Submitted to Symbiosis International (Deemed University)

For
DOCTOR OF PHILOSOPHY
(Faculty of Health Sciences)

Mrs. Mrudula Bipin Phule

( PRN 220500741)
AUGUST -2022

Assignment on
Application of Nursing Theories into Practices

Submitted to
Dr. Sonopant Joshi
Director
Symbiosis College of Nursing

Submitted on 24/3/23
 NURSING THEORIES

Introduction

Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or
event) that is explanatory & predictive in nature. Theories are composed of concepts, definitions, models,
propositions & are based on assumptions. They are derived through two principal methods; deductive
reasoning and inductive reasoning.
Objectives

 to assess the patient condition by the various methods explained by the nursing theory
to identify the needs of the patient
 to demonstrate an effective communication and interaction with the patient.
 to select a theory for the application according to the need of the patient
 to apply the theory to solve the identified problems of the patient
 to evaluate the extent to which the process was fruitful.

1.Definition:

Nursing theory is an organized and systematic articulation of a set of statements related to questions in the
discipline of nursing. A nursing theory is a set of concepts, definitions, relationships, and assumptions or
propositions derived from nursing models or from other disciplines and project a purposive, systematic view
of phenomena by designing specific inter-relationships among concepts for the purposes of describing,
explaining, predicting, and /or prescribing..

Importance of nursing theories:

 Nursing theory aims to describe, predict and explain the phenomenon of nursing
 It should provide the foundations of nursing practice, help to generate further knowledge and indicate
in which direction nursing should develop in the future. Theory is important because it helps us to
decide what we know and what we need to know
 It helps to distinguish what should form the basis of practice by explicitly describing nursing. The
benefits of having a defined body of theory in nursing include better patient care, enhanced
professional status for nurses, improved communication between nurses, and guidance for research
and education
 The main exponent of nursing – caring – cannot be measured, it is vital to have the theory to analyze
and explain what nurses do
 As medicine tries to make a move towards adopting a more multidisciplinary approach to health care,
nursing continues to strive to establish a unique body of knowledge
 This can be seen as an attempt by the nursing profession to maintain its professional boundaries
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 tested.
 Increasing the general body of knowledge within the discipline through the research implemented to
validate them.
 Used by the practitioners to guide and improve their practice.
 Consistent with other validated theories, laws, and principles but will leave open unanswered
questions that need to be investigated.

Purposes of theory in practice:

 Assist nurses to describe, explain, and predict everyday experiences.

 Serve to guide assessment, intervention, and evaluation of nursing care.
 Provide a rationale for collecting reliable and valid data about the health status of clients, which are
essential for effective decision making and implementation.
 Help to establish criteria to measure the quality of nursing care
 Help build a common nursing terminology to use in communicating with other health professionals.
Ideas are developed and words defined.
 Enhance autonomy (independence and self-governance) of nursing by defining its own independent
functions.

If theory is expected to benefit practice, it must be developed co- operatively with people who practice
nursing. People who do research and develop theories think differently about theory when they perceive the
reality of practice. Theories do not provide the same type of procedural guidelines for practice as do
situation- specific principles and procedures or rules. Procedural rules or principles help to standardise
nursing practice and can also be useful in achieving minimum goals of quality of care. Theory is ought to
improve the nursing practice. One of the most common ways theory has been organized in practice is in the
nursing process of analyzing assessment data.
2.Components of theory

