Florence Nightingale Environmental Theory

Faye Abdellah 21 Nursing Problems Theory

Virginia Henderson Nursing Need Theory

Dorothea Orem Self-Care Deficit Theory of Nursing

Callista Roy Roy Adaptation Model (RAM)

Hildegard Peplau Interpersonal Relations Theory

Betty Neuman Neuman Systems Model

Myra Levine Levine’s Conservation Model

Lydia Hall Core, Care, Cure Model

Jean Watson The Theory of Human Caring

Dorothy Johnson Behavioural System Model

Imogene King Goal Attainment Theory

Theory of Culture Care Diversity

Madeleine Leininger
and Universality

Abraham Maslow Hierarchy of Needs

Carmencita Abaquin Prepare Me Theory

Retirement and Role

Sister Letty Kuan
Discontinuities

Sigmund Freud Psychosexual Theory

Erik Erikson Psychosocial Theory

Jean Piaget Cognitive Development Theory

Lawrence Kohlberg Moral Development Theory

 Theory Nursing Human/Person Health Environment

The person is referred to as a patient and seen as an

Healthcare profession that focuses on human
individual.
life processes and patterns.
Florence Nightingale Environmental Being well and using every power (resource) to
Nursing is to assist nature in healing the patient.
(FN) Theory People are multidimensional, composed of biological, the fullest extent in living life.
Emphasizes promotion of health for individuals,
psychological, social, and spiritual components.
families, groups, and society as a whole.

Recognizing the nursing problems of the

patient.

Deciding the appropriate actions to take in
terms of relevant nursing principles.
21 Nursing
Faye G. Abdellah (FA)
Problems Theory
Adjusting total nursing care plan to meet the
patient’s individual needs.
Emphasis should be placed upon prevention and
Having physical, emotional, and sociological needs.
rehabilitation. Home or community from which the client comes.
Recipients of nursing, and health, or achieving of it is the
Holistic approach must be taken by the nurse to Society is included in “planning for optimum health.”
purpose of nursing services.
help the client achieve state of health.

Working with allied health professional in

planning for optimum health.

The ability to perform independently, the 14

basic needs. The effects of 7 components (light, temperature, air movement,
The unique function of the nurse is to assist the
Nursing Need Complete and independent being with biological, atmospheric pressure, proper waste disposal, absence of injurious
Virginia Henderson (VH) individual, sick or well, in the performance of
Theory sociological and spiritual components. Health is basic to human functioning and that chemicals, cleanliness of surroundings) on the life and development of a
activities contributing to health or its recovery.
promotion of health is more important than person.
care of the sick.

Structurally/Functionally whole or sound.

Has physical, chemical, and biological features.
Self-Care Deficit It is helping clients to establish or identify ways Has the capacity to regulate own functioning and
Dorothea E. Orem (DO) One must be able to perform self-care activities.
Theory of Nursing to perform self-care activities. development (self care agency).
It includes the family culture and community.
(Illness is having self-care deficit).
 Theory Contents of Theory Assumptions/Theoretical Assertions Theory Model

12 Canons Environmental model focuses on the

Physical manipulation of physical and social
Ventilation & Warmth | Light | Cleanliness | Health of Houses factors that affect health and illness.
| Noise | Bed & Bedding | Personal Cleanliness | Taking Food
Florence Psychological Physical environment is a critical
Environmental
Nightingale Variety | Chattering Hopes & Advices component in both health and
Theory
(FN) Social illness.
Social Considerations | Observation of the SIck
Healthy surroundings are necessary
5 Essential Components of Environmental Health for proper nursing care and
Pure air | pure water | efficient drainage | cleanliness | light. restoration/maintenance of health.

