168540329 nursing theories

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THEORETICALFOUNDATIONS OF

NURSING

Contessa M. Gabriel, RM,RN,MANProfessor

Ramon Magsaysay Technological University ba Zambales



A. ENVIRONMENTAL THEORY

Florence Nightingale (1860)

“I think one’s feelings waste themselves in words;

they ought all to be distilled into actions which

bring results.”



Florence Nightingale (1860)

Florence Nightingale defined Nursing“ the

act of utilizing the environment of the patient

to assist him in his recovery” (1860/1969) ,

that it involves the nurse 's initiative to

configure environmental settings

appropriate for the gradual restoration of the

patient's health, and that external factors

associated with the patient's surroundingsaffect life or biologic and physiologic

processes , and his development.



Disease is a reparative process, and that the

manipulation of the environment - ventilation,

warmth, light, diet, cleanliness, and noise - would

contribute to the process and health of the patient·

Did not agree with the “germ theory of disease”

although she accepted the ill effects ofcontamination from organic materials from the

patients and the environment hence found

sanitation as important·

Also renowned for pioneering statistical analysisof healthcare.



Environmental Factors Affecting Health:

pure or fresh air pure water

sufficient food supplies

efficient drainage

Cleanliness

light (especially direct sunlight )



Adequate ventilation has also been regardedas a factor contributing to changes of the

patient’s process of illness recovery. Any

deficiency in one or more of these factorscould lead to impaired functioning of life

processes or diminished health status.



She also emphasized in her environmentaltheory is the provision of a quiet or noise-

free and warm environment, attending to

patient’s dietary needs by assessment,documentation of time of food intake, and

evaluating it’s effects on the patient.



Nightingale believed that the environment

was the major component creating illness ina patient; she regarded disease as “the

reactions of kindly nature against the

conditions in which we have placed

ourselves.” Her theory Contains three major

relationships:

1) environment to patient

2) nurse to environment

3) nurse to patient



B. INTERACTIVE THEORIES

Hildegard Peplau (1952)

“The kind of person that the nurse

becomes makes a substantial differencein what each patient will learn as he or

she receives nursing care.”



Hildegard Peplau (1952)

Psychodynamic Nursing; Mother of Psychiatric Nursing

She defined Nursing a s an “interpersonal process

of therapeutic interactions between an individual

who is sick or in need of health services and a

nurse especially educated to recognize, respond to

the need for help.”

Stressed the importance of the nurse’s ability tounderstand one’s own behavior to help others

identify felt difficulties.



Dr. Peplau emphasized the nurse-client

relationship as the foundation of nursing practice. At the time, her research and

emphasis on the give-and-take of nurse-

client relationships was seen by many asrevolutionary. She described the nurse-

patient relationship as a four-phase

phenomenon. Each phase is unique and has

distinguished contributions on the outcome

of the nurse-patient interaction.



Phases Of Nurse-Patient Relationship

1. Orientation Individual/family has a “felt need” and seeks

professional assistance from a nurse (who is a

stranger). This is the problem identification

phase.

2. Identification

Where the patient begins to have feelings of

belongingness and a capacity for dealing with the problem, creating an optimistic attitude from

which inner strength ensues. Here happens the

selection of appropriate professional assistance.



3. Exploitation

The nurse uses communication tools to offerservices to the patient, who is expected to take

advantage of all services.

4. Resolution

Where patient’s needs have already been met by

the collaborative efforts between the patient and

the nurse.

Therapeutic relationship is terminated and thelinks are dissolved, as patient drifts away from

identifying with the nurse as the helping person.



3. Teaching Role: Gives instruct ions and provides training;

involves analysis and synthesis of the learner’s experience.

4. Counseling Role: Helps client understand and integrate the

meaning of current life circumstances; provides guidance

and encouragement to make changes.

5. Surrogate Role: Helps clients clarify domains of

dependence, interdependence, and independence and acts

on clients behalf as advocate.

6. Leadership Role: Helps client assume maximum

responsibility for meeting treatment goals in a mutually

satisfying way.



