University of Texas at El Paso College of Health Sciences School of Nursing

Objectives:
1. ID purposes & essential elements of nsg theories 2. Differentiate terms: concept, conceptual framework, conceptual model, & theory 3. Compare selected theories of nsg. in terms of Pt., environment, health & nursing. 4. Describe relationship of Nsg. Theory to nsg. Process & nsg. Research

Purposes of Nsg. Theories & Conceptual frameworks

Practice Education Research TRIANGULATION between the three is essential

What is a metaparadigm?
Meta = change Paradigm= world wide view (Websters, 1983)

What is a concept?
A mental image that has emotional, cognitive, spiritual and cultural dimensions
A conceptual framework is a group of related concepts A conceptual model is a graphic illustration of the relationships between concepts

What is the major distinction between a theory & conceptual framework? Level of abstraction Conceptual framework is more abstract than the theory Conceptual model is a diagram with its major purpose being to give clear & explicit direction to nsg. Practice, education & research

CONCEPTUAL TERMS
1. Conceptual framework 2. Conceptual model 3. Theory = system of ideas that is proposed to explain a given phenomenon Grand Nursing Theories
Middle Range Nursing Theories

Metaparadigm of Nursing
Metaparadigm of Nursing is composed of 4 concepts
Person Environment Health Nursing

SELECTED GRAND NSG. THEORIES (11)

Nightingale (1860) Peplau (1952) Henderson (1966) Martha Rogers (1970) Orem (1971) King (1971) Neuman (1972) Sister Roy (1970) Leininger (1985) Watson (1979) Parse (1981)

Nightingales Environmental Theory

First Nurse Theorist Nursing = act of utilizing environment of patient to assist him in his recovery (Kozier, 2000) Primary Concepts = Environmental factors (5)
Pure air Pure Water Efficient drainage Cleanliness Direct sunlight

Peplaus Interpersonal Relations Model

Psychiatric nurse Concept = therapeutic relationship between nurse & client Nurse-Client Relationship Phases (4)
Orientation Identification Exploitation Resolution

Hendersons definition of nursing

Formulated unique definition of nursing in relation to both well & will individuals
Major step in differentiating nursing from medicine

Fundamental needs of sick or well individuals (14);

1. Biophysical needs 2. Psychological needs 3. Spiritual needs 4. Social needs

Rogers Science of Unitary Human Beings

Draws from many scientific disciplines Major concepts:
Unitary man with 5 characteristics Human energy fields= non contact therapeutic touch

Differentiates whole from holistic

Orems General Theory of Nursing

Major concepts (5)
Self-care Self-care agency Self-care requisites Therapeutic self-care demand Nursing systems

Assumptions (3)
Universal requisites Developmental requisites Health deviation requisites

Kings Goal Attainment theory

Based on systems theory & behavioral sciences Major concepts
Personal systems Interpersonal systems Social systems Transactions

Assumptions (3)
All related to transactions

Neumans Systems Model

Community health nurse& clinical psychologist Major concept = STRESS Reconstitution = state of adaptation to stressors
Lines of resistance Normal line of defense Flexible line of defense

Stress categories: intrapersonal, interpersonal, extrapersonal Assumptions (3)

Roys Adaptation Model

Major concept = adaptation = process & outcome whereby thinking & feeling person uses conscious awareness & choice to create human & environmental integration Modes (4)
Physiologic mode Self-concept mode Role function mode Interdependence mode

Leiningers Cultural Care Diversity & Universality Theory

Anthropologist Care- essence of nsg. & dominant, distinctive & unifying feature of nsg. Major concepts = culture, culture care, culture care diversity, culture care universality, generic care, professional care, sunrise model Intervention modes (3): Preservation, accommodation, restructuring

Watsons Human Caring Theory

Major Concept = caring Assumptions (11) Carative Factors (10)
Interpersonal relationship Use of scientific process Addresses clinicians self

Parses Human Becoming Theory

Human Becoming Concepts (3)
Meaning; Nurse & true presence; Pt. Is authority figure Rhythmicity Co-transcendence

Assumptions (3) Human becoming & meaning

Human becoming & rhythmic patterns Human becoming co-transcending

Relationship of theories to Nursing Process

1. 2. 3. 4. 5. Assessing Diagnosing Planning Implementing Evaluating

SUMMARY
Terminology common to theory discussion Nursing Grand Theories (11) Relationship between theory & nursing practice