Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
Web: http://uep.edu.ph Email: uepnsofficial@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

BS NURSING

THEORETICAL FOUNDATION IN NURSING

Prepared by:

NEMIA G. FLORANO, RN, MMEM

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 LESSON 2.
STRUCTURE OF NURSING KNOWLEDGE

O VERVIEW
Introduction

Welcome to Lesson 2.

The structure of nursing knowledge can assist you

in your pursuit of knowledge as a nursing student. The
ways of knowing will help you define yourselves in terms
of what knowledge you possess and seek to acquire.
Today’s knowledge development will continue to alter
with times as societal values and resources changed but
despite these modifications, throughout time nurses
advanced and applied knowledge to improve practice.

This is it! Let’s start!! Good luck!

Figure 1. Welcome to Theoretical Foundation in Nursing

Module Lesson 2

LEARNING OUTCOMES:
1. Appreciate the value of evidence-based nursing practice in the application of nursing
and related models/theories.
2. Ensure a working relationship utilizing relevant concepts /theories of effective
communication and interpersonal relationship in nursing practice.

LEARNING OBJECTIVES
1. Appreciate nursing as both an art and a science
2. Learn to understand and interpret self and nursing practice at a much higher level.
3. Integrate relevant concepts and metaparadigm of theories on person, health, environment
and nursing in nursing practice
4. Describe the key terms; in the structure of nursing knowledge.
5. Discuss the role of knowledge development in the evolution of the discipline in nursing,
nursing science, and advance nursing practice.

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KEY TERMS:
Metaparadigm: Specify the broad boundaries of the phenomenon concern in a nursing discipline
Middle-Range Theory: Theories focused at the nursing practice level.
Person: The recipient of care.
Philosophy: Sets forth the meaning of nursing phenomena through analysis, reasoning, and
logical presentation.
Theory: One or more hypotheses that explains a set of related observations or events and has
been verified multiple times.

ACTIVITY
Do this activity before reading the abstraction:

1. To understand the fundamental truths about yourself, think of what is your

philosophy of life. Explore your philosophy of life and ask yourself will this help you
lead a meaningful life in the future as a nurse. Jot down notes while reflecting on this
philosophy.

ANALYSIS
After doing this activity, what have you realized? Do you have a philosophy of
life or not? I have given you this activity to help you seek to understand fundamental
truths about yourself, the world in which you live in, your relationship to the world, and
to others. This will further let you comprehend and appreciate the content of this lesson.

ABSTRACTION

Lesson 2:
STRUCTURE OF NURSING
KNOWLEDGE

1. Structure Level
Fawcett called the holarchy a theory of the structure of nursing
knowledge. It consist of a metaparadigm, philosophies,
conceptual models, and empirical indicators in a holarchy
organized by decreasing levels of abstraction.

2. Metaparadigm is the structure of a nursing theory. The

nursing metaparadigm is consist of four main concepts: person,
health, environment, and nursing. Each theory is regularly
defined and described by a Nursing Theorist. The main focal

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 point of nursing out of the four various common concepts is the
person (patient).
a. Person (patient, human beings)
b. Health
A dynamic process, is a synthesis of wellness and
illness and is defined by the perception of the client
across the lifespan.
.
c. Environment
Is the landscape and geography of human social
experience, the setting or context of experience as
everyday life and includes variation in space, time, and
quality. Environment also includes societal beliefs,
values, mores, customs and expectations
Geography includes personal, social, national,
global and beyond.

d. Nursing is an academic discipline and a practice

profession. It is the art and science of holistic health
care guided by the values of human freedom, choice
and responsibility.

a. Nursing as a Science
Nursing Science is a body of knowledge arrived at
through theory development, research and logical
analysis.

b. Nursing as an Art
The art of nursing practice, actualized through the
therapeutic nursing interventions, is the creative use of
this knowledge in human care.

Nurses use critical thinking and clinical judgment to

provide evidence-based care to individuals, families,
aggregates and communities to achieve an optimal level
of client wellness in diverse nursing settings/contexts.

