The document provides information about a PowerPoint assignment on nursing theories. Students are asked to: 1) Select a nursing theory and describe its conceptual model and application in nursing practice using a 10-15 slide PowerPoint. 2) Explain how the selected nursing theory incorporates the four metaparadigm concepts of person, environment, health, and nursing. 3) Provide three evidence-based examples demonstrating how the selected nursing theory supports nursing practice, with rationale.

1. Power Point Questions
This is a Collaborative Learning Community (CLC) assignment.Nursing theories are tested
and systematic ways to implement nursing practice. Select a nursing theory and its
conceptual model. Prepare a 10‐15 slide PowerPoint in which you describe the nursing
theory and its conceptual model and demonstrate its application in nursing practice.
Include the following:Present an overview of the nursing theory. Provide evidence that
demonstrates support for the model’s efficacy in nursing practice. Explain how the theory
proves the conceptual model.Explain how the nursing theory incorporates the four
metaparadigm concepts.Provide three evidence‐based examples that demonstrate how the
nursing theory supports nursing practice. Provide support and rationale for each.Refer to
the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success
Center, for additional guidance on completing this assignment in the appropriate
style.While APA style is not required for the body of this assignment, solid academic writing
is expected, and documentation of sources should be presented using APA formatting
guidelines, which can be found in the APA Style Guide, located in the Student Success
Center.This assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion. You are
required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical
Support articles for assistance. Questions:1. Explain how the nursing theory incorporates
the four metaparadigm concepts.2. Provide three evidence-based examples that
demonstrate how the nursing theory supports nursing practice. Provide support and
rationale for each.The theory that my group choose was:Hildegard Peplau’s Interpersonal
Relations TheoryHildegard Peplau’s interpersonal relations theory is referred to as
psychodynamic nursing, which refers to the understanding of one’s behavior. Peplau’s
(1909-1999) work was a major contribution to mental health laws and defined nursing as
an interpersonal process of therapeutic interactions between an ill individual in need of
health services and an educated nurse trained to recognize and respond to those needs
(Peplau, 1952). She considered the person to be an organism that desires to reduce tension
or anxiety. The environment is not clearly defined but is made up of existing forces outside
of the person. Health is defined as forward movement of the human process toward creative
and productive community living. Nursing is a therapeutic interpersonal process existing in
four phases: orientation, identification, exploitation, and resolution (see Figure 2.5).The
nurse has a variety of roles that include stranger, teacher, resource, counselor, technical
expert, and leader (Creasia & Friberg, 2011). This theory can be explained as the

2. understanding of the interpersonal relationship between the patient and the nurse. Peplau
recognized that such a relationship does exist, and the nurse is not just a messenger
between the physician and patient.Figure 2.5Hildegard Peplau’s Interpersonal Relations
TheoryLecture:Nursing TheoryA theory is a collection of statements that explain a
relationship between two or more ideas. Theory maintains a central role in the evolution of
the nursing discipline. It is something all nurses use in their daily practices, whether known
or not. Relatively new, nursing theory is a structure of purposeful and systematic ideas that
help to organize disciplinary thinking and influence practice. Much discussion and debate
have occurred regarding the various theory definitions. Levine (1995) promoted acceptance
of nursing theory, which she called the intellectual life of nursing. She identified that
students often fail to embrace nursing theory and do not fully grasp the importance of
nursing theory and its relevance for practice and education.Understanding nursing theory
strengthens the focus of care by guiding nursing practice. It may help to think about nursing
theories as various lenses used to view different perspectives of known nursing
phenomena. For example, Dorothy Orem’s self-care deficit theory focuses on assisting
others in managing self-care to maintain or improve human function at an effective level
(Orem, 1995). Also, Sister Callista Roy’s adaptation theory explains how individuals are in
constant interaction with a changing environment and that the individual must adapt to
change to have a positive response (Creasia & Friberg, 2011).Example of Dorothy Orem’s
Self-Care Deficit TheoryAn elderly man recently received a total hip replacement. During
the discharge process, the registered professional nurse educates the patient about many
things, including activity restrictions, medications, and wound care. The nurse also reviews
activities of daily living, such as showering and toileting. The nurse realizes that the
patient’s balance may be altered and discusses fall precautions with the patient. Detailed
discharge instructions are an example of moving the patient from a state of dependence on
others for care to a state of independence and self-care.Example of Sister Callista Roy’s
Adaptation TheoryThe school nurse receives a phone call from a parent of an eighth-grade
female student stating that the student recently suffered a femoral fracture from a
trampoline injury that required open reduction internal fixation. She has successfully
recovered to the point that she can return to class next week. The nurse realizes that
because of the full-leg cast the student will be excused from physical education class and
likely will require assistance with mobilization and toileting. Based on the student’s age,
psychosocial issues are likely to be involved due to an altered self-concept related to body
image. Her balance may be altered as well. Ultimately, the student demonstrated a positive
attitude and adapted well to this life-altering event.Nursing theory is present in day-to-day
interactions with patients. The core values derived from theoretical assumptions can serve
as a foundation upon which to build practices. The goal of applying theory is to improve
practice.The nursing profession is an art and science involving a complex mix of many parts.