Additional Roles include:

1) Technical expert

2) Consultant

3) Health teacher

4) Tutor

5) Socializing agent

6) Safety agent

7) Manager of environment

8) Mediator9) Administrator

10) Recorder observer

11) Researcher



“The nurse is temporarily the consciousness of the

unconscious, the love of life for the suicidal, the leg of the

amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge and confidence for the mother, the

mouthpiece for those too weak or withdrawn to speak and so

on.”

Virginia Henderson (1955)



Henderson defined Nursing as “ assistingthe individual, sick or well, in the

performance of those activities contributing

to health or it’s recovery (or to peacefuldeath) that an individual would perform

unaided if he had the necessary strength,

will or knowledge”.



“The unique function of the nurse is to

assist the individual, sick or well, in the performance of those activities contributing

to health or to recovery (or to a peaceful

death) that he would perform unaided if hehad the necessary strength, will, or

knowledge and to do this in such a way as

to help him gain independence as rapidly as

possible”



8) Keeping the body c lean and well – groomed

9) Avoiding dangers in the environment10) Communicating with others

11) Worshipping according to one’s faith

12) Working in such a way that one feels a sense of

accomplishment13) Playing/participating in various forms of recreation

14) Learning, discovering or satisfying the curiosity that

leads to normal development and health and using

available health facilities.



The Nurse-Patient Relationship:

Henderson stated that there are three levels

comprising the nurse-patient relationship:

1. The nurse as a substitute for the patient. In

times of illness, when the patient cannot functionfully, the nurse serves as the substitute as to what

the patient lacks such, as knowledge, will, and

strength in order to make him complete, whole

and independent once again.



2. The nurse as a helper to the patient. In

situations where the patient cannot meet his basicneeds, the nurse serves as a helper to accomplish

them.

3. The nurse as a partner with the patient. As

partners , the nurse and the patient formulate the

care plan together. Both as an advocate and as a

resource person, the nurse can empower the

patient to make effective decisions regarding hiscare plans.



Dynamic Nurse-Patient Relationship

“The role of the nurse is to find out and meet the

patient's immediate need for help. The patient's

presenting behavior may be a plea for help,however, the help needed may not be what

it appears to be.”

Ida Jean Orlando (1961)



Nursing Process; Dynamic Nurse-Patient

Relationship

Orlando 's theory was developed in the late 1950s

from observations she recorded between a nurse

and patient.

Despite her efforts, she was only able to

categorize the records as "good" or "bad" nursing.

It then dawned on her that both the formulations

for "good" and "bad" nursing were contained inthe records. From these observations she

formulated the deliberative nursing process.



Therefore, nurses need to use their perception, thoughts

about the perception, or the feeling engendered from theirthoughts to explore with patients the meaning of their

behavior. This process helps the nurse find out the nature

of the distress and what help the patient needs.

Orlando's theory remains one the of the most effective

practice theories available. The use of her theory keeps the

nurse's focus on the patient. The strength of the theory is

that it is clear, concise, and easy to use. While providing

the overall framework for nursing, the use of her theory

does not exclude nurses from using other theories whilecaring for the patient.



Focused on patient’s verbal and nonverbal expressions of

need and the nurse’s reactions to the behavior

3 Elements of a Nursing Situation

1) Patient behaviors

2) Nurse reactions

3) Nurse actions Used the nursing process to meet patient’s needs through

deliberate action; advanced nursing beyond automatic

response to disciplined and professional response



The major purpose of care is to achieve an

interpersonal relationship with theindividual that will facilitate the

development of the core.



The theory consists of 3 major tenets:

The nurse functions differently in the 3 interlockingaspects of the patient:

1) Cure (Disease) shared with doctors

2) Core (Person) addressed by therapeutic use of self; shared

with psychiatry/psychology, religious ministry, etc.3) Care (Body) exclusive to nurses; involves intimate bodily

care like feeding, bathing and toileting

As the patient needs less medical care, he needs more

professional nursing careWholly professional nursing care will hasten recovery



Joyce Travelbee (1966)

Human-to-Human Relationship Model“A nurse does not only seek to alleviate physical

pain or render physical care- she ministers to the

whole person. The existence of suffering, whether

physical, mental or spiritual is the proper concern

of the nurse.”



