Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
SCIENCE OF UNITARY HUMAN BEINGS
MARTHA ROGERS’ THEORY
Personal Background
 Born on May 12, 1914 at Dallas, Texas.
 Died on March 13, 1994, at 79 years of age.
Education:
 Studied science at the University of
Tennessee (1931-1933)
 Graduated her nursing course at Knoxville
General Hospital School of Nursing (1936)
 Obtained a bachelor of science degree from
George Peabody College in Nashville,
Tennessee (1937)
 Master‟s of arts degree in public health
nursing supervision from Teachers College,
Columbia University, New York (1945)
 Master‟s of public arts degree (1952)
 Doctor of science degree from Johns
Hopkins University in Baltimore (1954)
Historical Background:
 Martha E. Rogers served as a professor and
head of the Division of Nursing at New
York University from 1954 to 1975.
 In 1988, colleagues and students created the
Society of Rogerian Scholars (SRS) to
promote Rogerian nursing theory.
 They began publishing Rogerian Nursing
Science News in 1988 and Visions: The
Journal of Rogerian Nursing Science in
1993.
 The SRS also established the Martha E.
Rogers Fund.
 In 1995, New York University founded the
Martha E. Rogers Center to support
Rogerian research and practice.
Science of Unitary Human Beings
Assumptions:
1. Man is a unified whole possessing his own
integrity and manifesting characteristics that
are more than and different from the sum of
his parts.
2. Man and the environment are continuously
exchanging matter and energy with one
another.
3. The life process evolves irreversibly and
unidirectionally along the space-time
continuum.
4. Pattern and organization identify the man
and reflect his innovative wholeness.
CLARENZBEATRICEB.GOBOT
5. Man is characterized by the capacity for
abstraction and imagery, language and
thought sensation, and emotion.
Two Dimension of SUHB
 The science of nursing, which is the
knowledge specific to the field of nursing
that comes from scientific research; and
 The art of nursing, which involves using the
science of nursing creatively to help better
the lives of the patient.
Concepts of SUHB
 Openness
- There are no boundaries that stop
energy flow between the human and
environmental fields, openness in
Rogers‟ theory. It refers to qualities
exhibited by open systems; human
beings and their environment are
open systems.
 Pattern
- Rogers defined the pattern as the
distinguishing characteristic of an
energy field seen as a single wave. It
is an abstraction and gives identity to
the field.
 Pan-dimensionality
- Pan-dimensionality is defined as a
“non-linear domain without spatial
or temporal attributes.” Humans‟
parameters to describe events are
arbitrary, and the present is relative;
there is no temporal ordering of
lives.
- Synergy is defined as the unique
behavior of whole systems,
unpredicted by any behaviors of their
component functions taken
separately.
 Hemodynamic Principles
- Homeodynamics should be
understood as a dynamic version of
homeostasis (a relatively steady state
of internal operation in the living
system).
 Principle of Reciprocity
- Postulates the inseparability of man
and environment and predicts that
sequential changes in the life process
are continuous, probabilistic
revisions occurring out of the
interactions between man and
environment.
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
 Principle of Synchrony
- This principle predicts that change in
human behavior will be determined
by the simultaneous interaction of
the actual state of the human field
and the environmental field‟s actual
state at any given point in space-
time.
 Principle of Integrality
- Because of the inseparability of
human beings and their environment,
sequential changes in the life
processes are continuous revisions
occurring from the interactions
between human beings and their
environment.
- Between the two entities, there is a
constant mutual interaction and
mutual change whereby
simultaneous molding is taking place
at the same time.
 Principle of Resonancy
- It speaks to the nature of the change
occurring between human and
environmental fields. The life
process in human beings is a
symphony of rhythmical vibrations
oscillating at various frequencies.
- It identifies the human field and the
environmental field by wave patterns
manifesting continuous change from
longer waves of a lower frequency to
shorter waves of higher frequency.
 Principle of Helicy
- The human-environment field is a
dynamic, open system in which
change is continuous due to the
constant interchange between the
human and environment.
- This change is also innovative.
Because of constant interchange, an
open system is never the same at any
two moments; rather, it is continually
new or different.
Major Concepts and Definition
1970
- Life process in human beings
 wholeness
 openness
 unindirectionality
 pattern and organization
 sentience
 thought
CLARENZBEATRICEB.GOBOT
1983
- Four Building Blocks:
 energy field
 universe of open systems
 pattern
 four-dimensionality
- Changed her wording from unitary
man to unitary human being
- Unitary human beings as separate
and different from the term holistic
1992
- Four- dimensionality evolved into
pandimensionality
- Fundamental postulates remained
consistent
Energy Field:
- Fundamental unit of both living and
nonliving
- Infinite and pandimensional
 human field (unitary human being) -
irreducible, indivisible, pandimensional
energy field identified by pattern and
manifesting characteristics that are specific
to the whole and that cannot be predicted
from knowledge of the parts
 environmental field - irreducible,
pandimensional energy field identified by
pattern and integral with the human being
- Both human and environmental
fields change continuously,
creatively, and integrally
Universe of Open Systems
 Energy fields are infinite, open, and integral
with one another.
 Human and environmental fields are in
continuous process and are open systems.
Metaparadigm
Person
- Open system in continuous process
with the open system and that is the
environment. Human being as an
“irreducible, indivisible,
pandimensional energy field
identified by pattern and manifesting
the characteristics that are specific to
the whole”. (Rogers 1992)
Environment
- “Irreducible pandimensional energy
field identified by the pattern and
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
manifesting characteristics different
from those of the parts” . Each
environmental field is specific to its
given human field. It can be both
change continuously and creatively”.
(Alligood, 2013)
Health
- Rogers defines health as an
expression of the life process. The
characteristics and behavior coming
from the mutual, simultaneous
interaction of the human and
environmental fields and health and
illness are part of the same
continuum. The multiple events
occurring during the life process
show how a person is achieving his
or her maximum health potential.
The events vary in their expressions
from greatest health to those
incompatible with the maintaining
life process.
Nursing
-
Nursing exists to serve people, and
the safe practice of nursing depends
on the nature and amount of
scientific nursing knowledge the
nurse brings to his or her practice.
Application to Nursing
Practice
The Rogerian model is an abstract system of ideas
from which to approach the practice of nursing.
Education
Rogers clearly articulated guidelines for the
education of nurses within the Science of Unitary
