ISSN: 1981-8963 DOI: 10.5205/reuol.2163-16218-1-LE.

0603201223

Oliveira NF de, Belchior AS, Gonçalves MJF. Hospital assistance under the light of…

LITERATURE INTEGRATIVE REVIEW ARTICLE

HOSPITAL ASSISTANCE UNDER THE LIGHT OF NURSING THEORIES: ANALYSIS
OF THE SCIENTIFIC PRODUCTION
ASSISTÊNCIA HOSPITALAR À LUZ DAS TEORIAS DE ENFERMAGEM: ANÁLISE DA PRODUÇÃO
CIENTÍFICA
ASISTENCIA HOSPITALARIA A LA LUZ DE LAS TEORÍAS DE ENFERMERÍA: ANÁLISIS DE LA PRODUCCIÓN
CIENTÍFICA
Nathália França de Oliveira1, Aylana de Souza Belchior2, Maria Jacirema Ferreira Gonçalves 3
ABSTRACT
Objective: to identify the approaches based on Nursing theories in the hospital nursing assistance. Method: this is an
integrative literature review study in which three databases were used for the selection of papers, Bdenf, SciELO, and
Lilacs, through the following strategy for the search of terms in Portuguese and their equivalents in English: "enfermagem"
or "assistência de enfermagem" or "cuidados de enfermagem" or "plano de assistência de enfermagem" [theme descriptor];
"teoria de enfermagem" [theme descriptor]; and "assistência hospitalar" or "servico hospitalar de enfermagem" or "servicos
hospitalares" or "hospitalização" or "servicos de emergência" or "emergência" [words]. Results: ten papers were found,
from which seven formed the sample of this review. Conclusion: after analyzing the papers included in this review, the
results showed that the production on Nursing lacks grounding on the theories which support it as a science themselves.
Descriptors: nursing; nursing theory; nursing care; hospitalization.
RESUMO
Objetivo: identificar as abordagens baseadas em teorias de Enfermagem na assistência de enfermagem hospitalar.
Método: trata-se de estudo de revisão integrativa de literatura no qual se utilizaram três bases de dados para a seleção
dos artigos, Bdenf, SciELO e Lilacs, com a seguinte estratégia de busca de termos em português e seus equivalentes em
inglês: "enfermagem" or "assistência de enfermagem" or "cuidados de enfermagem" or "plano de assistência de
enfermagem" [descritor de assunto]; "teoria de enfermagem" [descritor de assunto]; e "assistência hospitalar" or "servico
hospitalar de enfermagem" or "servicos hospitalares" or "hospitalização" or "servicos de emergência" or "emergência"
[palavras]. Resultados: foram encontradas 10 publicações, das quais 7 constituíram a amostra desta revisão. Conclusão:
após a análise dos artigos incluídos nesta revisão, os resultados apontaram que a produção de Enfermagem é carente de
fundamentação nas próprias teorias que a sustentam como ciência. Descritores: enfermagem; teoria de enfermagem;
cuidado de enfermagem; hospitalização.
RESUMEN
Objetivo: identificar los abordajes basados en teorías de Enfermería en la asistencia de enfermería hospitalaria. Método:
esto es un estudio de revisión integradora de literatura en lo cual se utilizaron tres bases de datos para la selección de los
artículos, Bdenf, SciELO y Lilacs, con la siguiente estrategia de búsqueda de términos en portugués y sus equivalentes en
inglés: "enfermagem" or "assistência de enfermagem" or "cuidados de enfermagem" or "plano de assistência de
enfermagem" [descriptor de asunto]; "teoria de enfermagem" [descriptor de asunto]; y "assistência hospitalar" or "servico
hospitalar de enfermagem" or "servicos hospitalares" or "hospitalização" or "servicos de emergência" or "emergência"
[palabras]. Resultados: se encontraron 10 publicaciones, de las cuales 7 se incluyeron como muestra de esta revisión.
Conclusión: después del análisis de los artículos incluidos en esta revisión, los resultados apuntaron que la producción de
Enfermería es carente de fundamentación en las propias teorías que la sustentan como ciencia. Descriptores: enfermería;
teoría de enfermería; atención de enfermería; hospitalización.
1
Master’s student, Nursing Post Graduate Program, Joint Master’s Course – University of the State of Pará and Amazonas Federal University. E-mail:
natyoliveira03@yahoo.com.br; 2Master’s student, Nursing Post Graduate Program, Joint Master’s Course – University of the State of Pará and
Amazonas Federal University. E-mail: aylana_belchior@hotmail.com; 3Professor at Manaus Nursing School, Amazonas Federal University (UFAM).
Nursing Post Graduate Program, Joint Master’s Course – University of the State of Pará and Amazonas Federal University. UFAM’s Multi-Institutional
Post Graduation Program in Health, Society and Endemies in Amazonas, Leônidas and Maria Deane Research Center of FIOCRUZ and Federal
University of Pará (UFPA). E-mail: jaciremagoncalves@ufam.edu.br

