CONTRIBUTION OF NURSING THEORIST

THEORIST PRACTICE EDUCATION RESEARCH1.Virginia Henderson Assist nurses to describe, explain, and

predict everyday experiences.

Serve to guide assessment, interventions, and evaluation of nursing care.

Provide a rationale for collecting reliable and valid data about the health status of clients, which are essential for effective decision making and implementation.

Help to describe criteria to measure the quality of nursing care.

Help build a common nursing terminology to use in communicating with other health professionals. 

Ideas are developed and words are defined.

Enhance autonomy (independence and self-governance) of nursing through defining its own independent functions. 

Provide a general focus for curriculum design

Guide curricular decision making.

Offer a framework for generating knowledge and new ideas.

Assist in discovering knowledge gaps in the specific field of study.

Offer a systematic approach to identify questions for study; select variables, interpret findings, and validate nursing interventions.

Approaches to developing nursing theory

Borrowing conceptual frameworks from other disciplines.

Inductively looking at nursing practice to discover theories/concepts to explain phenomena.

Deductively looking for the compatibility of a general nursing theory with nursing practice.

Questions from practicing Nurse about using Nursing theory

2. Faye Glenn Abdellah

he believed that as the education of nurses improves, nursing practice improves as well. 

The most important impact of Abdellah’s theory to the nursing practice is that it helped transform the focus of the profession from

Many nurse educators feel that the PPC hospital where all five phases of care are available can provide clinical experience in which the nurse can learn to solve basic

She has been a leader in nursing research and has over one hundred publications related to nursing care, education for advanced practice in nursing and nursing research. 

being “disease-centered” to “patient-centered.” The patient-centered approach was constructed to be useful to nursing practice as it helped bring structure and organization to what was often been a disorganized collection of nursing care experiences. She categorized nursing problems based on the individual’s needs and developed a typology of nursing treatment and nursing goals which served as a basis for determining and organizing nursing care.

Her twenty one nursing problems made nurses look at patients’ problems and come up with nursing plan of care in a thorough and organized way. Abdellah’s identification of health needs as overt and covert assists nurses in exploring unmasked conditions about the client and plan appropriate interventions to address them. Client centered care emphasizes the principle that every nursing goal should be geared towards treating the patient and not just the mere illness. It has been viewed that if all 21 problems are investigated, the patient would be likely to be thoroughly assessed and thus will aid the nurse organize appropriate nursing strategies. Currently, the 21 nursing problems have been updated to focus on the patient and nursing diagnosis. It has ultimately helped nurses develop their individual critical-thinking skills leading to increase in job satisfaction and more productive nurse-patient and nurse-family interaction.

nursing problems in meeting patients’ needs. 

The three month assignment of professional nurses may no longer be realistic in such a setting. 

Organization of hospital and community services based on patients needs 

In the intensive care unit, the critically ill patients are concentrated regardless of diagnosis. 

These patients are under the constant audio-visual observation of the nurse, with life saving techniques and equipment immediately available 

In the intermediate care unit are concentrated patients requiring a moderate amount of nursing care, not of an emergency nature, who are ambulatory for short periods, and who are beginning to participate in he planning of their own care 

The self-care unit provides for patients who are physically self-sufficient and require diagnostic and convalescent care in hotel-type accommodations. This unit serves as a link between the hospital and the home. 

In the long-term care unit are concentrated patients requiring prolonged care. The grouping of such patients will permit staffing patterns that are less costly 

3. Jean Watson Watson’s work can be used to guide and

improve practice.

It can provide the nurse with the most satisfying aspects of practice and can provide the client with the holistic care so necessary for human growth and development.

Theories must be consistent with other validated theories, laws and principles but will leave open unanswered questions  that need to be investigated

Watson’s work is supported by the theoretical work of numerous humanists, philosophers, developmentalists and psychologists.

She clearly designates the theories of stress, development, communication, teaching-learning, humanistic psychology and existential phenomenology which provide the foundation for the science of caring.

