Theoretical Foundation of Nursing

CONCEPT
A mental idea of a phenomenon  A comprehensive idea or generalization  An idea that brings diverse elements into a basic relationship  A unit of knowledge abstracted from a set of characteristics attributed to a class of objects, relations or entities.

A unit of thought  A general idea formed in the mind  Something understood or retained in the mind.

 Concepts are basically vehicles of thought that involve images. . properties. Concepts are words that describe objects. or events & are basic components of theory.

 A set of interrelated concepts that symbolically represents and conveys a mental image of phenomenon. Conceptual models of nursing identify concepts and describe their relationships to a phenomena of central concern to the discipline (Power & Knapp) .Conceptual Framework/ Model Framework is a basic structure supporting anything.

It can be visualized as an umbrella under which many theories can exist. It provides an overall view to focus our thoughts.(Creasia & Parker) . A group of related concepts.

or predict relationships among concepts that have been systematically selected and organized as an abstract representation of some phenomenon (power & Knapp) .Theory  A set of statements that tentatively describe. explain.

. research. Theory serves as guides for nursing action in administration. and practice. education.

Nursing Theory Nursing Theory is a group of related concepts that derived from the nursing models. . A body of knowledge that describes or explains nursing and is used to support nursing practice.

.Principle  A basic generalization that is accepted as true and that can be used as a basis for reasoning or conduct.

Characteristics of a Theory .

 Basis for hypotheses that can be tested.  Generalizable.  Logical in nature.  .Interrelating concepts in such a way as to create a different way of looking at a particular phenomenon.

laws. and principles but will leave open unanswered Q that need to be investigated.  Consistent with other validated theories.  Used by the practitioners to guide and improve their practice.Increasing the general body of knowledge within the discipline through the research implemented to validate them.  .

Components of a Theory .

Concepts  Definitions  Assumptions  Phenomenon

A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific interrelationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing..

Concept
A theory is composed of interrelated concepts
Ex: Levine’s Conservation Model 3 Major concepts: Conservation Adaptation Wholeness

 King’s Theory of Goal Attainment Critical concepts to goal attainment in nrsg practice: Personal systems Interpersonal systems Social systems .

Definitions  The definitions within the description of a theory convey the general meaning of the concepts in a manner that fits the theory. .

purpose.Assumptions Are statements that describe concepts or connect two concepts that are factual. relationships and structure of the theory. They are the “taken for Granted” statements that determine the nature of the concepts. definitions. Ex: People & environment are open systems .

Phenomenon Is an aspect of reality that can be consciously sensed or experienced. Ex: caring. client responses to stress . self-care.

Types of Theories .

These are theories about theories. .Metatheories  are theories whose subject matters are some other theories.

abstract ideas about nursing.These are intended to provide structural framework for broad. .Grand Theories  Are broad in scope and complex and therefore require further specification through research before they can be fully tested.

Range Theories  Have more limited scope. less abstraction. address specific phenomena or concepts and reflect practice.Middle. .

Descriptive Theories

Are the first level of theory development. They describe phenomena, speculate on why phenomena occur, and describe the consequences. Have the ability to explain & relate some situations.

Ex: Theories of Growth & development

Prescriptive Theory

Address nursing interventions and predict the consequence of a specific nursing intervention. It is an action oriented which test the validity and predictability of a nursing intervention.

Importance of Nursing Theories
1. Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs1978). 2. It should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future (Brown 1964).

It helps to distinguish what should form the basis of practice by explicitly describing nursing. . The main exponent of nursing – caring – cannot be measured.3. it is vital to have the theory to analyze and explain what nurses do. 4.

enhanced professional status for nurses. . The benefits of having a defined body of theory in nursing include better patient care. improved communication between nurses.5. and guidance for research and education(Nolan 1996).

As medicine tries to make a move towards adopting a more multidisciplinary approach to health care. nursing continues to strive to establish a unique body of knowledge.7. .

This can be seen as an attempt by the nursing profession to maintain its professional boundaries. .8.

Evolution of Nursing Theories
Within Types of Works

Philosophies
Nightingale Wiedenbach Henderson Abdellah Hall Watson Benner

Grand Theories
Neuman King Roper, Logan, and Tierney Orem Levine Rogers Johnson Roy

and Swain Mercer Leininger Parse Pender Newman Adam . Tomlin.Middle.Range Theories Peplau Orlando Travelbee Kolcaba Erickson.

