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Nursing Theories

By Mrs.Melba Sahaya Sweety AMCON – Coimbatore

Definition Theory Theory is defined as a set of interpretative assumption,

principles and proposition that help to explain or guide action.

- Young , Taylor and Repenning (2000)Creative and rigorous structuring of ideas that project a

tentative purposeful and systematic view of phenomena.- Chinn and Knammer(2003)

It is an organized , coherent set of concepts and their relationship to each other that offers descriptions, explanations and prediction about phenomena – Parker (2001)

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Nursing Philosophies Philosophy Definition Love and pursuit of wisdom by intellectual

means and self – discipline It is defined as a statement of believes and

values about human beings and their world Nursing Philosophy Definition

– Nursing philosophy has been described as a statement of foundational and assumptions ,believes and knowledge and thought and about the nature of the entities represented in the meta paradigm – Reed 1995

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NURSING THEORIES AND PHILOSOPHIES:

NURSING THEORI ES PHILOSOPHIES

Florance Nightangle’s

Legacy of caring

Focuses on nursing and the patient environmental relationship

Virginia henderson’s

Definition of nursing

Patients require help towards achieving independence

Derived a definition of nursing

Jean watson’s

Philosophy and science of caring

Caring is moral ideal,mind-body,soal engagement with one and other

Fave abedellah’s

Typology of twenty one nursing problem

Patient’s problems determine nursing care

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NURSI NG THEORI ES PHI LOSOPHI ES

Lydia E Hall’s

Care,Cure,Core model

Nursing care is person directed towards self love

Patricia Benner’s

Primare of caring

Caring is centered to the essence of nursing. It sets up what matters, enabling connection and concerns. It creates possibility for mutual helpfulness

Ennestive Widenbach

The helping art of clinical nursing

Nurses should identify patient’s “need – for – help” by

Observation

Understanding client behavior

Identifying causes of discomfort

Determining if clients can resolve problems or have a need for help

Classification of Nursing Theories

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Depending on function

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Depending on the generalisability of their principles

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Based on philosophical under pinning of the theories

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Goals of Theoretical Nursing models

Identify domain and goals of nursing Provide knowledge to improve nursing

administration,practice,education and research Guide research to establish empirical knowledge

base for nursing Identify areas to be studied Identify research techniques and tools that will be

used to validate nursing interventions Identify nature of contribution that research will

make to advancement of knowledgecont…

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cont… Formulate legislation governing nursing practice,

research and education. Formulate regulations interpreting nurse practice acts

so that nurses and others better understands laws Develop curriculum plans for nursing education Establish criteria for measuring quality of nursing

care, education and research. Guide development of nursing care delivery Provide systematic structure and rationale for nursing

activities

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Nursing models

A nursing model is a set of inter related concepts that represents a particular way of thinking about nursing , clients , health and environment.

The models are examined to determine how well each model / theory “fits” with the clients health , concerns the nurses own view of nursing health. Clients and environment and mission, goals and philosophy of the employment agency.

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General models

Maslow’s hierarchy of needs

Erickson’s eight stages of development

General systems model

Aguilera and Mesick's : crisis intervention model

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Family model

Duvall's family development model

Stevenson’s family developmental model

Sater’s interactional family model

Friedman’s structural functional family model

Calgary's family model

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Nursing models/ Theories Needs / problem – Oriented theory Florence nightingale environmental theory Faye Glenn Abdullah holistic nursing problems theory Virginia Henderson complementary , supplementary

model Dorothea Orem self – care deficit theory Lydia – E Hall care ,core and cure total person

approach Jean – Watson’s human caring model

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Interaction – Oriented theory Hildegard Palau -Interpersonal model Ida Jean Orlando’s nursing patient interaction model Ernestine Wiedenbach prescriptive theory Imogene making interpersonal and goal attainment

theory Paterson and Zderad humanistic nursing practice theory Erickson’s , Tomlin and Swain theory of modeling and

role modeling Boykin and Schoenhofer nursing caring model

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Systems – Oriented theory

Dorothy ,E Johnson Behavioral systems model

Sister Callista Roy adaption model

Betty Neumann: Health care systems model

Myraestrin Levine: Adaption conservation and

integrity model

Madeleine Leininger : Transcultural Nursing Model

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Energy field theory

Martha E Rogers – science of unitary beings

model

Parse’s Man- Living :Health model

Margaret Newman : Health as Expanding

consciousness model

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Application of Nursing theories in Nursing practice

Introduce and orient nursing theories to practicing nurses and nursing students through inservice or continuing nursing education programs

Make available each theorist’s nursing system design/frame work in the clinical nursing units/ library

Discuss clinical nursing problems(patient/unit) and solve problems using a specific nursing theory

Motivate to assess diagnose , priorities plan implement care on the theoretical concepts of a specific theorists if nurse uses the nursing process frame work - cont..

