Theories of Nursing Practice

What is a theory? A set of concepts, definitions, relationships, and assumptions that project a systematic view of a phenomena It may consist of one or more relatively specific and concrete concepts and propositions that purport to account for, or organize some phenomenon (Barnum, 1988) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

What are the components of a theory? Concepts – ideas and mental images that help to describe phenomena (Alligood and Marriner-Tomey, 2002) Definitions – convey the general meaning of the concepts Assumptions – statements that describe concepts Phenomenon – aspect of reality that can be consciously sensed or experienced (Meleis, 1997). Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

What is a paradigm? A model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline (Alligood and Marriner – Tomey, 2002) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

What is a domain? The view or perspective of the discipline It contains the subject, central concepts, values and beliefs, phenomena of interest, and the central problems of the discipline Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

How does domain relate to nursing theory? Nursing has identified its domain in a paradigm that includes four linkages: 1) person/client 2) health 3) environment 4) nursing Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Purposes of nursing theory Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

What are the purposes of nursing theory? It guides nursing practice and generates knowledge It helps to describe or explain nursing Enables nurses to know WHY they are doing WHAT they are doing Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Types of nursing theories Grand theories – broad and complex Middle-range theories- address specific phenomena and reflect practice Descriptive theories – first level of theory development Prescriptive theories – address nursing interventions and predict their consequences Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Why on earth do we study nursing theory? Everyday practice enriches theory Both practice and theory are guided by values and beliefs Theory helps to reframe our thinking about nursing Theory guides use of ideas and techniques Theory can close the gap between theory and research To envision potentialities (Gordon, Parker, & Jester, 2001) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

“The study and use of nursing theory in nursing practice must have roots in the everyday practice of nurses (Gordon, Parker, and Jester, 2001).

So how do nurses use theory in everyday practice? Organize patient data Understand patient data Analyze patient data Make decisions about nursing interventions Plan patient care Predict outcomes of care Evaluate patient outcomes (Alligood, 2001) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

How do student nurses begin to use nursing theory? By asking yourself two very important questions….. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Student nurse questions What is the nature of knowledge needed for the practice of nursing? What does it mean to me to practice nursing? Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Nursing also utilizes non-nursing theories Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Commonly used non-nursing theories Systems theory Basic Human Needs theory Health and Wellness Models Stress and Adaptation Developmental Theories Psychosocial Theories Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

What is the link between nursing theory and the research process? Theory provides direction for nursing research Relationships of components in a theory help to drive the research questions for understanding nursing Chinn and Kramer (2004), indicate a spiral relationship between the two Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Current trends that influence nursing theory Medical science Nursing education Professional nursing organizations Evolving research approaches Global concerns Consumer demands Technologies Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Leah Curtin, RN, MS, FAAN (1989) Former Editor, Nursing Management “ Practicing nurses who despise theory are condemned to performing a series of tasks - either at the command of a physician or in response to routines and policies.” Leah Curtin, RN, MS, FAAN (1989) Former Editor, Nursing Management