Human Beings.
Research
Rogers' conceptual model provides a stimulus and
direction for research and theory development in
nursing science.
SYSTEMS MODEL
BETTY NEUMAN
Personal Background:
- Born in 1924 near Lowell, Ohio.
Education:
- Initially attending a one-room
schoolhouse, she was fascinated by
human behavior and pursued RN
studies in 1947 after working as an
aircraft instrument technician during
WWII.
Historical Background:
CLARENZBEATRICEB.GOBOT
 1957 - She received a baccalaureate degree
in Public Health and Psychology.
 1966 - Earned a master‟s degree in Mental
Health, Public Health consultation from
University of California, Los Angeles
(UCLA)
 1967 - 1973 - She developed her first
community mental health program for
graduate students
 1970 - Designed a nursing conceptual model
 1985 - concluded a doctoral degree in
clinical psychology at Pacific Western
University
Assumptions:
 Each client system is unique, a composite of
factors and characteristics within a given
range of responses.
 Many known, unknown, and universal
stressors exist. Each differs in its potential
for disturbing a client‟s usual stability level
or normal line of defense. The particular
interrelationships of client variables at any
point in time can affect the degree to which
a client is protected by the flexible line of
defense against possible reaction to
stressors.
 Each client/client system has evolved a
normal range of responses to the
environment referred to as a normal line of
defense. The normal line of defense can be
used as a standard from which to measure
health deviation.
 When the flexible line of defense is no
longer capable of protecting the client/client
system against an environmental stressor,
the stressor breaks through the normal line
of defense.
 Whether in a state of wellness or illness, the
client is a dynamic composite of the
variables‟ interrelationships. Wellness is on
a continuum of available energy to support
the system in an optimal system stability
state.
 Implicit within each client system is internal
resistance factors known as lines of
resistance, which function to stabilize and
realign the client to the usual wellness state.
 Primary prevention relates to general
knowledge applied in client assessment and
intervention in identifying and reducing or
mitigating possible or actual risk factors
associated with environmental stressors to
prevent a possible reaction.
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
 Secondary prevention relates to
symptomatology following a reaction to
stressors, an appropriate ranking of
intervention priorities, and treatment to
reduce their noxious effects.
 Tertiary prevention relates to the adjustive
processes as reconstitution begins and
maintenance factors move the client back in
a circular manner toward primary
prevention.
 The client as a system is in dynamic,
constant energy exchange with the
environment. (Neuman, 1995)
Concepts:
 Content - The variables of the person in
interaction with the environment.
 Basic structure or central core - Comprises
those basic survival factors common to the
species.
 Degree of reaction - The amount of system
instability resulting from stressor invasion of
the normal line of defense.
 Entropy - A process of energy depletion and
disorganization moving the client toward
illness
 Flexible line of defense - Prevents client
system stressor invasions, keeps the system
free from stressor reactions or symptoms.
 Normal line of defense - Adaptational level
of health developed over time and is
considered normal for a particular individual
client or system; it becomes a standard for
wellness-deviance determination.
 Line of resistance - Protection factors are
activated when stressors have penetrated the
normal line of defense, causing reaction
symptomatology.
 Input-output - The matter, energy, and
information exchanged between the client
and environment entering or leaving the
system at any point in time.
 Negentropy - A process of energy
conservation that increases organization and
complexity, moving the system toward
stability or a higher degree of wellness.
 Open system - A system of organized
complexity, where all elements are in
interaction.
 Reconstitution - Attempt to stabilize the
client and help the return to wellness, a
process.
 Stability - A state of balance or harmony
requiring energy exchanges as the client
CLARENZBEATRICEB.GOBOT
adequately copes with stressors to retain,
attain, or maintain an optimal health level,
thus preserving system integrity.
 Stressors - Model from the idea that unique
nursing techniques may enhance client
healing with an emphasis on stress
management or elimination.
 Prevention as intervention - Intervention
modes for nursing action and determinants
for both client and nurse entry into the
healthcare system.
 Client Variables - Neuman views the
individual client holistically and considers
the variables simultaneously and
comprehensively.
Systems Model Process
Assessment
- Nurses identify stressors and assess
the client's lines of defense.
Nursing Diagnosis
- Determining the degree of wellness
and potential for imbalance in the
client.
Nursing Goals
- Setting objectives to maintain or
restore the client's health and
balance.
Nursing Interventions
- Implementing actions to support the
client's lines of defense and reduce
stressors.
Evaluation
- Assessing whether the client's
condition has improved and if the
goals have been met.
Metaparadigm
Person
The human being is an open system that interacts
with internal and external environment forces or
stressors.
Environment
 a vital arena that is germane to the system
and its function.
 three relevant environments:
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
- (1)The internal environment
- (2)The external environment
- (3)The created environment
Health
 The condition of system stability and is
viewed as a sequence from wellness to
illness.
 When system needs are met, optimal
wellness exists. Death occurs when the
energy needed to support life ceases
Nursing
 Primary concern is to determine the
appropriate action during circumstances that
are stress related or concerns possible
reactions of the client or client system to
stressors
 Nursing interventions strive to help the
system adapt or maintain some degree of
stability between the client system variables
and environmental stressors, focusing on
saving energy.
Application to Nursing
Practice
 Facilitates goal-oriented, unified, wholistic
approaches to client care; also appropriate
for multidisciplinary use to prevent
fragmentation of client care
 Delineates a client system and classification
of stressors
Personal Background:
Lydia Hall was born on September 21, 1906, in
New York City as Lydia Eloise Williams.
Education:
- Lydia Hall graduated from York
Hospital School of Nursing in 1927.
- She entered Teacher‟s College at
Columbia University in New York
and earned a Bachelor of Science
degree in public health nursing in
1932.
- Received a master‟s degree in the
teaching of natural life sciences from
Columbia University in 1942.
Assumptions:
1. The motivation and energy necessary for
healing exist within the patient rather than in
the healthcare team.
2. The three aspects of nursing should not be
viewed as functioning independently but as
interrelated.
3. The three aspects interact, and the circles
representing them change the size,
depending on the patient‟s total course of
progress.
Concepts:

Education

 Well accepted in academe and is used

widely as a curriculum guide
 The model‟s wholistic perspective provides
an effective framework for nursing
education at all levels
 Works equally well to guide clinical
learning
 Used to guide learning in classroom and
clinical settings for multiple levels of
nursing and health-related curricula around Metaparadigm
the world Person

 Focuses on individuals aged 16 and older.

Research
 To generate nursing theory and use of the  Emphasizes uniqueness, growth, and
model as a conceptual framework to learning in each individual.
advance nursing as a scientific discipline  Advocates a holistic approach to care for
those past the acute stage of a long-term
CARE, CURE, CORE NURSING THEORY illness.
LYDIA HALL
CLARENZBEATRICEB.GOBOT
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
Environment School of Nursing and a research
 Implies self-awareness and purposeful associate emeritus (1971 -1996).
behavior. Assumptions:
 Exploring behavior's meaning, problem-  Nurses care for patients until they can care for
solving, and personal growth. themselves once again. Although not precisely
Health explained.
 Hall developed a concept called Loeb Center  Patients desire to return to health.
which focuses on providing an environment  Nurses are willing to serve, and “nurses will
that is conducive to self-development. devote themselves to the patient day and
 The focus of the action of the nurses is the night.”
individual.  Henderson also believes that the “mind and
Nursing body are inseparable and are interrelated.”
 Hall identified Nursing as consisting of
participation in the care, core, and cure Concepts:
aspects of patient care.
Application to Nursing
Practice
- During the assessment phase, nurses
draw upon theoretical frameworks to
collect relevant data and identify
patients' needs, incorporating both
objective and subjective findings.

