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Neuman 1972 A model for teaching total person

approach to patient’s problems
(with R.J Young)
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
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 &
• 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
The word ‘man’ in contemporary dictionary
tends to be gender-based as opposed to
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
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
 The movement towards professionalism
evolved through different eras.

1. Curriculum Era (1900 – 1940’s) - term given to the body of knowledge, used to support
nursing practice.
- Emphasizes on course included in nursing
program. - organized and systematic articulation of a set of
- With the emergence of baccalaureate nursing, statements or concepts related to questions in the
the ‘art of nursing’ was changed to ‘science of discipline of nursing.
Thus at present, the art and science of nursing is
more supported. Discipline - a branch of education, a department of
learning, a domain of knowledge, specific to academia
GOAL : To develop specialized knowledge & higher
education Profession - specialized field of practice founded on the
theoretical structure of the science or knowledge of
Nursing Arts Lab - Where procedure are taught, in later discipline and accompanying practice abilities.
decades it is referred to as Skills Laboratory.
2. Research Era (1950 – 1970s)
 Nursing can be a vocation or a discipline with a
- Emphasizes roles of nurses and what to
professional style of theory – based practice.
 Nursing theory is essential for existence nursing as
- Emphasizes the need to disseminate research
an academic discipline. It is also vital to the practice
finding in scholarly publication
- More nurse educators are into research of professional nursing
 Use of theory amplifies knowledge development &
enhances the quality of nursing practice
3. Graduate Education (1950s – 1970s)  Knowledge of person, health & environment forms
- curricula for masters level preparation includes that basis of recognition of nursing as a discipline
research, clinical specialty and leadership
- Emphasizes advanced role & basis for nursing HISTORY & PHILOSOPHY OF SCIENCE
practice Science - a method for describing, explaining,
predicting causes or outcomes of intervention
GOAL : to focus graduate education on knowledge to Scientific Activity - help to establish the evidence
development we use to guide practice in the delivery of nursing


4. Theory Era (1980’s – 1990s)
- Nursing theory development stimulated Rationalism -- epistemological view that “regards
phenomenal growth, been noted as the corner reasons as the chief sources and test of
stone of the development of the discipline of knowledge” or any view appealing to reason as
nursing a source of knowledge or justification
-- Methodology or theory in which the
GOAL : Theory guides research & practice criterion of truth is not sensory but intellectual
or deductive

Rationalist epistemology (scope of knowledge)

5. Theory Utilization Era (21 Century) - emphasizes the importance of prior reasoning as an
appropriate method for advancing knowledge.
- Nursing theory guides research, practice,
education and administration Empiricism -- Uses inductive method, based on the idea
- Shift from theory development to theory that the collection of fact attempts to formulate
generalization/ research – then – theory
application and utilization
GOAL : Shift from theory development to theory -- Empiricist view is based on the central idea
that scientific knowledge can be derived only
application and utilization
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;

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

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

- 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

- 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
2. Theoretical Definitions – permit
- Group of related concepts that propose actions consideration of the relationship between a given
and guide practice. concept and other theoretical ideas. WELL BEING is
also referred to as HEALTH
- Composed of concepts, definitions, conceptual
models, propositions & are based on Example: The nurse has the will to manipulate
assumptions. the environment (operational) so that the
patient will attain a sense of well – being
- Organized, coherent & systematic articulation (theoretical)
of a set of statements related to significant
questions… discovered, invented for
describing, predicting events, situation or
4. Proposition – statement about concept, or a
statement of a relationship between two or more
Derived through 2 principal methods; concept.
1. Deductive Reasoning 5. Assumption – accepted as truth and represents the
2 Inductive Reasoning value and believes of a theory.
- basis for defining concepts and
framing propositions.
- a statement that is assumed to be
1. Interrelating concepts to create a different way true from which conclusion can be drawn.
of looking at a particular phenomenon
2. Logical in nature Example: The nurse has the will to manipulate
3. Generalizable the environment so that the patient will attain
4. Bases for hypotheses that can be tested a sense of well - being.
5. Increasing the general body of knowledge
within the discipline through the research Questions:
implemented to validate them
6. Used by practitioners to guide and improve 1. How is the nurse linked to the
their practice environment? Or How is the nurse
7. Consistent with other validated theories, laws, related to the environment?
and principles but will leave open unanswered
2. What is the relationship of the
questions that need to be investigated
patient to the environment?

1. Concepts – are the building blocks of theories, they
classify the phenomenon of interest.  Term given to the body of knowledge that is
used to support nursing practice
Maybe classified as abstract or concrete.  Organized and systematic articulation of a set
of statements or concepts related to questions
2. Theoretical Statements - asserts a connection
in the discipline of nursing
between two or more concepts and introduces the
 more specific than a conceptual model
possibility of analysis.
Can be classified into 2 general categories:
1. Existence Statements – refer to specific component 1. Aims to describe, predict and explain the
2. Relational Statements- assert relationships between phenomenon of nursing
the properties of two or more concepts or variables 2. Provide the foundations of nursing or clinical
Example: The nurse has the will to manipulate
3. Helps us to decide what we know and what we
the environment (Existence) so that the patient need to know
will attain a sense of well - being. (Relational) 4. Helps to distinguish what should form the basis
of practice by explicitly describing nursing
3. Definitions – are classified into:
5. The benefits of having a defined body of theory
1. Operational Definitions – relate the concepts in nursing include better patient care, enhanced
to observable phenomenon. MANIPULATE THE professional status for nurses, improved
ENVIRONMENT is observable in any setting communication between nurses, and guidance
for research and education
- global concept that identify the phenomenon
of central interest to a discipline
-Proposition that states the relation between
or among the concepts


 Person – an individual/families, communities

and other groups who are participants in
 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 – broad in scope and highly

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


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