Objectives Define theory and list characteristics of a theory Describe the components of a theory and its use Trace the development of a nursing theory Describe the different types of theories and examples of each. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Introduction to Theory Nursing as a profession There has been questions about whether nursing is a profession or an occupation. An occupation is a job a career. A profession is a learned vocation or occupation that has status of superiority and precedence within a division of work. It needs widely varying levels of training or education, skills and variable knowledge base. All professions are occupations but not all occupations are professions (Logan,Franzen, Butcher,2004;Schwiran , 1998) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Characteristics of a profession Utilizes in its practice a well-defined and well organized body of specialized knowledge on the intellectual level of the higher learning. Constantly enlarges the body of knowledge it uses and improves its techniques of education and service by the use of scientific method. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Characteristic of a profession 3) Entrusts the education of its practitioners to institutions of higher education. 4) Applies its body of knowledge in practical services that are vital to human and social welfare. 5) Functions autonomously in the formulation of professional policy and in the control of professional activity. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Characteristics of a profession 6. Attracts individuals of intellectual and personal qualities who exalt service above personal gain and who recognize their chosen occupation as a life work. 7. Strives to compensate its practitioners by providing freedom of action, opportunity for continuous professional growth and economic security. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Definitions of theory Pinnel and Menesis (1986) Systematic set of interrelated concepts, definitions and deductions that describe, explain or predict interrelationships Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Definitions of a theory 2. Walker and Avant (1983) Internally consistent group of relational statements (concepts, definitions and propositions) that presents a systematic view of phenomenon and which is useful for description, explanation, prediction and control Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Definition of a theory 3. Chinn and Krammer creative and vigorous structuring of ideas that project a tentative, purposeful and systematic view of phenomena Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Definitions of a theory Ellis coherent set of hypothetical, conceptual and pragmatic principles forming a general frame of reference for a field of inquiry Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Some commonalities Purpose Concepts Definitions Propositions Structured ideas Tentative Describe a phenomenon or occurrence Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Components/Elements of theory 1.Purpose “Why is the theory formulated” 2.Concepts are building blocks of theory – ideas, mental images of a phenomenon, an event or object that is derived from an individual’s experience and perception Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Components/Elements of theory 3.Has a major concept like nursing, person, health or environment. 4. Definitions give meaning to concepts which can either be descriptive or procedural (stipulate-use of term within the theory) 3. Major concepts may not be present in the theory but a main concept is usually presnt and the author is usually Known for that example Orem’s Self Care Theory Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Components/Elements of theory Propositions are expressions of relational statements between and among the concepts. It can be expressed as statements, paradigms or figures . AKA as theoretical assertions Assumptions- accepted “truths” that are basic and fundamental to the theory. Or value assumptions where what is good or right or ought to be. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Characteristics of a Theory Systematic, logical and coherent (orderly reasoning,no contradictions) Creative structuring of ideas mental images of one’s experiences and create different ways of looking at a particular event or object. 3. Tentative in nature ( change over time or evolving but some remain valid despite passage of time) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Prof. Dawn M. Capaque MIT, School of Health Sciences Theory Development Prof. Dawn M. Capaque MIT, School of Health Sciences

How does a theory develop? Four strategies of theory development Theory practice theory ( theory developed in other discipline and used in nursing situations) 2. Practice – theory evolved from clinical practice Theories used using the practice theory strategy evolved from clinical practice. Example Orlando’s nursing process theory Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

How does a theory develop? 3. Research theory or inductive method Must evolve from research findings or empirical evidence. 4. Theory research theory theories developed by other disciplines are utilized but given unique nursing perspective. Original theory examined and given a new research findings. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

TERMINOLOGY METAPARADIGM Most abstract level of knowledge. In nursing this is main concepts that encompasses the subject matter and the scope of the discipline Central concepts of person, environment, health and nursing Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

TERMINOLOGY Philosophy Knowledge level which specifies the definitions of the metaparadigm concepts in each of the conceptual models of nursing. Nightingale is considered philosophical approach Out of these philosophies theory maybe formalized Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Conceptual models Frameworks or paradigms that provide a broad frame of reference for the systematic approaches to the phenomena with which the discipline is concerned. -different views nursing like Roy focuses on adaptation, King on interaction and Abdellah on interventions Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

theory Group of related concepts that propose actions that guide practice Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Nursing theory Group of related concepts that derive tfrom the nursing models. Some derive from other nursing discipline like LEininger which comes from anthropology Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Uses of theory Theory guides and improve nursing practice Theory provides goal for nursing care and with goals, nursing practice is rendered more effective and efficient. theories help to focus the goals, making nurses more confident about the practice. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Uses of theory 2. Theory guides research according to Meleis, primary use of theory is to guide research. It validates and modifies the theory. 3. Theory contributes to the development of the disciplines body of knowledge 4. Theory enhances communication Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Theory Development in Nursing: Historical Overview DMCAPAQUE