Travelbee's experience in initial psych nursing practice at a

Catholic charity hospital led her to believe that the caregiven in these type of institutions lacked compass ion. She

felt nursing needed “ humanistic revolution" and a

renewed focus on caring as central to nursing--she

warned that if this didn't happen, consumers might seek a

"new and different kind of health care worker". Travelbee's ideas have greatly influenced the hospice movement.



In her human-to-human relationship model, the nurse and

the patient undergoes the following series of interactional

phases:1) 1. Original Encounter- this is described as the first

impression by the nurse of the sick person and vice versa.

The nurse and patient see each other in stereotyped or

traditional roles.2) 2. Emerging Identities- this phase is described by the

nurse and patient perceiving each other as unique

individual. At this time, the link of relationship begins to

form.3) 3. Empathy- this phase is described as the ability to share

in the person’s experience.



4. Sympathy- I t happens when the nurse wants to lessen the

cause of the patient’s suffering. It goes beyond empathy.

The nurse at this time should use a disciplined intellectualapproach together with therapeutic use of self to make

helpful nursing actions.

5. Rapport- this is described as nursing interventions that

lessens the patient’s suffering. The nurse and the sick person are relating as human being to human being. The

sick person shows trust and confidence in the nurse.



Betty Neuman (1972)

“Health is a condition in which all parts and subparts

are in harmony with the whole of the client”



Her theory incorporated the concept of a whole

person and an open system approach. The conceptis aimed towards the development of a person in a

state of wellness having the capacity to function

optimally. The main role of the nurse in her theory

is to help a person to adapt with environmental

stimuli causing illnesses back to a state of

wellness.



Terms Related to Neuman’s System Theory Client

Variables

The clients’ variables can be one or combination of

the following: physiological, sociocultural, developmental

and spiritual. These variables function to achieve

stability in relation to the environmental stressors

experienced by the client.



Lines of Resistance

Lines of Resistance act when the Normal Line of Defense

is invaded by too much stressor, producing alterations in

the client’s health.

Normal Line of Defense

To achieve the stability of the system, the Normal Line ofDefense must act in coordination with the normal wellness

state. It must reflect the actual range of responses that is

normally acted by clients in response to any stressors. It is

the baseline in determining the level of client within the

continuum of health.



Flexible Line of Disease

It serves as a boundary for the Normal Line ofDefense to adjust to situations that threaten the

imbalance within the client’s stability.

Stressors

These are forces that produce tensions, alterations

or potential problems causing instability within the

client’s system.



Reaction

These are the outcomes or produced results ofcertain stressors and actions of the lines resistance

of a client. It can be positive or negative

depending on the degree of reaction the client

produces to adjust and adapt with the

situation . Neuman specified these reaction as

negentropy or egentropy. Negentropy is set

towards stability or wellness while Egentropy is set towards disorganization of the system

producing illness.



Dorothy Johnson (1971) Behavioral System Model

“Each individual has a predisposition to act, with

reference to the goal, in certain ways rather than in

other ways”



Johnson believes that each individual has a

focusing and repeating ways of acting whichcovers a behavioral system distinct to that

individual. These behaviors are logical, fixed,

predictable and adequately secure and persistent to

be satisfying to depiction and clarification.



Considered attachment or affiliative subsystem as

cornerstone of social organizations

Nursing problems arise because there are disturbances in

the structure or function of the subsystems:

1) Dependency

2) Achievement

3) Aggressive

4) Ingestive

5) Eliminative

6) Sexual



Seven Behavioral Subsystems

1. The Attachment or Affiliative Subsystem iswell known as the earliest response system to expand

in the individual. The most favorable functioning

of this subsystem allows social inclusion,

closeness, and the pattern and continuance of astrong public bond.

