PURPOSES OF NURSING THEORY

NURSING THEORY DEVELOPMENT

Nursing Theories – are developed to improve the quality of care rendered by nurses to their
clients
- have been very useful not just solely in a single facet of nursing but also in other aspects of
general information
- nursing theories, in many cases, serve as an excellent help in the development and
expansion of knowledge and as support in different features of learning such as education,
research and clinical practice
- theory development is inherent in the different nursing fields – education, research and
practice
 PURPOSES OF NURSING THEORY IN RELATION
TO:
 EDUCATION – nursing theory was used primarily to establish the profession’s place in the
university
 RESEARCH - nursing research identifies the philosophical assumptions or theoretical
frameworks from which it proceeds
 PRACTICE – the primary contribution of nursing theory when employed in a clinical setting is
the facilitation of reflection, questioning, and thinking about what nurses do
 EDUCATION
Nursing Theories were primarily used to develop and guide nursing education in universities and institutions
They were once known to be more strongly established in the field of academics rather than in clinical
practice
In the 1970s and 1980s, a number of nursing programs recognized the major concepts of some nursing
models, structured these concepts into a conceptual framework, and built the complete curriculum around
that framework
With these models, they were able to come up with unique terms such as program objectives, course
objectives and clinical performance criteria. These new terms assist and direct the entire education system
to create a more comprehensive curriculum
Theoretical concepts primarily prepare students for practice as members of the professional community
The general purpose of theory development primarily is to ensure adequate and quality nursing delivery
and to clarify and improve the status of the Nursing as a profession
 RESEARCH
Experts constantly believed that research in nursing was inspired from different theoretical
assumptions or conceptual frameworks in the past.
Through evolution of technology, ideas and emerging nursing issues, interpretations and perspectives
are generated to provide answers to questions encountered in practice.
The development of clear understanding about the quality of life as well as the management of
symptoms is an indication that conceptual perspective s are constantly improving
Since grand theories are broad in scope and complex in nature, they only assist nursing research in an
occasional manner.
Nursing researches are frequently based on middle-range theories which focus on the discovery of
concepts such as pain, self-esteem and learning.
It has been known that theoretical concepts from social sciences as one of the foundations in
qualitative nursing research
The term critical theory is used in the academe to describe theories that clarify how social
structures influence a wide variety of human experiences from art to social practices
In nursing critical theory research helps elaborate more on how structures such as race, gender,
sexual orientation, and economic class affect experiences and health outcomes of the patients

Grand middle-range and critical theories are used hand-in-hand in academics, research and in
clinical practice (chances are, all nurses have utilized a form of nursing theory, whether they
know it or not)
Studying nursing theories develop analytical skills and critical thinking ability for the purpose of
safe and effective nursing practice
 CLINICAL PRACTICE
A nurse’s ability is enriched through the help of different nursing theories
Theories thoroughly guide critical thinking and decision-making in clinical nursing practice
Nurses will have a better understanding on the basis and nature of their work and be able to
express it clearly in collaboration with other professionals
Nursing Theories strengthen professional independence by guiding the deepest and most
important part of their practice
Nursing Theories are always critical in assisting nurses to facilitate questions , reflections and
critical thinking in every aspect of care.
 INTERDEPENDENCE OF THEORY AND
RESEARCH
The more research is conducted, the more learning is gained to what extent a given theory can
be useful in providing knowledge that will enhance client’s care
Nursing knowledge is composed of both theoretical and practical knowledge. According to
Meleis (1997), theoretical knowledge includes and reflects on the basic values, guiding
principles, elements and phases of conception of nursing
Theoretical knowledge – aims to stimulate thinking and broaden understanding of the science of
the Nursing discipline
Practical knowledge – the art of nursing

The relationship between nursing theory and nursing research helps in building knowledge
 Nursing Practice

Nursing Theory Nursing Research

“Practice without theory, like map without route, is blind; theory without practice, like route
without map, is empty”
According to Chinn and Krammer (2004), research is linked to theory in two ways by generating
and testing
1. Theory-generating research – is designed to discover and describe relationships and
phenomena with out imposing predetermined notions on the nature of the phenomena. In
conducting this type of research, the investigators make observations with an open mind in order
to view a phenomenon in a new way
2. Theory-testing research - is utilized to determine how accurate a theory describes a
phenomenon. The researcher already has some predetermined notions as to how the
phenomenon is and creates a hypothesis to test the assumptions of the theory
Consider a sample case study of Nurse Xhaki on the concept of Death among Terminally-ill
Cancer Patients. The researcher is interested in studying about the concept of death of
terminally-ill cancer patients. After generating sufficient information from the respondents and
application of the research process, the researcher can now develop an initial theory about the
concept of death in terminally-ill patients
Step 1: Describing the concept of death of terminally –ill cancer patients, the nurse –researcher
can test the elements of the theory
Step 2: If the result of the study indicates that the concept of death varies depending on the
support system of the patient, the researcher can test the factors within the support system
affecting the perception of the cancer patients
Step 3: The theory is tested through a variety of research activities. There is no single study to
test all components of all theory
The end result of theory-generating and theory-testing research is to enhance nursing knowledge.
In addition, nurses are now able to apply research based interventions into practice.
Therefore, continued research is necessary to increase knowledge which in turn improves nursing care.
As a science, nursing is evidenced-based and is focused on promoting client satisfaction.

