Philosophies

The Environmental Theory

was developed by Florence Nightingale, often considered the founder of modern nursing. Her Environmental
Theory, also known as the "Theory of Environmental Adaptation," focuses on the impact of the environment
on the health and well-being of individuals. Nightingale's theory is particularly relevant to nursing practice and
healthcare design. Here are the key components of Nightingale's Environmental Theory:
1. Environmental Factors:
 Nightingale believed that the environment plays a crucial role in influencing health. She
identified several environmental factors, including clean air, pure water, efficient drainage,
cleanliness, and light, that are essential for maintaining and restoring health.
2. Ventilation and Light:
 Adequate ventilation and natural light were emphasized by Nightingale as critical components
of a healthy environment. She believed that fresh air and sunlight could help prevent the
spread of infection and promote overall well-being.

3. Cleanliness:
 Nightingale strongly advocated for cleanliness in healthcare settings. She believed that
maintaining a clean environment, including the cleanliness of patients, could prevent the
spread of diseases and contribute to the healing process.
4. Noise Control:
 Nightingale recognized the importance of minimizing noise in healthcare environments. She
believed that a quiet and peaceful environment was conducive to healing and recovery.
5. Provision of Comfort:
 Nightingale emphasized the importance of providing comfort to patients. This includes physical
comfort through appropriate bedding, clothing, and nutrition, as well as psychological comfort
through compassionate care and support.
6. Supporting the Body's Healing Processes:
 Nightingale's theory acknowledges the body's natural ability to heal. By providing a supportive
environment with proper ventilation, sanitation, and other essential factors, nurses can
enhance the body's healing processes.
7. Holistic Approach:
 Nightingale's Environmental Theory takes a holistic approach to health. It considers the
physical, social, and psychological aspects of the environment and how they collectively
influence an individual's well-being.
8. Role of the Nurse:
 Nightingale saw the nurse as a change agent in the environment. Nurses have a responsibility to
create and maintain a healing environment that supports patients in their recovery.
Florence Nightingale's Environmental Theory has had a profound and lasting impact on nursing practice and
healthcare design. It emphasizes the importance of considering the environment as a determinant of health
and underscores the nurse's role in creating a supportive and healing healthcare environment.

Philosophy and Science of Caring

The philosophy and science of caring are integral components of nursing that emphasize the importance of a
holistic, patient-centered approach to healthcare. These concepts are often associated with nursing theories
that highlight the significance of caring in the profession. One of the prominent nursing theories related to the
philosophy and science of caring is Jean Watson's Theory of Human Caring. Here are some key aspects of the
philosophy and science of caring:
Philosophy of Caring:
1. Holistic View of Individuals:
 The philosophy of caring recognizes individuals as holistic beings, encompassing physical,
emotional, social, and spiritual dimensions. It emphasizes the interconnectedness of these
aspects in promoting overall well-being.
2. Patient-Centered Care:
 Caring in nursing philosophy places the patient at the center of the healthcare experience. It
involves understanding and respecting the patient's values, preferences, and unique needs.
3. Therapeutic Relationships:
 Building and maintaining therapeutic relationships is a foundational element of the philosophy
of caring. Nurses aim to establish trust, communication, and empathy to foster healing and
support patients in their healthcare journey.
4. Cultural Sensitivity:

 Caring involves cultural competence, acknowledging and respecting the diverse backgrounds
and beliefs of patients. It requires an understanding of how culture influences health behaviors
and perceptions of care.
5. Promotion of Dignity and Respect:
 Caring philosophy emphasizes treating individuals with dignity and respect. This involves
recognizing and affirming the inherent worth and uniqueness of each person.
Science of Caring:
1. Evidence-Based Practice:
 The science of caring incorporates evidence-based practices to ensure that nursing
interventions are informed by the best available research. This helps in providing effective and
efficient care.
2. Critical Thinking and Clinical Judgment:
 Nurses integrate critical thinking and clinical judgment into their practice to assess, analyze, and
respond to the complex and dynamic healthcare needs of individuals.
3. Health Promotion and Prevention:
 The science of caring extends beyond illness care to include health promotion and prevention.
Nurses play a role in educating and empowering individuals to take an active role in maintaining
their health.
4. Interdisciplinary Collaboration:
 Caring in the context of science involves collaboration with other healthcare professionals to
provide comprehensive and coordinated care. This interdisciplinary approach enhances patient
outcomes.
5. Continuous Learning and Professional Development:
 The science of caring recognizes the dynamic nature of healthcare, requiring nurses to engage
in continuous learning and professional development. Staying updated with current evidence
ensures the delivery of high-quality care.

In summary, the philosophy and science of caring in nursing are interconnected, with the philosophy
emphasizing the humanistic and holistic aspects of care, and the science incorporating evidence-based
practices and a commitment to ongoing professional development. Together, these elements contribute to a
comprehensive and compassionate approach to nursing care.
Theory of Beaurucratic Training
The theory of bureaucratic caring is a nursing theory developed by Dr. Marilyn Anne Ray. This theory emphasizes the
importance of caring in bureaucratic organizations, particularly within the healthcare system. Dr. Ray's theory seeks to
bridge the gap between the bureaucratic structure of healthcare institutions and the essential humanistic aspect of
caring in nursing practice.

Key components of the theory of bureaucratic caring include:

1. Caring as the Central Focus:

 The theory places caring at the center of nursing practice within bureaucratic structures. It asserts that
caring is a fundamental aspect of nursing and should not be overshadowed by administrative and
organizational demands.

2. Caring and Bureaucracy Integration:

 Dr. Ray recognizes the existence of bureaucratic structures in healthcare organizations. However, she
advocates for the integration of caring behaviors within these structures. This means that nurses should
find ways to express care and compassion even within bureaucratic and institutional constraints.

3. Creating a Caring Environment:

 The theory encourages nurses to actively contribute to the creation of a caring environment within the
bureaucratic setting. This involves fostering a culture of empathy, compassion, and mutual respect
among healthcare professionals, administrators, and patients.

4. Humanistic Nursing Practice:

 Dr. Ray's theory promotes a humanistic approach to nursing practice, recognizing the uniqueness and
individuality of each patient. It encourages nurses to go beyond routine tasks and consider the holistic
needs of the patient.

5. Advocacy for Caring:

 Nurses are seen as advocates for caring within bureaucratic systems. This includes advocating for
policies, procedures, and organizational practices that prioritize and enhance the quality of care
delivered to patients.

6. Balancing Bureaucratic and Caring Functions:

 The theory recognizes that nurses operate within bureaucratic systems and are required to perform
administrative and organizational tasks. However, it emphasizes the importance of maintaining a
balance between these functions and the provision of compassionate, patient-centered care.

In summary, the theory of bureaucratic caring by Dr. Marilyn Anne Ray seeks to reconcile the bureaucratic nature of
healthcare organizations with the fundamental humanistic aspects of nursing care. It encourages nurses to navigate the
challenges of bureaucratic structures while preserving and promoting the essential elements of caring in their practice.

Novice to Expert Theory

The Novice to Expert theory, developed by Patricia Benner, is a conceptual framework that describes the stages of skill
acquisition and proficiency in nursing practice. Benner's theory proposes that nurses develop their clinical skills and
knowledge through a series of stages, progressing from novice to expert. This model has been widely influential in
nursing education and practice. The five stages in the Novice to Expert theory are:

1. Novice:

 Novices are beginners with limited experience in a particular area. They rely on rules and guidelines to
perform tasks, and their actions are typically context-free. Novices may struggle with decision-making
and may not fully understand the significance of different clinical cues.

2. Advanced Beginner:

 At this stage, individuals have gained some practical experience and can recognize recurring patterns in
clinical situations. Advanced beginners start to grasp the meaning of certain aspects of patient care and
may begin to make connections between theory and practice.

3. Competent:

 Competent nurses have acquired enough experience to be able to prioritize and plan care based on
long-range goals. They can anticipate potential problems and are more efficient in their clinical decision-
 making. However, competent nurses may still lack the speed and flexibility of more experienced
practitioners.

4. Proficient:

 Proficient nurses demonstrate a more holistic understanding of patient care situations. They can
perceive the entire picture rather than focusing on individual aspects. Proficient nurses have a
heightened situational awareness, allowing them to respond to clinical situations in a more intuitive and
integrated manner.

5. Expert:

 Experts have an extensive background of experience, enabling them to make rapid, intuitive decisions.
They have an intuitive grasp of clinical situations and can efficiently manage complex patient care
scenarios. Experts often rely on an innate understanding of patient needs and may not explicitly
articulate their decision-making processes.

Benner's theory emphasizes the importance of experiential learning in nursing and challenges the notion that nursing
expertise can be solely attained through theoretical knowledge. It recognizes that practical experience and exposure to
diverse clinical situations are essential for the development of nursing expertise.

This theory has practical implications for nursing education, as it suggests that educational programs should provide
opportunities for students to engage in hands-on, experiential learning to progress through the stages of skill acquisition
from novice to expert. It also highlights the significance of mentorship and ongoing professional development in the
nursing profession.

Philosophy of Caring in Nursing

by Kari Martinsen:

I believe that caring is the core of nursing practice, transcending the technical aspects to connect with the profound and
unique essence of each individual. Drawing inspiration from Kari Martinsen's perspective, my philosophy of caring is
rooted in the understanding that true care involves meeting patients at the intersection of vulnerability and strength,
embracing their humanity with respect and empathy.

