TOPIC 1 DEFINITION

OVERVIEW OF TFN  The definition within the description of

a theory conveys the general meaning
• By giving nurses a sense of identity, of the concepts in a manner that fits the
nursing theory can help patients, managers and theory. These definitions also describe
the activity necessary to measure the
other healthcare professionals to recognize the
constructs, relationships, or variables
unique contribution that nurses make to the
within a theory. (Chinn and Kramer
healthcare service (Draper 1990). THEORY 2004).
ORIGIN: “THOERIA” – speculate THEORY
THEORIES are set of interrelated concepts that ASSUMPTIONS
give a systematic view of a phenomenon (an  Are statements that describe concepts
observable fact or event) that is explanatory & or connect two concepts that are
predictive in nature. factual. Assumptions are the “taken for
granted” statements that determine
the nature of the concepts, definitions,
concept purpose, relationships, and structure of
the theory.

PRINCIPLE
proposition theory assumption
 A basic generalization that is accepted
as true and that can be used as a basis
for reasoning or conduct. NURSING
THEORY o A body of knowledge that
definiton
describes or explains nursing and is
used to support nursing practice. o An
organized and systematic articulation of
a set of statements related to questions
in the discipline of nursing.
CONCEPT
PHILOSOPHY
 A mental idea of a phenomenon.
 A comprehensive idea or  The most basic beliefs, concepts, and
generalization. attitudes of an individual or group o An
 An idea that brings diverse elements analysis of the grounds of and concepts
into a basic o relationship. expressing fundamental beliefs o Is the
 A unit of knowledge abstracted from a next knowledge level after
set of o characteristics attributed to a metaparadigm. It specifies the
class of objects, o relations or entities. definition of metaparadigm concepts.
o A unit of thought.
 A general idea formed in the mind.
 Something understood or retained in
the mind, from experience, reasoning,
and/or imagination, a generalization or
abstraction of a particular set of
instances or occurrences. • Examples:
person, health, environment, nursing
KNOWLEDGE PURPOSES OF NURSING THEORY IN
RELATION TO: (AREAS OF NURSING)
 Information, skills and expertise
acquired by a person through 1. Education
formal/informal learning.
• nursing theory was used primarily to
PHENOMENON establish the profession’s place in the
university.
 A set of empirical data or experiences • provide a general focus for
that can be physically observed or curriculum design.
tangible such as crying or grimacing • guide curricular decision making
when in pain.
2. Research
NURSING
• nursing research identifies the
 Nursing encompasses autonomous and philosophical assumptions or
collaborative care of individuals of all theoretical frameworks from which it
ages, families, groups and communities, proceeds.
sick or well and in all settings. It • offer a framework for generating
includes the promotion of health, the knowledge and new ideas.
prevention of illness, and the care of ill, • assist in discovering knowledge gaps
disabled and dying people. (WHO) in specific field of study.
• offer a systematic approach to
PARADIGM
identify questions for study, select
 In science and philosophy, a paradigm is variables, interpret findings and
a distinct set of concepts or thought validate nursing interventions.
patterns, including theories, research 3.PRACTICE
methods, postulates, and standards for
what constitutes legitimate • the primary contribution of nursing
contributions to a field. theory when employed in a clinical
setting is the facilitation of reflection,
HYPOTHESIS questioning, and thinking about what
 Translates a research question into a nurses do.
prediction of expected outcomes. - • assist nurses to describe, explain, and
research question identifies the predict everyday experiences.
variables/ concepts under investigation • serve to guide assessment,
and asks how the concepts might be intervention, and evaluation of nursing
related - hypothesis is the predicted care.
answer • provide a rationale for collecting
reliable and valid data about the health
RESEARCH status of clients, which are essential for
effective decision making and
 Research comprises "creative and implementation.
systematic work undertaken to increase
the stock of knowledge, including TYPES OF NURSING THEORY
knowledge of humans, culture and
society, and the use of this stock of Meta-theory - the theory of theory. Identifies
knowledge to devise new applications. specific phenomena through abstract concepts.
Grand theories – broad and complex Middle-
range theories- address specific phenomena through the development and use of
and reflect practice nursing theory.

