THEORY

A group of concepts that describe a

pattern of reality.
This term is used to signify a conjecture,
an opinion, a speculation or a hypothesis.
An idea or set of ideas that is intended to
explain facts or events.
An organized system of accepted
knowledge that is composed of concepts,
propositions, definitions, and
assumptions intended to explain a set of
fact, event, or phenomena.

CONCEPT
An idea formulated by the mind or
an
experience
perceived
and
observed such as justice, love, war,
disease.
Something conceived in the mid;
thought; idea.

PROPOSITION
Explains
the
relationships
of
different concepts.
Something that is presented to a
person or group to consider
A statement to be proved, explained,
or discussed.

DEFINITION
Composed of various descriptions
which convey a general meaning and
reduces the vagueness in
understanding a set of concepts.

ASSUMPTION
A statement that specifies the
relationship or connection of factual
concepts or phenomena.

PHILOSOPHY
Study of general and fundamental
problems
The most basic beliefs, concepts,
attitudes of an individual or group.
A set of ideas about how to do
something or how to live.

NURSING THEORY
is the body of knowledge that is used to
support NURSING PRACTICE.
Nursing theories are reservoirs in which
findings related to nursing concepts,
such as comfort, healing, recovering,
mobility, rest, caring, enabling, fatigue,
and family care, are stored.

COMPONENTS OF A THEORY
CONTEXT resembles environment
to which nursing act takes place
CONTENT subject of the theory
PROCESS method by which nurse
acts in using nursing theory

T
H
E
O
R
Y

Describes
Explains
Predicts
Prescribes

NURSING
CARE

NURSING THEORY
Differentiates nursing from other
disciplines and activities in that it
describes, explains, predicts, and controls
desired outcomes of nursing care practice

General theories:

General systems theory

Adaptation theory

Developmental theory

DIFFERENT TYPES OF THEORIES

DESCRIPTIVE Theories also known as
Factor-Isolating theories; primary level of
theory development.
They identify and describe major
concepts of phenomena
Their main purpose: to present a
phenomenon based on the five sense
together
with
their
corresponding
meaning

EXPLANATORY THEORIES
Also known as Factor-relating theories.
They
present
relationship
among
concepts and prepositions.
Aim to provide information on how or
why concepts are related.
Cause and effect relationship

PREDICTIVE THEORIES
Also
known
as
Situation-relating
theories.
This kind of theory is generated and
tested using experimental research

PRESCRIPTIVE THEORIES
Also known as Situation-producing
theories
Deal with nursing actions, and test the
validity and certainty of a specific
nursing intervention.
Commonly used in testing new nursing
interventions.

METATHEORIES
Theories whose subject matters
some other theories
These are theories about theories.

are

GRAND THEORIES
Broad in scope and complex and
therefore require further specification
through research before they can be fully
tested.
They are intended to provide structural
framework for broad, abstract ideas
about nursing.

MIDDLE RANGE THEORIES

Have more limited scope, addresses
specific phenomena or concepts and
reflect practice (administration, clinical
or teaching).
Quality of life, uncertainty in illness,
social support, incontinence, caring.

WHAT IS NURSING?
American Nursing Association (ANA)
is the diagnosis and the treatment
of human responses to actual or
potential health problems.

International Council of Nurses (ICN)

nursing encompasses autonomous and
collaborative care of individuals of all
ages, families, groups and communities,
sick or well and in all settings. Nursing
includes the promotion of health,
prevention of illness, and the care of ill,
disables and dying people...

Association of Deans of Philippine Colleges

of Nursing (ADPCN) Nursing is a dynamic
discipline. It is an art and a science of
caring for individuals, families, groups and
communities ageared toward promotion
and restoration of health, prevention of
illness, alleviation of suffering and
assisting clients to face death with dignity
and peace. It is focused on assisting the
client as he or she responds to healthillness situations, utilizing the nursing
process.

WHAT ARE NURSING PARADIGMS

Patterns or models used to show a clear
relationship
among
the
existing
theoretical works in nursing.
Focus (Metaparadigms):
1. Person/individual
2. Health
3. Environment
4. Nursing

METAPARADIGM
Came from the word meta a Greek
word which means with and
paradigm which means pattern.
The highest level of knowledge.

Nursing

Person

Health

Environment

PERSON
- Refers to all human beings; the
recipients of nursing care.
- They include individuals, families,
communities, and groups.

