Week 3: Nursing
Theory
Theory
The theory era began with a strong emphasis on knowledge development. Although in the
previous two decades, proponents of nursing theory and nursing theorists had begun to publish
their works, it is noteworthy that they denied being theorists when they were introduced as such
at the 1978 Nurse Educator Conference with the nursing theory theme held in New York. There
was an understanding among those attending the conference that the presenters were theorists,
and by the second day, the audience responded to their denials with laughter. This seems
strange today, but this was the first time most of the theorists even met each other. Their
works had grown out of content organization in nursing education courses, nursing practice
administration in large agencies, and structures for the thought and action of practice. It was
clear that their works were nursing theoretical structures even before they recognized them as
such. The theory era, coupled with the research and graduate education eras, led to an
understanding of the scientific process beyond the production ofa scientific product.
Theory forms the foundation of knowledge. Nursing theories form the foundation of nursing
practice, research, and education. Throughout your professional life, you will be applying theory
and the knowledge derived from theory in your practice environment regardless of the
setting. An understanding of the nature of nursing knowledge from a historical perspective will
help you relate better to where nursing theory development is today.
The new millennium has witnessed a rapid change in the global healthcare arena. This profession
is continually evolving to face the monumental changes that have emerged. In the past, nursing
theories were taught strictly from an academic point of view. Those in practice saw little
connection or integration of theory and practice. However, the contemporary move toward
evidence-based practice has seen nursing professionals applying theory to describe, predict, and
prescribe nursing practice.
Relevance to the Present and the Future
Theories are a reflection of the past, present, and future of nursing. Understanding the relevance of
theories will enhance the relationship of concept with practice. This will help you comprehend the
complex phenomena and interconnectedness between theory and practice and build a new way of
thinking, understanding, working, and living.
, Week 3: Nursing
Relevance to Research Theory
Research on theories helps in the systematic investigation of the domain of knowledge. Research
acts as a source of knowledge development. Studies conducted on nursing theories help
highlight the interlinking cyclical connection between theory and practice. Learners get an
idea about the interconnectedness between real-world clinical issues, theory, and actual
research.
Early knowledge consisted of loosely connected clusters of concepts. Later knowledge developed
interrelated statements connecting the concepts. Advanced theory provided a knowledge base for
intervention strategies that clusters of concepts could not.
Identification of theory is important to understand the characteristics of theory
structures. A complete theory of nursing identifies the three elements of context, content,
and process; some theorists articulate each element better than others.
Context is the environment in which nursing acts occur; the context ofa theory
describes the nature of the world of nursing and may describe the nature of the
patient’s world.
Content includes the subject matter ofa theory; this comprises the stable components that
are acted on or that do the acting.
Process implies the action part of the theory, the intervention elements.
In addition to these elements, all theories should be examined for certain common factors:
Theories should be based on concepts and propositions.
Theories should be specific to the nursing context. Theories can be applied to many
situations. Theories should be relevant to potential users.
Theories should be easy to define in operational terms.
Theories should correspond with empirical findings. Theories should demonstrate internal consistency.
Florence Nightingale made the first attempts at theory-based nursing during the late 19th and
early 20th centuries. She organized a group of women to deliver care under her supervision and
that of war surgeons. She established the need for hygiene, with environmental change as the
means to enhance healing. For her, the nursing domain was the patient and the environment in
which care was offered.
Her goals were to expose the unhealthy conditions of soldiers, to gain support for the need for
nurses, and to achieve formal education for nurses. She was the first to use data collection and
analysis to prove the efficacy of nursing actions.
Theory is defined as "an organized, coherent, and systematic articulation of a set of statements
related to
significant questions in a discipline that are communicated in a meaningful whole; a symbolic
depiction of aspects of reality that are discovered or invented for describing, explaining, predicting, or
, Week 3: Nursing
prescribing responses, events, situations, conditions, or relationships" (Meleis, 1997,
Theory pp. 8, 12).
Thus, a theory is a coherent set of propositions and statements that describe (factor-isolating),
explain (factor-relating), and predict (situation-relating) phenomena as well as prescribe
(situation-producing) actions toward goals (Dickoff et al., 1968).
