THEORETICAL

FOUNDATIONS
OF NURSING

ESTELITA MELENDEZ DELA CRUZ RN, MAN

Clinical Instructor
NURSING
“Art” and a “Science” (ADPCN)
Diagnosis and treatment of human
responses to actual or potential
health problems. (American Nurses
association)
Promotion of health, prevention of
illness and the care of ill, disabled
and dying people. (International
Council for Nurses)
To assist clients in the performance
of activities contributing to health ,
its recovery or peaceful death.
CONCEPTUAL FRAMEWORK/
MODEL
A set of interrelated concepts that
symbolically represents and conveys
a mental image of a phenomenon
(Power and Knapp, 1995)
Composed of concepts or constructs
that describe ideas about individuals,
groups, situations and events of
particular interest or discipline. (e.g.,
Nursing)
THEORY
A set of statements that tentatively
describe, explain, or predict a
relationships among concepts.
(power & Knapp)
An organized system of accepted
knowledge that is composed of
Concepts, propositions definitions
and assumptions intended to
explain a fact event or phenomena.
NURSING THEORY
A group of interrelated concepts that
are developed from various studies of
discipline and related experiences.
An organized and systematic
articulation of a set of statements
related to questions in the discipline of
nursing.
A body of knowledge that describes or
explains nursing and is used to support
nursing practice.
Components of a theory:
1. CONCEPTS
 Composed of interrelated concepts
 A mental idea or generalization
 A comprehensive idea or generalization.
 An idea that brings diverse elements into a
basic relationship.
 A unit of thought.
 A general idea formed in the mind.
 An idea formulated in the mind or an
experience perceived and observed
Example 1: Levine’s
Conservation Model in Nursing
Practice.
there are concepts that affect the
nursing practice.

Three Major Concepts:

1. Conservation
2. Adaptation
3. Wholeness
Example 2:
Kings theory in Goal
Attainment in Nursing Practice.
Concepts that are critical to
this model:
Personal systems
Interpersonal systems
Social systems
2. DEFINITIONS:
Composed of various description
which convey a general meaning
of the concepts in a manner that
fits the theory.

Describe the activity necessary to

measure the constructs,
relationships or variables within a
theory.
3. ASSUMPTIONS
A statement that specifies
the relationship or connection
of factual concepts or
phenomena.
Are statements that describe
concepts or connect two
concepts that are factual
4. PHENOMENON
An aspect of reality that
can be consciously
sensed or experienced
In Nursing, Phenomena can
be:
Clinical or environmental
setting of nursing - health
Center
Disease process – Stomach
ulcer
Clients behavior – guarding
behavior at the pain site.
TYPES OF THEORIES
METATHEORIES- theories whose
subject matters are some other
theories.
GRAND THEORIES- Broad in scope
and complex and therefore require
further specification through research
before they can be tested.
MIDDLE – RANGED THEORIES –
have more limited scope, less
abstraction, address specific
phenomena or concepts and reflect
practice.
DESCRIPTIVE THEORIES
 Are the first level of theory
development.
They describe the phenomena,
speculate on why phenomena occur
and describe the consequences of a
phenomena.
PRESCRIPTIVE THEORIES -
Address nursing interventions and
predict the consequence of a specific
nursing intervention.
Importance of Nursing
Theories:
Help provide better patient
care, enhanced professional
status for nurses.
Provide the foundations of
nursing practice
Establish a unique body of
Knowledge
What are Nursing Paradigms?
Nursing paradigm are patterns or models
used to show relationship among the
existing theoretical works in nursing.
NURSING

PERSON HEALTH ENVIRONMENT

Paradigm
 FOUR MAJOR CONCEPTS OF NURSING
THEORIES:
1. Person
- Refers to all human beings. People are the recipients
of nursing care; they include individual, families,
communities and groups.
2. Environment
- Includes factors that affect individuals internally and
externally. Includes settings where nursing care is
provided.
3. Health
- Addresses the person’s state of well being.
4. Nursing
- Is central to all nursing theories.
NON-NURSING THEORIES
1. General System Theory
(Von Bertalanffy)
oIncludes purpose, content and
process , breaking down in the
“whole” and analyzing the
parts.
oThe relationship between the
parts of the whole are
examined to ,earn how they
work together.
Input- information that enters a
system.
Output- end product of a system
Feedback- the process through
which the output is returned to the
system.
ASSUMPTIONS:
All systems must be goal directed.
A system is more than the sum of its
parts.
A system is ever-changing and any
change in one part affects the whole.
NURSING MODELS BASED ON
SYSTEM STHEORY