2. The Dependency Subsystem are act ions that

trigger nurturing behaviors from other individuals

in the environment. The product of dependency

behavior is consent, interest or appreciation, and

physical support.



5. The Sexual Subsystem imitates behaviors real ted to

procreation or reproduction.6. The Aggressive Subsystem relates to behaviors

concerned with the defense and self-preservation.

7. The Achievement Subsystem contains behaviors that

attempt to control the environment. Intellectual, physical,imaginative, mechanical, and communication skills are

some of the areas that Johnson distinguishes.



Imogene King (1971) Goal Attainment Theory

“If the students can’t do the fundamentals,

how can they use advanced knowledge.”



Interacting Systems Framework; Goal Attainment

Theory

Nursing is a process of human interaction between

nurses and patients who communicate to set goals,

explore means of attaining goals, and agree onwhat means to use

Perceptions, judgment and actions of nurse and

patient lead to reaction, interaction and transaction



King stated that Nursing is a process of action, reaction,

and interaction whereby nurse and client share

information about their perception in the nursing situation.

Action

Action is a means of behavior or activities that are

towards the accomplishment of certain act. It is both physical

and mental.



Reaction

In King’s theory, reaction is not specified butsomehow relates reaction as part of action.

According to her, reaction is a response to a

stimuli.

Interaction

Interaction, as defined by King, is any situation

wherein the nurse relates and deals with a clienteleor patient.



Open System

It is the absence of boundary existence, where adynamic interaction between the internal and

external environment can exchange information

without barriers or hindrances.

King proposed that the nurse interacts in the

system simultaneously at three different levels.

These levels are independent and at the same timeco-exist to influence over-all nursing practice.



Interacting systems:

1) Personal- how the nurse views and integrates self based

from personal goals and beliefs.

perception, self, body image, growth and development.

2) Interpersonal- how the nurse interrelates with a

coworker or patient, particularly in a nurse-patient

relationship.

role, interaction, communication, transaction, and stress.

3) Social- how the nurse interacts with co-workers,

superiors, subordinates and the client environment in

general

organization, power-authority status, decision making.



Dorothea Orem (1971)

“Individuals, families, groups and communities need

to be taught self-care.”



Orem defined Nursing as “The act of assisting others in

the provision and management of self-care to

maintain/improve human functioning at home level ofeffectiveness.”

The theory focuses on activities that adult individuals

perform on their own behalf to maintain life, health andwell-being. It has a strong health promotion and

maintenance focus.



She identified 3 related concepts:

1. Self-care - activities an Individual performsindependently throughout life to promote and

maintain personal well-being.

2. Self-care deficit - results when self - care agency

(Individual’s ability) is not adequate to meet the

known self-care needs.

3. Nursing System - nursing interventions needed

when Individual is unable to perform thenecessary self-care activities:



1) Wholly Compensatory - do for the patient.

nurse provides entire self-care for the client. Example: care of a new born , care of client recovering

from surgery in a post-anesthesia care unit

2) Partly Compensatory - help the patient do for himself.

nurse and client perform care, client can perform selectedself-care activities, but also accepts care done by the nurse

for needs the client cannot meet independently.

Example: Nurse can assist post operative client to

ambulate, Nurse can bring a meal tray for client who canfeed himself.



3) Supportive Educative - help the patient learn to do for

himself; nurse has important role in designing nursingcare.

nurse ’s actions are to help the client develop/learn their

own self-care abilities through knowledge, support and

encouragement. Example: Nurse guides a mother how to breastfeed her

baby. Counseling a psychiatric client on more adaptive

coping strategies.



Faye Glen Abdellah (1960)

Twenty-One Nursing Problems

“I never wanted to be a medical doctor because I

could do all I wanted to do in nursing, which is acaring profession.”



Problem solving was seen as the way of

presenting nursing(patient) problems as the patient

moved towards health.

Contributed to nursing theory development

through the systematic analysis of research reports

to formulate the 21 nursing problems that served

as an early guide for comprehensive nursing care



Typology of Twenty-one Nursing Problems

1) To maintain good hygiene.

