“Nursing theories mirror different realities, throughout their development; they reflected the interests of nurses of that time”

1. Vidya V S
MSc Nursing student

2. • A system of idea intended to explain something,
especially one based on general principle.
- Oxford dictionary
• Principle : Fundamental truth or proposition
serving as the foundation for belief or action.

3. • It may consist of one or more relatively
specific and concrete concepts and
propositions that purport to account for, or
organize some phenomenon (Barnum, 1988)
• A set of concepts, definitions, models,
propositions, and assumptions that project a
systematic view of a phenomena.

4. • Concepts – Ideas and mental images that help to
describe phenomena (Alligood and Marriner-Tomey,
2002).
• Definitions – Convey the general meaning of the
concepts.
• Models – These are representations of the
interaction among and between the concepts
showing patterns.

5. • Prepositions -are statements that explain the
relationship between the concepts.
• Assumptions – Statements that describe
concepts.
• Phenomenon – Aspect of reality that can be
consciously sensed or experienced (Meleis,
1997).

6. • A theory is a set of statements that is developed
through a process of continued abstractions. It
is a generalized statement aimed at explaining a
phenomenon.
• A model, on the other hand, is a purposeful
representation of reality.

7. • A nursing paradigm is a concept that has
developed over time from the beliefs and
practices of professionals in the healthcare sector.
• According to Nursing Theories, a nursing
paradigm is a pattern that shows the relationship
between a person, the environment in which she
lives and her health.

8. Client
Nurse
Health
Enviro-
nment

9. • Nursing has its domain in a paradigm that includes
four linkages:
• Person/client
• Health
• Environment
• Nursing (goals, roles, functions)
Each of these concepts is usually defined and described
by a nursing theorist. Of the four concepts, the most
important is that of the person. The focus of nursing
is the person.

10. • Nursing theory aims to describe, predict and
explain the phenomenon of nursing (Chinn and
Jacobs 1978).
• It provides the foundations of nursing practice,
help to generate further knowledge and
indicate in which direction nursing should
develop in the future (Brown 1964).

11. • 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 describing nursing.
• This can be seen as an attempt by the nursing
profession to maintain its professional
boundaries.

12. • It guides nursing practice and generates
knowledge.
• It helps to describe or explain nursing.
• Enables nurses to know WHY they are doing
WHAT they are doing.

13. 1. Systematic, logical and coherent
(orderly reasoning, no contradictions)
2. Creative structuring of ideas
mental images of one’s experiences and create
different ways of looking at a particular event or
object.
3. Tentative in nature ( change over time or evolving
but some remain valid despite passage of time)

14. 4. Interrelate concepts in such a way as to create
a different way of looking at a particular
phenomenon.
5. Are logical in nature.
6. Are generalizable.
7. Are the bases for hypotheses that can be
tested.

15. 8. Increase the general body of knowledge within
the discipline through the research implemented
to validate them.
9. Are used by the practitioners to guide and
improve their practice.
10.Are consistent with other validated theories,
laws, and Principles but will leave open
unanswered questions that need to be
investigated.

16. • Theory guides and improve nursing practice.
• Theory provides goal for nursing care and with
goals, nursing practice is rendered more
effective and efficient.
• Theories help to focus the goals, making nurses
more confident about the practice.

17. • Theory guides research
• It validates and modifies the theory.
• Theory contributes to the development of the
disciplines body of knowledge.
• Theory enhances communication.

18. • Meta-theory - the theory of theory. Identifies specific
phenomena through abstract concepts.
• Grand theories – broad and complex
• Middle-range theories- address specific phenomena
and reflect practice
• Practice theory - explores one particular situation
found in nursing. It identifies explicit goals and details
how these goals will be achieved.

19. • Descriptive theories – first level of theory
development
• Prescriptive theories – address nursing
interventions and predict their consequences

20. • These theories have the broadest scope and
present general concepts and propositions.
• Theories at this level may both reflect and provide
insights useful for practice but are not designed
for empirical testing.
• Grand theories consist of conceptual frameworks
defining broad perspectives for practice and ways
of looking at nursing phenomena based on the
perspectives.

21. • These theories are narrower in scope than
grand nursing theories and offer an effective
bridge between grand nursing theories and
nursing practice.
• They present concepts and propositions at a
lower level of abstraction and hold great
promise for increasing theory-based research
and nursing practice strategies.

22. • Nursing practice theories have the most
limited scope and level of abstraction and
are developed for use within a specific
range of nursing situations.
• Nursing practice theories provide
frameworks for nursing interventions, and
predict outcomes and the impact of nursing
practice.

23. • In the early part of nursing’s history, knowledge
was extremely limited and almost entirely task
oriented.
• Role of nurses where questioned; what they do, for
whom where and when were determined.
• The professionalization of nursing has been and is
being brought about through the development and
use of nursing theory.

