PRELIMS

I. DEFINITION OF TERMS:
 THEORY
- from ancient Greek “ THEORIA” , meaning looking at, viewing,
beholding
- A creative and rigorous structuring of ideas that project a tentative,
purposeful and systematic view of phenomena(proposed explanation
of a phenomena made in a way consistent with the scientific method)
CREATIVE*underscores the role of human imagination and vision in
theory development
TENTATIVE*open to revision as new evidences emerge
PURPOSEFUL*suggests a direction in how to view facts and events
SYSTEMATIC*step by step process
PHENOMENA
 That which strikes one as strange, unusual, or unaccountable; an
extraordinary or very remarkable person, thing, or occurrence
 Is an aspect of reality that people consciously sense or experience
 NURSING THEORY
- is a body of knowledge that is used to support nursing practice.
- This is derived from experiential learning, from formal sources such as
researches or from non-nursing sources(from other theories)
- Derived from nursing philosophies, conceptual models or more abstract
nursing theories or from works of other disciplines
- Conceptualization of some aspects of nursing for the purpose of
describing, explaining, predicting, nursing care
 NURSING PARADIGMS
- “meta” Greek Word àwith & “paradigm”à pattern
- These are patterns used to show relationship among existing theoretical
works in nursing
- Core content of a discipline
- Place a boundary on the subject matter of the discipline (focus of nursing
theory)
-stated in the most global and abstract form
1. PERSON
 Is the term used for HUMAN BEING
 The recipients of nursing care(individual, family or community)
 Focus of nursing practice
2. HEALTH
 Health is a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity (WHO)
 Has different meanings for each client, the clinical setting, and the
health care profession.
  is dynamic and continuously changing. Your challenge is to provide the
best possible care based on the client's level of health and health care
needs at the time of care delivery
3. ENVIRONMENT
 Represents the persons immediate physical surroundings,the
community or the universe and all that it contains
 The internal and external surroundings of the client
 Refers to the surroundings of an object
4. NURSING
 Profession concerned with the provision of services essential to the
maintenance and restoration of health
 diagnosis and treatment of human responses to actual or potential
health problems...

 PHILOSOPHY
- from the Greek word philosophia, which literally means love of wisdom
- an academic discipline that exercises reason and logic in an attempt to
understand reality and answer fundamental questions about knowledge,
life, morality and human nature
- It specifies the definition of paradigm concepts in each conceptual models
of nursing
- It provides a broad understanding and direction.
 CONCEPTUAL MODEL/FRAMEWORK
- representations of an idea(model is anything used in any way to represent
anything else) based on the own understanding of the person
- representations of the interaction among and between the concepts
showing patterns
- allow the concepts in nursing theory to be successfully applied to nursing
practice.
- Concepts that specify their interrelationship to form an organized perspective for
viewing the phenomena 
Ex.King’s Goal Attainment

 SCIENCE
- from Latin: scientia, meaning "knowledge"
- System of acquiring knowledge based on scientific method
- Organized knowledge based on research

 KNOWLEDGE
- expertise, and skills acquired by a person through experience or
education

 CONCEPTS
 - building blocks of theory
- words that describe objects , properties, or events and are basic
components of theory.
- an idea,thought or notion conceived in the mind
- words that bring forth mental pictures & give meanings of things
- Maybe empirical or abstract
EMPIRICAL/CONCRETE
-they can be observed or experienced through the senses
-ex.stethoscope(can be ssen and touch)
ABSTRACT
-those that are not observable,such as caring,hope, and infinity
-all concepts become abstractions in the absence of the object
-e.g social system,nurse competency
DISCRETE
-identifies categories or classes of phenomena
-e.g nurse cannot be a partial nurse
Typologies of marital status:single,married,widoewed or
divorced,female,male
Number of children in a household
Number of languages a person speaks
Number of people sleeping in stats class
CONTINUOUS CONCEPTS
-permits classifications of dimensions or gradations of a phenomena,
-e.g indicating degree of marital conflict.(high or low)
-uses continuum
Ex.degree of temperature, level of anxiety,degree of pain
-Can be simple or complex and relate to an object or event that comes
from individual perceptual experiences
-e.gHeight of children
Weight of cars
Time to wake up in the morning
Speed of the train

