LEARNING MODULE 1

Course Title : NCM 51 – Theoretical Foundation of Nursing

Topic : History of Nursing Theory, History and Philosophy of
Nursing Science

Introduction

In this module, the students will learn the overview of the Theory of Nursing,
the history and Philosophy of Nursing Science. Also, the different terms that are being
used in theoretical foundations of nursing and the importance of nursing theory.

LEARNING MAP

Learning Outcomes Tasks/Assessment

1. Apply knowledge of the History • Answer the PRE-TEST as a start-up
of Nursing Theory and History activity before reading the
and Philosophy of Science in the INFORMATION NOTES and chapter 2 of
practice of nursing. your textbook.

2. Show relevant concepts and

metaparadigm of theories on
Person, Health, Environment
and Nursing in nursing practice.
3. Distinguish the different terms
or the fundamental building
blocks of Nursing Theory.
• Read Information Notes and Chapter 2
of your textbook for more details on
Collecting Subjective Data: The
Interview and Health History in order
for you to understand this topic (refer
to the given references below)
• Answer the activities under
Evaluation of Learning Outcomes
You will be evaluated using a rubric.
(see attached rubrics)

• Write your REFLECTION

References:

1. Johnson, B & Webber, P. An Introduction to Theory and Reasoning in Nursing.

(4thed). USA. Lippincott William and Wilkins.
2. Wills, E. & McEwen, M. (2017). Theoretical Basis for Nursing. (3rd ed). USA.
Lippincott and Wilkins.
3. Udan, J.Q, (2011). Theoretical Foundations of Nursing (2nd ed.) Updated
2020.Educational Publishing House, Guiani Prints House, Malabon,
Philippines.
 Pre-test:

Take a few minutes to complete the Self-Assessment. It will not

be scored and you will be able to determine whether you answered
each question correctly as we progress through the lesson. Arrange
the events in order by putting the corresponding number (1 to 5).

____The Columbia School

____Florence Nightingale
____The time when there were many theories presented.
____The Yale School
____Research studies that tested and expanded nursing theory
were numerous

Read each sentence. Encircle your selected answer.

1. The nursing metaparadigm identifies four linkages of interest to the nursing

profession. These four linkages are:
a. Concepts, definitions, relationships, and assumptions.
b. The person, health, environment/situation, and nursing
c. The individual, groups, situations, and interests specific to nursing.
d. Description, explanation, prediction, and prescription of an interrelationship
of nursing.

2. A ________________________ is a set of concepts, definitions,

relationships, and assumptions that:
a. A theory formulates legislation.
b. A theory explains a phenomenon.
c. A theory measures nursing functions.
d. A theory reflects the domain of nursing

3. _________ is human being’s significant others and physical surroundings

as well as local, regional, national and worldwide, cultural, social, political,
and economic conditions that are associated with person’s health.
a. Person
b. Environment
c. Health
d. Nursing

3. Evidence-based nursing practice is the end result of

a. Use of practical knowledge
b. Theory-generating and theory-testing research
c. Application of theoretical knowledge
d. Prescriptive theory

5. Conceptualization of some aspect of nursing communicated for the purpose

of describing, explaining, predicting, and/or prescribing nursing care.
a. nursing theory
b. assumption
c. paradigm
d. phenomenon

6. ___________are accepted as truth and represented the values and beliefs

of the theory or conceptual framework. Assumptions form the basis for defining
concepts and framing propositions.
a. phenomenon
b. theory
c. assumption
d. paradigm

7. It is an aspect of reality that people consciously sense or experience.

a. phenomenon
b. theory
 c. concept
d. paradigm

8. Can be simple or complex and relate to an object or event that comes from
individual perceptual experiences.
a. phenomenon
b. theory
c. concept
d. paradigm

Write down your reflection about your reading assignment.

