INTRODUCTION TO

NURSING THEORIES
MS. GRACE KUSI
PHD(STUDENT,)MPHIL,BSC,RN
 Introduction

characteristics of a profession: own body of knowledge
 What a particular theorists believes about nursing –basis of nursing
knowledge and what nurses do or they practice in a world
 Each theory carries a WORLDVIEW
Worldviews
What is theory

 A creative and rigorous structure of ideas that projects a tentative ,

purposeful and systematic view of a phenomena(Chinn and
Krammer, 2004) .
DEFINITION

 CREATIVE
 Role of human imagination and vision
 Rigorous , systematic and disciplined.
 TENTATIVE
 Open to revision, as new evidence emerges
 PHENOMENA
 Subject matter of discipline. Nurses identified it as human beings
and their environment
DEFINITION OF THEORY -2

 A conceptualization of some aspects of nursing reality

communicated for the purpose of describing phenomenon ,
explaining relationships between phenomena, predicting
consequence or prescribing nursing care .

 -Meleis, 2007
Components of a theory
 COMPONENTS OF A THEORY
 1. CONCEPTS
-Ideas and mental images that help to describe a phenomena
Types
Empirical: observed /experienced

Abstract: not observable

WHAT CONCEPT IS THIS?
 COMPONENTS OF A THEORY
 1. Definition of concepts
 Look at the definitions provided
 Using concepts
 Familiar –unfamiliar ways
 New/unfamiliar labels
 COMPONENTS OF A THEORY
2. Assumptions
 Statements that describe concepts
 May be taken as truth(value statement/ethic)
3. Phenomena
 Human beings and their environment
COMPONENTS OF A THEORY

4. Propositions
 Theoretical statements that specify the relationship between the
concepts
 Asserts what is proposed to be true and testable in the from of
hypotheses .
 Eg. Nightingale proposed a beneficairy relationship between fresh
air and health
COMPONENTS OF A THEORY

4.Propositions
Eg. Nightingale environmental theory
Concepts: fresh air, Health
Fresh air Health
She proposed a beneficiary relationship between fresh air and
health
 METAPARADIGM
 Meta means ‘with’ and paradigm means ‘pattern’
 Defined as the core content of a discipline stated in the most global/abstract of terms
 It places a boundary on the subject matter of a discipline
 METAPARADIGM
Until 1990’s,
nursing’s metaparadigm consists of the central concepts of
 person,
 environment,
 health and
 Nursing.
 Metapardigms

Meleis(2007)-7 concepts
1. Nursing client
2. Transitions
3. Interactions
4. Nursing process
5. Environment
6. Nursing therapeutics
7. Health
Metaparadigm

 Person: the recipient of nursing care eg person, community

 Environment : The internal and external surroundings that affect
the person
 Health: state of well being as defined by person or mutually decided
by the person and the nurse
 Nursing: Practice of science and art of the discipline
Note: these concepts varies from one theorist to another theorist
 IMPORTANCE OF NURSING THEORY
 It provides the foundation of nursing practice , help to generate knowledge and
indicates in which direction nursing should develop in the future
 Helps to distinguish what should form the basis of practice by explicitly describing
nursing
 To establish a unique body of knowledge
 Criteria to be a profession: distinct body of knowledge as the basis for practice
Importance of nursing theory

 aims to describe, predict and explain the phenomenon of nursing.

 helps us to decide what we know and what we need to know.
 helps to distinguish what should form the basis of practice by
explicitly describing nursing.
LEARNING OBJECTIVE
 Learn about the purpose of theory in nursing practice, education and research.
RELATIONSHIP BETWEEN THEORY, RESEARCH AND
PRACTICE
 PURPOSES OF NURSING THEORY

1. Nursing practice
2. Nursing education
3. Nursing research
NURSING PRACTICE
Theory assists the practicing nurse to:
 Organize patient data
• Understand patient data
 Analyse patient data
 Make decisions about nursing interventions
 Plan patient care
 Predict outcomes of care
 Evaluate patient outcomes
 NURSING PRACTICE
 To improve practice by positively influencing the health and quality of life of patients
Reciprocal(theory and practice) :
 Practice is the basis for the development of nursing theory whereas nursing theory must be validated
in practice
 Clinical practice generates research questions and knowledge for theory
 In a clinical setting, its primary contribution has been the facilitation of reflecting, questioning and
thinking about what nurses do.
 NURSING PRACTICE
 Enhance autonomy (independence and self-governance)of nursing by defining its own independent
function.
Example
Imogene M. King
Knowledge of concepts –interaction, transaction(perceive and suggest approaches to cope)
Goal oriented Nursing Record(Documentation system)
 ACADEMIC DISCIPLINE /EDUCATION
 Earlier Nursing programs-identified the major concepts in one or two nursing models, organized the
concepts and build an entire nursing curriculum around the created framework.