3. A Philosophy of nursing is a statement that outline’s a nurse’s

values, ethics and beliefs, as well as their motivation for being
part of the profession. It covers a nurse’s perspective regarding
their education, practice, and patient care ethics.

Nursing Philosophy is the most abstract type and sets the

forth the meaning of nursing phenomena through analysis,
reasoning and logical presentation.

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4. Conceptual Models or a theoretical framework provides a
coherent, unified and orderly way of envisioning related events
or processes relevant to a discipline (Fawcett, 2005). The most
common use of conceptual models is to provide an organizing
structure for the research design and methods.

Nursing conceptual models comprises nursing works by

theorists referred to by some as pioneers in nursing. It
provides distinct frame of reference for its adherents… that
tells them how to observe and interpret the phenomena of
interest. Nursing models are comprehensive, and each
addresses the metaparadigm concepts of person,
environment, health and nu

5. Theory a system of ideas intended to explain something,

especially one based on general principles independent of the
thing to be explained

Nursing theory is the term given to the body of knowledge that

is used to support nursing practice. Nursing models are
constructed theories and concepts. They are used to help
nurses assess, plan and implement patient care by providing a
framework within which to work.

6. Middle-Range Theory is a set of related ideas that are focused

on a limited dimension of the reality of nursing. It can be used
to guide everyday practice, providing the frame of reference
the CNS needs to guide selection of interventions in various
patient care situations.

Middle-range theory are precise and answer specific

nursing practice questions. They address the specifics of
nursing situations within the perspective of the model or theory
from which they are derived.

Types of Knowledge Structure Levels with Examples

Structure Level Example

Metaparadigm Person, environment, health, and nursing

Philosophy Nightingale

Conceptual models Neuman’s systems model

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 Theory Neuman’s theory of optimal client
stability

Middle-range theory Maintaining optimal client stability with

structured activity (body recall) in a
community setting for healthy aging

This table presents the ten exemplars of early theoretical work of historical
significance. Read to learn more about these early nursing pioneers.

Early Theorists of Historical Significance

Hildegard E. Peplau 1909 to 1999

Virginia Henderson 1897 to 1996
Faye Glenn Abdellah 1919 to present
Ernestine Wiedenbach 1900 to 1996
Lydia Hall 1906 to 1969
Joyce Travelbee 1926 to 1973
Kathryn E. Barnard 1938 to present
Evelyn Adam 1929 to present
Nancy Roper 1918 to 2004
Winifred Logan*
Alison J.Tierney*
Ida Jean Orlando Pelletier 1926 to 2007

APPLICATION AND EXERCISE:

Post-test

Part I. Essay Test

Directions: Explain each question, before you begin writing, read the statement
carefully and plan what you will say. Your essay should be as well organized and as
carefully written as you can make it.

1. Why structure of knowledge in nursing profession important? ____________

______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
2. Why everybody needs a life’s philosophy? ___________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________

FEEDBACK

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 How was the lesson? Were you able to grasp the lesson, answer the activities / post-test
and met the learning objectives? If you were able to identify and acknowledge your philosophy
of life, well done, it will shape and guide your life and you’re ready with Lesson 3. But if you
have trouble identifying it, don’t worry, now is the best time to make a personal philosophy that
will make you live with direction and purpose as you pursue your nursing course. If you have
encountered a little difficulty with the lesson, don’t be discouraged, review the lesson until
you’re ready with Lesson 3.

SUMMARY

Lesson 2 presents the specialized nursing knowledge structure levels with examples. It
emphasized the importance of nurses to the nation’s health wherein sociologists recommends
that nursing be developed as a profession. The criteria for a profession provided a guidance and
an important driving force in recognition of nursing as a profession.

REFERENCES

1. Alligood, M. R. (2014). Nursing theorist and their work. 8th edition. Elsevier.
2. George, J. (2012). Nursing Theories: The base for Professional Nursing Practice. 6th
edition.
3. Tomey, A. M., & Alligood, M. R. (2006) Nursing theoists and their work. 6th Edition.
St Loius: Mosby