Theoretical Foundations

of Nursing Lesson 2
Purposes of Nursing Theory
Review Previous Lesson
Previous Key Points
• Phenomenon
• Concepts
• Conceptual Models
• Paradigms
• Assumptions
• Propositions
• Hypothesis
• Research
• Induction
• Deduction
Objectives for Today:
• I can:
• define nursing theory.
• explain the purpose of nursing theory to:
• Education
• Research
• Clinical practice
• connect theory, research and practice.
• describe the people who have contributed to nursing.
What is the purpose of Nursing Theory?
• You should be in groups.
• Make an A-Z Graffiti.
• You must review responses and choose five words or
phrases that best reflect the question or statement.
These are then written into a sentence or several
sentences to summarize what you think would be the
most important things for someone your age to know
about the topic.
 Profession – Proper means and
communication – Useful to Society
Example
(1) Farmer in the northern rural fields of Luzon will sow
seeds with the knowledge of plant growth, maturation,
harvest and exportation;
(2) a public school teacher in urban Manila will instruct
students with the knowledge of pedagogy and
motivation;
(3) a registered nurse in Davao is no exception to this
phenomenon. She will render nursing care and service in
the various disciplines of the profession utilizing the
THEORIES OF NURSING.
Nursing theory
• developed to improve the quality of care rendered by
nurses to their clients.
• Theory development
• inherent in the different nursing fields – education,
research and practice
Education
• Nursing theories were primarily used to develop and guide
nursing education in universities and institutions.
• Theories are thought to be more established in the field of
academics rather than in clinical practice.
• In the 1970s and 1980s, a number of nursing programs
recognized the major concepts of some nursing models,
structured these concepts into conceptual framework and
built the complete curriculum around the framework
(Kozier, 2008).
Education
• Models were used to derive terms for nursing to be utilized
in education: program objective, course objectives, course
description, and clinical performance criteria. These new
terms assist and direct the entire education system to
create a more comprehensive curriculum.
• Prepare students for practice as members of the
professional community.
• PRIMARY GENERAL PURPOSE: to ensure adequate and
quality nursing delivery and to clarify and improve the
status of nursing as a profession.
Research
• Inspiration of nursing research are different
theoretical assumptions or conceptual frameworks in
the past.
• Development of clear understanding about the quality
of life as well as the management of symptoms is an
indication that conceptual perspectives are constantly
improving.
Types of Theories in Nursing Research
• Grand theories – broad in scope and complex in nature; assist
nursing research in an occasional manner.
• Middle-range Theories – where most nursing researches are
based; focus on discovery of concepts such as pain, self-
esteem, and learning; social sciences has served as one of the
foundation of qualitative nursing research.
• Critical Theory – used in the academe to describe theory that
clarify how social structures influence a wide variety of human
experiences form art to social practices; helps elaborate more
on how structures such as race, gender, sexual orientation and
economic class affect experiences and health outcomes of
patients (Kozier, 2008).
Clinical Practice
• Nurse’s ability is enriched through the help of different
nursing theories.
• Theories: guide critical thinking and decision-making
in clinical practice.
• Nurses will have better understanding on the basis
and nature of their work and be able to express it
clearly in collaboration with other professionals.
Clinical Practice
• Nursing theories strengthen professional independence by
guiding the deepest reflections and most important part of
their practice.
• Nursing theories are always critical in assisting nurses to
facilitate questions, reflection and critical thinking in every
aspect of care. E.g. the application of Leininger’s
Transcultural Nursing Theory for developing culturally
similar strategies is useful to nurses working with
suspected child maltreatment cases.
INTERDEPENDENCE of
THEORY AND RESEARCH
“Practice without theory, like map without route, is blind;
theory without practice, like route without map, is empty.”
INTERDEPENDENCE of THEORY AND
RESEARCH
Nursing
Practice

