TFN
Smith and - a notion or an idea that explains
THEORETICAL FOUNDATIONS OF NURSING
Parker (2015)
JEAN LOUISE L. HIDALGO – 1B
CHAPTER 1 – INTRODUCTION TO NURSING THEORY
❖ CHARACTERISTICS OF A THEORY
❖ THEORY
- 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
➢ idea formulated by the mind;
experience perceived and observed.
➢ Helps describe or label phenomena
▪ Proposition
➢ explains the relationships of
different concepts.
▪ Definition
➢ composed of various descriptions
which convey a general meaning;
reduces vagueness.
▪ Assumption
➢ statement that specifies the
relationship or connection of
factual concepts or phenomena.
➢ Explains the nature of the concepts,
definitions, purpose, relationships,
and structure of a theory.
▪ Phenomenon
➢ Describes an idea or responses
about an event, a situation, a
process, a group of events or
situations.
- Chinn and Kramer (1991), a theory is “a
creative and rigorous structuring of ideas that
projects a tentative, purposeful, and systemic
view of phenomena.”
DEFINITION OF THEORY
Parker (2001) - an organized, coherent set of
concepts
- offers descriptions, explanations,
and predictions about a phenomena
Blackwell - a reasoned proposed explanation of
(2005) an occurrence
- lacks absolute proof
Delaune and - set of concepts and proposition that
Ladner (2006) provide early way to view
phenomena
Mosby (2006) - abstract statement formulated to
predict, explain, or describe
- tested by observation and research
using factual data
Kozier (2008) - a supposition of system of ideas that
is proposed to explain a given
phenomenon
Potter and - helps explain and event by defining
Perry (2014) ideas, explaining relationships, and
predicting outcomes
experiences, interprets observation,
describes relationships, & predicting
outcomes
- can correlate concepts to generate a different
way of looking at a certain fact or
phenomenon
- must be logical in nature
- should be simple but generally broad in
nature
- source of hypotheses that can be tested to be
elaborated
- contribute in enriching the general body of
knowledge through studies to validate them
- use by practitioners to direct and enhance
their practice
- must be consistent with other validated
theories, laws and principles.
❖ NURSING SCIENCE
- a melting-pot of the different knowledge,
creeds, and backgrounds of care and healing
that has been collected and preserved.
❖ NURSING
- dynamic & diverse as a kaleidoscope of ethnic,
cultural, and religious manifestations
- grounded on accepted scientific truths and
principles to give safe and quality nursing care
- a significant and therapeutic interpersonal
process (Peplau)
- Maintaining, restoring, or achieving a state of
optimum health and functioning, both a science
and art concerned with the quality of life.
- American Nursing Association (ANA),
Nursing is the “diagnosis and treatment of
human responses to actual or potential health
problems.”
- International Council of Nurses (ICN)
▪ Encompasses autonomous and
collaborative care of individuals
▪ Promotion of health, prevention of
illness, care of ill, disabled, and dying
people.
▪ Advocacy, promotion of a safe
environment, research, participation in
shaping health policy and health
systems management, and education.
- Henderson
▪ Assist clients in the performance of
activities contributing to health
▪ Recovery or peaceful death
- Association of Deans of Philippine Colleges
of Nursing (ADPCN)
▪ Nursing is a dynamic discipline
 ▪ An art and a science of caring for
individuals
▪ Promotion and restoration of health,
prevention of illness, alleviating of
suffering, and assisting clients to face
death with dignity and peace
▪ Utilize nursing process and guided by
ethico-moral-legal principles
❖ NURSING THEORY
- explain the science and art of nursing
- attune with Filipino spirit and culture
- highly dynamic and undergoes change
- a group of interrelated concepts developed
from various studies of disciplines and related
experiences.
- Aims to view the essence of nursing care
- According to Meleis (2012),
▪ a nursing theory conceptualizes as
aspect of nursing to describe, explain,
predict, or prescribe nursing care.
▪ An articulated and communicated
conceptualization of invented or
discovered reality pertaining to
nursing.
▪ Importance of expressing nursing
theory in providing direction to nursing
care.
❖ DIFFERENT TYPES OF THEORIES
- Descriptive Theories (Factor-Isolating)
▪ Primary level of theory development
▪ Identify and describe major concepts of
phenomena
▪ Do not explain the relationship of the
concepts
▪ Main purpose is to present a
phenomenon based on the five senses
- Explanatory Theories (Factor-Relating)
▪ Present relationship among concepts
and propositions
▪ Aim to provide information on how or
why concepts are related
▪ Ex. Cause and effect relationship
- Predictive Theories (Situation-Relating)
▪ Achieved when relationships of
concepts under a certain condition can
describe future outcomes consistently.
▪ Generated and tested using
experimental research
- Prescriptive Theories (Situation-
Producing)
▪ Deal with nursing actions and test the
validity and certainty of a specific
nursing intervention.
