NON- NURSING THEORIES A.

GENERAL SYSTEMS THEORY

a by Ludwig Von Bertalanffy

• INTRODUCTION
Systems theory may be considered as a specialization of systems thinking and a
generalization of systems science.
First proposed by Ludwig Von Bertalanffy ( 1901-1972) as General Systems Theory.
General Systems Theory is a general science of wholeness.
System Theory has been applied in developing nursing theories and conducting nursing
research.

 CHARACTERISTICS OF SYSTEMS

Systems refer specifically to self-regulating systems.

Systems are self-correcting through feedback.
Systems have a structure that is defined by their parts and processes.
Systems are generalizations of reality -Systems tend to function in the same way.
Every living organism is essentially an open system.

MODULE IV: NON-NURSING THEORIES

A. GENERAL SYSTEMS THEORY
 Describes how to break whole things into parts and then to learn how the parts work
together in systems.
 General system theory is known by different names systems theory, theory of open
systems, systems model, and family systems theory.
 1969- Von Bertalanffy’s described what has since become known as the General System
theory, the concept that systems cannot be reduced to a series of parts functioning in
isolation, but that, to understand the whole, one must understand the interrelations
between these parts.

B. CHANGE THEORY by Kurt Lewin

INTRODUCTION
 Kurt Lewin (1890-1947) is considered the father of social psychology.
 He was born in Germany, later emigrated to the US.
 He is well known for his writings on group dynamics, group therapy, and social
psychology.
 Lewin introduced his field theory concepts, emphasizing that the group differs from
the simple sum of its parts.
 Lewin coined the term group dynamics in 1939.
 His field theory states that one’s characteristics and the social situation in which one
finds oneself.

LEWINS CHANGE THEORY

 His most influential theory was his model of the change process in human systems.
 Kurt theorized a three-stage model of change that is known as the unfreezing- change-
refreeze model that requires before being rejected and replaced
 Lewin’s theory states behavior as a dynamic balance of forces working in opposing
directions.
 CONCEPTS DRIVING FORCES
 Driving forces are forces that push in a direction that causes change to occur.
 Driving forces facilitate change because they push the person in the desired direction.
They cause a shift in the equilibrium towards change.

RESTRAINING FORCES
 Restraining forces are forces that counter-driving forces.
 Restraining forces hinder change because they push the person in the opposite direction.
 Restraining forces cause a shift in the equilibrium which opposes change.

EQUILIBRIUM
 Is a state of being where driving forces equal restraining forces and no change
occurs.
 Equilibrium can be raised or lowered by changes that occur between the driving and
restraining forces.
STAGES
 Consists of three distinct and vital stages.
UNFREEZING - is the process that involves finding a method of making it possible for people
to let go of an old pattern that was counterproductive in some way.
 Unfreezing is necessary to overcome the strains of individual resistance and group
conformity.
 Unfreezing can be achieved by the use of three methods.
 A. increased the driving forces that direct behavior away from the existing situations or
status quo.
 B. decrease the restraining forces that negatively affect the movement from the existing
equilibrium.
 C. find a combination of the two methods listed above.

2. MOVING TO A NEW LEVEL OR CHANGING OR MOVEMENT

 This stage involves a process of change in thoughts, feeling, behavior, or all three, that is in
some way more liberating or more productive.

3. REFREEZING is establishing the change as a new habit so that it now becomes the
standard operating procedure.
 Without this stage of refreezing, it is easy to go back to the old ways.

APPLICATION - It is pertinent that the driving and restraining forces must be analyzed
before implementing a planned change.