Nursing Nursing
Theory Research
INTERDEPENDENCE of THEORY AND
RESEARCH
• Purpose of this relationship: TO HELP BUILD NURSING
KNOWLEDGE.
• MORE RESEARCH~MORE LEARNING gained as to what
extent a given theory can be useful in providing
knowledge that enhance client’s care.
INTERDEPENDENCE of THEORY AND
RESEARCH
• Nursing knowledge is composed of theoretical and
practical knowledge.
• Theoretical knowledge include and reflects on the
basic values, guiding principles, elements and phases
of conception of nursing.
• Theoretical Knowledge – aims to stimulate thinking and
broaden understanding of the science and practice of the
Nursing discipline.
• Practice Knowledge – the art of nursing.
INTERDEPENDENCE of THEORY AND
RESEARCH
• Research is linked to theories in two ways by generating
and testing (Chinn and Krammer, 2004).
• Theory-generating research – to discover and describe
relationships and phenomena without imposing
predetermined notion on the nature of the phenomena;
investigators make observations with an open mind in order
to view phenomenon in a new way.
• Theory-testing research – to determine how accurate a theory
describe a phenomenon; researcher has predetermined
notions as to how the phenomenon is and creates hypothesis
to test the assumptions of the theory.
INTERDEPENDENCE of THEORY AND
RESEARCH
• Example:
• Consider a sample case study of Nurse Arian on the
concept of Death among Terminally-ill Cancer Patients. The
researcher is interested in studying about concept of death
of terminally-ill cancer patients. After gathering sufficient
information form the respondents and application of the
research process, the researcher can now develop an initial
theory about the concept of death in terminally-ill cancer
patient.
INTERDEPENDENCE of THEORY AND
RESEARCH
• Analysis:
• Step 1: Describing the concept of death of terminally-ill cancer
patients, the nurse-researcher can test the elements of the
theory.
• Step 2: If the result of the study indicates that the concept if
death varies depending on the support system of the patient,
the researcher can test the factors within the support systems
affecting perception of the cancer patients.
• Step 3: The theory is test through a variety of research
activities. There is no single study to test all components of a
theory!
END RESULT OF THEORY-
GENERATING and THEORY-
TESTING RESEARCH = ENHANCE
NURSING KNOWLEDGE
*Nurses are now able to apply research-based interventions into practice.
*Thus, continued research is necessary to increase knowledge which in turn improves
nursing care.
*Nursing is evidence-based and is focused on promotion of client satisfaction, as a science.
Nursing
THEORIST Theorist and their
PRACTICE Theories
EDUCATION and
RESEARCH

purpose Environmental aspects Development

excellent
of
training
as integral part of system in St. Thomas
Florence Nightingale nursing: good Hospital and King’s Invented the “polar
(Environmental ventilation, proper College Hospital in diagrams” to analyze
Theory) disposal, control of London; Scientific and gather data.
noise, sanitation, water principles and practical
treatments experience in mastery
of skills.
Provides clear design
Author of Formulated concepts of
for the practice of
“Interpersonal anxiety as a means to
psychiatric nursing;
Hildegard Peplau Relations in Nursing” constructively resolve
emphasized the
(Psychodynamic which aids nurses; angry feeling through
development of
Nursing) formulated effective experiential learning
interpersonal
psychotherapeutic within the nurse-patient
relationship between the
methods. relationship.
patient and the nurse.
Nursing Theorist and their Theories
THEORIST PRACTICE EDUCATION
Nurse’s education
RESEARCH

and purpose
Virginia Henderson Nurses as direct
demands
understanding
universal
of
Recommended library
research; advocated
(14 Components of caregiver; help patients diverse human being;
research as a way to
Basic Nursing Care) become independent. designed three phases of
improve practice.
curriculum
development.
The focus of nursing
education has shifted
Hospice is one of her
from disease-oriented
essential contributions;
approach to holistic care Utilized by various
asserted that finding
approach; stated that author in their study of
Joyce Travelbee meaning in illness and
nursing programs need recently diagnosed
(Human to Human suffering enables the
to offer much broader cancer patients and their
Relationship Model) patient not only to
background in personal search for
accept illness but it will
communication meaning.
also serve as self-
techniques, values
actualizing experience.
clarifications and care
of the dying.
Nursing
THEORIST Theorist
PRACTICE and their EDUCATIONTheories and
RESEARCH

