Theory

Key emphasis

Florence Nightingale’s

Legacy of caring

Focuses on nursing and the patient-environment relationship.

Ernestine Wiedenbach’s

The helping art of clinical nursing

Helping process meets needs through the art of individualizing care.

Nurses should identify patients ‘need-for –help’ by:

1. Observation

2. Understanding client behaviour

3. Identifying cause of discomfort

4. Determining if clients can resolve problems or have a need for help

Virginia Henderson’s   Definition of Nursing

Patients require help towards achieving independence.

Derived a definition of nursing

Identified 14 basic human needs on which nursing care is based.

Faye G.Abedellah’s                              Typology of twenty one Nursing problems

Patient’s problems determine nursing care

Lydia E. Hall

Care, Cure, Core model

Nursing care is person directed towards self love.

Jean  Watson’s                               Philosophy and Science of caring

Caring is moral ideal: mind -body – soul engagement with one and other.

Caring is a universal, social phenomenon that is only effective when practiced interpersonally considering humanistic aspects and caring.

Patricia Benner’s

Primacy of caring                                    

• Caring is central to the essence of nursing.  It sets up what matters, enabling connection and concern.  It creates possibility for mutual helpfulness.

• Caring creates - possibilities of coping possibilities for connecting with and concern for others, possibilities for giving and receiving help

• Described systematically five stages of skill acquisition in nursing practice – novice, advanced beginner, competent, proficient and expert.

CONCEPTUAL MODELS AND GRAND THEORIES

Dorothea E.Orem’s                                                 Self care deficit theory in nursing

Self–care maintains wholeness.

Three Theories:

• Theory of Self-Care
• Theory of Self-Care Deficit
• Theory of Nursing Systems
  • Wholly compensatory (doing for the patient)
  • Partly compensatory (helping the patient do for himself or herself)
  • Supportive- educative(Helping patient to learn self care and emphasizing  on the importance of  nurses’ role

Myra Estrin Levine’s

The conservation model

Holism is maintained by conserving integrity

Proposed that the nurses use the principles of conservation of:

• Client Energy
• Personal integrity
• Structural integrity
• Social integrity

A conceptual model with three nursing theories –

• Conservation
• Redundancy
• Therapeutic intention

Martha E.Roger’s                                Science of unitary  human beings

• Person environment are energy fields that evolve negentropically
• Martha proposed that nursing was a basic scientific discipline
• Nursing is using knowledge for human betterment.                 

The unique focus of nursing is on the unitary or irreducible  human being and the environment (both are energy fields) rather than health and illness

Dorothy E.Johnson’s                                   Behavioural system model

• Individuals maintain stability and balance through adjustments and adaptation to the forces that impinges them.

• Individual as a behavioural system is composed of seven subsystems.
• Attachment, or the affiliative subsystems – is the corner stone of social organisations.                                
• Behavioural system also includes the subsystems of dependency, achievement, aggressive, ingestive-eliminative and sexual.                                                         
• Disturbances in these causes nursing problems.

Sister Callista Roy‘s  Adaptation model

• Stimuli disrupt an adaptive system
• The individual is a biopsychosocial adaptive system within an environment.
• The individual and the environment provide three classes of stimuli-the focal, residual and contextual.                                   
• Through two adaptive mechanisms, regulator and cognator, an individual demonstrates adaptive responses or ineffective responses requiring nursing interventions

Betty Neuman’s  Health care systems model

• Reconstitution is a status of adaptation to stressors
• A conceptual model with two theories “Optimal patient stability and prevention as intervention”
• Neuman’s model includes intrapersonal, interpersonal and extrapersonal stressors.
• Nursing is concerned with the whole person.  
• Nursing actions (Primary, Secondary, and Tertiary levels of prevention) focuses on the variables affecting the client’s response to stressors.

Imogene King’s Goal attainment theory

• Transactions provide a frame of reference toward goal setting.
• A conceptual model of nursing from which theory of goal attainment is derived.
• From her major concepts (interaction, perception, communication, transaction, role, stress, growth and development) derived goal attainment theory. 

·        Perceptions, Judgments and actions of the patient and the nurse lead to reaction, interaction, and transaction.(Process of nursing).

Nancy Roper, WW.Logan and A.J.Tierney    A model for nursing based on a model of living

Individuality in living.

• A conceptual model of nursing from which theory of goal attainment is derived.
• Living is an amalgam of activities of living (ALs). 
• Most individuals experience significant life events which can affect ALs causing actual and potential problems.
• This affects dependence – independence continuum which is bi-directional.
• Nursing helps to maintain the individuality of person by preventing potential problems, solving actual problems and helping to cope.

Hildegard E.Peplau’s

Psychodynamic

Nursing Theory

Interpersonal process is maturing force for personality.

• Stressed the importance of nurses’ ability to understand own behaviour to help others identify perceived difficulties.
• The four phases of nurse-patient relationships are:

1. Orientation

2. Identification

3. Exploitations

4. Resolution

• The six nursing roles are:

1. Stranger

2. Resource person

3. Teacher

4. Leader

5. Surrogate

6. Counselor

Ida Jean Orlando’s

Nursing Process Theory

Interpersonal process alleviates distress.

• Nurses must stay connected to patients and assure that patients get what they need, focused on patient’s verbal and non verbal expressions of need and nurse’s reactions to patient’s behaviour to alleviate distress.
• Elements of nursing situation:   

1. Patient

2. Nurse reactions

3. Nursing actions

Joyce Travelbee’s

Human To Human Relationship Model

Therapeutic human relationships.

• Nursing is accomplished through human to human relationships that began with: The original encounter and then progressed through stages of

Emerging identities

Developing feelings of empathy and sympathy, until the nurse and patient attained rapport in the final stage.

Kathryn E. Barnard’s

Parent Child Interaction Model

Growth and development of children and mother–infant  relationships

• Individual characteristics of each member influence the parent–infant system and adaptive behaviour modifies those characteristics to meet the needs of the system.

Ramona T.Mercer’s

Maternal Role Attainment

Parenting and maternal role attainment in diverse populations

• A complex theory to explain the factors impacting the development of maternal role over time. 

Katharine Kolcaba’s

Theory of comfort

Comfort is desirable holistic outcome of care.

• Health care needs are needs for comfort, arising from stressful health care situations that cannot be met by recipients’ traditional support system. 
• These needs include physical, psycho spiritual, social and environmental needs.                                             
• Comfort measures include those nursing interventions designed to address the specific comfort needs.

Madeleine Leininger’s

Transcultural nursing, culture-care theory

Caring is universal and varies transculturally.

• Major concepts include care, caring, culture, cultural values and cultural variations
• Caring serves to ameliorate or improve human conditions and life base.
• Care is the essence and the dominant, distinctive and unifying feature of nursing

Rosemarie Rizzo Parse’s

Theory of human becoming

Indivisible beings and environment co-create health.

• A theory of nursing derived from Roger’s conceptual model.
• Clients are open, mutual and in constant interaction with environment.
• The nurse assists the client in interaction with the environment and co creating health

Nola J.Pender’s

The Health promotion; model

Promoting optimum health supersedes disease prevention.

• Identifies cognitive, perceptual factors in clients  which are modified by demographical and biological characteristics, interpersonal influences, situational and behavioural factors that help predict in health promoting behaviour