C. DEVELOPMENTAL THEORY
INTRODUCTION
 Theories are a set of interrelated concepts that give a systematic view of a phenomenon
( an observable fact or event) that is explanatory and predictive.
 Theories are composed of concepts, definitions, models, propositions and are based on
assumptions.
  Theory gives planners tools for moving beyond intuition to design and evaluate health
behavior and health promotion interventions based on an understanding of behavior.
( Robert T. Croyle 2005).
 They are derived through two principal methods: deductive reasoning and inductive
reasoning. Nursing theorists use both of these methods.
 The theory is a creative and rigorous structuring of ideas that projects a tentative,
purposeful, and systematic view of phenomena.
 A theory makes it possible to organize the relationship among the concepts to describe,
explain, predict, and control practice.
 DEFINITIONS Concepts
 are vehicles of thought that involve images. Concepts are words that describe objects,
properties, or events and are basic components of the theory.
Types:
1. Empirical concepts
2. Inferential concepts
3. Abstract concepts
 MODELS
 are representations of the interaction among and between the concepts showing patterns.
 The terms model and theory are often wrongly used interchangeably, which further
confounds matters.
 In nursing, models are often designed by theory authors to depict the beliefs in their
theory( Lancaster 1981)
 Models are useful as they allow the concepts in nursing theory to be successfully applied to
nursing practice ( Lancaster 1981). Their main limitation is that they’re only accurate or
useful as the underlying theory.

 PROPOSITIONS are statements that explain the relationship between the concepts.

 PROCESS is a series of actions, changes, or functions intended to bring about the desired
result. During a process, one takes systemic and continuous steps to meet goals and uses
both assessments and feedback to direct actions to the goal.

 A CONCEPTUAL FRAMEWORK directs how these actions are carried out. The delivery of
nursing care within the nursing process is directed by the way specific conceptual
frameworks and theories define the person(Patient), the environment, health, and nursing.

IMPORTANCE OF NURSING THEORIES

 The nursing theory aims to describe, predict and explain the phenomenon
of nursing (Chinn and Jacobs 1978).
 It should provide the foundations of nursing practice, help to generate
further knowledge, and indicate in which direction nursing should develop
in the future (Brown 1964).
 The theory is important because it helps us to decide what we know and
what we need to know (Parsons 1949).
 It helps to distinguish what should form the basis of practice by explicitly
describing nursing.
 The benefits of having a defined body of theory in nursing include better
patient care, enhanced professional status for nurses, improved
 communication between nurses, and guidance for research and education
(Nolan 1996).
 The main exponent of nursing caring- cannot be measured, it is vital to have
the theory to analyze and explain what nurses do.
 As medicine tries to make a move towards adopting a more
multidisciplinary approach to health care, nursing continues to strive to
establish a unique body of knowledge.
 This can be seen as an attempt by the nursing profession to maintain its
professional boundaries.

CHARACTERISTICS OF THEORIES
 1. Interrelating concepts in such a way creates a different way of looking at
a particular phenomenon.
 2. Logical
 3. Generalizable
 4. Bases for hypotheses that can be tested.
 5. Increasing the general body of knowledge within the discipline through
the research implemented to validate them.
 6. Used by the practitioners to guide and improve their practice.
 7. Consistent with other validated theories, laws, and principles but will
leave open unanswered questions that need to be investigated.
BASIC PROCESSES IN THE DEVELOPMENT OF NURSING THEORIES
 Nursing theories are often based on and influenced by broadly applicable processes and
theories. Following theories are basic to many nursing concepts.

GENERAL SYSTEM THEORY describes how to break whole things into parts and then
how the parts work together in systems. These concepts may be applied to different
kinds of systems. E.g. molecules in chemistry, cultures in sociology, and organs in
Anatomy and Health in Nursing.

 ADAPTATION THEORY -as the adjustment of living matter to other living things and
environmental conditions.
 -Is a continuously occurring process that affects change and involves interaction and
response.

HUMAN ADAPTATION OCCURS ON THREE LEVELS

 The internal self
 2. The social
 3. The physical ( biochemical reactions)

DEVELOPMENTAL THEORY - It outlines the process of growth and development of

humans as orderly and predictable, beginning with conception and ending with
death.
 The progress and behaviors of an individual are influenced by heredity, temperament,
emotional and physical environment, life experiences, and health status.

COMMON CONCEPTS IN NURSING THEORIES

 The person (patient)
  2. The environment
 3. Health
 4. Nursing (goals, roles, functions)

CLASSIFICATION OF NURSING THEORIES

A. CLASSIFICATION ON FUNCTION (Polit et al 2001)
 1.Descriptive – to identify the properties and workings of a discipline.
 2. Explanatory – to examine how properties relate and thus affect the discipline.
 3. Predictive – To calculate relationships between properties and how they occur.
 4. Prescriptive- to identify under which conditions relationships occur.

