1 Introduction to Foundation of Nursing I.pdf

FOUNDATION OF NURSING – I
FOR 2nd YEAR NURSING STUDENTS
Module Name: Foundation of Nursing I
Module Code: Nurs1043
Module ECTS: 19
By: Adem Hussein (BSc N, MSc In ADHN)
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Adem H Foundation of Nursing
February 12, 2021

Introduction to Foundation of Nursing
Presentation outlines
Definition of Nursing
Historical Background/Development of Nursing
Scope of Nursing
The Aims Of Nursing
Role Of Nurses
Philosophy of Nursing Theory
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Definition of Nursing
The word “nursing” is originated from the Latin word “Nutrix”
meaning “to nourish”.
 Nurse is a person who nourishes, foster & protects others. or ;
A person prepared to take care of sick, injured & aged person.
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Definition of Nursing …….
 An acceptable version of the word nurse:
N – Noble
U – Unselfish
R – Responsible
S – Sincere
E – Efficient
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Definition of Nursing …….
There were different definitions given for nursing at different times by
different scholars. Some of these are:
Is science and an art that deals with prevention of disease, care and
treatment of the sick and rehabilitation of patients.
 Science- knowledge based for care given,
Art – means skilled application of knowledge to help others.
Nursing is a profession or practice of providing care for the sick and infirm
(unwell).
It encompasses autonomous and collaborative care of individuals of all ages,
families, groups and communities, sick or well and in all settings.
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Definition of Nursing….
1. ICN, 2002
 Nursing includes ;
 The promotion of health,
 Prevention of illness, and
 The care of ill, disabled and dying people.
 Advocacy, promotion of a safe environment, research,
participation in shaping health policy and inpatient and health
systems management, and education are also key nursing roles.
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2. Florence Nightingale’s definition of nursing
 Nursing is the act of utilizing the environment of clients to
assist him/her in his/her recovery.
 It is to put the patient in a best condition for nature to act up
on him.
3. American nursing association (ANA,2010)
Nursing is the diagnosis and treatment of human response
to actual and potential health problems.
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4. Virginia Henderson definition of nursing
“ Nursing is assisting the individuals sick or well in the
performance of those activities (contributing to health or
its recovery or to a peaceful death) that he will 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.”
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Definition of Nursing….
Generally, Nursing is
• A profession whose focus is to help the client to prevent, solve, alleviate or
cope with problems associated with the activities he or she carries out in
order to live.
• A profession that assists the sick person or well in the performance of those
activities contributing to health or its recovery (or to a peaceful death) that
he or she would perform unaided, given the necessary strength, will or
knowledge.
• A human service related to the clients’ need and ability to undertake self-
care and to help them sustain health, recover from disease and injury or
cope with their effects.
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Definitions of important term
Care:- Involves activities from carrying out complicated technical
procedures to something seeming simple.
Health:-is a state of optimal functions.
WHO definition of Health;
 Is a state of complete mental, physical, social& spiritual
well-being not merely the absence of disease or infirmity.
Handicap- a long term disadvantage which adversely affects
individual’s capacity to achieve the personal economic
independence. i.e. normal for ones peer.
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February 12, 2021 Adem H Foundation of Nursing

Physical health- anatomical integrity& physiological
functioning of the body.
 To be physically healthy
 All body parts must be present
All body parts in natural place& position
None of them has any pathology
All doing their physiological function properly
They work each other harmoniously
Mental health- the ability to learn & think clearly. 11