Practice theory - explores one particular HISTORY OF NURSING

situation found in nursing. It identifies explicit
goals and details how these goals will be  The word nurse is derived from the
achieved. Anglo-French nurice and the Latin word
nutrica, both of which mean NOURISH.
Descriptive theories – first level of theory » Florence Nightingale pioneer
development activities in nursing practice & her
subsequent writings about nursing
Prescriptive Theories – address nursing served as a guide for establishing
interventions and predict their consequences nursing schools in the US at the
TOPIC 2 beginning of 20th century.
» In the last century, nursing began
HISTORY OF NURSING THEORY with a strong emphasis on practice.
» Throughout that century, nurses
 The history of professional nursing work toward the development of the
began with 1. Florence Nightingale. She profession in what has been viewed as
envisioned nurses as a body of successive
educated women at a time when
women were neither 2. educated nor Nightingale’s vision of nursing has been
3. employed in public service. Following practiced for more than a century, and theory
her service of organizing and caring for development in nursing has evolved rapidly
the wounded in Scutari, during the over the past 5 decades, leading to the
4. Crimean War, her vision and recognition of nursing as an academic discipline
establishment of a 5. School of Nursing with a substantive body of knowledge
at St. Thomas’ Hospital in London
marked the birth of modern nursing. HISTORICAL ERAS
CURRICULUM ERA
 Nightingale’s pioneering activities in
nursing practice and subsequent •Moving nursing education from hospital -
writings describing nursing education based diploma programs into college and
became a guide for establishing nursing universities
schools in the United States at the
beginning of the twentieth century RESEARCH ERA
(Kalisch & Kalisch, 2003; Nightingale,
1859/1969). • Research is the path to new knowledge

HISTORICAL DEVELOPMENT • Part of the curricula of developing

graduate programs.
 In the early part of nursing’s history,
knowledge was extremely limited and GRAD EDU ERA
almost entirely task oriented.
• Masters program in nursing emerged to
 Role of nurses where questioned; what
meet the need for nurses with specialized
they do, for whom where and when
education in nursing
were determined.
 The professionalization of nursing has
been and is being brought about
 THEORY ERA CHANGES OF EDUCATION IN NURSING

• Outgrowth of research era 1874 – the St. Catherine Training School

was the first hospital diploma school in
• Research without theory produced Canada where the nursing program went
isolated information; however research and from an apprenticeship to an educational
theory produced nursing science model.
MID 1800’S & 1960’S
1881 – the school for Nurses at the
MID 1800’S Toronto General Hospital was established.
1896 – Mary Agnes Snively developed 3-
 Nursing Knowledge is distinct from year course with 84 hours of practical
medical knowledge (Nightingale) nursing and 119 hours of instruction by the
 Nursing as a Vocational heritage more medical staff.
than professional vision
1918 - following World War 1, the
MID 1970’S widespread influenza pandemic led to
support forpublic health programs and new
 Evaluation of 25 years of nursing patterns of health care delivery.
research revealed that nursing lacked
conceptual connections and theoretical 1919 – was the year the first
frameworks. undergraduate nursing degree program was
 MILESTONES: established at the University of British
Columbia.
14. The standardization of curricula for
nursing master’s education 1932 – demanded for transfer of
15. Doctoral education for nurses should be responsibility for nursing education to
in nursing o Transition from vocation to general educational system. 1950’s and
profession 1960’s – experiments with two-year
programs for nursing began and the
 Nursing practice is based on Nursing movement to separate nursing education
Science. from the authority of hospitals began. 1967
– Laurentian University started student
MID 1980’S intake.
 Preparadigm period to Paradigm period 2000 – all professional nurses are required
o Introduced an organizational to have a bachelor at degree
structure for nursing knowledge
development to the nursing literature THE NURSING THEORY
 Utilization phase of the Theory Era –
emphasis shifts from thedevelopment  Provides a basis of nursing practice.
to the use and application of what  It is important to nurses because it
helps to interpret data, make decisions
FIRST CONFERENCE NURSING THEORY based on relevant information, plan for
care, and predict and evaluate
 Brought leading scholars and theorists outcomes.
to discuss and debate on issues  It helps to differentiate nursing from
regarding nursing science and theory other disciplines.
development. (1969)
 TOPIC 3 o Nursing development was the subject of
numerous studies of numerous studies by
SIGNIFICANCE OF THEORY FOR NURSING AS sociologists
A DISCIPLINE & A PROFESSION
NURSING THEORY AND THE PRACTICING
 Discipline is specific to academia NURSE
and a branch of education, a
department of learning or field of Theory assists the practicing nurse to: o
knowledge. Organize patient data
 Profession refers to specialized
field of practice, which is founded o Understand patient data
upon the theoretical structure of
o Analyze patient data
the science or knowledge of that
discipline and the accompanying o Make decisions about nursing interventions
practice abilities.
o Plan patient care
The theoretical works have taken nursing to
higher levels of education and practice as a o Evaluate patient outcomes
nurses
WHAT IS A PROFESSION?
SIGNIFICANCE OF THEORY FOR NURSING AS A
DISCIPLINE o A profession is an occupation with ethical
components, i.e, devoted to the promotion of
o University baccalaureate programs human and social welfare.
proliferated, master’s programs in nursing were
developed, and a standardized curriculum was o The services and knowledge by a profession
realized through accreditation. are based on specialized skills.