2) To promote optimal activity; exercise, rest and sleep.

3) To promote safety.

4) To maintain good body mechanics

5) To facilitate the maintenance of a supply of oxygen6) To facilitate maintenance of nutrition

7) To facilitate maintenance of elimination

8) To facilitate the maintenance of fluid and electrolyte

balance



9) To recognize the physiologic response of the body to

disease conditions.10) To facilitate the maintenance of regulatory mechanisms

and functions.

11) To facilitate the maintenance of sensory functions

12) To identify and accept positive and negative expressions,feelings and reactions

13) To identify and accept the interrelatedness of emotions

and illness.

14) To facilitate the maintenance of effective verbal and non-verbal communication

15) To promote the development of productive in terpersonal

relationship



16) To facilitate progress toward achievement of personal

spiritual goals

17) To create and maintain a therapeutic environment

18) To facilitate awareness of self as an individual with

varying needs.

19) To accept the optimum possible goals20) To use community resources as an a id in resolving

problems arising from illness.

21) To understand the role of social problems as influencing

factors



Ernestine Wiedenbach (1964) Helping Art of Clinical Nursing

"My thesis is that nursing art is not comprised of rational

nor reactionary actions but rather of deliberative action."



“…nursing is nurturing or caring for someone in a

motherly fashion.” Proposed that nurses identify patient’s need-for-

help by:

1) Observing behaviors regarding comfort

2) Exploring meanings of the behavior

3) Knowing the cause of discomfort

4) Knowing if they can solve on their own or need

help



Wiedenbach conceptualizes nursing as the practice

identification of a patient’s need for help through

observation of presenting behaviors and symptoms,

exploration of the meaning of those symptoms with t he

patient, determining the cause(s) of discomfort, and

determining the patient’s ability to resolve the discomfort

or if the patient has a need for help from the nurse or otherhealthcare professionals.



According to Wiedenbach there are four elements to

clinical nursing (1): philosophy, (2) purpose, (3)

practice, and (4) art. The nurses ’ philosophy was their attitude and belief about

life and how that effected reality for them. Philosophy is

what motivates the nurse to act in a certain way.

Wiedenbach also believed that there were 3 essentialcomponents associated with a nursing philosophy:

1) Reverence for life

2) Respect for the dignity, worth, autonomy and

individuality of each human being3) Resolution to act on personally and professionally held

beliefs



Nurses ’ purpose is that which the nurse wants to

accomplish through what she does. It is all of the activities

directed towards the overall good of the patient. Practices are those observable nursing actions that are

affected by beliefs and feelings about meeting the patient’s

need for help.

The Art of nursing includes understanding patient’s needsand concerns, developing goals and actions intended to

enhance patient’s ability and directing the activities related

to the medical plan to improve the patient’s condition.

The nurses also focuses on prevention of complicationsrelated to reoccurrence or development of new concerns.



Myra Estrin Levine (1977)

The Conservation Model

"Ethical behaviour is not the display of one's moral rectitude

in times of crisis. It is the day-to-day expression of one's

commitment to other persons and the ways in which human

beings relate to one another in their daily interactions.”



She defined nursing as supportive & therapeutic

interventions based on scientific or therapeutic knowledge. Nursing actions based on four principles:

1) conservation of energy

2) structural integrity

3) personal integrity

4) Social integrity



Major Concepts:

1) Wholism (Holism)

2) Adaptation - process whereby patients retain integrity; establish body economyto safeguard stability:

a) Environment

b) Organismic Response - (1)Fight or flight, (2)inflammatory response,

3)response to stress, (4)perceptual awareness

c) Trophicogenesis - alternative to nursing diagnosis

3) Conservation - 4 principles of conservation - Nursing intervention is based on

the conservation of the patients:

1) Energy

2) Structural Integrity

3) Personal Integrity

4) Social Integrity



Sister Callista Roy (1979)

Adaptation Model

“The model provides a way of thinking about people

and their environment that is useful in any setting. It

helps one prioritize care and challenges the nurse tomove the patient from survival to transformation.”