Social health- ability to make& maintain acceptable interaction with
others.
Illness- the subjective state of a person who feels aware of not being
well.
Disease- denotes the condition of the human body in which
something has gone wrong & has upset the normal functions of the
body or mind.
Disability- any restriction or lack of ability to perform an activity in a
manner or range considered normal for human beings.
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Nursing as a profession /Occupation
Profession: an occupation that requires extensive education, special
knowledge, skill, and preparation
Professionalization: is the process of becoming professional.
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Nursing as a profession
A profession is defined as a calling or vocation, especially one that
involves some branch of advanced learning or science where as
occupation is a job, a career.
A profession is a learned vocation or occupation that has status of
superiority and precedence within a division of work.
All professions are occupations but not all occupations are professions.
 The essence of professionalism is both having a unique or special
knowledge and the self-imposed obligation to serve the community
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Nursing as a profession ….
The nursing profession began with a genuine desire to serve and care for
others, combined with a sense of compassion and commitment
 To be a nurse is a calling and difficult to describe in words.
Who can say why a person would want to do a nurses work, but those
who do will tell you there is nothing as fulfilling or rewarding
The essence of nursing is an unconditional love for mankind.
To be called a nurse is an honor – a profession of the highest realm
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Characteristics of a profession
1. Utilizes in its practice in a well-defined and well organized body
of specialized knowledge on the intellectual level of the higher
learning.
2. Constantly enlarges the body of knowledge it uses
3. Applies its body of knowledge in practical services
4. Functions autonomously in the formulation of professional
policy and in the control of professional activity
5. Attracts individuals of intellectual and personal qualities who
exalt service above personal gain and who recognize their
chosen occupation as a life work.
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Characteristics of a profession……
6. Strives to compensate its practitioners by providing
freedom of action, opportunity for continuous
professional growth and economic security.
7. Provides a specific service.
8. Members have autonomy in decision making and practice.
9. The profession/professional has a code of ethics for
practice.
10. The knowledge base of a profession is normally
expressed in the form of concepts, propositions and
theories. Nursing has currently reached this level of
theoretical evolution
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Professions Vs. Occupations
Professions Occupations
 College or University  On the job training
 Prolonged education  Length varies
 Mental creativity  Largely manual work
 Decisions based on science or
theoretical constructs
 Guided decision making
 Values, beliefs & ethics integral part of
preparation
 Values, beliefs & ethics not part of
preparation
 Strong commitment  Commitment may vary
 Autonomous  Supervised
 Unlikely to change professions  Often change jobs
 Commitment greater than $ reward  Motivated by $ reward
 Individual accountability  Employer is primarily accountable
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Criteria for professions
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1. A body of knowledge on which skills and services are based.
2. An ability to deliver a unique service to other humans
3. An active and solid professional organization.
4. Control of standards for practice
5. Career commitment by members
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Criteria for professions……
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6. Education that is standardized and based in colleges and universities.
7. Responsibility and accountability of members for their own actions.
8. Recognized social worth and contribution
9. Independent functions.
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Is nursing a science? Or not ?
What is nursing science?
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Nursing science
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Science is
A unified body of knowledge about phenomena that is
supported by evidence.
Activity that combines research and theory.
Science = Research + Theory.
 The spring issue of “what is nursing science”? Was raised
in 1997 at international dialogue.
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Nursing science cont’d
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Is an identifiable, discrete body of knowledge comprising paradigms,
frame works, and theories.
Represents cluster of precisely selected beliefs and values that are
crafted into different theoretical structure.
In nursing science we are dwelling in question emerging from human
life which are illuminating meanings in relation to the human universe
process.
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Is body of knowledge developed from question raised by nurses and
investigated by them, concerning the relationship of human-health-
environment.
Has goal of testing new interpretations and explore different
explanations, under general laws about phenomenon refining to caring
well-being and autonomy of person as harmonious entities.
Is a unique human science which focuses on phenomena related o
human health.
Has both practical and theoretical aspects.
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Is the substantive, abstract knowledge describing nursing’s unique
phenomena of concern, the integral nature of unitary human being and
their environment.
The creation of this knowledge occurs through synthesis as well as
qualitative and quantitative modes of inquiry.
Nursing science based practice is the imaginative and creative use of
nursing knowledge to promote the health and well-being of all people.
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Is the essence of nursing as a scholarly discipline.
Is characterized by a unique perspective, a distinct way of
viewing all phenomena, which ultimately defines the limits and
nature of its inquiry”.
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Historical Background of Nursing
Pre-Civilization
 Belief that good and evil spirits bring health/illness
Physician as medicine person
Nurse as mother caring for family, society.
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Historical Background of Nursing…..
Beginning of Civilization
Belief that illness is caused by sin and gods’ displeasure /disapproval.
Temples/holly place were centers of therapy
Priest believed as therapist
Nurse viewed as care provider carrying out menial/unskilled tasks
ordered by priests.
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Historical Background of Nursing…
