Nursing Theories

1) FLORENCE NIGHTINGALE:
ENVIRONMENTAL NURSING
THEORY
Often considered the first nurse
theorist
Defined nursing as the act of
utilizing the environment of the
patient to assist him in his
recovery.
Nightingales theory remains an
integral part of nursing and
healthcare today.

1) FLORENCE NIGHTINGALE:
ENVIRONMENTAL NURSING
THEORY
5 Factors for
Environment:

Pure or fresh air

Pure water
Efficient drainage
Cleanliness
Light,
especially
sunlight

Healtthy

direct

1) FLORENCE NIGHTINGALE: ENVIRONMENTAL NURSING THEORY

Nightingales general
concepts of Environmental
Sanitation includes:
Proper Ventilation
Adequate Lighting
Cleanliness
Adequate Warmth
Quiet
Diet

1) FLORENCE NIGHTINGALE: ENVIRONMENTAL NURSING THEORY

Application:
A. Nursing Practice
The principles of Nursing Practice by FN are
continuously used to this very day. With the advent of
technology and with it globalization, comes threats
from the environment.
> Global Warming
> Industrial Noise
> Air Pollution
> Fad Diets
> Vanity
Nurses of today still needs to:
Maintain Adequate Ventilation
Promote Adequate & Appropriate Nutrition
Maintain Normal Homeostatic Body
Temperature
Observe Basic Hygiene
Comfort Measures including Environmental
Sanitation

1) FLORENCE NIGHTINGALE: ENVIRONMENTAL NURSING THEORY

B. Nursing Education
St. Thomas & Kings College Hospital in London
- able to provide framework for the
establishment of Nursing Training Schools through
a Universal template that contains principles of
nursing training. It included instruction in Scientific
Principles & Practical Experience for the mastery of
skills
- FN advocated the separation of nursing
training from hospital to more appropriate learning
environment in the School or University setting. This
was advocated for FN believed the SNs role is to
learn the Art & Science of Nursing before being
employed in the Nursing Service.
- FN is also a strong proponent of practice
nursing in education. She believed that Good
Nursing only come from Good Education

2) VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL
NEEDS
Assisting sick or
healthy individuals to
gain independence in
meeting 14
fundamental needs
Patient-centered

2) VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS
Virginia Hendersons 14 Fundamental Needs of a
Person
1) Breathing normally
2) Eating and drinking adequately
3) Eliminating body waste
4) Moving and maintaining a desirable position
5) Sleeping and resting
6) Selecting suitable clothes
7) Maintaining body temperature within normal
range by adjusting clothing and modifying the
environment

2) VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS
8) Keeping the body clean and well groomed
to protect the integument
9) Avoiding dangers in the environment and
avoiding injuring others
10) Communicating with others in expressing
emotions, needs, fears, or opinions
11) Worshipping according to ones faith
12) Working in a such way that one feels a
sense of accomplishment
13) Playing or 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

2) VIRGINIA HENDERSON:
FOURTEEN FUNDAMENTAL NEEDS
Application:

Bedside Nursing
- pt.s

ability to perform the 14 basic

needs should be assessed before
considering the kind of nursing care function
you will administer. Essential to determine if
the N will be performing as a HELPER,
DOER or a PARTNER
Nsg interventions are implemented
according to the 14 basic human needs of
the patient. The degree of performance,
involvement of the pt. and the level of
nursing activity will be dependent on the
specific role the nurse will be playing

3) FAYE ABDELLA:
PROBLEM SOLVING APPROACH
TO
21 NURSING PROBLEMS
Focus is on PROPER
IDENTIFICATION of
the problem
Particularly about the
proper
NURSING
DIAGNOSIS
Nurse-centered

3) FAYE ABDELLA:
PROBLEM SOLVING APPROACH TO 21 NURSING PROBLEMS

21 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
supply of oxygen.
6.To facilitate maintenance of
nutrition.
7.To facilitate maintenance of
elimination.

3) FAYE ABDELLA:
PROBLEM SOLVING APPROACH TO 21 NURSING PROBLEMS

8.To facilitate the maintenance of fluid and

electrolytes 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 function.
12.To identify and accept positive and
negative expressions, feelings and
reactions.
.

3) FAYE ABDELLA:
PROBLEM SOLVING APPROACH TO 21 NURSING PROBLEMS

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 interpersonal relationship.
16. To facilitate progress toward
achievement of personal spiritual
goals.
17. To create and maintain a
therapeutic environment.

3) FAYE ABDELLA:
PROBLEM SOLVING APPROACH TO 21 NURSING PROBLEMS

18. To facilitate awareness of self

as an individual with varying
needs.
19. To accept the optimum possible
goals.
20.To use community resources as
an aid in resolving problems
arising from illness.
21.To understand the role of social
problems as influencing factors.

