Ma. Tosca Cybil A. Torres, RN, MAN
• Theories are a set of interrelated concepts that
give a systematic view of a phenomenon (an
observable fact or event) that is explanatory &
predictive in nature. Theories are composed of
concepts, definitions, models, propositions & are
based on assumptions. Nursing theorists use both
of these methods. Theory is “a creative and
rigorous structuring of ideas that projects a
tentative, purposeful, and systematic view of
phenomena”. A theory makes it possible to
“organize the relationship among the concepts to
describe, explain, predict, and control practice”
Definition of terms
• Concepts- are vehicles of thought that involve images.
Concepts are words that describe objects, properties, or
events & are basic components of theory.
– Types: Empirical concepts , Inferential concepts, Abstract concepts
• Models - representations of the interaction among and
between the concepts showing patterns.
• Propositions -statements that explain the relationship
between the concepts.
• Process - a series of actions, changes or functions intended to
bring about a desired result. During a process one takes
systemic & continuous steps to meet a goal & uses both
assessments & feedback to direct actions to the goal.
Importance of nursing theories
• Nursing theory aims to describe, predict and explain the phenomenon of
nursing (Chinn and Jacobs1978).
• It should provide the foundations of nursing practice, help to generate
further knowledge and indicate in which direction nursing should develop
in the future (Brown 1964).
• Theory is important because it helps us to decide what we know and what
we need to know (Parsons1949).
• It helps to distinguish what should form the basis of practice by explicitly
• The benefits of having a defined body of theory in nursing include better
patient care, enhanced professional status for nurses, improved
communication between nurses, and guidance for research and education
(Nolan 1996). In addition, because
• The main exponent of nursing – caring – cannot be measured, it is vital to
have the theory to analyze and explain what nurses do.
• As medicine tries to make a move towards adopting a more
multidisciplinary approach to health care, nursing continues to strive to
establish a unique body of knowledge.
• This can be seen as an attempt by the nursing profession to maintain its
The characteristics of theories
• interrelating concepts in such a way as to create a
different way of looking at a particular phenomenon.
• logical in nature.
• bases for hypotheses that can be tested.
• increasing the general body of knowledge within the
discipline through the research implemented to
• used by the practitioners to guide and improve their
• consistent with other validated theories, laws, and
principles but will leave open unanswered questions
that need to be investigated.
Common concepts in nursing theories
Four concepts common in nursing theory that
influence & determine nursing practice are:
– The person (patient).
– The environment
– Nursing (goals, roles, functions)
• Each of these concepts is usually defined &
described by a nursing theorist, often uniquely;
although these concepts are common to all
nursing theories. Of the four concepts, the most
important is that of the person. The focus of
nursing, regardless of definition or theory, is the
• Defined Nursing: “The act of utilizing the
environment of the patient to assist him in
• Focuses on changing and manipulating the
environment in order to put the patient in
the best possible conditions for nature to act.
• Identified 5 environmental factors: fresh air,
pure water, efficient drainage,
cleanliness/sanitation and light/direct
• Considered a clean, well-ventilated, quiet
environment essential for recovery.
• Deficiencies in these 5 factors produce illness
or lack of health, but with a nurturing
environment, the body could repair itself.
Defined Nursing: “An interpersonal process of therapeutic interactions between an
Individual who is sick or in need of health services and a nurse especially educated to
recognize, respond to the need for help.
• Nursing is a “maturing force and an educative instrument”
Identified 4 phases of the Nurse - Patient relationship:
Orientation - individual/family has a “felt need” and seeks
professional assistance from a nurse (who is a stranger). This is
the problem identification phase.
Identification - where the patient begins to have feelings of
belongingness and a capacity for dealing with the
problem, creating an optimistic attitude from which inner
strength ensues. Here happens the selection of appropriate
Exploitation - the nurse uses communication tools to offer
services to the patient, who is expected to take advantage of all
Resolution - where patient’s needs have already been met by
the collaborative efforts between the patient and the nurse.
Therapeutic relationship is terminated and the links are
dissolved, as patient drifts away from identifying with the nurse
as the helping person.
Faye Glenn Abdellah’s Concept of
Twenty One Nursing Problems
• Nursing is broadly grouped
into 21 problem areas to
guide care and promote the
use of nursing judgement.
• Nursing is a comprehensive
service that is based on the
art and science and aims to
help people, sick or
well, cope with their health
21 Nursing Problems
1. To maintain good hygiene.
2. To promote optimal activity; exercise, rest and sleep.
3. To promote safety.
4. To maintain good body mechanics
5. To facilitate the maintenance of a supply of oxygen
6. To facilitate maintenance of nutrition
7. To facilitate maintenance of elimination
8. To facilitate the maintenance of fluid and electrolyte balance
9. To recognize the physiologic response of the body to disease
10. To facilitate the maintenance of regulatory mechanisms and
11. To facilitate the maintenance of sensory functions
12. To identify and accept positive and negative expressions, feelings
13. To identify and accept the interrelatedness of emotions and illness.
14. To facilitate the maintenance of effective verbal and non-verbal
15. To promote the development of productive interpersonal
16. To facilitate progress toward achievement of personal spiritual
17. To create and maintain a therapeutic environment
18. To facilitate awareness of self as an individual with varying needs.
19. To accept the optimum possible goals
20. To use community resources as an aid in resolving problems arising
21. To understand the role of social problems as influencing factors
Dorothy Johnson’s Key Concepts of
• Each individual has
patterned, purposeful, repetitive ways
of acting that comprises a behavioral
system specific to that individual.
The four major concepts
Johnson views “human being” as having two major systems, the biological system
and the behavioral system. It is role of the medicine to focus on biological system
where as Nursling's focus is the behavioral system.
“Society” relates to the environment on which the individual exists. According to
Johnson an individual’s behavior is influenced by the events in the environment
“Health” is a purposeful adaptive response, physically mentally, emotionally, and
socially to internal and external stimuli in order to maintain stability and comfort.
“Nursing” has a primary goal that is to foster equilibrium within the individual .she
stated that nursing is concerned with the organized and integrated whole, but that
the major focus is on maintaining a balance in the Behavior system when illness
occurs in an individual.