Rev enferm UFPE on line. 2012 Mar;6(3):665-70 665

ISSN: 1981-8963
Oliveira NF de, Belchior AS, Gonçalves MJF.
INTRODUCTION
Among the several environments in which
nursing is practiced are the institutions that
provide services in hospital or outpatient
health services, schools, community
associations, factories, homes, among others.
In this scenario, the particular interest of
nursing are the responses of individuals,
families, communities to real or potential
health problems, regardless of the
environment where nursing care is
performed.1 It is an action that is inherent in
every human being, since the beginning of
mankind, ranging from an attitude of
occupation, preoccupation, responsibility and
affective involvement with one’s fellow.
Without care, man ceases to be human.2
Hospital care is the one provided in
hospital, to admitted patients or not. The
hospital is an extremely complex enterprise,
which features two areas of activity:
assistance or intrinsic and supportive or
operational. Hospital care has two types of
customers: internal and external. Internal
customers in the assistance area are the
patients and their families; and external
clients are all people connected to the
administrative area.3
Nursing theories contribute to the
formation of relatively strong bases of
knowledge, fostering a more organized
hospital care from the phenomenal
perspective of nursing. It is believed that a
major goal of Nursing Theories is to define,
characterize and explain/
understand/interpret, based on the selection
and conceptual inter-relation, the phenomena
that constitute the domain of interest for this
profession.3
In this sense, the Nursing Theories can be
used as fundamental epistemological
contributions to the construction of
knowledge and professional practice, as these
help guide nursing clinical models and have
enabled professionals to describe and explain
aspects of health care reality, assisting in the
development of the triad theory, research and
practice in the area. It is important to
highlight that these theories, in general, are
structured from four central concepts, which
are: human beings, health, environment
(physical, social and symbolic) and nursing.4
This study is based on the consideration
that one needs to be aware of studies that
address these theories, which are scattered.
So it requires a systematization of
Rev enferm UFPE on line. 2012 Mar;6(3):665-70
DOI: 10.5205/reuol.2163-16218-1-LE.0603201223
Hospital assistance under the light of…
information, through a review work directed
to this end.
OBJECTIVE
To identify the publications on Nursing
Theories, used in studies on hospital nursing
care.
METHOD
This study is an integrative literature
review of academic publications consisting of
retrospective search of scientific articles, in
this case, on the production of hospital care
nursing grounded in nursing theories. This
methodology provides a synthesis of
knowledge and the incorporation of the
applicability of significant study results in
practice.5 It consisted in the search of
scientific articles in computerized databases,
as well as manual search based on the
references found. No language restrictions or
date of issue were established.
Searches were performed in the following
automated bibliographic databases: LILACS
(Latin-American and Caribbean Center on
Health Sciences Information), BDENF (Nursing
Database) and SciELO (Scientific Electronic
Library Online), accessed on November 18th,
2010.
The following search strategy was used,
with the respective terms in English:
“Enfermagem" or "Assistencia De Enfermagem"
or "Cuidados de Enfermagem" or "Plano De
Assistencia de Enfermagem" [Subject
Descriptor] And "Teoria de Enfermagem"
[Subject Descriptor] and "Assistencia
Hospitalar" or "Servico hospitalar de
enfermagem" or "Servicos hospitalares" or
"Hospitalizacao" or "Servicos de emergencia"
or "Emergencia" [Words].
The selected studies were assessed for the
following aspects: year of publication, study
design, population and characteristics of the
study sample, nursing theory discussed and
main results.
BASIC AND DISCUSSION
The initial sample of this review comprised
10 retrieved articles, of which five were found
in the LILACS database; three in BDENF and
two in SciELO. Of these articles, two were
obtained as result in both databases (LILACS
and BDENF), then were excluded from one of
them, and one article was excluded from
SciELO since it had no association with the
subject matter. Therefore, the final sample of
666
ISSN: 1981-8963 DOI: 10.5205/reuol.2163-16218-1-LE.0603201223

