Chapter 06

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 6Chapter 6
Overview ofOverview of
Grand Nursing TheoriesGrand Nursing Theories

Grand Nursing Theories
• Most complex and widest in scope of the levels of theory
• Attempt to explain broad areas within the discipline

Relationship of conceptual model, theory, and hypotheses.

Grand Nursing Theories—(cont.)
• Characteristics
– Composed of relatively abstract concepts
– Developed through thoughtful appraisal
of existing ideas
– May incorporate other theories

• Have helped develop the discipline
• Some believe need for grand theories is outdated.

• Provide a background of philosophical reasoning
• Many nursing theorists are still writing, updating
their work based on changes in the health care
system and society.

• The number of grand nursing theories leads to confusion.
• Many have coined their own terms also leading to
confusion.

• Categorizations or groupings of the theories have been
attempted based on theory commonalities and
worldviews.
• Three main groups
– Human needs theories (particulate–deterministic)
– Interactive theories (integrative, reciprocal)
– Unitary process theories (unitary, simultaneity)

Question
Which of the following is NOT one of categorizations of
grand nursing theories described in the text?
A.Historical/generative theories
B.Human needs theories
C.Interactive/integrative process theories
D.Unitary process theories

Answer
A. Historical/generative
Rationale: One way to organize the large number of grand
nursing theories is by human needs theories, interactive or
integrative process theories, and unitary process theories.

Comparison of categories (paradigms) of theories.

Human Needs Theories
• Also termed “particulate–deterministic”
• Based on the positivist view of science
– Stress quantitative research methods
– Humans are viewed a reducible (sum of parts).
– Change is linear and causal.

Human Needs Theories—(cont.)
• Humans are biopsychosocial-spiritual beings.
• Humans react to their environment in a causal way.
• Change is predictable as humans survive and adapt.

• Earliest theorists drew from the empirical (positivist)
worldview focusing on meeting needs.
• Early theories were developed to distinguish nursing from
medicine.
• In needs-based theories, clients are sum of their parts.
• Cause of the problem can be identified, measured, and
treated.

• F. Abdellah
• V. Henderson
• D. Johnson
• F. Nightingale
• B. Neuman
• D. Orem

Interactive Nursing Theories
• Also termed integrative or reciprocal
• Postpositive worldview (not strictly positivistic)
– Recognize that reality is multidimensional and
contextual
– Objectivity and subjectivity are desirable.

Interactive Nursing Theories—(cont.)
• Humans are holistic beings.
• Humans interact reciprocally with their environment.

• Interactive theories came after the needs-based theories.
• Theorists frequently use systems theory to describe
interaction between client/person and environment.

Question
Tell whether the following statement is true or false:
Interactive/integrative process theories frequently stress
that humans should be considered in the context of their
environment and the theories use a systems approach.

Answer
True
Rationale: Interactive nursing theories recognize that
reality is contextual and typically involve systems theory.

• Artinian
• Erickson, Tomlin, and Swain
• King
• Levine
• Roper, Logan, and Tierney
• Roy
• Watson

Unitary Process Theories
• Also termed unitary or simultaneity theories
• Views humans as unitary beings
• Humans are self-evolving and self-regulating.

Unitary Process Theories—(cont.)
• Humans are in constant and simultaneous interaction
with a universal energy system.
• Humans are known by patterns of energy and
distinctions from others.
• Change is unidirectional and unpredictable.

Question
Tell whether the following is true or false:
According to unitary process theory, humans are complex
energy systems whose responses can be predicted.

Answer
False
Rationale: Unitary process theories recognize that,
although humans are energy systems in constant and
simultaneous interaction with their environment, because
they are complex and constantly changing, change is
unidirectional and unpredictable.

Unitary Process Theories—(cont.)
• M. Rogers
• R. Parse
• M. Newman

Online Resources
• http://www.sandiego.edu/academics/nursing/theory/
• http://nursing-theory.org/
• http://www.nurses.info/nursing_theory_accepted_theories.h

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