3) FAYE ABDELLA:
PROBLEM SOLVING APPROACH TO 21 NURSING PROBLEMS

Application:
Bedside Nursing
The Ns ability to address &
effectively manage the 21 Nursing
problems will spell the patients
state of health whether he fully
recovers well & fast, or deteriorate
further with devastating
consequences
Ns therefore, have very
important role to play. By adhering
to these nursing problems, the
work of a N becomes More Definite

4) MADELEINE LEININGER:
TRANSCULTURAL NURSING
THEORY

Nursing is a HUMANISTIC and

SCIENTIFIC mode of helping
through
CULTURE-SPECIFIC
PROCESS

Emphasizes human caring

varies among cultures
Culture Care Preservation and
Maintenance
Culture Care Accommodation
and Negotiation
Culture Care Restructuring and
Repatterning

4) MADELEINE LEININGER:
TRANSCULTURAL NURSING THEORY
Application:
Important esp because of the rapid
expansion of knowledge & increasing
globalization with the advent of advances in
ICT.
Working Overseas
Impt to learn the cultures of other
people because each culture has its own sets
of patterns, expressions & values of caring.
Getting acquainted with the culture of
a country you are seeking employment as a
professional nurse will be a good stepping
stone towards a more fulfilling career in
nursing.

5) MARTHA ROGERS

SCIENCE of UNITARY HUMAN BEING

Views the person as a irreducible
whole, the whole being greater
than the sum of its parts
Man is composed of energy fields,
which are in constant interaction
with the environment
Seek to promote harmonic
interactions between the two
energy fields (Human and
Environmental)

5) MARTHA ROGERS
SCIENCE of UNITARY HUMAN BEING

Application
Her theory is relevant in
todays nurses focusing
on the Totality of the
Person. Nurses should
strive to promote
symphonic interaction
between the 2 energy
fields in order to
strengthen the coherence
& integrity of the person.

6) IMOGENE KING

GOAL ATTAINMENT THEORY

Patient has THREE (3) interacting

systems
Individuals / Personal systems
How the nurse views and integrates self based
from personal goals and beliefs.

Group systems / Interpersonal

systems
How the N interrelates w/ a co-workers or pt.
particularly in N-Pt. relationship

Social systems
how the N interacts w/ co-workers, superiors,
subordinates & the ct. environment in general

6) IMOGENE KING
GOAL ATTAINMENT THEORY
Action
A means of behavior or activities that are
towards the accomplishment of certain act. It is both
PHYSICAL & MENTAL.
Mental (POA)
Action (Goal Setting w/ Ct.)
Perform

Achieve Goal

Reaction
A form of reacting or response to a certain
Stimuli.

Interaction
Any situation wherein the N relates & deals
With a ct. or pt.

Transaction

6) IMOGENE KING
GOAL ATTAINMENT THEORY

Application:
Provides enough direction to how
nurses should be able to behave or
act in the presence of pts. Since
majority of nursing activities involves
direct interaction w/ pts., Ns should
understand the basic implications of
the Action-Reaction-InteractionTransaction model of the N-Pt.
Relationship.

7) HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL
Peplau is a psychiatric
nurse
Focus: Therapeutic
process
Attained through: Healthy
Nurse-Patient
Relationship

7) HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

Four (4) Phases of NursePatient Interaction

1. Orientation
Nurse and patient test the
role each one assumes
patient
for
Prepares
termination
Patient identifies areas of
difficulty

7) HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

2. Identification Phase
Patient identifies with
the personnel who can
satisfy his needs

3. Exploitation Phase
Nurse maximizes all the
resources to benefit the
patient

7) HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

4. Resolution Phase or
Termination Phase
Occurs when patients
needs have been met

7) HILDEGARD PEPLAU
INTERPERSONAL RELATIONS MODEL

Application
Significant in terms of the
different phases of the N-Pt.
interaction & the different ROLES the
N can play in giving nursing care to
pts. It thus becomes important for
nurses to understand the principles
behind each of these concepts so
that clinical nsg will be more
meaningful for the nurse. Eventually,
this will translate to pt. outcomes like:
Improved health
Prevention of Disease pr
Enhancement of care faculties

8) JEAN WATSON:
HUMAN CARING MODEL
Nursing involves the
application of ART and
HUMAN
SCIENCE
through
TRANSPERSONAL
TRANSACTIONS
in
order to help the person
achieve mind, body and
soul harmony

8) JEAN WATSON:
HUMAN CARING MODEL

7 Assumptions on the Science of

Caring
1.
2.
3.

4.

Caring can be effectively demonstrated

& practiced only interpersonally
Effective caring promotes health and
individual or family growth
Caring responses accept a person not
only as he or she is now but as what he
or she may become
A caring envi. Is one that offers the
devt of potential while allowing the
person to choose the best action for
himself at a given point in time.

8) JEAN WATSON:
HUMAN CARING MODEL
5. Caring is more healthogenic
than is curing. The practice of
caring integrates biophysical
knowledge w/ knowledge of
human behavior to generate or
promote hx & 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

8) JEAN WATSON:
HUMAN CARING MODEL
10 CARATIVE FACTORS
1.
2.
3.
4.
5.
6.

