Nursing Theories: An Overview

ESTELITA M. DELA CRUZ, RN, MAN

Clinical Instructor
 Florence Nightingale
“Environmental Theory”
Florence Nightingale (mid-1800)
 “Environmental Theory” (first Nursing
Theory)
 Focused on manipulating the
environment in order to put the patient
in the best possible conditions for
nature to act.
 Client’s environment is manipulated to
include appropriate noise, nutrition,
hygiene, light, comfort, socialization
and hope.
 Provided the Nursing Profession the
“Legacy of Caring”
 VIRGINIA HENDERSON
Nature on Nursing Model
“Definitions and
Components of Nursing”
VIRGINIA HENDERSON (1955)
• “The Nature of Nursing Model”
(Definitions and Components of
Nursing”)
• Identified fourteen basic needs.
• The unique function of the nurse is to
assist the clients, sick or well.
• Believed that nursing involves
assisting the client in gaining
independence as rapidly as possible,
or assisting him to achieve peaceful
death.
Physiological
1.Breath normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable postures
5. Sleep and rest
6. Select suitable clothes
7. Maintain body temperature within normal range by adjusting clothing and
modifying environment
8 . Keep the body clean and well groomed
9. Avoid dangers in the environment and avoid injuring others
 10. Communicate with others in expressing emotions, needs fears
or opinion.
 11. worship according to one’s faith
 12. Work in such a way that there is a sense of accomplishment
 13. Play or participate in various forms of recreation
 14. Learn, discover or satisfy the curiosity that leads to normal
development .
FAYE ABDELLAH
“Patient-Centered
Approaches”
FAYE ABDELLAH (1960)
• “Patient-Centered Approaches”
• Identified 21 nursing problems which
determine nursing care.
• NURSING- a service to individuals,
families and society.
• Conceptualized NURSING as an art
and a science that molds individual
nurse into the desire and ability to
help people.
DOROTHY JOHNSON
“ Behavioral System
Model”
DOROTHY E. JOHNSON (1960-1980)
• “ Behavioral System Model”
• Seven subsystems:
• 1. Ingestive – taking in nourishment in
socially and culturally acceptable ways.
• 2. Eliminative – ridding the body waste
• 3. Affiliative – security seeking behavior
• 4. Aggressive – Self- protective behavior
• 5. Dependence – Nurturance - seeking
behavior.
• 6. Achievement - master of oneself and ones
environment according to internalized
standard of excellence.
• 7. Sexual and role identity behavior.
 IMOGENE KING
“Systems Framework and
Theory of Goal Attainment”
IMOGENE KING (1971-1981)
• “Systems Framework and Theory of
Goal Attainment”
• NURSING
• -helping profession that assist
individuals and groups in society to
attain, maintain and restore health.
• - interaction process between client
and nurse whereby during perceiving,
setting goals and acting on them,
transactions occurs and goals are
achieved.
MADELEINE LEININGER
“Theory of Culture Care
Diversity and Universality”
MADELEINE LEININGER (1978-1984)
• “Theory of Culture Care Diversity and
Universality” (transcultural Nursing
Model).
NURSING – is a humanistic and scientific
mode of helping a client through specific
cultural caring processes (cultural values,
beliefs, and practices) to improve or
maintain a health condition.
• Care is the essence and the dominant,
distinctive and unifying feature of
nursing.
MYRA ESTRIN LEVINE
“The Conservation
Principles: A Model for
Health”
MYRA ESTRIN LEVINE (1973)
• “The Conservation Principles: A Model
for Health”
• NURSING – is a human interaction and
proposed four conservation principles of
nursing which are concerned with the
unity and integrity of individual.
• Four Conservation Principles:
• 1. Conservation of energy
• ( Food , oxygen and fluids)
• 2. Conservation of Structural Integrity
• ( skin and mucous membrane)
Four Conservation Principles:
• 3. Conservation of Personal Integrity
• The nursing interventions are based on
the conservation of the individual client’s
personality.
• 4. Conservation of Social Integrity
• The social integrity of the client reflects
the family and the community in which
the client functions.
 BETTY NEUMAN
“The Neuman System
Model”
BETTY NEUMAN (1982, 1989, 1992)
• “The Neuman System Model” or
“Health Care System Model”
• NURSING – unique profession in that
it is concerned with all the variables
affecting an individuals response to
stresses:
• Which are:
• Intrapersonal
• Interpersonal
• extrapersonal
 DOROTHEA OREM
“Self-Care Deficit Model
Nursing Model”
DOROTHEA OREM (1970-1985)
• “Self-Care Deficit Model Nursing
Model”
• SELF-CARE – the practice of activities
that individuals initiate and perform on