Nurses are expected to perform the science of nursing through medical and technical
competencies, such as nursing skills, academic knowledge, and professional performance.
Nurses must become lifelong learners and engage in continuing education throughout their
careers to maintain those nursing skills and competencies. Included in the science of
nursing are theories, conceptual models, and research that is specific to nursing. The art of

3. nursing requires a foundation of nursing skills, academic knowledge, and professional
performance. It is difficult to define or measure the art of nursing other than by looking at
the pronounced noticeability of its absence. Treating patients with dignity and respect,
being cognizant of nonverbal cues, and using active listening and communication skills are
all qualities patients and families value highly. Nurses should strive to find a balance
between the science and the art of nursing in their practices (Palos, 2014).Nursing is a
knowledge-based discipline and profession that incorporates a body of knowledge to guide
its practice (Smith & Parker, 2015). Because nursing is a profession, nurses are required to
meet specific educational qualifications. Education is systematically obtained from colleges
and universities that ultimately produce knowledge-based professional nurses who can
practice autonomously. The following characteristics define the meaning of a professional
(Creasia & Friberg, 2011):Formal education requiredLifelong mission, recognized as life
workEncompass knowledgeService to societyPractice autonomouslyPractice guided by
ethicsProfessional culture and valuesCompensation receivedMetaparadigmTheories are
built upon a foundation of concepts. Theoretical statements compose a theory. The concepts
incorporated into theoretical statements include areas of interest to the discipline. For
nursing theory, these concepts include person, environment, health, and nursing, also
referred to as metaparadigm. The metaparadigm includes basic assumptions regarding the
theory and highlights areas vital to the nursing discipline and ultimately patient care (see
Figure 2.3).Figure 2.3Metaparadigm of Nursing ConceptsNote. Adapted from “Nursing
Metaparadigm Concepts,” by CJT Consulting & Education, 2017.Person refers to the patient,
client, individual, family, community, or group. These are the recipient(s) of said nursing
care. Environment includes external and internal space associated with the person. Health
encompasses all areas of, or lack of, the person(s) wellbeing. As the final metaparadigm
component, nursing expresses the goal of nursing that is specific to the theory (McEwen,
2007).Conceptual ModelsTheories can be categorized according to their complexity. These
categories include practice theories, midrange theories, and grand theories (also referred to
as conceptual models). Conceptual models explain a particular way of thinking, or a mental
picture of how the theory fits together, according to the theorist. A conceptual model is the
organizing structure that defines the theory.Types of TheoriesNursing theories are
categorized by their level of complexity and are identified as practice theories, midrange
theories, or grand theories.Practice TheoryThe purpose of nursing theory is to improve
nursing practice, and the lives of patients, families, and communities served by nursing
practice. Practice theory defines the delivery of nursing care in specific situations related to
practice, incorporating “nurses’ clinical wisdom” (McEwen, 2007) by answering clinical
questions. Practice theory is limited in scope in that it focuses on specific areas of nursing,
such as a specific patient population or a certain type of nursing practice. Nursing
interventions and actions in response to patient-specific needs are often prescribed.