Her work Nursing: the philosophy and science of Caring, she defines her intent to describe the core of nursing (those aspect s of the nurse patient relationship resulting in a therapeutic outcome) rather than the trim of nursing (the priocedures, Tasks and techniques used in the practice setting) The framework is not limited to any nursing specialty.. her works lead to thought-provoking experience by emphasizing deep inner reflection and personal growth.

Watson’s theory is based on phenomenological studies that generally ask questions rather than state hypotheses. Its purpose is to describe the phenomena, to analyze and to gain an understanding.

Theories contribute to and assist in increasing the general body within the discipline through research implemented to validate them

According to Watson the best method to test this theory is through field study.

An example is her work in the area of loss and caring that took place in Cundeelee, Western Australia and involved a tribe of aborigines.

4. Betty Neuman The Neuman systems model has been applied and adapted to various specialties include family therapy, public health, rehabilitation, and hospital nursing.

The sub specialties include pulmonary, renal, critical care, and hospital medical units. One of the model’s strengths is that it can be used in a variety of settings

Using this conceptual model permits comparison of a nurse’s interpretation of a problem with that of the patient, so the patient and nurse do not work on two separate problems.

The role of the nurse in the model is to work with the patient to move him as far as possible along a continuum toward wellness.

Because this model requires individual interaction with the total health care system, it is indicative of the futuristic direction the nursing profession is taking.

The patient is being relabeled as a consumer with individual needs and wants.

The model has also been widely accepted in academic circles.

It has often been selected as a curriculum guide for a conceptual framework oriented more toward wellness than toward a medical model and has been used at various levels of nursing education.

In the associate degree program at Indiana University.

One of the objectives for nursing graduate is to demonstrate ability to use the Neuman health care system in nursing practice. This helps prepare the students for developing a frame of reference centered on holistic care.

At northwestern State University in Shreveport, Louisiana, the faculty determined that a systems model approach was preferred for their master’s program because of the universality framework.

Acceptance by the nursing community for education therefore is evident.

A study was published by Riehl and Roy to test the usefulness of the Neuman model in nursing practice.

There were two major objectives of the study.

To test the model/assessment’ tool for its usefulness as a unifying method of collecting and analyzing data for identifying client problems.

To test the assessment tool for its usefulness in the identification of congruence between the client’s perception of stressors and the care giver’s perception of client stressors.

Results indicated that the model can help categorize data for assessing and planning care and for guiding decision making.

Neuman’s model can easily generate nursing research.

It does this by providing a framework to develop goals for desired outcomes. Acceptance by the nursing community for research applying this model is in the beginning stages and positive.

5.Myra Estine Levine Conservational model has been used for nursing practice in different settings

Conservational model was used as guidelines for curriculum development

Principles of conservation have been used for data collection in various

Bayley discussed the care of a severely burned teenagers on the basis of four conservational principles and discussed patient’s perceptual, operational and conceptual environment

Pond used conservation model for guiding the nursing care of homeless at a clinic, shelters or streets

It was used to develop nursing undergraduate program at Allentown college of St.Francis de sales, Pennsylvania

Used in nursing education program sponsored by Kapat Holim in Israel

researches

Conservational model was used by Hanson et al.in their study of incidence and prevalence of pressure ulcers in hospice patient

Newport used principle of conservation of energy and social integrity for comparing the body temperature of infant’s who had been placed on mother’s chest immediately after birth with those who were placed in warmer

6. Hildegard Peplau Used widely around the world – nursing educationOften integrated into policies without credit to Peplau – Public DomainPatient health education, palliative care, oncology, AIDS care, quality of life, private practice, nurse practitioners, home care & of course, psychiatric nursing Nurse counseling of individuals and groups

U.S. focus has been on cost containment, causing delivery to be fragmented and restricted - minimal research efforts

