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Paradigm – conceptual framework
Competency Appraisal 1
WEEK 1: NURSING FOUNDATION
a. Theory – foundation for the art & science of nursing
b. Research – testing theories
c. Practice – application
Florence Nightingale (Environmental Theory)
> First nursing theorist
> based on five points that are essential to obtain a healthy home
1. Clean water
2. Clean air Nursing Metaparadigm
3. Basic sanitation a. Person – recipient of nursing care
4. Cleanliness b. Health – degree of wellness or well-being that the client
5. Light experiences
> unsanitary environments contribute greatly to ill health & can be c. Environment – or situation, positive or negative internal &
altered to improve conditions to allow healing external surrounding that affects the patient
d. Nursing – nurse attributes, characteristics, & actions provide care
on behalf of or in conjunction with the client
HISTORY
Curriculum Era 1900 – 1940’s
Research Era 1950 – 1970’s
Graduate Education Era 1950 – 1970s
Theory Era 1980 – 1990s
Theory Utilization Era 2000 – present
Theories are dynamic & responsive to the changing environment in
which we live
Fundamental Patterns of Knowing a.
Ethics, The Moral Component
➢ Matters of obligation, ought
b. Aesthetics: The art of nursing
➢ Ability to skillfully perform nursing activities
➢ Constantly changing as knowledge development is built
Theory
Explains event by: c. Personal Knowledge: Knowing what you are doing & doing what
➢ Defining ideas or concepts you know
➢ Explaining relationship among the concepts ➢ Self-knowing that is conscious to know fully who you are
➢ Predicting outcomes & understand your actions & relationships being made on
the job through care
Nursing Theory ➢ Experiential knowing – understanding
- Describes, explains, predicts &/or prescribes nursing care ➢ Interpersonal knowing – awareness
d. Empirics: The science of nursing
Components of a Theory ➢ What is known is accessible through the physical senses:
a. Phenomenon – an observable event seeing, touching, hearing
b. Concepts – abstract description of phenomena, building blocks of
theories Classification of Nursing Theories
c. Definitions – meaning of the concept By Abstraction
➢ Theoretical/conceptual • A. Grand Nursing Theories
➢ Operational • are abstract, broad in scope, and complex, therefore
d. Assumptions – statements that describe concepts requiring further research for clarification
• do not provide guidance for specific nursing interventions
The Domain of Nursing • develop their works based on their own experiences
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• Components of Nursing Theories o
• B. Middle-Range Nursing Theories Phenomenon o Concepts o
• More limited in scope Definitions
• Address a specific phenomenon o Relational Statements o Assumptions
• Proposed using this level of theory.
• Why are Nursing Theories Important?
• Purposes of Nursing Theories o In
• C. Practice-Level Nursing Theories
Academic Discipline o In Research o
• situation specific theories that are narrow in scope and
In Profession
focuses on a specific patient population at a specific time
• provide frameworks for nursing interventions and suggest • Classification of Nursing Theories o By
outcomes or the effect Abstraction
▪ Grand Nursing Theories
By Goal Orientation ▪ Middle-Range Nursing
Theories can also be classified based on their goals, they can be: Theories
a. Descriptive – describe phenomena, speculate on why ▪ Practice-Level Nursing
phenomena occur & describe the consequences of Theories o
phenomena (ENLIGTHENMENT & UNDERSTANDING) By Goal Orientation
b. Prescriptive – address nursing interventions for a ▪ Descriptive Theories
phenomena & predict their consequence of a specific ▪ Factor-
nursing intervention (CONTROL & MANIPULATION) Isolating
Theory
Classification according to Afaf Meleis ▪ Explanatory Theory
a. Needs based ▪ Prescriptive Theories o
b. Interaction Other Ways of Classifying
c. Outcome Nursing Theories
According to Alligood
• List of Nursing Theories and Theorists o
a. Nursing Philosophies Florence Nightingale o Hildegard E. Peplau
b. Nursing Conceptual Models o Virginia Henderson o Faye
c. Grand Theories Glenn Abdellah o Ernestine Wiedenbach o
d. Middle Range Theories Lydia E. Hall o Joyce Travelbee o Kathryn
E. Barnard o Evelyn Adam o Roper,
Logan, and Tierney o Ida Jean Orlando o
Nursing Theories and Theorists Jean Watson o Marilyn Anne Ray o
Patricia Benner o Kari Martinsen o Katie
Eriksson o Myra Estrin Levine o
Martha E. Rogers o Dorothea E. Orem
o Imogene M. King o Betty
Neuman
o Sister Callista Roy o Dorothy E. Johnson o
Anne Boykin and Savina O. Schoenhofer o
Afaf Ibrahim Meleis o Nola J. Pender o
Madeleine M. Leininger o Margaret A.
