nursing theorists

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Gloria A. Hagopian, RN, EdD 6/10/2014 1

Nursing Theorists


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Definitions

Theory- a set of related statements thatdescribes or explains phenomena in a

systematic wayConcept-a mental idea of a phenomenon

Construct- a phenomena that cannot be

observed and must be inferred


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Definitions

Proposition- a statement ofrelationship between concepts

Conceptual model- made up ofconcepts and propositions


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Nursing Theorists

Florence Nightingale, HildegardPeplau, Virginia Henderson, Fay

Abdella, Ida Jean Orlando, DorothyJohnson, Martha Rogers, DorotheaOrem, Imogene King, Betty Neuman,

Sister Calista Roy, Jean Watson,Rosemary Rizzo Parse, MadeleineLeininger, Patricia Benner


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Concepts in the

nursing metaparadigm

Person

Recipient of care, including physical,spiritual, psychological, and socioculturalcomponents

Individual, family, or community


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Concepts in the nursing

metaparadigmEnvironment

All internal and external conditions,circumstances, and influences affectingthe person


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metaparadigmHealth

Degree of wellness or illness experiencedby the person




metaparadigmNursing

Actions, characteristics and attributes ofperson 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



Nightingales Concepts

PersonPatient who is acted on by nurse

Affected by environment

Has reparative powers

Environment

Foundation of theory. Includedeverything, physical, psychological, andsocial



Nightingales Concepts

Health

Maintaining well-being by using a

persons powersMaintained by control of environment

NursingProvided fresh air, warmth, cleanliness,

good diet, quiet to facilitate personsreparative process



Hildegard PeplauInterpersonal Relations

Model



Hildegard PeplauInterpersonal

Relations Model

Based on psychodynamic nursing

using an understanding of ones ownbehavior to help others identify theirdifficulties

Applies principles of human relationsPatient has a felt need



Peplaus Concepts

Person

An individual; a developingorganism who tries to reduce anxietycaused by needs

Lives in instable equilibrium

Environment- Not defined



Peplaus Concepts

Health

Implies forward movement of thepersonality and human processestoward creative, constructive,

productive, personal, andcommunity living



Peplaus Concepts

Nursing

A significant, therapeutic,interpersonal process that functionscooperatively with others to make

health possibleInvolves problem-solving



Virginia Henderson


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Virginia Henderson

The Nature of Nursing

The unique function of the nurse is to

assist the individual, sick or well, inthe performance of those activitiescontributing to health or its recovery

(or to peaceful death) that he wouldperform unaided if he had thenecessary strength, will, or knowledge.


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Virginia Henderson

And to do this in such a way as to helphim gain independence as rapidly as

possible. She must in a sense, getinside the skin of each of her patientsin order to know what he needs.


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Virginia HendersonShe is temporarily theconsciousness of the unconscious,

the love of life for the suicidal, theleg of the amputee, the eyes of thenewly blind, a means of locomotion

for the infant, knowledge andconfidence for the young mother, themouthpiece for those too weak or

withdrawn to speak, and so on.


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Fay Abdella- Topology of

21 Nursing Problems


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Fay AbdellaTopology of 21 Nursing

Problems

A list of 21 nursing problems

Condition presented or faced by thepatient or family.

Problems are in 3 categories

physical, social and emotional

The nurse must be a good problemsolver


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Abdellas ConceptsNursingA helping profession

A comprehensive service to meet patients

needsIncreases or restores self-help ability

Uses 21 problems to guide nursing care

Health

Excludes illness

No unmet needs and no actual oranticipated impairments


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Abdellas Concepts

Person

One who has physical, emotional, orsocial needs

The recipient of nursing care.

Environment

Did not discuss much

Includes room, home, and community


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Ida Jean Orlando

Deliberative Nursing Process


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Ida Jean Orlando

Deliberative Nursing Process The deliberative nursing process is set in

motion by the patients behavior

All behavior may represent a cry for help.Patients behavior can be verbal or non-verbal.

The nurse reacts to patients behavior and

forms basis for determining nurses acts.

Perception, thought, feeling


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Ida Jean OrlandoDeliberative Nursing

Process

Nurses actions should be deliberative,

rather than automatic Deliberative actions explore the

meaning and relevance of an action.