ENVIRONMENT
Factors that affect individuals internally
and externally.
Also includes setting
where nursing care is provided.
Ventilation
Warmth
Noise
Light
Cleanliness

HEALTH
The holistic level of wellness that the
person experiences.
- It addresses the persons state of wellbeing.

goal of all nursing activity should

promote clients health

NURSING
The interventions of the nurse rendering
care in support of, or in cooperation with
the client.
- nurse is responsible in promoting wellbeing of clients by manipulating the
environment

WHAT IS PHILOSOPHY IN
NURSING?
Philosophy is the next knowledge level
after metaparadigm.
It sets forth the meaning of phenomena
through analysis, reasoning, and logical
argument.

CONCEPTS
The building blocks of theories.
Enhances ones capacity to understand
phenomena as it helps define the
meaning of a word.
ABSTRACT CONCEPTS indirectly
observed or intangible. Eg: love, care,
freedom
CONCRETE
CONCEPTS

directly
observed or tangible. Eg: nurse, mother,
pain

CONCEPTS CAN BE USED IN MAKING OR

FORMULATING:
CONCEPTUAL DEFINITIONS = meaning of
a word based on how a certain theory or
relevant literature perceives it to be.
Examples: roles/concepts of a nurse,
patient care, environment.
OPERATIONAL DEFINITIONS = meaning of
a word based on the method of how it
was measured or how the person come
up with that perception.

CONCEPTUAL MODELS AND

THEORETICAL MODELS
THEORETICAL MODELS
Highly established set of
concepts that are testable.

CONCEPTUAL MODELS
Representations of an idea or body of
knowledge
based
on
the
own
understanding or perception of a person
or researcher on a certain topic,
phenomena or theory.
Represented thru a diagram or in
narrative form which shows how
concepts are interrelated.

CONCEPTUAL
It is a structure
of concepts or
theories which
are
pulled
together as a
map for the
study

THEORETICAL
It is a structure
of
concepts
which exist or
tested in the
literature,
a
ready-made
map for the
study

T YPES OF DEFINITION OF
CONCEPTS
CONCEPTUAL
OPERATIONAL
Comparable
to Specifies
exactly
definition from a how the concept will
literature such as be determined and
a
dictionary, assess
it,
also
encyclopedia,
identifies
and journals.
procedures
and
operations
significant
to
determine concepts

SCIENCE
From the Latin SCIENTIA meaning
knowledge, refers to any systematic
knowledge or practice in a discipline of
study. A system of acquiring knowledge
based on the scientific method. It is also
the organized body of knowledge gained
through research.

STEPS
Observation
Gathering information / data
Forming hypothesis
Experimental investigation
Conclusion
or
theoretical
explanation

KNOWLEDGE
Information, skills and expertise
acquired by a person through various
life
experiences,
or
through
formal/informal learning such as
formal
education,
self-study,
vocational

Knowledge is acquired through:

Perception,
Association,
Learning,
Reasoning,
Communication.

Perception

Achieving understanding of
sensory data

Association

Combining two or more

concepts/ideas to form a new
concept, or for comparison

Learning

Acquiring experience, skills,

information and values

Reasoning

Mental process of
seeking conclusions
through reason

Communication

Transferring data from

sender to receiver
using different medium
or tools of
communication

SOURCES

TRADITIONAL KNOWLEDGE
passed down from generation to
generation.
Example: routine changing of bed
linens whether it is soiled or not.

AUTHORITATIVE KNOWLEDGE

An idea by a person of authority

which is perceived as true
because of his or her expertise.
Example: a nurse supervisor
teaching a nurse beginner on the
proper insertion of a urinary
catheter.

SCIENTIFIC KNOWLEDGE
Type of knowledge which came from a
scientific method through research.
These new ideas are tested and
measured systemically using objective
criteria.
Example: A student nurse providing
TSB(tepid sponge bath) to a patient
with fever scientific rationale is heat
transfer through evaporation.

PHENOMENON
Sets of empirical data or
experiences that can be physically
observed or tangible
All natural events that the human
senses can perceive can be called
PHENOMENON

It is concerned with how an

individual person reacts using the
human senses concerning their
surrounding and assessing the
different behavior and factors
that affect such behavior.

IN NURSING, PHENOMENA CAN BE:

Clinical or environmental setting of
nursing health center
Disease process stomach ulcer
Clients behavior guarding behavior at
the pain site
Interventions care of the client in pain
Practices that are utilized in nursing
theories and metaparadigms

KEY POINTS

PHENOMENON

An empirical data that

can be observed

Concepts

Building blocks of
theories which can
either be an
empirical or abstract
data

Conceptual
models

Derived from a
persons own point of
view

Paradigms

Assumptions

Another term
for conceptual
framework or
model
Statements that
the theorists
hold as factual

Propositions statements that imply

the relationships of concepts
Hypothesis a testable relationship
statement
Research use of systematic methods
to study a phenomenon and create a
general knowledge
Induction a type of reasoning that
uses specific details to form a general
conclusion

Deduction a type of reasoning

wherein general conclusions are
made based from specific
concepts.