Newman o Rosemarie Rizzo Parse o
Erickson, Tomlin, and Swain o Gladys L.
Husted and James H. Husted o Ramona T.
Mercer o Merle H. Mishel o Pamela G.
Reed o Carolyn L. Wiener and Marylin J.
Dodd o Eakes, Burke, and Hainsworth o Phil
ADVERTISEMENTS Barker o Katharine Kolcaba o Cheryl Tatano
In this guide for nursing theories, we aim to help you understand Beck o Kristen M. Swanson
what comprises a nursing theory and its importance, purpose, o Cornelia M. Ruland and Shirley M. Moore
history, types, or classifications, and give you an overview through
summaries of selected nursing theories.
• References
What are Nursing Theories?
• What are Nursing Theories? Nursing theories are organized bodies of knowledge to define what
• Defining Terms nursing is, what nurses do, and why they do it. Nursing theories
• History of Nursing Theories provide a way to define nursing as a unique discipline that is
• The Nursing Metaparadigm o Person o separate from other disciplines (e.g., medicine). It is a framework of
Environment o Health o Nursing concepts and purposes intended to guide nursing practice at a more
concrete and specific level.
, lOMoAR cPSD| 66549320
Nursing, as a profession, is committed to recognizing its own • In 1860, Florence Nightingale defined nursing in
unparalleled body of knowledge vital to nursing practice—nursing her “Environmental Theory” as “the act of
science. To distinguish this foundation of knowledge, nurses need to utilizing the patient’s environment to assist him
identify, develop, and understand concepts and theories in line with in his recovery.”
nursing. As a science, nursing is based on the theory of what nursing
• In the 1950s, there is a consensus among
is, what nurses do, and why. Nursing is a unique discipline and is
nursing scholars that nursing needed to validate
separate from medicine. It has its own body of knowledge on which
itself through the production of its own
delivery of care is based.
scientifically tested body of knowledge.
• In 1952, Hildegard Peplau introduced her
Defining Terms Theory of Interpersonal Relations that
emphasizes the nurse-client relationship as the
The development of nursing theory demands an understanding of
foundation of nursing practice.
selected terminologies, definitions, and assumptions.
• In 1955, Virginia Henderson conceptualized the
nurse’s role as assisting sick or healthy
• Philosophy. These are beliefs and values that individuals to gain independence in meeting 14
define a way of thinking and are generally fundamental needs. Thus her Nursing Need
known and understood by a group or discipline. Theory was developed.
• Theory. A belief, policy, or procedure proposed • In 1960, Faye Abdellah published her work
or followed as the basis of action. It refers to a “Typology of 21 Nursing Problems,” which
logical group of general propositions used as shifted the focus of nursing from a
principles of explanation. Theories are also used diseasecentered approach to a patient-centered
to describe, predict, or control phenomena. approach.
• Concept. Concepts are often called the building • In 1962, Ida Jean Orlando emphasized the
blocks of theories. They are primarily the reciprocal relationship between patient and
vehicles of thought that involve images. nurse and viewed nursing’s professional function
• Models. Models are representations of the as finding out and meeting the patient’s
interaction among and between the concepts immediate need for help.
showing patterns. They present an overview of • In 1968, Dorothy Johnson pioneered the
the theory’s thinking and may demonstrate how Behavioral System Model and upheld the
theory can be introduced into practice. fostering of efficient and effective behavioral
• Conceptual framework. A conceptual functioning in the patient to prevent illness.
framework is a group of related ideas, • In 1970, Martha Rogers viewed nursing as both
statements, or concepts. It is often used a science and an art as it provides a way to view
interchangeably with the conceptual model and the unitary human being, who is integral with
with grand theories. the universe.