In summary, my philosophy of caring in nursing, influenced by Kari Martinsen's perspectives, revolves around
attunement, ethical awareness, embodied understanding, recognizing vulnerability as strength, and narrative
competence. Through these tenets, I aim to contribute to a caring and humanistic approach to nursing that respects the
inherent worth and dignity of each person entrusted to my care.

Modelling and Role Modelling Theory

The Modeling and Role Modeling Theory was developed by nursing theorist Helen Erickson, Evelyn Tomlin, and Mary
Ann Swain. This theory emphasizes the importance of understanding and respecting the unique perspectives and
experiences of individuals in nursing care. It provides a framework for nurses to develop therapeutic relationships and
deliver patient-centered care. Here are the key concepts of the Modeling and Role Modeling Theory:

1. Modeling:

 Modeling refers to the process of the nurse modeling (demonstrating) caring behaviors, empathy, and
respect for the patient. The nurse serves as a role model for the patient, showing genuine concern and
understanding.

2. Role Modeling:

 Role modeling involves the nurse recognizing and supporting the patient's unique perspectives, values,
and experiences. The nurse aims to understand the world from the patient's point of view and
encourages the patient to express their needs and desires

In summary, the Modeling and Role Modeling Theory in nursing places a strong emphasis on individualized, holistic, and
culturally sensitive care. It encourages nurses to be role models of caring behaviors and to recognize and support the
unique perspectives of each patient in the pursuit of optimal health and well-being.
Conceptual Models and
Grand Theories
The Conservation Model
is a nursing theory developed by Myra Estrin Levine. It provides a framework for understanding and organizing nursing
care based on the conservation principles. Levine's model emphasizes the importance of promoting adaptation and
maintaining wholeness through the conservation of energy, structural integrity, personal integrity, and social integrity.
Here are the key components of the Conservation Model:

1. Conservation Principles:

 The Conservation Model is built on four conservation principles:

 Conservation of Energy: The individual's ability to preserve and use energy efficiently.

 Conservation of Structural Integrity: The preservation of physical structures and functions in

the body.

 Conservation of Personal Integrity: The individual's ability to maintain a sense of self and
personal identity.

 Conservation of Social Integrity: The preservation of social structures and relationships.

2. Adaptation:

 The central concept of the model is adaptation. Levine posits that nursing interventions should focus on
assisting individuals to adapt to stressors and challenges in their environment while conserving energy
and integrity.

3. Wholeness:

 Levine emphasizes the importance of maintaining wholeness, recognizing that individuals are holistic
beings with interconnected physical, psychological, and social dimensions. Nursing care should strive to
promote balance and harmony in these dimensions.

In summary, Myra Levine's Conservation Model in nursing is centered on the principles of energy conservation,
structural integrity, personal integrity, and social integrity. The model guides nurses in promoting adaptation,
maintaining wholeness, and providing individualized care that respects the client's personal and social identity.

The Science of Unitary Human Beings (SUHB)

is a nursing theory developed by Martha E. Rogers. This theoretical framework, often referred to as the Rogerian
Nursing Science, departs from traditional medical models and focuses on viewing individuals as integral, unified wholes.
Here are key concepts of the Science of Unitary Human Beings:

1. Unitary Human Beings:

 Individuals are considered as irreducible wholes, inseparable from their environments. The unitary
human being is a dynamic system of energy fields, continuously interacting with and evolving within the
environmental field.

2. Energy Fields:

 The central concept in the Science of Unitary Human Beings is the energy field, which encompasses the
person and their environment. Rogers posits that the energy field is irreducible and cannot be divided
into smaller parts. Changes in the energy field are viewed as simultaneous changes in the person and
the environment.

3. Open Systems:

 Human beings are seen as open systems, constantly exchanging energy and information with their
environment. This perspective contrasts with closed-system views common in traditional medical
models.

4. Pattern and Organization:

 Rogers emphasizes the importance of pattern and organization in the human energy field. Health is
considered a harmonious integration of patterns, while illness results from disruptions in the field's
organization.

5. Three Dimensions of Time:

 SUHB incorporates three dimensions of time: past, present, and future. These dimensions influence the
energy field and contribute to the uniqueness of each individual's experience.
The Self-Care Deficit Nursing Theory
was developed by Dorothea Orem. This theory, also known as the Orem Model of Nursing, revolves around the concept
of self-care and the role of nursing in assisting individuals who are unable to meet their own self-care needs. Here are
the key components of the Self-Care Deficit Nursing Theory:

1. Self-Care:

 Orem defines self-care as the practice of activities that individuals initiate and perform on their own
behalf to maintain life, health, and well-being. Self-care activities can include both basic activities of
daily living (ADLs) and more complex health-related behaviors.

2. Self-Care Agency:

 Self-care agency refers to an individual's ability to engage in self-care activities. It involves the person's
capacity to recognize their needs, make decisions, and perform actions to meet those needs.

3. Self-Care Deficit:

 According to Orem's theory, nursing comes into play when individuals are unable to perform adequate
self-care due to limitations in their self-care agency. A self-care deficit arises when there is an
incongruence between the individual's capabilities and the demands of their self-care requisites.

4. Nursing Systems:

 Orem introduces the concept of nursing systems, which are categorized into three types:

 Wholly Compensatory System: Nurses provide all aspects of care for the individual who is
unable to perform any self-care.

 Partly Compensatory System: Both the individual and the nurse share the responsibility for self-
care.

 Supportive-Educative System: Nurses primarily support and educate individuals in their self-
care efforts.

5. Nursing Process:

 The nursing process in Orem's theory involves assessing the individual's self-care abilities, identifying
deficits, and implementing appropriate nursing systems to meet the person's needs. Evaluation is
ongoing to determine the effectiveness of the nursing interventions.

6. Universal, Developmental, and Health Deviation Self-Care Requisites:

 Orem categorizes self-care requisites into three types:

 Universal Requisites: Basic needs common to all individuals.

 Developmental Requisites: Needs that arise during normal growth and development.

 Health Deviation Requisites: Needs related to health challenges or deviations from the norm.

7. Nursing Role:

 The nurse's role is to facilitate the individual's self-care ability, promote independence, and intervene
when self-care deficits exist. Nursing actions are directed toward empowering individuals to engage in
self-care to the best of their abilities.

8. Goal of Nursing:

 The ultimate goal of nursing in Orem's model is to help individuals achieve and maintain a level of self-
care that allows for optimal health and well-being. The nurse's role evolves as the individual's self-care
agency improves.

In summary, the Self-Care Deficit Nursing Theory by Dorothea Orem focuses on the assessment of an individual's ability
to engage in self-care and the role of nursing in compensating for self-care deficits. The theory provides a framework for
understanding the dynamic relationship between individuals and their self-care needs, guiding nursing interventions to
promote independence and well-being.

The Interacting Systems Framework and Theory of Goal Attainment

were developed by Imogene King, a nursing theorist. These theories provide a framework for understanding and guiding
nursing practice. Let's briefly explore each of these concepts:
Interacting Systems Framework:

1. Conceptual Basis:

 The Interacting Systems Framework is based on the premise that individuals and groups are open
systems that interact with their environment. The model acknowledges the dynamic nature of health
and emphasizes the need to consider multiple factors that influence an individual's well-being.

2. System Components:

 King's framework identifies three interacting systems:

 Personal System: The individual's personal characteristics, experiences, and perceptions.

 Interpersonal System: The relationships and interactions between individuals, including

communication and feedback.

 Social System: The broader social context, including cultural and societal influences on health.

3. Concept of Transaction:

 The framework emphasizes transactions, which are the interactions and exchanges between individuals
and their environment. Transactions can involve communication, decision-making, and goal-setting.

4. Role of Nursing:

 Nurses, in this framework, play a crucial role in facilitating and supporting transactions to enhance
individuals' well-being. Nursing interventions are aimed at promoting effective communication,
understanding personal and interpersonal systems, and addressing social factors that impact health.

Theory of Goal Attainment:

1. Concept of Goal Attainment:

 Imogene King's Theory of Goal Attainment focuses on the nurse and patient working together to set and
achieve health-related goals. The central idea is that individuals seek to achieve their personal goals, and
nurses assist in this process.

2. Three Systems of Interaction:

 King identifies three systems of interaction in the goal attainment process:

 Personal System of the Patient: The patient's perceptions, experiences, and personal goals.

 Personal System of the Nurse: The nurse's perceptions, experiences, and professional goals.

 Social System: The broader context, including family, community, and healthcare institutions.

3. Concept of Transaction:

 Transactions involve communication and interactions between the patient and nurse. These
transactions aim to establish shared goals, understanding, and plans for achieving optimal health
outcomes.

4. Role of Nursing:

 The nurse's role is to help individuals identify and clarify their health goals, formulate plans to achieve
these goals, and evaluate the outcomes. Nursing interventions are directed toward enhancing
communication, understanding, and collaboration in the goal-setting process.

5. Assumptions:

 The theory assumes that individuals strive for achievement, have the capacity for growth and
development, and seek to reduce tension and anxiety in their lives. Nurses are viewed as active
participants in the health promotion process.