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Dorothy Johnson

Behavioral Systems Model


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Dorothy Johnson

Behavioral Systems ModelThe person is a behavioral system

comprised of a set of organized,

interactive, interdependent, andintegrated subsystems

Constancy is maintained through

biological, psychological, and sociologicalfactors.


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Dorothy Johnson

Behavioral SystemsModelA steady state is maintained through

adjusting and adapting to internal andexternal forces.


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Johnsons 7 Subsystems

Affiliative subsystem

social bonds

Dependencyhelping or nuturing

Ingestive

food intake

Eliminative

excretion

D h J h


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Dorothy JohnsonBehavioral Systems

Model 7 Sub Systems

Sexual

procreation and gratification

Agressive

self-protection and preservation

Achievement

efforts to gain mastery and control


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Johnsons Concepts

Person

A behavioral system comprised ofsubsystems constantly trying to maintain

a steady state

Environment

Not specifically defined but does say

there is an internal and externalenvironment

D h J h


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Dorothy JohnsonBehavioral Systems

Model

Health

Balance and stability.Nursing

External regulatory force that is indicated

only when there is instability.


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Martha Rogers

Unitary Human Beings


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Martha Rogers

Unitary Human Beings Energy fields

Fundamental unity of things that are

unique, dynamic, open, and infiniteUnitary man and environmental field

Universe of open systems

Energy fields are open, infinite, andinteractive


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Martha Rogers

Unitary Human Beings Pattern

Characteristic of energy field

A wave that changes, becomes complexand diverse

Four dimensionality

A nonlinear domain with out time orspace


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Rogers Definitions

Integrality

Continuous and mutual interaction

between man and environmentResonancy

Continuous change longer to shorter

wave patterns in human andenvironmental fields


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Martha Rogers

Unitary Human BeingsHelicy

Continuous, probabilistic, increasing

diversity of the human andenvrionmental fields.

Characterized by nonrepeatingrhymicities

Change


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Dorothea Orem

Self-Care Model


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Dorothea Orem

Self-Care ModelSelf-care comprises those activities

performed independently by an

individual to promote and maintainperson well-being

Self care agency is the individualsability to perform self care activities


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Dorothea Orem

Self-Care ModelSelf- care deficit occurs when the

person cannot carry out self-care

The nurse then meets the self-careneeds by acting or doing for;guiding,

teaching, supporting or providing theenvironment to promote patientsability


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Dorothea Orem

Self-Care ModelWholly compensatory nursing system

Patient dependent

Partially compensatoryPatient can meet some needs but needs

nursing assistance

Supportive educativePatient can meet self care requisites, but

needs assistance with decision making orknowledge


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Imogene King

Goal Attainment Theory


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Imogene King

Goal Attainment TheoryOpen systems framework

Human beings are open systems in

constant interaction with the environmentPersonal System

individual; perception, self, growth,development, time space, body image

Interpersonal

Society


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Imogene King

Goal Attainment TheoryPersonal SystemIndividual; perception, self, growth,

development, time space, body image

Interpersonal

Socialization; interaction, communicationand transaction

Society

Family, religious groups, schools, work,peers


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Imogene King

Goal Attainment TheoryThe nurse and patient mutually

communicate, establish goals and take

action to attain goals


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Imogene King

Goal Attainment TheoryEach individual brings a different set

of values, ideas, attitudes, perceptions

to exchange


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Betty Neuman

Systems Model

Betty Neuman


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Betty NeumanHealth Care

Systems ModelThe person is a complete system, with

interrelated parts

maintains balance and harmonybetween internal and externalenvironment by adjusting to stress

and defending against tension-producing stimuli

Betty Neuman


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Systems ModelFocuses on stress and stress reduction

Primarily concerned with effects ofstress on health

Stressors are any forces that alter the

systems stability

Betty Neuman


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Systems ModelFlexible lines of resistance

Surround basic core

Internal factors that help defend againststressors

Normal line of resistanceNormal adaptation state

Flexible line of defenseProtective barrier, changing, affected by

variables


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Betty Neuman

Systems ModelWellness is equilibrium

Nursing interventions are activites to:strengthen flexible lines of defense

strengthen resistence to stressors

maintain adaptation


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Sister Calista Roy

Adaptation Model


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Sister Calista Roy

Adaptation ModelFive Interrelated Essential Elements

Patiency- The person receiving care

Goal of nursing- Adapting to change

Health-Being and becoming a wholeperson

Environment

Direction of nursing activities-Facilitating adaptation


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Sister Calista Roy

Adaptation ModelThe person is an open adaptive system

with input (stimuli), who adapts by

processes or control mechanisms(throughput)