II. IMPORTANCE OF THEORY:

 in CLINICAL PRACTICE
1. Assists nurse to describe, explain, & predict everyday experiences
2. Serves to guide assessment, intervention, and evaluation of nursing care
3. Provides a rationale for collecting reliable data about the health status of
clients à essential for decision-making & implementation
4. Helps to establish criteria to measure the quality of nursing care
5. Helps build a common nursing terminology to use in communicating with
other HCPs
 6. Enhances autonomy of nursing through defining its own independent
functions

 in EDUCATION
1. Provides a general focus for curriculum design
2. Guides curricular decision making

 in RESEARCH
1. Offers a framework for generating knowledge & new ideas
2. Assists in discovering knowledge gaps in the specific field of study
3. Offers a systematic approach to identify questions for study, select
variables, interpret findings & validate nursing interventions

I. FOUR WAYS OF KNOWING

"Nursing depends on the scientific knowledge of human behavior in health and in

illness, the esthetic perception of significant human experiences, a personal
understanding of the unique individuality of the self, and the capacity to make
choices within concrete situations involving particular moral judgments."Barbara
A. Carper, 1978
 1. EMPIRICAL
- denotes information gained by means of observation, experience, or
experiment

2. ETHICS
- Being in accordance with the accepted principles of right and wrong that
govern the conduct of a profession

3. AESTHETICS/ ESTHETICS
- is a branch of philosophy dealing with the nature of beauty, art, and taste,
and with the creation and appreciation of beauty.

4. PERSONAL
- Knowledge of the self, individual’s, private, owned
II. NURSING SCIENCE & THEORY IN THE EARLY 20TH CENTURY
  PHILOSOPHERSà knowledge should be based on the understanding of
existing theories
 SCIENTISTS à knowledge should not only be based on existing understanding
but what is still to be observed
 MAJOR DEVELOPMENTS:
- experimentation
- POSITIVISM
- EMPIRICAL & OBJECTIVE DATAà co-exist

 RATIONALISM
- makes use of reason
- Expert study, tested theory & established facts

 EMPIRICISM
- Objective & tangible data
- perceived by the senses to observe & collect data

III. NURSING SCIENCE IN THE LATE 20TH CENTURY

- Affected by different nursing leaders & theories of the early 20 th century
- roles of nurses became more defined

 ROLES OF NURSES:
 CARE PROVIDER à care & comfort
 TEACHER
 COUNSELOR
 CLIENT ADVOCATE
 CHANGE AGENT
 LEADER
 MANAGER

IV. LEVELS / SCOPE OF THEORY

1. GRAND THEORY
- Any theory which attempts an overall explanation of human experiences
- Abstract and do not easily lend themselves to application or testing.
- tend to include views on person, health and environment to create a
perspective of nursing
- several well-known nursing theorists whose grand theories have served as
a basis for practice and research

- Grand Theories – does not prescribe actions

 - provide structural framework
Example:

A. Madeleine Leininger
Cultural Care, Diversity & Universality

 Leininger is the founder of the transcultural nursing movement in education

research and practice.
transcultural nursing is:
Focus - cultural dynamics that influence the nurse–client relationship.
- area of study and practice focused on comparative cultural care (caring)
values, beliefs, and practices of individuals or groups of similar or different
cultures are compared
goal – culturally congruent holistic care.
- provide culture-specific and universal nursing care practices to promote well-
being or to help people face unfavorable human conditions in culturally
meaningful ways'