purpose integrated and holistic provides an effective Additional

Goal-directed, Holistic curriculum;
and
clarification
generation of
approach to client care; framework in
testable nursing
formulated Neuman conceptual evolution
Betty Neuman theories; guide model to
Nursing Process among levels of
(Systems Model) enhance the nursing
Format: Nursing education of nursing
care of clients with
Diagnosis, Nursing students from diploma
specific physiological
Goals, Nursing to associate to
stressors.
Outcomes. baccalaureate programs.
Used assessment, Stated that nursing
disorders, treatment and research would:
evaluation instead of “Identify and explain
Dorothy Johnson Nursing Process; “The Focuses on the patient the behavioral system
(Behavioral System behavioral system is as a behavioral system disorders which arise in
Model) said to determine and and its dysfunction. connection with illness,
limit the interaction and develop the
between the patient and rationale for the means
his environment”. of management”.
 THEORIST PRACTICE EDUCATION RESEARCH
Nursing Theorist andin their Theories and
Utilized professionals
most specialty areas;
purpose developed the Goal
Imogene King (Goal Oriented Nursing
Nursing
development
curriculum
and Her work served as
practice application in theoretical basis for
Attainment Theory) Record (GONR) which
Ohio state and other various studies.
is used to record goals
universities.
and outcomes in patient
settings.
Came up with the idea
of need for nursing-
Developed a number of
specific knowledge
Described nursing instruments for
structure; Author of
management of research: Exercise Self-
Dorothea Orem (Self “Guides for Developing
Pertussis; Teaching self- Care Agency (ESCA)
Care Deficit Theory in Curriculum for the
care to Diabetic patients which is used to
Nursing) Education of Practical
and ESRF; Pain determine the capacity
Nurses” and
assessment and control. of patients to care for
“Foundations of
their selves.
Nursing and its
Practice”.
 THEORIST PRACTICE EDUCATION RESEARCH
Nursing Theorist and their Theories and
Organized and systematic
basis of nursing practice;
purpose Typology helps in efficient
Faye Abdellah (Typology assessment, nursing
The typology provided
scientific body of
Believed that evidenced-
based practice on scientific
knowledge and filled-in
of 21 Nursing Problems) diagnosis, and planning data has great impact in
the gaps of weaknesses in
interventions; Uses nursing research.
nursing education.
scientific basis in problem-
solving process.
Development of
curriculum development in
various institutions; Three
Manipulating the stimuli Development and testing
vertical strands in the
and not the patients; of theories; Practice-based
curriculum: The adapting
Sis. Callista Roy Nurses enhance the researched; Development
person, health-illness,
(Adaptation Model) interaction of person and of programs of research;
nursing management; Two
their environment thus Development of adaptation
horizontal strand in the
improving health. research instruments.
curriculum: Nursing
process, student adaptation
and leadership.
 THEORIST PRACTICE EDUCATION RESEARCH
Nursing Theorist
Prepares andto their Theories and
nurses
prevent culture shock Helps produce a well-
purpose and conflicts as they qualified
practice in different prepared
faculty
in
Focused on culture care;
Madeleine Leininger places with different Transcultural Nursing to
With research method
(Transcultural cultures; Provides teach and guide
of (ethnonursing) to
Nursing) human care and health students; Education in
examine theories.
behaviors as Transcultural Nursing
background knowledge leads to culturally
to understand nursing competent nursing care.
phenomena.
Author of “Nursing:
Human Science and
Research must focus on
Caring as an essential Human Care-a Theory
both subjective and
Jean Watson field in nursing; of Nursing”; Described
objective patient
(Philosophy and Example in clinical the core of Nursing as
outcomes in knowing
Science of Caring) setting (ICU, NICU, aspects of the nurse-
that caring is important
PICU and Geron Units) patient relationship
in nursing.
resulting in therapeutic
result.
Nursing Theorist and their Theories and
purpose
THEORIST PRACTICE EDUCATION RESEARCH
Formulated the levels of
Patricia Benner (From Learning needs at an Extended the study of
Competency in Nursing
Novice to Expert: early stage of clinical formal models which
Practice: Novice,
Excellence and Power knowledge are different direct care and
Advance Beginner,
in Clinical Nursing from those needed in substitute knowledge
Competent, Proficient
Practice) later stage. used in nursing practice.
and Expert.
Practice!
Fill in the boxes by identifying the name
of the theorist corresponding to her
contribution in nursing community.
Fill in the boxes by identifying the name
of the theorist corresponding to her
contribution in nursing community.
Questions?
• What fields are nursing theory useful?
• What is the purpose of Nursing theory to each field?
• How is Nursing Research, Nursing theory and Nursing
practice interrelated?
Reflection
• Make a reflection as to who among the nursing
theorists have the most significant involvement in
nursing practice at present? Why? Write this in a 1
whole sheet of paper. This will serve as your exit
cards.
Theoretical Foundations
of Nursing Lesson 2
Purposes of Nursing Theory
FIN