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Grading
Rubric for
What’s Up!
Exemplary= Above Adequate= Inadequate=
CRITERIA 4 (Far Average=3 2 (Meets 1 (Below
Exceeds (Exceeds Standard) Standard)
Standard) Standard)
Writing shows Writing is Writing is Writing lacks
high degree of coherent coherent and logical
attention to and logically logically organization. It
logic and organized organized. shows some
ORGANIZATIO reasoning of with Some points coherence but
N points. Unity transitions remain ideas lack
clearly leads used misplaced unity. Serious
the reader to between and stray errors.
the conclusion ideas and from the
and stirs paragraphs topic.
thought to create Transitions
regarding the coherence. evident but
topic. Overall not used
unity of throughout
ideas is essay.
present.
Content Content Content Shows some
indicates indicates indicates thinking and
synthesis of original thinking and reasoning but
LEVEL OF ideas, in- thinking and reasoning most ideas are
CONTENT depth analysis develops applied with underdevelope
and evidences ideas with original d and
original sufficient thought on a unoriginal.
thought and and firm few ideas.
support for the evidence.
topic.
Main points Main points Main points Main points lack
well developed well are present detailed
CRITICAL with high developed with limited development.
THINKING quality and with quality detail and Ideas are vague
quantity supporting development. with little
support. details and Some critical evidence of
Reveals high quantity. critical thinking.
 degree of Critical thinking is
critical thinking is present.
thinking. weaved into
points
Essay is free of Essay has Most spelling, Spelling,
distracting few spelling, punctuation, punctuation,
spelling, punctuation and grammar and
punctuation, , and correct grammatical
GRAMMAR & and grammatical allowing errors create
MECHANICS grammatical errors reader to distraction,
errors; absent allowing progress making reading
of fragments, reader to though difficult;
comma follow ideas essay. Some fragments,
splices, and clearly. Very errors comma splices,
run-ons. few remain. run-ons
fragments evident. Errors
or run-ons. are frequent.

TOTAL

Adopted from http://home.snu.edu-hculbert/survive.pdf

LET’S LEARN TOGETHER

INFORMATION NOTES

A. Introduction to Nursing Theory

Introduction:
The nursing profession has impressively evolved over time, and along this
transition came nursing theories. The beginning of the nursing theory development
can be traced to Florence Nightingale. However, it was not until the second half of
the twentieth century that nursing theory caught the attention of nursing as a
discipline. It was recognized that, to develop nursing as an academic discipline and
a profession, a body of knowledge to guide nursing practice is essential. Furthermore,
it was realized that theory development is significant to develop a substantive body
of knowledge to guide nursing practice to establish as a profession and an academic
discipline. (Udan, 2020)
B. History and Philosophy of Science

1. Rationalism- This can be described as the ‘theory-then-research’ approach

(Reynolds, 1971). Because the theory comes first, this approach to knowledge
development can also be called deductive or a priori reasoning.

2. Empiricism- is a philosophy of science which believes that knowledge is derived

entirely from sensory experience. Empiricism can be described as the ‘research-then-
theory’ approach (Reynolds, 1971). In essence, theorists experience a phenomenon
through their senses and they identify concepts and propositions that attempt to
explain what they perceive.

3. Early twentieth Century views- During the first half of this

century, philosophers focused on the analysis of theory structure,
whereas scientists focused on empirical research (Brown, 1977). Positivism, a term
first used by Comte, emerged as the dominant view of modern science (Gale, 1979).
Modern logical positivists believed that empirical research and logical analysis
(deductive and inductive) were two approaches that would produce scientific
knowledge (Brown, 1977).

4. Emergent views of science and theory in the late twentieth century-

Foucault (1973) published his analysis of the epistemology (knowledge) of human
sciences from the seventeenth to the nineteenth century. His major thesis stated that
empirical knowledge was arranged in different patterns at a given time and in a given
culture and that humans where emerging as objects of study. In The Phenomenology
of the Social World, Schutz (1967) argued that scientists seeking to understand the
social world could not cognitively know an external world that is independent of their
own life experiences. A phenomenological approach reduces observations or text to
the meanings of phenomena independent of their particular context. This approach
focuses on the lived meaning of experiences.

Definition of Terms

§ Theory- Group of related concepts that propose actions that guide practice.