Theory development requires perceiving phenomena that are peculiar to nursing and proposing
a meaningful explanation for those perceptions. The nursing profession identifies four levels of
theory: metatheory, grand theory, middle-range theory, and practice theory. The theories are
classified on the basis of their levels of abstraction or complexity.
A complete structure includes a conceptual model, derived theories, and correlated empirical research
methods. Each conceptual model and theory comprises concepts and propositions. The complete
structure forms a hierarchy that is based on levels of abstraction:
Most abstract: The conceptual model that provides the context or frame of
reference for theory-generating and theory-testing research
Intermediate level: The theory that is generated or tested
Most concrete: The empirical research methods used to collect and analyze the data
References:
Dickoff, J., James, P., & Wiedenbach, E. (1968). Theory in a practice discipline. Part 1: Practice
oriented theory. Nursing Research, 17(5), 415—435.
Meleis, A. I. (1997). Theoretical nursing: Development and progress (3rd ed.). Philadelphia, PA:
Lippincott.
Nursing theories are normally derived from conceptual models in which the nursing
metaparadigm phenomena are clearly identified (Fawcett, 1983). For this reason, the conceptual
model is considered a precursor of nursing theory (Peterson, 1977; Fawcet 1983). A conceptual
model of nursing is a set of abstract concepts and propositions that are integrated into a meaningful
configuration and represents an involvement in theoretical formulations by describing nursing
phenomena and their interrelationships in abstract terms (Fawcett, 1983).
The concepts of a conceptual model are so abstract and general that they often cannot be
observed or tested directly and may not even be defined. The concepts and definitions of each
conceptual model are often stated in a distinctive vocabulary, where the meaning of each term
is connected to the unique focus of the conceptual model. Therefore, the same terms may have
different meanings in different conceptual models.
Each conceptual model provides a different perspective from which to view the phenomena that
are within the domain of inquiry ofa particular discipline. Most disciplines have more than one
conceptual model; each focuses on certain phenomena that are regarded as relevant, and other
phenomena are ignored because they are deemed less important.
some of the factors that influence the development of nursing theory—the barriers to and the
facilitators of the process of theory development.
Next, we will begin our theoretical journey through the various milestones that provided an
impetus to the growth of theories, and trace the evolution of nursing theoretical foundations. As
Theory
Theory
The theory era began with a strong emphasis on knowledge development. Although in the
previous two decades, proponents of nursing theory and nursing theorists had begun to publish
their works, it is noteworthy that they denied being theorists when they were introduced as such
at the 1978 Nurse Educator Conference with the nursing theory theme held in New York. There
was an understanding among those attending the conference that the presenters were theorists,
and by the second day, the audience responded to their denials with laughter. This seems
strange today, but this was the first time most of the theorists even met each other. Their
works had grown out of content organization in nursing education courses, nursing practice
administration in large agencies, and structures for the thought and action of practice. It was
clear that their works were nursing theoretical structures even before they recognized them as
such. The theory era, coupled with the research and graduate education eras, led to an
understanding of the scientific process beyond the production ofa scientific product.
Theory forms the foundation of knowledge. Nursing theories form the foundation of nursing
practice, research, and education. Throughout your professional life, you will be applying theory
and the knowledge derived from theory in your practice environment regardless of the
setting. An understanding of the nature of nursing knowledge from a historical perspective will
help you relate better to where nursing theory development is today.
The new millennium has witnessed a rapid change in the global healthcare arena. This profession
is continually evolving to face the monumental changes that have emerged. In the past, nursing
theories were taught strictly from an academic point of view. Those in practice saw little
connection or integration of theory and practice. However, the contemporary move toward
evidence-based practice has seen nursing professionals applying theory to describe, predict, and
prescribe nursing practice.
Relevance to the Present and the Future
Theories are a reflection of the past, present, and future of nursing. Understanding the relevance of
theories will enhance the relationship of concept with practice. This will help you comprehend the
complex phenomena and interconnectedness between theory and practice and build a new way of
thinking, understanding, working, and living.
, Week 3: Nursing
Relevance to Research Theory
Research on theories helps in the systematic investigation of the domain of knowledge. Research
acts as a source of knowledge development. Studies conducted on nursing theories help
highlight the interlinking cyclical connection between theory and practice. Learners get an
idea about the interconnectedness between real-world clinical issues, theory, and actual
research.