Practice theory offers a specific framing of how nurses handle situations within their scope
of practice (Levine, 1995). Scenarios of practice theories are often reviewed in nursing
journals that focus on management of disease or journals that discuss nursing interventions
related to specific patient populations (Creasia & Friberg, 2011).General System
TheoryGeneral system theory is a broad theory that specifies any system being studied as

4. composed of smaller subsystems and also a part of a larger subsystem. It suggests that a
system is a set of interrelated parts that are constantly interacting with the environment to
attain a common goal (Creasia & Friberg, 2011). In other words, a system is more than the
sum of its parts (Boettcher, 1996). When studying the circulatory system, for example, one
cannot simply study the components of blood, but must also include the cardiovascular
system, the vascular system, respiratory system, and so on to understand how the
circulatory system functions.Change TheoryChange theory is one of the most commonly
used theories related to nursing education and patient learning. This theory’s governing
principle is that by using certain motivating factors, patients feel empowered and desire to
change unhealthy habits. By setting goals and offering incentives, learning and change occur
for the patient.Kurt Lewin (1890-1947), commonly referred to as the father of psychology,
was known for his life space or field theory. Kurt Lewin’s field theory states that human
behavior is related to both the individual and the environment. Lewin explored human
behavior by performing field research. The concepts of driving forces, restraining forces,
and equilibrium were used by Lewin to explain human behavior (McEwen, 2007). Lewin
believed that desired change in human behavior could occur by first identifying the
undesired behavior, then understanding the cause of such behavior, and what forces would
need to be strengthened or weakened to bring about change (Burnes & Cooke, 2013). This
theory can be applied to many areas of nursing, including mental health, or any area that
desires improved health outcomes based on patient compliance with prescribed
regimens.Coping/Adaptation TheoryThe ability to cope requires the body to adapt
continually to a changing environment. Richard Lazarus (1922-2002) was a psychologist
and author who was best known for his theoretical work related to coping. Developed in
1984, Richard Lazarus’s theory of stress, coping, and adaptation centers on how an
individual copes with stressful situations (see Figure 2.4).The theory focuses on various
psychological responses to stress that are considered negative, such as emotional distress,
anxiety, depression, anger, and fear, to name a few. Lazarus saw these responses as coping
mechanisms. Stress is viewed as more than a stimulus causing a response. Nurses can apply
this theory to assess the effects of stress on the individual patient. Physical and
psychological responses to stressors can occur (Smith & Parker, 2015). For example, an
individual working in a stressful environment may develop emotional distress that causes
disruptive outbursts and chronic overeating. Physical responses may include high blood
pressure and obesity. Another example would be soldiers returning to civilian life and
experiencing post-traumatic stress disorder.Figure 2.4Richard Lazarus’s Theory of Stress,
Coping, and AdaptationMidrange TheoryMidrange theories are not as complicated as grand
theories. Midrange theories contain fewer concepts, are easier to use, and usually contain
single applications that can be applied to a variety of practice settings.Hildegard Peplau’s
Interpersonal Relations TheoryHildegard Peplau’s interpersonal relations theory is referred
to as psychodynamic nursing, which refers to the understanding of one’s behavior. Peplau’s
(1909-1999) work was a major contribution to mental health laws and defined nursing as
an interpersonal process of therapeutic interactions between an ill individual in need of
health services and an educated nurse trained to recognize and respond to those needs
(Peplau, 1952). She considered the person to be an organism that desires to reduce tension

5. or anxiety. The environment is not clearly defined but is made up of existing forces outside
of the person. Health is defined as forward movement of the human process toward creative
and productive community living. Nursing is a therapeutic interpersonal process existing in
four phases: orientation, identification, exploitation, and resolution (see Figure 2.5).The
nurse has a variety of roles that include stranger, teacher, resource, counselor, technical
expert, and leader (Creasia & Friberg, 2011). This theory can be explained as the
understanding of the interpersonal relationship between the patient and the nurse. Peplau