In summary, Imogene King's Interacting Systems Framework and Theory of Goal Attainment provide a comprehensive
approach to nursing practice. The Interacting Systems Framework outlines the dynamic interactions between personal,
interpersonal, and social systems, while the Theory of Goal Attainment focuses on the collaborative process of setting
and achieving health-related goals between nurses and patients. Together, these frameworks guide nursing
interventions to enhance individuals' well-being and achieve optimal health outcomes.
Betty Neuman's Systems Model
is a nursing theory that provides a comprehensive framework for understanding the complex interactions between
individuals and their environments. This model, often referred to as the Neuman Systems Model, focuses on the impact
of stressors and the role of nursing in promoting stability and wellness. Here are key components of the Neuman
Systems Model:

Central Concepts:

1. Client or Patient:

 The individual or group for whom nursing care is provided. Neuman's model views the client as a
dynamic, open system.

2. Environment:

 The environment includes internal and external factors that influence the client's well-being. Internal
factors involve physiological and psychological aspects, while external factors include social, cultural,
and physical elements.

3. Health:

 Neuman defines health as a dynamic state of being in which the client maintains a sense of well-being
and equilibrium. Illness is viewed as a deviation from this state.

4. Nursing:

 The role of nursing is to assist individuals in maintaining or regaining stability in the face of stressors.
Nursing interventions focus on preventing or managing stressors to promote optimal health.

5. Stressors:

 Stressors are any factors that disrupt the stability of the client's system. They can be internal or external
and may be of various origins, such as psychological, physiological, or socio-cultural stressors.

6. Prevention as Primary Nursing Intervention:

 Neuman emphasizes the importance of preventive interventions to maintain client stability and prevent
the negative effects of stressors. Nurses aim to strengthen the client's lines of defense and resistance.

7. Lines of Defense and Resistance:

 Neuman identifies three lines of defense:

 Normal Line of Defense: The usual state of equilibrium.

 Flexible Line of Defense: The range of responses that the client can use to adapt to stressors.

 Lines of Resistance: The factors that protect the client's normal line of defense.

Summary:

The Neuman Systems Model is a holistic and preventive approach to nursing that considers individuals as dynamic
systems interacting with their environments. It emphasizes the importance of understanding stressors, strengthening
lines of defense, and promoting stability and wellness through nursing interventions. The model guides nurses in a
systematic process of assessment, diagnosis, planning, implementation, and evaluation to address the complex and
dynamic nature of health and well-being.

The Adaptive Model

is a nursing theory developed by Sister Callista Roy, a nursing theorist and professor. This theory is formally known as
the "Roy Adaptation Model." It is a comprehensive framework that guides nursing practice and research, with a focus on
the adaptation of individuals to various health and environmental conditions.

The Roy Adaptation Model is based on the idea that individuals are biopsychosocial beings who constantly interact with
their environment. Sister Callista Roy proposed that nursing should be concerned with helping individuals adapt to these
environmental changes in order to maintain or restore health.

The model consists of several key components:

1. Person: The person is the central focus of nursing care. In this model, a person is seen as a biopsychosocial being
with adaptive systems that interact with the environment.

2. Health: Health is viewed as a state of physical, psychological, and social well-being, and it is affected by the
person's ability to adapt to changes in the environment.
 3. Environment: The environment includes all the internal and external factors that can influence an individual's
health and well-being. This can include physical, social, and cultural factors.

4. Adaptation: Adaptation is the process by which individuals respond to changes in their environment. It involves
both coping with and adjusting to these changes.

5. Nursing: Nursing is seen as a profession that helps individuals adapt to changes in their environment to promote
and maintain their health.

The Roy Adaptation Model provides a framework for assessing an individual's adaptation levels, identifying factors that
may be affecting their ability to adapt, and implementing nursing interventions to facilitate adaptation. The goal is to
help individuals achieve optimal adaptation and maintain or restore their health.

This model has been influential in nursing practice and research, and it emphasizes the importance of individualized care
and holistic nursing approaches. It also highlights the dynamic nature of health and the need for nurses to assess and
support a person's ability to adapt to changing circumstances.

The Behavioral System Model

is a nursing theory developed by Dorothy E. Johnson, a nurse theorist. Johnson's model, often referred to as the
"Johnson Behavioral System Model," was first proposed in 1968 and has since been influential in nursing education,
research, and practice.

Key components of the Johnson Behavioral System Model include:

1. Behavioral Subsystems: According to Johnson, the individual is a behavioral system composed of seven
subsystems. These subsystems are:

 Attachment-Affiliative

 Dependency

 Ingestive

 Eliminative

 Sexual

 Aggressive

 Achieving

Each subsystem has its own patterns of behavior and response, contributing to the overall adaptation of the individual.

2. Environment: The environment is an external system that surrounds and influences the individual. It includes
both the internal and external factors that impact the individual's behavioral responses.

3. Stimuli: Stimuli are events or situations in the environment that trigger a response from the individual. They can
be internal or external and can influence the individual's behavior and adaptation.

4. Critical Influences: Critical influences are factors that can affect the stability of the behavioral system. These
influences may include stressors, support systems, and developmental milestones.

5. Johnson's Nursing Process: The model outlines a nursing process that includes assessment, nursing diagnosis,
goal setting, intervention, and evaluation. Nurses use this process to understand the individual's behavioral
system, identify areas of potential instability, and intervene to promote adaptation.

6. Concept of Balance: Johnson emphasizes the concept of balance in the behavioral system. Adaptation is
achieved when the behavioral subsystems maintain a level of equilibrium in response to internal and external
stimuli.

The Behavioral System Model provides a framework for understanding the dynamic interplay between an individual's
behavioral subsystems, the environment, and the stimuli that influence behavior. It guides nurses in assessing and
intervening to promote adaptation and maintain balance within the behavioral system.

Nurses using this model would focus on understanding the patient's behaviors within each subsystem, identifying any
disruptions or imbalances, and implementing interventions to restore equilibrium and promote adaptation to changing
conditions. The model underscores the importance of the nurse's role in facilitating the patient's ability to respond to
stimuli and maintain a state of balance in their behavioral system.
"Nursing as Caring: A Model for Transforming Practice"
is a nursing theory developed by Anne Boykin and Savina Schoenhofer. The Nursing as Caring theory was first published
in the early 1990s and has been influential in shaping the philosophy of nursing care. This model emphasizes the
humanistic and caring aspects of nursing, viewing nursing as both a science and an art.

Key concepts of the Nursing as Caring theory include:

1. Caring as the Central Focus: The theory places caring at the center of nursing practice. It views caring as a
fundamental and unique aspect of nursing that goes beyond tasks and procedures. Caring is seen as a moral
imperative and the essence of nursing.

2. Persons as Caring Beings: Boykin and Schoenhofer conceptualize individuals as caring beings, highlighting the
importance of recognizing and respecting the uniqueness and dignity of each person. The model encourages
nurses to see beyond the patient's illness and to appreciate their holistic humanity.

3. Nursing as a Discipline of Knowledge and Practice: The theory recognizes nursing as both a discipline of
knowledge and a practice. It encourages the integration of scientific knowledge with the art of caring in nursing
practice.

4. Caring Occurs in Multiple Contexts: The Nursing as Caring model acknowledges that caring occurs within various
contexts, including the nurse-patient relationship, family dynamics, and the broader healthcare system. It
emphasizes the interconnectedness of individuals within these contexts.

5. Intentionality of Caring: The model underscores the intentional nature of caring in nursing. Nurses are
encouraged to be present, fully engaged, and responsive to the needs of individuals under their care.

6. Caring as a Transformative Process: Caring is viewed as a dynamic and transformative process that influences
both the nurse and the person receiving care. The model suggests that caring has the potential to contribute to
healing and personal growth for both the caregiver and the care recipient.

The Nursing as Caring theory has been influential in promoting a more holistic and humanistic approach to nursing. It
has implications for nursing education, practice, and research, encouraging nurses to reflect on the meaning and
significance of their caring role in the lives of those they serve. This model has also influenced the development of
curricula and educational programs that emphasize the importance of the nurse-patient relationship and the ethical
dimensions of caring in nursing practice.

Care Core Cure Model

Lydia Hall, The cure is the attention given to patients by medical professionals. Hall explains in the model that
the nurse shares the cure circle with other health professionals, such as physicians or physical therapists.
These are the interventions or actions geared toward treating the patient for whatever illness or disease they
are suffering from.
The care circle addresses the role of nurses and is focused on performing the task of nurturing patients. This
means the “motherly” care provided by nurses, which may include comfort measures, patient instruction, and
helping the patient meet his or her needs when help is needed. Nurses function thru 3 circles but to different
degrees.