NEED THEORY
VIRGINIA HENDERSON
Personal Background:
- Virginia Henderson was born in
Kansas City, Missouri, ON
November 30, 1897
Education:
- Army School of Nursing at Walter
Reed Hospital in Washington D.C.
- In 1921, she received her Diploma in
Nursing from the Army School of
Nursing at Walter Reed Hospital,
Washington D.C.
- In 1929, she entered Teachers
College at Columbia University for
her Bachelor‟s Degree in 1932 and
took her Master‟s Degree in 1934.
Historical Background:
- From 1924 to 1929, she worked as
an instructor and educational director
in Norfolk Protestant Hospital, Metaparadigm
Norfolk, Virginia. Person
- 1930, she was a nurse supervisor and - Henderson states that individuals have
clinical instructor at the outpatient basic health needs and require
department of Strong Memorial assistance to achieve health and
Hospital, Rochester, New York. independence or a peaceful death.
- From 1934 to 1948, 14 years of her Environment
career, she worked as an instructor - Henderson stated that maintaining a
and associate professor at Teachers supportive environment conducive to
College, Columbia University in health is one of her 14 activities for
client assistance.
New York.
- Since 1953, Henderson was a - Henderson’s theory supports the
private and public health sector’s tasks
research associate at Yale University
or agencies to keep people healthy.
CLARENZBEATRICEB.GOBOT
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
Health
- It is equated with the independence or
ability to perform activities without aid
in the 14 components or basic human
needs.
- According to Henderson, good health is
a challenge because it is affected by
numerous factors such as age, cultural
background, emotional balance, and
others
Nursing
- She defined nursing as “the unique
function of the nurse is to assist the
individual, sick or well, in the
performance of those activities
contributing to health or its recovery
that he would perform unaided if he
had the necessary strength, will or
knowledge. And to do this in such a way
as to help him gain independence as
rapidly as possible.”
- The nurse’s goal is to make the patient
complete, whole, or independent. In
turn, the nurse collaborates with the
physician’s therapeutic plan.
Application to Nursing
Achieving the goal of meeting the 14 needs of the
client can be a helpful guide in order to improve
one‟s quality of care. The nurse will observe all 14
basic needs of the patient and will determine how to
assess, plan, and evaluate their possibilities
regarding those needs.
BEHAVIORAL SYSTEM MODEL
DOROTHY JOHNSON
Personal Background:
- She was born August 21, 1919 in
Savannah, Georgia and died on
February 4, 1999 at the age of 79 in Key
Largo, Florida
Education:
In 1938, Dorothy got her associate of arts
from Armstrong Junior College in
Savannah, Georgia.
 On June 8, 1942, she received her Bachelor
of Science in Nursing from Vanderbilt
University in Tennessee.
 Finally, in 1948 she received her Master of
public health from Harvard University.
Historical Background:
 From January to July 1943, she worked as
an instructor of nursing at Vanderbilt
University.
CLARENZBEATRICEB.GOBOT
 In 1944, she returned to her academic
career at Vanderbilt University School of
Nursing, a position that she held until 1948.
From 1949 until 1978, she served as
assistant, associate, and professor of
pediatric nursing at the University of
California at Los Angeles.
Assumptions:
 Assumptions about System or How Things
Work Together- People's actions and
feelings are like parts of a machine that
work together. They try to find a balance in
life, and when something's off, they adjust to
make it better.
 Assumptions about Structure and Function
or Why People Do Things- When people do
something, like being happy or sad, it tells
us what they're trying to achieve. Everyone
has their own way of doing things, and they
have different options to choose from.
 Functional Requirements for Subsystems or
Taking Care of Ourselves- We need to
protect ourselves from bad things, get the
right stuff we need, and keep learning and
growing to stay healthy and happy.
Concepts:
Definition
 Dorothy Johnson is known for her
“Behavioral System Model of Nursing,”
which was first proposed in 1968.
 Her nursing model states that “each
individual has patterned, purposeful,
repetitive ways of acting that comprises a
behavioral system specific to that
individual.”
 Her model was greatly influenced by
Florence Nightingale‟s book, Notes on
Nursing.
 It advocates the fostering of efficient and
effective behavioral functioning in the
patient to prevent illness. The patient is
defined as a behavioral system composed of
seven behavioral subsystems: affiliative,
dependency, ingestive, eliminative, sexual,
aggressive, and achievement.
 Defined Nursing as “an external regulatory
force which acts to preserve the organization
and integration of the patient‟s behaviors at
an optimum level under those conditions in
which the behavior constitutes a threat to the
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
physical or social health, or in which illness
is found.”
Goal
1. To assist the patient whose behavior is
proportional to social demands.
2. To assist the patient who can modify his
behavior in ways that supports biological
imperatives.
3. To assist the patient who can benefit to the
fullest extent during illness from the
physician‟s knowledge and skill.
4. To assist the patient whose behavior does
not give evidence of unnecessary trauma as
a consequence of illness.
Model
Behavioral System
Man is a system that indicates the state of the
system through behaviors.
System
That which functions as a whole under organized
independent interaction of its parts.
Subsystem
A mini system is maintained concerning the entire
system when it or the environment is not disturbed
Process
1. · Begins with patient assessment
and diagnosis.
· Develops a nursing care plan with
interventions.
· Ends with evaluation based on
subsystem balance
CLARENZBEATRICEB.GOBOT
2. · Most useful in the evaluation
phase.
· Assesses balance in the patient's
subsystems.
· Nurse success involves helping
the patient maintain behavioral
system equilibrium during illness in
the biological system.
Metaparadigm
Person
Johnson views human beings as having two major
systems: the biological system and the behavioral
system.
Environment
The environment is not directly defined, but it is
implied to include all elements of the human system’s
surroundings and includes interior stressors.
Health
Seen as the opposite of illness, and Johnson defines
it as “some degree of regularity and constancy in
behavior. The behavioral system reflects
adjustments and adaptations that are successful
somehow, and to some degree… adaptation is
functionally efficient and effective.”
Nursing
Seen as “an external regulatory force that acts to
preserve the organization and integrate the patient‟s
behavior at an optimal level under those conditions
in which the behavior constitutes a threat to
physical or social health or in which illness is
found.”
Application to Nursing:
Focuses on how the client adapts to illness; the
goal of nursing is to reduce stress so that the client
can move more easily through recovery. Viewed
the patient's behavior as a system, which is a whole
with interacting parts.
HUMAN-TO-HUMAN RELATIONSHIP
MODEL
JOYCE TRAVELBEE
Personal Background:
- Joyce E. Travelbee was born on
December 14, 1925 in New Orleans.
Education:
- Travelbee had a BSN from Louisiana
State University (1956) and an MSN
from Yale University (1959).
Historical Background:
- She worked as a psychiatric nursing
instructor at several institutions.
Assumptions:
Nursing is fulfilled by means of human-to-human
relationships. She defined nursing as “an
interpersonal process whereby the professional
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
nurse practitioner assists an individual, family or
community to prevent or cope with the experience
of illness and suffering, and if necessary, to find
meaning in these experiences”.
Concepts:
Suffering
"An experience that varies in intensity, duration and
depth ... a feeling of unease, ranging from mild,
transient mental, physical or mental discomfort to
extreme pain and extreme tortured ..."
Meaning
Meaning is the reason as oneself attributes
Nursing
 Is to help man to find meaning in the
experience of illness and suffering.
 Has a responsibility to help individuals and
their families to find meaning.
 The nurses' spiritual and ethical choices, and
perceptions of illness and suffering, is
crucial to helping to find meaning.
Hope
 Nurse's job is to help the patient to maintain
hope and avoid hopelessness.
 Hope is a faith that can and will be change
that would bring something better with it.
 Hope's core lies in a fundamental trust the
outside world, and a belief that others will
help someone when you need it.
 Six important factors charecteristics of hope
are:
1. It is strongly associated with