recognized that such a relationship does exist, and the nurse is not just a messenger
between the physician and patient.Figure 2.5Hildegard Peplau’s Interpersonal Relations
TheoryNote. Adapted from “Developmental States of the Nurse-Client Relationship: Peplau’s
Interpersonal Relations Theory,” from Effective Communication in Nursing: Theory and
Best Practice, by Southeastern University.Imogene King’s Theory of Goal AttainmentThe
central concept of Imogene King’s theory of goal attainment is that personal, interpersonal,
and social systems all interact together to reach a common goal (see Figure 2.6).Imogene
King (1923-2007) views the person as the patient in the nurse-patient relationship. Internal
and external environments both generate stressors. Health is defined as the patient’s ability
to function in societal roles. The focus of nursing is to help the patient maintain health so
the patient can perform the duties related to the patient’s current role (King, 1981). For
example, to ensure that an elderly patient who lives alone and has no transportation can
receive hemodialysis three days a week, it would be necessary to incorporate the family in
discharge planning.Figure 2.6Imogene King’s Theory of Goal AttainmentNote. Adapted from
A Theory for Nursing: Systems, Concepts, Process, by I. M. King, 1981, p. 145.Madeleine
Leininger’s Cultural Care TheoryIn Madeleine Leininger’s cultural care theory, she believed
that cultural competency improved nursing practice. Madeleine Leininger’s (1925-2012)
cultural care theory (see Figure 2.7) focuses on the analysis of different cultures to better
understand their ideas of health, their behaviors, and their thoughts regarding nursing care
(Creasia & Friberg, 2011).The metaparadigm concept of Person is prominent in this theory,
with its focus on better understanding of people and their cultural differences. Persons are
not only referred to as human beings, but families, groups, and communities that contribute
to their cultural background. The environment is where the individuals live, and it has an
impact on a person’s ability to perform self-care. Leininger defined health as “a state of
wellbeing that is culturally defined, valued, and practiced, and which reflects the ability of
individuals (or groups) to perform their daily role activities in culturally expressed,
beneficial, and patterned lifeways” (Leininger, 1991, p. 48). The goal of nursing is to support
individuals to maintain or improve their health in a culturally competent way. An example
of providing culturally competent care would be respecting the belief of a severely anemic
patient who refuses blood products based on the patient’s religion as a Jehovah’s
Witness.Figure 2.7Madeleine Leininger’s Cultural Care TheoryNote. Adapted from “The
Sunrise Model: A Contribution to the Teaching of Nursing Consultation in Collective Health,”
by L. Pereira de Melo, 2013, in American Journal of Nursing Research, 1(1), 20-23.
Copyright 2013 by the Science and Education Publishing.Midrange Theory Metaparadigm
ConceptsTable 2.1 compares the midrange theories of Peplau, King, and Leininger and
presents the midrange theoretical principals related to the metaparadigm concepts of

6. nursing for deeper understanding.Table 2.1Midrange Theory Metaparadigm
ConceptsMidrange TheoristPersonEnvironmentHealthNursingHildegard Peplau:
Interpersonal Relations TheoryViewed humans as organismsExisting forces outside of the
individualForward movement of human process toward creative and productive
community livingTherapeutic interpersonal processImogene King: Theory of Goal
AttainmentPatient in a nurse-patient relationshipInternal and external environments
generate stressPatient’s ability to function in current roleAssist the patient in maintaining
healthMadeleine Leininger: Cultural Care TheoryHuman beings, families, groups,
communitiesWhere individuals live impacts ability for self-careState of culturally defined
well-beingProvide culturally competent supportNote. (Creasia & Friberg 2011; King, 1981;
Leininger, 1991; Peplau, 1952)Grand TheoryLewin stated that exploring a variety of
nursing theories could provide the nurse with new insights into patient care. The term
grand theory indicates that the theory has a broad scope, including general concepts. The
nature, purpose, and goals are broad (McEwen, 2007). Sister Callista Roy developed a grand
theory in 1976 that is considered to be an adaptation model focusing on the human
response and adaptation to a constantly changing environment. Grand theories typically are
complicated and abstract and are not easily understood (Kolcaba, 2001).Nightingale’s
Environmental TheoryFlorence Nightingale’s environmental theory presents disease as a
reversible process achieved by altering the patient’s environment. Nightingale believed that