Oliveira NF de, Belchior AS, Gonçalves MJF. Hospital assistance under the light of…

this review consisted of 7 articles that met
the criteria for this search.
Table 1 shows the general characteristics of
the studies describing authors, year of
publication, country where the study was
conducted, study design, population and
characteristics of the sample.
Table 2 shows the synthesis of the articles
included in this integrative literature review,
presenting the addressed nursing theory, the
theoretical focus and main findings of the
studies.
Regarding the purpose of this review, it was
found that, due to the number of studies that
constitute the initial sample of this study, it is
clear that theories are not widely used in
approaches and analysis of scientific studies.
Based on the Data-Based Theory one can
add new perspectives and meanings to the
Nursing Care Systematization (NCS), in order
to generate a complex, consolidated
knowledge, primarily based on data. From the
methodological framework adopted, namely,
the theory, the main findings about the
meaning of NCS for nursing professionals show
that it provides nurses with autonomy, legal
support and safe nursing records, besides
facilitating the approach of the nurse with the
patient and other health professional in the
hospital environment.6

Table 1. Characterization of identified studies on hospital nursing care based on nursing theories
Country
Year of Study Study Sample Study
Authors of
Publication design approach (n) population
origin
Nascimento,
KCN
Backes, DS Health
2008 Brazil _ Qualitative 15
Koerich, MS professionals
Alacoque, LE
Montezeli, JH
Meier, MJ
Peres, AM Reflexive
2009 Brazil Qualitative _ _
Venturi, KK study
Wolff , LDG
Maas,T Theoretical
2005 Brazil Qualitative _ _
Zagonel, IPS reflection
Almeida, IS
Rodrigues, Hospitalized
2005 Brazil _ Qualitative 14
BMRD teenagers
Simões, SMF
Bergold, LB Hospitalized
2008 Brazil _ Qualitative _
Avim, NAT clients
Pereira, EP 2003 Brazil Case study Qualitative 20 Nurse
Mothers of
Morais, GSN
2004 Brazil _ Qualitative 5 hospitalizes
Costa, SFG
children

Rev enferm UFPE on line. 2012 Mar;6(3):665-70 667

ISSN: 1981-8963 DOI: 10.5205/reuol.2163-16218-1-LE.0603201223

Oliveira NF de, Belchior AS, Gonçalves MJF. Hospital assistance under the light of…

Table 2. Presentation of the synthesis of articles included in the integrative review