NURSING as an ART relies on

knowledge gained from practice
and
reflection
of
past
experiences. As a SCIENCE, it is
based on scientifically tested
knowledge that is applied in the
practice setting.

IMPORTANCE OF NURSING
THEORIES
Aim to describe, predict, and explain the
phenomenon of nursing
Provide the foundations of nursing practice,
help to generate further knowledge and
indicate in which direction nursing should
develop in the future
Help to distinguish what should form the
basis of practice by explicitly describing
nursing.

Help to provide better patient care,

enhanced professional status for
nurses, improved communication
between nurses, and guidance for
research and education.
Maintains professional boundaries in
nursing

PURPOSES OF THEORIES
IN PRACTICE
Assist nurses to describe, explain, and
predict everyday experiences
Serve
to
guide
assessment,
intervention, and evaluation of nursing
care
Provide rationale for collecting reliable
and valid data about the health status
of clients

Help to establish criteria to measure

the quality of nursing care
Help
build
a
common
nursing
terminology to use in communicating
with other health professionals. Ideas
are developed and words defined.
Enhance autonomy of nursing by
defining its own independent functions.

IN EDUCATION
Provide a general focus for curriculum
design.
Guide curricular decision making.
IN RESEARCH
Offer
a
framework
for
generating
knowledge and new ideas.
Assist in discovering knowledge gaps in
specific field of study.
Offer a systematic approach to identify
questions for study.

INTERDEPENDENCE OF THEORY
AND RESEARCH
NURSING PRACTICE

NURSING THEORY

NURSING RESEARCH

The relationship between nursing

theory and nursing research
helps
in
building
nursing
knowledge.

ACCORDING TO MELEIS 1997

Nursing knowledge is
composed of both:
1.Theoretical
Knowledge
2.Practical Knowledge

THEORETICAL KNOWLEDGE

Aims to stimulate thinking and

broaden understanding of the
science and practice of the
nursing discipline.

PRACTICAL KNOWLEDGE

Referred to as the art of nursing.

FLORENCE NIGHTINGALE
(ENVIRONMENTAL THEORY)
PRACTICE = environmental aspects as
integral part of nursing care
EDUCATION = development of training
system in St. Thomas Hospital and Kings
College Hospital in London; scientific
principles and practical experience in
mastery of skills.
RESEARCH = invented the polar
diagrams to analyze and gather data

HILDEGARD PEPLAU (PSYCHODYNAMIC

NURSING)
PRACTICE = provides clear design for the
practice
of
psychiatric
nursing;
emphasized
the
development
of
interpersonal relationship between the
patient and nurse.
EDUCATION = formulated effective
psychotherapeutic methods
RESEARCH = formulated concepts of
anxiety as a means to constructively
resolve angry feelings

VIRGINIA HENDERSON (14 COMPONENTS

OF BASIC NURSING CARE)

PRACTICE = nurses as direct

caregiver help patients to become
independent.
EDUCATION = designed the three
phases of curriculum development
RESEARCH = recommended library
research; advocated research as a
way to improve practice

JOYCE TRAVELBEE (HUMAN TO HUMAN

RELATIONSHIP MODEL)
PRACTICE = hospice is one of her essential
contributions;
asserted
that
finding
meaning in illness and suffering enables
the patient not only to accept illness but it
will also served as a self-actualizing
experience.
EDUCATION
=
from
disease-oriented
approach to holistic care approach; nursing
programs need to offer much broader
background in communication techniques,
values clarifications, and care of the dying.

RESEARCH = utilized by various

authors in their study of recently
diagnosed cancer patients and their
personal search for meaning.

BETT Y NEUMAN (SYSTEMS MODEL)

PRACTICE = goal-directed, integrated and
holistic approach to client care; formulated
Neuman nursing process format: Nsg.
Diagnosis, Nsg. Goals, Nsg. Outcomes
EDUCATION = holistic curriculum; provides
an effective framework in conceptual
evolution among levels of education of
nursing students from diploma to associate
to baccalaureate programs.

RESEARCH = guide model to

enhance the nursing care of clients
with specific physiological stressors.

DOROTHY JOHNSON (BEHAVIORAL

SYSTEM MODEL)
PRACTICE = used assessement, disorders,
treatment, and evaluation instead of
nursing process
EDUCATION = focuses on the patient as a
behavioral system and its dysfunction.
RESEARCH = stated that nursing research
would identify and explain the behavioral
system disorders which arise in connection
with illness, and develop the rationale for
the means of management.

