NON – NURSING THEORIES → End product: a type of output that is not
reusable as input
A. The General Systems Theory
▪ proposed in the 1940’s
▪ by the biologist Ludwig von Bertalanff
▪ furthered by Ross Ashby in 1964
 System
→ a set of components/units interacting with
each other within a boundary that filters
both the kind and rate of flow of inputs and
outputs to and from the system.
→ System acts as a whole because of the
interdependence of its parts.
→ When a part fails, the whole system suffers
→ Parts have common function: make system
work well to achieve its overall purpose
 The 3 major points that make up the
definition of a system
a. Boundaries
b. Parts of the system interacts with one another
c. The whole system itself interacts with its
environment.
 Function
→ To convert or process energy, information
or materials into a product or outcome for
use within the system or outside of the
system or both.
 Elements of a System
a. Input
→ the information that enters the system
→ any type of info, energy or material that
enters the system from the environment
through its boundaries.
b. Throughput
→ the process use by the system to convert
raw materials or energy from the
environment into products that are usable
by either the system itself or environment.
→ a process that allows the input to be
changed so that it is useful to the system
(example in text- gas in car is changed to a
useful form of energy. Similarly, food to a
human)
c. Output
→ the end product or service which results
from the systems throughput or processing
a technical, social, financial and human
input.
→ any info, energy or material that leaves the
system and enters the environment
through its boundaries.
d. Feedback
→ information about some aspect of data or
energy processing that can be use to
evaluate and monitor the system and to
guide it to more effective performance.
→ allows the system to monitor internal
functioning so it can ↑ or ↓ the input or
output and maintain the highest level of
functioning (‘quality control’)
● Feedback Loop
a. Positive Feedback:
→ leads to change within the system, with
the goal of improving the system
(positive comments to students)
b. Negative Feedback:
→ maintains stability, therefore does not
produce change. Only good if system
is at peak level of functioning. (athlete
trying to ‘maintain’)
 Aspects of a System
a. Structure
→ the static arrangement of a system’s parts
at any moment.
b. Function/process
→ the dynamic change in matter, energy or
information contained in a system
overtime.
 Characteristics of a System
1. Openness
a. Closed system – one that does not
interact with the environment. It prevents any
movement into & out of the system. It is totally
static and unchanging.
b. open system – exchanges matter,
energy and across its boundaries. It is relatively
free movement of info, matter, and energy into
& out of the system. Most living organisms are
‘open’.
2. Wholeness
System – a unified whole which is identifiable &
is greater than the sum of its parts.
3. Hierarchical order or arrangement
Each system has a subsystem or supra-system.
 The system process
3 Essential processes of a system
a. Adaptation to the environment
→ the process of interaction or exchange
between the system and its environment in
which the system is influenced by & in turn
influences the environment.
PILONES,RISHELLE MAE M.
b. Integration of system parts
→ to ensure the harmonious functioning of all
its parts.
c. Decision making about allocation of
resources
→ the process whereby a system makes
choices about allocation of its resources in
order to adapt to the environment and
integrates its subsystem.
B. Developmental Theory
► Human growth and development is an
orderly predictive process that begins with
conception and continues through death.
► Developmental theories provide a the center of the body and moves
framework for examining, describing, and
appreciating human development. For
example, knowledge of Erikson’s
psychosocial theory of development helps
caregivers understand the importance of
supporting the development of basic trust
in the infancy stage.
► Trust establishes the foundation for all
future relationships
► Developmental theories are also important
in helping nurses assess and treat a
person’s response to an illness.
Understanding the specific task or need of
each developmental stage guides
caregivers in planning appropriate
individualized care for patients.
► Human development is a dynamic and
complex process that cannot be explained
by only one theory. It presents biophysical,
psychoanalytical/psychosocial, cognitive,
and moral developmental theories.
 Four main areas of developmental theory
A. Biophysical Development
▪ attempts to describe the way our physical
bodies grow and change.
▪ Health care providers are able to quantify
and compare the changes that occur as a
newborn infant grows into adulthood
against established norms.
▪ How does the physical body age? What are
the triggers that move the body from the
physical characteristics of childhood,
through adolescence, to the physical
changes of adulthood?
● Gesell's Theory of Child Development
→ Fundamental to Gesell’s theory of
development is that each child’s pattern of
growth is unique
→ pattern is directed by gene activity
→ found the pattern of maturation follows a
fixed developmental sequence in humans
→ Sequential development is evident in
fetuses, in which there is a specified order
of organ system development
→ humans is both cephalocaudal and
proximodistal.
a. The cephalocaudal pattern describes
the sequence in which growth is fastest
at the top (head and then down);
b. The proximodistal growth starts at
toward the extremities.
→ He concluded that children go through
predictable stages of growth.
→ Although all children cycle through the
same stages or sequences of growth, they
don't enter the stages at the same time.