• Proposition. Propositions are statements that • In 1971, Dorothea Orem stated in her theory
describe the relationship between the concepts. that nursing care is required if the client is
• Domain. The domain is the perspective or unable to fulfill biological, psychological,
territory of a profession or discipline. developmental, or social needs.
• Process. Processes are organized steps, changes, • In 1971, Imogene King‘s Theory of Goal
or functions intended to bring about the desired attainment stated that the nurse is considered
result. part of the patient’s environment and the
nursepatient relationship is for meeting goals
• Paradigm. A paradigm refers to a pattern of towards good health.
shared understanding and assumptions about
reality and the world, worldview, or widely • In 1972, Betty Neuman, in her theory, states
accepted value system. that many needs exist, and each may disrupt
client balance or stability. Stress reduction is the
• Metaparadigm. A metaparadigm is the most goal of the system model of nursing practice.
general statement of discipline and functions as
a framework in which the more restricted • In 1979, Sr. Callista Roy viewed the individual as
structures of conceptual models develop. Much a set of interrelated systems that maintain the
of the theoretical work in nursing focused on balance between these various stimuli.
articulating relationships among four major • In 1979, Jean Watson developed the philosophy
concepts: person, environment, health, and of caring, highlighted humanistic aspects of
nursing. nursing as they intertwine with scientific
knowledge and nursing practice.
History of Nursing Theories The Nursing Metaparadigm
The first nursing theories appeared in the late 1800s when a strong
emphasis was placed on nursing education. Four major concepts are frequently interrelated and fundamental to
nursing theory: person, environment, health, and nursing. These
four are collectively referred to as metaparadigm for nursing.
, lOMoAR cPSD| 66549320
Person, Nursing, Environment, and Health – the four main
concepts that make up the nursing metaparadigm. Person
Person (also referred to as Client or Human Beings) is the recipient
of nursing care and may include individuals, patients, groups,
families, and communities.
Environment
Environment (or situation) is defined as the internal and external
surroundings that affect the client. It includes all positive or negative An overview of the nursing metaparadigm of different nursing
conditions that affect the patient, the physical environment, such as theories. (Click to enlarge)
families, friends, and significant others, and the setting for where Components of Nursing Theories
they go for their healthcare. Health
Health is defined as the degree of wellness or well-being that the For a theory to be a theory, it has to contain concepts, definitions,
client experiences. It may have different meanings for each patient, relational statements, and assumptions that explain a phenomenon.
the clinical setting, and the health care provider. It should also explain how these components relate to each other.
Nursing Phenomenon
The nurse’s attributes, characteristics, and actions provide care on A term given to describe an idea or response about an event, a
behalf of or in conjunction with the client. There are numerous situation, a process, a group of events, or a group of situations.
definitions of nursing, though nursing scholars may have difficulty Phenomena may be temporary or permanent. Nursing theories
agreeing on its exact definition. The ultimate goal of nursing focus on the phenomena of nursing.
theories is to improve patient care.
Concepts
You’ll find that these four concepts are used frequently and defined Interrelated concepts define a theory. Concepts are used to help
differently throughout different nursing theories. Each nurse describe or label a phenomenon. They are words or phrases that
theorist’s definition varies by their orientation, nursing experience, identify, define, and establish structure and boundaries for ideas
and different factors that affect the theorist’s nursing view. The generated about a particular phenomenon. Concepts may be
person is the main focus, but how each theorist defines the nursing abstract or concrete.
metaparadigm gives a unique take specific to a particular theory. To
give you an example, below are the different definitions of various
theorists on the nursing metaparadigm: • Abstract Concepts. Defined as mentally
constructed independently of a specific time or
place.
• Concrete Concepts. Are directly experienced and
related to a particular time or place.