Early knowledge consisted of loosely connected clusters of concepts. Later knowledge developed
interrelated statements connecting the concepts. Advanced theory provided a knowledge base for
intervention strategies that clusters of concepts could not.
Identification of theory is important to understand the characteristics of theory
structures. A complete theory of nursing identifies the three elements of context, content,
and process; some theorists articulate each element better than others.
Context is the environment in which nursing acts occur; the context ofa theory
describes the nature of the world of nursing and may describe the nature of the
patient’s world.
Content includes the subject matter ofa theory; this comprises the stable components that
are acted on or that do the acting.
Process implies the action part of the theory, the intervention elements.
In addition to these elements, all theories should be examined for certain common factors:
Theories should be based on concepts and propositions.
Theories should be specific to the nursing context. Theories can be applied to many
situations. Theories should be relevant to potential users.
Theories should be easy to define in operational terms.
Theories should correspond with empirical findings. Theories should demonstrate internal consistency.
Florence Nightingale made the first attempts at theory-based nursing during the late 19th and
early 20th centuries. She organized a group of women to deliver care under her supervision and
that of war surgeons. She established the need for hygiene, with environmental change as the
means to enhance healing. For her, the nursing domain was the patient and the environment in
which care was offered.
Her goals were to expose the unhealthy conditions of soldiers, to gain support for the need for
nurses, and to achieve formal education for nurses. She was the first to use data collection and
analysis to prove the efficacy of nursing actions.
Theory is defined as "an organized, coherent, and systematic articulation of a set of statements
related to
significant questions in a discipline that are communicated in a meaningful whole; a symbolic
depiction of aspects of reality that are discovered or invented for describing, explaining, predicting, or
, Week 3: Nursing
prescribing responses, events, situations, conditions, or relationships" (Meleis, 1997,
Theory pp. 8, 12).
Thus, a theory is a coherent set of propositions and statements that describe (factor-isolating),
explain (factor-relating), and predict (situation-relating) phenomena as well as prescribe
(situation-producing) actions toward goals (Dickoff et al., 1968).
Theory development requires perceiving phenomena that are peculiar to nursing and proposing
a meaningful explanation for those perceptions. The nursing profession identifies four levels of
theory: metatheory, grand theory, middle-range theory, and practice theory. The theories are
classified on the basis of their levels of abstraction or complexity.
A complete structure includes a conceptual model, derived theories, and correlated empirical research
methods. Each conceptual model and theory comprises concepts and propositions. The complete
structure forms a hierarchy that is based on levels of abstraction:
Most abstract: The conceptual model that provides the context or frame of
reference for theory-generating and theory-testing research
Intermediate level: The theory that is generated or tested
Most concrete: The empirical research methods used to collect and analyze the data
References:
Dickoff, J., James, P., & Wiedenbach, E. (1968). Theory in a practice discipline. Part 1: Practice
oriented theory. Nursing Research, 17(5), 415—435.
Meleis, A. I. (1997). Theoretical nursing: Development and progress (3rd ed.). Philadelphia, PA:
Lippincott.
Nursing theories are normally derived from conceptual models in which the nursing
metaparadigm phenomena are clearly identified (Fawcett, 1983). For this reason, the conceptual
model is considered a precursor of nursing theory (Peterson, 1977; Fawcet 1983). A conceptual
model of nursing is a set of abstract concepts and propositions that are integrated into a meaningful
configuration and represents an involvement in theoretical formulations by describing nursing
phenomena and their interrelationships in abstract terms (Fawcett, 1983).
The concepts of a conceptual model are so abstract and general that they often cannot be
observed or tested directly and may not even be defined. The concepts and definitions of each
conceptual model are often stated in a distinctive vocabulary, where the meaning of each term
is connected to the unique focus of the conceptual model. Therefore, the same terms may have
different meanings in different conceptual models.
Each conceptual model provides a different perspective from which to view the phenomena that
are within the domain of inquiry ofa particular discipline. Most disciplines have more than one
conceptual model; each focuses on certain phenomena that are regarded as relevant, and other
phenomena are ignored because they are deemed less important.
some of the factors that influence the development of nursing theory—the barriers to and the
facilitators of the process of theory development.
Next, we will begin our theoretical journey through the various milestones that provided an
impetus to the growth of theories, and trace the evolution of nursing theoretical foundations. As