dependence on other people.
2. It is future oriented.
3. It is linked to elections from several
alternatives or escape routes out of
its situation.
4. The desire to possess any object or
condition, to complete a task or have
an experience.
5. Confidence that others will be there
for one when you need them.
6. The hoping person is in possession
of courage to be able to acknowledge
its shortcomings and fears and go
forward towards its goal
Communication
"a strict necessity for good nursing care"
Using Himself Therapeutic
 One is able to use itself therapeutic."
 Self-awareness and self-understanding,
understanding of human behavior, the ability
to predict one's own and others' behavior are
imporatnt in this process.
Targeted Intellectual Approach
CLARENZBEATRICEB.GOBOT
Nurse must have a systematic intellectual approach
to the patient's situation.
Definition
 Travelbee believed nursing is accomplished
through human-to-human relationships that
begin with the original encounter and then
progress through stages of emerging
identities, developing feelings of empathy,
and later feelings of sympathy.
 The nurse and patient attain a rapport in the
final stage. For meeting the goals of nursing
it is a prerequisite to achieving a genuine
human-to-human relationships.
 This relationship can only be established by
an interaction process.
Five Phases:
1. The inaugural meeting or original encounter
2. Visibility of personal identities/ emerging
identities.
3. Empathy
4. Sympathy
5. Establishing mutual understanding and
contact/ rapport
Metaparadigm
Person
 Person is defined as a human being.
 Both the nurse and the patient are human
beings.
Environment
Environment is not clearly defined.
Health
 Health is subjective and objective.
 Subjective health is an individually defined
state of well being in accord with self-
appraisal of physical-emotional-spiritual
status.
 Objective health is an absence of discernible
disease, disability of defect as measured by
physical examination, laboratory tests and
assessment by spiritual director or
psychological counselor.
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
Nursing
"An interpersonal process whereby the professional
nurse practitioner assists an individual, family or
community to prevent or cope with experience or
illness and suffering, and if necessary to find
meaning in these experiences.”
Application to Nursing
Travelbee's grand theory of Human-to-Human
Relationships provides nurses with a foundation
necessary to connect therapeutically with other
human beings. The assumptions involve humans,
who are nurses, relating to humans who are
suffering, are in distress, or have the potential to
suffer.
21 NURSING PROBLEMS THEORY
FAYE ABDELLAH
Personal Background:
On March 13, 1919, Faye Abdellah was born in
New York to a father of Algerian heritage and a
Scottish mother.
Education:
- Faye Abdellah earned a nursing
diploma from Fitkin Memorial
Hospital‟s School of Nursing, now
known as Ann May School of
Nursing.
- Abdellah went on to earn three
degrees from Columbia University: a
bachelor of science degree in nursing
in 1945, a master of arts degree in
physiology in 1947, and a doctor of
education degree in 1955.
Historical Background:
- In her early twenties, Faye Abdellah
worked as a health nurse at a private
school, and her first administrative
position was on the faculty of Yale
University from 1945-1949.
- In 1949, she met Lucile Petry Leone,
the first Nurse Officer, and decided
to join the Public Health Service.
- In another innovation within her
field, Abdellah developed the Patient
Assessment of Care Evaluation
(PACE), a system of standards used
to measure the relative quality of
individual health-care facilities that
were still used in the healthcare
industry into the 21st century.
Assumptions:
1. Learn to know the patient.
2. Sort out relevant and significant data.
CLARENZBEATRICEB.GOBOT
3. Make generalizations about available
data concerning similar nursing
problems presented by other patients.
4. Identify the therapeutic plan.
5. Test generalizations with the patient
and make additional generalizations.
6. Validate the patient‟s conclusions
about his nursing problems.
7. Continue to observe and evaluate the
patient over a period of time to
identify any attitudes and clues
affecting this behavior.
8. Explore the patient‟s and family‟s
reaction to the therapeutic plan and
involve them in the plan.
9. Identify how the nurse feels about
the patient‟s nursing problems.
10. Discuss and develop a
comprehensive nursing care plan.
Concepts:
Major Concepts
Individual
She describes nursing recipients as individuals (and
families), although she does not delineate her
beliefs or assumptions about the nature of human
beings.
Health
Health, or the achieving of it, is the purpose of
nursing services. Although Abdellah does not
define health, she speaks to “total health needs” and
“a healthy state of mind and body.”
Health may be defined as the dynamic pattern of
functioning whereby there is a continued interaction
with internal and external forces that results in the
optimal use of necessary resources to minimize
vulnerabilities.
Society
Society is included in “planning for optimum health
on local, state, and international levels.” However,
as Abdellah further delineates her ideas, the focus
of nursing service is clearly the individual.
Nursing Problems
The client‟s health needs can be viewed as
problems, overt as an apparent condition, or covert
as a hidden or concealed one.
Because covert problems can be emotional,
sociological, and interpersonal in nature, they are
often missed or misunderstood. Yet, in many
instances, solving the covert problems may solve
the overt problems as well.
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
Problem Solving
Quality professional nursing care requires that
nurses be able to identify and solve overt and covert
nursing problems. The problem-solving process can
meet these requirements by identifying the problem,
selecting pertinent data, formulating hypotheses,
testing hypotheses through collecting data, and
revising hypotheses when necessary based on
conclusions obtained from the data.
Moreover, patients‟ needs are further divided into
four categories: basic to all patients, sustenance care
needs, remedial care needs, and restorative care
needs.
Basic Needs
The basic needs of an individual patient are to
maintain good hygiene and physical comfort;
promote optimal health through healthy activities,
such as exercise, rest, and sleep; promote safety
through the prevention of health hazards like
accidents, injury, or other trauma and the prevention
of the spread of infection; and maintain good body
mechanics and prevent or correct deformity.
Sustenal Care Needs
Sustenal care needs to facilitate the maintenance of
a supply of oxygen to all body cells; facilitate the
maintenance of nutrition of all body cells; facilitate
the maintenance of elimination; facilitate the
maintenance of fluid and electrolyte balance;
recognize the physiological responses of the body to
disease conditions; facilitate the maintenance of
regulatory mechanisms and functions, and facilitate
the maintenance of sensory function.
Remedial Care Needs
Remedial care needs to identify and accept positive
and negative expressions, feelings, and reactions;
identify and accept the interrelatedness of emotions
and organic illness; facilitate the maintenance of
effective verbal and non-verbal communication;
promote the development of productive
interpersonal relationships; facilitate progress
toward achievement of personal spiritual goals;
create and maintain a therapeutic environment; and
facilitate awareness of the self as an individual with
varying physical, emotional, and developmental
needs.
Restorative Care Needs
Restorative care needs include the acceptance of the
optimum possible goals in light of limitations, both
physical and emotional; the use of community
resources as an aid to resolving problems that arise
from an illness; and the understanding of the role of
social problems as influential factors in the case of
illness.
Abdellah‟s work, based on the problem-solving
method, serves as a vehicle for delineating nursing
(patient) problems as the patient moves toward a
CLARENZBEATRICEB.GOBOT
healthy outcome. The theory identifies ten steps to
identify the patient‟s problem and 11 nursing skills
to develop a treatment typology.
Faye Abdellah‟s 10 Steps to Identify
the Patient‟s Problem. Click to enlarge.
The ten steps are:
1. Learn to know the patient.
2. Sort out relevant and significant data.
3. Make generalizations about available data
concerning similar nursing problems
presented by other patients.
4. Identify the therapeutic plan.
5. Test generalizations with the patient and
make additional generalizations.
6. Validate the patient‟s conclusions about his
nursing problems.
7. Continue to observe and evaluate the patient
over a period of time to identify any