Purposes of Theories .

and evaluation of nursing care. explain. and predict everyday experiences. Serve to guide assessment.In Practice Assist nurses to describe. . intervention.

which are essential for effective decision making and implementation.Provide a rationale for collecting reliable and valid data about the health status of clients. Help to establish criteria to measure the quality of nursing care .

Ideas are developed and words defined. .Help build a common nursing terminology to use in communicating with other health professionals. Enhance autonomy (independence and self-governance) of nursing by defining its own independent functions.

In Education Provide a general focus for curriculum design. . Guide curricular decision making.

Offer a systematic approach to identify questions for study. and validate nursing interventions. select variables. Assist in discovering knowledge gaps in specific field of study. . interpret findings.In Research Offer a framework for generating knowledge and new ideas.

philosophy. and theory that is accepted and applied by the discipline. .Nursing Paradigm It has a model or paradigm that explains the linkages of science.

4 major concepts of nursing theories .

Nursing (goals.The person( patient) . functions) .The environment --.Four concepts common in nursing theory that influence and determine nursing practice are --. roles.Health --. --.

regardless of definition or theory.  . The focus of nursing .Each of these concepts is usually defined and described by a nursing theorist.  Of the four concepts . the most important is that of the PERSON.

communities and groups . They are the recipients of nursing care  Individuals. families.Person  Refers to all human beings.

.Environment  Includes factors that affect individuals internally and externally. not only everyday surroundings but also settings where nursing care is provided.

Health Addresses the person’s state of well-being. Degree of wellness or illness experienced by the person .

characteristics and attributes of person giving care  Describe what Nursing is.Nursing  Actions.  It is the Diagnosis and Treatment of human responses to actual or potential Health Problems. and how nurses interact with clients. . what nurses do.

NURSING THEORIES USED IN NURSING .NON.

General Systems Theory It describes how to break whole things into parts & then to learn how the parts work together in “systems”. Molecules in chemistry.g. These concepts may be applied to different kinds of systems e. and organs in Anatomy & Health in Nursing.  . cultures in sociology.

Nursing Models  Imogene King’s Systems Interaction Model  Betty Neuman’s Health Care System Model  Dorothy Johnson’s Behavioral System Model .

This growth and change are evident in the dynamic nature of basic human needs and how they are met. .Change Theory Kurt Lewin (1962)  People grow and change throughout their lives.

.3 states of change 1. 2. Movement.is the recognition of the need for change and the dissolution of previously held patterns of behavior. Unfreezing.is the shift of behavior toward a new and more healthful pattern.is the long-term solidification of the new pattern of behavior. 3. Refreezing.

.Developmental Theory  Human Growth and Development is an orderly predictive process that begins with conception and continues through death.

Moral Development . Biophysical development B.4 Main Areas of Developmental Theory A. Psychoanalytic/ Psychosocial Development C. Cognitive Development D.

Biophysical Development  Attempts to describe the way our physical bodies grow & change. Geselle’s Theory of Development  Ex: .

Sigmund Freud’s Psychoanalytic Model of Personality Development  Ex: . behavior and emotions.Psychosocial Development  Attempts to describe the development of the human personality.

Sigmund Freud’s 5 Psychosexual Developmental Stages .

Stage Oral (birth – 18 months) Focus Sucking & oral satisfaction is not only vital to life. but very pleasurable in its own right Anal ( 12-18 months to 3 yrs) Focus of pleasure is the anal zone (Toilet training process) Genital organs become the focus of pleasure. The Oedipal & Electra Complex Dormant Sexual feelings channeled into productive activities that are socially acceptable Phallic /Oedipal (3-6 yrs) Latency (6-12 yrs) Genital (Puberty – Adulthood) Maturation of sexual interest .

Erik Erickson’s Psychosocial Theory .

such as the adolescent’s need to develop a sense identity challenged by many confusing choices. Individuals need to accomplish a particular task before successfully completing the stage.  Each task is framed with opposing conflicts. .

Mistrust Autonomy vs. Shame and Doubt Initiative vs. Despair . Role Confusion Intimacy v. Isolation Generativity vs. Guilt Industry vs. Stagnation Birth to 18 mos 18 mos – 3 years 3 to 6 years 6 – 12 years ( Latency period ) 12 – 18 years Adolescence 18 – 25 years (Early Adulthood) 25 – 65 years (Adulthood) 65 years and older Ego Integrity vs.ERIK ERIKSON’S PSYCHOSOCIAL STAGES Trust vs. Inferiority Identity vs.