Nursing as an ART relies on knowledge gained from practice and reflection of past experiences
Nursing as a SCIENCE, it is based on scientifically tested knowledge that is applied innthe practice setting
 CONTRIBUTIONS OF NURSING
THEORISTS
THEORIST PRACTICE
Florence  Environmental aspects as
Nightingale integral part of nursing care
(Environ-mental o good ventilation
Theory) o proper disposal of waste
o control of noise
o sanitation
o water treatments
Hildegard Peplau  provides clear design for the
(Psychodynamic practice of psychiatric nursing
Nursing )  emphasized the development
of interpersonal relationship
between the patient and the
nurse
EDUCATION RESEARCH
 development of  invented the “polar
excellent training system diagrams” to analyze
in St. Thomas Hospital and gather data
and King’s College
Hospital in London
 author of  formulated concepts
“Interpersonal Relations of anxiety as a means
in Nursing” which aids to constructively
nurses resolve angry feelings
 formulated effective through experiential
psychotherapeutic learning within the
methods nurse-patient
relationship
 THEORIST PRACTICE EDUCATION RESEARCH
Virginia Henderson  Nurses as direct  Nurse’s education  recommended library
(14 Components of caregiver help patients demands universal research
Basic Nursing Care) to become understanding of diverse  advocated research as
independent human being a way to improve
 designed three phases practice
of curriculum
development
Joyce Travelbee  hospice is one of her  the focus of Nursing • utilized by various
(Human to Human essential contributions Education has shifted authors in their study of
Relationship)  asserted that finding from a disease-oriented recently diagnosed
meaning in illness and approach to holistic care cancer patients ad their
suffering enables the approach personal search for
patient not only to  stated that nursing meaning
accept illness but it programs need to offer a
will also served as self- much broader background
actualizing experience in communication
techniques , values
clarifications, and care of
the dying
 THEORIST PRACTICE EDUCATION RESEARCH
Betty Neuman  goal directed, integrated  holistic curriculum  additional clarification
(Systems Model) and holistic approach to  provides an effective and generation of
client care framework in conceptual testable nursing theories
 formulated Neuman evolution among levels of  guide model to enhance
Nursing Process Format: education of nursing the nursing care of clients
o Nursing Diagnosis students from diploma to with specific physiological
o Nursing Goals associate to stressors
o Nursing Outcomes baccalaureate programs
Dorothy Johnson  used assessment,  focuses on the patient  stated that nursing
(Behavioral System disorders, treatment and as a behavioral system research would: “Identify
Model) evaluation instead of and its dysfunction and explain the behavioral
Nursing Process system disorders which arise
in connection with illness
 “The behavioral system and develop the rationale
is said to determine and for the means of
limit the interaction management
between the patient and
his environment .”
 THEORIST PRACTICE
Imogene King  utilized by professionals in
(Goal Attainment) most specialty areas
 developed the Goal
Oriented Nursing Record
(GONR) which is used to
record goals and outcomes
in patient settings
Dorothea Orem  described nursing
(Self Care Deficit management of Pertussis
Theory in Nursing )  teaching self-care to
Diabetic patients and End-
Stage Renal Failure
 pain assessment and
control
EDUCATION RESEARCH
 Nursing curriculum  her work served as a
development and theoretical basis for
practice application various studies
in Ohio state and
other universities
 came up with the  developed a number
idea of a need for of instruments for
nursing - specific research
knowledge structure  the 1st instrument
 author of “Guides developed named
for Developing Exercise Self- Care
Curriculum for the Agency (ESCA) which is
Education of used to determine the
Practical Nurses” and capacity of patients to
“Foundations of care for their selves
Nursing and Its
Practice”
 THEORIST PRACTICE EDUCATION RESEARCH
Faye Abdellah  organized a systematic  the typology provided scientific  believed that
(Typology of 21 basis of nursing practice body of knowledge and filled-in- evidenced-based
Nursing Problems )  typology helps in the gaps of weaknesses in practice on scientific
efficient assessment, nursing education data has a great
nursing diagnosis and impact in nursing
planning interventions research
 uses scientific basis in
problem-solving process
Sr. Callista Roy  manipulating the stimuli  development of curriculum  development and
(Adaptation Model) and not the patient development in various testing of theories
 nurses enhance the institutions  practice-based
interaction of person and  three vertical strands in the research
their environment thus curriculum  development of
improving health  the adapting person programs
 health-illness  development of
 Nursing Management adaptation research
 two horizontal strands in the instruments
curriculum
 Nursing Process
 Student Adaptation and
Leadership
 THEORIST PRACTICE
Madeleine Leininger  prepares nurses to
(Trans-cultural Nursing) prevent culture shock and
conflicts as they practice in
different places with
different cultures
 provides human care and
health behaviors as
background knowledge to
understand nursing
phenomena
Jean Watson  caring as an essential
(Philosophy and Science field in nursing
of Caring)  example in clinical
setting (Intensive Care
Units, Neonatal Intensive
Care Units, Pediatric and
Gerontological Units)
EDUCATION
 helps produce a well-
qualified faculty prepared
in Transcultural Nursing to
teach and guide students
 education in
Transcultural Nursing
leads to culturally
competent nursing care
 author of “Nursing:
Human Science and
Human Care – A Theory of
Nursing”
 described the Core of
Nursing as aspects of the
nurse-patient relationship
resulting in a therapeutic
result
RESEARCH
 focused on culture
care
 with research
method of
(ethnonursing) to
examine theories
 research must focus
on both subjective and
objective patient
outcomes in knowing
that caring is important
in nursing
 THEORIST PRACTICE EDUCATION RESEARCH
Patricia Benner  formulated the  learning needs at an  extended the study
(From Novice to Levels of Competency early stage of clinical of formal models
Expert: Excellence and in Nursing Practice: knowledge are which direct care and
Power in Clinical 1. Novice different from those substitute knowledge
Nursing Practice ) 2. Advance Beginner needed in later stage used in nursing
3. Competent practice
4. Proficient
5. Expert