11 Skills in Developing NCP

Observation of Health Status | Skills of Communication |
Application of Knowledge | Teaching of Patients and Families |
Planning & Organization of Work | Use of Resource Materials |
Use of Personnel Materials | Problem-Solving | Direction of Work
of Others | Therapeutic Use of Self | Nursing Procedure
The theory has combined the
concepts of health, nursing
21 Nursing Problems
problems, and problem-solving.
Basic to All Patients
Good Hygiene | Physical Comfort | Exercise, Rest, Sleep |
Problem-solving is an activity that is
Prevention of Accidents, Injury, Trauma, Infection | Good
inherently logical in nature.
Body Mechanics & Correcting Deformity

The framework focuses on nursing

Sustenal Care Needs
practice and individual patients.
Facilitating maintenance of
oxygen supply & nutrition to all body cells, waste
The nursing problem and nursing
elimination, fluid & electrolyte balance, regulatory
Faye G. treatment typologies are the
21 Nursing mechanisms and functions, and sensory function.
Abdellah principles of nursing practice and
Problems Recognize physiological responses of the body to disease
(FA) constitute the unique body of
conditions.
knowledge that is nursing.

Remedial Care Needs

Correct identification of the nursing
Identify and accept positive and negative expressions,
problem influences the nurse's
feelings, reactions, and interrelatedness of emotions to
judgment in selecting steps in solving
organic illness.
the patient's problem.
Facilitate effective verbal/non-verbal communication,
progress toward achievement of personal & spiritual goals,
The core of nursing is patient/client
and awareness of self according to varying needs.
problems that focus on the patient
and his/her problems.
Restorative Care Needs
Accept the optimum possible goals in the light of limitations,
physical and emotional.
Use community resources as an aid in resolving problems
arising from illness.
Understand the role of social problems as influencing
factors in the case of illness.

14 FUNDAMENTAL NEEDS OF HUMANS Henderson’s 14 Components

Breathe normally as applied to Maslow’s
Eat & drink adequately Hierarchy of Needs
Nurses care for patients until patient
Eliminate body wastes
can care for themselves once again.
Move and maintain desirable postures
Sleep & rest
Nurses are willing to serve and that
Virginia Select suitable clothes
Nursing Need nurses will devote themselves to the
Henderson Keep body clean & groomed; protect integument
Theory patient day and night.
(VH) Maintain body temperature
Avoid dangers in environment and avoid injuring others
Nurses should be educated at the
Communicate with others
university level in both arts and
Worship according to one’s faith
sciences.
Work in such a way that there is sense of accomplishment
Recreational activity
Learn, discovery, satisfy curiosity

Key Concepts
Self Care (acts to achieve health)
Agency (innate ability)
Demand (care needed)
Propositions
Requisites (action towards provision of self care)
The individual is capable of providing
Deficit (unable to meet self-requisites)
self-care to meet some health needs.
Activities to
Therapeutic Self-care (care provided by nurse) achieve health
The nurse compensates for the
patient’s inability to engage in self-
Nursing Agency (knowledge & abilities of nurse to meet client’s
care by providing care. Capacity of a
self-care demand)
person
The patient resumes self-care actions
Nursing Systems
as he/she regains ability to do so.
Wholly Compensatory (nurse does everything for patient’s
Dorothea E. Self-Care Deficit
self care)
Orem (DO) Theory of Nursing Assumptions
Partially Compensatory (nurse & patient act for self care)
Human require continuous,
Supportive-Educative (patient independently performs self
deliberate self-care for health
care & nurse regulates self-care agency)
development and well-being.

Self Care Requisites

Maintenance of
Individuals have the power to make Care needed
decisions about their self care. of a person
Sufficient air, water, and food intake
Balance between activity & rest
Nurses maintain the capacity of
Balance between solitude & social interaction
individual for self-care and assist
Knowledge &
Prevention of hazards to human life, functioning, and well-being abilities of nurse
when he/she is unable to do so.
Provision of care associated with elimination processes and
excrements.
Promotion of human functioning and development within social
groups.
 Theory Nursing Human/Person Health Environment Adaptation