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diet. cleanliness and noise-would contribute to the reparative process and the health of the patient. Patient’s surroundings-ventilation. Nightingale believed that disease was a reparative process.Philosophies Florence Nightingale Florence Nightingale’s work is closely related to her philosophical orientation of the patient environment interaction and the principles and rules on which nursing practice was founded. light. warmth. Notes on Nursing: What it is and what it is not. .

Clinical Nursing: A Helping Art.Ernestine Wiedenbach concentrated on the art of nursing and focused on the needs of the patient. Four Elements: 1. . Practice 4. Art Postulated that clinical nursing is directed toward meeting the patient’s perceived need-for-help. It guides the nurse’s action in the art of nursing. Philosophy 2. Purpose 3.

Henderson emphasized the art of nursing and identified the 14 basic human needs on which nursing care is based. She envisioned the practice of nursing as independent from the practice of the physicians and acknowledges her interpretation of the nurse’s function as a synthesis of many influences. Her definition of nursing first appeared in 1995 in the fifth edition of Textbook of the Principles and Practice of Nursing by Harmer and Henderson.Virginia Henderson viewed the patient as an individual requiring help toward achieving independence. .

“The unique function of the nurse is to assist the individual sick or well.Henderson stated. She identified the following 14 basic needs of patients that comprise the components of nursing care: . in the performance of those activities contributing to health or its recovery (or to peaceful death)” that he would perform unaided if he had the necessary strength.

4. 3. 4.1. Breathing Eating and drinking Elimination Movement Rest and sleep Suitable clothing Body temperature 1. 7. 2. 6. 5. 5. 7. Clean body and protected integument Safe environment Communication Worship Work Play Learning . 2. 3. 6.

She supports empathetic understanding and states that the nurse must “get inside the skin of each of her patients in order to know what he needs. Partner with the patient.” . Substitute for the patient 2.She identified three levels of nurse-patient relationships in which the nurse is a: 1. Helper to the patient 3.

but promotes his or her plan if there is physician in attendance . Major Assumptions  Nursing  The nurse has a unique function to help sick or well individuals  The nurse functions as a member of a medical team  The nurse functions independently of the physician.

 The nurse is knowledgeable in both biological and social sciences.  The nurse can assess basic human needs  The 14 components of nursing care encompass all possible functions of nursing .

 Person The person must maintain physiological and emotional balance  The mind and body of the person are inseparable  The patient requires help toward  independence  The patient and his and her family are a unit  .

 Health Health is a quality of life  Health is basic to human functioning  Health requires independence and interdependence  Promotion of health is more important than care of the sick  Individuals will achieve or maintain health if they have the necessary strength. will. or knowledge.  .

and maintenance  . purchase of equipment. but illness may interfere with that ability  Nurses should have safety education  Nurses should protect patients from mechanical injury  Nurses should minimize the chances of injury through recommendations regarding construction of buildings. Environment Healthy individuals may be able to control their environment.

 Nurses must know about social customs and religious practices to assess dangers.Doctor’s use nurses observations and judgments as the base of their prescriptions for protective devices.  .

 Theoretical Assertions  The nurse. The nurse as a partner to the patient . The nurse as a helper to the patient  3. The nurse as a substitute for the patient  2.patient relationship  1.

 The nurse-physician relationship The nurse have a unique function that is distinct from the physician’s function. .

 The nurse as a member of the health care team The nurse works independence with other healthcare professionals. .

 Logical Form  Henderson appeared to use the deductive form of logical reasoning to develop her definition of nursing. .

 Acceptance by the nursing community  Practice The nurse must make every effort to understand the patient when he or she lacks will. or strength. . knowledge.

. Education The nurse’s education demands universal understanding of diverse human beings.

 Research Nurse’s should base their practice on research findings and acquire the habit of looking for research. .

She continued to write and reflect on the practice of nursing through out her life. Further Development Henderson’s last revision of her nursing definition was in 1966. .

 Critique  “My interpretation of the nurse’s function is the synthesis of many influences. Rather.” . some positive and negative…I should first made clear that I do not expect everyone to agree with me. I would urge every nurse to develop her own concept.

 Simplicity Henderson’s concept of nursing is complex rather than simplistic. .

It attempts to include the function of all nurses and all patients in their various interrelationships and interdependencies. . Generality  Generality is present in Henderson’s definition because it is broad is scope.