Paradigm – conceptual framework
Competency Appraisal 1
WEEK 1: NURSING FOUNDATION
a. Theory – foundation for the art & science of nursing
b. Research – testing theories
c. Practice – application
Florence Nightingale (Environmental Theory)
> First nursing theorist
> based on five points that are essential to obtain a healthy home
1. Clean water
2. Clean air Nursing Metaparadigm
3. Basic sanitation a. Person – recipient of nursing care
4. Cleanliness b. Health – degree of wellness or well-being that the client
5. Light experiences
> unsanitary environments contribute greatly to ill health & can be c. Environment – or situation, positive or negative internal &
altered to improve conditions to allow healing external surrounding that affects the patient
d. Nursing – nurse attributes, characteristics, & actions provide care
on behalf of or in conjunction with the client
HISTORY
Curriculum Era 1900 – 1940’s
Research Era 1950 – 1970’s
Graduate Education Era 1950 – 1970s
Theory Era 1980 – 1990s
Theory Utilization Era 2000 – present
Theories are dynamic & responsive to the changing environment in
which we live
Fundamental Patterns of Knowing a.
Ethics, The Moral Component
➢ Matters of obligation, ought
b. Aesthetics: The art of nursing
➢ Ability to skillfully perform nursing activities
➢ Constantly changing as knowledge development is built
Theory
Explains event by: c. Personal Knowledge: Knowing what you are doing & doing what
➢ Defining ideas or concepts you know
➢ Explaining relationship among the concepts ➢ Self-knowing that is conscious to know fully who you are
➢ Predicting outcomes & understand your actions & relationships being made on
the job through care
Nursing Theory ➢ Experiential knowing – understanding
- Describes, explains, predicts &/or prescribes nursing care ➢ Interpersonal knowing – awareness
d. Empirics: The science of nursing
Components of a Theory ➢ What is known is accessible through the physical senses:
a. Phenomenon – an observable event seeing, touching, hearing
b. Concepts – abstract description of phenomena, building blocks of
theories Classification of Nursing Theories
c. Definitions – meaning of the concept By Abstraction
➢ Theoretical/conceptual • A. Grand Nursing Theories
➢ Operational • are abstract, broad in scope, and complex, therefore
d. Assumptions – statements that describe concepts requiring further research for clarification
• do not provide guidance for specific nursing interventions
The Domain of Nursing • develop their works based on their own experiences
, lOMoAR cPSD| 66549320
• Components of Nursing Theories o
• B. Middle-Range Nursing Theories Phenomenon o Concepts o
• More limited in scope Definitions
• Address a specific phenomenon o Relational Statements o Assumptions
• Proposed using this level of theory.
• Why are Nursing Theories Important?
• Purposes of Nursing Theories o In
• C. Practice-Level Nursing Theories
Academic Discipline o In Research o
• situation specific theories that are narrow in scope and
In Profession
focuses on a specific patient population at a specific time
• provide frameworks for nursing interventions and suggest • Classification of Nursing Theories o By
outcomes or the effect Abstraction
▪ Grand Nursing Theories
By Goal Orientation ▪ Middle-Range Nursing
Theories can also be classified based on their goals, they can be: Theories
a. Descriptive – describe phenomena, speculate on why ▪ Practice-Level Nursing
phenomena occur & describe the consequences of Theories o
phenomena (ENLIGTHENMENT & UNDERSTANDING) By Goal Orientation
b. Prescriptive – address nursing interventions for a ▪ Descriptive Theories
phenomena & predict their consequence of a specific ▪ Factor-
nursing intervention (CONTROL & MANIPULATION) Isolating
Theory
Classification according to Afaf Meleis ▪ Explanatory Theory
a. Needs based ▪ Prescriptive Theories o
b. Interaction Other Ways of Classifying
c. Outcome Nursing Theories
According to Alligood
• List of Nursing Theories and Theorists o
a. Nursing Philosophies Florence Nightingale o Hildegard E. Peplau
b. Nursing Conceptual Models o Virginia Henderson o Faye
c. Grand Theories Glenn Abdellah o Ernestine Wiedenbach o
d. Middle Range Theories Lydia E. Hall o Joyce Travelbee o Kathryn
E. Barnard o Evelyn Adam o Roper,
Logan, and Tierney o Ida Jean Orlando o
Nursing Theories and Theorists Jean Watson o Marilyn Anne Ray o
Patricia Benner o Kari Martinsen o Katie
Eriksson o Myra Estrin Levine o
Martha E. Rogers o Dorothea E. Orem
o Imogene M. King o Betty
Neuman
o Sister Callista Roy o Dorothy E. Johnson o
Anne Boykin and Savina O. Schoenhofer o
Afaf Ibrahim Meleis o Nola J. Pender o
Madeleine M. Leininger o Margaret A.