Where do I begin? Florence Nightingale Considered first modern nursing theorist First one to delineate what is considered the nursing goal and practice domain. “ placing the client in the best condition for nature to act upon him” Taught about symptoms and what they indicate, rationale for actions and trained powers of observation and reflection Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Historical Development of Nursing Theories: Significant Events Nightingale until the 50’s Florence Nightingale Notes on Nursing control of the environment to care for the individual (ventilation, light, warm , noise absence or reduction, cleanliness & diet ) 1952 Nursing Research Journal publication 1960’s nature of nursing practice was debated, defined nursing practice, or develop nursing theory, and created a substantive body of knowledge Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Historical development 1960-1970 proliferation of conceptual models and frameworks, and philosophy of nursing. Examples: Abdellah 21 nursing problems and Hall’s Core, care and cure (person,body,disease) 1969 first conference on nursing theory Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Historical Development Role of nurses where questioned; what they do, for whom where and when were determined. purpose of nursing, process of theory development was discussed Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

First Conference in Nursing theory Brought leading scholars and theorists to discuss and debate on issues regarding nursing science ad theory development. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Historical Development Writings of Dickoff, James and Wiedenbach “Theory in a Practice Discipline” influenced the theoretical thinking in nursing . They presented a definition of nursing theory and goals for theory development in nursing, approaches where discussed Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Historical Development 1980’s characterized by acceptance of the significance of theory in nursing. Less debates on whether or not to use theory, practice theory or borrowed ones. More and more publication up to the present. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Stages of Theory Development according to Kidd and Morrison 1. Silent Knowledge stage Blind obedience to medical authority Training schools were hospital based, emphasis on carrying out physicians orders and few books, depended on physicians diagnosis, exploited as workers and as students. Persisted for more than 80 years Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

2. Received Knowledge Stage Learning through listening to others Nursing now challenged to be in the university as opposed to apprenticeship that happens to most hospital programs. Nurses acquired non nursing degrees relying on the authority of educators, sociologist, psychologists, physiologists, and anthropologists to provide answers to nursing problems. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

3. Subjective Knowledge stage Authority was internalized and a new sense of self emerged. Negative attitude toward borrowed sciences or theories Defining on nursing and developing theories about and for nursing Research focused on the nurse rather on he clients and clinical situations. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

4.Procedural Knowledge Includes both separate and connected knowledge Proliferation of approaches to theory development applying theory in practice was frequently underemphasized Emphasis was on procedures used to acquire knowledge, with over attention to appropriateness of methodology the criteria for evolution and statistical procedures Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

5. Constructed Knowledge Integration of different types of knowledge ( intuition, reason and self-knowledge) Nursing theory based on empirical studies theoretical literature client reports, clinical experiences and nurses scholar intuition. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Types of theories According to range - Grand theory Middle range theory Micro theory Grand Theory consist of broad conceptual frameworks that reflect wide and expansive perspectives for practice and ways of describing, explaining, predicting and looking at nursing phenomena. They are the most complex and broadest in scope. Henderson’s The Nature of Nursing ; Levine’s The Four Conservation Principles of Nursing, Roy’s Adaptation Model, and Orem’s Self-Care (Marriner-Tomey) Mid Range- less complex and narrower in scope than grand theory and micro theory. A more workable level is the middle range.more limited in scope and less variables, and testable. Example: grand theory on stress and adaptation might not yield any interpretable guidelines on practice but if the theory is focused on chronic lingering illness as the stressor on family, the stress theory becomes becomes operational for both research and practice purposes. Ex. Peplau’s Psychodynamic Nursing and Orlando’s Nursing Process Theory Micro theories- are the least complex. They contain the least complex concepts and are narrowest in scope. They deal with a small aspect of reality, generally a set of theoretical statements - Deals with with specific and naroow defined phenomena Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Types of theories Grand Theory consist of broad conceptual frameworks that reflect wide and expansive perspectives for practice and ways of describing, explaining, predicting and looking at nursing phenomena. They are the most complex and broadest in scope. Henderson’s The Nature of Nursing ; Levine’s The Four Conservation Principles of Nursing, Roy’s Adaptation Model, and Orem’s Self-Care (Marriner-Tomey) Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Types of Theories Mid Range- less complex and narrower in scope than grand theory and micro theory. A more workable level is the middle range.more limited in scope and less variables, and testable. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Types of Theories Mid range Example: grand theory on stress and adaptation might not yield any interpretable guidelines on practice but if the theory is focused on chronic lingering illness as the stressor on family, the stress theory becomes operational for both research and practice purposes. Ex. Peplau’s Psychodynamic Nursing and Orlando’s Nursing Process Theory Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Types of theories Micro theories- are the least complex. They contain the least complex concepts and are narrowest in scope. They deal with a small aspect of reality, generally a set of theoretical statements - Deals with specific and narrow defined phenomena Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