. Derivable Consequences His perspective has been useful in promoting new ideas and furthering conceptual development of emerging theorists.

intellectual competencies and technical skills of the individual nurse into the desire and ability to help people cope with their health needs whether they are ill or well. Abdellah’ viewed nursing as both an art and a science that molds the attitude. She formulated 21 nursing problems based on a review of nursing research studies. The typology of her 21 nursing problems first appeared in the 1960 edition of Patient Centered approaches to nursing Abdellah’s work is considered a philosophy of nursing .Faye Glenn Abdellah’s work is based on the problem-solving method and had a great impact on nursing curriculum development.

Jean Watson began publishing in the mid 1970s. She identified the following 10 carative factors: . She presented Nursing: Human Science and Human Care. with another edition in 1988. Nursing: the Philosophy and Science of Caring was published in 1979. In 1985. and published Post-modern nursing and Beyond in 1999. Her book. In an effort to reduce the dichotomy between theory and practice.

The formation of a humanistic altruistic system of values 2. . The development of a helping-trust relationship 5. The instillation of faith-hope. 3.1. The promotion and acceptance of the expression of positive and negative. The cultivation of sensitivity to self and to others 4.

or corrective mental. and 10. physical. protective. .Assistance with the gratification of human needs. 9. The promotion of interpersonal teaching-learning.6. 8. The provision for a supportive. The systematic use of the scientific problem-solving method for decision making 7. socio-cultural and spiritual environment. The allowance for existential-phenomenological forces.

Patricia Benner. and expert). . The Dreyfus Model of Skills Acquisition was developed in reached about pilot’s performance in emergency situation. competent. advanced beginner. She validated the Dreyfus Model of Skill Acquisition in nursing practice with her systematic description of the five stages (novice. proficient.

Dorothea E Orem has been publishing about nursing practice and education SINCE THE 1950s. Orem explicated self-care as a human need and nursing as human service. she emphasized nursing’s special concern for a person’s need for self-care actions on a continuous basis to sustain life and malized the Self-Care deficit Theory of nursing as a general theory composed of the following three related theories: .

The theory of self-care 2. The theory of self-care deficit The theory of nursing systems Her work identifies three types of nursing systems: 1. . Wholly compensatory (doing for the patient) 2. 3.1. Partly compensatory (helping the patient do for himself or herself) Supportive-educative (helping the patient learn to do for himself or herself and emphasizing the important role of the nurse in designing nursing care).

Energy 2. Social integrity to keep the holism of the individual balanced. a textbook to teach medical-surgical nursing to beginning students.Myra Estrin Levine started publishing in the mid 1960s. Structural integrity 3. She proposed that nurses use the principles of conservation of: 1. she wrote Introduction to Clinical Nursing. By contributing to the nursing literature. . she facilitated the development of theory. Personal integrity 4.

Levine specified four levels of organismic response:  Fear  Inflammatory response  Response to stress Sensory response .

Rogers has publishes widely since the early 1960s and is considered one of the most creative thinkers in nursing.Martha E. . Her work regarding unitary human beings appears in An Introduction to the Theoretical Basis of Nursing.

or because the level of behavioral functioning is less than desirable. Her behavioral system also includes the subsystems of dependency. Johnson published from the mid 1940s to the early 1970s. Conceptual Mode for Nursing Practice.” . “Nursing problems arise because there are disturbances in the structure or functions o of the subsystems of the system. Johnson presented the Behavioral System Model in Riehl and Roy’s books. ingestive. achievement.Dorothy E. eliminative and sexual. In Johnson’s words. aggressive.

Environment and self provide three classes of stimuli: 1. Residual 3. Focal 2.Sister Callista Roy Sister Callista Roy proposed that humans are biopsychosocial beings who exist within an environment. Contextual .

intervention. lines of resistance.Betty Neuman Betty Neuman developed her first teaching practice model for mental health consultation in the late 1960s. open system. stressors. lines of defense. She designed the Systems Model in 1970 to help graduate students evaluate nursing problems. 1989 and 1995. energy resources. . Major concepts include: total persons approach. levels of prevention and reconstitution. It was first published in Nursing Research in 1972 and further refined in the Neuman Systems Model in 1982. holism.

self. . framework specifies the following interacting systems: personal system. interpersonal system and social system.Imogene King has been publishing since the mid1960s. body image. communication and transaction and stress. Toward a Theory for Nursing was published in 1971 and a Theory for Nursing was published in 1981. The concepts of the personal systems are perception. interaction. King’s conceptual. The concepts of interpersonal system are role. growth and development and time and space.

The 12 activities of living (ALs) include maintaining a safe environment. eliminating. expressing sexuality. socio-cultural. Tierney. . The Elements of Nursing: A Model for Nursing based of a Model for Living. psychological. working and playing. breathing. and environmental and politico economic. personal cleansing and dressing. Winifred W. communicating. and Alison J. controlling body temperature. eating and drinking.Nancy Roper. sleeping and dying. Logan. mobilizing. The five groups of factors influencing the Als are biological.

