The document summarizes several influential nursing models and theories focused on nursing goals and functions, including Florence Nightingale's Environmental Model, Virginia Henderson's Fourteen Components of Nursing Care, Dorothy Johnson's Behavioral Systems Model, and Nola Pender's Health Promotion Model. Each theory identifies concepts related to person, environment, health, and nursing and provides a framework for nursing practice.

1. Chapter 17
Models and
Theories Focused
on Nursing Goals
and Functions

2. Introduction
• Nursing models and theories can be
categorized by a focus on goals and functions
of advanced practice nurses.
• Theories by Nightingale, Henderson, Johnson,
and Pender all fall under this categorization.
• These theories provide the foundation for
practice discipline.

3. Environmental Model of Nursing:
Florence Nightingale
• Nightingale described 13 cannons for nursing
practice that focus on several specific areas:
– Controlling environmental components
– Maintaining patient and environment cleanliness
– Ensuring patient comfort
– Providing patient nutrition and stimulation
– Observing and recording patient behavior
• Canons are not all-inclusive and do not address
Nightingale’s concern for holistic, spiritual care or
health promotion.

4. Major Concepts of the Environmental
Model
• Nightingale’s landmark model provided the
foundation for nursing’s four metaparadigms:
– Person: The recipient of care
– Environment: Internal and external physical
surroundings
– Health: Being well and using talents well
– Nursing: Managing the environment to put
patients in the best possible situation for the
natural laws of health to act upon them

5. Assumptions of the Environmental
Model
• Five philosophical assumptions can be inferred
from Nightingale’s work:
– Nursing is a calling
– Nursing is an art and a science
– Persons can control outcomes of their lives and,
therefore, pursue perfect health
– Nursing requires a specific educational base
– Nursing is distinct and separate from medicine
• Other assumptions can also be extracted, though
none are explicitly stated.

6. Propositions of the Environmental
Model
• Two primary relationships can be derived
from Nightingale’s work:
– The person is desirous of health, so the nurse,
nature, and the person will cooperate in order for
all reparative processes to occur
– The nurse’s role is to prevent the reparative
process from being interrupted and to provide
conditions to optimize the reparative process

7. Analysis of the Environmental Model
• Provides a broad framework for organizing
observations about nursing phenomena.
• Strives to provide guidelines for all nursing
situations based on the relationships of
environment to patient, nurse to environment,
and nurse to patient.
• Basic principles of these relationships are still
relevant to modern nursing care.

8. Fourteen Components of Basic Nursing
Care: Virginia Henderson
• Henderson identified 14 basic patient needs
that focus on several specific areas:
– Performing bodily functions adequately
– Moving and resting appropriately
– Grooming and dressing to maintain comfort
– Avoiding danger and enjoying life
– Expressing emotions and faithfulness

9. Nursing Care and Henderson’s
Fourteen Components
• Henderson’s theory revolves around meeting the
bodily, safety, and self-actualization needs of
patients.
• Needs are easily applied to specific situations
that arise in advanced practice nursing.
• Needs lend themselves to clear, unambiguous
assessment and development of care plans that
contribute to independence and health
maintenance.

10. Major Concepts of Nursing According
to Henderson
• Henderson’s work did not explicitly define the
domains of nursing but contributed to the four
metaparadigms:
– Person: Inseparable biological, psychological,
sociological, and spiritual components Environment:
Biological, physical, and behavioral influences
– Health: Independence
– Nursing: Assisting an individual in the performance of
activities contributing to health to help him or her
gain independence

11. Assumptions of the Fourteen
Components of Nursing Care
• Seventeen assumptions can be extracted from
Henderson’s work.
• Six of these relate to nursing functions:
– The nurse’s unique function is to help persons
– The nurse is a member of the medical team
– The nurse is always working toward a goal
– The nurse must consider health promotion a goal
– The nurse should protect persons from injury
– The nurse should understand social and religious
customs

12. Propositions of the Fourteen
Components of Nursing Care
• The primary relationships in Henderson’s work
are related to the nurse-patient relationship:
– The nurse as a substitute for the patient
– The nurse as a helper to the patient
– The nurse as a partner with the patient

13. Analysis of the Fourteen Components
of Nursing Care
• Henderson’s work is logical and in agreement
with literature and research from other scientific
fields.
• Concepts are simple and clear, yet broad enough
in scope to be applicable to all patients at all
levels of practice.
• Even in complex care situations, concepts and
relationships exhibit internal consistency.

