Nursing Theorists
This page was last updated on 16-01-2010
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Definitions
- Theory- a set of related statements that describes or explains phenomena in a systematic way
- Concept-a mental idea of a phenomenon
- Construct- a phenomena that cannot be observed and must be inferred
- Proposition- a statement of relationship between concepts
- Conceptual model- made up of concepts and propositions
Nursing Theorists
- Florence Nightingale,
- Hildegard Peplau
- Virginia Henderson
- Fay Abdella
- Ida Jean Orlando
- Dorothy Johnson
- Martha Rogers
- Dorothea Orem
- Imogene King
- Betty Neuman
- Sister Calista Roy,
- Jean Watson
- Rosemary Rizzo Parse
- Madeleine Leininger
- Patricia Benner
Concepts in the nursing
Metaparadigm
Person
Recipient of care, including physical, spiritual, psychological, and sociocultural components.
Individual, family, or community
Environment
All internal and external conditions, circumstances, and influences affecting the person
Health
Degree of wellness or illness experienced by the person
Nursing
Actions, characteristics and attributes of person giving care
Florence Nightingale- Environmental Theory
First nursing theorist
Unsanitary conditions posed health hazard (Notes on Nursing, 1859)
5 components of environment
ventilation, light, warmth, effluvia, noise
External influences can prevent, suppress or contribute to disease or death
Nightingale’s Concepts
Person
- Patient who is acted on by nurse
- Affected by environment
- Has reparative powers
Environment
- Foundation of theory. Included everything, physical, psychological, and social
Health
- Maintaining well-being by using a person’s powers
- Maintained by control of environment
Nursing
- Provided fresh air, warmth, cleanliness, good diet, quiet to facilitate person’s reparative process
Hildegard Peplau -Interpersonal Relations Model
Based on psychodynamic nursing
using an understanding of one’s own behavior to help others identify their difficulties
Applies principles of human relations
Patient has a felt need
Peplau’s Concepts
Person
- An individual; a developing organism who tries to reduce anxiety caused by needs
- Lives in instable equilibrium
Environment- Not defined
Health
- Implies forward movement of the personality and human processes toward creative, constructive, productive, personal, and community living
Nursing
- A significant, therapeutic, interpersonal process that functions cooperatively with others to make health possible
- Involves problem-solving
Virginia Henderson -The Nature of Nursing
"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. She must in a sense, get inside the skin of each of her patients in order to know what he needs".
Fay Abdella- Topology of 21 Nursing Problems
A list of 21 nursing problems
Condition presented or faced by the patient or family.
Problems are in 3 categories
physical, social and emotional
The nurse must be a good problem solver
Abdella’s Concepts
Nursing
- A helping profession
- A comprehensive service to meet patient’s needs
- Increases or restores self-help ability
- Uses 21 problems to guide nursing care
Health
- Excludes illness
- No unmet needs and no actual or anticipated impairments
Person
- One who has physical, emotional, or social needs
- The recipient of nursing care.
Environment
- Did not discuss much
- Includes room, home, and community
Ida Jean Orlando- Deliberative Nursing Process
The deliberative nursing process is set in motion by the patient’s behavior
All behavior may represent a cry for help. Patient’s behavior can be verbal or non-verbal.
The nurse reacts to patient’s behavior and forms basis for determining nurse’s acts.
Perception, thought, feeling
Nurses’ actions should be deliberative, rather than automatic
Deliberative actions explore the meaning and relevance of an action.
Dorothy Johnson-Behavioral Systems Model
The person is a behavioral system comprised of a set of organized, interactive, interdependent, and integrated subsystems
Constancy is maintained through biological, psychological, and sociological factors.
A steady state is maintained through adjusting and adapting to internal and external forces.
Johnson’s 7 Subsystems
Affiliative subsystem
Dependency
Ingestive
Eliminative
Sexual
- procreation and gratification
Aggressive
- self-protection and preservation
Achievement
- efforts to gain mastery and control
Johnson’s Concepts
Person
- A behavioral system comprised of subsystems constantly trying to maintain a steady state
Environment
- Not specifically defined but does say there is an internal and external environment
Health
Nursing
- External regulatory force that is indicated only when there is instability.
Martha Rogers -Unitary Human Beings
Energy fields
- Fundamental unity of things that are unique, dynamic, open, and infinite
- Unitary man and environmental field
Universe of open systems
- Energy fields are open, infinite, and interactive
Pattern
- Characteristic of energy field
- A wave that changes, becomes complex and diverse
Pandimensionality
- A nonlinear domain with out time or space
Roger’s Definitions
Integrality
- Continuous and mutual interaction between man and environment
Resonancy
- Continuous change longer to shorter wave patterns in human and environmental fields
Helicy
- Continuous, probabilistic, increasing diversity of the human and envrionmental fields.