Beginning of 16th Century
Focus on religion replaced by focus on warfare
Exploration and expansion of knowledge
In shortage of nurses: criminals recruited for service
Nursing considered disreputable /notorious
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18th–19th Century
Hospital schools organized, Female nurses under control of male
hospital administrators &physicians,
Male dominance of health care
Nursing becomes respected occupation
Modern methods in nursing education founded.
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World War II
Explosion of knowledge in medicine& technology
Efforts made to upgrade nursing education
Women more assertive/confident & independent
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1950s to Present:
Varied healthcare settings developed
Nursing broadened in all areas
Growth of nursing as a profession
Nursing’s Code of Ethics was revised in 2001 to reflect current ethical
issues
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Contributions of future Nursing (F.N ).
Identified personal needs of patient and role of nurse in meeting them
Established standards for hospital management
Established nursing education and respected occupation for nurse
professionals
Recognized two components of nursing – health and illness
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Contributions of F.N…
Believed nursing is separate and distinct from medicine
Recognized nutrition as important to health care
Instituted occupational & recreational therapy for sick people
Stressed the need for continuing education for nurses
Maintained accurate records/beginning of nursing research
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Scope of Nursing
Nursing is for individual, family and community.
Nursing practice involves four major area.
1. Promotion of health and wellness
2. Prevention of illness
3. Restoration of health
4. Care of disabled and dying
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The Aims Of Nursing
1. Promoting wellness
Wellness- is the achievement of one maximum attainable potential.
2. Preventing illnesses- the main objectives are;
To reduce the risk for illness
To promote good health habit
To maintain optimal functioning
3. Restoring health
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The Aims Of Nursing….
4. Providing direct care of the person.
5. Facilitate ,coping
 The goals of health cannot always be met. The nurses also facilitate
patient& family coping with altered function, life crisis& death.
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Role of Nurses
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Philosophy of Nursing Theory
Overview of Nursing Theory
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Theory
Systematic set of interrelated concepts, definitions and
deductions that describe, explain or predict interrelationships.
Creative and vigorous structuring of ideas that project a
tentative, purposeful and systematic view of phenomena .
Coherent set of hypothetical, conceptual and pragmatic
principles forming a general frame of reference for a field of
inquiry.
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Theory cont’d….
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A notion or an idea that explains experience, interprets
observation, describes relationships, and projects outcomes
A set of statements that tentatively describe, explain, or
predict relationships between concepts that have been
systematically selected and organized as an abstract
representation of some phenomenon
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Theory cont’d….
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A systematically related set of statements including law-like
generalizations that are empirically testable.
A set of concepts, definitions, and propositions that projects a
systematic view of phenomena by designating specific
interrelationships among concepts for purposes of describing,
explaining, predicting, and/or controlling phenomenon.
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Theory cont’d….
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A group of related concepts that propose action that guide
practice.
A logically interrelated set of confirmed hypotheses”.
A theory deals with one or more relatively specific and concrete
concepts and propositions”.
Theories are not discovered in nature but are human inventions.
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Some Terms Related to Theory
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Theory
Purpose
Concepts
Construct
Proposition
Assumption
Supposition
 Premise
Axioms and postulates
Theorems
Conclusion
A hypothesis
Law
Conceptual Model
Paradigm
Discipline
Research
Concept analysis
Deductive Reasoning
Inductive Reasoning
Metaparadigm
 Philosophy
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Theory cont’d
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Central to all definitions, there are some
communalities of terms/elements of nursing theory
Purpose
Concepts
Definitions
Propositions
Structured ideas
Tentative
Describe a phenomenon or occurrence
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Theory cont’d …..
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Purpose
 It answers the question why is the theory formulated
Concepts
 Building blocks of theory
 Ideas, mental images of a phenomenon, an event or object that is derived
from an individual’s experience and perception (object, property, process,
or event).
Construct
 If the phenomena are very abstract and the resultant concept is not directly
observable or measurable it is often referred to as a ‘construct’
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Proposition
The linking statements of different concepts, constructs and
variables
Tentative statements about reality and its nature
 In the logical development of theories, it is expected that
propositions will follow a clearly identifiable line of reasoning
from initial premises to conclusions
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Proposition
Some specific types of propositions are ""postulates,
""premises, and ""axioms, which in a formal logical
deductive format are introductory prepositional
statements.
Other types of propositions are “theorems, 'hypotheses,
and laws, which in a chain of logical deductive reasoning
are concluding propositional statements
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Preposition cont’d
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types of statement.
Assumption
Supposition
Premise
Axiom
Postulate
Conclusion
Hypothesis
Theorem
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Assumption count…
positivist (P) and naturalist (N) assumptions about the
nature of reality (ontology) and the relationship of the
knower to the known (epistemology):
1. The nature of reality
P—reality is single, tangible, and fragmentable
N—realities are multiple, constructed, and holistic
2. The relationship of the knower to the known
P—Knower and known are independent, a dualism
N—Knower and known are interactive, inseparable