attitudes and clues affecting his or her
behavior.
8. Explore the patient and their family‟s
reactions to the therapeutic plan and involve
them in the plan.
9. Identify how the nurses feel about the
patient‟s nursing problems.
10. Discuss and develop a comprehensive
nursing care plan.
The 11 nursing skills are:
1. observation of health status
2. skills of communication
3. application of knowledge
4. the teaching of patients and families
5. planning and organization of work
6. use of resource materials
7. use of personnel resources
8. problem-solving
9. the direction of work of others
10. therapeutic uses of the self
11. nursing procedure
Abdellah also explained nursing as a
comprehensive service, which includes:
1. Recognizing the nursing problems of the
patient
2. Deciding the appropriate course of action to
take in terms of relevant nursing principles
3. Providing continuous care of the
individual‟s total needs
4. Providing continuous care to
relieve pain and discomfort and provide
immediate security for the individual
5. Adjusting the total nursing care plan to meet
the patient‟s individual needs
6. Helping the individual to become more self-
directing in attaining or maintaining a
healthy state of body and mind
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
7. Instructing nursing personnel and family to
help the individual do for himself that which
he can within his limitations
8. Helping the individual to adjust to his
limitations and emotional problems
9. Working with allied health professions in
planning for optimum health on local, state,
national, and international levels
10. Carrying out continuous evaluation and
research to improve nursing techniques and
to develop new techniques to meet people‟s
health needs
Focus of Care Pendulum of Faye Abdellah’s
Theory.
The nursing-centered orientation to client care
seems contrary to the client-centered approach that
Abdellah professes to uphold. The apparent
contradiction can be explained by her desire to
move away from a disease-centered orientation. In
her attempt to bring the nursing practice to its
proper relationship with restorative and preventive
measures for meeting total client needs, she seems
to swing the pendulum to the opposite pole, from
the disease orientation to nursing orientation, while
leaving the client somewhere in the middle.
In the assessment phase, the nursing problems
implement a standard procedure for data collection.
A principle underlying the problem-solving
approach is that for each identified problem,
pertinent data is collected. The overt or covert
nature of problems necessitates a direct or indirect
approach, respectively.
The outcome of the collection of data in the first
phase concludes the patient‟s possible problems,
which can be grouped under one or more of the
broader nursing problems. This will further lead to
the nursing diagnosis.
After formulating the diagnosis, a nursing care
plan is developed, and appropriate nursing
interventions are determined. The nurse now sets
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those interventions in action, which complete the
implementation phase of the nursing process.
The evaluation takes place after the interventions
have been carried out. The most convenient
evaluation would be the nurse‟s progress or lack of
progress toward achieving the goals established in
the planning phase.
Application to Nursing
Changed the focus of nursing from disease-
centered to patient-centered and began to include
the care of families and the elderly in nursing care.
SELF-CARE DEFICIT NURSING THEORY
DOROTHEA ELIZABETH OREM
Personal Background:
Born on 1914 in
Baltimore, US
Education:
- Received a diploma from the
Providence Hospital School of
Nursing in Washington, D.C., in
1934
- Catholic University of America to
earn a B.S. in Nursing Education in
1939 and an M.S. in Nursing
Education in 1945.
Historical Background:
- Orem held the directorship of both
the nursing school and the
Department of Nursing at Providence
Hospital, Detroit, from 1940 to 1949.
- After leaving Detroit, she spent 8
years (1949 to 1957) in Indiana
working at the Division of Hospital
and Institutional Services of the
Indiana State Board of Health.
- In 1957, Orem moved to
Washington, DC, to take a position
at the Office of Education, U.S.
Department of Health, Education,
and Welfare, as a curriculum
consultant. From 1958 to 1960, she
worked on a project to upgrade
practical nurse training.
Assumptions:
1. All patients wish to care for themselves.
2. Nursing is a deliberate helping actions
performed by nurses for the benefits of
others over a certain period of time
3. Humans are capable and willing to engage
in self-care and care for dependent members
of the family.
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
4. Humans are supposed to be self-reliant and
responsible for their self-care needs and care
needs for dependent members of the family.
5. Self-care and development care are learned
behaviors through human communication
and interaction with each other
6. Humans are unique individuals that are
separated from each other and from their
environment.
Concepts:
THEORY OF SELF-CARE
Self-care is the performance or practice of activities
that individuals initiate and perform on their own
behalf to maintain life, health and wellbeing. When
self-care is effectively performed, it helps to
maintain structural integrity and human functioning
and contributes to human development.
SELF-CARE AGENCY
- Self-care agency is the human‟s
acquired powers and capabilities to
engage in self-care. - The ability to
engage in self-care is affected by
basic conditioning factors.
THERAPEUTIC SELF-CARE DEMAND
- Total of care activities needed, either
at an identified moment or over a
period of time, to meet a person‟s
known requirements for self-care.
SELF-CARE REQUISITES
- Actions directed towards provision
of self-care.
- Three categories of self-care
requisites are:
1. Universal self-care requisites
2. Developmental self-care requisites
3. Health deviation self-care
requisites
UNIVERSAL SELF-CARE REQUISITES
Universal self-care requisites are associated with
life processes and the maintenance of the human
structure and functioning integrity.
- The maintenance of a sufficient
intake of air - The maintenance of a
sufficient intake of water
- The maintenance of a sufficient
intake of food
- The provision of care associated with
the elimination process and
excrements
- The maintenance of a balance
between activity and rest
- The maintenance of a balance
between solitude and social
interaction
CLARENZBEATRICEB.GOBOT
- The prevention of hazards to human
life, human functioning, and human
wellbeing
- The promotion of human
functioning and development within
social groups in accord with human
potential, known human limitations,
and the human desire to be normal
- Normalcy is used in the sense of that
which is essentially human and that
which is in accord with the genetic
and constitutional characteristics and
individuals‟ talents.
DEVELOPMENTAL HEALTH CARE
REQUISITES
Developmental self-care requisites are “either
specialized expressions of universal self-care
requisites that have been particularized for
developmental processes or they are new requisites
derived from a condition or associated with an
event.”
HEALTH DEVIATION SELF-CARE
REQUISITES
Health deviation self-care requisites are required in
conditions of illness, injury, or disease or may result
from medical measures required to diagnose and
correct the condition.
- Seeking and securing appropriate
medical assistance.
- Being aware of and attending to the
effects and results of pathologic
conditions and states
- Effectively carrying out medically
prescribed diagnostic, therapeutic,
and rehabilitative measures.
- Being aware of and attending to or
regulating the discomforting or
deleterious effects of prescribed
medical measures
- Modifying the self-concept (and self-
image) in accepting oneself as being
in a particular state of health and in
need of specific forms of health care
- Learning to live with the effects of
pathologic conditions and states and
the effects of medical diagnostic and
treatment measures in a lifestyle that
promotes continued personal
development
THEORY OF SELF-CARE DEFICIT
It is the central focus of Orem‟s general theory of
nursing. It describes how people can be helped
through nursing. Orem identifies 5 methods of
helping:
 Acting for and doing for others
 Guiding and directing
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
 Providing physical or psychological support
 Providing an environment promoting
personal development
 Teaching
Orem has identified work operations of nurse in
clinical nursing practice:
 Entering into and maintaining nurse-patient
relationships with individuals, families, or
groups
 Designing, planning for, instituting, and
managing systems for nursing care
 Responding to patients‟ requests, desires and
needs for nurse contact and assistance.

