LESSON 4.

NURSING THEORETICAL WORKS

O VERVIEW
Introduction

Welcome to Lesson 4.
This unit presents the Conceptual Models that addresses broad
metaparadigm concepts (human beings, health, nursing, and
environment) that are central to their meaning in the context of
the particular framework and the discipline of nursing. These
conceptual models provide perspectives with different foci for
critical thinking about persons, families, and communities, and
for making knowledgeable nursing education.
Let’s dig in now and see what is inside!

Figure 1. Welcome to Theoretical Foundation in Nursing

Module Lesson 4

LEARNING OUTCOMES:
1. Describe specific management and leadership concepts and principles in selected
theories.
2. Assume responsibilities for lifelong learning, own personal development and
maintenance competence.

LEARNING OBJECTIVES
1. Appreciate the value of Conceptual Models that addresses broad metaparadigm concepts.
2. Explain how the Science of Unitary Human Being Model influence professional practice in
nursing.
3. Describe the significance of Self-Care Deficit Theory for nursing practice and nursing
research.
4. Differentiate between the three (3) 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.

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 5. Discuss the use of nursing process as described on King’s Goal Attainment Theory.
6. Identify the Betty Neuman’s Systems Model three levels of nursing intervention based
on Caplan’s concept of levels of prevention.
7. Appreciate Sister Callista Roy’s Adaptation Model and how it greatly influenced the
profession of nursing.

KEY TERMS:
Adaptation: the act or process of changing to better suit a situation.
Conceptual Model: a set of relatively abstract and general concepts and propositions
about those concepts that address the concepts of the nursing metaparadigm
Self-care: the ability of individuals, families and communities to promote health, prevent
disease, maintain health, and to cope with illness and disability with or without the
support of a healthcare provider.
Self-Care Deficit is the inability of an individual to perform self-care.

ACTIVITY

Before reading the abstraction, do this activity:

1. Have you taken cared of just recently of a family member who’ve been sick at
home? Take a minute to reflect and jot down notes on the concept of your experience
as the provider of care to someone who is dependent on you or need an assistance to
meet his/her activities of daily living? A simplified way to think of it is to imagine
you taking good care of an ill person at home with a goal of satisfying her/his needs.
Was the experience fulfilling or exhausting? What did you feel when the condition of
the patient improves or worsen? What have you realized then? Explore your feelings.
.
ANALYSIS
Now that you have done this activity, what did you learn from the experience? I
have given you this activity to prepare you for this section. I am confident that you will
learn to appreciate the lesson as you proceed to reading the abstraction.

ABSTRACTION

Lesson 4:
Nursing Conceptual Models

I.
MARTHA ROGER’S SCIENCE OF
UNITARY HUMAN BEINGS
NURSING CONCEPTUAL MODEL
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 The theory views nursing as both a science and an art as it provides a way
to view the unitary human being, who are integral with the universe.
 The unitary human and his or her environment as one.
 Nurses focuses on people and manifestations that emerge from the mutual
human-environmental field process.
o SUHB contains 2 Dimensions:
 1. The science of nursing, which is the knowledge specific
to the field of nursing that comes from scientific research,
and
 2. The art of nursing, in which involves using the science of
nursing creatively to help better the life of the patient.
 Addresses environment as an integral part of the patient and uses that
knowledge to help nurses blend the science and art of nursing to ensure
patients have smooth recovery and can get back to the best health possible.
o Patient can’t be separated from his or her environment when
addressing health and treatment. This view lead SUHB which
allowed nursing to be considered one of the scientific disciplines.
 Considers man as a
a. unitary human being co-existing within the universe,
b. views nursing primarily as a
1. science and
2. is committed to nursing research.

II.
OREM’S SELF-CARE DEFICIT
MODEL

 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 home level of effectiveness.”
 Focuses on each individual’s ability to perform self-care.
 Composed of three (3) 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
 Emphasizes the client’s self-care needs, nursing care becomes necessary when
client is
a. unable to fulfill
b. biological,
c. psychological,
d. developmental or

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 e. social needs

 Developed the Self-Care Deficit Theory

 Defined self-care as “the practice of activities that individuals initiate to perform
on their own behalf in maintaining life, health well-being.
 She conceptualized three systems as follows:
Three Systems:
1. Wholly Compensatory: when the nurse is
• expected to accomplish all the patient’s therapeutic self-care
or
• to compensate for the patient’s inability to engage in self
care or
• when the patient needs continuous guidance in self care;

2. Partially Compensatory:
• when both nurse patient engage in meeting self care
needs
3. Supportive-Educative:
• the system that requires
− assistance decision making,
− behavior control and
− acquisition knowledge and skills

III.
KING’S GENERAL SYSTEMS
FRAMEWORK NURSING
CONCEPTUAL MODEL

 Conceptual System and Middle-Range Theory of Goal Attainment

 Imogene M. King Postulated the Goal Attainment Theory

 “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 the 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 the goals towards
good health.

 Nursing Process is defined as dynamic interpersonal process between

• nurse,
• client and

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 • health care system

• Described nursing as a
• helping profession that assists individuals and groups in
society to
− attain,
− maintain, and
− restore health.
− If is this not possible, nurses help
individuals die with dignity.