The Health Promotion Model (HPM)

is a theoretical framework developed by nursing theorist Nola J. Pender. It was first proposed in 1982 and has
undergone revisions since then. The model is designed to guide health-promoting behaviors and activities to
enhance well-being. Pender developed the HPM as a complement to existing health models and theories,
integrating concepts from various disciplines.
Key components of the Health Promotion Model include:
1. Individual Characteristics and Experiences:
 Prior-related behavior and personal factors: Past experiences and behaviors play a role in
shaping current health behaviors. Personal factors such as age, gender, and biological factors
also influence health choices.
 Personal biographical factors: These include demographic variables such as age, gender, and
race, as well as socioeconomic status and education.
  Perceived health status and benefits of action: Individuals assess their own health and the
benefits of taking a particular health-related action. Perceptions of health risks and the
effectiveness of the recommended behavior influence the likelihood of adoption.
2. Behavior-Specific Cognitions and Affect:
 Perceived self-efficacy: This refers to an individual's belief in their ability to successfully
perform a behavior. Higher levels of self-efficacy are associated with increased likelihood of
engaging in health-promoting behaviors.
 Perceived barriers to action: Individuals evaluate the obstacles or challenges that may hinder
them from adopting a health-promoting behavior. Identifying and addressing these barriers is
crucial for behavior change.
 Perceived benefits of action: Individuals weigh the positive outcomes and advantages
associated with adopting a particular behavior.
3. Behavioral Outcomes:

 Commitment to a plan of action: Once individuals decide to adopt a health-promoting

behavior, they commit to a specific plan of action.
 Immediate competing demands and preferences: Other factors and priorities may compete
with the commitment to the health-promoting behavior.
 Health-promoting behavior: The ultimate goal is the adoption and maintenance of the desired
health-promoting behavior.
4. Sociocultural Influences:
 Interpersonal influences: The impact of family, peers, and social support on health behaviors.
 Situational influences: Environmental and situational factors that may facilitate or hinder the
adoption of health-promoting behaviors.
 Cultural influences: The influence of cultural values, beliefs, and norms on health-related
decisions.
The Health Promotion Model provides a comprehensive framework for understanding and promoting health
behaviors. It emphasizes the importance of individual perceptions, self-efficacy, and social and cultural factors
in the adoption of health-promoting behaviors. It is commonly used in nursing and health education to guide
interventions and programs aimed at promoting wellness and preventing illness.

Helping Art of Clinical Nursing

Ernestine Wiedenbach, a nursing theorist, developed the "Helping Art of Clinical Nursing" conceptual model.
Her work is primarily outlined in her book titled "Clinical Nursing: A Helping Art," which was first published in
1964. The model emphasizes the importance of the nurse-patient relationship and the role of nursing in
meeting the patient's needs.
Here are the key components of Wiedenbach's Helping Art of Clinical Nursing:
1. Philosophical Foundation:
 Wiedenbach's model is grounded in the philosophy that nursing is an art, and the essence of
nursing lies in understanding the patient's needs and helping them meet those needs.
2. Central Theme:
 The central theme of Wiedenbach's model is the identification and fulfillment of patient needs.
She focuses on the nurse's responsibility to understand and interpret the patient's behavior,
identify their needs, and take appropriate actions to meet those needs.
3. Clinical Nursing Process:
 Wiedenbach proposed a clinical nursing process that involves three major steps:
 Determining the patient's need for help: This step involves assessing the patient's
behavior and identifying any expressions of discomfort or need for assistance.
  Determining the appropriate course of action: Once the needs are identified, the nurse
must decide on the most suitable course of action to help the patient.
 Implementing the action: The nurse then carries out the chosen course of action to
meet the patient's needs.
4. Nursing Art:
 Wiedenbach emphasized the artistry of nursing, suggesting that the nurse should use creativity
and intuition to understand the patient's needs and provide individualized care.
5. Helping Relationship:
 The nurse-patient relationship is considered essential for effective care. Wiedenbach
emphasized communication and understanding as key elements in establishing a therapeutic
relationship.
It's important to note that while Wiedenbach's model has contributed to the understanding of nursing care,
the field of nursing theory has evolved over time, and various other models and frameworks have been
developed. The Helping Art of Clinical Nursing remains a significant contribution to the humanistic aspects of
nursing care. If you are looking for more recent developments or critiques of this model, consulting
contemporary nursing literature would be beneficial.
Middle Range Nursing
Theories
The Maternal Role Attainment Theory
was developed by Ramona Mercer, a nursing theorist, and researcher. Mercer introduced this theory to
explore and explain the process through which a woman becomes a mother. Her work in this area has had a
significant impact on the field of maternal-child health nursing.
Key components of the Maternal Role Attainment Theory include:
1. Maternal Role Attainment Process:
 Mercer proposed that the process of becoming a mother involves several stages. These stages
include:
 Anticipatory stage: During pregnancy, a woman begins to form expectations and
attitudes about motherhood.
 Formal stage: This stage occurs after childbirth when the woman focuses on caring for
her newborn and learning maternal behaviors.
 Informal stage: Over time, the woman develops her own unique mothering style and
integrates the maternal role into her identity.
2. Four Maternal Tasks:
 Mercer identified four tasks that women go through in the process of maternal role attainment:
 Seeking safe passage: The mother seeks information and support during pregnancy and
birth to ensure a safe transition to motherhood.
 Securing a sense of connectedness: The mother establishes a bond with her baby
during pregnancy and after birth.
 Learning to give and take: The mother learns to interpret her baby's cues and respond
appropriately.
 Negotiating roles: The mother navigates her role within the family and society,
integrating the maternal role into her identity.
3. Factors Influencing Maternal Role Attainment:
 Mercer identified several factors that can influence the maternal role attainment process,
including the mother's health, the baby's health, and support from family and healthcare
professionals.
4. Mother-Infant Attachment:
 The theory emphasizes the importance of the mother forming a strong emotional bond with
her infant. This attachment is crucial for the infant's well-being and development.
5. Sociocultural Context:
 Mercer acknowledged the impact of cultural and societal factors on the maternal role
attainment process. Different cultures may have varying expectations and practices related to
motherhood.
The Maternal Role Attainment Theory has been widely used in nursing practice, especially in the care of
pregnant women and new mothers. It provides a framework for understanding the dynamic process of
becoming a mother and helps healthcare professionals support women in this transition. The theory has also
influenced research and education in maternal-child health nursing.

The Theory of Uncertainty in Illness

was developed by Merle Mishel, a nursing theorist, in the late 1980s. This theory focuses on how individuals
and families experience and cope with uncertainty when faced with a health-related crisis or illness. Mishel's
work has been particularly influential in the field of nursing, providing insights into the psychological and
emotional aspects of dealing with uncertainty in the context of illness.
Key components of the Theory of Uncertainty in Illness include:
1. Definition of Uncertainty:
 Uncertainty, in this context, refers to the inability to determine the meaning of illness-related
events. It encompasses a lack of information, ambiguity, and unpredictability in the illness
experience.
2. Antecedents of Uncertainty:
 Mishel identified several factors that contribute to uncertainty in illness, including:
 Complexity of the health condition: The more complex and unpredictable the illness,
the greater the uncertainty.
 Ambiguity of information: Incomplete or conflicting information about the illness can
heighten uncertainty.

 Novelty of the situation: If the illness is new or unfamiliar, individuals may experience
increased uncertainty.
 Lack of information from healthcare providers: Insufficient communication from
healthcare professionals can contribute to uncertainty.
3. Cognitive Appraisal:
 Individuals engage in cognitive appraisal, a process of evaluating and interpreting information
about the illness. This appraisal influences their perceptions of uncertainty and coping
strategies.
4. Coping Mechanisms:
 Mishel proposed that individuals employ various coping mechanisms to manage uncertainty.
These mechanisms include seeking information, engaging in positive thinking, and utilizing
social support.
5. Outcome:
 The theory suggests that the individual's ability to manage uncertainty influences the outcome
of their illness experience. Effective coping strategies can lead to a sense of mastery and
reduced psychological distress.
6. Levels of Uncertainty:
 Mishel identified three levels of uncertainty: (1) State Uncertainty, which occurs when
individuals are aware of missing information, (2) Effect Uncertainty, involving the emotional
response to uncertainty, and (3) Response Uncertainty, which refers to the individual's coping
strategies and actions in the face of uncertainty.
The Theory of Uncertainty in Illness has been applied in various healthcare settings, particularly in nursing
practice, to guide interventions aimed at reducing uncertainty and enhancing coping strategies among
patients and their families. It highlights the importance of effective communication, education, and support in
helping individuals navigate the uncertain terrain of illness.

The Theory of Self-Transcendence

was developed by Pamela Reed, a nursing theorist, to explain the process by which individuals move beyond
their own limitations and self-interest to connect with something greater than themselves. Reed's theory is
particularly relevant in the context of nursing and healthcare, emphasizing the potential for personal growth
and well-being through self-transcendence.
Key components of the Theory of Self-Transcendence include:
1. Definition of Self-Transcendence:
  Self-transcendence involves moving beyond the limits of personal concerns, integrating a
broader perspective that encompasses connections to others, nature, and the divine. It is a
process of personal development that goes beyond self-centeredness.
2. Three Levels of Self-Transcendence:
 Reed proposed three levels of self-transcendence:
 Self-Transcendence in Bodily Functioning: This level involves the ability to see beyond
physical limitations and discomforts.
 Self-Transcendence in Self-Concept: Individuals at this level are able to move beyond
egocentrism and consider the perspectives of others.
 Self-Transcendence in Temporal and Spatial Dimensions: This highest level involves
transcending time and space, recognizing a connection to something beyond the
immediate and concrete.
3. Attributes of Self-Transcendence:

 Reed identified specific attributes associated with self-transcendence, including:

 Intrapersonal: Inner strengths, such as creativity, curiosity, and integrity.
 Interpersonal: Connections with others, including empathy, love, and a sense of
community.
 Transpersonal: A connection to something greater than oneself, which may include a
spiritual or existential dimension.
4. Antecedents of Self-Transcendence:
 Various factors contribute to the development of self-transcendence, including personal
experiences, relationships, and exposure to diverse perspectives.
5. Consequences of Self-Transcendence:
 Reed proposed that individuals who experience self-transcendence may achieve a sense of
well-being, inner peace, and a deeper understanding of the interconnectedness of all things.
6. Nursing Implications:
 In the context of nursing, Reed's theory suggests that nurses can play a role in facilitating self-
transcendence in patients by creating environments that support personal growth, providing
holistic care, and recognizing and respecting individual beliefs and values.
The Theory of Self-Transcendence is particularly relevant in healthcare settings where patients may be facing
illness, suffering, or existential questions. By fostering self-transcendence, nurses aim to contribute to the
overall well-being and quality of life of individuals under their care.