 Coordinating nursing care

 Establishing the kind and amount of
immediate and continuing care needed.
 Coordinating the care with other services,
such as other health care, social, or
educational services, needed or being
received.
 Discharging patients from nursing care
when they have regained their abilities to
perform own selfcare needed.
THEORY OF NURSING SYSTEM
Legitimate client and legitimate nurse relationships
led to the development of this idea. When a client's
need for therapeutic self-care exceeds the capacity
of the available self-care agency, this system gets
activated, necessitating nursing care.

THREE CLASSIFICATIONS:
WHOLLY COMPENSATORY NURSING
SYSTEM
A situation wherein the client is unable to engage
in self-care due to their situations. Example: A
newborn patient, post-surgery patient.
PARTIAL COMPENSATORY NURSING OREM’S NURSING PROCESS
SYSTEM Step 1: Diagnosis and Prescription, determine why
A situation wherein both the nurse and the client nursing is needed. Analyze and interpret, make
judgement regarding care.
plays a role in performing self care. Example: A
Step 2: Design of a nursing system and plan for delivery
nurse assisting a patient in ambulation. A nurse
of care.
provides food for patients to eat
Step 3: Production and management of nursing
SUPPORTIVE-EDUCATIVE SYSTEM
systems.
The client is able to provide self-care and can learn
(INCOMPLETE REFER TO PPT)
self-care but with assistance. Example: A nurse
teaching the mother how to breastfeed her infant.
Metaparadigm
Person
Is defined by Orem as the patient (a recipient of
nursing care). A being who functions biologically,
symbolically, and socially and who has the potential
for learning and development. An individual, who is
with the capacity of self-knowledge, who can
engage in deliberate action, interpret experiences,
and perform beneficial actions.
Environment
CLARENZBEATRICEB.GOBOT
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
Consists of environmental factors, environmental
elements, environmental conditions (external
physical and psychological surrounding). And
developmental environment. Can positively or
negatively affect the person‟s ability to provide self-
care.
Health
Includes promotion and maintenance of health,
treatment of illness, and prevention of
complications.
Nursing
Orem defines nursing as an intellectual quality of
the individual nurse; this quality is related to
creativity as well as analysis and synthesis of
information, all of which contribute to development
of nursing systems to assist individuals or
multiperson units. Orem further defines nursing as
human service. Nursing is distinguished from other
human services by its focus on persons with
inabilities to maintain the continuous provision of
health care.
Application to Nursing
Many articles document the use of the self-care
theory as a basis for clinical practice. - Orem‟s self-
care deficit theory has been used in the context of
the nursing process to teach patients to increase
their self-care agency to evaluate nursing practice
and to differentiate nursing from medical practice
THEORY OF GOAL ATTAINMENT AND
INTERACTING SYSTEMS FRAMEWORK
IMOGENE M. KING
Personal Background:
- Born on January 30, 1923, in West
Point, Iowa.
Education:
- 1945: Earned a nursing diploma
from St. John‟s Hospital School of
Nursing in St. Louis, Missouri
- 1948: Pursued a Bachelor of Science
in Nursing Education, graduating
from St. Louis University.
- 1957: She obtained a Master of
Science in Nursing from the same
university. 1961: She pursued further
studies at Columbia University,
under Mildred Montag‟s guidance,
earning her EdD (Doctor of
Education).
Historical Background:
- Developed her Theory of Goal
Attainment in the 1960s
- Focuses on the attainment of life
goals
CLARENZBEATRICEB.GOBOT
- Emphasizes nurse-patient
communication, goal-setting, and
action
- Initial Problems in Nursing
Knowledge Development
- King‟s model was influenced by the
General System Theory and
Howland Systems Model
- Three systems in the Theory of Goal
Attainment: Personal system,
Interpersonal system, Social system
Assumptions:
 The focus of nursing is the care of the
human being (patient).
 The goal of nursing is the health care of both
individuals and groups.
 Human beings are open systems interacting
with their environments constantly.
 The nurse and patient communicate
information, set goals mutually, and then act
to achieve those goals. This is also the basic
assumption of the nursing process
 Patients perceive the world as a complete
person making transactions with individuals
and things in the environment.
 Transaction represents a life situation in
which the perceiver and the thing being
perceived are encountered. It also represents
a life situation in which a person enters the
situation as an active participant. Each is
changed in the process of these experiences
Concepts:
Interacting Systems
 According to King. These are the personal
system, the interpersonal system, and the
social system. Each system is given different
concepts.
 PERSONAL SYSTEM - The personal
system concepts are perception, self, growth
and development, body image, space, and
time.
 INTERPERSONAL - The concepts
associated for the interpersonal system are:
interaction, communication, transaction,
role, and stress. King refers to two
individuals as dyads, three as triads and four
or more individuals as small group or large
group (King, 1981).
 SOCIAL SYSTEM - The social system
concepts are organization, authority, power,
status, and decisionmaking.
Social Systems
 ORGANIZATION - composed of human
beings with prescribed roles and positions
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
 AUTHORITY - a transactional process
characterized by active, reciprocal relations
in which manners „ values, backgrounds,
and perceptions play a role in defining,
validating, and accepting the authority of
individuals within an organization
 POWER - the process whereby one or more
persons influence other persons in a
situation
 STATUS - the position of an individual in a
group in relation to other groups in an
organization.
 DECISION MAKING - a dynamic and
systemic process which goal- directed
choice of perceived alternatives is madeand
acted upon by individuals or groups to
answer a question and attain a goal
composed of human beings with prescribed
roles and positions
 CONTROL - being in charge

