THEORETICAL FOUNDATION OF NURSING
Shane Valerie C. Diez 1NUR-2
Non-nursing theories
• nursing theories do not have original
concepts
• They borrow concepts and disciplines from
others
Borrowed theory in nursing:
• Knowledge is not a private domain of one
discipline
• The use of knowledge generated by any
discipline is not borrows but shared
• Shared theory does not lessen nursing
education but enhances it
• Nursing theories incorporates concepts and
theories shared with other discipline to
guide theory development
NON-NURSING THEORIES
ABRAHAM MASLOW
- Conceptualize the theory of motivation
- An American psychologist who studied the
needs or motivations of the individuals
- Maslow (1943) stated that people are
motivated to achieve certain needs. When
one need is fulfilled a person seeks to
fulfilled next one, and so on
• And these leads to the hierarchy of
needs. (Means that if one need is
satisfied it will then lead to
another one)
MOTIVES
- human motivation is based on people
seeking fulfillment and change through
personal growth
- Love, personal fulfillment, the need to
belong and self esteem
- Arousing and directive force of human
behavior
LOWER NEEDS
Physiological needs
• lower needs which keep individual alive
• Food, air, shelter, sleep sex
• Sex must be met for the service of the
human race, not for individual only
Safety and security
• need to avoid pain; to obtain bodily
comforts and to be free from fear and
insecurity
• Example: the patient is shouting because of
the pain or feels anxious therefore he or
she is seeking for security through our care
to the patient
HIGHER NEEDS
Love and belongingness
• The need to give and receive affection and
love
• This is the beginning of higher needs or the
psychological needs
Self-esteem needs
• feeling of success and self-worth,
competence and mastery of the
environment
• Includes the need to accomplish and to
achieve
• You will be able to receive self-esteem if
you accomplish something
MASLOW’S HIERARCHY OF NEEDS- EXTENDED
VERSION
- there is now a cognitive need, to share the
knowledge, Aesthetic and transcendence needs
Cognitive needs
- to increase intelligence and knowledge,
meaning, etc.
- Task: to learn, explore, discover and create
better understanding of the world
Aesthetic needs
- appreciation and search for beauty, balance
and form
- To relate in a beautiful way with the
environment and leads to beautiful feeling
of intimacy with nature and everything
beautiful
- How you are going to share your knowledge
o Ex: promoting advocacy
Self-actualization Needs
- the tendency to be an achiever
- Self-actualization is not perfection
- Self-actualization is achieving one’s
potential
- Less than two percent of the population
achieve self-actualization
 THEORETICAL FOUNDATION OF NURSING
Shane Valerie C. Diez 1NUR-2
Transcendence Needs
- need for you to help others
- Helping others to achieve the self-
actualization
- Refers to spiritual needs
- To feel satisfied with our needs and sense
of social worth
• To go beyond our ordinary human
consciousness and be united with the
greater whole, the higher truth
CONCEPT OF HEIRARCHY OF NEEDS
- basic needs must be reasonably met before
higher needs can be approached and met
- If the lower needs are not satisfied, the
person tends to focus again on the lower
need until it is met
- The lower needs are very powerful. Even if
an individual has progressed to the higher
needs, if satisfaction of a lower need is
blocked, we will move down again to the
lower needs until it is met
How does it apply:
- it allows the nurse to emphasize the
persons strengths instead of the persons
deficit
- Focus on human potential, thus giving hope
- Provides blueprint for prioritizing client care
according to hierarchy of needs
Characteristics of Human Needs:
1. Universal - all must meet these needs
- No one is an exemption
- You may be consistently provided with food
and shelter but love and belongingness is
not there
2. Deferred (delayed) depending on the
priority
• Example: The patients will be given the
priority depending on the need of the
patient
• Example: Why is it that despite the
provision of the gov of free education
there are still some parents who would
not go their parents go to school?
Because of the physiologic needs,
ipapawork muna sila
3. Human needs can be met in different ways
• Example the other person prefers
to eat vegs than meat it still
satisfies the physiologic needs
• Example: Muslims, they don’t eat
pork but they still other food. They
still meet their physiologic needs
4. Human needs are interrelated
• The lower needs should be
satisfied first in order to satisfy the
upper needs
5. When unmet, needs may lead to a problem
then illness
APPLICATION TO NURSING
Which of the needs will be prioritized?
- those who live way below the poverty line
with no certainty as to where the next meal
will come from
- People in war torn countries who live in
constant fear
Prioritization of Care
- The need to maintain life and physical
integrity give top priority in nursing care