B.DEPENDING ON THE GENERALISABILITY OF THEIR PRINCIPLES

 1. Metatheory: the theory. Identifies specific phenomena through abstract concepts.
 2. Grand Theory: provides a conceptual framework under which the key concepts.

C.PRINCIPLES OF THE DISCIPLINE CAN BE IDENTIFIED

 1. Middle range theory: is more precise and only analyses a particular situation with a
limited number of variables.
 2. Practice Theory: explores one particular situation found in nursing. It identifies explicit
goals and details how these goals will be achieved.

D. BASED ON THE PHILOSOPHICAL UNDERPINNINGS OF THE THEORIES

 1. Needs theories
 2. Interaction Theories
 3. Outcome Theories
 4. Humanistic Theories

 Needs Theories are based on helping individuals to fulfill their physical and mental needs.
Needs theories have been criticized for relying too much on the medical model of health
and placing the patient in an overtly dependent position.

 INTERACTION THEORIES revolve around the relationships nurses form with patients. Such
theories have been criticized for/largely ignoring the medical model of health and not
attending to basic physical needs.

 OUTCOME THEORIES portray the nurse as the changing force, who enables individuals to
adapt to or cope with ill health.
 Outcomes theories have been criticized as too abstract and difficult to implement in
practice.

 HUMANISTIC THEORIES developed in response to the psychoanalytic thought that a

person’s destiny was determined early in life.
 Humanistic Theories emphasize a person’s capacity for self-actualization.
 -Humanistic believe that the person contains within himself the potential for healthy and
creative growth.
 Carl Rogers developed-centered a model of psychotherapy that emphasizes the uniqueness
of the individual.
  The major contribution that Rogers added to nursing practice is the understandings that
each client is a unique individual, so, person-centered approach is now practiced in nursing.

CONCLUSION
 Theory and practice are related.
 A theory presents a systematic way of understanding events or situations.
 It is a set of concepts, definitions, and propositions that explain or predict these events or
situations by illustrating the relationships between variables.
 Theories must apply to a broad variety of situations. They are by nature, abstract, and don’t
have a specified content or topic area. Like empty coffee cups, theories have shapes and
boundaries, but nothing inside. They become useful when filled with practical topics, goals,
and problems.

FILIPINO NURSING THEORIES

Letty Kuan “Retirement and Role Discontinuities”

• BIRTHDAY: November 19, 1936

• BIRTHPLACE: Katipunan-Dipolog, Zamboanga del Norte
• Master degree in Nursing and Guidance and Counseling
• Doctoral degree in Education
• Professor Emeritus: a title awarded only to a few who met the strict criteria
• Clinical Fellowship and Specialization in Neuropsychology in University of Paris, France
(Salpetriere Hospital)
• Neurogerontology in Watertown, New York (Good Samaritan Hospital) and Syracuse
University, New York.
• Bioethics formal training at Institute of Religion, Ethics and Law at Baylor College of
Medicine in Houston, Texas.
• Metrobank Foundation “Outstanding Teacher’s Award” in 1995 and “Award of Continuing
Integrity and Excellence in Service” in 2004. (ACIES)
• Former member of the Board of Nursing
• Concepts of illness and health care intervention in an urban community.
• by Kuan, Letty Gurdiel; Quezon City: 1975
• Understanding the Filipino elderly: atextbook for nurses and related health professional.
• By Kuan, Letty G.; Dipolog City: Jesus G. Kuan Foundation, 1993
• Essence of Caring
• By Letty G. Kuan
• National Teacher Training Center for the Health Professions, University of the
Philippines, Manila, Learning Resources Unit, 1993
• Pag-aaruga Sa Mga Taong May Edad Na.
• By Kuan, Letty G.; Quezon City: UP-KAT, 1998
• Bioethics in Nursing
• by Kuan, Letty G.; Manila: Educational Pub. House, 2006
Basic Assumptions and Concepts:
• Physiological Age:
endurance of cells and tissues to withstand the wear-and-tear phenomenon of the human body
• Role:
set of shared expectations focused upon a particular position
set of shared expectations from the retiree’s socialization experiences and the values
internalized while preparing for the position as well as the adaptations to the expectations socially
defined for the position itself
• Change of Life:
period between near retirement and post retirement years; the climacteric period of adjustment
and readjustment to another tempo of life
Basic Assumptions and Concepts:
• Retiree
an individual who has left the position occupied for the past years of productive life because
he/she has reached the prescribed retirement age of has completed the required years of service
• Role Discontinuity
the interruption in the line of status enjoyed or role performed
• Coping Approaches
interventions or measures applied to solve a problematic situation or state in order to restore or
maintain equilibrium and normal functioning
Determinants of positive perceptions in retirement and positive reactions toward role
discontinuities:
• Health Status
physiological and mental state of the respondents, classified as either sickly or healthy
• Income
(economic level) refers to the financial affluence of the respondent which can be classified as
poor, moderate or rich
• Work Status
• Family Constellation
type of family composition described either close knit or extended family where three more
generations of family members live under one roof; or distanced family, whose member live in
separate dwelling units; or nuclear type of family where only husband, wife and children live
together
• Self-Preparation