The degree of internal or external environmental change

and the person’s ability to cope with that change is likelyto determine the person’s health status. Nursing

interventions are aimed at promoting physiologic,

psychologic, and social functioning or adaptation.



Madeleine Leininger (1985)

Transcultural Theory

“Care is the heart of nursing; Care is power; Care is

essential to healing; Care is curing; and Care is the

central and dominant focus of nursing and transcultural

nursing decisions and actions.”



She stated that Nursing is a learned humanistic and

scientific profession and discipline which is focused onhuman care phenomena and activities in order to assist,

support, facilitate, or enable individuals or groups to

maintain or regain their well being (or health) in culturally

meaningful and beneficial ways, or to help people face

handicaps or death.



Transcultural nursing as a learned subfield or branch of

nursing which focuses upon the comparative study and

analysis of cultures with respect to nursing and health

illness caring practices, beliefs and values with the goal to

provide meaningful and efficacious nursing care services

to people according to their cultural values and health

illness context. It focuses on the fact that different cultureshave different caring behaviors and different health and

illness values, beliefs, and patterns of behaviors.

Awareness of the differences allows the nurse to design

culture-specific nursing interventions.



Margaret Jean Watson (1979)

Philosophy and Science of Caring

“Caring in nursing conveys physical Acts but embraces

the mind-body-spirit as it reclaims the embodied spirit as

its focus attention.”



Philosophy and Science of Caring; Carative Factors

Caring is a universal social phenomenon that is onlyeffective when practiced interpersonally. Nurses should be

sensitized to humanistic aspects of caring.

Watson proposes seven assumptions about the science of

caring and ten primary carative factors to form theframework of her theory. The basic assumptions are:

1) Caring can be effectively demonstrate d and practiced

only interpersonally;

2) Effective caring promotes health and individual or familygrowth;



3) Caring responses accept a person not only a s he or she is now but as what he

or she may become;

4) A caring environment is one that offers the development of potential while

allowing the person to choose the best action for himself or herself at a given

point in time

5) Caring is more “healthogenic” than is curing. The practice of caring integrates

biophysical knowledge of human behavior to generate or promote health and

to provide care to those who are ill. A science of caring is therefore

complementary to the science of curing.6) The practice of caring is central to nursing.



Ten Carative Factors

1. The promotion of a humanistic - altruistic sys tem of values2. Instillation of faith - hope

3. The cultivation of sensitivity to one’s self and others

4. The development of a helping-trusting, human caring

relationship

5. Promotion and acceptance of the express ion of positive

and negative feelings.



6. The systemic use of the scientific problem-solving method

for decision making

7. The promotion of interpersonal teaching- learning

8. The provision for supportive , protective and corrective

mental, physical, socio-cultural and spiritual environment

9. Assistance with the gratification of human needs

10.The allowance for existential phenomenological forces



Martha Rogers (1970)

The Science of Unitary Human Beings, and Principles of

Homeodynamics

“Nursing is an art and science that is humanistic and

humanitarian. It is directed toward the unitary human and isconcerned with the nature and direction of human

development.”



Nursing interventions seek to promote harmonious

interaction between persons and their environment,

strengthen the wholeness of the individual and redirecthuman and environmental patterns or organization to

achieve maximum health.

There are 5 Basic Assumptions:

1. The human being is a unified whole , possessing individual

integrity and manifesting characteristics that are more than

and different from the sum of parts.



2. The individual and the environment are continuously

exchanging matter and energy with each other3. The life processes of human beings evolve irreversibly

and unidirectionally along a space-time continuum

4. Patterns identify human being and reflect their innovative

wholeness

5. The individual is characterized by the capacity for

abstraction and imagery, language and thought,

sensation and emotion



Rosemarie Rizzo Parse (1981)

Theory of Human Becoming

“Nursing is a scientific discipline, the practice of

which is a performing art.”



