Nursing Models by Siti Nur Baizura

1. DNNS1043
PRINCIPLE & PRACTICE of
NURSING
LESSON 2
NURSING MODELS

2. LEARNING OBJECTIVES
After completing the lecture, student will be able to:
1. Define nursing ‘theory’ and ‘model’.
2. State the purpose of using nursing theory in nursing practice.
3. Identify three key components to a nursing model.
4. Discuss the different viewed of nursing model on the four major
concepts in nursing theory

3. Definition of Model and Theory
Model
• The term ‘nursing model’ has been defined as
“a symbolic representation of empirical experience in
words, pictorial or graphic diagrams, mathematical
notations, or physical material [and] a form of
knowledge within the empirical pattern”
(Chinn & Kramer 2004: 264)

4. Definition of Model and Theory
Model
• describe nursing phenomena and assumptions in abstract and logical ways.
• can be presented and organized into nursing language, words, pictures,
diagrams, drawings or logical structures to help understand what was
observed in practice.
• Use model as a tools in research for developing a theory

5. Definition of Model and Theory
Theory
• The term ‘nursing model’ has been defined as
“‘a creative and rigorous structuring of ideas that project a tentative,
purposeful, and systematic view of phenomena”
(Chinn & Kramer 2004: 219)

6. Definition of Model and Theory
Theory
• Nursing theory is constructed out of specific nursing phenomena represented
as concepts, definitions, assumptions and propositions that help describe,
explain or predict how nursing may support and help patients, families or
society.
• Theory is a body of knowledge of nursing, and provides answers to questions
that are of interest to nursing.
• Use specific language, ideas or sometimes symbols to give answers to
practice based nursing problems.

7. Purpose of Nursing Theory
1. Directs nurses toward common goal.
2. Leads to improved patient care.
3. Provides rational and knowledgeable reasons for
nursing actions.
4. Gives nurses knowledge base necessary for
appropriate actions.

8. Purpose of Nursing Theory
5. Helps resolve current nursing issues.
6. Prepares nurses to question assumptions and values.
7. Serves research, education, and practice.

9. Nursing Theories
1. Florence Nightingale: The Environmental Theory
2. Virginia Henderson: The Definition of Nursing
3. Dorothea Orem: General Theory of Nursing
4. Jean Watson: Human Caring Theory
5. Madeleine Leininger: Transcultural Care Theory and
Ethnonursing

10. Nursing Theories
6. Callista Roy: Adaptation Theory
7. Hildegard Peplau: Interpersonal Relations Theory
8. Imogene King: Goal Attainment Theory
9. Rosemarie Rizzo Parse: Human Becoming Theory

11. Florence Nightingale: The
Environmental Theory
1. Often considered the first nurse theorist.
2. She linked health with five environmental factors :
• Pure or fresh air
• Pure water
• Efficient drainage
• Cleanliness
• Light, especially direct sunlight
3. Deficiencies in these five factors produced
lack of health or illness but with a nurturing environment,
the body could repair itself

12. Florence Nightingale: The
Environmental Theory
4. Considered a clean, well-ventilated, quiet environment
essential for recovery.
5. Nightingale set the stage for further work in the
development of nursing theories.
6. Her general concepts about ventilation, cleanliness,
quiet, warmth and diet remain integral parts of
nursing and health care today.

13. Defined Nursing: “The act of
utilizing the environment of
the patient to assist him in
his recovery.”

15. Virginia Henderson: The Definition
of Nursing a Unique Function
1. Defined Nursing: “Assisting
the individual, sick or well, in
the performance of those
activities contributing to
health or it’s recovery (or to
peaceful death) that an
individual would perform
unaided if he had the
necessary strength, will or
knowledge”.

16. Virginia Henderson: The Definition
of Nursing a Unique Function
2. Henderson (1996) conceptualizes the nurse’s role as
assisting sick or healthy individuals to gain
independence in meeting 14 Fundamental needs.

18. 14 Fundamental Needs of Human
1. Breathe normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable postures
5. Sleep and rest
6. Select suitable clothes—dress and undress
7. Maintain body temperature within normal range by adjusting clothing and modifying the
environment
8. Keep the body clean and well groomed and protect the integument
9. Avoid dangers in the environment and avoid injuring others
10. Communicate with others in expressing emotions, needs, fears, or opinions
11. Worship according to one’s faith
12. Work in such a way that there is a sense of accomplishment
13. Play or participate in various forms of recreation
14. Learn, discover, or satisfy the curiosity that leads to normal development and health and
use the available health facilities.

19. Dorothea Orem: General Theory of
Nursing
1. Focuses on activities that adult
individuals perform on their own
behalf to maintain life, health and
well-being.
2. Has a strong health promotion
and maintenance focus.

20. Dorothea Orem: General Theory of
Nursing
3. Dorothea Orem’s theory (published in 1971) includes three
related concepts:
i. Self-care - activities an Individual performs
independently throughout life to promote and maintain
personal well-being.
ii. Self-care deficit - results when self-care agency
(Individual’s ability) is not adequate to meet the known
self-care needs.
iii. Nursing systems - nursing interventions needed when
Individual is unable to perform the necessary self-care
activities:-

21. Dorothea Orem: General Theory of
Nursing
i. Wholly compensatory – nurse provides entire self-care for the
client. Example: care of a new born, care of client recovering from
surgery in a post-anesthesia care unit
ii. Partial compensatory – nurse and client perform care, client can
perform selected self-care activities, but also accepts care done by the
nurse for needs the client cannot meet independently. Example:
Nurse can assist post operative client to ambulate, Nurse can bring a
meal tray for client who can feed himself
iii. Supportive-educative – nurse’s actions are to help the client
develop/learn their own self-care abilities through knowledge,
support and encouragement. Example: Nurse guides a mother how to
breastfeed her baby, Counseling a psychiatric client on more adaptive
coping strategies.