FILIPINO NURSING THEORIES

CARMENCITA ABAQUIN

• nurse with Master’s Degree in Nursing obtained from the University of the Philippines
College of Nursing
• Medical Surgical Nursing with subspecialty in Oncologic Nursing
 • served the University of the Philippines College of Nursing, as faculty and held the position
as Secretary of the College of Nursing

“PREPARE ME”
Interventions and the Quality of Life Advance Progressive Cancer Patients.
BASIC ASSUMPTIONS AND CONCEPTS:
• PREPARE ME (Holistic Nursing Interventions)
• nursing interventions provided to address the multi-dimensional problems of cancer
patients that can be given in any setting where patients choose to be confined.
• emphasizes a holistic approach to nursing care
PREPARE ME components
• Presence
being with another person during the times of need
includes therapeutic communication, active listening, and touch
• Reminisce Therapy
recall of past experiences, feelings and thoughts to facilitate adaptation to present
circumstances
• Prayer
• Relaxation-Breathing
techniques to encourage and elicit relaxation for the purpose of decreasing undesirable signs
and symptoms such as pain, muscle tension, and anxiety
• Meditation
encourages an elicit form of relaxation for the purpose of altering patient’s level of awareness by
focusing on an image or thought to facilitate inner sight which helps establish connection and
relationship with God
may be done through the use of music and other relaxation techniques
• Values Clarification
assisting another individual to clarify his own values about health and illness in order to facilitate
effective decision making skills
patient develops an open mind that will facilitate acceptance of disease state or may help
deepen or enhance values
helps one become internally consistent by achieving closer between what we do and what we
feel

FILIPINO NURSING THEORIES

Ma. Irma C. Bustamante, RN, PhD

WOMEN ABUSE
• BSN and her Master of Arts in Nursing, Major in Maternal and Child Health, both at the
University of Santo Tomas, with the highest honors
• Doctor of Philosophy in Nursing at the University of the Philippines.
 • educator, a counselor, a writer, a consultant, and a researcher, both nationally and
internationally
• faculty of the UST Graduate School and College of Nursing
• spoken in various international conference in the USA, Amsterdam, Malaysia, Bangkok, Hong
Kong, Beirut, Bahrain, South Africa, among others
• associate Professor at the Aga Khan International University, with eight international
satellite campuses for several years
BACKGROUND OF HER THEORY
• Women abuse has ben recognized as an increasing social problem affecting women of all
ages, race, creed, nationality, and socioeconomic status.
• To explore the womens perceptions of womanhood and sel-esteem.
• The study is about women abuse and how these women can be helped, the critical social
theory and feminist principles are most appropriate framework to us.
BASIC CONCEPTS AND ASSUMPTIONS
• Jurgens Habermas Critical Social Theory, feminism, and feminist principles were used as
framework.
Findings and Recommendations:
1. The essence of womanhood is being a good mother and a good wife;
2. Roles that women play can either be working mother or non-working mother, however,
whether women are working or not, they should still perform their responsibilities as
mother and wife.
3. Respondents felt that it is still the male who has the higher status in the society, although
they were others who felt that men and women are equal.
4. Abused was perceived wrong, however, respondents felt they could do little about the
situation.
5. A number of respondents felt that women are to blame for the occurrence of abuse.
6. 6. As measured by the self-esteem scale, the respondent self-esteem was found to be
moderate.
7. 7.There was no relationship between the roles that women play and their status in society to
their levels of self esteem.
8. 8. A significant difference in the self esteem existed:
a. Among the study group before and after the intervention measure, the Nursing Self-
Esteem Enhancement Program, which had been used for four consecutive weeks.
b. Between the study and the control group after the intervention measure has been used.
9. 9. There was no significant difference in Self esteem:
a. Among the control group before and after four weeks time duration
b. Between the control and study group before an intervention measure has been used.
10. 10. When the study and control group were taken together, the presence of the intervention
measure could predict an increase in self esteem. When taken singly among the study group,
no demographic variable could predict increase self-esteem.