A. Imogene King’s Systems Interaction

Model

B. Betty Neuman’s Health Care

System Model

C. Dorothy Johnson’s Behavioral

Model
• 2. Change Theory – Kurt Lewin (1962)
• People grow and change throughout
their lives.
• Change happens daily.
• Change involves modification or
alteration.
• SIX COMPONENTS:
• 1. Recognition of the area where change
is needed.
• 2. Analysis of a situation to determine
what forces exist.
•3. Identifications of the methods
by which change can occur.
•4. Recognition of the influence of
group mores or customs on
change.
•5. Identification of the methods
that the reference group uses to
bring about change.
•6. The actual process of change.
•Three States of Change:
•1. UNFREEZING- is the recognition
of the need for change and the
dissolution of previously held
patterns of behavior.
•2. MOVEMENT- Is the shift of
behavior toward a new and more
healthful pattern.
•3. REFREEZING- is the long-term
solidification of the pattern of
behavior.
• 3. DEVELOPMENTAL THEORY
• Human growth and development is an
orderly predictive process that begins with
the conception and continues through
growth.
• Four Main Areas:
• 1. Biophysical Development
• describe the way our physical bodies grow
and change.
• 2. Psychoanalytic/Psychosocial
Development.
• describe the development of the human
personality, behavior and emotions.
•Psychoanalytic
Psychosocial Development
• Example 1.
• Sigmund Freud’s Psychoanalytic
Model of Personality
• Five psychosexual developmental
stages.
• Stage 1. ORAL (birth to 18 months)
• Initially, sucking and oral satisfaction is
not only vital to life, but also very
pleasurable in its own right.
 STAGE 2. ANAL (12 months to 3 years)
The focus of pleasure is anal zone.
STAGE 3. PHALLIC OR OEDIPAL (3-6 years)
The genital organs becomes the focus of
pleasure.
STAGE 4. LATENCY (6-12 years)
Sexual urges, from the earlier Oedipal stage
are repressed and channeled into productive
activities that are socially acceptable.
STAGE 5. GENETAL (Puberty through
adulthood)
This is the time of turbulence when earlier
sexual urges awaken and are directed to an
individual outside the family circle.
•4. COGNITIVE DEVELOPMENT
• Focused on reasoning and thinking
processes, including the changes in
how people come to perform
intellectual operations.
• Example Jean Piaget’s Theory of
Cognitive Development
• This theory includes four periods and
recognizes that children move
through these specific periods at
different rates but in the same
sequence or order.
• Jean Piaget’s Theory of Cognitive Development:
Period 1. SENSORIMOTOR (Birth to 2 years)
The infant develops action pattern for dealing with
the environment.
Period 2. PREOPERATIONAL (2-7 years)
Children learn to think with the use of symbols and
mental images.
Period 3. CONCRETE OPERATIONAL ( 7-11)
Children achieve the ability to perform mental
operations.
Period 4. FORMAL OPERATIONS (11 up to
adulthood)
The individual’s thinking moves to abstract and
theoretical subjects.
• D. MORAL DEVELOPMENT
• Focuses on the description of moral
reasoning.
• Example:
Lawrenze Kohlberg’s Theory on Moral
Development
• Three Levels of Moral Development:
• 1. Premoral- children are more
responsive to cultural rules and labels
of good and bad, right or wrong.
• 2. Conventional- individual is
concerned with maintaining the
expectations of the family, groups or
nation and sees this as right.
•Postconventional- people make
the effort to define valid values and
principles without regard to outside
authority.

•4. ADAPTATION THEORY

•Adjustment of living matter to
another living things and to the
environmental conditions.
Two models of causal statements: Giere
(1997)

Deterministic models – assert that the

presence or absence of other variable .

Probabilistic models – assert that

relationships between variables do not
occur in every instance, but rather occur
because of probability or chance.
Theoretical Model

• Theoretical model represents an

equation that describes the path or
explains the phenomenon being
observed or experienced.
• Theoretical model is characterized by the
organization of the concepts and
definitions into their primitive and derived
terms and the organization of the
statements and linkages into premises
and hypotheses and equations.
Three forms of organizing the conceptual system
that constitute the theory
• 1. Set of Laws Model – allows the organization
of findings from available research in an area
of particular interest.

CLASSIFICATIONS
1. Laws- contain overwhelming empirical support
2. Empirical generalizations – contain only some
empirical support, they are not conclusive as
laws.
3. Hypotheses- have no empirical support.
2. Axiomatic model – composed of
explicit definitions, set of concepts,
set of existence statement and a set
of relationship statements arranged
in a hierarchical order.
3. Causal Process Model –
characterized by the development of
theoretical statements that identify
and specify cause-effect mechanism
between the independent and
dependent variables.
 • ANALYZING A THEORY
• Theory analysis is the process of
acquiring knowledge of the theory.

• Parameters of theory analysis

1. Clarity
Guidelines in analyzing a theory for
clarity:
1. Identify intersubjectivity.
2. Identify meanings of logical adequacy.
3. Use of criterion of terminology
4. Identify the logical structure of the
concepts.
•2. Generality
•3. Simplicity
•Empirical Precision
•Derivable Consequences