their own behalf in maintaining life, health
and well being.
• Three Nursing Systems:
• 1. Wholly compensatory:
• - the nurse is expected to accomplish all
the patient’s therapeutic self-care or
when the patient needs continuous
guidance in self care.
Three Nursing Systems:
• 2. Partially Compensatory
• - both nurse and pt. engage in meeting
self care needs.
• 3. Supportive-Educative
• - system that requires assistance in
decision making, behavior control
acquisition of knowledge and skills to
learn self- care
 HILDEGARD PEPLAU
“Interpersonal Relation in
Nursing”
HILDEGARD PEPLAU (1952)
• “Interpersonal Relations in Nursing
Model” (Psychodynamic Nursing
Model)
• NURSING – Interpersonal process of
therapeutic interactions between an
individual who is sick or in need of
health services
• NURSE - especially educated to
recognize and respond o the need for
help.
HILDEGARD PEPLAU (1952)
• Four Phases of Nurse-Client
Relationship:
• 1.Orientation -assessment
• 2. Identification-planning
• 3. Exploitation-intervention
• Resolution-termination phase
(evaluation)
 MARTHA ROGERS
“Science of Unitary Human
Beings”
MARTHA ROGERS (1970)
• “Science of Unitary Human
Beings”
• Unitary man- an energy field in
constant interaction with the
environment.
• Human beings characterized by the
capacity for abstraction and
imagery, language and thought,
sensation and emotion.
SISTER CALLISTA ROY
“Roy Adaptation Model”
SISTER CALLISTA ROY (1979, 1984)
• “Roy Adaptation Model”
• Viewed each person as unified bio
psychosocial system in constant
interaction with a changing environment.
• Adaptive human behavior is directed as
an attempt to maintain homeostasis or
integrity of the individual by conserving
energy and promoting the survival,
growth, reproduction and mastery of
human system.
 LYDIA HALL
“Core, Care and Cure
Model”
LYDIA HALL (1962)
• “Core, Care and Cure Model”
• CARE represents nurturance and is
exclusive to nursing.
• CORE involves the therapeutic use of
self and emphasizes the use of reflection.
• CURE focuses on nursing related to the
physicians orders.
• She articulated her views in nursing in
her book “Nursing-What is it?
IDA JEAN ORLANDO
“Nursing Process
Discipline”
IDA JEAN ORLANDO (1961)
• “Nursing Process Discipline” (The
Dynamic Nurse-Patient
Relationship Model)
• NURSE helps patients meets a
perceived need that the patient
cannot meet for themselves.
IDA JEAN ORLANDO
• AUTOMATIC NURSING ACTION
• -Those chosen for reasons other than the
immediate need for help.
• DELIVERATIVE NURSING ACTION
• - Those resulting from validating the need
for help, exploring the meaning of the
need, and validating effectiveness of the
actions taken to meet the need.
• 3 Elements of Nursing:
• 1. client behavior
• 2. nurse reaction
• 3. nurse actions
ERNESTEINE WIEDENBACH
“The Prescriptive Theory
of Nursing”
ERNESTEINE WIEDENBACH (1964)
• “The Prescriptive Theory of Nursing”
(Clinical Nursing – A Helping Art
Model)
• Believed that nurses meet the individual’s
need for help through the identification of
needs, administration of help, and
validation of actions
• Components of Clinical Practice:
• Philosophy
• Purpose
• Practice and an art
 JEAN WATSON
“Theory of Transpersonal
Caring”
JEAN WATSON (1979-1985)
• “Theory of Transpersonal Caring Model”
(Nursing: Human Science and Human Care)
• NURSING is the application of the art and
human science through transpersonal caring
transactions to help persons achieve mind-body-
soul harmony.
• 10 Carative Factors in Nursing:
• 1. Forming humanistic-altruistic value
system.
• 2. Instilling faith- hope
• 3. Cultivating sensitivity to self and others.
JEAN WATSON
• 10 Carative Factors in Nursing
• 4. Developing helping-trust relationship
• 5. Promoting expressions of feelings.
• 6. Using problem-solving for decision
making
• 7. Promoting teaching-learning
• 8. Promoting supportive environment
• 9. Assisting with gratification of human
needs.
• 10. Allowing for existential –
phenomenological forces.
ROSEMARIE RIZZO PARSE
“ Theory Of Human
Becoming”
ROSEMARIE RIZZO PARSE
• “ Theory Of Human Becoming”
• Emphasized free choice of personal
meaning in relating value priorities, co-
creating of rhythmical patterns, in
exchange with the environment, and
cotranscending in many dimensions as
possibilities unfold.
 JOYCE TRAVELBEE
“Interpersonal Aspects of
Nursing Practice”
JOYCE TRAVELBEE
• “Interpersonal Aspects of Nursing
Practice”
• Goal of Nursing
• - assist individual or family in preventing
or coping with illness, regaining health,
finding meaning in illness or maintaining
maximal degree of health.
JOSEPHINE PATERSON & LORETTA ZDERAD