“Health is a state and a process of Environment is “all the conditions, circumstances, and
Humans are holistic, adaptive systems. As an being and becoming integrated and a influences surrounding and affecting the development and The process and outcome whereby thinking and
Healthcare profession that focuses adaptive system, the human system is whole person. It is a reflection of behavior of persons or groups, with particular consideration feeling persons, as individuals or in groups, use
on human life processes and described as a whole with parts that function adaptation, that is, the interaction of of the mutuality of person and earth resources that includes conscious awareness and choice to create human
patterns. as unity for some purpose. the person and the environment.” focal, contextual, and residual stimuli.” and environmental integration.”
Callista Roy Roy Adaptation
(CR) Model (RAM)
Emphasizes promotion of health for Human systems include people as Adaptation is a process of promoting “It is the changing environment [that] stimulates the person Rather than being a human system that simply
individuals, families, groups, and individuals or in groups, including families, physiological, psychological, and to make adaptive responses.” strives to respond to environmental stimuli to
society as a whole. organizations, communities, and society as a social integrity, and that integrity maintain integrity, every human life is purposeful in
whole. implies an unimpaired condition Any environmental change demands increasing energy to a universe that is creative, and persons are
leading to completeness or unity. adapt to the situation. inseparable from their environment.

Therapeutic interpersonal process. Health is defined as “a word symbol

Man is an organism that “strives in its own that implies forward movement of
Interpersonal
Hildegard Peplau Functions cooperatively with other way to reduce tension generated by needs.” personality and other ongoing human Existing forces outside the organism and in the context of
Relations
(HP) human process that make health processes in the direction of creative, culture.
Theory
possible for individuals in The client is an individual with a felt need. constructive, productive, personal,
communities. and community living.”

The client or client system. A composite of

Is concerned with the whole person,
a unique profession concerned with
all the variables affecting clients in
Betty Neuman Neuman
their environment actions which
(BN) Systems Model
assist individuals, families and groups
to maintain a maximum level of
wellness
“Health is a condition in which all
five interacting variable areas: The totality of the internal and external forces which
parts and subparts (variables) are in
surround a person and with which they interact at any given
harmony with the whole of the
Physiological, psychological, sociocultural, time.
client.”
developmental, and spiritual.
Internal (intrapersonal), external (interpersonal), and
The condition or degree of system
An open system that interacts with both created (unconsciously developed used by the client to
stability is viewed as a continuum
internal and external environmental forces support coping) environments.
from wellness to illness.
or stressors and is in constant change.

Includes both the internal (complex biochemical;

physiological and pathophysiological process) and external
environment.

The human interaction relying on a. Perceptual aspects - interpreted by the individual

Levine’s
communication, rooted in the with the five senses.
Myra Levine Conservation Is a unique individual in unity and integrity, Health is the patterns of adaptive
organic dependency of the individual
(ML) Model feeling, believing, thinking, and whole. change of the whole being.
human being in his relationships with b. Operational components - physically affects a person
other human beings. but can not be seen.

c. Conceptual aspects - characterized by cultural

patterns, spirituality and mediated through symbols of
language, thought, and history.

It is helping others to move in the

direction of self-awareness. Unique, capable of growth and learning, and
It is the state of being able to achieve
Lydia Hall Core, Care, requiring a total person approach (Goal The concept of society or environment is dealt with in
self-awareness thereby releasing own
(LH) Cure Model Nursing is identified as consisting of setting and action plan). relation to the individual.
power to heal.
participation in the care, core, and
cure aspects of patient care.

Unity and harmony within the mind,

A human science of persons and
human health–illness experiences
Jean Watson The Theory of
that are mediated by professional,
(JW) Human Caring
personal, scientific, esthetic, and
ethical human care transactions.
body, and soul.
Caring and nursing has existed in every society. The nurse is
A valued person to be cared for, respected,
Health is associated with the degree part of the environment.
nurtured, understood, and assisted.
of congruence between the self as
perceived and the self as Nurse should ensure a caring-healing environment capable
Unity of mind/body/spirit/nature.
experienced. (patient is healthy when of transformative measures.
he sees himself healthy; unity is
present)