o Attention to the importance of nursing o Professions are those occupations possessing

conceptualizations for the research process and a particular combination of characteristics.
the role of a conceptual framework in the o Nursing profession is an Occupation based on
purpose and design of research production of the specialized intellectual study and training,
science and nursing theoretical works also the purpose of which is to supply skilled
began to publish. services with ethical components.
o Works began to be recognize for their CRITERIA OF PROFESSION
theoretical nature, such as Henderson,
Nightingale and Orlando, Peplau, and o Bixler and Bixler Criteria of Profession
Wiedenbach were recognized for the
theoretical nature of their earlier wings. o Abraham Flexner’s criteria for a profession

SIGNIFICANCE OF THEORY FOR NURSING AS A o Kelley’s Criteria BIXLER AND BIXLER CRITERIA
PROFESSION FOR PROFESSION

o Clearly nursing is recognized as a profession o Genevieve and Roy Bixler who were against
today having used the criteria for a profession the status of Nursing as a profession 1945,
to guide development\ appraised nursing according to their original
seven criteria as follows:
1. Utilizes in its practice a well defined and well 6. Has practitioners who are motivated by
organized body of knowledge, which is on the altruism( the desire to help others) and who are
intellectual level of the higher training. responsive to human interests.

2. Constantly enlarges the body of knowledge KELLEY'S CRITERIA

its uses and improves and improves its
techniques of education and service by the use Kelley(1981) reiterated and expanded Flexner's
of the scientific method. criteria in her 1981 listing of characteristics of a
profession.
3. Entrusts the education of its practitioners to
institutions of higher education. 1. The services provided are vital to humanity
and the welfare of the society
4. Applies its body of knowledge in practical
service, which is vital to human beings and 2. There is a special body of knowledge that is
social welfare. continually enlarged through research.

5. Functions autonomously in the formulation 3. The services involve intellectual activities;

of professional policy and in control of individual responsibility (accountability) is a
professional activities thereby. strong feature.

6. Attracts individuals of intellectual and 4. Practitioners are educated in institutions of

personal qualities who exalt service above higher learning
personal gain and who can recognize their
5. Practitioners are relatively independent and
chosen profession as lifelong.
control their own policies and activities
7. Strives to compensate its practitioners by (autonomy).
providing freedom of action, opportunity for
6. Practitioners are motivated by service
continuous professional growth and economic
(altruism) and consider their work as an
security
important component of their lives.
ABRAHAM FLEXNER'S CRITERIA FOR A
7. There is a code of ethics to guide the
PROFESSION
decisions and conduct of practitioners.
Flexner believed that professional work:
8. There is an organization (association) that
1. Is basically intellectual (as opposed to encourages and support high standards of
physical) and is accompanied by a high degree practice
of individual responsibility.
CHARACTERISTICS OF PROFESSIONS
2. Is based on a body of knowledge that can be
1. GREAT RESPONSIBILITY
learned and is refreshed and refined through
research  Professionals deal in matters of vital
3. Is practical in addition to being theoretical. importance to their clients and are
therefore with grave responsibilities.
4. Can be taught through a highly specialized And entrusted obligations.
education. professional  Given these inherent obligations,
professional work typically involves
5. Has a strong internal organization of circumstances where carelessness,
members and a welldeveloped group inadequate skill, or breach of ethics
consciousness.
 would be significantly damaging to the clients (either directly or as
client and/or his fortunes. preconditions for their ongoing agency
employment).
2. ACCOUNTABILITY
6. CLIENTS RATHER THAN CUSTOMERS.
 Professionals hold themselves
ultimately accountable for the quality of  Members of a profession exercise
their work with the client. discrimination in choosing clients rather
 The profession may or may not have than simply accepting any interested
mechanisms in place to reinforce and party as a customer (as merchants do).
ensure adherence to this principle
among its members. If not, the 7. DIRECT WORKING RELATIONSHIPS
individual professionals will (e.g.
 Professionals habitually work directly
guarantees and/or contractual
with their clients rather than through
provisions).
intermediaries or proxies.
3. BASED KNOWLEDGE ON SPECIALIZED,
8. ETHICAL CONSTRAINTS.
THEORETICAL
 Due to the other characteristics on this
 Professionals render specialized
list, there is a clear requirement for
services based on theory, knowledge,
ethical constraints in the professions.
and skills that are most often peculiar
Professionals are bound to a code of
to their profession and generally
conduct or ethics specific to the distinct
beyond the understanding and/or
profession (and sometimes the
capability of those outside of the
individual). Professionals also aspire
profession. Sometimes, this
toward a general body of core values,
specialization will extend to access to
which are centered upon an
the tools and technologies used in the
uncompromising and unconflicted
profession (e g. medical equipment)
regard for the client's benefit and best
4. INSTITUTIONAL PREPARATION interests.