Newman o Rosemarie Rizzo Parse o
Erickson, Tomlin, and Swain o Gladys L.
Husted and James H. Husted o Ramona T.
Mercer o Merle H. Mishel o Pamela G.
Reed o Carolyn L. Wiener and Marylin J.
Dodd o Eakes, Burke, and Hainsworth o Phil
ADVERTISEMENTS Barker o Katharine Kolcaba o Cheryl Tatano
In this guide for nursing theories, we aim to help you understand Beck o Kristen M. Swanson
what comprises a nursing theory and its importance, purpose, o Cornelia M. Ruland and Shirley M. Moore
history, types, or classifications, and give you an overview through
summaries of selected nursing theories.
• References
What are Nursing Theories?
• What are Nursing Theories? Nursing theories are organized bodies of knowledge to define what
• Defining Terms nursing is, what nurses do, and why they do it. Nursing theories
• History of Nursing Theories provide a way to define nursing as a unique discipline that is
• The Nursing Metaparadigm o Person o separate from other disciplines (e.g., medicine). It is a framework of
Environment o Health o Nursing concepts and purposes intended to guide nursing practice at a more
concrete and specific level.
, lOMoAR cPSD| 66549320
Nursing, as a profession, is committed to recognizing its own • In 1860, Florence Nightingale defined nursing in
unparalleled body of knowledge vital to nursing practice—nursing her “Environmental Theory” as “the act of
science. To distinguish this foundation of knowledge, nurses need to utilizing the patient’s environment to assist him
identify, develop, and understand concepts and theories in line with in his recovery.”
nursing. As a science, nursing is based on the theory of what nursing
• In the 1950s, there is a consensus among
is, what nurses do, and why. Nursing is a unique discipline and is
nursing scholars that nursing needed to validate
separate from medicine. It has its own body of knowledge on which
itself through the production of its own
delivery of care is based.
scientifically tested body of knowledge.
• In 1952, Hildegard Peplau introduced her
Defining Terms Theory of Interpersonal Relations that
emphasizes the nurse-client relationship as the
The development of nursing theory demands an understanding of
foundation of nursing practice.
selected terminologies, definitions, and assumptions.
• In 1955, Virginia Henderson conceptualized the
nurse’s role as assisting sick or healthy
• Philosophy. These are beliefs and values that individuals to gain independence in meeting 14
define a way of thinking and are generally fundamental needs. Thus her Nursing Need
known and understood by a group or discipline. Theory was developed.
• Theory. A belief, policy, or procedure proposed • In 1960, Faye Abdellah published her work
or followed as the basis of action. It refers to a “Typology of 21 Nursing Problems,” which
logical group of general propositions used as shifted the focus of nursing from a
principles of explanation. Theories are also used diseasecentered approach to a patient-centered
to describe, predict, or control phenomena. approach.
• Concept. Concepts are often called the building • In 1962, Ida Jean Orlando emphasized the
blocks of theories. They are primarily the reciprocal relationship between patient and
vehicles of thought that involve images. nurse and viewed nursing’s professional function
• Models. Models are representations of the as finding out and meeting the patient’s
interaction among and between the concepts immediate need for help.
showing patterns. They present an overview of • In 1968, Dorothy Johnson pioneered the
the theory’s thinking and may demonstrate how Behavioral System Model and upheld the
theory can be introduced into practice. fostering of efficient and effective behavioral
• Conceptual framework. A conceptual functioning in the patient to prevent illness.
framework is a group of related ideas, • In 1970, Martha Rogers viewed nursing as both
statements, or concepts. It is often used a science and an art as it provides a way to view
interchangeably with the conceptual model and the unitary human being, who is integral with
with grand theories. the universe.