• Example: a nurse attended to a patient in
the ER by first relieving the patient’s
difficulty of breathing before gathering info
about the patient’s condition by interview
Understanding of human behavior and its
consequences
- the behavior of the client will give clues to
his or her needs
CARL ROGERS
- Client centered theory
- A humanistic American psychologist who
focused on therapeutic relationship
- He was the first to use the term ‘client’
- Self-concept- is the most important feature of
personality, and it includes all the thoughts,
feelings, and beliefs peoples have about
themselves
o Believed that there should be
agreement on the self-concept
according to self and according to
others to facilitate self-actualization
CONCEPT OF CLIENT-CENTERED THERAPY
• A form of talk psychotherapy which aims to
provide clients with an opportunity to
develop a sense of self wherein they can
realize how their attitude, feelings, and
behavior are being negatively affected and
try to find their true positive potential
• believed that each person experiences the
world differently and knows his or her own
experiences best
APPLICATION TO NURISNG
• client centered approach in nursing care
• Focus on the role of the client as an
important instrument in the healing process
• A supportive and nurturing nurse client
relationship
• The nurse has a supportive role, rather than
directive or expert role
 THEORETICAL FOUNDATION OF NURSING
Shane Valerie C. Diez 1NUR-2
The nurse must support the self-esteem of the
client through:
1. Unconditional positive regard
- Non-judgement attitude toward
the client
2. Genuine
- Realness, honesty, and sincerity
toward the client
3. Empathetic understanding
- Ability to sense the feelings and
meaning from the client and to
convey the understanding toward
the client
Example:
A 45-year old obese female came to the health
center for consultation. The nurse taught her about
factors that contribute to the development of
diabetes and ways to maintain health
• Nurse aim: we have to change the way she
believes, because the belief and the
thoughts of the patient can affect the
health of the patient & nakafocus sa ability
ng patient na kaya niya gumaling on her
own
LUDWIG VON BERTALANFFY
- An Austrian-born biologist
- Proponent of the General System Theory
- Father of system theory
CONCEPT OF GENERAL SYSTEM THEORY:
• a system is a set of components or unite
interacting with each other within boundary
that filters the kind or rate of flow of inputs
and outputs to and from the system
• The system can be open or closed
• Open system
- move in the direction of higher
organization
- constantly affected by the
environment
- always on a constant state of
change move in the direction of
higher organization
Note: Man as an open system is continually
interacting with and being influenced by other
system
• Close system - move toward disorder,
illness and death
- do not exchange matter, energy
and information with the
environment
- Do not receive input from the
environment and give no output to
the environment
- Example: depression, ayaw niya na
magreceive and process ng info to
make that person hopeful sa
environment niya
Systems can be:
• Complex
o Human body
o Composed of subsystem
o Organ, tissue
• Simple
o Take in food stomach, will digest
tas poop
Process of exchange
1. Input
2. Process
3. Output
CONCEPTS (input to output)
• Matter to matter
• Matter to energy (food magiging energy)
• Matter to information (when you eat may
masasagot ka, coz you need food to process
info)
• Energy to matter (when the weather is hot,
you sweat)
• Info to matter ( positive and negative info
can lead to physiological something?)
• Man, having biological and social systems,
has subsystems interacting with each other
• The interrelatedness of all parts of the
system is the basis of the wholistic
approach of the nurse
o Malalaman na ok yung health ng
patient if we assess the patient
from head to toe, all the system
APPLICATION TO NURISNG
• People interact with the environment by
adjusting themselves to it or adjusting it to
themselves
• The nurse looks at environmental factors
influencing the patients’ health
o Ex: I want to find out what causes
the prevalence of dengue, of
course you have to look at the
input of the environment
• Skill: know a history or a survey froom the
patients
KURT LEWIN
- A German psychologist
- Father of social psychology
- Proponent of the Field Theory
Field Theory
- focused on the subjective reality of an individual
- Asserts that if a person is to be understood he
must be seen in the light of how she views the
world (subjective reality), not merely in terms of
how the world really is (objective reality)
- an individual lives in a life space: his
environment. External forces act on him (things,
conditions, situations). His drives, ideas,
concepts, feelings, attitudes and insights
constitute the internal forces that interact with
them (these are the internal forces)
 THEORETICAL FOUNDATION OF NURSING
Shane Valerie C. Diez 1NUR-2