To maintain and restore the person’s

behavioral system of balance and
stability or to help the person
achieve a more optimum level of
A behavioral system with patterned Elusive, dynamic state influenced by
Dorothy Johnson Behavioural balance and functioning.
repetitive, and purposeful ways of behaving biological, psychological, and social
(DJ) System Model
that link the person with the environment. factors.
Nursing is an external force acting to
preserve the organization and
integration of the patient’s behavior
to an optimal level.
 Theory Contents of Theory Assumptions/Theoretical Assertions Theory Model Theory Contents of Theory Assumptions/Theoretical Assertions Theory Model

Stimuli Core (The Person)

Focal Therapeutic use of self.
Contextual Addressing patient’s social and emotional needs for effective 1. The motivation and energy necessary for healing exist within
Residual communication and comfortable environment. the patient, rather than in the healthcare team.
The Roy Adaptation Model (RAM) focuses on the interrelatedness
Four Adaptative Modes
Callista of four adaptive systems. Care (The Body) 2. The three aspects of nursing should not be viewed as
Roy Adaptation Physiologic-physical Lydia Hall Core, Care,
Roy It is a deductive theory based on nursing practice. The RAM Providing bodily care for the patient. Helping patient complete daily functioning independently but as interrelated.
Model (RAM) Self-concept-group identity (LH) Cure Model
(CR) guides the nurse who is interested in physiologic adaptation, as biological functions.
Role Function
well as the nurse who is interested in psychosocial adaptation. The nurse’s goal is the comfort of the patient. 3. The three aspects interact, and the circles representing them
Interdependence
Two Subsystems change size, depending on the patient’s total course of
Regulator Cure (The Disease) progress.
Cognator Interventions or actions geared toward treating patient.
The nurse is an active advocate of the patient.

Johari Window
Open-Public - known to us and to other people. characteristics, 10 Carative Factors
behavior, talents, customs, traditions, and everything pertaining Formation of a Human Altruistic System of Values
to ourselves. Instillation of Faith & Hope
Blind-Unaware - characteristics, behaviors, talents, and Cultivation of Sensitivity to Self & to Others
everything pertaining to ourselves that we do not know or are Development of a Helping-Trust Relationship
unaware of but what other people are aware of. We usually can’t Promotion and Acceptance of the Expression of Positive and Negative
see ourselves, but others can see them in us. Feelings
Hidden-Private - keeping to ourselves; not visible to others, Systematic Use of Scientific Problem-Solving Method for Decision Making Caring can be effectively demonstrated and practiced only
undisplayed to other people. Promotion of Interpersonal Teaching-Learning interpersonally.
Nurse and patient can interact. Provision for Supportive, Protective, and Correctional Mental, Physical,
Unknown - discovering more about ourselves by interacting with
other people, growing by the years, we progress to learn more Sociocultural, and Spiritual Environment (Holistic) Caring consists of carative factors that result in the
Both the patient and nurse mature as the result of the Assistance with Gratification of Human Needs satisfaction of certain human needs.
about ourselves.
therapeutic interaction. Allowance for Essential Existential-Phenomenological Forces
Four Psychobiological Experiences
Hildegard Interpersonal Effective caring promotes health and individual or family
Needs
Peplau Relations Communication and interviewing skills remain fundamental Transpersonal Caring Relationship growth.
Frustrations
(HP) Theory nursing tools. Nurse’s commitment to protecting and enhancing human dignity.
Conflicts
Anxieties Caring responses accept person not only as he or she is now
Nurses must clearly understand themselves to promote their Jean
Six Nursing Roles The Theory of The ‘nurses' caring and connection have the potential to heal since the but as what he or she may become.
client’s growth and to avoid limiting client’s choices to those that Watson
Stranger Human Caring experience, intention, and perception are taking place.
nurses value. (JW)
Resource Person A caring environment is one that offers the development of
Teacher Nursing goals beyond an objective assessment and shows concern for potential while allowing the person to choose the best
Leader the patient's health care. action for himself or herself at a given point in time.
Surrogate Example: Person-Centered Care for an Elderly Resident in a
Counselor Caring Moment/Caring Occasion Long-Term Care Facility.
Phases of Nurse-Patient Relationship and Its Process A caring occasion is the moment when the nurse and another person
Orientation (Problem-defining phase) come together in such a way that an occasion for human caring is Caring is more “healthogenic” than is curing. A science of
Identification created. caring is complementary to the science of curing.
Exploitation
Resolution Both persons come together in a human-human transaction. The practice of caring is central to nursing.