• Proposition. Propositions are statements that • In 1971, Dorothea Orem stated in her theory
describe the relationship between the concepts. that nursing care is required if the client is
• Domain. The domain is the perspective or unable to fulfill biological, psychological,
territory of a profession or discipline. developmental, or social needs.
• Process. Processes are organized steps, changes, • In 1971, Imogene King‘s Theory of Goal
or functions intended to bring about the desired attainment stated that the nurse is considered
result. part of the patient’s environment and the
nursepatient relationship is for meeting goals
• Paradigm. A paradigm refers to a pattern of towards good health.
shared understanding and assumptions about
reality and the world, worldview, or widely • In 1972, Betty Neuman, in her theory, states
accepted value system. that many needs exist, and each may disrupt
client balance or stability. Stress reduction is the
• Metaparadigm. A metaparadigm is the most goal of the system model of nursing practice.
general statement of discipline and functions as
a framework in which the more restricted • In 1979, Sr. Callista Roy viewed the individual as
structures of conceptual models develop. Much a set of interrelated systems that maintain the
of the theoretical work in nursing focused on balance between these various stimuli.
articulating relationships among four major • In 1979, Jean Watson developed the philosophy
concepts: person, environment, health, and of caring, highlighted humanistic aspects of
nursing. nursing as they intertwine with scientific
knowledge and nursing practice.
History of Nursing Theories The Nursing Metaparadigm
The first nursing theories appeared in the late 1800s when a strong
emphasis was placed on nursing education. Four major concepts are frequently interrelated and fundamental to
nursing theory: person, environment, health, and nursing. These
four are collectively referred to as metaparadigm for nursing.
, lOMoAR cPSD| 66549320
Person, Nursing, Environment, and Health – the four main
concepts that make up the nursing metaparadigm. Person
Person (also referred to as Client or Human Beings) is the recipient
of nursing care and may include individuals, patients, groups,
families, and communities.
Environment
Environment (or situation) is defined as the internal and external
surroundings that affect the client. It includes all positive or negative An overview of the nursing metaparadigm of different nursing
conditions that affect the patient, the physical environment, such as theories. (Click to enlarge)
families, friends, and significant others, and the setting for where Components of Nursing Theories
they go for their healthcare. Health
Health is defined as the degree of wellness or well-being that the For a theory to be a theory, it has to contain concepts, definitions,
client experiences. It may have different meanings for each patient, relational statements, and assumptions that explain a phenomenon.
the clinical setting, and the health care provider. It should also explain how these components relate to each other.
Nursing Phenomenon
The nurse’s attributes, characteristics, and actions provide care on A term given to describe an idea or response about an event, a
behalf of or in conjunction with the client. There are numerous situation, a process, a group of events, or a group of situations.
definitions of nursing, though nursing scholars may have difficulty Phenomena may be temporary or permanent. Nursing theories
agreeing on its exact definition. The ultimate goal of nursing focus on the phenomena of nursing.
theories is to improve patient care.
Concepts
You’ll find that these four concepts are used frequently and defined Interrelated concepts define a theory. Concepts are used to help
differently throughout different nursing theories. Each nurse describe or label a phenomenon. They are words or phrases that
theorist’s definition varies by their orientation, nursing experience, identify, define, and establish structure and boundaries for ideas
and different factors that affect the theorist’s nursing view. The generated about a particular phenomenon. Concepts may be
person is the main focus, but how each theorist defines the nursing abstract or concrete.
metaparadigm gives a unique take specific to a particular theory. To
give you an example, below are the different definitions of various
theorists on the nursing metaparadigm: • Abstract Concepts. Defined as mentally
constructed independently of a specific time or
place.
• Concrete Concepts. Are directly experienced and
related to a particular time or place.
