History of Nursing Theory
NCM 100 | Theoretical Foundations of Nursing
HISTORY OF NURSING THEORY
I. History and Philosophy of Science
 Historical View of the Nature of Science
1. Rationalism
2. Empiricism
II. Early 20th Century Views of Science and
Theory
 First half of the 20th century
 Emergent Views of Science and Theory in
the Late 20th Century
III. Interdependence of Theory and Research
 Phenomenology
 Postpositivist and Interpretive paradigms
 Science as a Social Enterprise
IV. Scope of Theories and Analysis
 Preliminary Concepts
 Analysis and Evaluation of Theory
LEARNING OBJECTIVES
 Searching for specialized nursing knowledge led
nurse scholar to theories that guide research,
education, administration, and professional
practice.
 Nursing followed a path from concepts to
conceptual frameworks to models to theories, and
finally to middle range theory, in this theory
utilization era.
 Nursing history demonstrates the significance of
theory for nursing as a division of education (the
discipline) and a specialized field of practice (the
profession).
 Knowledge of the theory development process is
basic to a personal understanding of the theoretical
works of the discipline.
 Analysis facilitates learning through systematic
review and critical reflection of the theoretical
works of the discipline.
 Theory analysis begins the process of identifying a
decision making framework for nursing research or
nursing practice.
HISTORY OF NURSING THEORY
“The systematic accumulation of knowledge is
essential to progress in any profession… however,
theory and practice must be constantly
interactive.Theory without practice is empty and
practice without theory is blind.” (Cross, 1981, p. 110)
 The history of professional nursing began with
Florence Nightingale.
ALVEZ, ARCA, CASTIL, CHAVEZ, COLIBAO
WEEK #3
Date (10/13/2022) | Ms. Vivian Cezar
 Nightingale envisioned nurses as a body of
educated women at a time when women were
neither educated nor employed in public service.
 A brief history of nursing development from
vocational to professional describes the search for
nursing substance that led to this exciting time in
nursing history as linkages were strengthened
between nursing as an academic discipline and as
professional practice.
 It as during the mid-1800s that Nightingale
recognized the unique focus of nursing and
declared nursing knowledge as distinct from
medical knowledge.
 Nursing as a science in the 1950s; transition from
vocation to profession included successive eras of
history as nurses began to develop a body of
specialized knowledge on which to base nursing
practice.
 The curriculum era addressed the question of
what content nurses should study to learn how to
be a nurse.
 The research era which focused on the research
process and the long-range goal of acquiring
substantive knowledge to guide nursing practice.
 Research was the path to new nursing knowledge.
2 SIGNIFICANT MILESTONES IN THE EVOLUTION
OF NURSING THEORY:
1. The standardization of curricula for nursing master’s
education by the National League for Nursing
accreditation criteria for baccalaureate and higher-
degree program.
2. The decision that doctoral education for nurses
should be in nursing.
 Graduate education era - Master’s degree
programs in nursing emerged across the country
to meet the public need for nurses for specialized
clinical nursing practice.
 The theory era was a natural outgrowth of the
research and graduate education eras.
 There was an understanding that research and
theory together were required to produce nursing
science.
 The theory era accelerated as works began to be
recognized as theory, having been developed as
frameworks for curricula and advanced practice
guides.
 It was at the Nurse Educator Conference in
New York City in 1978 that theorists were
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 History of Nursing Theory WEEK #3
NCM 100 | Theoretical Foundations of Nursing Date (10/13/2022) | Ms. Vivian Cezar

recognized as nursing theorists and their works as practice?

nursing conceptual models and theories.
Theory What new Nursing Middle- Nursing
 The 1980s was a period of major developments Utilization theories theory range frameworks
Era: are needed guides theory produce
in nursing theory that has been characterized as a Twenty- to produce research, may be knowledge
transition from the pre-paradigm to the paradigm first evidence of practice, from (evidence)
period. Century quality education, quantitativ for quality
care? and e or care
 Classifying the nursing models as paradigms administra qualitative
within a metaparadigm of the person, tion. approaches
environment, health, and nursing concepts
Alligood, M.R. (2014, in press). Nursing Theory: Utilization &
systematically united the nursing theoretical Application. Maryland Heights, (MO): Mosby-Elsevier.
works for the discipline.

 Kuhn’s (1970) description of normal science to

life clarifies our understanding of the evolution of HISTORY AND PHILOSOPHY OF SCIENCE
nursing theory through paradigm science. It is
important historically to understand that what we
view collectively today as nursing models and HISTORICAL VIEWS OF THE NATURE OF SCIENCE
theories is the work of individuals in various areas  Epistemology is concerned with the theory of
of the country who published their ideas and knowledge in philosophical inquiry.
conceptualizations of nursing.
 Nursing science has been characterized by two
 The theory utilization era has restored a balance branching philosophies of knowledge as the
between research and practice for knowledge discipline developed - Rationalism and
development in the discipline of nursing. Empiricism
 The reader is referred to the 5th edition of  Various terms are utilized to describe these forms
Nursing Theory: Utilization & Application for of science:
case applications and evidence of outcomes from
utilization of nursing theoretical works in practice.  Empiricist and Interpretive,