Peplau’s contributions to nursing in general and to the specialty of psychiatric nursing in particular have been enormous since1950s. Interpersonal Relations in Nursing. She identified four phases of the nurse-patient relationship: 1. Resolution . Exploitation 4. Orientation 2.Hildegard E. Identification 3.

Surrogate 6. Leader 5.Peplau proposed and described six nursing roles: 1. Teacher 4. Counselor . Stranger 2. Resource person 3.

Patient behaviors 2. Nurse Reactions 3. Ida Jean Orlando (Pelltier) first describe her discipline’s Professinal Response Theory in The Dynamic Nurse-patient Relationship which was reissued by the National League for Nursing in 1991. Orlando used the interpersonal nursepatient relationship in response to the patient’s needs as the basis for her work. Three elements comprise a nursing situation: 1. Nursing actions . She reported related research in the Discipline and Teaching of Nursing Process.In 1961.

suffering. sympathy. She proposed that nursing was accomplished through human-to-human relationships that begin with: . She died in 1973 at a relatively young age. interaction. and therapeutic use of self.Joyce Travelbee published predominantly in the mid1960s. Travelbee proposed her Human-to-Human Relationship Theory in Her book. empathy. rapport. pain. communication. hope. Interpersonal Aspects of Nursing about illness.

sympathy. The work is categorized as a nursing theory. the nurse and patient attained rapport in the final stage. sympathy. The original encounter and then progressed through stages of 2.1. developing feelings of empathy and later. until 5. Travelbee’s emphasis on caring stressed empathy. emerging identities 3. and the emotional aspects of nursing. rapport. 4. .

Katharine Kolcaba defies healthcare needs as those needs for comfort including physical. . Comfort measures include physiological. environmental and physical measures. social. spiritual. psychological. social and environmental needs. psycho-spiritual. financial. Types of comfort •a sense of ease •calm or contentment and •transcendence when a person rises above problems of pain.

First-Time Motherhood: Experiences from Teens to Forties.Ramona T. Mercer has researched and published 1970s. Researched the field of maternal role attainment and developed a complex theory about factors influencing maternal role development over time her 1986 book. .

Kathryn E. Barnard is an active researcher who has published extensively about infants and children since the mid 1960s. She began by studying the activities of the well child and then expanded her work to include methods of evaluating the growth and development of children and mother-infant relationships. .

Care: The Essence of Nursing and Health. supportive. Transcultural Care Theory is found in her 1984 book.Madeleine Leininger has published extensively about many nursing topics since 1960. Caring includes assistive. or facilitative acts toward an individual or group with evident or anticipated need. .

connectingseparating. originating and transforming.Rosemarie Rizzo Parse derives her theory form Roger’s principles and concepts and from Heidegger. Merle Mishel used qualitative and quantitative findings to conceptualize uncertainty in illness. enabling-limiting. Major concepts include imaging. first book of her theory. . valuing. powering. revealing-concealing. Man-Living-Health: A Theory of Nursing in 1981. languaging .

. but to help people use the power within them as they evolve toward a higher level of consciousness. She has drawn from several fields of inquiry. Newman began publishing in the mid 1960s. Newman’s theory of health is derived from Roger’s model. the goal of nursing is not to promote wellness or to prevent illness. Her model appeared in Theory Development in Nursing. According to Newman.Margaret A.

Evelyn Adam is a Canadian nurse who started publishing in the mid1970s. . She began to build the foundation for studying how individuals make decisions about their own healthcare in her article. Nola J. Pender defines the goal of nursing care as the optimal health of the individual.

Italy.Florence Nightingale. 1820. Edward and Frances Nightingale. Germany. affluent. her parents were on extended European tour. At the time of her birth. a Protestant religious community with a hospital facility. . was born on May 12. the matriarch of modern nursing. After she understood that she was called to become a nurse. Her parents. she was finally able to complete her training in 1851 at Kaiserworth. named their daughter after her birthplace Florence. The Nightingales were a well-educated. aristocratic Victorian family who maintained residences.

Notes on Hospitals and Report on Measures Adopted for Sanitary Improvements in India from June 1869 to June 1870.She was called “The lady of the Lamp”. because she made ward rounds during the night. . as immortalized in the poem “Santa Filomena” by Henry Wadsworth Longfellow. Notes on matters Affecting the Health. Efficiency and Hospital Administration of the Bristish Army. Florence Nightingale’s reputation as the founder of modern nursing was establish. Her writings.