According to Orientation or focus of the theory Client centered: Nightingale, Henderson Client-nurse dynamics: Watson Client-nurse environment : Leininger . This category includes theories developed by the following : Nightingale,Abdellah,Henderson,Orem,Pender, Roy, Levine, Hall. Nurse-client-dynamics focus on interaction between the nurse and client. This category includes theories developed by the following: Peplau, Watson, King and Orlando CLIENT NURSE ENVIRONMENT- focus on the interaction between nurse and client in an environment that includes broader dimensions of time and space. As well as culture, cultural diversity, and universality. Theories of Neuman and Leininger are discussed under this category. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Categories of nursing theories nurse client ` environment Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Client centered theory Client centered theories are those focused on the needs and problems of clients which are met, resolved or alleviated by nursing interventions This category includes theories developed by the following : Nightingale,Abdellah,Henderson,Orem,Pender, Roy, Levine, Hall. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Nurse – client dynamics 2.Nurse-client-dynamics focus on interaction between the nurse and client. This category includes theories developed by the following: Peplau, Watson, King and Orlando Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Client Nurse Environment Dynamics 3. CLIENT NURSE ENVIRONMENT- focus on the interaction between nurse and client in an environment that includes broader dimensions of time and space. As well as culture, cultural diversity, and universality. Theories of Neuman and Leininger are discussed under this category. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Framework to Analyze the Nursing theory I What are the major concepts? Person, nursing, health and environment II Based on Focus Client centered, nurse-client dynamics, nurse client-environment dynamics How similar and how different are their concepts of persons, nursing, health, environment Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Framework to Analyze the Nursing theory III Key concepts unique to the theory. Some theories have several key concepts and it may have sub-concepts. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

The Theoretical Foundation of Nursing Nursing theory provides the theoretical foundation of the profession. Theory defines what nursing is, what it does, and the goals or outcomes of nursing care. Nursing is the synthesis of many theories. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Components of the Theoretical Foundation A theory is a set of concepts and propositions that provides an orderly way to view phenomena. Concepts and propositions are the structural elements of a theoretical foundation. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Concepts Building blocks of a theory Labels or names for phenomena/observable facts Assist us in formulating a mental image about an object or situation Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Concepts Theories are formed by linking concepts together. A conceptual framework links global concepts together. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Conceptual Model The “symbolic representation of empiric experience in words, pictorial, or graphic diagram, mathematical notations or physical material.” Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Propositions A proposition is a statement that proposes a relationship between concepts. Propositional statements in a theory represent the theorist’s view of which concepts fit together. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Theories A theory helps us to organize our thoughts and ideas. In science, the purpose of a theory is to guide research, support existing knowledge, or generate new knowledge. The term theory is not restricted to the scientific world. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Importance of Nursing Theories Framework for thought in which to examine situations Structure for organization, analysis, and decision making Structure for communicating with other nurses and other health team members Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Importance of Nursing Theories Assist the nursing discipline in clarifying beliefs, values, and goals. Help to define the unique contribution of nursing in the care of clients. Standards of clinical practice are developed out of nursing theories. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Process of Knowledge Development Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Scope of Theories Grand Theories Middle-Range Theories Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Grand Theory Provides an overall framework for structuring broad, abstract ideas. Composed of concepts representing global and extremely complex phenomena. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Middle-Range Theory Provides a perspective from which to view complex situations and a direction for interventions in three levels of abstractness. High middle-range Middle middle-range Low middle-range Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Florence Nightingale’s Influence on Knowledge Development in Nursing Described nursing as both an art and a science. Stressed the importance of caring for the ill person rather than the illness. Viewed a person’s health as the direct result of environmental influences (cleanliness, light, pure air, pure water, efficient drainage). Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Florence Nightingale’s Influence on Knowledge Development in Nursing The turn of the 20th century marked the beginning of hospital-based schools of nursing. Nightingale’s principles were incorporated into modern nursing theory. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