Research has been fairly inconsistent and scattered abroadMost within National Healthcare System of Canada in recent yearsMost research has been qualitative – not quantitativeHome care, Public Health, Depression, Education of Patients, Nature of Nurse-patient relations, Role expectations, Preferred Nursing care of ventilated patients

(Peterson, 2009)Yet worldwide influences on the development of psychiatric nursing practice have been substantial For any theory, the acid test is utility in practice

7. Calista Roy the nurse assesses first the behaviors and second the stimuli affecting those behaviors. In a third step the nurse makes a statement or

The adaptation model is also useful in educational setting. Roy states that the

If research is to affect practitioners’ behavior, it must be directed at testing and retesting conceptual models for

nursing diagnosis of the person’s adaptive state and fourth, sets goals to promote adaptation. Fifth, nursing interventions are aimed at managing the stimuli to promote adaptation. The last step in the nursing process is evaluation. By manipulating the stimuli and not the patient, the nurse enhances the interaction of the person with their environment, thereby promoting health.

Hamner in 1989 discussed the Roy model and how it could be applied to nursing care in a cardiac unit (CCU). Hamner describes the model as enhancing care in the CCU and being consistent with the nursing process. Hamner found that the model assessed all patients’ behavior, so that none was excluded. The author discovered that the Roy model provides a structure in which manipulation of stimuli are not overlooked. The model puts emphasis on identifying and reinforcing positive behavior which speeds recovery.

model defines for students the distinct purpose of nursing which is to promote man’s adaptation in each of the adaptive modes in situations of health and illness.

In the early 1980’s the School of Nursing at the University of Ottawa experienced a major curriculum change. This change included incorporating a nursing model by which to base their new curriculum. The change included incorporating a nursing model by which to base their new curriculum. The Roy adaptation model was one of the models to be included in the first year of the baccalaureate program. The professors had to meet four challenges during this change:

1. Adapting the course to be congruent with the Roy model,

2. Developing teaching tools suitable for student learning.

3. Sequencing of content for student learning

4. Obtaining competent role models.

nursing practice. Roy has stated that theory development and the testing of developed theories are nursing’s highest priorities. The model must be able to regenerate testable hypotheses for it to be researchable.

8. johnson Johnson's theory can be applied to to administrative nursing as well. The behavioral model has been used to structure administration departments of clinical agencies.

Today nursing has made large improvements in becoming a profession, but has not yet met its goal. The challenges that are faced today are that our health care system is fragmented. Hospitals are receiving less money for services

Johnson’s model of behavioral subsystems has been, and continues to be, utilized as a conceptual framework for understanding and defining the behavioral patterns demonstrated by human beings as well as evaluating patient care outcomes within the clinical setting. Researchers have utilized

provided, budget cuts are leading to layoffs, and managed care is controlling funding. Money for nursing is decreasing and there is a threat that associate degree programs will be eliminated and other programs will be downsized. There is a need for urgency to continue theory development in nursing to justify and guide practice. As the field of nursing continues to face decreases in funding, nursing will have to continue to justify its existence to governmental and private sources in order to continue to receive support. As nurses, it is important that we continue to understand the importance of theory, research, and evidence based practice; our "profession" depends on it.

Johnson’s model in initiating studies on matters such as the quality of nursing care received by hospitalized patients, the alterations in behavioral patterns of psychiatric patients, management of pain in patients with metastatic cancer, accomplishments made by ill-stricken children in comparison to those made by children who are presumably healthy, etc; all of which have significantly impacted profession of nursing and differentiating it from the world of medicine. Johnson’s model has assisted researchers in studying and analyzing various behavioral subsystems among human beings spanning from the time of birth well into seniority. The model has been utilized and incorporated in the development of numerous assessment tools used to examine and measure alterations in human behavior. Johnson’s model has essentially paved the way for the development of theory for the purpose of developing a foundation of knowledge for nurses to utilize in practice.