Nightingale’s work was recognized through the many awards she received from her own country and many other countries. 1910 at age 90.In her lifetime. . She was able to work into her eighties and died in her sleep on August 13.

. Nightingale wrote Notes on Nursing to provide women with guidelines fro providing nursing care and to give advice on how to “think like a nurse”. would be a nurse in the sense that nursing is having the responsibility for someone else’s health.MAJOR ASSUMPTIONS Nursing Nightingale believed that every woman. at one time in her life.

Nurses performed tasks to and for the patient and controlled the patient’s environment to enhance recovery.Person Nightingale referred to the person as a patient. .

. what she described is modern public health nursing and the more modern concept of health promotion. Envisioned the maintenance of health through the prevention of disease via environmental control.Health Health as being well and using every power that the person has to the fullest extent.

” She believed that nurses could be instrumental in changing the social status of the poor by improving their living conditions. .Environment Fitzpatrick and Whall describe Nightingale’s concept of environment as “those elements external person” and included “everything from the patient’s food and flowers to the patient’s verbal and nonverbal interactions with the patient.

. perseverance and ingenuity. Although she wrote Notes on Nursing that nurses needed to be excellent at the observation of their patients and the environment. She believed that persons desired good health and that they would cooperate with the nurse and nature to allow the reparative process. coupled with their observation.THEORETICAL ASSERTIONS Nightingale was totally committed to nursing education (training). She believed that nurses needed to use common sense in their nursing practice.

quiet. Education Nightingale’s principles of nursing training (instruction in scientific principles and practical experience for the mastery of skills) provided a universal template for early nurse training schools beginning with St. diet and cleanliness) remain integral components of current nursing care. warmth. Thomas Hospital and King’s College Hospital in London.ACCEPTANCE BY THE NURSING COMMUNITY Practice The environmental aspects of her theory (ventilation. .

Research Nightingale’s interest in scientific inquiry and statistics continues to define the scientific inquiry used in nursing research. .

THE HELPING ART OF CLINICAL NURSING Ernestine Wiedenbach’s affluent family immigrated from Germany. She wrote family-Centered Maternity Nursing a text on clinical nursing that was published in 1958. . Her interest in nursing began with her childhood experiences with nurses. She greatly admired the private duty nurse who cared for her ailing grandmother.

and individuality of each human being 3. reverence for the gift of life 2. autonomy. Basic to this philosophy of nursing are: 1.MAJOR ASSUMPTIIONS Nursing Nurses ascribe to an explicit philosophy. resolution to act dynamically in relation to one’s beliefs . worth. respect for the dignity.

Interest in advancing knowledge in the area of interest and in creating new knowledge 5. Dedication to furthering the goal of humankind rather than supporting self-aggrandizement. Clarity of purpose 2. Mastery of skill and knowledge essential for fulfilling the purpose 3.Weidenbach identifies five essential attributes of a professional person: 1. . Ability to establish and sustain purposeful working relationships with other (both professional and nonprofessional individuals) 4.

Each human being is endowed with the unique potential to develop-within self-resources that enable them to maintain and sustain himself .Person Four explicit assumptions are stated in relation to human nature: 1.

3. The human being basically strives toward selfdirection and relative independence and desires not only to make best use of his capabilities and potentialities, but also to fulfill his responsibilities. 4. Self-awareness and self-acceptance are essential to the individual’s sense of integrity and self-worth.
5. Whatever the individual does represents his or her best judgment at the moment of his doing.

Health
The definitions of nursing, patient, and need-for-help, and the relationships among these concepts, imply health related concerns in the nurse-patient situation. Environment She recognized the potential effects of the environment. It is implied the environment may produce obstacles resulting in the person experiencing a need-for-help.

Faye Glenn Abdellah was born in New York City in 1919. She graduated magna cum laude from Fitkin Memorial Hospital School of Nursing (now Ann May School of Nursing) in 1942. Abdellah received her B.S. in 1945, her M.A. in 1947 and her Ed.D in 1955 from Teachers College at Columbia University.

To maintain good hygiene and physical comfort 2. rest and sleep 3. To promote safety through prevention of accident. To promote optimal activity: exercise. To maintain good body mechanics and prevent and correct deformity .Abdellah’s Typology of 21 Nursing Problems 1. injury or other trauma and through the prevention of the spread of infection 4.