Demonstrates the conceptual system that provided “

one approach to studying systems as a whole rather
than as isolated parts of a system ” and was
“designed to explain the organized wholes within
which nurses are expected to function.“

Dynamic Conceptual Systems Metaparadigm

The nurse and client communicate, first in Person
interaction and then in the transaction, to attain  The need for the health information that is
mutually set goals. The relationship takes place in unable at the time when it is needed and can
space identified by their behaviors and occurs in be used.
forward-moving time.  The need for care that seek to prevent
She believed that her “framework differs from other illness.
conceptual schemas in that it is concerned not with  The need for care when human beings are
fragmenting human beings and the environment but unable to help themselves.
with human transactions in different kinds of Environment
environments.”

CLARENZBEATRICEB.GOBOT
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing
 King defined Environment as the process of
balance involving internal and external
interactions inside the social system.
 Reactions from the interaction between the
internal and external environment can be
biological, psychological, physical, social or
spiritual.
 It has a direct exchange of information
between the internal and externa
Health

It is a dynamic state in the life cycle; illness
interferences with that process.
 Health implies continuous adjustment to
stress in the internal and external
environment through optimum use of one's
resources to achieve maximum potential for
daily living.
Nursing
 Nursing is a process of action, reaction, and
interaction whereby nurse and client.
 The nurse and client share specific goals,
problems, and concerns and explore means
to achieve a goal.
INTERPERSONAL RELATIONS THEORY
HILDEGARD PEPLAU
Personal Background:
- Hildegard Peplau was born on
September 1, 1909. She was raised in
Reading, Pennsylvania, by her
parents of German descent, Gustav
and Otyllie Peplau.
Education:
- In 1931, she graduated from
Pottstown, Pennsylvania School of
Nursing.
- Peplau earned a Bachelor‟s degree in
interpersonal psychology in 1943 at
Bennington College in Vermont.
- Peplau held master‟s and doctoral
degrees from Teachers College,
Columbia University, in 1947.
Historical Background:
- Hildegard Peplau then worked as a
staff nurse in her place and New
York City.
- Peplau to become the school nurse at
Bennington College in Vermont,
where she earned a Bachelor‟s
degree in interpersonal psychology.
- She served in the Army Nurse Corps
and was assigned to the 312th Field
Station Hospital from 1943-1945 in
England.
CLARENZBEATRICEB.GOBOT
- At Rutgers University, she created
the first graduate-level program to
prepare clinical specialists in
psychiatric nursing.
Assumptions:
1. Nurse and the patient can interact.
2. Peplau emphasized that both the patient and
nurse mature as the result of the therapeutic
interaction.
3. Communication and interviewing skills
remain fundamental nursing tools.
4. Peplau believed that nurses must clearly
understand themselves to promote their
client‟s growth and avoid limiting their
choices to those that nurses value.
Concepts:
THERAPEUTIC NURSE-CLIENT
RELATIONSHIP
Orientation Phase
The nurse‟s orientation phase involves engaging the
client in treatment, providing explanations and
information, and answering questions.
Identification Phase
The identification phase begins when the client
works interdependently with the nurse, expresses
feelings, and begins to feel stronger.
Exploitation Phase
In the exploitation phase, the client makes full use
of the services offered.
Resolution Phase
In the resolution phase, the client no longer needs
professional services and gives up dependent
behavior. The relationship ends.
The following are the roles of the Nurse in the
Therapeutic relationship identified by Peplau:
 Leader: offering direction to the client or
group
 Surrogate: serving as a substitute for
another such as a parent or a sibling
 Counselor: promoting experiences leading
to health for the client such as expression of
feelings.
Emilio Aguinaldo College
Bachelor of Science in Nursing – 1st Year
Theoretical Foundations of Nursing

Metaparadigm
Person
Man who is an organism that lives in an unstable
balance of a given system. “Strives in its own way
to reduce tension generated by needs.”

Peplau defines man as an organism that “strives in

its own way to reduce tension generated by needs.”
The client is an individual with a felt need.
Environment
Forces outside the organism and in the context of
socially-approved way of living, from which vital
human social processes are derived such as norms,
customs, and beliefs.

Although Peplau does not directly address

society/environment, she does encourage the nurse
to consider the patient‟s culture and mores when the
patient adjusts to the hospital routine.
Health
Implies a forward movement of personality

Health is defined as “a word symbol that implies

forward movement of personality and other ongoing
human processes in the direction of creative,
constructive, productive, personal, and community
living.”
Nursing
Significant therapeutic interpersonal process that
functions cooperatively with another human process
that makes health possible for individuals in
communities.

Peplau considers nursing to be a “significant,

therapeutic, interpersonal process.” She defines it as
a “human relationship between an individual who is
sick, or in need of health services, and a nurse
specially educated to recognize and to respond to
the need for help.”

Application to Nursing

Peplau stressed the need for a therapeutic nurse-

patient relationship, vital for trust, effective
communication, and quality care.

CLARENZBEATRICEB.GOBOT