 Example
 king’s conceptual framework
 Used by several universities –design curriculum
NURSING RESEARCH
 To identify meaningful and relevant areas for study
 To interpret research findings
 To develop or refine middle-range theories linked to research
 To develop clinical practice protocols
 NURSING RESEARCH
USE OF THEORY IN Research
1. Theory generation via inductive research
2. Theory testing via deductive research
LEARNING OBJECTIVES
 Classification of theories
Scope, functions, philosophical underpinnings

 Characteristics of theories
SCOPE OF GENERALIZABILITY
1. Grand theory MORE ABSTRACT
2. Middle-range theory
3. Micro-range theories/Practice theory

 L.ESS ABSTRACT
 GRAND THEORY

 Developed through thoughtful and insightful appraisal of existing ideas as opposed to empirical
research
 It is the broadest in scope, represents the most abstract level of development, and addresses the broad
phenomena of concern within the discipline.
 Eg. Orems theory of self-care , Rogers, Parse theory of unbecoming
 GRAND THEORIES

Example
 Consciousness –grand theory concept
Relational proposition
The evolving pattern of the person-environment can be viewed as a process of expanding consciousness
(Newman’s theory of health as expanding consciousness).
 MIDDLE-RANGE THEORIES
 Specific number of concepts
 Theory that addresses more concrete and more narrowly defined phenomena. It is intended to
answer questions about nursing phenomena, yet they do not cover the full range of phenomena of
concern to the discipline
 Have propositions and operational definitions
 Eg Peplau’s theory of interpersonal relations,
 Watson’s, Orlando
Middle-range theories

 EXAMPLE
 Nurses activity –concept( Orlando’s theory of deliberative nursing process).
 PROPOSITIONS
 What a nurse says or does is necessarily an outcome of her reaction to something
in the situation
 MICRO-RANGE THEORY /PRACTICE THEORIES

Concrete and narrow in scope.

Tends to be prescriptive
Limited to specific population or field
Eg. Infant bonding theories, oncology pain management
theories.
2. BASED FUNCTION/PURPOSE

PRESCRIPTIVE
DESCRIPTIVE EXPLANATORY PREDICTIVE
THEORIES
THEORIES/FACTOR THEORIES /FACTOR THEORIES/SITUATI
/SITUATION
ISOLATING RELATING ON RELATING
THEORIES PRODUCING
THEORIES THEORIES
THEORIES
 DESCRIPTIVE THEORIES/FACTOR ISOLATING
THEORIES
 Describe, observe and name concepts , properties and dimensions.

 Identifies and describes the major concepts of a phenomena but does not explain how or why the
concepts are related.
 Eg. Peplau's theory of interpersonal relationship
EXPLANATORY THEORIES/FACTOR
RELATING THEORIES
 Relates concepts to one another, describe the relationship among concepts and
propositions.
 PREDICTIVE THEORIES/SITUATION RELATING THEORIES

 Prediction of precise relationship between concepts

 Describe the way in which changes take place under different phenomenon
 Developed by Experimental research
 Orlando’s theory
PRESCRIPTIVE
THEORIES/SITUATION PRODUCING
THEORIES
Provide activities necessary to reach defined goals


 They address nursing therapeutics and the consequence of an intervention.

PRESCRIPTIVE THEORIES /SITUATION PRODUCING
THEORIES
 Mishel’s theory of uncertainty
 Increasing the coping skills of patients with gynaecological cancer assists their ability to deal with
the uncertanity of the cancer diagnosis and treament (Mishel, 1997)
BASED ON PHILOSOPHICAL UNDERPINNING OF
THE THEORY
NEED THEORY

INTERACTION THEORY

OUTCOME THEORY

HUMANISTIC THEORY
1. “Needs” theories

Are based around

helping individuals
to fulfil their
physical and
mental needs.
NEEDS THEORY

 EXAMPLE
 1. Abdellah‘s 21 nursing process
 2. Henderson
 3. Orem's
Patients in an overtly dependent position
2.“Interaction” theories

As described by Peplau
(1988), these theories
revolve around the
relationships nurses form
with patients.
 INTERACTION THEORY
 King, Orlando,Peplau,Travelbee,Wiedenbach etc
 3. “Outcome” theories"

Outcome theories portray the nurse as

the changing force, who enables
individuals to adapt
to or cope with ill health
OUTCOME THEORIES

 Dorothy Johnson Behavioural system model

 Myra Levine conservation model
 Roys adaptation model
4. “Humanistic” Theories

• Humanistic theories developed in

response to the psychoanalytic
thought that a person’s destiny was
determined early in life.
• Humanistic theories emphasize a
person’s capacity for self-
actualization.
HUMANISTIC THOERIES

 Rogers theory of unitary human being.

CHARACTERISTICS OF THEORIES

1. Theories can interrelate concepts in such a way as to

create a different way of looking at a particular
phenomenon.
2. Theories must be logical in nature.
3. Theories should be relatively simple yet generalizable.
4. Theories can be the bases for hypotheses that can be
tested.
ASSIGNMENT

 1. Identify three nursing theories.

 a. List the concepts of each of these identified nursing theories.
 B. Classify each of these theories according to the scope, function and
philosophical underpinnings
 RECOMMENDED BOOKS
 1. Alligood, M. R. (2017). Nursing theorists and their work-e-book. Elsevier Health
Sciences.
 2. Smith, M.C ( 2019). Nursing theories and Nursing Practice. F.A Davis,Philadelphia