Article Title Authors Nursing Theoretical Main Results

Theory Focus
Systematization of SNC is able to
Nursing Care (SNC): Nascimento subsidize with
Anticipating an KCN, methods /inter-
Explores the
interactive, Backes DS, disciplinary and
Data-Based phenomenon in
complementary and Koerich MS, humanized
Theory its own reality
multi-professional Alacoque methodologies of
care LE. care
Nursing in The relation
Emergency: Montezel between nursing
humanization of JH, Imogene The conceptual care and the
initial care to Meier MJ, King’s Theory model of context of trauma
polytrauma patients Peres AM, of Goal interacting open is supported by the
in the light of Venturi KK, Attainment systems concepts of
Imogene King’s Wolff LDG. personal system by
Theory King
New ways of care
strengthen the
Theory
Health Transition: action of the
Maas T, developed by It understands
Disease of the Being nursing
Zagonel Callista Roy: the being as
a Hospitalized professional,
IPS. “Adaptation someone affected
Adolescent showing the true
Theory” in its totality
dimension of the
care practice
The adolescent
Unveiling the Almeida IS, Humanistic was a being-with
everyday life of a Rodrigues Theory by It values human and understands
hospitalized BMRD, Paterson & interaction himself as a being-
adolescent Simões SMF. Zderad in-the-world
released to death
The concept of
care and The musical visit is
Musical visit:
Jean Watson’s phenomenological a therapeutic
therapeutic strategy Bergold LB,
Theory of presuppositions strategy for the
grounded in the Avim NAT.
Human Caring which bring the nursing care to the
human caring theory
viewpoint beyond hospitalized client
the physical body
The influence of
lato and stricto-
Post graduation
sensu post The convictions
Behavioral contributes with
graduations in the of managers
Theory by the management
management style Pereira EP. about human
Rensis Likert activity
of nurses in a behavior
university hospital
An approach
Existential
centered on
experience of
mothers which
mothers of
subsidizes a new
hospitalized Morais GSN, Humanistic Inter-human
viewpoint within
children in a Costa SFG. Theory event
nursing care,
Pediatric Intensive
teaching and
Care Unit
research

The propositions of Imogene King’s theory
enable nurses to better Interact with
customers so as to achieve the goal of
restoring health, since this theory uses the
conceptual model of interacting open
systems, through the interaction and
transaction between nurse and client in an
organization formed by personal systems,
interpersonal systems and social systems,
each with its own distinct group of concepts.7
In an emergency service, this theory is
characterized as an important tool for
reorganizing the work process, facilitating the
systematization, emphasizing the personal,
interpersonal and social systems.
Roy’s theory offers concepts that underpin
Rev enferm UFPE on line. 2012 Mar;6(3):665-70
the process of adaptation and help understand
the being as someone affected as a whole.8
Based on this reference, adolescence
represents two phenomena of human
development along with emotional frailty in
the face of hospitalization, interfering with
existential integrity. The nurse must
understand the process of adapting the
individual, so as to provide a more effective
care to the hospitalized adolescent.
In this sense, based on Paterson’s and
Zderad’s Humanistic Theory, a model of
reasoning to support teen customers through
the humanistic practice,9 one can see that
despite the difficult reality to be lived,
teenagers understand that inhabiting the
hospital world helps their lives. So they value
668
ISSN: 1981-8963
Oliveira NF de, Belchior AS, Gonçalves MJF.
the relationship built with professionals and
hospital fellows.9 The importance of the
Nursing Humanistic Theory lays in the fact
that it can be done to improve and guide
practice through a care existentially oriented
by the genuine commitment of the nurse, and
there is no prescription for his satisfactory
performance, mainly due to the
interactive/relational process that
characterizes it.10
Therefore, as in the young study
population, this theory contributes for a
service based on respect for uniqueness of the
one who suffers, enabling to grasp the true
meaning of the existence of each mother, as a
parent chaperone, and helps redirect the
nursing care towards this special being.11
The musical visit was an efficient
therapeutic strategy in nursing care to the
hospitalized client, based on Watson’s Human
Caring Theory, according to which the real
health care focuses on life style, social
conditions and environment.11
It was possible to verify likewise that post
graduation, either lato or stricto sensu,
