HIGHLIGHTS OF SIGNIFICANCE EVENTS IN HISTORY B.

Neuman 1972 A model for teaching total person

approach to patient’s problems
(with R.J Young)
1974
FLORENCE NIGHTINGALE (1859/1992)
The Betty Neuman Health – care
• “Notes on Nursing” System Model: a total person
approach to patient problems
presents the first nursing theory that focuses on the
manipulation of environment for the benefit of the Sr. C. Roy 1976 Introduction to Nursing: An
patient. Adaptation Model
J. Paterson
and 1976 Humanistic Nursing
L.T. Zderad
THE COLUMBIA SCHOOL (1950S)
M. Newman 1979 Theory Development in Nursing
• Prepare nurses at the graduate level for J. Watson 1979 Nursing: The Philosophy and
administrative & faculty positions Science of Caring

(Graduates includes: Peplau, Henderson, Hall &

Abdellah) 1980’s

Theories Year Title

D. Johnson 1980 Behavioral System Model for
YALE SCHOOL (1960S) nursing
R. Parse 1981 Man – Living – health: A theory of
• The focus of theoretical thinking in nursing moved Nursing
from problem/need and functional roles focus to the H. Erickson 1983 Modeling and Role Modeling
relationship between nurse and patient. E. Tomlin
M. Swain
• was influenced by the Columbia Teachers College 1980 Caring: a central focus of nursing &
graduates who became faculty members M. Leininger healthcare services
1981 The Phenomenon of Caring
(Henderson, Weidenbach, Orlando) 1985 Transcultural Care Diversity &
Universality
• Theorist in the Yale School views nursing as a process 1988 Leininger’s Theory of Nursing:
rather than an end itself, their theories look at how Culture care Diversity and
nurses do, what they do, and how patient perceives Universality
his/her situation.