24. Brought leading scholars and theorists to discuss and
debate on issues regarding nursing science and
theory development.

25. Environmental theory
• Pure fresh air
• Pure water
• Effective drainage
• Cleanliness
• Light(especially direct sunlight)
Any deficiency in one or more of these factors could lead to
impaired functioning of life processes or diminished health
status.

26. • "Patients are to be put in the best condition for nature
to act on them, it is the responsibility of nurses to
reduce noise, to relieve patients’ anxieties, and to help
them to sleep."
• As per most of the nursing theories, environmental
adaptation remains the basis of holistic nursing care.

27. Nursing need theory
Modern Nursing Nightingale /The 20th century Nightingale
“ 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 rapidly as possible" (Henderson, 1966)”

28. The 14 components
1. Breath 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 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.

29. Interpersonal theory
• Focuses on the interpersonal processes and therapeutic
relationship that develops between the nurse and client.
4 phases of Nurse- patient relationship
• Orientation
• Identification
• Exploitation
• Resolution

30. 21 Nursing Problems Theory
1. To maintain good hygiene and physical comfort
2. To promote optimal activity: exercise, rest, sleep
3. To promote safety through prevention of accident, injury, or
other trauma and through prevention of the spread of infection
4. To maintain good body mechanics and prevent and correct
deformity
5. To facilitate the maintenance of a supply of oxygen to all body
cells
6. To facilitate the maintenance of nutrition for all body cells
7. To facilitate the maintenance of elimination
8. To facilitate the maintenance of fluid and electrolyte balance
9. To recognize the physiologic responses of the body to disease
conditions—pathologic, physiologic, and compensatory

31. 10. To facilitate the maintenance of regulatory mechanisms and functions
11. To facilitate the maintenance of sensory function
12. To identify and accept positive and negative expressions, feelings, and
reactions
13. To identify and accept interrelatedness of emotions and organic illness
14. To facilitate the maintenance of effective verbal and nonverbal
communication
15. To promote the development of productive interpersonal relationships
16. To facilitate progress toward achievement and personal spiritual goals
17. To create or maintain a therapeutic environment
18. To facilitate awareness of self as an individual with varying physical,
emotional, and developmental needs
19. To accept the optimum possible goals in the light of limitations, physical
and emotional
20. To use community resources as an aid in resolving problems that arise
from illness
21. To understand the role of social problems as influencing factors in the
cause of illness

32. Theory of Goal Attainment
King has interrelated the concepts of interaction,
perception, communication, transaction, self, role, stress,
growth and development, time, and space into a theory of
goal attainment.
Nursing is a process of action, reaction, and interaction
whereby nurse and client share information about their
perceptions in the nursing situation. The nurse and client
share specific goals, problems, and concerns and explore
means to achieve a goal.

33. Concepts for Personal
System
• Perception
• Self
• Growth & development
• Body image
• Space
• Time
Concepts for Interpersonal
System
• Interaction
• Communication
• Transaction
• Role
• Stress
Concepts for Social System
• Organization
• Authority
• Power
• Status
• Decision making

34. Self care deficit theory
People should be self-reliant and responsible for their own
care and others in their family needing care.
Composed of three interrelated theories:
(1) The theory of self-care
(2) The self-care deficit theory, and
(3) The theory of nursing system

35. • Nursing is as art through which the practitioner of
nursing gives specialized assistance to persons
with disabilities which makes more than ordinary
assistance necessary to meet needs for self-care.
The nurse also intelligently participates in the
medical care the individual receives from the
physician.

36. System model
It provides a comprehensive flexible holistic and
system based perspective for nursing.
Human being is viewed as an open system that
interacts with both internal and external environment
forces or stressors. The human is in constant change,
moving toward a dynamic state of system stability or
toward illness of varying degrees.

37. The Conservation Model
Nursing’s role in conservation is to help the person with the
process of “keeping together” the total person through the least
expense of effort.
Levine proposed the following four principles of conservation:
• The conservation of energy of the individual
• The conservation of the structural integrity of the individual.
• The conservation of the personal integrity of the individual.
• The conservation of the social integrity of the individual.

38. Adaptation model (RAM)
RAM is one of the widely applied nursing models
in nursing practice, education and research.
Nursing goals are to promote adaptation for
individuals and groups in the four adaptive
modes, thus contributing to health, quality of life,
and dying with dignity.

39. 1. Physiologic-physical mode
2. Self-concept-group identity mode
3. Role function mode
4. Interdependence mode:

40. Theory of human caring
• Caring can be effectively demonstrated and
practiced only interpersonally.
• Caring consists of carative factors that result in
the satisfaction of certain human needs.
• Effective caring promotes health and individual
or family growth.

