Unit VI

conceptual and theoretical model of

nursing
 Definition of Nursing Theory
• A theory is a group of related
concepts that propose action that
guide practice.
Kerlinger
• Theories as a set of interrelated
concepts that give a systematic view
of a phenomenon (an observable fact
or event) that is explanatory and
predictive in nature.
 Importance
• Nursing theories are the support
of nursing practice today.
• They are significant
to nursing practice, education and
scientific research.
 The characteristics of theories
• Theories are interrelating concepts in
such a way as to create a different
way of looking at a    particular
phenomenon.
• Logical in nature.
• Generalizable.

• Bases for hypotheses that can be

 Cont..,

• increasing the general body of

knowledge within the discipline
through the research.
• used by the practitioners to guide and
improve their practice.
 Conceptual model
• A model is a way to visualize reality
to simplify thinking.
• A conceptual model shows how
various concepts are interrelated and
applies theories to predict or evaluate
consequences of alternative actions.
 Common concepts in nursing
theories
• There are four major concepts in
nursing theories.
They are:
• The person (patient).
• The environment
• Health
• Nursing (goals, roles, functions)
• Of the four concepts, the most important
is that of the person.
 i) Holistic model
• Holistic Health is actually an approach to
life. Rather than focusing on illness or
specific parts of the body, this ancient
approach to health considers the whole
person and how he or she interacts with
his or her environment.
• It emphasizes the connection of mind,
body and spirit.
 The 5 Aspects Of Holistic Health

• Physical, emotional, social, spiritual, and

Mental.
Holistic nursing
• Holistic nursing is a practice of nursing that
focuses on healing the whole person. This
practice recognizes that a person is not
simply his or her illness.
Holistic model
 ii) Rosenstock’s Health Belief Model

• One of the first theories of health behavior,

 the Health Belief Model was developed by
et
social psychologists Irwin M. Rosenstock
al.  
• The model is based on the theory that a
person's willingness to change their health
behaviors 
 Cont..,
• Person's willingness to change their health
behaviors is primarily due to the following
factors:
• Perceived Susceptibility
• Perceived severity
• Perceived benefits
• Perceived barriers
• Modifying variables
• Cues to action
• Self-efficacy
 Cont..,
Perceived Susceptibility
• refers to subjective assessment of risk of
developing a health problem.
• People will not change their health
behaviors unless they believe that they are
at risk.
 Cont..,
Perceived severity
• refers to the subjective assessment of the
severity of a health problem and its
potential consequences.
Perceived benefits
• refer to an individual's assessment of the
value or efficacy of engaging in a health-
promoting behavior to decrease risk of
disease.
 Cont..,
Perceived barriers
• refer to an individual's assessment of the
obstacles to behavior change.
Modifying variables
• Individual characteristics,
including demographic, psychosocial, and
structural variables, can affect perceptions
(i.e., perceived seriousness, susceptibility,
benefits, and barriers) of health-related
behaviors.
 iii) Pender’s Health Promotion
Model
• The Health Promotion Model was
designed by Nola J. Pender.
• She defines health as a positive
dynamic state rather than simply the
absence of disease. 
• Health promotion is directed at
increasing a patient's level of well-
being.
 Pender’s health
promotion model
Theories can also be categorized as:

• "Needs "theories.

• "Interaction" theories.

• "Outcome "theories.

• "Humanistic theories"
 "Needs" theories

• These theories are based around helping

individuals to fulfill their physical and
mental needs.
• Ex - Orem’s Self-Care Theory 
 "Interaction" theories

• These theories revolve around the

relationships nurses form with patients.
• Ex- Peplau’s Interpersonal Theory
 "Outcome" theories

• This explains the nurse as the changing

force, who enables individuals to adapt to
or cope with ill health.
• Ex - Roy's Adaptation theory
 "Humanistic" Theories:

• Humanistic theories emphasize All the

human beings are viewed as an integral
part of universe.
• Ex - Roger’s theory Science of Unitary
Human Beings
i) Peplau’s Interpersonal Theory
• This interpersonal theory emphasizes
the need for a partnership between
the nurse and client as opposed to
the client passively receiving
treatment (and the nurse passively
acting out doctor’s orders).
• There are 4 phases in this theory
which overlap and occur over a
period of time.
 Four phases of Inter Personal
Relationship theory
i) Orientation phase – patient expresses
a need. Patient and nurse collaborate
(interview process) to define the problem.
ii)Identification phase – patient react to
the nurse who can meet their needs and
encouraged to participate in care.
 Cont..,
iii) Exploitation – patient attempts to
explore, understand and deal with the
problem, and gains independence on
achieving the goal.
iv) Resolution – termination of the
therapeutic relationship to encourage
emotional balance for nurse and
patient.
ii) Virginia Henderson’s Need theory
• The theory focuses on the
importance of increasing the
patient's independence to hasten
their progress in the hospital.
• Henderson's theory emphasizes on
the basic human needs and how
 iii) Dorothea E. Orem’s Self-Care
Theory 
• Orem's self-care deficit
theory suggests patients are better
able to recover when they maintain
some independence over their
own self-care.
 Cont..,

• Dorothea Orem’s Self-Care Deficit Theory

“The act of assisting
defined Nursing as 
others in the provision and management
of self-care to maintain or improve human
functioning at home level of effectiveness.”
 
 Cont..,
Self-Care
• Self-care is the performance or practice of
activities (ADL).
Self-Care Agency
• Self-care agency is the human’s ability to
engage in self-care (affected by basic
conditioning factors like age, gender, health
state, etc..).
• Self-Care Deficit: Impaired ability to perform
ADL.
 Cont..,
Therapeutic Self-Care Demand
• is the totality of “self-care actions to be
performed for some duration in order to
meet known self-care requisites.
Nursing Agency
• Nursing care is required to maintain
optimum functioning (self-care demand). It
includes three types of nursing intervention.
 iv) Neuman’s Systems Theory
• This theory views the client as an open
system that responds to stressors in the
environment.
• The client variables are physiological,
psychological, sociocultural, developmental,
and spiritual.
• The client system consists of a basic or
core structure that is protected by lines of
resistance.
 Cont..,
• Neuman defines nursing as “action which
assist individuals, families and groups to
maintain a maximum level of wellness, and
the primary aim is stability of the patient/
client system, through nursing interventions
to reduce stressors.
 Neuman’s system model
Stressor Stressor
s s

Intervention

Primary
Prevention

Secondaryprevention

Tertiary prevention

Reconstitution
 v) Roger’s theory Science of Unitary
Human Beings
• All the human beings are viewed as an
integral part of universe.
• Human beings and the environment have
energy field, nursing action is directed
towards patterning and maintaining these
energy fields.
 vi) Roy's Adaptation
Model of Nursing
• In her theory, Sister Callista Roy's model
sees the individual as a set of interrelated
systems who strives to maintain a balance
between various stimuli.
• Nurses help the patients to manage stimuli.
Input
• Stimuli
• Adaption level
 Types of Stimuli
• Three types of stimuli influence an
individual's ability to cope with the
environment.
• These include focal stimuli, contextual stimuli,
and residual stimuli.
• Focal stimuli are those that immediately
confront the individual in a particular
situation.
• Contextual stimuli are those other stimuli that
influence the situation.
 Cont..,
• Residual stimuli include the individual's
beliefs or attitudes that may influence the
situation.
Adaptation level
• Four types of adaptation level
• In the physiologic mode, adaptation involves
the maintenance of physical integrity such as
nutrition, oxygen, etc.
• self-concept mode is the need for
maintenance of psychic integrity.
 Cont..,
• Interdependence mode involves maintaining
a balance between independence and
dependence in one's relationships with
others.
• The need for social integrity is emphasized
in the role function mode. When human
beings adapt to various role changes that
occur throughout a lifetime, they are
adapting in this mode. Ex- adjustment
lifestyle after retirement.
 Regulator mechanism
Two types of regulator mechanism.
• Regulator mechanism – involved in
physiologic mode.
• Cognator mechanism – coping process
involving cognitive and emotional
channels.
Effectors
• Changes in the adaptation level.
 Cont..,
Output
• Adaptive
or
• ineffective response  feedback 
stimuli
Roy's Adaptation theory
Linking theories with nursing
process
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Thank you all for listening