SR. CAROLINA S. AGRAVANTE

SPC, RN, PH
AUTOBIOGRAPHY

She is famous for being the first Filipina theorist for writing the CASAGRA
Transformative Leadership Model. The title of the theory was derived from her name,
CArolina S. AGRAvante.“Focus on the type of leadership in nursing that can challenge
the values of the changing world.
She finished her secondary education at St. Paul Univeristy - Manila (formerly St. Paul
College - Manila) as class salutatorian.
In 1964, she earned her BS Nursing degree in the same school as magna cum laude. In
the same year, she passed the nurse licensure examinations as the board topnotcher.
From 1967 to 1969, she studied Master’s Degree in Nursing Education at Catholic
University of America as a full-fledged scholar.
In 2002, she earned her Doctoral Degree in Philosophy at University of the Philippines
Manila the same year her theory was published.

The model is a Three-Fold Transformation Leadership Concept rolled into one,

comprising of the following elements:
1.Servant-Leader Spirituality
2.Self-Mastery
3.Special Expertise

 The CASAGRA Transformative Leadership Model have concepts of leadership from a

psycho-spiritual point of view, designed to lead to radical change from apathy or
indifference to a spiritual person.

The CASAGRA Transformative Leadership Concept is classified as Practice theory

a. Complexity/Abtrsactness, Scope.
b. Generalizibility/ Specificity.
c. Characteristics of Scope.
d. Characteristic of Proposition.
e. testability.
f. Source of Development.

 Servant-leader formula is the enrichment package prepared as intervention for the

study which has three parts that parallel the three concepts of the CASAGRA
transformative leadership model, namely: the care complex primer, a retreat-
workshop on Servant-leadership, and a seminar-workshop on Transformative
Teaching for nursing faculty.
 Special expertise is the level of competence in the particular nursing area that the
professional nurse is engaged in workshop is the spiritual exercise organized in an
ambience of prayer where the main theme is the contemplation of Jesus Christ as a
Servant-leader.
 Servant-leadership behavior refers to the perceived behavior of nursing faculty
manifested through the ability to model the servant leadership qualities to students,
ability to bring out the best in students, competence in nursing skills, commitment to
the nursing profession, and sense of collegiality with the school, other health
professionals, and local community.
 Nursing leadership is the force within the nursing profession that sets the vision for
its practitioners, lays down the roles and functions, and influences the direction
toward which the profession should go.
  Transformative teaching may also be termed Reflective teaching, an umbrella term
covering ideas, such as thoughtful instruction, teacher research, teacher narrative, and
teacher empowerment.
 Care complex is the nucleus of care experiences in the personality of a nurse formed
by a combination of maternal care experiences, culture based-care practices
indigenous to a race and people, and the professional training on care acquired in a
formal course of nursing.