• Focus on what nurses do that is their functional roles. 1990’s

They consider patient problem and need to be the
 M. Rogers published her latest refinement of
practice focus.
theory “Nursing: Science of Unitary,
• Federal funds were made available for doctoral study Irreducible Human Beings”
for nurse educators.  Parse (1992) Change the name of her theory
from Man – living – health to Theory of Human
Becoming.
The word ‘man’ in contemporary dictionary
1970s
tends to be gender-based as opposed to
THEORIES YEAR TITLE mankind.
M. Rogers 1970 An introduction to the theoretical
basis of nursing  The history of theory development in nursing
I. King 1971 Towards a theory of nursing: began, with the writings of Florence Nightingale
General concepts of human
“Notes on Nursing” and continues to the
behavior
present.
D. Orem 1971 Nursing: Concepts of Practice  Second half of century, nurse saw the need to
M. Levine 1973 Introduction to Clinical Nursing develop nursing knowledge through theory
development to transition from vocation to
profession.
 The movement towards professionalism
evolved through different eras.
ERA’S OF NURSING KNOWLEDGE
1. Curriculum Era (1900 – 1940’s)
- Emphasizes on course included in nursing
program.
- With the emergence of baccalaureate nursing,
the ‘art of nursing’ was changed to ‘science of
nursing’.
Thus at present, the art and science of nursing is
more supported.
GOAL : To develop specialized knowledge & higher
education
Nursing Arts Lab - Where procedure are taught, in later
decades it is referred to as Skills Laboratory.
2. Research Era (1950 – 1970s)
- Emphasizes roles of nurses and what to
research
- Emphasizes the need to disseminate research
finding in scholarly publication
- More nurse educators are into research
3. Graduate Education (1950s – 1970s)
- curricula for masters level preparation includes
research, clinical specialty and leadership
- Emphasizes advanced role & basis for nursing
practice
GOAL : to focus graduate education on knowledge to
development
4. Theory Era (1980’s – 1990s)
- Nursing theory development stimulated
phenomenal growth, been noted as the corner
stone of the development of the discipline of
nursing
GOAL : Theory guides research & practice
st
5. Theory Utilization Era (21 Century)
- Nursing theory guides research, practice,
education and administration
- Shift from theory development to theory
application and utilization
GOAL : Shift from theory development to theory
application and utilization
Nursing Theory
- term given to the body of knowledge, used to support
nursing practice.
- organized and systematic articulation of a set of
statements or concepts related to questions in the
discipline of nursing.
Discipline - a branch of education, a department of
learning, a domain of knowledge, specific to academia
Profession - specialized field of practice founded on the
theoretical structure of the science or knowledge of
discipline and accompanying practice abilities.
SIGNIFICANCE OF NURSING THEORY TO DISCIPLINE
AND PROFESSION
 Nursing can be a vocation or a discipline with a
professional style of theory – based practice.
 Nursing theory is essential for existence nursing as
an academic discipline. It is also vital to the practice
of professional nursing
 Use of theory amplifies knowledge development &
enhances the quality of nursing practice
 Knowledge of person, health & environment forms
that basis of recognition of nursing as a discipline
HISTORY & PHILOSOPHY OF SCIENCE
Science - a method for describing, explaining,
predicting causes or outcomes of intervention
Scientific Activity - help to establish the evidence
we use to guide practice in the delivery of nursing
care.
PHILOSOPHICAL PERSPECTIVE USED IN SCIENCE
Rationalism -- epistemological view that “regards
reasons as the chief sources and test of
knowledge” or any view appealing to reason as
a source of knowledge or justification
-- Methodology or theory in which the
criterion of truth is not sensory but intellectual
or deductive
Rationalist epistemology (scope of knowledge)
- emphasizes the importance of prior reasoning as an
appropriate method for advancing knowledge.
Empiricism -- Uses inductive method, based on the idea
that the collection of fact attempts to formulate
generalization/ research – then – theory
strategy
-- Empiricist view is based on the central idea
that scientific knowledge can be derived only
from sensory experience
 Philosophies of Nursing
Rationalism Empiricism
- Set of forth the general meaning of nursing
• Reason is the source  The senses are the and nursing phenomenon through reasoning and logical
of all knowledge source of knowledge presentation of ideas.
• Knowledge can be  Knowledge is only
gained a priori  Addresses the ff. questions
gained a posteriori
(deductive logic) 1. What is nursing?
( Inductive method)
• Senses are easily  Uses research-then- 2. What is the nature of human caring?
fooled theory strategy 3. What is the nature of nursing practice?
• Uses theory-then- 4. What is the social purpose of nursing
research strategy practice?

Phenomenon – the subject matter of discipline;

Early 20th Century Views
- Positivism which supports that empirical research and
logical analysis (deductive and inductive) were two
approaches that would produce scientific knowledge
(Brown, 1977)
anything observable.
Philosophy – is a way of thinking about the world, the
universe and society, about the nature of the universe
and the connection between them.

Emergent Views of Science & Theory in the Late 20th
Century
- Brown argued for an intellectual revolution in
philosophy that emphasized the history of science was
replacing formal logic as the major analytical tool in the
philosophy of science.
One major perspective is that science was a process of
continuously building research rather than a product
of findings.
CONCEPTUAL MODELS OF NURSING
- composed of abstract and general concepts and
propositions that provide a frame of reference for
members of the discipline.
- set of concepts and statements that integrate the
concepts into a meaningful configuration.
1. Conceptual Models of Nursing
( also called Paradigm or Framework)

CONCEPTS
- vehicles of thought that may involve images,
something that is conceived in the mind - a thought or
a notion
- used to describe a phenomenon or
understanding about the phenomenon
- term or label the describe objects, properties,
or events & are basic components of theories and
enhance our ability to communicate.