Wellness-Illness Continuum
Wellness = Available Energy > Needed Energy
Illness/Death = Available Energy < Needed Energy
Nursing Process Format
Betty 1. Nursing Diagnosis - assumes that the nurse collects an adequate
Neuman
Neuman database from which to analyze variances from wellness to make the
Systems Model
(BN) diagnoses.
2. Nursing Goals - determined by negotiation with the client for desired
prescriptive changes to correct variances from wellness.
3. Nursing Outcomes - confirmation of prescriptive change or
reformulation of nursing goals is evaluated.
Evaluation - used to confirm that the desired outcomes have been
achieved
Four Conservation Principles
The principle of the conservation of energy - balance between
activity and the person’s available energy.
The principle of the conservation of structural integrity - is the
basis for nursing interventions to limit the amount of tissue
Levine’s
Myra involvement.
Conservation
Levine
Model
(ML) The principle of the conservation of personal integrity - is based
on nursing interventions that permit the individual to make
decisions for himself or participate in the decisions.
The principle of the conservation of social integrity - is based on
nursing interventions to preserve the client’s interactions with
family and the social system to which they belong.
The one caring for and the one being cared for are influenced by the
Nurse is an active participant in a reciprocal relationship with choices and actions decided within the relationship.
the client, keeping the client system stable.
Caring-Healing Modalities
Primary Prevention Caring-healing modalities are often noninvasive, nonintrusive, natural-
focuses on preventing the occurrence of a health condition or human, energetic environmental field modalities.
disease. It involves interventions to reduce the risk factors
and promote overall health and well-being in a population
that is not yet affected by the condition. NURSING
Goal: To Maintain and restore the person’s behavioral
Behavior system balance and stability or to help the person
Secondary Prevention
the output of intra-organismic structures and processes as they are achieve a more optimum level of balance and
aims to detect and treat health conditions in their early stages
when they are more easily managed and before they cause coordinated and articulated by and responsive to changes in sensory functioning.
severe complications. stimulation.
System Nursing is an external force acting to preserve the
Tertiary Prevention a whole that functions as a whole by virtue of the interdependence of organization and integration of the patient’s behavior to
managing and reducing the impact of a health condition once its parts. an optimal level.
it has fully developed. It's often applied to individuals who are Dorothy Behavioral System
Behavioural
already diagnosed with a disease to prevent complications Johnson encompasses the patterned, repetitive, and purposeful ways of PERSON
System Model
and improve their quality of life. (DJ) behaving. A behavioral system with patterned repetitive, and
Subsystems purposeful way of behaving that link the person with the
behavioral system has many tasks to perform thus parts of the system environment
Each individual is an active participant in interactions with the evolved into subsystem with specialized tasks.
environment constantly seeking information from it. HEALTH
Seven Subsystems Elusive, dynamic state influenced by biological,
The individual is a sentient being and the ability to interact with Three Functional Elements psychological, and social factors.
the environment seems ineluctably tied to his sensory organs. Four Structural Elements
ADTE
Change is the essence of life and it is unceasing as long as life Assessment, Disorders, Treatment, Evaluation
goes on. Change is characteristic of life.
Ultimately the decisions for nursing intervention must be based
on the unique behavior of the individual patient.
Patient centered nursing care means individualized nursing care.
It is predicated on the reality of common experience: every man
is a unique individual, and as such he requires a unique
constellation of skills, techniques and ideas designed specifically
for him.