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Supposition :Refers similar meaning with assumption
Suppositions are taken to be true for the sake of argument.
We tend to accept the supposition that the environment is forever
changing
Premise: A premise is an introductory prepositional statement about
the relationship between concepts in a theory.
A relationship statement ‘used in deductive logic as a basis for
forming a conclusion.
In mathematics and deductive logic, premises serve as the basis for
forming a conclusion.
Postulates and axioms are other types of premises.
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Axioms and postulates
Similar to premises and form the major components within
deductive logic.
An axiom is a proposition that, is presumed to be true or self-
evident.
Axioms provide a basis from which other truths may be deductively
inferred.
an axiom is ‘a statement from which other statements of a theory
may be logically derived.
Axioms as premises are presumed to be true, in contrast to the
tentative nature of most propositions.
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Theorems:
is a conclusion, drawn from a set of axioms within a logical
deductive framework, which is accepted as truth.
Because axioms as premises connote a greater degree of
certainty, theorems also will be considered as less
tentative/unsure than hypotheses
Conclusion
A prepositional statement that refers to the end result of
deductive reasoning
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A hypothesis
• A proposition that refers to as a tentative statement which
suggests some sort of relationship between two or more
variables in a theory and can be tested through using
research methods’.
• Supported hypotheses may also serve as premises in
deductive arguments, where they lend a higher degree of
soundness to conclusions than do untested premises
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Law
• Is a proposition about the relationship between concepts in a
theory that has been repeatedly supported and accepted as valid.
• Laws are highly generalizable; that are consistently supported and
not tentative.
• Patterns of relationships that have become widely accepted by
virtue of repeated validation through research.
• A propositional statement that is highly generalizable , consistently
supported and therefore not tentative .
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Conceptual Model
 is a set of interrelated concepts that symbolically
represents and conveys a mental image of a phenomenon.
Are conceptual tools or devices that can be used by an
individual to understand and place complex phenomena
into perspective.
An abstract and general system of concepts and
propositions
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Conceptual Model
• It has also been described as ‘a mental or diagrammatic
representation of care which systematically constructed and
assists practitioners in organizing their thinking about what
they do and in the transfer of their thinking into practice for
the benefits.
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Paradigm:
It refers to patterns or systems of beliefs (worldviews) about
science and knowledge production occurring within and across
disciplines.
Theoretical thinking
A particular viewpoint or perspective
Further classified as system paradigm, interactional paradigm,
developmental paradigm and behavioral paradigm
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Systems paradigm
• Theories within this paradigm are largely based upon the
‘general systems’ paradigm
• Nursing theories that have their roots within the system
paradigm, the client is often referred to as an ‘open system
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Interactional paradigm
• Interactional theories have their origin in the symbolic
integrationist paradigm.
• This paradigm emphasizes the relationships between
people and the roles they play in society.
• Nursing activities are perceived as interactional
processes between practitioners and clients.
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Developmental paradigm
• Within this paradigm, it is argued that human beings are
constantly developing whether this be physiologically,
socially, cognitively, psychologically or spiritually.
• Development is seen as an ongoing process in which the
person must pass through various stages.
• The nurse’s role is to encourage positive development and
to break down or discourage the formation of barriers to
natural development
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Behavioral paradigm
• The behavioral paradigm owes much to the theoretical
formulations of Abraham Maslow (1954) concerning
motivation.
• Because of this, the theories which emanate from it are often
referred to as ‘human needs’ theories’ (Webb, 1986).
• The behavioral paradigm assumes that individuals normally
exist and survive by meeting their own needs.
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Discipline
• A discipline is characterized by a unique perspective, a
distinct way of viewing all phenomena, which ultimately
defines the limits and nature of its inquiry.
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Research
• Research is a systematic process of investigation, the general
purpose of which is to contribute to the body of knowledge
that shapes and guides academic and/or practice disciplines.
• Research may be defined as ‘a systematic process of enquiry
which utilizes a variety of methodological approaches to
investigate the questions and concepts of interest in nursing’
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The nature of theory
• Tentative in nature
• Theory is not reality; it is an abstraction of reality based on
assumptions about the true nature of a phenomenon that cannot
be proved or disproved.
• The degree of support that may be found for a theory relies on
applying various forms of reasoning to test the logic of
propositional statements and validating associated hypotheses
through research.
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Borrowed/Shared Theory
• A borrowed theory is theory developed in another
discipline that is not adapted to the worldview and
practice of nursing.
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Concept analysis
• Defining relevant attributes/empirical indicators and
criteria by which they may be judged to be present in a
particular situation.
• A concept development through concept exploration,
concept clarification and analysis
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Concept analysis (a concept development strategy
which sometimes alternates in usage with the terms
concept development and concept clarification] is
represented by a number of approaches.
A technique or mental activity that requires critical
approaches to uncovering subtle elements of meaning
that can be embedded in concepts.
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Concept exploration
• Labeling, identifying major components/dimensions,
and establishing why development of the concept
should be pursued.
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Concept clarification