“TRANSFORMATIVE LEADERSHIP THEORY”

The CASAGRA Transformative Leadership Model:
A. Servant – Leader Formula
B. Nursing Faculty’s Transformative Leadership Behavior

CARMELITA DIVINAGRACIA
AUTHOR’S BIBLIOGRAPHY
• former president of the Association of Deans of Philippine Colleges of Nursing (ADPCN) and
the dean of the University of the East Ramon Magsaysay Memorial Medical Center in the
College of Nursing
• currently a member of CHED’s Technical Committee on Nursing Education
• Bachelor’s degree in Nursing at the University of the East Ramon Magsaysay Memorial
Medical Center in 1962
• Master’s degree in Nursing at the University of the Philippines in 1975 and her Doctorate’s
degree in Nursing at the University of the Philippines in 2001
• She has been a clinic nurse, staff nurse, head nurse, instructor, assistant dean and dean
• lectured and written about her work as a nurse and has used her hands-on experience to
develop better ways to teach nursing
THREE MAIN THEMES AND SUB THEMES WERE IDENTIFIED:
• COORDINATION
Intra-organizational Coordination
Inter-Organizational Coordination
Reciprocal Interdependence
• COMMUNICATION
Environmental factors
Personal factors

• INTERPERSONAL RELATIONSHIP
Engagement
Esprit (morale)
Concern
Support
CONCLUSION
• Coordination, communication and interpersonal relationships have been identified as major
components of collaboration based in the lived experiences of the respondents.
• Quality patient care and training of students can be at best only if nursing service and
education can truly operationalize the meaning of collaboration and put into real action.
• The connectedness of nursing service and education calls for a new wave of visionary
leadership, empowerment and an environment of trust and openness.
• Nursing as a profession can really draw a power base if only a unification model can be
crafted which is culture-based, practical, relevant and acceptable to the concerned nursing
professionals.
• Recommend “unification model for collaboration”
COMPOSURE BEHAVIORS
• Are sets of behaviors or nursing measures that the nurse demonstrates to selected patients
• COMPOSURE is an acronym which stands for competence. Presence and Prayer. Open-
mindedness, Stimulation, Understanding, Respect and Relaxation, Empathy

FILIPINO NURSING THEORIES

Cecilia Laurente
➢ Filipino nursing theorist, who focused her works primarily on helping a patient through
support systems, specifically the family
➢ published a paper entitled, “Categorization of Nursing Activities as Observed in Medical-
Surgical Ward Units in selected Government and Private Hospitals in Metro Manila.”
➢ known for her work in the field of nursing
➢ emphasized effective communication and championed using the family as an entry point to
help a patient
Cecilia Laurente’s Career
• Graduated BSN at University of the Philippines in 1967 and
• a Master of Nursing in 1973.
• She worked as a Staff Nurse in 1968-1969
• She became a Head Nurse in 1970-1972
• And as a Nursing Supervisor IN 1973-1976 at Philippine General Hospital
• She also worked at Metropolitan Hospital in Michigan US in 1977-1979
• She came and become an Instructor at the University of the Philippines College of Nursing in
1979
• And Later on she became a Dean of College of Nursing in UP Manila from 1966 - 2002
Theory of Nursing Practice and Career
• Categorization of Nursing Activities as Observed in Medical-Surgical Ward Units in selected
Government and Private Hospitals in Metro Manila, which was conducted from January to
June year 1987
• the other entry point of helping the patient is through the family when nurses can be of
great assistance to prevent at the very beginning serious complications
• The nurse can help strengthen the family’s term of knowledge, skills, and attitude through
effective communication, employed informative, psychotherapeutic, modeling, behavioral,
cognitive-behavioral, and/or hypnotic techniques are summarized and evaluated

Concepts of the Theory

❖ What is “Anxiety”?
➢ A mental state of fear or nervousness about what might happen
Nursing Caring Behavior that affects patient’s Anxiety:
• Presence
Person to person contact between the client and the nurses.
• Concern
Development in the time though mutual trust between the nurse and the patient
• Stimulation
Nurse stimulation through words tops the powerful resources of energy of person for healing
Enhancing and Predisposing Factor
❖ What is a predisposing Factor?
➢ factors that exert their effects prior to a behavior occurring, by increasing or
decreasing a person or population’s motivation to undertake that particular
behaviour
❖ Predisposing Factors
➢ Age
➢ Sex
➢ Civil Status
➢ Educational Status
➢ Length of Work
➢ Experience
❖ Enhancing Factors
➢ One’s caring experience, beliefs and attitude
➢ Feeling good about
➢ Learning at school
➢ What patients tell about the nurse coping mechanism to problems encountered
➢ Communication