 Mechanistic and Holistic,

HISTORICAL ERAS OF NURSING’S SEARCH FOR  Quantitative and Qualitative,

SPECIALIZED KNOWLEDGE
 and Deductive and Inductive.
Historical Major Emphasis Outcomes Emerging
Eras Questions Goal

Curriculum What Courses Standardiz Develop RATIONALISM

Era: 1900 curriculum included n ed specialized
to 1940s content nursing curricula knowledge  Emphasizes the importance of a a priori
should programs for diploma and higher reasoning as the appropriate method for
student programs education advancing knowledge.
nurses
study to be  Deductive type of logic/reasoning.
nurses?
 Theoretical assertions derived by deductive
Research What is the Role of Problem Isolated
Era: 1950 focus for nurses and studies studies do reasoning are then subjected to experimental
to 1970s nursing what to and not yield testing to corroborate the theory.
research? research studies of unified
nurses knowledge  Reynolds (1971) labeled this approach the
theory-then-research strategy.
Graduate What Carving Nurses Focus
Education knowledge out an have an graduate
Era: 1950 is needed advanced important education
to 1970s for the role and role in on EMPIRICISM
practice of basis for health care knowledge
nursing? nursing developmen
 The empiricist view is based on the central idea
practice t
that scientific knowledge can be derived only from
Theory How do There are Nursing Theories sensory experience (i.e., seeing, feeling,
Era: 1980 these many theoretical guide hearing facts).
to 1990s framework ways to works shift nursing
s guide think the focus research  Francis Bacon received credit for popularizing
research about to the and practice the basis for the empiricist approach to inquiry.
and nursing patient

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History of Nursing Theory
NCM 100 | Theoretical Foundations of Nursing
 Inductive method scientific truth was discovered
through generalizing observed facts in the natural
world based on the idea that the collection of facts
precede/attempts to formulate generalizations.
 Research-then-Theory Strategy.
EARLY 2OTH CENTURY VIEWS OF SCIENCE
AND THEORY
FIRST HALF OF THE 20TH CENTURY
 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.
 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.
 The increasing use of computers, which permit
the analysis of large data sets, may have
contributed to the acceptance of the positivist
approach to modern science.
EMERGENT VIEWS OF SCIENCE AND THEORY IN
THE LATE 20TH CENTURY
 Foucault (1973) published his analysis of the
epistemology (knowledge) of human sciences
from the seventeenth to the nineteenth century.
 The Phenomenology of the Social World, Schutz
(1967) argued that scientists seeking to
understand the social world could not cognitively
know an external world that is independent of
their own life experiences.
 Edmund Husserl (1859 to 1938) proposed that
the objectivism of science could not provide an
adequate apprehension of the world.
 In 1977, Brown argued an intellectual revolution
in philosophy that emphasized the history of
science was replacing formal logic as the major
analytical tool in the philosophy of science.
 One of the major perspectives in the new
philosophy emphasized science as a process of
continuing research rather than a product focused
on findings.
 Empiricists view phenomena objectively, collect
data, and analyze it to inductively proposed
theory.
ALVEZ, ARCA, CASTIL, CHAVEZ, COLIBAO
WEEK #3
Date (10/13/2022) | Ms. Vivian Cezar
 Gale (1979) answered by proposing that the
scientist is able to perceive forceful intrusions
from the environment that challenge his or her,
thereby raising questions a prior mental set
regarding the current theoretical perspective.
 Brown identified the following three different
views of the relationship between theories and
observation:
1. Scientists are merely passive observers of
occurrences in the empirical world. Observable
data are objective truth waiting to be discovered.
2. Theories structure what the scientist perceives
in the empirical world.
3. Presupposed theories and observable data
interact in the process of scientific investigation.
INTERDEPENDENCE OF THEORY AND
RESEARCH
 Theory and research can be viewed as distinct
operations, they are regarded more appropriately
as interdependent components of the scientific
process.
 In constructing a theory, the theorist must be
knowledgeable about available empirical findings
and be able to take these into account because
theory is, in part, concerned with organizing and
formalizing available knowledge of a given
phenomenon.
 In contemporary theories of science, the scientific
enterprise has been described as a series of
phases with an emphasis on the discovery and
verification (or acceptance) phases.
 Verification is characterized by the scientific
community’s efforts to critically analyze and test
the new conceptions in an attempt to refute them.
 In any scientific discipline, it is not appropriate to
judge a theory on the basis of authority, faith, or
intuition; it should be judged on the basis of
scientific consensus.
 The advancement of science is thus a
collaborative endeavor in which many researchers
evaluate and build on the work of others.
 The consensus regarding the correspondence of
the theory is, therefore, not based on a single
study.
 Repeated testing is crucial.
 Scientific consensus is necessary in three key
areas for any given theory as follows:
1. Agreement on the boundaries of the theory;
that is, the phenomenon it addresses and the
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History of Nursing Theory WEEK #3
NCM 100 | Theoretical Foundations of Nursing Date (10/13/2022) | Ms. Vivian Cezar

phenomena it excludes (criterion of  Science does not depend on the personal

coherence),
2. Agreement on the logic used in constructing
the theory to further understanding from a
similar perspective (criterion of coherence),
and
3. Agreement that the theory fits the data
collected and analyzed through research
characteristics or persuasions of any given
scientist or group of scientists, but it is
powerfully self-correcting within the
community of scientists (Randall, 1964).
 Science progresses by the diversity of dialogue
within the discipline of nursing.