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Cont…. Emphasize and give more weightage for application

of suitable nursing theories in clinical situation Guide in evaluating the theory and making the

approach choice of a theory for application an a specific situation

Introduce an organization policy on application of nursing theories

Convince the nursing or non nursing fraternity in clinical nursing unit on importance of nursing process approach and need for the record to be include in patients chart as a useful document for quality assurance

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Statement of the Problem

An experimental study to assess the

effectiveness of vitamin E upon

menopausal symptoms among

menopausal women at Chennai.

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The conceptual frame work for the present study is based on Roy’s adaptation model. The Roy’s

adaptation model views the person as an adaptive system in constant interaction with an internal

and external environment .The person’s major task is to maintain integrity in face of these

environmental stimuli.

Roy’s categorizes three types of stimuli they are,

Focal: Focal is defined as the internal or external stimulus most immediately challenging the

person’s adaptation. In this study focal stimulus refers to the symptoms of menopausal women.

Contextual: The contextual stimuli are all other stimuli existing in a situation that strengthen the

effect of the focal stimulus. In this study it refers to the with drawl of hormones.

Residual: Residual stimuli are any other phenomena arising from a person’s internal or external

environment that may affect the focal stimulus but whose effects are unclear. The residual

stimuli of the menopausal women’s are psychological, BMI, age, parity, duration of menopause.

Roy’s categorizes the coping mechanisms into either the regulator or the cognator

subsystem. The coping mechanisms are,

Regulator subsystem: It occurs through neural, chemical and endocrine processes. In this study

the regulator subsystem is decrease estrogen and progesterone level, decreased calcium and

weakness.

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Cognator subsystem: It occurs through cognitive and emotive processes. The cognator

subsystems for the present study are tension, restless, irritability, depression and mood swing.

In Roy’s theory person as an adaptive system: This Roy’s theory of the person as an adaptive

system postulates that the four adaptive modes,

The physiological adaptive mode

The self concept adaptive mode

The role function adaptive modes

Inter dependent adaptive modes are interrelated through perception.

The physiological adaptive mode:

Refers to the way a person responds as a physical being to stimuli from the environment.

The five physiological needs of this mode are oxygenation, nutrition, elimination, activity and

rest and protection. The menopausal women has the physiological adaptation as nutritional

problem as indigestion, elimination problem like frequency of micturition and dysuria, activity

intolerance like tiredness, self-protection alteration like decreased alertness.

The self concept adaptive mode:

The self concept adaptive mode refers to psychological and characteristics of the persons.

Body image changes, interruption of self consistency, self ideal moral, ethical and spiritual

problems are the self concept adaptive mechanisms of menopausal women.

Interdependent adaptive mode: The interdependent adoptive mode refers to coping

mechanism arising from close relationship that results in the giving and receiving of love respect

and value. Lack of love and affection with spouse are causing interdependent adaptive problems.

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Focal stimuli:

Symptoms of menopause

Contextual stimuli:

Withdrawal of estrogen +ve adaptation

Hormone.

Residual stimuli: - ve adaptation

Psychological, BMI, age,

Parity, duration of

Menopause.

Feed back

Physiological function:

Frequency of micturition,

dryness of vagina, joint and

leg pain, insomnia, itching of

vagina.

Self concept:

Body image changes,

interruption of self

consistency, self moral, ethical

and spiritual self.

Inter dependence adaptive

mode:

Lack of love and affection

with spouse.

Coping mechanisms

Regulator:

Decreased estrogen

level and progesterone,

and calcium level,

weakness.

Cognator:

Tension, restless,

irritability, depression,

mood

Administration

of vitamin E

200IU twice

daily for 4

weeks

Reduction of menopausal symptoms.

No reduction of menopausal symptoms.

INPUT CONTROL PROCESS EFFECTORS OUT PUT INTERVENTION

Fig: 1 Conceptual Framework on Roy’s Adaptation Model (1970)

Thank you..,

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