The Theory of Illness Trajectory

, developed by Wiener and Dodd, challenges previous theoretical limitations in understanding coping with
illness. It recognizes that illness disrupts various aspects of life, including physiology, social interactions, and
self-perception. Coping responses are complex and situated in the sociological context of living. This theory
frames coping as a dynamic process over time, influenced by biographical and sociological factors. Unlike
linear models, the illness trajectory emphasizes the variability of responses to disruptions caused by illness.
The theory highlights the role of uncertainty in the illness experience but cautions against overemphasizing
uncertainty to the detriment of understanding the dynamic interplay of living with chronic illness. Tolerating
uncertainty is crucial in the illness trajectory theory, recognizing that the trajectory is shaped by the dynamic
flow of uncertainties in both biographical and sociological contexts.

The Theory of Chronic Sorrow

was developed by clinical psychologists and nursing researchers Georgene Gaskill Eakes, Mary Lermann
Burke, and Margaret A. Hainsworth. This theory focuses on the long-term or chronic grief experienced by
individuals living with a chronic illness, disability, or other enduring conditions. The theory recognizes that the
ongoing nature of these situations can lead to persistent feelings of sorrow.
Key components of the Theory of Chronic Sorrow include:
1. Definition of Chronic Sorrow:
 Chronic sorrow refers to a pervasive and enduring sense of grief or sadness that individuals
experience when facing ongoing losses associated with a chronic condition. It is not a
pathological condition but a normal emotional response to the ongoing challenges and losses
inherent in living with a chronic situation.
2. Characteristics of Chronic Sorrow:
 The theory identifies several characteristics of chronic sorrow, including the cyclical nature of
grief, the unpredictability of triggers for sorrow, and the potential for the intensity of sorrow to
vary over time.
3. Antecedents and Triggers:

 Chronic sorrow may be triggered by various factors, such as the diagnosis of a chronic illness,
progressive deterioration of health, limitations in activities of daily living, and societal attitudes
or stigmas associated with the condition.
4. Two Components of Chronic Sorrow:
 Primary Component: This involves the initial grief reaction to the diagnosis or recognition of
the chronic condition.
 Secondary Component: This component reflects the ongoing grief that individuals experience
as they continue to face losses related to the chronic condition over time.
5. Coping Strategies:
 Individuals employ various coping strategies to manage chronic sorrow. These strategies may
include seeking support from others, finding meaning in the experience, and adjusting life goals
and expectations.
6. Role of Healthcare Professionals:
 Healthcare professionals play a crucial role in supporting individuals experiencing chronic
sorrow. Acknowledging and validating the ongoing grief, providing emotional support, and
helping individuals develop coping strategies are essential aspects of care.
The Theory of Chronic Sorrow is particularly relevant in healthcare settings where individuals face chronic
health conditions. It helps healthcare providers and caregivers understand the ongoing emotional challenges
and losses experienced by patients and offers insights into how to provide empathetic and supportive care.
Recognizing and addressing chronic sorrow contributes to a holistic and person-centered approach to
healthcare.

The Tidal Model of Nursing

is a nursing theory and practice framework developed by Phil Barker and Poppy Buchanan-Barker. It is a
person-centered approach that focuses on the individual's experience of mental health and wellness. The Tidal
Model is particularly applied in mental health nursing, but its principles can be relevant to other healthcare
contexts as well.
Key components of the Tidal Model include:
1. Theoretical Foundations:
 The Tidal Model is based on a philosophical foundation that values subjective experiences and
the uniqueness of each individual. It rejects the traditional medical model's emphasis on
pathology and diagnosis and instead places importance on the person's narrative and personal
story.
2. The 10 Commitments of Tidal Model:
 The model is characterized by the "10 Commitments" that guide nursing practice:
  Value the voice: Respect and give importance to the individual's experience and
perspective.
 Respect the language: Use the language that the person employs to describe their
experience.
 Develop genuine curiosity: Be open-minded and curious about the person's narrative.
 Become the apprentice: Acknowledge the person as the expert in their own life and
experiences.
 Use the available toolkit: Utilize the resources and coping mechanisms that the person
already possesses.
 Craft the step beyond: Encourage small steps toward positive change and growth.
 Give the gift of time: Be patient and provide time for the person to express themselves.
 Reveal personal wisdom: Share personal experiences and wisdom to foster a genuine
connection.

 Know that change is constant: Recognize that change is a natural and constant part of
life.
 Be transparent: Maintain openness and honesty in the nurse-client relationship.
3. Assessment and Care Planning:
 Assessment in the Tidal Model involves collaboratively exploring the person's story, identifying
their strengths, and understanding their needs. Care planning is a joint endeavor between the
individual and the nurse, focusing on the person's goals and aspirations.
4. Reclaiming:
 The concept of "reclaiming" emphasizes the person's ability to reclaim aspects of their life,
identity, and wellness that may have been affected by mental health challenges.
5. Storying:
 "Storying" refers to the process of individuals telling their own story and creating meaning from
their experiences. It involves listening to the narrative of the person and respecting their
unique perspective.
The Tidal Model encourages a collaborative and empowering approach in nursing, emphasizing the
importance of the individual's voice, narrative, and personal strengths. It aligns with the broader shift in
healthcare toward person-centered and recovery-oriented practices.

The Theory of Comfort

was developed by nursing theorist Katharine Kolcaba. It is a middle-range nursing theory that focuses on the
holistic experience of comfort as an essential component of nursing care. Kolcaba's theory explores the
dynamic and multifaceted nature of comfort and how it contributes to the well-being of individuals across
various healthcare settings.
Key components of the Theory of Comfort include:
1. Definition of Comfort:

 Kolcaba defines comfort as the immediate and holistic experience of being strengthened
through having physical, psychospiritual, social, and environmental needs met.
2. Three Types of Comfort:
 Relief Comfort: The alleviation of specific sources of discomfort or distress, such as pain or
anxiety.
 Ease Comfort: The state of contentment and freedom from pain, anxiety, or tension.
 Transcendence Comfort: The understanding and acceptance of the complexities of life and the
ability to rise above challenges.
 3. Four Contexts of Experience:
 Kolcaba identified four contexts within which comfort can be experienced:
 Physical Comfort: Related to bodily sensations and the absence of pain or discomfort.
 Psychospiritual Comfort: Involves addressing emotional and spiritual needs, finding
meaning, and experiencing a sense of inner peace.
 Sociocultural Comfort: Pertains to the individual's sense of connection with others,
social support, and cultural considerations.
 Environmental Comfort: Relates to the external surroundings and how they contribute
to the overall sense of comfort.
4. Comfort Interventions:
 Nursing interventions are aimed at promoting comfort and can include both pharmacological
and non-pharmacological approaches. Nurses assess the individual's comfort needs and
implement strategies to enhance comfort in each of the identified contexts.

5. Holistic Perspective:
 The Theory of Comfort takes a holistic approach, recognizing that individuals are complex
beings with physical, emotional, social, and spiritual dimensions. Nursing care, therefore,
should address all aspects of an individual's experience.
6. Comfort Theory Framework:
 Kolcaba's theory includes a diagrammatic representation of the Comfort Theory Framework,
illustrating the dynamic relationships between the concepts of comfort, comfort needs, and
comfort interventions.
The Theory of Comfort is applied in nursing practice to guide holistic care and enhance the overall well-being
of patients. It emphasizes the importance of individualized care that considers the diverse needs and
experiences of patients. The theory has been widely used in various healthcare settings, contributing to the
development of nursing interventions that prioritize the promotion of comfort as a fundamental aspect of
quality care.

Theory of Postpartum depression

Cheryl Tatano Beck is a nursing theorist who has made significant contributions to the understanding of
postpartum depression. Beck's theory, known as the Postpartum Depression Theory, focuses on the
experiences of women who encounter postpartum depression.
Key components of Cheryl Tatano Beck's Postpartum Depression Theory include:
1. Negative Appraisals of Self:
 Beck's theory emphasizes the negative appraisals that women with postpartum depression
have about themselves. These negative self-perceptions can be related to feelings of
inadequacy, guilt, or shame in their role as mothers.
2. Negative Appraisals of the Infant:
 Women experiencing postpartum depression may also have negative appraisals of their infants.
This could involve viewing the baby as difficult, demanding, or expressing feelings of
detachment from the infant.
3. Negative Appraisals of the Relationship with the Partner:
 Beck's theory acknowledges the impact of postpartum depression on the woman's relationship
with her partner. Negative appraisals may extend to feelings of detachment or strain in the
relationship.
4. Disturbances in Maternal-Infant Bonding:
  Postpartum depression, according to Beck's theory, can lead to disturbances in the maternal-
infant bonding process. This might manifest as difficulties in forming a close emotional
connection with the baby.
5. Factors Contributing to Negative Appraisals:
 Beck recognizes various factors that contribute to the negative appraisals experienced by
women with postpartum depression. These factors include a history of depression, lack of
social support, difficult childbirth experiences, and unrealistic expectations of motherhood.
6. Coping Mechanisms:
 Beck's theory explores the coping mechanisms used by women experiencing postpartum
depression. These coping strategies may include seeking support, engaging in self-blame, or
withdrawing from social interactions.
7. The Process of Resolution:
 Beck's theory outlines a process of resolution, where women gradually move away from
negative self-appraisals and emotional distress. This process may involve seeking professional
help, building social support, and engaging in self-care.
Cheryl Tatano Beck's Postpartum Depression Theory provides a comprehensive understanding of the
psychological and emotional experiences of women during the postpartum period. It has influenced research,
clinical practice, and interventions aimed at supporting women who are at risk of or experiencing postpartum
depression. The theory underscores the importance of holistic and individualized approaches in addressing the
multifaceted aspects of postpartum depression.