- Characterized by nonrepeating rhymicities
- Change
Dorothea Orem- Self-Care Model
- Self-care comprises those activities performed independently by an individual to promote and maintain person well-being
- Self care agency is the individual’s ability to perform self care activities
- Self- care deficit occurs when the person cannot carry out self-care
- The nurse then meets the self-care needs by acting or doing for; guiding, teaching, supporting or providing the environment to promote patient’s ability
- Wholly compensatory nursing system-Patient dependent
- Partially compensatory- Patient can meet some needs but needs nursing assistance
- Supportive educative-Patient can meet self care requisites, but needs assistance with decision making or knowledge
Imogene King-Goal Attainment Theory
- Open systems framework
- Human beings are open systems in constant interaction with the environment
- Personal System
- individual; perception, self, growth, development, time space, body image
- Interpersonal
- Society
- Personal System
- Individual; perception, self, growth, development, time space, body image
- Interpersonal
- Socialization; interaction, communication and transaction
- Society
- Family, religious groups, schools, work, peers
- The nurse and patient mutually communicate, establish goals and take action to attain goals
- Each individual brings a different set of values, ideas, attitudes, perceptions to exchange
Betty Neuman - Health Care Systems Model
- The person is a complete system, with interrelated parts
- maintains balance and harmony between internal and external environment by adjusting to stress and defending against tension-producing stimuli
- Focuses on stress and stress reduction
- Primarily concerned with effects of stress on health
- Stressors are any forces that alter the system’s stability
- Flexible lines of resistance
Surround basic core
Internal factors that help defend against stressors
- Normal line of resistance
Normal adaptation state
Protective barrier, changing, affected by variables
- Wellness is equilibrium
- Nursing interventions are activates to:
strengthen flexible lines of defense
strengthen resistance to stressors
maintain adaptation
Sister Calista Roy - Adaptation Model
- Five Interrelated Essential Elements
Patiency- The person receiving care
Goal of nursing- Adapting to change
Health-Being and becoming a whole person
Environment
Direction of nursing activities- Facilitating adaptation
- The person is an open adaptive system with input (stimuli), who adapts by processes or control mechanisms (throughput)
- The output can be either adaptive responses or ineffective responses
Jean Watson - Philosophy and Science of Caring
- Caring can be demonstrated and practiced
- Caring consists of carative factors
- Caring promotes growth
- A caring environment accepts a person as he is and looks to what the person may become
- A caring environment offers development of potential
- Caring promotes health better than curing
- Caring is central to nursing
Watson’s 10 Carative Factors
- Forming humanistic-altruistic value system
- Instilling faith-hope
- Cultivating sensitivity to self and others
- Developing helping-trust relationship
- Promoting expression of feelings
- Using problem-solving for decision making
- Promoting teaching-learning
- Promoting supportive environment
- Assisting with gratification of human needs
- Allowing for existential-phenomenological forces
Watson’s Concepts
- Person
- Human being to be valued, cared for, respected, nurtured, understood and assisted
- Environment
- Health
- Complete physical, mental and social well-being and functioning
- Nursing
- Concerned with promoting and restoring health, preventing illness
Rosemary Parse - Human Becoming Theory
- Human Becoming Theory includes Totality Paradigm
- Man is a combination of biological, psychological, sociological and spiritual factors
- Simultaneity Paradigm
- Man is a unitary being in continuous, mutual interaction with environment
- Originally Man-Living-Health Theory
Parse’s Three Principles
- Meaning
- Man’s reality is given meaning through lived experiences
- Man and environment cocreate
- Rhythmicity
- Man and environment cocreate ( imaging, valuing, languaging) in rhythmical patterns
- Cotranscendence
- Refers to reaching out and beyond the limits that a person sets
- One constantly transforms
- Person
- Open being who is more than and different from the sum of the parts
- Environment
- Everything in the person and his experiences
- Inseparable, complimentary to and evolving with
- Health
- Open process of being and becoming. Involves synthesis of values
- Nursing
- A human science and art that uses an abstract body of knowledge to serve people
Madeleine Leininger - Culture Care Diversity and Universality
- Based on transcultural nursing, whose goal is to provide care congruent with cultural values, beliefs, and practices
- Sunrise model consists of 4 levels that provide a base of knowledge for delivering cultural congruent care
- Modes of nursing action
- Cultural care preservation
- help maintain or preserve health, recover from illness, or face death
- Cultural care accommodation
- help adapt to or negotiate for a beneficial health status, or face death
- Cultural care re-patterning
- help restructure or change lifestyles that are culturally meaningful
Patricia Benner - From Novice to Expert
- Described 5 levels of nursing experience and developed exemplars and paradigm cases to illustrate each level
- Levels reflect:
- movement from reliance on past abstract principles to the use of past concrete experience as paradigms
- change in perception of situation as a complete whole in which certain parts are relevant
- Novice
- Advanced beginner
- Competent
- Proficient
- Expert
Importance of Theoretical Frameworks
- Foundation of any profession is the development of a specialized body of knowledge. Theories should be developed in nursing, not borrow theories form other disciplines
- Responsibility of nurses to know and understand theorists
- Critically analyze theoretical frameworks
Reference
- Alligood M.R, Tomey. A.M. Nursing theory utilization and application. 2nd Ed. Mosby, Philadelphia, 2002.
- Tomey AM, Alligood. MR. Nursing theorists and their work. (5th ed.). Mosby, Philadelphia, 2002.
- George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed. Norwalk, Appleton and Lange.
- Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williamsand wilkins.
- Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development and Progress 3rd ed. Philadelphia, Lippincott.
- Taylor Carol,Lillis Carol (2001)The Art and Science Of Nursing Care 4th ed. Philadelphia, Lippincott.
- Potter A Patricia, Perry G Anne (1992)Fundamentals Of Nursing –Concepts Process and Practice 3rd ed. London Mosby Year Book.
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