▪ Commonly used in testing new nursing
interventions
❖ CONCEPTS
- Building block of Theories
- Can come from an empirical phenomena or
abstraction of how a person perceived an
object.
- It enhances one’s capacity to understand
phenomena as it helps define the meaning of
a word.
- Two types of concepts:
▪ Abstract concepts
➢ Indirectly observed or intangible
➢ Independent of time and place
▪ Concrete concepts
➢ Directly observed or intangible
- Can be used in making or formulating:
▪ Conceptual definitions
➢ The meaning of a word based on
how a certain theory or relevant
literature perceives it to be.
▪ Operational Definitions
➢ Meaning of a word based on the
method of how it was measured
or how the person come up with
that perception
➢ Specifies exactly how the concept
will be determined and assess
❖ Conceptual Models and Theoretical Models
- Theoretical Models or Frameworks
▪ Highly established set of concepts that
are testable
▪ A structure of concepts which exist or
tested in the literature
▪ A read-made map for the study
- Conceptual Models or Frameworks
▪ Representations of an idea or body of
knowledge based on the own
understanding or perception of a
person.
▪ Structure of concepts or theories which
are pulled together as a map for the
study.
❖ NURSING PARADIGMS
- Patterns or models used to show a clear
relationship among the existing theoretical
works in nursing.
- Nursing Metaparadigm
▪ Four major concepts establish a better
direction and understanding of nursing
profession
▪ Embodies the knowledge base, theory,
philosophy, research, practice, and
educational experience and literature
with nursing.
▪ Metaparadigm is the highest level of
knowledge.
▪ Four major concepts:
➢ Person – recipient of nursing care
 ➢ Environment – external and
internal aspects of life that
influences the person
➢ Health – holistic level of wellness
the person experiences
➢ Nursing – interventions of the
nurse rendering care in support
of, or in cooperation with the
client.
❖ Philosophy In Nursing
- Next knowledge after metaparadigm
- Specifies the definition of metaparadigm
concepts in each of the conceptual models of
Nursing.
- Sets the meaning of phenomena through
analysis, reasoning, and logical argument.
- Forming a basis of subsequent development
❖ Science
- Any systematic knowledge or practice in a
discipline of study
- System of acquiring knowledge based on the
scientific method
▪ Observation – integration of
knowledge and/or phenomenon by a
rational being
▪ Gathering Data – recognition and
collecting data for a particular scientific
problem
▪ Forming Hypothesis – an attempt to
explain or suggest a nature of a
phenomenon
▪ Experimental Investigation - set of
examinations to solve a query
▪ Conclusion or Theoretical
explanation – statement explaining a
set of natural phenomena or a scientific
query
❖ KNOWLEDGE
- Information, skills, and expertise acquired
by a person through various life
experiences.
- Abstract or workable understanding of a
subject or idea.
- What is known in a particular field of study
- Knowledge acquirement involves several
cognitive processes. Types of Cognitive
Processes:
▪ Perception – achieving understanding
of sensory data
▪ Association – combining to 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
mediums.
- Sources of Knowledge:
▪ Traditional Knowledge
➢ Nursing practice which is passed
down from generation to
generation.
➢ “It’s always been practiced this
way”
▪ Authoritative Knowledge
➢ an idea by a person of authority
which is perceived as true because
of their expertise.
▪ Scientific Knowledge
➢ type of knowledge which came
from a scientific method through
research.
➢ Tested and measured systemically
using objective criteria
❖ PHENEMENON
- Sets of empirical data or experiences that can
be physically observed or tangible
- Concerned with how an individual reacts
using the human senses concerning their
surrounding and assessing the different
behaviors and factors that affects it.
- In nursing, Phenomena can be:
▪ Clinical or environmental setting of
nursing
▪ Disease process
▪ Client’s behavior
▪ Interventions
▪ Practices (utilized in nursing theories
and metaparadigms)
CHAPTER 2 – THE PURPOSE OF NURSING THEORY
❖ Serves as an excellent help in the
development and expansion of knowledge
❖ Support in different features of learning such
as education, research, and clinical practice.
❖ lies the core structures that give direction and
purpose to those who practice it.
❖ Nursing Theory Development
- Developed to improve the quality of care
rendered by nurses
- Theory development is inherent in the
different nursing fields.
▪ Education
➢ Primarily used to develop and
guide nursing education
➢ More strongly established in the
field of academics rather than in
clinical practice.
➢ In the 1970s & 1980s, nursing
programs recognized the major
concepts of some nursing
models, structured these
concepts into a conceptual
framework, and built the
complete curriculum. (Kozier,
2008)
➢ Terms:
o Program objectives
o Course objectives
o Course description
o Clinical performance
criteria
➢ Ensures adequate and quality
nursing delivery
➢ To clarify and improve the status
of nursing as a profession
▪ Research
➢ Constantly believed that
research in nursing was inspired
from different theoretical
assumptions or conceptual
frameworks in the past.