41. 1. The formation of a humanistic- altruistic system of values.
2. The installation of faith-hope.
3. The cultivation of sensitivity to one’s self and to others.
4. The development of a helping-trust relationship
5. The promotion and acceptance of the expression of positive
and negative feelings.
6. The systematic use of the scientific problem-solving method
for decision making
7. The promotion of interpersonal teaching-learning.
8. The provision for a supportive, protective and /or corrective
mental, physical, socio-cultural and spiritual environment.
9. Assistance with the gratification of human needs.
10. The allowance for existential-phenomenological forces.

42. The Dynamic Nurse-Patient Relationship
• The role of the nurse is to find out and meet the
patient's immediate need for help.
• The patient's presenting behavior may be a plea for
help, however, the help needed may not be what it
appears to be.
• Therefore, nurses need to use their perception,
thoughts about the perception, or the feeling
engendered from their thoughts to explore with
patients the meaning of their behaviour.

43. The Aspects of Care, Core, Cure
The theory contains of three independent but
interconnected circles:
• The core: The person or patient to whom nursing care
is directed and needed.
• The care : The attention given to patients by the
medical professionals
• The cure: The attention given to patients by the
medical professionals.

44. Theories can also be categorized as:
– "Needs "theories.
– "Interaction" theories.
– "Outcome "theories.
– "Humanistic theories"

45. • These theories are based around helping
individuals to fulfill their physical and mental
needs.
• Needs theories have been criticized for relying
too much on the medical model of health and
placing the patient in an overtly dependent
position.

46. • These theories revolve around the
relationships nurses form with patients.
• Such theories have been criticized for
largely ignoring the medical model of health
and not attending to basic physical needs.

47. • These portray the nurse as the changing force,
who enables individuals to adapt to or cope
with ill health (Roy 1980).
• Outcome theories have been criticized as too
abstract and difficult to implement in practice
(Aggleton and Chalmers 1988).

48. • Humanistic theories developed in response to the
psychoanalytic thought that a person’s destiny was
determined early in life.
• Humanistic theories emphasize a person’s capacity
for self actualization .
• Humanists believes that the person contains within
himself the potential for healthy and creative growth.
• The major contribution that Rogers added to nursing
practice is the understanding that each client is a
unique individual, so person-centered approach now
practice in Nursing.

49. Need theorists Interaction
Theorists
Outcome
theorists
• Abdellah
• Henderson
• Orem
• King
• Orlando
• Peterson and
Zderad
• Paplau
• Travelbee
• Wiedenbach
• Johnson
• Levine
• Rogers
• Roy

50. • Systems model
• Basic Human Needs model
• Health and Wellness Models
• Stress and Adaptation
• Developmental Theories
• Psychosocial Theories

51. • Systems theory may be considered as a specialization of
systems thinking and a generalization of systems science.
• Many nursing theorists have drawn from systems theory.
– Neuman's Systems Theory
– Rogers 's Theory of Unitary Human Beings
– Roy's Adaptation Model
– Imogene King's Theory of Goal Attainment
– Orem Self-care Deficit Theory
– Johnson's Behavior Systems Model

55. • Freud : Psychosexual theory
• Erikson : Psychosocial theory
• Piaget : Cognitive theory
• Kohlberg : Theory of moral development

56. • Everyday practice enriches theory
• Both practice and theory are guided by
values and beliefs
• Theory helps to reframe our thinking about
nursing
• Theory guides use of ideas and techniques
• Theory can close the gap between theory
and research
• To envision potentialities (Gordon, Parker, &
Jester, 2001)

57. • Organize patient data
• Understand patient data
• Analyze patient data
• Make decisions about nursing interventions
• Plan patient care
• Predict outcomes of care
• Evaluate patient outcomes (Alligood, 2001)

58. • Medical science
• Nursing education
• Professional nursing organizations
• Evolving research approaches
• Global concerns
• Consumer demands
• Technologies

59. They are derived through two principal methods:
1. Deductive reasoning
2. Inductive reasoning.

60. • Theory → practice → theory
Theory developed in other discipline and used in nursing
situations
• Practice → theory : theory evolved from clinical practice
• Research → theory or inductive method
Must evolve from research findings or empirical evidence.
• Theory → research → theory . Original theory examined
and given a new research findings.

61. • Nursing theory is generally neglected on the wards.
• A nursing theory should have the characteristics of
accessibility and clarity.
• It is important that the language used in the development
of nursing theory be used consistently.
• Many nurses have not had the training or experience to
deal with the abstract concepts presented by nursing
theory.
• Majority of nurses fail to understand and apply theory
to practice (Miller 1985).