DEFINITION

phenomenon

CONCEPT ASSUMPTION

3.Evolution Of Nursing Theories – Application

Contemporary
Era
Theory Era

Research Era

Curriculum
Era
Practice Era
3.Historical perspectives

1860 – FLORENCE NIGHTINGALE

1952 - PEPLAU

1955- HENDERSON

1960 – ABDELLAH
1962- ORLANDO

1968 – DOROTHY JOHNSON

1970 – MARTHA ROGERS

1971-OREM

1971- KING

1972 – NEUMAN

1979 – ROY

1979 – WATSON
 4.THEORY APPLICABLE TO CURRENT STUDY

IMOGENE KING: THEORY OF GOAL ATTAINMENT

Introduction of Theorist
 Born in 1923
 Completed her Bachelor in science of nursing from St. Louis University in 1948
 Completed her Master of science in nursing from St. Louis University in 1957
 Completed her Doctorate from Teacher’s college, Columbia University
King’s Conceptual Framework
It includes:
 Several basic assumptions
 Three interacting systems
 Several concepts relevant for each system
Basic assumptions
 Nursing focus is the care of human being
 Nursing goal is the health care of individuals & groups
 Human beings: are open systems interacting constantly with their environment
 Interacting systems:
personal system
Interpersonal system
Social system
 Concepts are given for each system
Concepts for Personal System
 Perception
 Self
 Growth & development
 Body image
 Space
 Time
Concepts for Interpersonal System
 Interaction
 Communication
 Transaction
 Role
 Stress
Concepts for Social System
 Organization
 Authority
 Power
 Status
 Decision making
Major Theses of King’s conceptual framework
 “Each human being perceives the world as a total person in making transactions with individuals
and things in environment”
 “Transaction represents a life situation in which perceiver & thing perceived are encountered and in
which person enters the situation as an active participant and each is changed in the process of
these experiences”
King’s Theory of Goal Attainment
 Theory of goal attainment was first introduced by Imogene King in the early 1960’s.
 Theory describes a dynamic, interpersonal relationship in which a person grows and develops to
attain certain life goals.
 Factors which affects the attainment of goal are: roles, stress, space & time
Propositions of King’s Theory
From the theory of goal attainment king developed predictive propositions, which includes:
 If perceptual interaction accuracy is present in nurse-client interactions, transaction will occur
 If nurse and client make transaction, goal will be attained
 If goal are attained, satisfaction will occur
 Proposition cont…
 If transactions are made in nurse-client interactions, growth & development will be enhanced
 If role expectations and role performance as perceived by nurse & client are congruent, transaction
will occur
 If role conflict is experienced by nurse or client or both, stress in nurse-client interaction will occur 
 If nurse with special knowledge skill communicate appropriate information to client, mutual goal
setting and goal attainment will occur.
Major concepts of king’s theory
1. Human being /person: is social being who are rational and sentient. Person has ability to :
-perceive
-think
-feel
-choose
-set goals
-select means to achieve goals
-and to make decision
       According to King, human being has three fundamental needs:
(a)  The need for the health information that  is unable at the time when it is needed and can be used
(b)  The need for care that seek to prevent illness, and
(c)  The need for care when human beings are unable to help themselves.
2.     Health:
According to King, health involves dynamic life experiences of a human being, which
implies continuous adjustment to stressors in the internal and external environment through
optimum use of one’s resources to achieve maximum potential for daily living
3.     Environment
Environment is the background for human interactions. It involves:
(a)  Internal environment: transforms energy to enable person to adjust to continuous external
environmental changes.
(b)  External environment: involves formal and informal organizations. Nurse is a part of the patient’s
environment.
4.     Nursing
Nursing: is defined as “A process of action, reaction and interaction by which nurse and
client share information about their perception in nursing situation.” and “ a process of
human interactions between nurse and client whereby each perceives the other and the
situation, and through communication, they set goals, explore means, and agree on means
to achieve goals.”
1.   Action: is defined as a sequence of behaviors involving mental and physical action.
2.   Reaction: not specified, but might be considered as included in the sequence of behaviors described
in action.
3.      In addition king discussed:
(a)    goal
(b)   domain and
(c)    functions of professional nurse
4.    Goal of nurse: “To help individuals to maintain their health so they can function in their roles.”
5.   Domain of nurse: “includes promoting, maintaining, and restoring health, and caring for the sick,
injured and dying.
6.   Function of professional nurse: “To interpret information in nursing process to plan, implement and
evaluate nursing care.
King said in her theory, “A professional nurse, with special knowledge and skills, and a
client in need of nursing, with knowledge of self and perception of personal problems,
meet as strangers in natural environment. They interact mutually, identify problems,
establish and achieve goals.
Theory of Goal Attainment and Nursing Process
Assumptions
Basic assumption of goal attainment theory is that nurse and client communicate
information, set goal mutually and then act to attain those goals, is also the basic
assumption of nursing process.
Assessment
 King indicates that assessment occur during interaction. The nurse brings special knowledge and
skills whereas client brings knowledge of self and perception of problems of concern, to this
interaction.
 During assessment nurse collects data regarding client (his/her growth & development, perception
of self and current health status, roles etc.)
 Perception is the base for collection and interpretation of data.
 Communication is required to verify accuracy of perception, for interaction and transaction.
Nursing diagnosis
 The data collected by assessment are used to make nursing diagnosis in nursing process. Acc. to
king in process of attaining goaI the nurse identifies the problems, concerns and disturbances
about which person seek help.
Planning
 After diagnosis, planning for interventions to solve those problems is done.
 In goal attainment planning is represented by setting goals and making decisions about and being
agreed on the means to achieve goals.
 This part of transaction and client’s participation is encouraged in making decision on the means to
achieve the goals.
Implementations
 In nursing process implementation involves the actual activities to achieve the goals.
 In goal attainment it is the continuation of transaction.
Evaluation
 It involves to finding out weather goals are achieved or not.
 In king description evaluation speaks about attainment of goal and effectiveness of nursing care.
Nursing Process and Theory of Goal Attainment
Nursing process method Nursing process theory
 A system of oriented A system of oriented concepts
actions