14. Behavioral System Model: Dorothy
Johnson
• Johnson nursing should maintain or restore
balance to seven behavioral subsystems.
• Each subsystem has functional requirements
that must be met, sometimes with assistance.
• Assessment focuses on environmental factors
affecting the subsystems.
• Management focuses on restoration or
maintenance of subsystem balance to achieve
overall system stability.

15. Major Concepts of Nursing According
to Johnson
• Johnson’s work contributes the following to the
four metaparadigms:
– Person: A behavioral system with seven subsystems
– Environment: Forces that can disturb system balance
– Health: The interaction of psychological, social,
biological, and physiological factors
– Nursing: An external regulatory force that acts to
preserve patient behavior at an optimal level

16. Assumptions of the Behavioral System
Model
• Johnson based her theory on four assumptions:
– Behavior is the some of physical, biological, and social
factors
– A person is a system of behaviors that strives toward
balance
– There are different levels of balance and stabilization
– Persons expend large amounts of energy attempting
to maintain or reestablish system balance

17. Propositions of the Behavioral System Model
• The primary relationships in Johnson’s model
exist between the person and the
environment according to three notions:
– The system manages its relationship with the
environment
– Balance is essential for effective and efficient
functions
– Nursing is an external regulatory force that acts to
restore balance

18. Analysis of the Behavioral System
Model
• Johnson’s model is based on inductive
reasoning and is detailed in its description of
systems.
• Has nearly unlimited applications with both ill
and well persons.
• Concepts are clearly and consistently defined
and provide comprehensive direction for
nursing research and practice.

19. The Health Promotion Model: Nola J.
Pender
• Pender emphasized the multidimensionality of
persons interacting with their environments as
they pursue health.
• Model is considered a middle-range theory.
• Model described three basic categories of health
promotion:
– Individual characteristics and experiences
– Behavior-specific cognitions and affect
– Behavioral outcome

20. Major Concepts of Nursing According
to Pender
• Pender’s work contributes the following to the
four metaparadigms:
– Person: The unique individual who is the focus of
the model
– Environment: The physical, interpersonal, and
economic circumstances in which persons live
– Health: A positive high-level state that is
personally defined
– Nursing: Raising consciousness of health-
promoting behaviors and promoting self-efficacy

21. Assumptions of the Health Promotion Model
• Pender’s theory relies on seven assumptions:
– Persons seek to express their unique potential
– Persons are capable of reflective self-awareness
– Persons value growth in positive directions
– Persons seek to actively regulate their behavior
– Persons transform and are transformed by the
environment
– Health professionals are part of the environment
– Self-initiated pattern reconfiguration leads to
behavior change

22. • Pender’s model relies on fourteen theoretical
propositions that focus on several specific
areas:
– Impact of behaviors and characteristics
– Affect of perceived barriers and self-efficacy
– Influence of significant others and positive emotions
– Commitment to change
Propositions of the Health Promotion Model

23. Analysis of the Health Promotion Model
• Pender’s model is based on inductive reasoning
and existing research that is applicable to a
wide cross-section of people.
• It is easy to understand and uses language
common to and understood by nurses.
• It is popular with practicing nurses and
researchers for this reason.

24. Summary
• Functional nursing models emphasize the
function of nursing practice in relation to
health outcomes.
• Concepts of health and patient may differ
among theories, but all strive to achieve the
common goal of health restoration.