 King viewed nursing as an interaction process between client and

nurse whereby
• perceiving,
• setting goals, and
• acting on them transactions occurred and
• goals are achieved

IV.
BETTY NEUMAN’S SYSTEM
MODEL

 She defined nursing as “a unique profession 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 the five (5) variables (physiological,
psychological, sociocultural, developmental, and spiritual) and is
conceptualized as an inner core (basic energy resources) surrounded
by concentric circles that include lines of resistance, a normal line of
defense, and a flexible line of defense.
 Stress reduction is the goal of system model of nursing practice
 Nursing actions are in
o Primary
o Secondary, or
o Tertiary level of prevention

V.
ROY’S ADAPTATION MODEL

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 Sis. Callista Roy presented the Adaptation Model
Views the client as an adaptive system
Defined nursing as a “health care profession that focuses on human life processes
and patterns and emphasizes promotion of health foe individuals, families,
groups, and society as a whole.”
The goal of nursing is to help the person adapt to changes in physiological
needs, self-concept, role function and interdependent relations during health and
illness.
She viewed each person as a unified bio-psychosocial system in constant
interaction with a changing environment.
Views the individual as a set of interrelated systems who strives to maintain
balance between various stimuli.
She consented that the person as an adaptive system, functions as a whole
through interdependence of its part.
The system consists of input, control processes, output feedback.
She inspired the development of many middle-range nursing theories and of
adaptation instruments

VI.
JOHNSON’S BEHAVIORAL
SYSTEMS MODEL

 Conceptualized the Behavioral System Model

 The Dorothy Johnson’s Behavioral System Model define Nursing as “an
external regulatory force which acts to preserve the organization and
integration of the patient’s 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 the fostering of 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.
 Focuses on how the client adapts to illness.
 The goal of nursing is to reduce stress so that the client can move more easily
through recovery
 The nursing process is viewed as a major tool.
 Viewed the patient’s behavior as a system, which is a whole with interacting
parts
 Describes the person as a behavioral system with seven subsystems: the
achievement, attachment-affiliative, aggressive-protective, dependency,
ingestive, eliminative, and sexual subsystems.

 Johnson system is composed of seven subsystems namely:

• Ingestive.

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 • Taking in nourishment in socially and culturally acceptable ways.
• Eliminated.
• Ridding the body of waste in socially and culturally acceptable
ways.
• Affiliative.
• Security seeking behavior.
• Aggressive.
• Self – protective behavior.
• Dependence.
• Nurturance – seeking behavior.
• Achievement.
• Master of oneself and one’s environment according to internalized
standards of excellence.
• Sexual role identity behavior

APPLICATION AND EXERCISE:

Post-test

Part I. Mastery

1. Discuss the goal of nursing in Dorothy Johnson’s Behavioral System Model?

2. Explain in your own words the meaning of viewing the client as an adaptive system?
3. What is the ultimate goal of caring King’s Goal Attainment in Caritative Theory? Please
elaborate?

FEEDBACK
How was it? Did the lesson easier to comprehend? Did you understand what was
presented, answered the activity/post-test and met the set learning objectives? If the answer is yes, then
you are now ready for our next lesson. But if you find the topic difficult, then read more about it, review
and analyze the lesson very carefully until you fully understand the content.

SUMMARY

This unit presented the Conceptual Models that addresses broad metaparadigm concepts (human
beings, health, nursing, and environment) that are central to their meaning in the context of the particular
framework and the discipline of nursing.
Martha Rogers Science of Unitary Human Beings model provides a challenging framework from
which to provide nursing care. Understanding the concepts of and principles of this model requires a
foundation in general education, a willingness to let go of the traditional, and an ability to perceive the
world in a new and creative way.

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 Imogene M. King postulated the Goal Attainment Theory focusing on the attainment of the goals,
or outcomes, by nurse-patient partnerships, and has demonstrated its usefulness to nurses. Nurses
working in a variety of settings with patients from around the world continue to use King’s work to
improve the quality of patient care.
Orem’s Self-Care Deficit Theory describes the limitations involved in meeting requirements for
nursing care and the effects they have on health and well-being of the person or dependent. Orem’s work
related to SCDNT and the form of nursing science as a practical science provides a foundation for the
development of a body of knowledge which serves nurses in their provision of care to persons requiring
nursing.
Betty Neuman’s Systems Model proposes three levels of nursing intervention based on Caplan’s
concept of levels of prevention with a purpose as an intervention is to achieve the maximum possible
level of client system stability. Suggesting to use a nursing process format in which the client, as a
recipient of care, participates actively with the nurse as caregiver to set goals and select interventions.
Sister Callista Roy presented the Adaptation Model that greatly influenced the profession of
nursing. A frequently used models to guide nursing research. According to Roy, persons are holistic
adaptive systems and the focus of nursing. Adaptation promotes survival, growth, reproduction, mastery
and transformation of persons and the environment. Dorothy Johnson’s Behavioral System Model
describes the person as a behavioral system with seven subsystems. When the individual has balance and
stability, the individual’s behavior will be purposeful, organized, and predictable. Johnson’s ultimate goal
were directed toward nursing practice, a curriculum for schools of nursing and to develop nursing science.

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 theorists and their work. 6th Edition. St.
Louis: Mosby

Recommended Follow-Up/Readings:
In order to reinforce your understanding of the material, you are encouraged to read the
following:
1. Nursing conceptual models from the references listed above and identify the different
models/diagrams used by the nursing theorist to present their theory.

Thank you!