22. Jean Watson: Human Caring
Theory
1. Jean Watson (2005) believes the practice of caring is
central to nursing.
2. She has wrote 11 major assumption about caring.
3. Human caring in nursing is not just an emotion,
concern, attitude, or benevolent desire. Caring
connotes a personal response.
4. Caring is an intersubjective human process and is the
moral ideal of nursing.

23. Jean Watson: Human Caring
Theory
5. Caring can be effectively demonstrated only
interpersonally
6. Effective caring promotes health and individual or
family growth.

24. The Relation of Nursing Theory &
Practice

25. NURSING CONCEPT
• Definition of Nurse - originated from the Latin word
nutrix (to nourish)
• A nurse is a person who nourishes, fosters and protects,
a person prepared to take care of the sick, injured and
aged people (Ellis & Hartley, 1992)

26. NURSING CONCEPT
The unique function of the nurse is to assist the
individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to
peaceful death) that he would 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 to help
him gain independence as rapidly as possible.
The International Council of Nurses ( 1973) adopted from
Virginia Henderson’s definition.

27. Common concept of nursing
• Nursing is caring
• Nursing is an art
• Nursing is a science
• Nursing is client centered
• Nursing is holistic

28. Recipients of Nursing
The recipients of nursing are sometimes called
consumers, patients and clients.
1. Consumer – is an individual, a group of people, or a
community that uses a service or commodity.
2. Patient – is a person who is waiting for or undergoing
medical treatment and care.
3. Client – is a person who engages the advices or
services of another who is qualified to provide this
services.

29. Scope of Nursing
1. Promoting health and wellness
2. Preventing illness
3. Restoring health
4. Caring for the dying

30. Roles and function of the nurse
1. Caregiver
2. Communicator
3. Teacher
4. Client advocate
5. Counselor
6. Change agent
7. Leader
8. Case manager
9. Research consumer

31. CONCEPT OF NURSING
1. There are FOUR (4) concepts in nursing profession :
• Person /client - recipient of nursing care
• Environment - internal and external surroundings
that affect the client
• Health - degree of wellness or well-being
• Nursing - attributes, characteristics and actions of
the nurse providing care on behalf of

32. i. PERSON
1. In nursing theory, human beings are considered in terms of
their physiological, psychological, social, spiritual and cultural
selves.
2. People are evaluated in terms of their individual place in
society as well as their relationships to their family,
community and society as a whole.
3. The purpose of nursing and nursing theory is to identify how a
particular individual's needs are either met or not met, to
predict future needs and to prioritize those needs in order of
importance.

33. ii. ENVIRONMENT
1. The environment concept of nursing comprises all the internal
and external factors that act on human beings and affect their
behaviour and development.
2. This includes psychological, spiritual, social, physical and
cultural forces as well as the environment in which nursing care
is provided.
3. The idea behind this concept is that the environment influences
individual and collective health and that individuals who
experience a positive, comfortable nursing environment are
more likely to demonstrate good health versus those who receive
a level of care that is lacking.

34. iii.HEALTH
• The concept of health refers to an individual's physical, mental and
social well-being and at what point they are on the health spectrum,
which ranges from good health to poor health or death.
• Health is considered to be affected by genetic factors, environmental
factors, lifestyle factors and external mechanisms, such as bacteria.
• A person's place on the health spectrum is constantly changing and
in a nursing context, it's the responsibility of nursing professionals to
identify the patient's place on the spectrum and to take steps to help
the person's health improve.

35. iv.NURSING
1. the process of caring for the health of human beings and
assisting individuals in meeting their needs while also teaching
them the basics of caring for themselves.
2. The responsibilities of the nursing profession are to promote
good health, to prevent disease when possible, to promote
healing in those who are ill and to ease the suffering of dying
patients.
3. The concept of nursing extends beyond the health care facility
to the community and society as a whole, and views individual
health and the environment as closely related.
4. Nursing is defined as care that is tailored to the needs of
individuals and that is provided in an efficient and effective
manner.

36. CONCEPT OF NURSING
PERSON
to identify how a
particular
individual's needs
& to predict
future needs and
to prioritize those
needs in order of
importance.
ENVIRONMENT
When the
environment
influences
individual and
collective health
are excellent it
can demonstrate
a good health.
HEALTH
A person’s health
spectrum is
constantly
changing & need
to be sort
accordingly to
improve athe
person's health.
NURSING
Resposibility of a
nurse are to promote
good health, to
prevent disease when
possible, to promote
healing in those who
are ill and to ease the
suffering of dying
patients.

37. REFERENCE
• Fundamentals of Nursing., 2007. Pearson Practice Hall, Petaling Jaya (Chapter 2, pg 23-26)
• Kozier, B., Glenora, E., Audrey, B. & Shirlee, S., 2004, Fundamental of Nursing: Concept, Process & Practice, 7th .ed, Pearson
Practice Hall
• Taylor, C., Lillis, C. & LeMone, P., 2005, Fundamentals of Nursing: The Art and Science of Nursing Care, 5th.ed, Lippincott
Williams & Wilkins
• "Theory and Practice of Nursing: An Integrated Approach to Caring Practice"; Lynn Basford, Oliver Slevin; 2003
• Medical College of Georgia: School of Nursing Mission/Vision
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