Refining existing definitions, considering
interrelationships between different elements of the
concept, discovering and discussing new relationships to
resolve existing conflicts about meaning and definitions.
Developing an operational definition
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Deductive Reasoning
• Deductive reasoning is a way of thinking that begins with premises
about a phenomenon and systematically formulates a conclusion
that must necessarily follow.
• (Premise) all A is B
• (Premise) all C is A
• (Conclusion) all C is B
• The format is fixed, and therefore if the premises are faulty, the
conclusion will be faulty as well.
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Inductive Reasoning
• Inductive reasoning is a way of thinking begins with
observation of patterns or repetitive occurrences and
systematically formulates conclusions about what
probably or possibly is going on, that is what those
observations may signify.
• Thus, conclusions are reached by moving from lower
to higher levels of abstraction.
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• Metaparadigm:
is a term referring globally to the subject matter of greatest
interest to members of a discipline.
The issue is about boundaries that distinguish disciplines from
one another, not so much in terms of subject matter (because
certain subject matter may be of mutual interest to many
disciplines) but in terms of how disciplines view and address
the phenomena they see as central to their missions.
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Metaparadigm
• The most global perspective of a discipline acting as an
encapsulating unit or framework within which the more
restricted structures develop.
• It identifies certain phenomena which are of interest to a
discipline and explains how that discipline deals with those
phenomena in an unique manner.
• The four components are: ‘nursing’, ‘health’, ‘person’, and
‘environment’ Fawcett, 1995
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Person/man/human being/client/patient
• Uniform whole composed of inseparable Physiological,
Psychological, Social, Spiritual, Cultural parts
• The human being is an open system
• The scope of human being in nursing Individual,
Family, Community and Society
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Health
• The ability to function independently regarding fourteen activities of daily living
(Henderson, 1966)
• The optimum level of independence in each activity of living which enables the
individual to function at his/her maximum potential (Roper, Logan and Tierney,
1990)
• A state of wholeness or integrity of the individual, his parts and his modes of
functioning (Orem, 1980)
• The adaptation of the person to stimuli on a continuous line between wellness
and illness (Roy, 1971)
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Environment
• That which may act in a positive or negative way upon the client
(Henderson, 1966)
• Circumstances that may impinge upon the individual as he or she travels
along the life-span and cause movement towards maximum dependence
or maximum independence (Roper, Logan and Tierney, 1990)
• A sub-component of man and with man forms an integrated system
related to self-care (Orem, 1980).
• Both internal and external. From the environment people are subject to
stresses (Roy, 1971).
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Philosophy’
• A philosophy is concerned with the nature of being, the
nature of reality and the limits of knowledge (Silva 1986 ).
• A philosophy is also perceived as ‘a statement of beliefs and
values about the world, a perspective on human beings and
their world, and an approach to the development of
knowledge’ (Fawcett, 1992).
• A philosophy identifies what is believed to be the basic or
central issues of a discipline (Salsberry 1994).
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Characteristics of theory
Theories are:
 Interrelating concepts as to create a different
way of looking at a particular phenomena.
 Logical in nature & Generalizable.
 Bases for hypotheses that can be tested.
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Characteristics…
 Increasing the general body of knowledge within the
discipline through the research implemented to validate
them.
 Used by the practitioners to guide and
improve their practice.
 Consistent with other validated theories, laws, and
principles but will leave open unanswered questions that
need to be investigated.
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Importance of nursing theories:
Nursing theory aims to:
Describe –the relation of concepts ( nursing to client),
Interprets –the observation,
Predict/project –the out comes of the reality,
Explain the phenomenon/experience of nursing,
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Importance…..
 It helps to decide what we know and what we
need to know.
 It helps to distinguish what should form the
basis of practice by explicitly describing nursing.
For better patient care .
Enhanced professional status for nurses.
Improved communication between nurses, and
Guidance for research and education .
.
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Importance…..
The main exponent/promoter of nursing is:
 Caring – can be measured
It is vital to have the theory to analyze and
 explain what nurses do to measure the phenomena.
One of the most common ways theory has been organized
in practice is ,in the nursing process of analyzing assessment
data.
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Purposes of theory in practice
Assist nurses to describe, explain, and predict everyday experiences.
Serve to guide assessment, intervention, and evaluation of nursing care.
Provide a rationale for collecting reliable and valid data about the health
status of clients, which are essential for effective decision making and
implementation.
Enables nurses to know WHY they are doing & WHAT they are
doing.
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Purposes …..
Help to establish criteria to measure the quality of
nursing care
Helps building a common nursing terminology to use in
communicating with other health professionals.
Ideas are developed and words defined.
Enhance autonomy (independence and self-governance) of
nursing by defining its own independent functions.
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Why nurses use theory in daily practice ?
Organize patient data.
Understand patient data.
Analyze patient data.
Make decisions about nursing interventions.
Plan patient care.
Predict outcomes of care.
Evaluate patient outcomes.
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The Role of Theory in Clinical Nursing Practice
The role of theory in clinical practice:
Viewed in the context of knowledge‐use in practice
Clinical nursing practice as a situation‐specific, singular
human experience.
Also as a system of nursing‐specific practice in clinical
situations
The role of theory as:
Background building for practice
Use in “specific clinical practice”
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February 12, 2021