Type of Concepts
1. Empirical Concepts – one that can either be observed
or experience through the senses
2. Abstract Concepts – one that is not observable, such
as hope and caring

NURSING PARADIGM
- Philosophical and theoretical framework based
on nursing discipline within which theories, laws, and
generalizations and experiments performed in support
of them are formulated

Examples of phenomenon in nursing

 Wound Healing
 Childbirth
 Development of Disease
 Recovery
 Death
THEORY
- Group of related concepts that propose actions
and guide practice.
- Composed of concepts, definitions, conceptual
models, propositions & are based on
assumptions.
- Organized, coherent & systematic articulation
of a set of statements related to significant
questions… discovered, invented for
describing, predicting events, situation or
relationship.
Derived through 2 principal methods;
1. Deductive Reasoning
2 Inductive Reasoning
CHARACTERISTICS OF THEORIES
1. Interrelating concepts to create a different way
of looking at a particular phenomenon
2. Logical in nature
3. Generalizable
4. Bases for hypotheses that can be tested
5. Increasing the general body of knowledge
within the discipline through the research
implemented to validate them
6. Used by practitioners to guide and improve
their practice
7. Consistent with other validated theories, laws,
and principles but will leave open unanswered
questions that need to be investigated
COMPONENTS OF A THEORY
1. Concepts – are the building blocks of theories, they
classify the phenomenon of interest.
Maybe classified as abstract or concrete.
2. Theoretical Statements - asserts a connection
between two or more concepts and introduces the
possibility of analysis.
Can be classified into 2 general categories:
1. Existence Statements – refer to specific component
2. Relational Statements- assert relationships between
the properties of two or more concepts or variables
Example: The nurse has the will to manipulate
the environment (Existence) so that the patient
will attain a sense of well - being. (Relational)
3. Definitions – are classified into:
1. Operational Definitions – relate the concepts
to observable phenomenon. MANIPULATE THE
ENVIRONMENT is observable in any setting
2. Theoretical Definitions – permit
consideration of the relationship between a given
concept and other theoretical ideas. WELL BEING is
also referred to as HEALTH
Example: The nurse has the will to manipulate
the environment (operational) so that the
patient will attain a sense of well – being
(theoretical)
4. Proposition – statement about concept, or a
statement of a relationship between two or more
concept.
5. Assumption – accepted as truth and represents the
value and believes of a theory.
- basis for defining concepts and
framing propositions.
- a statement that is assumed to be
true from which conclusion can be drawn.
Example: The nurse has the will to manipulate
the environment so that the patient will attain
a sense of well - being.
Questions:
1. How is the nurse linked to the
environment? Or How is the nurse
related to the environment?
2. What is the relationship of the
patient to the environment?
NURSING THEORY
 Term given to the body of knowledge that is
used to support nursing practice
 Organized and systematic articulation of a set
of statements or concepts related to questions
in the discipline of nursing
 more specific than a conceptual model
PURPOSES/IMPORTANCE OF NURSING THEORIES
1. Aims to describe, predict and explain the
phenomenon of nursing
2. Provide the foundations of nursing or clinical
practice
3. Helps us to decide what we know and what we
need to know
4. Helps to distinguish what should form the basis
of practice by explicitly describing nursing
5. The benefits of having a defined body of theory
in nursing include better patient care, enhanced
professional status for nurses, improved
communication between nurses, and guidance
for research and education
METAPARADIGM
- global concept that identify the phenomenon
of central interest to a discipline
-Proposition that states the relation between
or among the concepts

4 MAJOR CONCEPTS OF A NURSING METAPARADIGM

 Person – an individual/families, communities

and other groups who are participants in
Nursing
 Health – human processes of living and dying
 Environment - human being, significant other,
and physical surroundings as well as local,
regional, national and nationwide, cultural
social, political and economic conditions that
are associated with human being’s health
 Nursing – healthcare profession focused on the
detail-oriented care of individuals, families, and
communities in attaining, maintaining, and
recovering optimal health and functioning

GRAND THEORY MIDDLE– RANGE THEORY

 Grand Theory – broad in scope and highly

abstract conceptually
 Middle-Range Theory – narrow scope and more
concrete or practical

TYPES OF NURSING THEORETICAL WORKS

1. Nursing Philosophies
- Nightingale
- Watson
- Benner
- Erickson
2. Nursing Conceptual Models
- Levine
- Rogers
- Orem
- King
- Neuman
- Roy
- Johnson
3. Nursing Theories and Grand Theories
- Pender
- Parse
- Leininger
- Newman
4. Middle – Range Nursing Theories
- Mercer
- Mishel
- Reed