▪ Pacing is influenced by
a. internal factors, such as physical and
mental development, genetics,
personality and temperament.
b. external factors, like parenting style,
environment, peers, culture and health.
→ Genes direct the sequence of development;
but environmental factors also influence
development, resulting in developmental
changes.
 For example
a. Genes may direct the growth rate for
an individual, but that growth is only
maximized if environmental conditions
are adequate.
b. Poor nutrition or chronic disease
often affects the growth rate and
results in smaller stature, regardless of
the genetic blueprint.
→ adequate nutrition and the absence of
disease cannot result in stature beyond
that determined by heredity.
→ Children's development changes due to a
feeling of equilibrium, or calm plateau's of
learning, and disequilibrium, an unsettled
time of rapid growth and learning.
● Gesell's Spiral
→ Using the idea that children cycle through
periods of equilibrium & disequilibrium
→ Gesell created a spiral-like pattern to
describe how children develop.
 Gesell identified six stages of growth:
a. Smooth
PILONES,RISHELLE MAE M.
b. Break-up ▪ individuals need to accomplish a particular
c. Sorting-out task before successfully mastering the
d.Inwardizing stage and progressing to the next one
e. Expansion ▪ Each task is framed with opposing conflicts,
f. Fitting together and tasks once mastered are challenged
→ known as a maturational-developmental and tested again during new situations or
theory. at times of conflict (Hockenberry and
→ It comprised of both internal and external Wilson, 2011)
factors
a. The intrinsic factors include genetics,
temperament, personality, learning styles, as
well as physical and mental growth.
b. The extrinsic also influenced by factors such
as environment, family background, parenting
styles, cultural influences, health conditions,
and early experiences with peers and adults.
B. Psychoanalytic Development
▪ attempts to describe the development of
human personality, behavior and emotions.
● Freud’s psychoanalytical model of
personality development D. Cognitive Development
▪ states that individuals go through five ▪ focused on reasoning & thinking processes,
stages of psychosexual development and including the changes in how people come
that each stage is characterized by sexual to perform intellectual operation.
pleasure in parts of the body: the mouth, ▪ Jean Piaget's stage theory cognitive
the anus, and the genitals. development of children.
▪ Freud believed that adult personality is the ▪ Cognitive development involves changes in
result of how an individual resolved cognitive process and abilities
conflicts between these sources of pleasure
and the mandates of reality

E. Moral development
▪ focuses on the description of moral
reasoning.
C. Psychosocial Development
▪ The ability of an individual to distinguish
▪ Erik H. Erickson identifies a crisis, that is, a
right from wrong and to develop ethical
particular challenge that exists for healthy
values on which to base his/her actions.
personality development to occur.
▪ Lawrence Kohlberg observed that growing
▪ He adapted and expanded Freud’s theory
children advance through definite stages of
of development to include the entire life
moral development in a manner similar to
span, believing that people continue to
their progression through Piaget's well-
develop throughout life.
known stages of cognitive development.
● Erikson’s theory of psychosocial
▪ Moral reasoning – is how people think
development
about, the rules of ethical and moral
conduct but does not predict what a
PILONES,RISHELLE MAE M.
 person would actually do in a given
situation.
▪ Moral development – involves respect for
other humans and that relationships are
based on mutual trust.
C. Change Theory
▪ Kurt Lewin (1890-1947) is considered as
the father of social psychology. He was
born in Germany, later emigrated to the US.
▪ Lewin coined the term group dynamics in
1939. His field theory states that "one’s
behavior is related both to one’s personal
characteristics and to the social situation in
which one finds oneself."
● LEWIN’S CHANGE THEORY
▪ most influential theory was his model of
the change process in human systems
▪ Change
→ a dynamic process in which an individual’s
behaviour is altered in response to a
stressor. It is an inherent part of life,
whether it is planned or unplanned, change
is both inevitable and constant.
→ The pace of change is rapidly increasing in
health care agencies which have been
changing and continue to change in
response to consumer demands.
→ “Change is inevitable and nurses have the
qualities & a strategic position to
participate actively”
▪ Change is the process of making
something different from what it was
a. involve gaining new knowledge
b. involve obtaining new skills
▪ Difference between behavior change and
social change:
a. Behavior change – often directed at
individuals.
b. Social change – refers to a group or
community.
▪ Types of Change
1) Planned change – results of a conscious,
deliberate and collaborative effort intended to
improve the operation of a system or a situation.
Important factor in planned change:
a. problem-solving skills
b. decision making skills
c. interpersonal skills
2) Unplanned change – change that “just
happens”.
3) Covert change – is hidden or occurs without
the individual’s awareness.
4) Overt change – usually not under individual’s
direct control. A change of which a person is
aware.
5) Developmental change – physical and
emotional changes that occur at different stages
of the life cycle.
6) Reactive change – adaptive responses to
external stimuli. An effort to cope with change
imposed by others.
▪ Two major theories of change
a. Lewin’s Theory of Change
→ used a systematic theory to analyse casual
relationships and to build scientific
constructs.