The output can be either adaptiveresponses or ineffective responses

Jean Watson


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Jean WatsonPhilosophy and Science of

Caring

Jean Watson


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Jean WatsonPhilosophy and

Science of Caring

Caring can be demonstrated and

practicedCaring consists of carative factors

Caring promotes growth

A caring environment accepts a personas he is and looks to what the personmay become

Jean Watson


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Science of Caring

A caring environment offers

development of potential

Caring promotes health better

than curingCaring is central to nursing


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Watsons 10 Carative

Factors

Forming humanistic-altruistic

value systemInstilling faith-hope

Cultivating sensitivity to self andothers


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Watsons 10 Carative

Factors

Developing helping-trust

relationshipPromoting expression of feelings

Using problem-solving fordecision making


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Watsons 10 Carative

Factors

Promoting teaching-learning

Promoting supportive environmentAssisting with gratification of human

needs

Allowing for existential-phenomenological forces


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Watsons Concepts

Person

Human being to be valued, cared

for, respected, nurtured, understoodand assisted

Environment

Society

Jean Watson


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Science of CaringHealth

Complete physical, mental andsocial well-being and functioning

Nursing

Concerned with promoting andrestoring health, preventing illness


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Rosemary Parse

Human Becoming TheoryHuman Becoming Theory includes

Totality Paradigm

Man is a combination of biological,psychological, sociological and spiritualfactors

Simultaneity ParadigmMan is a unitary being in continuous,

mutual interaction with environment

Originally Man-Living-Health Theory


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Parses Three Principles

Meaning

Mans reality is given meaning through

lived experiencesMan and environment cocreate

Rhythmicity

Man and environment cocreate ( imaging,valuing, languaging) in rhythmicalpatterns


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Parses Three Principles

Cotranscendence

Refers to reaching out and beyondthe limits that a person sets

One constantly transforms


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Rosemary Parse

Human BecomingTheoryPerson

Open being who is more than and

different from the sum of the partsEnvironment

Everything in the person and his

experiencesInseparable, complimentary to and

evolving with


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Rosemary Parse

Health

Open process of being and becoming.Involves synthesis of values

Nursing

A human science and art that uses anabstract body of knowledge to servepeople

Human BecomingTheory

Madeleine Leininger


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Madeleine LeiningerCulture Care Diversity and

UniversalityBased on transcultural nursing, whose

goal is to provide care congruent withcultural values, beliefs, and practices

Sunrise model consists of 4 levels thatprovide a base of knowledge fordelivering cultural congruent care

M d l i L i i


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Madeleine Leininger

Culture Care DiversityModes of nursing actionCultural care preservation

help maintain or preserve health, recoverfrom illness, or face death

Cultural care accommodation

help adapt to or negotiate for a beneficial

health status, or face deathCultural care re-patterning

help restructure or change lifestyles that areculturally meaningful

P i i B


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Patricia Benner

From Novice to Expert

Patricia Benner


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Patricia BennerFrom Novice to

Expert

Described 5 levels of nursing

experience and developed exemplarsand paradigm cases to illustrate eachlevel

Patricia Benner


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ExpertLevels reflect:

movement from reliance on past abstractprinciples to the use of past concreteexperience as paradigms

change in perception of situation as a

complete whole in which certain parts arerelevant

Patricia Benner


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Expert

Novice

Advanced beginnerCompetent

Proficient

Expert

I t f Th ti l


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Importance of Theoretical

FrameworksFoundation of any profession is the

development of a specialized body ofknowledge. Theories should bedeveloped in nursing, not borrowtheories form other disciplines


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Next Steps

Responsibility of nurses to know andunderstand theorists

Critically analyze theoreticalframeworks

nursing theorists

Documents

care5242018 nursing

death5242018 nursing

external conditions

noise external influences

jean watson

ida jean orlando

sister calista roy

rosemary rizzo parse