To facilitate the maintenance of fluid and electrolyte balance. physiological and compensatory . To facilitate the maintenance of the supply of oxygen to all body cells 6. To facilitate the maintenance of nutrition of all body cells 7. 9.5. To recognize the physiological responses of the body to disease conditions-pathological. To facilitate the maintenance of elimination 8.

To promote the development of productive interpersonal relationships . To identify and accept interrelatedness of emotions and organic illness 14. feelings and reactions 13. To identify and accept positive and negative expressions.10. To facilitate the maintenance of sensory function 12. To facilitate the maintenance of regulatory mechanisms and functions 11. To facilitate the maintenance of effective verbal and nonverbal communication 15.

To understand the role of social problems as influencing factors in the cause of illness.16. . 17. To facilitate awareness of self as an individual with varying physical. To use community resources as an ald in resolving problems arising from illness 21. 19. emotional and developmental needs.To facilitate progress toward achievement and personal spiritual goals. physical and emotional 20. To create or maintain a therapeutic environment 18. To accept the optimum possible goals in the light of limitations.

Lydia Hall began her prestigious career in nursing as a graduate of the York Hospital School of Nursing in York. She then earned her B. Hall’s career interests revolved around public health nursing. pediatric cardiology and nursing of long-term illnesses. . in New York. and M. cardiovascular nursing. degrees from Teachers College. Columbia University.S.A. Pennsylvania.

The Person Social sciences Therapeutic use of self-aspects of nursing “The Core” The Body Natural and biological sciences Intimate bodily care-aspects of nursing “The Care” The Disease Pathological and therapeutic sciences Seeing the patient and family through the medical care-aspects of nursing “The Cure” .

Philosophy and Science of Caring Margaret jean Harman Watson was born in southern West Virginia and grew up during the 1940s and 1950s in the small town of Welch. West Virginia in the Appalachian Mountains. Cultivation of Sensitivity to Self and to Others 4. Instillation of faith-Hope 3. Development of a Helping-Trust Relationship . 10 Carative Factors 1. Formation of a Humanistic-Altruistic System of Values 2.

Assistant with gratification of Human Needs 10. Protective and Corrective Mental. Systematic Use of the Scientific Problem-Solving Method for Decision-Making 7. and Environmental 9. Provision for Supportive. Physical. Socio-cultural. Allowance for Existential-Phenomenological Forces . Promotion and Acceptance of the Expression of Positive and negative Feelings 6. Promotion of Interpersonal Teaching-Learning 8.5.

Virginia and spent her childhood in California. Majoring in nursing. she earned a master’s degree in nursing.Patricia Benner was born in Hampton. with her major emphasis in medical-surgical nursing from the University of California. . she obtained a Bachelor of Arts degree from Pasadena College in 1964. In 1970. where she received her early and professional education. San Francisco School of nursing.

the person has no background experience of the situation in which he or she is involved. . or to have pointed out by a mentor. Advanced Beginner Advanced beginner stage in the Dreyfus model develops when the person can demonstrate marginally acceptable performance having coped with enough real situations to note.Novice In the novice stage of skill acquisition in the Dreyfus model. the recurring meaningful components of the situation.

The proficient level is qualitative leap beyond the competent. Nurses at this level demonstrate a new ability to see changing relevance in a situation including the recognition and the implementation of skilled responses to the situations as it evolves. . the advanced beginner moves to the competent level.Competent Through learning from actual practice situations and by following the actions of others. Proficient Performer perceives the situation as a whole (the total picture) rather than in terms of aspects and the performance is guided by maxims.

Expert The fifth stage of the Dreyfus model is achieved when “the expert performer no longer relies on analytical principle (rule. maxim) to connect her or his understanding of the situation to an appropriate action. guideline.” .

Maryland. one of America’s foremost nursing theorists. hospital staff nursing on pediatric and adult medical and surgical units. was born in Baltimore. evening supervisor in the emergency room.Dorothea Elizabeth Orem. and biological science teaching. Her early nursing experiences included operating room nursing. Labels her self-care deficit theory of nursing as a general theory composed of three related theories: . private duty nursing (home and hospital).

the theory f self-care. the theory of nursing systems.1. which describes and explains relationships that must be brought about and maintained for nursing to be produced. which describes why and how people care for themselves 2. which describes and explains why people can be helped through nursing 3. the theory of self-care deficit. .

.N.S. an S. from the University of Chicago in1949. Hutchins’ curriculum was being taught to undergraduate students at the University of Chicago. from Wayne State University in 1962.Myra Estrin Levine obtained a diploma from Cook Country School of Nursing in 1944.B. an M. and she has taken postgraduate course at the University of Chicago.