“Humanistic Nursing”
JOSEPHINE PATERSON & LORETTA ZDERAD
• “Humanistic Nursing”
• Based on their belief that nursing
is an existential experience.
• NURSING involves the coming
together of the nurse and the
person to be nursed.
• The essential characteristic of
nursing is NURTURANCE.
Evelyn Tomlin, Helen Erickson and Mary Ann Swain

“The Modeling and Role-

Modeling Theory”
Evelyn Tomlin, Helen Erickson and Mary Ann Swain (1983)

• “Modeling and Role-Modeling Theory”

• The focus of this theory is the
PERSON.
• A. Nurse models(assesses)
• B. Role models (plans)
• C. Nurse intervenes
• NURSES facilitate, nurture and accept
the person unconditionally.
MARGARET NEWMAN
“Health as Expanding
Consciousness”
MARGARET NEWMAN (1979, 1986,1994)
• “Health as Expanding
Consciousness”
• Humans are unitary beings in whom
disease is the manifestation of the
pattern of health.
• Consciousness as the information
capability of the system which is
influenced by time, space and movement
and is ever expanding.
 PATRICIA BENNER
“Primacy of Caring Model”
“From Novice to Expert Model”
PATRICIA BENNER (1989)
• “Primacy of Caring Model” (From
Novice to Expert Model)
• Caring is central to the essence of
nursing and that, caring creates the
possibilities for coping and creates
possibilities of connecting with and
concerns for other
PATRICIA BENNER
• Five stage of skill acquisition in Nursing:
• 1. Novice – performance is limited
• 2. Advanced beginner – marginally acceptable
performance
• 3. Competent - organizational and planning
activities (2-3 years experience)
• 4. Proficient – holistic understanding and
perception of the client (3-5 yrs.)
• 5. Expert – No longer requires rules or
guidelines
ANNE BOYKIN and SAVINA SCHOENHOFER
• “Nursing as Caring”
• The focus of nursing is on nurturing
persons living and growing in caring in a
manner that is specific to each nurse-
nursed relationship.
JOYCE FITZPATRICK
“The Rhythm Model”
JOYCE FITZPATRICK
• “The Rhythm Model”
• The primary purpose of nursing is the
promotion and maintenance of an optimal
level of wellness.
• Professional nurse participates in a
multidisciplinary approach to health in
assessing, implementing and evaluating
programs in regards to how they affect
optimum wellness to patients.
 NOLA PENDER
“ Health Promotion Model”
NOLA PENDER
• “ Health Promotion Model”
• Promoting optimum health
supersedes disease prevention.
• Health promotion involves
activities that promote healthful
lifestyle
 RAMONA MERCER
“ Maternal Role Attainment
Model”
RAMONA MERCER
• “ Maternal Role Attainment Model”
• Advocated that there are factors that can impact
the development of parenting and maternal role
identity.
• FOUR STAGES OF MATERNAL ROLE
ATTAINMENTS:
• 1. ANTICIPATORY
Begins in pregnancy: Learns expectations of
motherhood role.
• 2. FORMAL
• Assumed at birth: Behaviors guided by
others.
RAMONA MERCER
• FOUR STAGES OF MATERNAL ROLE
ATTAINMENTS:
• 3. INFORMAL
• Learns own way of mothering
• 4. PERSONAL
• Has achieved harmony, competence and
confidence in mothering role.