§ Nursing Theory- According to Meleis (2005), it is defined as conceptualization

of some aspect of nursing reality communicated for the purpose of describing
phenomena, explaining relationships between phenomena, predicting
consequences, or prescribing nursing care.

§ Metaparadigm- Nursing has a model or paradigm that explains the linkages of

science, philosophy, and theory that is accepted and applied by discipline.

§ A metaparadigm is the global perspective of a discipline that identifies the primary

phenomena of interest to that discipline and explains how the discipline deals with
those phenomena in a unique manner (Fawcett, 2000).

o Person- Human being or person: individuals, families, communities,

and other groups who are participants in nursing. (Udan, 2020)

o Health- Human process of living and dying. (Udan, 2020)

o Environment- Human being’s significant others and physical

surroundings as well as local, regional, national and worldwide,
cultural, social, political, and economic conditions that are associated
with person’s health. (Udan, 2020)

o Nursing- The actions taken by the nurses on behalf or in conjunction

with persons, and the goals of nursing actions; the process of which
encompasses activities that are referred to as assessment, diagnosis
(labeling), planning, intervention and evaluation (Fawcett, 2005, p.6)

§ Nursing Philosophy- Set forth the general meaning of nursing and nursing
 phenomena through reasoning and the logical presentation of ideas.

§ Philosophies are broad and address general ideas about nursing. Because of the
breadth, nursing philosophies contribute to the discipline by providing directions,
clarifying values and forming foundation for theory development.

§ Conceptual Framework/Model- Also called paradigms or frameworks. Are

composed of abstract and general concepts and propositions that provide a frame
of reference for members of the discipline. This frame of reference determines
how the world is viewed by the members of discipline and guides the members as
they propose questions and make observations It is a set of concepts and
statements that integrate the concepts into meaningful configuration.

§ Science- Science is concerned with causality (cause and effect). The scientific
approach to understanding reality is characterized by observation, verifiability,
and experience; hypothesis testing and experimentation are considered scientific
methods.

§ Knowledge- refers to the awareness or perception of reality acquired through

insight, learning, or investigation. In a discipline, knowledge is what is collectively
seen to be a reasonably accurate understanding of the world as seen by members
of the discipline.

§ Phenomenon- A set of empirical data or experiences that can be physically

observed or tangible such as crying or grimacing when in pain.

§ Concepts- A term or a label that describes a phenomenon or group of

phenomenon (Meleis, 2007). The label or word or phrase that summarizes ideas,
observations, and experiences so as to provide a mental image for the purpose of
facilitating communication and understanding about the phenomena (Fawcett,
2005). The phenomenon described by a concept maybe either empirical or
abstract. An empirical concept is one that can be either observed or experienced
through the sense. An abstract concept is one that is not observable, such as
hoping or caring. (Hickman, 2002)

§ Assumption- are accepted as truth and represented the values and beliefs of the
theory or conceptual framework. Assumptions form the basis for defining concepts
and framing propositions. (Meleis, 2007).

§ Middle Range Theories- The need for practice disciplines to develop middle
range theories was first proposed in the field of sociology in the 1960s. In nursing,
development of middle range theory is growing to fill the gaps between grand
nursing theories and nursing practice.

§ Compared to grand theories, middle range theories contain limited numbers of

concepts and are limited in scope. Within the scope of middle range theories, how-
ever, some degree of generalization is possible across specialty areas and
settings. Propositions are clear, and testable hypotheses can be derived. Middle
range theories cover such concepts as pain, symptom management, cultural
issues, and health pro- motion (Higgins & Moore, 2000; Peterson, 2008; Walker
& Avant, 2005).

§ Grand theories- In nursing, grand theories are composed of relatively abstract

concepts that are not operationally defined and attempt to explain or describe
very comprehensive aspects of human experience and response. Grand theories
consist of conceptual frameworks defining broad perspectives for practice and
ways of looking at nursing phenomena based on these perspectives. They provide
global viewpoints for nursing practice, education, and research, but they are
limited because of their generality and abstract- ness. Because of their level of
abstraction, these theories are generally difficult to apply to the daily practice of
nurses and are difficult to test (Hickman, 2002; Higgins & Moore, 2000; Peterson,
2008; Walker & Avant, 2005).
§ Early grand nursing theories focused on the nurse–client relationship and the role
of the nurse. Later grand theories expanded to more encompassing concepts
(holistic perspective, interpersonal relations, social systems, and health). Recent
grand theories have attempted to address phenomenological aspects of nursing
(caring, transcultural issues) (Moody, 1990). Chapters 6 through 9 provide an
examination of grand nursing theories.