influences the management style of nurses in
a university hospital, and this change is
perceived by them. We adopted Likert
Rensis’s Behavioral Theory, which defines four
administrative systems: the exploitive
authoritative system, the benevolent
authoritative system, the consultative system
and the participative group system, according
to the leadership, motivation, interaction,
communication, decision-making, control,
informal organization and cooperation
variables used by managers with their
subordinates.12
CONCLUSION
Therefore, in search of the best available
evidence concerning what nursing has been
producing on hospital care nursing based on
nursing theories, it is understood that nursing
care in the hospital environment can not only
be developed, but reorganized through the
use of theories, as each theory has a
theoretical focus which characterizes them as
an instrument of care.
The results of this review show that nursing
has a little production based on its own
grounding theories which support is as a
science. It is necessary to improve the
knowledge about these theories, so as to
make that these actions are more grounded on
scientific principles, which will not only
reflect on the quality of reflection, but also in
the care provided.
Rev enferm UFPE on line. 2012 Mar;6(3):665-70
DOI: 10.5205/reuol.2163-16218-1-LE.0603201223
Hospital assistance under the light of…
Based on the gaps and results found in the
articles included in this integrative literature
review, it becomes necessary to intensify
efforts for the development of research with
theoretical foundations and designs that
produce strong evidence on the subject under
investigation.
REFERENCES
1. Garcia TR, Nóbrega MML, Carvalho EC.
Nursing process: application to the
professional practice. Online Braz J Nurs.
2004; 3(2): 29-40.
2. Dantas RAN, Nóbrega WG, Morais Filho LA,
Macêdo EAB, Fonseca PCB, Enders BC, et al.
Paradigmas no cuidar em saúde e sua relação
com as teorias de enfermagem: um ensaio
analítico. Rev enferm UFPE on line[periódico
na internet]. 2010 Abr/Jun [acesso em 2011
Ago 30];4(2):467-75. Disponível em:
http://www.ufpe.br/revistaenfermagem/inde
x.php/revista/article/view/609/pdf_25.
3. Zanon U. Qualidade da Assistência Médico-
Hospitalar: Conceito, avaliação e discussão
dos indicadores de qualidade. Rio de Janeiro:
Médica e Cientifica; 2001.
4. Schaurich D.; Crossetti, MGO. Produção do
conhecimento sobre teorias de enfermagem:
análise de periódicos da área, 1998-2007. Esc
Anna Nery Rev Enferm. 2010 jan-mar; 14 (1):
182-88.
5. Souza MT, Silva MD, Carvalho R. Revisão
Integrativa: o que é e como fazer. Einstein.
2010; 8(1):102-6.
6. Nascimento KC, Backes DS, Koerich MS,
Erdmann AL. Sistematização da assistência de
enfermagem: vislumbrando um cuidado
interativo, complementar e multiprofissional.
Rev Esc Enferm USP. 2008; 42(4): 643-8.
7. Montezelli JH, Meier MJ, Peres AM, Venturi
KK, Wolff LDG. Enfermagem em Emergência:
humanização do atendimento inicial ao
politraumatizado à luz da teoria de Imogene
King. Cogitare Enferm. 2009; 14(2): 384-7.
8. Maas T, Zagonel IPS. Transição de saúde-
doença do ser adolescente hospitalizado.
Cogitare Enferm. 2005; 10(2): 66 -75.
9. Almeida IS, Rodrigues BMRD, Simões SMF.
Desvelando o cotidiano do adolescente
hospitalizado. Rev Bras Enferm. 2005 abr;
58(2): 147-51.
10. Morais GSN, Costa SFG. Experiência
existencial de mães de crianças hospitalizadas
em Unidade de Terapia Intensiva Pediátrica.
Rev Esc Enferm USP. 2009; 43(3): 639-46.
11. Bergold LB, Avim NAT. Visita musical:
669
ISSN: 1981-8963 DOI: 10.5205/reuol.2163-16218-1-LE.0603201223

Oliveira NF de, Belchior AS, Gonçalves MJF. Hospital assistance under the light of…

estratégia terapêutica fundamentada na

teoria do cuidado transpessoal. Online Braz J
Nurs. 2008; 7(1).
12. Pereira EP. A influência da pós-graduação
lato e strictu-sensu, no estilo gerencial dos
enfermeiros de um hospital universitário
[dissertação]. Rio de Janeiro (RJ): Faculdade
de Enfermagem, Universidade do Estado do
Rio de Janeiro; 2003.

Sources of funding: No
Conflict of interest: No
Date of first submission: 2011/10/10
Last received: 2012/02/06
Accepted: 2012/02/06
Publishing: 2012/03/01
Corresponding Address
Maria Jacirema Ferreira Gonçalves
Universidade Federal do Amazonas
Escola de Enfermagem de Manaus
Rua Teresina, 495  Adrianópolis
CEP: 69057-070  Manaus (AM), Brazil

Rev enferm UFPE on line. 2012 Mar;6(3):665-70 670

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de
Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without
the copyright holder's express written permission. However, users may print, download, or email articles for
individual use.