” “Wholeness emphasizes a sound. Wholeness (HOLISM) . organic. adaptation and conservation. mutuality between diversified functions and parts within an entirety. hale is all derivations of Anglo-Saxon word hal. the boundaries of which are open and fluent. progressive.“Whole.Three major concepts of the Conservation Model are wholeness. health.” . 1.

Environment .Environment is “where we are constantly and actively involved. . Adaptation .” 3.” The person and his or her relationship to the environment is what count.“Adaptation is a process of change whereby the individual retains his integrity within the realities of his internal and external environment.2.

Conservation of Structural Integrity Healing is a process of restoring structural and functional integrity in defense of wholeness. .Conservation Principles Conservation of Energy The individual requires a balance of energy and a constant renewal of energy to maintain life activities. Processes such as healing and aging challenge that energy.

providing privacy during procedures. valuing personal possessions. The most vulnerable become patients. .Conservation of Personal Integrity Self-worth and a sense of identity are important. respecting their wishes. This begins with the erosion of privacy and the creation of anxiety. Nurses can show patients respect by calling them by name. supporting their defenses and teaching them.

Conservation of Social Integrity Life gains meaning through social communities and health is socially determined. and use interpersonal relationships to conserve social integrity. Nurses fulfill professional roles. . provide for family members. assist with religious needs.

Moral Theories .

or conscience.Freud (1961) Believed that the mechanism for right and wrong within the individual is the superego. He hypothesized that a child internalizes and adopts the moral standards and character traits of the model .

The strength of the superego depends on the intensity of the child’s feelings of aggression or attachment toward the .

Erikson (1964) Erikson’s theory on the development of virtues or unifying strengths of the “good man” suggests that moral continues throughout life. He believed that if the conflicts of each psychosocial development stages are favorably resolved then .

At first level called the premoral or the preconventional level. He focused on the reasons for the making of a decision.Kohlberg Suggested three levels of moral development. children are responsive to cultural rules . not on the morality of the decision itself.

At the second level. i. the conventional level. children interpret these in terms of the physical consequences of their actions.However. punishment or reward.e.. the individual is concerned about maintaining the expectations of .

At this level. people make an effort to define valid values and principles without regard to outside authority or to the expectations of others. autonomous. These involve respect for other humans .At the third level called the postconventional. or principled level.

Moral development is usually considered to involve three separate components: moral emotion (what one feels). and moral behavior (how one acts). In addition.Peters Proposed a concept of rational morality based on principles. moral judgment (how one reasons). Peters believed that the development of .

And that virtues or character traits can be learned from others and encouraged by the example of others. Peters believed that some virtues can be described as habits because they are in some sense automatic and therefore are performed . Also.

Schulman and Mekler (1985) Believed that morality is a measure of how people treat fellow humans and that a moral child is one who strives to be kind and just. namely: . They believed that morality has two components.

2. The person acting must be fair or just in the sense that the person considers the rights of .1. The intention of the person acting must be good in the sense that the goal of the act is the well being of one or more people.

as follows: a. Developing emphatic reactions c. which they believed can be taught. Internalizing parental standards of right and wrong b.Furthermore. Acquiring personal standards . the aforementioned authors asserted that the theory of moral development is based on three foundations.

Caring for oneself b. Caring for self and others. . Caring for others c. She describe three stages in the process of developing an “Ethic of Care” which are as follow: a.Gilligan (1982) Included the concepts of caring and responsibility.

what is right is taking responsibility for others as self-chosen decision. For women. On .She believed that women see morality in the integrity of relationship and caring.

Spiritual Theories .

or the spiritual dimenston is a force that gives meaning to person’s life. He used the term “faith” as a form of .Fowler (1979) Described the development of faith. He believed that faith.

faith is a relation phenomenon: it is “ an active made-ofbeing-in-relation to another or others in which invest commitment belief. love.To Fowler. risk and .

Westerhoff Proposed that faith is a way of behaving. These stages as . He developed a four-stage theory of faith development based largely on his life experiences and the interpretation of those experiences.

Experienced faith (infancy to early adolescence): experiences faith through interactions with others who are living a particular faith b. Affiliative faith (late adolescence): actively participates in activities that .a.

d. Owned faith (middle adulthood): puts faith into personal and social action and is willing to stand up for what he/she believes even against . acquires a cognitive as well as effective faith. Searching faith (young Adulthood): through a process of questioning ad doubting own faith.c.

The End .

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