 Professions typically require a period of 9. MERIT-BASED

hands-on, practical experience in the
 In a profession, members achieve
protected company of senior members
employment and success based on
before aspirants are recognized as
merit and corresponding voluntary
professionals. After this provisional
relationships rather than on corrupted
period, ongoing education toward
ideals such as social principle,
professional development is
mandated support, or extortion (e.g.
compulsory. A profession may or may
union members are not professionals).
not require formal credentials and/or
Therefore, a professional is one who
other standards for admission.
must attract clients and profits due to
5. AUTONOMY the merits of his work. In the absence of
this characteristic, issues of
 Professionals have control over and, responsibility, accountability, and
correspondingly, ultimate responsibility ethical constraints become irrelevant,
for their own work. Professionals tend negating any otherwise-professional
to define the terms, processes, and characteristics.
conditions of work to be performed for
10. CAPITALIST MORALITY when in pain. Or A set of empirical data or
experiences that can be physically observed
 The responsibilities inherent to the or tangible such as crying or grimacing
practice of a profession are impossible when in pain.
to rationally maintain without a moral
foundation that flows from a HYPOTHESIS- Predicted answer
recognition of the singular right of the
individual to his own life, along with all PHENOMENON- Help to describe or label
of its inherent and potential sovereign phenomena
value; a concept that only capitalism
EDUCATION- Nursing theory was used
recognizes, upholds and protects.
primarily to establish the profession’s place
TOPIC 1 REVIEW in the university.

THEORY - A well-substantiated explanation CHARACTERISTICS OF A THEORY:

of some aspect of the natural world; an a. Interrelating concepts in such a way as to
organized system of accepted knowledge create a different way of looking at a
that applies in a variety of particular phenomenon
situations/hypotheses
b. Logical in nature
CONCEPT- An idea that brings diverse
elements into a basic relationship or c. Generalizable
Something understood or retained in the
mind, from experience, reasoning, and/or d. Basis for hypothesis that can be tested
imagination; a generalization or abstraction
of a particular set of instances or e. Increasing the general body of
occurrences. knowledge within the discipline through the
research implemented to validate them f.
PRINCIPLE- A basic generalization that is Used by practitioners to guide and improve
accepted as true and that can be used as a their practice
basis for reasoning or conduct
PHILOSOPHY- The most basic beliefs, g. Consistent with other validated theories,
concepts, and attitudes of an individual or laws, and principles but will leave open
group unanswered questions that need to be
investigated
CONCEPTUAL FRAMEWORK/MODEL-
identify concepts and describe their TYPES OF NURSING THEORY
relationships to the phenomena of central a. Meta-Theory
concern to the discipline: person,
environment, health and nursing b. Grand Nursing Theory
THEORETICAL FRAMEWORKS/MODELS- Are
highly established set of concepts that are c. Mid-Range Nursing Theories
testable.
d. Nursing Practice
KNOWLEDGDE- Information, skills and
Theories COMPONENTS OF NURSING
expertise acquired by a person through
THEORY
formal/informal learning. PHENOMENON-
Experiences that can be physically observed a. Concept
or tangible such as crying or grimacing
b. Assumption 1. Science is logical, systematic, & coherent
way to solve problems and answer
c. Definition questions.
d. Proposition 2. It is a collection of facts known in area
and the process used to obtain that
NURSING METAPARADIGM CONCEPTS
knowledge.
a. Person
NURSING AND PHILOSOPHY
b. Nursing
 Philosophy studies concepts that
c. Environment structure thought processes,
foundations, and presumptions.
d. Health  It is an approach for thinking about the
nature of people, the methods that
NURSING- The attributes, characteristics, should be used to create a scientific
and actions provide care on behalf of or in knowledge and the ethics involved. It
conjunction with the client denotes a perspective, implying a
certain broad, “taken for granted”
PERSON- the recipient of nursing care and
assumptions
may include individuals, patients, groups,
families, and communities EPISTEMOLOGY
HEALTH- defined as the degree of wellness  a branch of philosophy that is
or well- being that the client experiences concerned with the nature and scope of
ENVIRONMENT- defined as the internal and knowledge. It is referred to as the
external surroundings that affect the client. “theory of knowledge” HISTORICAL
It includes all positive or negative conditions VIEWS OF THE NATURE OF SCIENCE
that affect the patient, the physical
environment, such as families, friends, and 01 RATIONALISM It is the use of the
significant others, and the setting for where rational senses in ensuring the truthfulness
they go for their healthcare. of a phenomenon