The Evolution of Nursing Theory Since the early 1950s, many nursing theories have been systematically developed to help describe, explain, and predict the phenomena of concern to nursing. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Knowledge Development in Nursing Paradigm A particular viewpoint or perspective A “worldview” about the phenomena of concern in a discipline (Kuhn, 1970) Metaparadigm The major concepts in a discipline that names the phenomena of concern Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Knowledge Development in Nursing Metaparadigm of Nursing Person: Individual, family or group Health: Continuum of wellness to terminal illness Environment: Place or community where care is provided Nursing: Actions; interactions of the nurse with the person Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Knowledge Development in Nursing Two individuals with different paradigmatic views can look at the same phenomenon and view the phenomenon differently. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Knowledge Development in Nursing The prevailing paradigm in a discipline represents the dominant view of particular concepts. A paradigm revolution is the turmoil and conflict that occur in a discipline when a competing paradigm gains acceptance over the dominant paradigm. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Knowledge Development in Nursing A paradigm shift refers to the acceptance of the competing paradigm over the prevailing paradigm or a shifting away from one worldview toward another worldview. Members of a discipline cannot subscribe to two competing paradigms at the same time. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Knowledge Development in Nursing Four Levels of Knowing Empirical Aesthetic Personal Ethical Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Early Nursing Theorists Hildegard Peplau Defined concepts of stages of nurse-client relationships. Virginia Henderson Defined basic human needs as the unique focus of nursing practice. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Maslow’s Hierarchy of Needs Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Early Nursing Theorists Faye Abdellah Identified 21 nursing problems that became the foundation of nursing diagnoses. Joyce Travelbee, Josephine Paterson and Loretta Zderad Emphasized the humanistic and existential basis of nursing practice to understanding the uniqueness of patients. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Contemporary Nursing Theorists The work of contemporary theorists form the theoretical basis for many interventions in current nursing practice. Myra Levine Dorothea Orem Sister Callista Roy Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Contemporary Nursing Theorists Myra Levine’s Conservation Theory (1969) Four universal principles of conservation designed to apply concepts of nursing practice in different environments Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Dorothea Orem Self-Care Deficit Theory of Nursing Theory of Self-Care Theory of Self-Care Deficit Theory of Nursing Systems Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Roy Adaptation Model Developed by Sister Callista Roy, 1976. Combined general systems theory with adaptation theory. Goal of nursing is “promotion of adaptation” in each of four modes of adaptation. Applicable to the home setting. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Roy Adaptation Model The goal of nursing is “the promotion of adaptation” in each of four adaptive modes. Physiologic Self-concept Role function Interdependence Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Theories for the New Worldview of Nursing Describe, explain, and predict the phenomena of concern to nursing from a more holistic perspective. Jean Watson Martha Rogers Rosemarie Parse Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

The Theory of Human Caring Developed by Jean Watson in the 1980s. Conceptualizes human-to-human transactions that occur daily in nursing practice. Ten carative factors are classified as nursing actions or caring processes. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

The Science of Unitary Human Beings Developed by Martha Rogers in 1990. The person is characterized as a human energy field that unites all aspects of the person into a unified whole. Nursing aims to repattern the rhythm and organization of these energy fields to heighten the integrity of the person. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Gordon’s Functional Health Patterns Influenced by Maslow’s Hierarchy of Basic Human Needs and Von Bartlaffny’s general systems theory. Offer a holistic approach to the development of nursing diagnoses and client care. Provides an appropriate method for organization of textbook topics. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

Continuing Evolution of Nursing Theory Nursing is always in a state of change. Nursing knowledge continues to expand in a multiplicity of ways. New theories will come from a global perspective and international nursing leaders in the 21st century. Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

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