9. R o s e m a r i e R i z z o P a r s

A transformative approach to all levels of

nursing

Differs from the traditional nursing

process, particularly in that it does not

seek to “fix” problems

Ability to see patients perspective allows

nurse to “be with” patient and guide them

toward desired health outcomes

Nurse-person relationship cocreates

changing health patterns

Enhances understanding of human

lived experience, health, quality of

life and quality of nursing practice

Expands the theory of human

becoming

Builds new nursing knowledge

about universal lived experiences

which may ultimately contribute to

health and quality of life

10. PENDER “We are moving toward an era of science-based practice in nursing that incorporates the latest findings from the behavioral and biological sciences into practice to assist people of varying cultural backgrounds to adopt healthy lifestyles.” – Pender

As what they say, prevention is better than cure. Thus, health promotion is valued much. But how? Question seems hard…hard as if you don’t know how to solve the problems of the world…But how, again? If super heroes could save life using their super powers, we nurses could do more by using our caring touch, and therapeutic talks. Health teachings are always part of nurses’ experience in the workplace. Despite of various clinical & community health care settings, we nurses are always interacting with our patient/client.ommunity health care setting is the best avenue in promoting health & preventing illnesses. Using Pender’s Health Promotion Model, community program may be focused on activities that can improve the well-being of the people. Health promotion and disease prevention can more easily be carried out in the community, as compared to programs that aim to cure disease conditions. This is because the people in the rural area tend to veer away from modern medical methods. Most of them, due to financial reasons, choose to avail of the services offered by “herbolarios” and other folk healers. In our local setting, promoting health to our fellow Filipinos is very crucial. Though, there are campaigns provided by our government’s health agency, which is the Department of Health (DOH), there’s still a big percentage in the population who live unhealthily and many are suffering from different type

“I believe that the future will be very bright and productive for nurses who direct their careers toward understanding disease prevention and health promotion processes.” – Pender

Nurses are expected to be adaptive. Indeed, changes are always constant. In health care settings, patients come & go. Meet & greet. Recover or expire. As this theory advocated, we should not allow our patients to experience severe conditions if we could only prevent them from encountering such. We are expected to know, if not in depth, the disease processes. Because of this know-how, we could apply health promotion and worsening prevention before the hands of the clock stop moving.

Percentage of nurses is geared towards continuing professional education. Attending seminars & conventions. Enrolling to masteral & doctoral classes. All are goaled towards becoming competent nurses. Nursing education is not a one-phase process. It does not end after passing the licensing exam. It is continuous. Unending. Ever changing. We must be abreast with new technologies, new approaches, and new techniques. Because of this theory, we nurses could address more the needs and problems of the client before it progresses to exacerbation. This model could be a basis for structuring nursing protocols and interventions.

1. “I was committed to health promotion and encouraged other scholars to move in that direction long before health promotion and risk reduction became popular.” - Pender

Research help Health Care provider to develop a systematic problem-solving approach to improve and develop strategies to promote good health to individuals. Through research we will be able to clarify and verify the phenomenon.

Evidenced-based practice is fast emerging because of its factual and substantive results. These researches yield fruitful outcome that of great help in addressing arising problems and in setting nursing protocols. Much more research must be done to tailor interventions to individuals rather than to group stereotypes.

If we could remember, common research topics in our nursing college days are health promotion techniques and disease prevention. To name a few, some geared their research on effectiveness of Expanded Program on Immunization, others on health practices of mothers and families, some on efficiency of early detection

of diseases.

Nurses, though are scattered in different fields, have common primary concern: to promote health to every individual. The following are just examples of methods on how to promote health to our fellows.

Insight from an ICU nurse… Although most patients admitted in the ICU are experiencing health problems, Health Promotion Model may still be applied in one way or another. This is projected towards improving health condition and prevention of further debilitating conditions. Diet modifications and performing passive & active range of motion exercises are examples of its application.

of common illnesses. These are all but few of the model’s application to research.