§ Evidence-based nursing practice is the end result of Theory-generating and

theory-testing research.

Evaluation of Learning Outcomes

1. Based on your knowledge about the History of Nursing Theory and

History and Philosophy of Science, site a nursing theory from the past
that would be helpful in the prevention of COVID. State the reason
why you chose that particular nursing theory.

2. Identifying Metaparadigm
Choose a Nursing theory and determine the theory’s definition
of nursing metaparadigm. Give your thoughts about the theory why
is it important in the nursing practice.
DISCUSSION POINT RUBRICS
Exemplary Proficient Limited Unsatisfact SCOR
Criteria
(4) (3) (2) ory(1) E
Critical Discussion Discussion Discussion Discussion
Analysis points points points points show
display an display an repeat and little or no
(Under- excellent understandi explained evidence that
standing understandi ng of the basic, scenarios
of the ng of the required correct were
given required scenarios informatio completed or
scenario) scenarios and n, but do understood.
and underlying not link Points are
underlying concepts scenarios largely
concepts including to outside personal
including correct use references opinions or
correct use of , relevant feelings, or "I
of terminology research agree" or
terminology. and proper or specific "Great idea,"
Points citation. real-life without
integrate an application supporting st
outside and do not ate-ments
resource, or consider with concepts
relevant alternative from the
research, or perspectiv scenario,
specific real- es or outside
life connection resources,
application; s between relevant
Well-edited ideas. research, or
quotes are Sources specific real-
cited are not life
appropriatel cited. application.
y.
Connectio Strong, Some direct
Minimal No
n to direct connections
direct connections
Course connections are made to connection are made to
Materials are made to readings s are made readings or
readings and/or other
to readings other course
and/or other course and/or materials
course materials other (textbook,
materials (textbook,course journal,
(textbook, journal, materials media,
journal, media, (textbook, resources,
media, resources,journal, etc.), and/or
resources, etc.) and are
media, if made, are
etc.) and are clearly resources, not clearly
clearly stated for
etc.). stated and
stated. the most
Connectio are largely
part. ns are personal
largely opinions.
inferred
and
somewhat
unclear at
times.
Quality of Written Written Written Written
Writing responses responses responses responses
and are free of are largely include contain
Proofreadi grammatical free of some numerous
ng , spelling or grammatical grammatic grammatical,
punctuation , spelling or al, spelling spelling or
errors. The punctuation or punctuation
 style of errors. The punctuatio errors. The
writing style of n errors style of
facilitates writing that writing does
communicat generally distract not facilitate
ion facilitates the effective
communicati reader. communicati
on. on.

3. Case Study

The given scenario has the application of the important terms or the building
blocks of the nursing theory. Write the sentence or sentences that corresponds to
the terms in the table below.

Sarah Walker is a 22-year-old, senior-level nursing student who is participating

in a month long clinical experience on the pediatric ward of a large urban hospital.
One of Ms. Walker’s responsibilities is to record food and fluid intake for each of the
children under her care. By the third week, Ms. Walker observes the phenomenon
that the children she is caring for eat better at mealtime if their mothers are present.
Ms. Walker realizes that if this observation is true, it could have a significant effect
on how the pediatric unit approaches meeting nutritional needs of children.

Ms. Walker has to develop a research question for the nursing research class
she is taking. She decides to use her observations about the relationship between
children eating and the presence of their mothers to demonstrate the various
theoretical building blocks to form the research question for her class.

Terms Sentence or Sentences

1. Phenomenon

2. Knowledge

3. Assumption

4. Concept

Reflection:
What are your insights on the lesson?
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________