TOPIC 4 02 EMPIRICISM It is the way of looking at

reality using the five general senses of sight,
HISTORY AND PHILOSOPHY OF SCIENCE touch, hearing, taste, and smell
“Philosophy in its broadest sense is
wondering and being curious about the EARLY 12TH CENTURY VIEWS OF SCIENCE &
“big” or fundamental questions that THEORY
humans have grappled with throughout the
history. Questions about “what is real?” Philosophers focused on the analysis of
(ontology), “what is knowable? theory structure whereas, o Scientists
(epistemology), “is this just?” (ethics), and focused on empirical research
“is there an art to caring?” (aesthetics) are
o Positivism (imposed on the mind by
considered indispensable reflections in
experience) is the philosophy of science
nursing Practice.” -BRUCE, RIETZE KIM 2014
that information is derived from logical and
NURSING AS A SCIENCE mathematical treatments and reports of
sensory experience is the exclusive source
of all authoritative knowledge
EMERGENT VIEWS IN THE LATE 20TH CENTURY o Esthetic knowledge
OF SCIENCE & THEORY
o Moral knowledge
• Empiricists argue that for science to
maintain its objectivity, data collection and o Personal knowledge
analysis must be independent of a theory.
▪ 1980s - Further acceptance of nursing theory
Brown argues that the new epistemology and its incorporation in the nursing curricula;
challenged the empiricist view of perception by publication of several nursing journals
acknowledging that theories play a significant
▪ 1990s - Nursing as a basic science, an applied
role in determining what the scientist will
science, or a practical science
observe and how it will be interpreted. He
identified 3 different views of the relationship ▪ Progress in the Discipline of Nursing (Meleis)
between theories and observation:
o Practice
o Scientists are merely passive observers of
occurrences in the empirical world. Observable o Education and Administration
data are objective truth waiting to be
discovered. o Research o Development of Nursing Theory

o Theories structure what the scientists o ▪ Peplau developed the first theory of nursing
perceived in the empirical world. practice in her book, Interpersonal Relations in
Nursing (1952) ▪ Journal of Nursing Research
o Presupposed theories and observable data (1952) ▪ 1960s and 1970s – analysis and debate
interact in the process of scientific investigation on the metatheoretical issues related to theory
INTERPENDENCE BETWWEN THEORY & development
RESEARCH
➢ Postpositivism focuses on discovering the
o A theory should be judged based on the basis patterns that may describe a phenomena.
of scientific o consensus.
➢ Interpretive paradigm tends to promote
o The acceptance of scientific hypothesis understanding by addressing the meanings the
through research depends on the appraisal of participants social interaction that emphasize
the coherence of theory situation, context and multiple cognitive
constructions that individuals create on
o Dubin identified when scientific consensus is everyday events.
necessary:
➢ Critical paradigm for knowledge
1. on the boundaries of the theory; the development in nursing , provides framework
phenomenon it addresses and what it excludes for inquiring about the interaction between the
2. on the logic used in constructing the theory social, political, economic, gender and cultural
to further understanding from a similar factors and experiences of health and illness.
perspective “Philosophy of science without history of
science is empty; history of science without
3. that the theory fits the data collected and
philosophy of science is blind - Imre Lakatos
analyzed though research ISSUES IN NURSING
PHILIOSOPHY & SCIENCE DEVELOPMENT Four
fundamental patterns of knowledge in Nursing
(Carper, 1978)

o Empirical knowledge