individuals are in control of their own lives and desire good health. Also, the individual
should be viewed as a holistic, multidimensional being, composed of biological,
psychological, and spiritual components who possesses the ability to recover from disease if
the environment allows. The environment is the most crucial concept in this theory (see
Figure 2.8). Poor environmental factors lead to sickness and disease. Environmental factors
include fresh air, sunlight, clean water, adequate food supply, efficient drainage, good
hygiene, low noise, adequate temperature, and a clean environment. The environment is
external; however, it can affect the individual in sickness or health. Nursing is a service
intended to relieve pain and suffering.It is the professional nurse’s responsibility to alter the
patients’ environment to affect change in their health. The goal of nursing should be to
promote the reparative process by manipulating the environment. Environmental change is
needed for optimal health (Zborowsky, 2014).Figure 2.8Florence Nightingale’s
Environmental TheoryNote. Adapted from “Nightingale’s Environmental Theory Conceptual
Framework,” by Nurselabs.com, 2014.Rogers’s Science of Unitary Human Beings
TheoryMartha Rogers’s science of unitary human beings theory was first publicized in 1970
in her publication, An Introduction to the Theoretical Basic for Nursing. She claimed that
nursing was a science and an art. Her work began in the 1960s when she theorized that
humans are dynamic energy fields that react with the environment and are continually
changing. She viewed the individual as a whole energy field constantly in motion, with
language and thought that are sensitive and emotional (see Figure 2.9).Health is valued and
occurs when living in harmony with the environment (Rogers, 1970).Figure 2.9Martha
Rogers’s Science of Unitary Human Beings TheoryExample of Science of Unitary Human
Beings TheoryA pediatric patient is hospitalized over the Christmas holiday. The patient’s
mother, father, and two younger siblings are in the room as the nurse enters to assess the

7. patient. The nurse feels that the atmosphere is very somber and wants to do something to
improve the energy in the room. She mentions that she would be glad to bring in some
Christmas DVDs if they are interested in watching movies. They agree, and when she enters
the room an hour later, the family is laughing, enjoying a movie. The energy has changed in
the room, and it feels more positive and cheerful.Orem’s Self-Care Deficit TheoryDorothea
Orem’s self-care deficit theory, developed during the years of 1959-2001, focuses on
assisting others in managing self-care to maintain or improve human function at an
effective level (Orem, 1995). Orem’s three-part theory includes self-care, self-care deficit,
and nursing systems (see Figure 2.10).Self-care is ideally performed by individuals to
maintain health and well-being. Self-care deficit requires nursing assistance. Nursing
systems define how the nurse will meet the individual’s needs. Orem’s theory states that the
individual should be in an appropriate environment to receive care. The environment is
external; however, for Orem’s theory, the environment and individual are bound together,
and they function as one unit. Individual health is a condition in which humans are
structurally and functionally complete. Health is considered physical, psychological,
interpersonal, and social (Orem, 1995). The nursing focus should be to maintain health or to
return the individual to the previous state of health by assisting with self-care to sustain life
and maintain health (Current Nursing, 2012).Figure 2.10Orem’s Self-Care Deficit
TheoryGrand Theory Metaparadigm ConceptsTable 2.2 compares the grand theories of
Nightingale, Rogers, and Orem and presents the grand theoretical principals related to the
metaparadigm concepts of nursing (person, environment, health, and nursing) for deeper
understanding.Table 2.2Grand Theory Metaparadigm ConceptsGrand
TheoristPersonEnvironmentHealthNursingNightingale: Environmental TheoryHolistic and
multidimensionalCan recover from disease if environment allowsPoor environment leads to
sickness and disease.Goal is optimal health.Responsibility to alter the patient’s
environmentRogers: Science of Unitary Human BeingsWholeNot reducibleEnergy
fieldSynergistic human beingsConstantly reactingExchanging matter and energy with
humansValuedOccurs when living in harmony with environmentAccepting of
changeViewed as a science and an artOrem: Self-Care Deficit TheoryIndividuals perform
self-care to maintain health and well-beingExternal environment and individual bound
togetherHealth is viewed as structurally and functionally completeAssist with self-careHelp
maintain or return to previous state of healthNote. (Orem, 1995; Rogers, 1970; Zborowsky,
2014; Current Nursing, 2012).Future of Nursing