Field
- realities in the environment of an individual Refreeze
that are working together to move towards - new behavior becomes habitual, which
or against his or her goal includes developing a new self-concept and
Life Space identify and establishing new interpersonal
- the subjective concept of a person about relationships
himself
- Behavior depends on the 3 major life space: APPLICATION TO NURSING:
• Home life • planning and providing health teachings
• Professional or student life based on the assessments
• Social life • Making the patients aware of their present
health conditions and the consequence of
CONCEPTS OF FIELD THEORY their current health practices -
• human behavior is the function of both the dissatisfaction
person and the environment • Patients follow the health teaching: changes
• Human motivation is goal-directed and their lifestyle and practices
purposeful • Sees the return of their health
• Human behavior is greatly influenced by the • Continuous to the things that prevents the
surroundings recurrence of their illness

APPLICATION TO NURSING: ERIK H. ERIKSON

• Environmental data are collected in the
assessment of the individual, family and the
community
• It’s important to assess their environment
to know what causes their sickness
• Health education involves motivation of the
patient
• As much as possible, the nurse gives priority
to needs recognized by the patient himself
CHANGE THEORY
- 3 stages of change
• Unfreezing
• Change
• Refreezing
- Asserts that previous or prior learning must
be rejected and replaced before change can
manifest
- Depends on the driving force (the nurse)
and resistance force (patient, coz they have
their own belief)
o Student of Freud
o A German psychologist
o Proponent of the Psychosocial
Developmental Theory
CONCEPT OF PSYCHOSOCIAL DEVELOPMENTAL
THEORY:
• people continue to develop throughout life
• Each stage signifies a task to be
accomplished by an individual to move
forward to the next task
• Failure to complete a developmental stage
influences the person’s ability to progress
to the next level
• Environment is highly influential in the
development of the individual

Unfreeze stage 6-12 years

- refers to the readiness and motivation to 12-18 years

change 18-25 years

- Present behavior is established by past 25-65 years

earning and cultural influences

- Requires adding new forces for change or
removal of some of the existing factors that
inhibits change to manifest
Change
- there is enough dissatisfaction with the
current conditions that leads to a real
desire to make some change (facilitate
motivation)
- Activities that facilitate change:
o limitation of role model
▪ Showing students how to
wash their hands properly
o trial and error learning
▪ Making the person try it
first to see the effect
 THEORETICAL FOUNDATION OF NURSING
Shane Valerie C. Diez 1NUR-2

Generativity vs. Stagnation

Trust vs Mistrust • middle adult
- infancy stage • Being creative and productive (they need
- Viewing the world as safe and reliable, something to support their family and to
relationship as nurturing, stable and the society) ; establishing the next
dependable generation
- Virtue that will be develop is hope • Develop virtue of care
- There would be mistrust if you have no
mother you can depend on or people Ego integrity vs. Despair
available to you • maturity
- Mistrust in not entirely negative, b/c if you • Accepting responsibility for one’s self and
have too much trust you became gullible; other
too much mistrust naman suspicious ka so it • Develop virtue of wisdom
should be balance
APPLICATION TO NURSING:

Autonomy vs. Shame and Doubt
- toddler
- Achieving a sense of control and free will
- Autonomy- what can I do to the
environment on my own? (But the parents
are there supervising not controlling)
- If the environment is controlling, it develops
shame and doubt for fear of punishment
- You will develop the virtue of will
- Too much autonomy doesn’t know how to
seek help with others; too much shame and
doubt will not initiate anything which would
put down the self esteem
Initiative vs Guilt
- preschool
- Beginning dev. of conscience, learning to
manage conflict and anxiety
- Initiative- wanting to do it on your own; if
the environment is not supportive to that
the you will question yourself guilt will
develop
- Virtue of Purpose
Industry vs. Inferiority
• school age
• Emerging confidence in own abilities, taking
pleasure in accomplishments
• Virtue of competence
• too much industry you are overworking na;
too much inferiority takot ka sa dagdag na
responsibilty kasi takot ka na baka di mo
matapos
• Nurses can enhance a client’s development
by being aware of the individuals’
developmental stage and assisting with the
development of coping skills
- “What would be my behavior toward
my client”
- Example: In the nursery, the nurse
attends immediately to the need of a
crying infant (trust vs mistrust)
• Nurse should be aware of the
developmental task in each stage, it may be
Negative or positive
• Nurses can strengthen a client’s positive
resolution of a developmental task by
providing the individual with appropriate
opportunities and encouragement
- Example: A nurse encourages a 65-
year-old male patient (integrity vs
despair) to participate in
commonly activities such as church
activities, bingo socials etc.

Identity vs. Role confusion

• adolescences
• Establishing a sense of self and
belongingness
• Develop virtue of fidelity

Intimacy vs. Isolation

• young adult
• Forming adult, loving relationships and
meaningful attachments to other
• Develop virtue of love