PHENOMENOLOGY SCOPE OF THEORIES AND ANALYSIS

 Is a science that describes how we experience the

objects of the external world and provides and PRELIMINARY CONCEPTS
explanation of how we construct objects of
experience.  THEORIES  PRACTICE LEVEL
THEORIES
 The investigator posits that all objects exist  NURSING THEORIES
because people perceive and construct them as  DESCRIPTIVE
such. Ethnomethodology focuses on the world of  SCOPE THEORIES
“social facts” as accomplished or co-created
through people’s interpretative work.  GRAND THEORIES  PRECRIPTIVE
THEORIES
 When examining phenomena fro this perspective,  MIDDLE-RANGE
THEORIES  MICRO-RANGE
social reality and social facts are constructed,
produced, and organized through the mundane THEORIES
actions and circumstances of everyday life.

ANALYSIS AND EVALUATION OF THEORY

THE POSTPOSITIVIST AND INTERPRETIVE
PARADIGMS  CLARITY

 Paradigms to guide knowledge development  SIMPLICITY

 Postpositivism focuses on discovering patterns  GENERABILITY

that may describe, explain, and predict
phenomena.  ACCESIBILITY

 The philosophy of caring involves knowledge,  IMPORTANCE

skills, patient trust, and the ability to manage all
elements simultaneously in the context of care.

 Wholism (Holism) is another philosophy in

understanding the patient. LECTURE NOTES: (10-13-22)
 Naturalism has a metaphysical component that
implicates that the natural world exists; there is
no non-natural or supranatural realm. Evolution of Nursing Theories

 Introduce various perspective

SCIENCE AS A SOCIAL ENTERPRISE  Understand the nursing theorists and their works

 Related to Knowledge (4 Ways of Knowing)

 The process of scientific inquiry may be viewed as
a social enterprise (Mishler, 1979).  Approaches to what theory is all about

 In Gale’s words, “Human beings do science” (Gale,  Nightingale wasn’t satisfied that she’s the only one who
1979, p. 290) knows, so she extended and disseminated her learning.

 Therefore, it might be anticipated that social,

economic, or political factors may influence the
scientific enterprise. History of Nursing Theory
 Leads to 4 ways of knowing

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History of Nursing Theory WEEK #3
NCM 100 | Theoretical Foundations of Nursing Date (10/13/2022) | Ms. Vivian Cezar

 Provides context and perspective  Theory should not be fake, and should always be based
on science
 Logically into analysis
 To confirm if a theory is applicable
 Essential process of critical reflection
 To apply, it should support with research first because it
 Leaves to a systematic approach
is evidence based
 Florence shared her knowledge for the continuity of
 Subject to revisions
quality nursing care.

 Started in the mid-1800  Consensus - general agreement

 Answers the question: What content do nurses study on Phenomenology

how to be a nurse
 Personal experiences
Curriculum Era
Ethnomethodology
 emphasized what course nursing students should take
 Social facts, works of other people
Graduate Education Era
Middle-Range Theory
 Many graduate programs introduced students to nursing
process  Least abstract

Theory Era Grand Theory

 When we gained recognition (our profession) as the  Broad range

academic discipline
Practice-Level Theory
 When talking about theoretical models, we should not
modify or alter anything  More abstract - Descriptive

 Individual’s original ideas of theoretical frameworks are  Least abstract - Prescriptive

disrespected when doing so
Naturalism
 Applying the theories takes a lot of reading
 Nursing is a holistic approach. It will depend on the
 Theorists have their own ideas so we are not to alter it theoretical/conceptual framework

Rationalism Postpositivist and Interpretive paradigms

 Example: to reason of lack of support will result in  nursing practice will depend on what theoretical
hospital admission framework and conceptual framework you will apply

 Evidence-based  Theories help to define how it is different

 Cause and effect  Scope is the coverage of various topics

Empiricism Science as a Social Enterprise

 Reflected of the theory of Schimmer  To provide systematic approach

 A bit of difficulty with inductive inquiry  It’s a matter of discussion between scientists to come up
a correct theory and approaches for the good of
 If you want to be a theorist, you should be inquisitive everyone

 Emphasis when it comes to the nursing era: Empirism Scope of Analysis and Evaluation

 Modern Science - application of Modern Technology  How useful theory is

Emergent Views of Science  To find out how applicable the theory is to nursing
practice
 Focused in research than findings
 Clarity - concepts or ideas are easy to understand
Interdependence of Theory and Research
 Simplicity - simple and clear understanding
 Every theoretical concept backups theoretical research

 There is a rebuttal to refute or confirm the theory

 Extract ideas from a theory and create a new theory

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