Theory of Caring
Kristen M. Swanson, a nursing theorist, developed the "Theory of Caring" in the early 1990s. Swanson's theory
focuses on the essence of nursing as caring and highlights the significance of the nurse-patient relationship.
The theory is often referred to as the "Theory of Caring" or "Swanson's Theory of Caring."
Key components of Kristen Swanson's Theory of Caring include:
1. Caring as a Central Nursing Phenomenon:
 Swanson places caring at the core of nursing practice, considering it a fundamental and central
phenomenon in the nursing profession.
2. Five Processes of Caring:
 Swanson identified five processes that characterize caring in nursing:
 Knowing: Striving to understand the patient's unique experience.
 Being with: Being emotionally present and available to the patient.
 Doing for: Taking action to meet the patient's needs and provide assistance.
 Enabling: Facilitating the patient's independence and supporting their capabilities.
 Maintaining belief: Sustaining a sense of confidence and hope for the patient.
3. Caring in the Clinical Setting:
 Swanson's Theory of Caring emphasizes the importance of these caring processes in the clinical
setting, guiding nurses in their interactions with patients.
4. Understanding the Patient's Perspective:
 The theory encourages nurses to go beyond the medical aspects of care and strive to
understand the patient's perspective, values, and unique needs.
5. Caring in Critical Situations:
 Swanson's theory has been particularly applied in critical and challenging situations where
caring plays a crucial role in promoting positive patient outcomes.
 6. Evolution of Caring:
 The theory recognizes that caring is an evolving process that may change over time as the
nurse-patient relationship develops and as the patient's needs and condition change.
Kristen Swanson's Theory of Caring has been influential in shaping the understanding of caring within the
nursing profession. It provides a framework for nurses to conceptualize and enact caring behaviors in their
interactions with patients. The emphasis on knowing, being with, doing for, enabling, and maintaining belief
reflects a holistic and person-centered approach to nursing care.

Peaceful End of Life Theory

Cornelia Ruland and Shirley M. Moore developed the Peaceful End of Life Theory (PEACE). This theory, which
emerged from nursing research, aims to guide nursing care for patients at the end of life, focusing on
promoting a peaceful and meaningful dying experience. The theory emphasizes the importance of person-
centered care, effective communication, and the creation of a supportive environment for patients and their
families during the dying process.
Key components of the Peaceful End of Life Theory include:
1. Assessment and Individualized Care:
 The theory encourages a thorough assessment of the patient's physical, psychological, social,
and spiritual needs. It emphasizes the importance of individualized care plans that consider the
unique preferences, values, and beliefs of each patient.
2. Communication and Shared Decision-Making:
 Effective communication is central to the Peaceful End of Life Theory. It highlights the need for
open and honest communication between healthcare professionals, patients, and their
families. Shared decision-making is encouraged to ensure that the patient's wishes and goals
are respected.
3. Creating a Supportive Environment:
 The theory underscores the significance of creating a peaceful and supportive environment for
patients and their families. This involves providing comfort, managing symptoms, and creating
spaces that allow for privacy and dignity.
4. Promotion of Autonomy and Control:
 The theory advocates for promoting the patient's autonomy and control over the dying process.
It recognizes the importance of respecting the patient's choices, preferences, and decisions
regarding their end-of-life care.
5. Addressing Spiritual and Existential Concerns:
 Recognizing the spiritual dimension of individuals, the theory encourages healthcare providers
to address spiritual and existential concerns. This involves supporting patients in finding
meaning, addressing spiritual distress, and facilitating connections with religious or existential
beliefs.
6. Support for Families and Caregivers:

 Peaceful End of Life Theory acknowledges the impact of end-of-life care on families and
caregivers. It promotes support services, education, and communication to help families cope
with the emotional challenges of losing a loved one.
7. Ethical and Cultural Considerations:
 The theory emphasizes the importance of ethical considerations in end-of-life care and
encourages healthcare providers to be sensitive to cultural differences and diverse beliefs
surrounding death and dying.
8. Quality of Life and Dignity:
 Peaceful End of Life Theory places a strong emphasis on maintaining or enhancing the patient's
quality of life and preserving their dignity throughout the dying process.
Overall, the Peaceful End of Life Theory provides a comprehensive framework for healthcare professionals to
approach end-of-life care with sensitivity, compassion, and a focus on promoting a peaceful and meaningful
transition for patients and their families.
The Theory of Interpersonal Relations
developed by Hildegard Peplau, is a seminal nursing theory that focuses on the nurse-patient relationship and
its impact on the therapeutic process. This theory is also known as the "Interpersonal Relations Theory" and
lays the groundwork for understanding how nurses can effectively interact with patients to facilitate healing
and growth.
1. Orientation Phase:
 In this initial phase, the nurse and the patient establish contact. The nurse helps the patient
understand the purpose of the relationship, clarifies roles, and begins to build trust.
2. Identification Phase:
 The patient begins to identify with the nurse and shares feelings and thoughts more openly.
Trust is developed, and the nurse acts as a resource person, providing information and
guidance.
3. Exploitation Phase:
 The patient uses the therapeutic relationship to explore issues and emotions. The nurse takes
on roles such as teacher, counselor, and leader to assist the patient in problem-solving and
achieving goals.
4. Resolution Phase:
 In the final phase, the nurse-patient relationship concludes. The patient and nurse evaluate the
progress made, express emotions related to termination, and discuss ways the patient can
apply what they've learned.
5. Roles of the Nurse:
 Peplau identified several roles that nurses play in the therapeutic relationship:
 Stranger Role: The nurse is initially unfamiliar to the patient.
 Resource Person Role: The nurse provides information and support.
 Teacher Role: The nurse educates the patient about their health and treatment.
 Leader Role: The nurse helps the patient set and achieve goals.
 Surrogate Role: The nurse may act as a substitute for someone else in the patient's life.
 Counselor Role: The nurse helps the patient understand and integrate their
experiences.
6. Phases of Anxiety:
 Peplau described three phases of anxiety within the nurse-patient relationship:
 Mild Anxiety: The patient is uneasy but can still solve problems and learn.
 Moderate Anxiety: The patient's problem-solving ability is decreased, and they may
need help.
 Severe Anxiety: The patient is unable to solve problems and may exhibit irrational
behavior. Intervention and support are crucial.
7. Therapeutic Use of Self:
 Peplau emphasized the therapeutic use of self by the nurse. This involves self-awareness,
empathy, and effective communication to establish a trusting and therapeutic relationship.
8. Crisis Intervention:
 The nurse is involved in helping the patient and their family cope with crisis situations. Crisis
intervention aims to stabilize the patient and facilitate problem-solving.
Hildegard Peplau's Theory of Interpersonal Relations has had a significant impact on nursing practice,
education, and research. It underscores the importance of the nurse-patient relationship in promoting healing
and the well-being of the patient. The theory continues to be relevant and influential in contemporary nursing
practice.

Theories
The Nursing Process Theory
is not a specific nursing theory developed by a single theorist but rather a systematic and dynamic framework
that guides nursing practice. It is a problem-solving approach that nurses use to deliver patient-centered care.
The Nursing Process involves a series of systematic steps to assess, diagnose, plan, implement, and evaluate
nursing care. Various nursing theorists have contributed to the development and refinement of the Nursing
Process.
The key steps of the Nursing Process include: ADPIE
1. Assessment:
 In this phase, nurses collect data through observation, interviews, and physical examinations to
gather information about the patient's health status, needs, and preferences. Assessment is an
ongoing and dynamic process.
2. Diagnosis:
 Nursing diagnosis involves analyzing the collected data to identify health problems, risks, and
strengths. It's distinct from medical diagnosis and focuses on the patient's response to the
health condition rather than the medical condition itself.
3. Planning:
 In the planning phase, nurses set goals and develop a care plan that outlines interventions to
address the identified nursing diagnoses. The plan is individualized and patient-centered,
considering the patient's preferences and resources.
4. Implementation:
 The implementation phase involves carrying out the planned interventions. Nurses collaborate
with the patient and other healthcare team members to provide holistic care. Interventions can
include health education, administering medications, and performing nursing procedures.
5. Evaluation:
 Evaluation is an ongoing process that involves assessing the effectiveness of the nursing care
and determining if the goals were achieved. Nurses revise the care plan based on the patient's
response to interventions and any changes in the patient's condition.
The Nursing Process provides a systematic and organized framework for nurses to deliver quality and patient-
centered care. It is widely accepted and used in nursing education and practice. While not a theory in itself,
the Nursing Process aligns with various nursing theories and models, incorporating their principles into the
practical aspects of care.
Nursing theorists like Virginia Henderson, Dorothea Orem, and Sister Callista Roy have contributed to the
development and understanding of the Nursing Process by emphasizing the importance of individualized care,
patient self-care abilities, and adaptation to stressors. The Nursing Process serves as a unifying structure that
integrates these theoretical perspectives into clinical practice.

