tasks - either
at the command of a physician or in response to
routines and policies.”
Leah Curtin, RN, MS, FAAN (1989)
Former Editor, Nursing Management