→ Lewin's theory states behavior as "a
dynamic balance of forces working in
opposing directions”.
→ Kurt Lewin theorized a three-stage model
of change that is known as the unfreezing-
change refreeze model that requires prior
learning to be rejected and replaced.
→ The model represents a very simple and
practical model for understanding the
change process.
→ The process of change entails creating the
perception that a change is needed, then
moving toward the new, desired level of
behavior and finally, solidifying that new
behavior as the norm.
→ The model is still widely used and serves as
the basis for many modern change models
Three distinct and vital stages model of change:
1. “Unfreezing”
→ Unfreezing is necessary to overcome the
strains of individual resistance and group
conformity.
→ This stage is about getting ready to change.
→ Unfreezing and getting motivated for the
change is all about weighing up the 'pro's'
and 'con's' and deciding if the 'pro's'
PILONES,RISHELLE MAE M.
 outnumber the 'con's' before you take any
action.
→ This is the basis of what Kurt Lewin called
the Force Field Analysis.
 Force Field Analysis
→ fancy way of saying that there are lots
of different factors (forces) for and
against making change that we need
to be aware of (analysis).
→ It is a useful way to understand this
process and there are plenty of ideas
of how this can be done.
 Unfreezing can be achieved by the use of
three methods.
a. Increase the driving forces that direct
behavior away from the existing situation or
status quo.
Driving Forces:
► Forces that push in a direction that
cause change to occur.
► Facilitate change because they push the
person in the desired direction.
► They cause a shift in the equilibrium
towards change.
b. Decrease the restraining forces that
negatively affect the movement from the
existing equilibrium.
Restraining Forces:
► Fear that something of personal value
will be lost
► Hinder change because they push the
person in the opposite direction.
► Cause a shift in the equilibrium which
opposes change.
c. Find a combination of the two methods listed
above.
Equilibrium:
► A state of being where driving forces
equal restraining and change occurs.
► Can be raised or lowered by changes
that occur between the driving and
restraining forces.
2. “Moving to a new level or Changing” or
Movement or Transition
→ This stage involves a process of change in
thoughts, feeling, behavior, or all three,
that is in some way more liberating or
more productive.
→ Kurt Lewin was aware that change is not an
event, but rather a process. He called that
process a transition.
→ Transition is the inner movement or
journey we make in reaction to a change.
→ People are 'unfrozen' and moving towards
a new way of being. This is not an easy time
as people are learning about the changes
and need to be given time to understand
and work with them.
3. “Refreezing”
→ 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.
→ Kurt Lewin refers to this stage as freezing
although a lot of people refer to it as
'refreezing'.
→ As the name suggests this stage is about
establishing stability once the changes have
been made.
An important aspect of planning change:
a. Establishing the likelihood of the
acceptance of the change.
b. Determining the criteria by which
that acceptance can be identified.
Problem solving – major thrust of planned
change.
Resistance to Change:
Many people tend to resist change because of
the energy required to adapt
▪ Reasons to Resist Change:
1. Conformity – often referred to as
“groupthink”; complying with the group’s
expectation; going along with others to avoid
conflict.
2. Dissimilar beliefs and values – differences in
attitudes and expectations regarding health &
illness behaviours; differences between client
and nurse that can impede positive change.
3. Habits – routine, “set” behaviours are often
hard to change.
4. Satisfaction with status quo – seeing only
advantages to the present system can blind one
to the possible need for change. Satisfaction
with the way things are now reinforces
resistance to change.
5. Secondary gains (outcomes other than
alleviation of anxiety) - benefits or payoffs of
the sick role, often are so desirable that the
client has little incentive to change.
6. Threats to satisfying basic needs – change
may be perceived as a threat to self- esteem,
security and survival.
7. Fear – fear of failure and fear of the unknown
especially block change.
PILONES,RISHELLE MAE M.
8. Unrealistic goals – set up the individual for
failure in change efforts.
Overcoming Barriers for Change:
► Overcoming these barriers doesn’t mean
embracing every new idea uncritically. It
means being willing to suspend judgment
long enough to make an informed decision
on whether the change is worthwhile.
General Strategies for Effecting Changes in
Human Systems (Robert Chin & Kenneth
Benner)
a. Empirical – Rational Strategies
→ fundamental assumption – that people are
rational being and that people will follow
reason once this is revealed to them.
→ Most health professionals & educators
thought that giving information was
enough to effect behaviour change such as
regular intake of anti-TB drugs.
b. Normative – re-educative strategy
→ this strategy contends that pattern of
action and behaviour are supported by
sociocultural norms and by commitment of
individuals to the collective norms.
→ Changing normative orientations will
involve changes in attitudes, values, skills &
significant relations – not just changes in
knowledge or information.
c. Power-coercive strategy
→ the influence process involved in that those
with lesser power will comply with the
plans, directions & leadership of those with
greater power.

PILONES,RISHELLE MAE M.