The Cultural Care Diversity and Universality Theory

was developed by Madeleine Leininger, a nursing theorist and anthropologist. This theory, often referred to as
the Transcultural Nursing Theory, emphasizes the importance of understanding and integrating cultural
factors into nursing care. Leininger's theory recognizes the influence of culture on health, illness, and
healthcare practices and aims to provide culturally congruent care.
Key components of the Cultural Care Diversity and Universality Theory include:
1. Cultural Care:
 Leininger defines cultural care as the broadest and most comprehensive aspect of care. It
encompasses the values, beliefs, practices, customs, and lifeways of individuals within a cultural
 group. Cultural care is considered essential for maintaining health, preventing illness, and
promoting well-being.
2. Cultural Care Diversity:
 This dimension of the theory acknowledges the wide range of cultural variations and diversities
that exist among individuals and groups. It emphasizes the need for nurses to recognize and
respect these diversities in providing effective and meaningful care.
3. Cultural Care Universality:
 Cultural care universality refers to the commonalities and shared aspects of care that exist
across different cultures. Despite cultural differences, there are certain fundamental aspects of
care that are universally valued. Leininger encourages nurses to identify and integrate these
universal care practices into their nursing interventions.
4. Sunrise Model:
 The Sunrise Model is a conceptual framework within Leininger's theory that depicts the
interrelationships between cultural care diversity and universality. It illustrates the dynamic
nature of cultural care, emphasizing that care is influenced by individual and cultural factors
and evolves over time.
5. Cultural Competence:
 Cultural competence is a key concept in Leininger's theory. It involves the nurse's ability to
provide culturally congruent care, which means being sensitive and responsive to the cultural
values and practices of the patient. Cultural competence requires ongoing learning, self-
awareness, and a commitment to delivering effective care in diverse cultural contexts.
6. Ethnonursing Research:
 Leininger encourages ethnonursing research, which involves the study of nursing care from the
perspective of a specific cultural group. This research method aims to uncover the unique
cultural care patterns and practices within different populations.
The Cultural Care Diversity and Universality Theory has been influential in promoting culturally competent
nursing practice. It has played a significant role in advancing the understanding of cultural influences on health
and healthcare and has contributed to the development of nursing education programs focused on cultural
competence. Leininger's theory underscores the importance of considering cultural factors in nursing care to
ensure that it is respectful, relevant, and effective for individuals from diverse cultural backgrounds.

The Theory of Health as Expanding Consciousness

was developed by Margaret Newman, a nursing theorist, educator, and researcher. Newman's theory focuses
on the concept of health as a process of expanding consciousness and evolving patterns of understanding. It
represents a departure from traditional models of health that emphasize the absence of illness or disease.
Key components of the Theory of Health as Expanding Consciousness include:
1. Health as Expanding Consciousness:
 Newman defines health as a process of becoming more conscious and more aware of one's
own existence and potential. It is not merely the absence of illness but a dynamic and evolving
state of being.
2. Pattern Recognition:
 According to Newman, individuals continuously interact with their environment and interpret
these interactions through pattern recognition. Patterns represent the way individuals
understand and make sense of their experiences.
3. Consciousness:
 Consciousness, in Newman's theory, is the awareness of the interrelationships between
individuals and their environment. It involves the recognition of patterns and the integration of
new experiences into one's understanding of self and the world.
 4. Rhythmicity:
 Rhythmicity refers to the regular and recurring patterns of change and transformation that
individuals experience as they move through life. These rhythms contribute to the ongoing
process of expanding consciousness.
5. Expanding Consciousness in Illness:
 Even in the presence of illness or disease, Newman's theory posits that individuals can
experience expanding consciousness. Illness is seen as an opportunity for growth and increased
awareness, allowing individuals to transcend limitations and gain new insights.
6. Transformative Change:
 The theory emphasizes the potential for transformative change in health and illness. Through
expanding consciousness, individuals can experience a shift in their understanding of self,
others, and the world, leading to a more profound sense of well-being.
7. Nursing's Role:

 Nurses, according to Newman, play a crucial role in facilitating the process of expanding
consciousness. Nursing care is not just about treating symptoms or managing illness but
involves supporting individuals in their journey toward greater awareness and understanding.
8. Research and Practice:
 Newman encourages nursing research that explores the patterns and rhythms of individuals'
experiences and the impact of health and illness on expanding consciousness. In practice,
nurses are encouraged to engage with patients holistically, recognizing the potential for growth
and transformation.
The Theory of Health as Expanding Consciousness provides a philosophical foundation for nursing that
challenges traditional views of health and illness. It invites nurses to view health as an ongoing process of self-
awareness and growth, with illness seen as an opportunity for transformative change. Newman's theory has
influenced nursing education, research, and practice, contributing to a more holistic and patient-centered
approach to care.

The Theory of Human Becoming

, developed by Rosemarie Rizzo Parse, is a nursing theory that offers a unique perspective on the nature of
human existence, health, and nursing. Parse's theory emphasizes the individual's experience of becoming,
focusing on the dynamic and evolving nature of human life.
Key components of the Theory of Human Becoming include:
1. Three Central Ideas:
 Meaning: Parse posits that humans create their own meanings in every situation, shaping their
unique perspectives and interpretations of experiences.
 Rhythmicity: Rhythmic patterns exist in human life, representing the ever-changing nature of
experiences. Individuals move through various rhythms and patterns as they navigate life's
journey.

 Transcendence: Transcendence involves rising above challenges and moving beyond limits. It is
the process of reaching new understandings and possibilities.
2. Three Dimensions of Human Becoming:
 The Lived Experience: Parse emphasizes the importance of understanding the lived experience
of individuals. This involves recognizing and respecting the uniqueness of each person's
journey.
 Relating to Others: Human becoming occurs in relation to others. Interpersonal relationships
and connections play a significant role in shaping one's existence and understanding.
 Quality of Life: The quality of life is subjective and individualized. It is influenced by the
meanings individuals assign to their experiences and the patterns they create in their lives.
 3. Freedom and Choice:
 Human becoming places a strong emphasis on freedom and choice. Individuals have the
freedom to create their own meanings, rhythms, and patterns, contributing to their continuous
process of becoming.
4. Nursing Practice:
 In nursing practice, Parse suggests that nurses should focus on being present with individuals,
recognizing their unique experiences, and facilitating their process of becoming. Nursing care is
not about controlling or predicting outcomes but about supporting individuals in their journey.
5. Research Methodology:
 Parse introduced a research methodology called the "Human Becoming Hermeneutic Research
Method." This method involves engaging in dialogue with individuals to understand their
perspectives and experiences, recognizing the co-creation of meaning between the researcher
and the participant.

6. Critique of Objectivity:
 Parse challenges the traditional objective approach in nursing and healthcare, advocating for a
more subjective understanding of individuals' experiences. She encourages nurses to move
beyond standardized measures and embrace the unique qualities of each person's journey.
The Theory of Human Becoming offers a philosophical and humanistic perspective on nursing and healthcare.
It has influenced nursing education, research, and practice by encouraging a deeper understanding of the
individual's experience and the importance of personal meanings in the health and healing process.

14 Basic Needs
Virginia Henderson, a renowned nurse theorist, developed a model that emphasizes the importance of
meeting the basic needs of patients to promote health and well-being. Henderson's 14 Basic Needs provide a
comprehensive framework for nursing care. Here are the 14 Basic Needs according to Virginia Henderson:
1. Breathing Normally:
 The ability to breathe unassisted and maintain proper respiratory function.
2. Eating and Drinking Adequately:
 The ability to consume and absorb nutrients for growth and maintenance.
3. Eliminating Bodily Waste:
 The ability to eliminate waste products from the body through urination and defecation.
4. Moving and Maintaining a Desirable Posture:
 The ability to move freely and maintain a comfortable and functional body position.
5. Sleeping and Resting:
 The ability to achieve adequate and restful sleep.
6. Selecting Suitable Clothes:
 The ability to choose and wear clothing appropriate for comfort and protection.
7. Maintaining Body Temperature Within Normal Range:

 The ability to regulate body temperature within a normal range.

8. Keeping the Body Clean and Well-Groomed:
 The ability to maintain personal hygiene and grooming for health and well-being.
9. Avoiding Dangers in the Environment:
 The ability to recognize and avoid potential hazards in the environment.
10. Communicating with Others:
  The ability to express emotions, thoughts, and needs through verbal and nonverbal
communication.
11. Worshipping According to One’s Faith:
 The ability to engage in spiritual or religious practices according to personal beliefs.
12. Working in a Manner That Provides a Sense of Accomplishment:
 The ability to engage in meaningful work and activities that contribute to a sense of
accomplishment.
13. Playing or Participating in Various Forms of Recreation:
 The ability to engage in enjoyable and recreational activities for relaxation and well-being.
14. Learning, Discovering, or Satisfying the Curiosity That Leads to Normal Development and Health, and
Using Available Health Facilities:
 The ability to engage in ongoing learning and seek health information, as well as access health
services when needed.

