This document provides an overview of various nursing theories, including their components, applications, and criticisms. It discusses meta-theories, grand theories, middle-range theories, and practice theories. Examples of descriptive and prescriptive theories are given. Several influential nursing theories are described in depth, including Nightingale's Environmental Theory, Henderson's Nursing Need Theory, King's Goal Attainment Theory, Roy's Adaptation Model, Orlando's Nursing Process Theory, and Watson's Theory of Human Caring. The methods of theory development and potential barriers to applying theory in practice are also summarized.

1. OVERVIEW OF NURSING
THEORIES
By
Syed Yousaf Shah

2. Objectives
• Discuss various Nursing Theories.
• Appraise the component of various nursing
theories; description, purpose, concepts,
definition.
• Discuss the application of nursing theories in
nursing practice.
• References

3. • 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.

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

5. 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.

6. • "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.

7. 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)”

8. 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.

9. 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

10. 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

11. 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 asan 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 asan aid in resolving problems that arise
from illness
21. To understand the role of social problems asinfluencing factors in the
cause of illness

12. 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.

13. 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

14. 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

15. • 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.

16. 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.

17. 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.

18. 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.

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

20. 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.

21. 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.

22. 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 explorewith
patients the meaning of their behaviour.

23. 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.

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

25. • 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.

26. • 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.

27. • 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).

28. • 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.

29. Need
theorists
Interactio
n
Theorists
Outcom
e
theorists
• Abdellah
• Henderso
n
• Orem
• King
• Orlando
• Peterson
and Zderad
• Paplau
• Travelbee
• Wiedenbac
h
• Johnso
n
• Levine
• Rogers
• Roy

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

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

32. • 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.

33. • 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).

36. References
• Johnson, M. B., Webbe, B. P. (2001). An
Introduction to Theory & Reasoning in
Nursing. New York: Lippincott.
• Kenney, W. J. (2002). Philosophical and
Theoretical Perspectives for Advanced
Nursing.