➢ Development of clear
understanding about the quality
of life
➢ Management of symptoms, an
indication that conceptual
perspectives are constantly
improving. (Kozier, 2008)
o Grand Theories – broad
in scope and complex in
nature; only assist
nursing research in an
occasional manner.
o Middle-Range Theories
– focuses on the
discovery of concepts.
o Critical Theory – used in
the academe to describe
theories that clarify how
social structures
influence a wide variety
of human experiences
and health outcomes of
the patients.
▪ Clinical Practice
➢ Theories thoroughly guide critical
thinking and decision-making in
clinical nursing practice.
➢ A better understanding on the
basis and nature of their work
➢ Express it clearly in collaboration
with other professionals.
➢ Strengthen professional
independence by guiding the
deepest and most important part
of their practice.
➢ Always critical in assisting nurses
to facilitate questions, reflections
and critical thinking in every
aspect of care.
❖ Interdependence Of Theory and Research
- The more research is conducted; the more
learning is gained as to what extent a given
theory can be useful in providing
knowledge that will enhance client’s care.
- Nursing knowledge is composed of both
theoretical and practical knowledge.
- Potter and Perry (2018), Nursing
knowledge is derived from basic and
nursing sciences, experience, aesthetics,
nurse’s attitudes, and standards of
practice.
- The Overall Goal of nursing knowledge is
to explain the practice of nursing as
different and distinct from the practice of
other health care disciplines.
- Composition of Nursing 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
because it is gained through
personal experience and learned
during practice
- Chinn and Kramer (2004) researched is
linked to theory in two ways by generating
and testing.
▪ Theory-Generating research
 ➢ Designed to discover and
describe relationships and
phenomena without imposing
▪ Theory-Testing research
➢ Utilized to determine how
accurate a theory describes a
phenomenon.
➢ Has some predetermined notions
as to how the phenomenon is
and creates hypothesis to test
the assumptions of the theory.
- End result: to enhance nursing knowledge;
apply research based interventions into
practice
- Increase knowledge which in turn improves
nursing care.
- Nursing is evidence-based and is focused on
promoting client satisfaction.
CHAPTER 3 – FOUR WAYS OF KNOWING
❖ Barbara Carper (1978)
- Personal Knowledge or Self Knowledge
(Smith, 1992; Sweeney, 1994) - Achieved
and realized by harnessing the nurse’s
collective stores of knowledge, character,
and profound experience.
❖ Empirical Knowing
- The principal form of relating factual and
descriptive knowing aimed at the
expansion of abstract and theoretical
explanations.
- Focuses on evidence-based research for
effective and accurate nursing practice.
- Empiric ways of knowing has dominated
the nursing profession.
- Nurses are inclined to believe that only
valid and reliable knowledge is factual,
objective, descriptive, and generalizable
(Khuan, 2006).
❖ Evidence-Based Practice (EBP) as part of
Empirical Knowing
- Uses a form of evidence in making clinical
judgement. This evidence or support may
stem from tradition, authority, experience,
trial and error, logic or reason, and
research.
- Involves accurate thought and thoughtful
decision making about health care delivery
for clients.
- Based on the result of the most relevant
and supported evidence derived from
research in response to client’s
preferences and expectations.
❖ Evidence Reports
- Benefield (2002), Evidence report is
comprised of knowledge, synthesis,
review, and documentation of how
evidence-based practices are being
implemented in the clinical area.
▪ Systemic Review
➢ Utilizes all relevant literature
from multiple sources and
undergoes systematic
evaluation.
▪ Literature Review
➢ Provides a qualitative summary
of evidences on a topic using
informal or subjective methods
to collect and interpret studies.
- A structured research summary statement
should briefly describe the evidence
reports.
- The level of evidence ranks the strength
and the quality of the study results.
- Research findings should also be evaluated
within the context of actual or potential
usefulness in the practice.
❖ Aesthetic Knowing
- Related to understanding what is of
significance to particular patients (Carper,
1978)
- The comprehension of meaning in a
singular, particular, subjective expression
that we call the art of nursing (Khuan,
2006)
- Focuses on empathy – the ability for
sharing or vividly understanding another’s
feeling.
❖ Ethical Knowing
- Requires knowledge of different
philosophical positions regarding what is
good and right in making moral actions and
decisions, particularly in the theoretical
and clinical components of nursing.
- Code of Morals or Code of Ethics – leads
the conduct of nurses, deeply rooted in the
concepts of human dignity, service, and
respect for life.
-
❖ Personal Knowing
- Encompasses knowledge of the self in
relation to others and to self.
- Involves entirely of the nurse-client
relationship
- Khuan (2006), reflection and response are
the processes of personal knowing.
- key to comprehending heath in terms of
personal well-being and involves the
therapeutic use of self.