Henderson's 14 Basic Needs form a comprehensive guide for nursing care, focusing on holistic patient needs
and promoting independence. Nurses can use these principles to assess, plan, and provide patient-centered
care across various healthcare settings.

Typology of 21 Nursing Problems

The Typology of 21 Nursing Problems was developed by Faye Glenn Abdellah, a nursing theorist, in the mid-
20th century. theory emphasizes the importance of understanding the unique needs and challenges faced by
patients and developing appropriate nursing interventions to address these issues. The Typology of 21 Nursing
Problems provides a framework for identifying and addressing various aspects of patient care.
Here is an overview of the Typology of 21 Nursing Problems:
1. Biophysical Problems:
 These problems are related to the physical health and functioning of the patient, including
issues such as illness, injury, or physical disabilities.
2. Psychophysical Problems:
 This category includes problems that involve both the physical and psychological aspects of the
patient. It recognizes the interplay between physical and mental health.
3. Psychosocial Problems:
 Psychosocial problems focus on the patient's emotional and social well-being. This includes
aspects such as relationships, coping mechanisms, and emotional responses to illness.
4. Social Problems:
 Social problems encompass difficulties related to the patient's social environment, including
family dynamics, support systems, and societal factors influencing health.
5. Educational Problems:
 Educational problems relate to the patient's understanding of health information, the ability to
learn, and the need for educational interventions to promote health.

6. Economic Problems:
 Economic problems involve financial challenges that may impact the patient's ability to access
healthcare, medications, and other necessary resources.
7. Environmental Problems:
 Environmental problems pertain to the patient's physical surroundings and living conditions,
considering how the environment influences health.
8. Communication Problems:
  Communication problems focus on difficulties in expressing needs, understanding information,
or interacting effectively with healthcare providers and others.
9. Moral and Ethical Problems:
 Moral and ethical problems involve dilemmas related to values, beliefs, and ethical decision-
making in healthcare.
10. Philosophical Problems:
 This category encompasses problems related to the patient's life philosophy, values, and beliefs
about health and well-being.
11. Religious Problems:
 Religious problems involve challenges related to the patient's religious beliefs, practices, and
spiritual well-being.
12. Cultural Problems:
 Cultural problems consider the impact of the patient's cultural background on their health
beliefs, practices, and preferences.
13. Personal Development Problems:
 Personal development problems focus on issues related to the patient's personal growth, self-
awareness, and self-actualization.
14. Occupational Problems:
 Occupational problems relate to challenges in the patient's work or daily activities that may
affect health.
15. Recreational Problems:
 Recreational problems involve difficulties related to the patient's leisure and recreational
activities.
16. Group Relationships Problems:
 Group relationships problems consider challenges in the patient's interactions with social
groups and communities.
17. Self-Image Problems:
 Self-image problems focus on the patient's perception of themselves and their body image.
18. Role Problems:
 Role problems involve challenges related to the patient's roles in various aspects of life, such as
family, work, or community.
19. Dependency Problems:
 Dependency problems pertain to difficulties the patient may face in relying on others for
support and care.
20. Guilt Problems:
 Guilt problems involve feelings of guilt or remorse that may impact the patient's emotional
well-being.
21. Self-Care Deficit Problems:

 Self-care deficit problems relate to the patient's inability to meet their own basic needs and
require assistance with activities of daily living.
Faye Glenn Abdellah’s Typology of 21 Nursing Problems underscores the importance of a holistic approach to
patient care, considering physical, psychological, social, and environmental factors. It provides a
comprehensive framework for nurses to assess and address the multifaceted needs of individuals under their
care.
Human-to-Human Relationship Model.
Joyce Travelbee, a nursing theorist and psychiatric nurse, developed the Human-to-Human Relationship
Model. This model is often referred to as the Human-to-Human Relationship Theory. Travelbee's theory
focuses on the interpersonal aspects of nursing and the therapeutic relationship between the nurse and the
patient.
Key components of the Human-to-Human Relationship Theory by Joyce Travelbee include:
1. Parties Involved:
 The theory centers on the interaction between two individuals: the nurse and the patient.
Travelbee emphasizes the importance of viewing both the nurse and the patient as unique
individuals with their own experiences, values, and perspectives.
2. Interpersonal Process:
 The theory views nursing as an interpersonal process that involves the establishment of a
therapeutic relationship between the nurse and the patient. This relationship is dynamic and
evolves over time.
3. Purpose of Nursing:
 The primary purpose of nursing, according to Travelbee, is to assist the patient in preventing or
alleviating suffering. The nurse achieves this by engaging in a therapeutic relationship that
addresses the patient's physical, emotional, and spiritual needs.
4. Concept of Suffering:
 Travelbee defines suffering broadly, including physical pain, emotional distress, and spiritual
anguish. The nurse's role is to understand and alleviate the patient's suffering through
compassionate and empathetic care.
5. Empathy and Identification:
 Travelbee emphasizes the importance of empathy in the nurse-patient relationship. The nurse
should strive to understand the patient's experience and identify with their feelings while
maintaining professional boundaries.
6. Mutual Sharing:
 The therapeutic relationship involves mutual sharing of thoughts, feelings, and experiences
between the nurse and the patient. This mutual sharing contributes to the development of
trust and rapport.
7. Interventions and Goals:
 Nursing interventions are directed toward achieving the goals of preventing or alleviating
suffering. These interventions may include physical care, emotional support, and spiritual care,
depending on the patient's needs.
8. Patient Autonomy:
 Travelbee recognizes the importance of respecting the patient's autonomy and individuality.
The nurse should collaborate with the patient in decision-making and care planning.
9. Communication:

 Effective communication is a key component of the therapeutic relationship. The nurse should
use open and honest communication to foster understanding and trust.
10. Transpersonal Caring:
 Travelbee introduces the concept of "transpersonal caring," which involves caring for the
patient as a unique individual and acknowledging the interconnectedness of human
experiences.
The Human-to-Human Relationship Theory has been influential in shaping the understanding of the nurse-
patient relationship in nursing practice. Travelbee's emphasis on empathy, mutual sharing, and the alleviation
of suffering contributes to a holistic and patient-centered approach to care. The theory has been applied in
various healthcare settings to enhance the quality of nursing care and promote positive patient outcomes.

Humanistic Nursing Theory

Josephine Paterson and Loretta Zderad, nursing theorists and practitioners, developed the Humanistic Nursing
Theory. This theory, often referred to as the Humanistic Nursing Theory of Paterson and Zderad, is rooted in
existential phenomenology and emphasizes the importance of understanding the lived experience of
individuals in the context of nursing care.
Key components of the Humanistic Nursing Theory by Paterson and Zderad include:
1. Philosophical Foundation:
 The theory is grounded in existential phenomenology, which is concerned with understanding
the subjective experiences of individuals. Paterson and Zderad advocate for a humanistic
approach to nursing that goes beyond medical or technical aspects.
2. Nursing as a Human Science:
 Paterson and Zderad view nursing as a human science rather than a natural science. They
emphasize the importance of recognizing the uniqueness and individuality of each person in the
context of their health and illness.
3. Interpersonal Process:
 The theory emphasizes the interpersonal process between the nurse and the patient. It
highlights the significance of the nurse's presence, caring, and understanding in promoting
healing and well-being.
4. Lived Experience:
 Understanding the lived experience of individuals is central to the Humanistic Nursing Theory.
The nurse seeks to comprehend the patient's subjective reality, including their thoughts,
feelings, and perceptions.
5. Caring as Essential:
 Caring is considered an essential aspect of nursing. Paterson and Zderad argue that true caring
involves being present with the patient, acknowledging their humanity, and engaging in a
genuine and meaningful relationship.
6. Mutuality and Reciprocity:
 The theory emphasizes mutuality and reciprocity in the nurse-patient relationship. Both the
nurse and the patient contribute to the healing process through their interactions and shared
experiences.
7. Phases of Nursing:
 Paterson and Zderad describe three phases of nursing:
 Orientation Phase: Establishing a connection with the patient.

 Working Phase: Engaging in the caring process and understanding the patient's
experience.
 Resolution Phase: Concluding the nurse-patient relationship.
8. The Art of Nursing:
 Nursing is considered an art that involves creativity, intuition, and responsiveness to the unique
needs of each patient. The nurse's ability to be present and engaged is essential to the art of
nursing.
9. Authenticity and Presence:
  Authenticity and presence are emphasized as crucial qualities for the nurse. Being authentic
and fully present with the patient enhances the therapeutic relationship.
10. Openness to Meaning:
 The nurse remains open to the meaning that the patient attributes to their experiences. This
involves avoiding preconceived judgments and embracing the patient's perspective.
The Humanistic Nursing Theory of Paterson and Zderad has contributed to the development of a humanistic
and patient-centered approach to nursing. It encourages nurses to engage in deep and meaningful
connections with patients, recognizing their humanity and individuality. The theory has influenced nursing
practice, education, and research, promoting a holistic understanding of the person in the context of health
and illness.

CURRENT HEALTHCARE ISSUES

• Cultural beliefs and practices
• Global Health Pandemic
• The Expanding Role of Health Care Professionals
• Health, Wellness, and Safety in the Workplace
• Moral, Ethical, and Legal Considerations in Health Care Practice