This document discusses the theoretical foundations of nursing. It explains that nursing theory provides the basis of the nursing profession by defining what nursing is, its goals, and outcomes. The document outlines the key components of a theoretical foundation, including concepts and propositions. It discusses important nursing theorists like Nightingale, Peplau, Henderson, Abdellah, and contemporary theorists like Levine, Orem, and Roy. The document also examines the evolution of nursing theory and knowledge development.

1. Framework of Practice
Nursing

2. 2
The Theoretical Foundation of
Nursing
 Nursing theory provides the theoretical
foundation of the profession.
 Theory defines what nursing is, what it
does, and the goals or outcomes of
nursing care.
 Nursing is the synthesis of many
theories.

3. 3
Components of the Theoretical
Foundation
 A theory is a set of concepts and
propositions that provides an orderly way
to view phenomena.
 Concepts and propositions are the
structural elements of a theoretical
foundation.

4. 4
Concepts
 Building blocks of a theory
 Labels or names for
phenomena/observable facts
 Assist us in formulating a mental image
about an object or situation

5. 5
Concepts
 Theories are formed by linking concepts
together.
 A conceptual framework links global
concepts together.

6. 6
Conceptual Model
 The “symbolic representation of empiric
experience in words, pictorial, or graphic
diagram, mathematical notations or
physical material.”

7. 7
Propositions
 A proposition is a statement that
proposes a relationship between
concepts.
 Propositional statements in a theory
represent the theorist’s view of which
concepts fit together.

8. 8
Theories
 A theory helps us to organize our
thoughts and ideas.
 In science, the purpose of a theory is to
guide research, support existing
knowledge, or generate new knowledge.
 The term theory is not restricted to the
scientific world.

9. 9
Importance of Nursing Theories
 Framework for thought in which to
examine situations
 Structure for organization, analysis, and
decision making
 Structure for communicating with other
nurses and other health team members

10. 10
Importance of Nursing Theories
 Assist the nursing discipline in clarifying
beliefs, values, and goals.
 Help to define the unique contribution of
nursing in the care of clients.
 Standards of clinical practice are
developed out of nursing theories.

11. 11
Process of Knowledge
Development

12. 12
Scope of Theories
 Grand Theories
 Middle-Range Theories

13. 13
Grand Theory
 Provides an overall framework for
structuring broad, abstract ideas.
 Composed of concepts representing
global and extremely complex
phenomena.

14. 14
Middle-Range Theory
 Provides a perspective from which to
view complex situations and a direction
for interventions in three levels of
abstractness.
• High middle-range
• Middle middle-range
• Low middle-range

15. 15
Florence Nightingale’s Influence on
Knowledge Development in Nursing
 Described nursing as both an art and a
science.
 Stressed the importance of caring for the
ill person rather than the illness.
 Viewed a person’s health as the direct
result of environmental influences
(cleanliness, light, pure air, pure water,
efficient drainage).

16. 16
Florence Nightingale’s Influence on
Knowledge Development in Nursing
 The turn of the 20th century marked the
beginning of hospital-based schools of
nursing.
 Nightingale’s principles were
incorporated into modern nursing theory.

17. 17
The Evolution of Nursing
Theory
 Since the early 1950s, many nursing
theories have been systematically
developed to help describe, explain, and
predict the phenomena of concern to
nursing.

18. 18
Knowledge Development
in Nursing
 Paradigm
• A particular viewpoint or perspective
• A “worldview” about the phenomena of
concern in a discipline (Kuhn, 1970)
 Metaparadigm
• The major concepts in a discipline that
names the phenomena of concern

19. 19
Knowledge Development
in Nursing
 Metaparadigm of Nursing
• Person: Individual, family or group
• Health: Continuum of wellness to terminal
illness
• Environment: Place or community where
care is provided
• Nursing: Actions; interactions of the nurse
with the person

20. 20
Knowledge Development
in Nursing
 Two individuals with different
paradigmatic views can look at the same
phenomenon and view the phenomenon
differently.

21. 21
Knowledge Development
in Nursing
 The prevailing paradigm in a discipline
represents the dominant view of
particular concepts.
 A paradigm revolution is the turmoil and
conflict that occur in a discipline when a
competing paradigm gains acceptance
over the dominant paradigm.

22. 22
Knowledge Development
in Nursing
 A paradigm shift refers to the acceptance
of the competing paradigm over the
prevailing paradigm or a shifting away
from one worldview toward another
worldview.
 Members of a discipline cannot
subscribe to two competing paradigms at
the same time.

23. 23
Knowledge Development in
Nursing
 Four Levels of Knowing
• Empirical
• Aesthetic
• Personal
• Ethical

24. 3-24
Early Nursing Theorists
 Hildegard Peplau
• Defined concepts of stages of nurse-client
relationships.
 Virginia Henderson
• Defined basic human needs as the unique
focus of nursing practice.

25. 3-25
Maslow’s Hierarchy of Needs

26. 3-26
Early Nursing Theorists
 Faye Abdellah
• Identified 21 nursing problems that became
the foundation of nursing diagnoses.
 Joyce Travelbee, Josephine Paterson
and Loretta Zderad
• Emphasized the humanistic and existential
basis of nursing practice to understanding
the uniqueness of patients.

27. 3-27
Contemporary Nursing
Theorists
 The work of contemporary theorists form
the theoretical basis for many
interventions in current nursing practice.
• Myra Levine
• Dorothea Orem
• Sister Callista Roy

28. 3-28
Contemporary Nursing
Theorists
 Myra Levine’s Conservation Theory
(1969)
• Four universal principles of conservation
designed to apply concepts of nursing
practice in different environments

29. 3-29
Dorothea Orem
 Self-Care Deficit Theory of Nursing
• Theory of Self-Care
• Theory of Self-Care Deficit
• Theory of Nursing Systems

30. 30
Roy Adaptation Model
 Developed by Sister Callista Roy, 1976.
 Combined general systems theory with
adaptation theory.
 Goal of nursing is “promotion of
adaptation” in each of four modes of
adaptation.
 Applicable to the home setting.

31. 31
Roy Adaptation Model
 The goal of nursing is “the promotion of
adaptation” in each of four adaptive
modes.
• Physiologic
• Self-concept
• Role function
• Interdependence

32. 32
Theories for the New
Worldview of Nursing
 Describe, explain, and predict the
phenomena of concern to nursing from a
more holistic perspective.
• Jean Watson
• Martha Rogers
• Rosemarie Parse

33. 33
The Theory of Human Caring
 Developed by Jean Watson in the 1980s.
 Conceptualizes human-to-human
transactions that occur daily in nursing
practice.
 Ten carative factors are classified as
nursing actions or caring processes.

34. 34
The Science of Unitary
Human Beings
 Developed by Martha Rogers in 1990.
• The person is characterized as a human
energy field that unites all aspects of the
person into a unified whole.
• Nursing aims to repattern the rhythm and
organization of these energy fields to
heighten the integrity of the person.

35. 35
Gordon’s Functional Health
Patterns
 Influenced by Maslow’s Hierarchy of
Basic Human Needs and Von
Bartlaffny’s general systems theory.
 Offer a holistic approach to the
development of nursing diagnoses and
client care.
 Provides an appropriate method for
organization of textbook topics.

36. 36
Continuing Evolution of Nursing
Theory
 Nursing is always in a state of change.
 Nursing knowledge continues to expand
in a multiplicity of ways.
 New theories will come from a global
perspective and international nursing
leaders in the 21st century.

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