Some scholars might place this theory in the middle range classification.
Leininger holds that it is not a grand theory because it has particular dimensions to
assess for a total picture.
But it is a wholistic and comprehensive approach, which has led to broader nursing
practice applications than is traditionally expected with a middle-range, reductionist
approach

Florence Nightingale
Environmental Adaptation Model
Florence Nightingale – ENVIRONMENTAL THEORY

Focus - " utilizing the environment of the patient to assist him in his recovery"

- man inherently has the capacity to heal itself, given the right
environment
- For most part, the descriptions describe a passive patient
- referred to the person as the patient (passive)

Watson, Jean – Theory of Caring

- Caring can be effectively demonstrated and practiced only
interpersonally.

 Caring consists of carative factors that result in the satisfaction of certain

human needs.
 Effective caring promotes health and individual or family growth.
 Caring responses accept person not only as he or she is now but as what he
or she may become.
  A caring environment is one that offers the development of potential while
allowing the person to choose the best action for himself or herself at a given
point in time.
 Caring is more “ healthogenic” than is curing. A science of caring is
complementary to the science of curing.
 While the carative factors have a sound foundation based on other
disciplines, they need further research in nursing to demonstrate their
application to practice

1. Betty Neuman – HEALTH CARE SYSTEMS MODEL

- human being is an open system consisting of basic structure or central
core of survival factors surrounded by concentric rings that are bounded
by lines of resistance, a normal line of defense, & a flexible line of defense
- person has a core & outside the core are rings of defenses which can
be flexible at certain times, when the normal defenses are low, the normal
person gets sick

The basic structure energy resources contain the following features:

1. Ability to maintain body temperature within the normal range
2. genetic characteristics/structures
3. response pattern
4. organ strength/weaknesses
5. ego structure
6. knowns or commonalities (inter-relationship)

2. Imogene King – GOAL ATTAINMENT THEORY

- believes that there are 3 interacting systems: Individual (Personal
System); Group (Interpersonal System); and Society (Social Systems)

2. MIDDLE RANGE THEORIES

- Deals with portion of nursing’s total concern but not with the totality of
the discipline
- They are moderately abstract and inclusive but are composed of concepts
and propositions that are measurable

- Middle Range Theories – more helpful to nursing practice

- narrower focus than grand theory, more precise than grand theories
& focus on developing theoretical statements to answer questions
about nursing
-

3. MICRO-RANGE THEORIES
- is a linking of concrete concepts into a statement that can be examined in
practice and research
V. NON-NURSING THEORIES

1. HUMAN NEEDS THEORY

- The physiological needs.  oxygen, water, protein, salt, sugar, calcium, and
other minerals & vitamins. the need to maintain a pH balance (getting too
acidic or base will kill you) and temperature.  there’s the needs to be
active, to rest, to sleep, to get rid of wastes (CO2,  sweat, urine, and
feces), to avoid pain, and to have sex.

- The safety and security needs.  When physiological needs are largely
taken care of. You will become increasingly interested in finding safe
circumstances, stability, protection.

- The love and belonging needs.  When physiological needs and safety
needs are, a third layer starts to show up.  You begin to feel the need for
friends, a sweetheart, children, affectionate relationships in general, even
a sense of community.
 - The esteem needs.  Next, we begin to look for a little self-esteem.
(FAME,GLORY SELF-RESPECT)

- Self-actualization - continuous desire to fulfill potentials, to “be all that

you can be.”  They are a matter of becoming the most complete, the
fullest, “you” -- hence the term, self-actualization.

2. SYSTEMS THEORY
- considers a system as a set of independent and interacting parts. The
main goal is to study general principles of system functioning to be
applied to all types of system in all fields of research.
3. CHANGE THEORY
- provides the ability to identify strategic communication needs and allows
identification of the obstacles to the accomplishment of change
- teaches patience in the achievement of change as well as the importance
of flexibility on the part of management in achieving change objectives.
- Change is constant;
- Resistance to change is normal; and that
- Change basically takes place in two ways