IMOGENE KING (GOAL ATTAINMENT

THEORY)
PRACTICE = developed the Goal Oriented
Nursing Record which is used to record
goals and outcomes in patient settings.
EDUCATION
=
nursing
curriculum
development and practice application in
Ohio state and other universities.
RESEARCH = her work served as a
theoretical basis for various studies

DOROTHEA OREM (SELF CARE DEFICIT

THEORY IN NURSING)
PRACTICE
=
described
nursing
management of pertussis; teaching selfcare to diabetic patients and End-stage
Renal Failure; pain assessment and control.
EDUCATION = came up with the idea of a
need for a nursing=specific knowledge
structure.
RESEARCH
=
the
first
instrument
developed,
named
Exercise
Self-care
Agency which is used to determine the
capacity of patients to care for their selves.

FAYE ABDELLAH (T YPOLOGY OF 21

NURSING PROBLEMS)
PRACTICE = typology helps in efficient
assessment, nursing diagnosis, and
planning interventions
EDUCATION = provided scientific body of
knowledge and filled-in the gaps of
weaknesses in nursing education.
RESEARCH = believed that evidencedbased practice on scientific data has a
great impact in nursing research

SR. CALLISTA ROY (ADAPTATION MODEL)

PRACTICE = manipulating the stimuli and
not the patient; nurses enhance the
interaction
person
of
and
their
environment thus improving health.
EDUCATION = Three vertical strands in
the curriculum: the adapting person,
health-illness, nursing management; two
horizontal strands in the curriculum:
nursing process, student adaptation and
leadership

MADELEINE LEININGER (TRANSCULTURAL

NURSING)
PRACTICE: provides human care and health
behaviors as background knowledge to
understand nursing phenomena; prepares
nurses to prevent culture shock and
conflicts as they practice in different places
with different cultures.
EDUCATION = education in transcultural
nursing leads to culturally competent
nursing care.
RESEARCH = focused on cultural care

JEAN WATSON (PHILOSOPHY SCIENCE OF

NURSING)
PRACTICE = caring as an essential field
in nursing; eg: ICU, NICU
EDUCATION = described the core of
nursing as aspects of the nurse-patient
relationship resulting in a therapeutic
result
RESEARCH = research must focus on
both subjective and objective patient
outcomes in knowing that caring is
important in nursing.

PATRICIA BENNER (FROM NOVICE TO

EXPERT: EXCELLENCE AND POWER IN
CLINICAL NURSING PRACTICE
PRACTICE = formulated the levels of
competency in nursing practice
EDUCATION = learning needs at an early
stage of clinical knowledge are different
from those needed in later stage.
RESEARCH = extended the study of
formal models which direct care and
substitute knowledge used in nursing
practice

FOUR WAYS OF KNOWING

Empirics / empirical = scientific
discipline of nursing
Ethics / ethical = the moral
directions of nursing
Personal = method by which nurses
approach their patients
Aesthetics / esthetics = deals with
the emphatic aspect of nursing

EMPIRICAL KNOWING

1. It is a knowing that is base on:

a. fact or experience
b. it should be objective
2. Empirical evidence is not just facts but
RELEVANT facts.
3. Empirical knowing focuses on
EVIDENCE-BASED RESEARCH for
effective and accurate nursing practice

Any
scientific,
research-based,
theoretical and factual information that
the nurse makes use of is under
empirical knowing.
Example: knowledge obtained from
textbooks, lectures, journals, and online
resources

EVIDENCE-BASED PRACTICE (EBP)

Involves accurate and thoughtful

decision making about health care
delivery for clients.
It can bridge the gap of nursing
practice and research to provide
basis for nurses to transform
research into quality care.
Promotes quality care

AESTHETIC KNOWING
Used in the process of giving appropriate
nursing care through understanding the
uniqueness of every patient, thus
emphasizing use of creative and
practical styles of care
It is the manifestation of the creative
and expressive styles of the nurse.

Used in the process of giving appropriate

nursing care through understanding the
uniqueness of every patient, thus
emphasizing use of creative and physical
styles of care.
Focuses on EMPATHY = the ability for
sharing
or
vividly
understanding
anothers feelings.

ETHICAL KNOWING
Involves the judgment of right and
wrong in relation to intentions, reasons
and attributes of individuals and
situations.
Requires
knowledge
of
different
philosophical positions: what is good
and right.
The code of morals or code of ethics
that leads the conduct of nurses is the
main basis for ethical knowing.

PERSONAL KNOWING

Encompasses knowledge of the self

in relation to others and to self.
Is focused on realizing, meeting and
defining the real, true self. One
nursing term defines this as SELFAWARENESS
Involves the therapeutic use of self.