EVOLUTION OF NURSING
NURSES
 Licensed health care professionals engaged in the
practice of providing nursing care both
interdependently and independently.
 Latin word nutricia, nutriz, nutrire.
 meaning to ‘nurse’, ‘nourish’, or ‘cherish’
History of Nursing Theory
1860, Florence Nightingale (1820-1910)
 defined nursing in her “Environmental Theory” as
“the act of utilizing the environment of the patient to
assist him in his recovery.”
1952, Hildegard Peplau (1909-1999 )
 introduced her Theory of Interpersonal Relations
that puts emphasis on the nurseclient relationship as
the foundation of nursing practice.
In 1955, Virginia Henderson (1897-1996)
 conceptualized the nurse’s role as assisting sick or
healthy individuals to gain independence in meeting
14 fundamental needs.
In 1960, Faye Abdellah (1919-Present)
 published her work “Typology of 21 Nursing
Problems” that shifted the focus of nursing from a
disease-centered approach to a patient-centered
approach.
1962, Ida Jean Orlando (1926-2007)
 emphasized the reciprocal relationship between
patient and nurse and viewed the professional
function of nursing as finding out and meeting the
patient’s immediate need for help.
1968, Dorothy Johnson (1919-1999)
 pioneered the Behavioral System Model and
upheld the fostering of efficient and effective
behavioral functioning in the patient to prevent
illness.
1970, Martha Rogers (1914-1994)
 viewed nursing as both a science and an art as it
provides a way to view the unitary human being, who
is integral with the universe.
1971, Dorothea Orem (1914-2007)
 states in her theory that nursing care is required if the
client is unable to fulfill biological, psychological,
developmental, or social needs.
1971, Imogene King (1923-2007)
 Theory of Goal attainment states that the nurse is
considered part of the patient’s environment and the
nurse-patient relationship is for meeting goals
towards good health.
1972, Betty Neuman (1924-Present)
 in her theory states that many needs exist, and each
may disrupt client balance or stability. Stress
reduction is the goal of the system model of nursing
practice.
1979, Sr. Callista Roy (1939-Present)
 viewed the individual as a set of interrelated systems
who strives to maintain the balance between these
various stimuli.
1979, Jean Watson (1940-Present)
 developed the philosophy of caring highlighted
humanistic aspects of nursing as they intertwine with
scientific knowledge and nursing practice.
Significance for the Discipline and Profession
 Nursing theory makes research findings meaningful
and credible.
 make valid , safe and accurate decisions and to
demonstrate it’s unique contribution to nursing care.
 helps avoid a random approach to client care and
guides the nurse in making pertinent observations,
analyzing deviations from normal, and planning
nursing care activities.
Importance of Nursing Theories
1. Aim to describe, predict and explain the phenomenon
of nursing.
2. Provide the foundations of nursing practice, help to
generate further knowledge and indicate in which
direction nursing should develop in the future.
3. Help to distinguish what should form the basis of
practice by explicitly describe nursing.
4. Help provide better patient care, enhanced
professional status for nurses, improved communication
between nurse, and guidance for research and
education.
5. The main exponent of nursing – caring-cannot be
measured. It is vital to have the theory to analyze and
explain what nurses do.
6. Establish a unique body of knowledge.
7. Maintain professional boundaries in nursing.Purposes
of Theories.
A.In Practice
a. Assist nurses to describe , explain, and predict
everyday experiences.
b. Serve to guide assessment, intervention, and
evaluation of nursing care.
c. Provide a rationale for collecting reliable and valid data
about the health status of clients, which are essential for
effective decision making and implementation.
d. Help to stablish criteria to measure the quality of
nursing care.
e. Help build the common nursing terminology to use in
communicating with other health profesionals. Ideas are
developed and words defined.
f. Enhance autonomy (independence and self –
governance) or nursing by defining its own independent
functions.
Purposes of Theories
B. In Education
a. Provide a general focus for curriculum design.
b. Guide curricular decision making
C. In Research
a. Offer a framework for generating knowledge and new
ideas
b. Assist in discovering knowledge gaps in specific field of
study
c. Offer a systematic approach to identify question for
study select variables, interpret findings and validate
nursing interventions

History and Philosophy of Science
 Science is a method for describing, explaining, and
predicting causes or outcomes of interventions
 Scientific activity has helped to establish the
evidence we use to guide practice in the delivery of
nursing care
Two Philosophical Perspectives Used in Science
1. Rationalism
2. Empiricism
Rationalism
 Rationalist epistemology (scope of knowledge)
emphasizes the importance of a priori reasoning as
the appropriate method for advancing knowledge.
 A pri'ori reasoning uses deductive logic by reasoning
from the cause to an effect or from a generalization
to a particular instance.
 Theoretical assertions derived by deductive
reasoning are then subjected to experimental testing
to corroborate the theory. Reynolds labeled this
approach the theory-then-research Strategy
Empiricism
 is based on the central idea that scientific knowledge
can be derived only from sensory experience (i.e.,
seeing, feeling, hearing facts).
 Francis Bacon received credit for popularizing the
basis for the empiricist approach to inquiry. Bacon
believed that scientific truth was discovered through
generalizing observed facts in the natural world.
 This approach, called the inductive method, is based
on the idea that the collection of facts precedes
attempts to formulate generalizations, or as Reynolds
(1971, as cited by Alligood, 2018) called it, the
research-then-theory strategy
 Skinner’s approach to theory construction was clearly
inductive.
 With induction it is important not to end the
observations too soon and arrive at a premature
conclusion that is faulty. In summary, deductive
inquiry uses the theory-then research approach, and
inductive inquiry uses the research-then-theory
approach. Both approaches are used in the field of
nursing.
Early Twentieth Century Views
 philosophers focused on the analysis of theory
structure, scientists focused on empirical research
Positivism, a term first used by Comte, emerged as
the dominant view of modern science.
 Modern logical positivists believed that empirical
research and logical analysis (deductive and
inductive) were two approaches that would produce
scientific knowledge
 The logical empiricists offered a more lenient view of
logical positivism and argued that theoretical
propositions (proposition affirms or denies
something) must be tested through observation and
experimentation.
 This perspective is rooted in the idea that empirical
facts exist independently of theories and offer the
only basis for objectivity in science.
 “The scientist first sets up an experiment;
observes what occurs ….
reaches a preliminary hypothesis to describe the
occurrence; runs
further experiments to test the hypothesis [and] finally
corrects or
modifies the hypothesis in light of the results”.
Emergent Views
 Foucault (1973) published his analysis of the
epistemology (knowledge) of human sciences from
the seventeenth to the nineteenth century. His major
thesis stated that empirical knowledge was arranged
in different patterns at a given time and in a given
culture and that humans where emerging as objects
of study.
 In 1977, Brown , One of the major perspectives in the
new philosophy emphasized science as a process of
continuing research rather than a product focused on
findings. In this emergent epistemology, emphasis
shifted to understanding scientific discovery and
process as theories change over time.
 Brown (1977) set forth a new epistemology
challenging the empiricist view proposing that
theories play a significant role in determining what
the scientist observes and how it is interpreted. The
following story illustrates Brown’s premise that
observations are concept laden; that is, an
observation is influenced by values and ideas in the
mind of the observer.