Perception, communication and

Assessment
interaction of nurse and client

Planning Decision making about the goals

Be agree on the means to attain
the goals

Implementation Transaction made

Evaluation Goal attained

Title of Study:

• A study to develop , validate & to assess the effectiveness of SOP (Standard operating
protocols) for selected cardiac haemodynamic monitoring with drug monograph
through APIE ( Assessment Planning Implementation Evaluation ) module for staff
nurses working in selected tertiary care hospital of government sector
Objectives of study:
1) To develop SOP( Standard operating protocols ) for cardiac haemodynamic monitoring with
drug monograph through APIE module
2) 2) To validate SOP( Standard operating protocols ) for cardiac haemodynamic monitoring with drug
monograph through APIE module
3) 3) To implement SOP on experimental & control group only
4) 4) To assess the effectiveness of developed SOP on practices of staff nurses on cardiac
haemodynamic monitoring
5) 5) To assess the pre interventional practices score of of staff nurses on cardiac haemodynamic
monitoring in experimental & control group
6) 6) To assess the post interventional practices score of staff nurses on cardiac haemodynamic
monitoring in experimental & control group
7) 7) To find out the association between practices of staff nurses with selected demographic variables
Theoretical Conceptual Framework:
In this study conceptual framework is applied based on Goal Attainment theory ( IMOGENE KING
THEORY)

This goal attaiment theory mainly consist of three components

1) Personal component- in this component participants will undergo specific training like SOP,APIE
module,
2) Interpersonal component- In this component after perceiving certain trainings participants will be
clear with their role,will not have stress, and interact,communicate effectively with other health care
team members
3) Social component- In this component after gaining insight participants will be recognized socially with
status ,can take clinical decision and implement effectively & will be given power ,authority to work
efficiently and independantly
 Social Component
After having SOP & undergone certain training APIE module , pariticipants will
develop trust & status ,decision making skill ,,can control the unforeseen &
ultimately get the power & authority to practice & implement protocol
Interpersonal Component
independantly
Participants will be clear with their role ,
with stressfree environment they will
communicate with other health care team
Personal component
members
Seif perception, self
growth & Development
through SOP , APIE
module

5. SIGNIFICANCE OF NURSING THEORIES IN NURSING PRACTICES

IMPLICATIONS- CONEPTUAL MODEL:

Nursing practice: 

provides general guidelines for nursing practice.  What to look at when interacting with clients, how to
interpret observations.  How to plan interventions in a general manner.  Provides beginning criteria for
evaluation of intervention outcomes.

Nursing education •

General Outline For Curriculum content and teaching learning activities.

• identifies priority concepts, indicates logical sequence for courses progression and format of the evaluation.

• used for curriculum construction, (linked with theories about education and teaching learning process as
well as content from nursing ).

• The resulting conceptual theoretical system then applies to the client, the student and the educator.

Nursing administration

• they can serve as guides to planning organizational structures in health care agencies. For eg, patient
classification systems, staffing patterns.

• Provides structure for goals/objectives of organisation as well as direction for management decision.

• Provides criteria for standards of nursing administration.

• Provides criteria for standards of nursing practice/ quality assurance/ nursing audit programs.

Nursing research

 The precise nature of the problem to be studied/ the purposes to be fulfilled by the investigations.

 Phenomena to be studied

.  Research techniques to be employed and research tools to be used.

 Settings in which data to be gathered and subjects who are to provide the datas.

 The methods to be employed in reducing and analysing the data

.  The nature of contributions that the research will make to the advancement of knowledge

REFERENCES

1. Alligood M R, Tomey A M. Nursing Theory: Utilization &Application .3rd ed. Missouri: Elsevier Mosby
Publications; 2002.

2. Tomey AM, Alligood. MR. Nursing theorists and their work. (5th ed.). Mosby, Philadelphia, 2002

3. George JB .Nursing Theories: The Base for Professional Nursing Practice .5th ed. New Jersey :Prentice
Hall;2002.
1.
2. Alligood M.R, Tomey. A.M. Nursing theory utilization and application. 2nd Ed.
Mosby,  Philadelphia, 2002.
3. George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed.
Norwalk, Appleton & Lange.
4. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia.
Lippincott Williams& wilkins.
5. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed.
Philadelphia,  Lippincott.
6. Taylor Carol,Lillis Carol (2001)The Art & Science  Of Nursing Care 4th ed.
Philadelphia,  Lippincott.
7. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process &
Practice 3rd ed. London Mosby Year Book.
8.  Tomey AM, Alligood. MR. Nursing theorists and their work. (5th ed.).  Mosby, 
Philadelphia, 2002.

THANK YOU