Three assumptions about Human Becoming

1) Human becoming is freely choosing personal meaning in

situation in the inter-subjective process of relating value

priorities

2) Human becoming is co-creating rhythmic pat terns or

relating in mutual process in the universe

3) Human becoming is co- transcending multidimensionally

with emerging possibilities.



A unique, humanistic approach instead of a physiological basis for

nursing

Nursing is a human science that is not dependent on medicine or anydiscipline for its practice.

Major concepts include:

1) Imaging

2) Connecting-separating

3) Valuing

4) Powering

5) Languaging

6) Originating

7) Revealing-concealing8) Transforming

9) Enabling-limiting



Merle Mishel - Uncertainty in Illness

Researched into experiences with

uncertainty as it relates to chronic and life-

threatening illness

Later reconceptualized to accommodate the

responses to uncertainty over time in people

with chronic conditions who may notresolve the uncertainty



Margaret A. Newman - Model of Health

Major concepts are movement, time, space and

consciousness. “Movement is a reflection of

consciousness. Time is a function of movement. Time is a

measure of consciousness.”

The goal of nursing is not to promote wellness or to prevent illness, but to help people use the power within

them as they evolve toward a higher level of

consciousness.



Evelyn Adam - Conceptual Model for Nursing

Used a model from Dorothy Johnson and definition ofnursing from Virginia Henderson

Identified assumptions, beliefs, and values, and major units

Included goal of the profession, beneficiary of the

professional service, role of the professional, source of the beneficiary’s difficulty, the intervention of the

professional, and the consequence.



Nola J. Pender - Health Promotion Model

The goal of nursing care is the optimal health of the

individual

Developed the idea that promoting optimal health

supersedes disease prevention

Identifies cognitive-perceptual factors of a person, like

importance of health-promotion behavior and its perceived

barriers, and these factors are modified by demographics,

biology, interpersonal influences, and situational and

behavioral factors.



Katherine Kolcaba - Theory of Comfort

Defined healthcare needs as those needs for comfortincluding physical, psycho-spiritual, social, and

environmental needs

Intervening factors influence client’s perception of

comfort: age, attitude, emotional support, experience,finance, prognosis

Types of comfort:

1) Relief when specific need is fulfilled

2) Sense of ease, calm, and contentment3) Transcendence or rising above the problems of pain



Erikson, Tomlin and Swain - Modeling and Role-

Modeling

Synthesis of multiple theories related to basic needs,

developmental tasks, object attachment, and adaptive

coping potential

Views nursing as self-care based on the person’s

perception of the world and adaptation to stressors

Promotes growth and development while recognizing

individual differences according to worldview and inherent

endowment



Ramona Mercer - Maternal Role

AttainmentFocused on parenting and maternal role

attainment in diverse populations

Developed a complex theory to explain thefactors impacting the maternal role over

time



Kathryn Barnard - Parent-Child Interaction;

Child Health Assessment Interaction Theory Individual characteristics of each member

influence the parent-infant system and that

adaptive behavior modifies those characteristics to

meet the needs of the system

The theory is based on scales developed to

measure feeding, teaching, and environment



Patricia Benner - Novice to Expert

Validated the Dreyfus Model of SkillAcquisition in nursing practice with the

systematic description of the 5 stages

(Novice, Advanced beginner, Competent,Proficient, and Expert)



Roper, Logan, and Tierney - Model for Nursing Based on a Model of Living

Conceptual Components

12 Activities of Living (AL) - complex process of living in the view of anamalgam of activities

1) Maintain safe environment

2) Temperature

3) Communicate

4) Mobility

5) Breathe

6) Work and play

7) Eat and drink

8) Express sexuality

9) Eliminate10) Sleep

11) Personal cleansing and dressing

12) Dying



Life span - concept of continuous change from birth to

death

Dependence-independence continuum

5 factors influencing AL: Biological, Psychological, Socio-

cultural, Environmental, Politicoeconomic.

The individuality of living is the way in which the

individual attends to ALs in regard to place on life span

and dependence-independence continuum and as

influenced by the 5 factors



THANK YOU!

168540329 nursing theories

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