Types of nursing theories
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1. Meta-theory
2. Grand theory
3. Middle range theory
4. Micro theory
February 12, 2021

1. Meta-theory focuses
1.Philosophical and methodological questions to base of
theory for nursing
2.Analyzing the purpose and type of theory needed in
nursing
3.proposing & critiquing sources of theory
4.proposing the criteria most suited for evaluating theory
in nursing
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February 12, 2021

2. Grand Theory
90
• Consist of broad conceptual frameworks that reflect
wide and expansive perspectives for practice and ways
of describing, explaining, predicting and looking at
nursing phenomena.
• They are the most complex and broadest in scope.
February 12, 2021

3. Middle Range Theory
91
• Less complex and narrower in scope than grand theory.
• A more workable level is the middle range. more limited in
scope and less variables, and testable.
February 12, 2021

4. Micro theories
92
• The least complex
• They contain the least complex concepts and are
narrowest in scope.
• They deal with a small aspect of reality, generally a set of
theoretical statements.
• Deals with specific and narrow defined phenomena.
February 12, 2021

Major nursing theorists & their works
used for nursing practice
 Peplau 1952 : interpersonal relation in nursing
 Orlando 1961: the Dynamic nurse –pt relation ship
 Wiedenbach 1964 : clinical nursing: A helping art
 Henderson 1966 : The nature of nursing
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February 12, 2021

Major nursing theorists…..
Levine, 1967: The four conservation principles
of nursing
 Ujhely 1968: Determination of the nurse- patient r/ship
Rogres 1970: An introduction to theoretical Basis of nursing
 King 1971: Toward a theory of nursing
 Orem 1971: nursing concepts of practice
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February 12, 2021

Major nursing theorists…..
Travel bee 1971: Interpersonal aspects of nursing
 B. Neumann 1974: Health-care systems model
 Roy1976 : Introduction to nursing: An adaptation model
Auger: 1976: Behavioral systems and
nursing
New man 1979 : Towards theory of the health
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February 12, 2021

THANK YOU !!!
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February 12, 2021

1 Introduction to Foundation of Nursing I.pdf

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