Formation of a Humanistic-Altruistic system

of values
Instillation of faith-Hope
Cultivation of sensitivity to ones self & to
others
Development of a helping-trusting, human
caring relationship
Promotion and acceptance of the
expression of positive & negative feelings;
Systematic use of a creative problemsolving caring process

8) JEAN WATSON:
HUMAN CARING MODEL
10 CARATIVE FACTORS
7. Promotion of transpersonal teaching-learning
8. Provision for a supportive, protective and
corrective mental, physical, societal &
spiritual environment
9. Assistance with gratification of human needs
10. Allowance for existential-phenomenologicalspiritual forces

8) JEAN WATSON:
HUMAN CARING MODEL
Application:
Her model of nursing reflects & embodies the
TRUE ESSENCE or nursing profession to this very
day. It viewed the pt. as the Mind-Body-Spirit entity
that needs holistic nursing care. It thus becomes a
must for all nurses to view each pt. in the light of
the caring theory of Watson.
One major implication of the theory is in the realm
of Bedside Nursing, where Ns of today have
particularly begun to neglect. The essence of
nursing is in the caring aspect & caring is taking the
wholeness, the totality of the pt. into consideration.
It is every Ns duty & obligation to care for his pt. not
by merely looking into and caring for his physical
dse.but try to care for the pt. for who he is.

9) IDA JEAN ORLANDO:

NURSING PROCESS THEORY

The Nursing Process is an interaction of Three Basic Elements:

1. Patients Behavior
2. Nurses reaction
3. Nursing Actions designed for the patients benefit
The Role of the Nurse is to find out & meet the Pts stat need for help. Ns should use his perception, thoughts about the perception or the feeling engendered from
their thoughts to explore with patients the meaning of their behavior

9) IDA JEAN ORLANDO:

NURSING PROCESS THEORY

The use of the theory keeps the Ns focus on the patient

Application:
The Theory increases the Therapeutic Effectiveness of nurses by
the expression of Empathy, Warmth & Genuineness esp in the light of
addressing the Stat Need of the Patient for help. This framework will be
important for Ns who are assigned in special clinical areas that requires
quick decision making & critical thinking skills.
If the patients condition improved, then the intervention is effective
and the patient moves on to new problems

10) JOYCE TRAVELBEE

INTERPERSONAL ASPECTS OF NURSING THEORY
Human to Human Relationship
Greatly emphasized on the
Therapeutic Human Relationship
between the Nurse & the Patient.
Her model emphasizes:
Empathy
Sympathy
Rapport & the
Emotional aspects of Nursing

4 Interlocking Phases that precedes

RAPPORT
And the establishment of N-Pt.
Relationship:
Original Encounter
Emerging Identities
Empathy

10) JOYCE TRAVELBEE

INTERPERSONAL ASPECTS OF NURSING THEORY
Human to Human Relationship
Application:
The theory describes the
various stages of interpersonal elations
that occur bet a Patient and a N. It thus
becomes important for Ns to fully
understand the phases and its effects
to the patients welfare. Due
consideration should be given to the
pts inherent personal characteristics
to interact w/ other people, most
especially Ns & other members of the
healthcare professions.
The key concept of Empthy,
Sympathy, Rapport & Emotional
Understanding are very important for
the Ns of today because it makes the

11) NOLA PENDER:

HEALTH PROMOTION MODEL
Focuses on 10 Categories of
determinants
of
healthPromoting Behaviors.
Views a persons healthpromoting behavior in the
light
of
his
individual
characteristics & experiences

11) NOLA PENDER:

HEALTH PROMOTION MODEL
The 10 Determinants are:

Prior related behavior

Perceived benefits of action
Perceived barriers of action
Perceived self-efficacy
Activity related effect
Interpersonal Influences (family, friends,
providers) norms, support & models
Situational Influences ( options, demand
characteristics, aesthetics)
Immediate competing demands (low
control) and preferences (high demand)
Commitment to a plan of action
Personal
Factors
(
Biological,
Psychological, Sociocultural)

11) NOLA PENDER:

HEALTH PROMOTION MODEL
Application:
Health Promotion Activities are the
major Focus of Hx Care Organizations.
In order for Patients to take on the
Behaviour we, Hx care professionals,
advise them to take, we should carefully
looked into a host of factors that can
influence his decision to really adopt the
behaviour.
It is important for Ns to be ROLE MODELS
for the pts.

12) BETTY NEUMAN:

HEALTH CARE SYSTEMS
MODEL
The model is based on
the
Persons
Relationship to Stress,
his Reaction to it and
Reconstitution factors
that are dynamic in
nature
The concern of nursing is to
PREVENT STRESS INVASION

12) BETTY NEUMAN:

HEALTH CARE SYSTEMS
MODEL

Person is viewed as an Open

System composed of Basic
Structure of Energy Resources
which includes:
Physiologic
Psychologic
Sociocultural
Developmental
Spiritual

12) BETTY NEUMAN:

HEALTH CARE SYSTEMS
MODEL

Basic Structure/Central Core

- surrounded by 2 concentric
boundaries
or Rings called
Lines Of Resistance which
represents the internal factors
that AID the person Defend
against a Stressor.
Lines of Resistance further
surrounded by 2 lines of
Defense
1. Normal Line of Defense
2. Flexible Line of Defense

12) BETTY NEUMAN:

HEALTH CARE SYSTEMS
MODEL
1. Normal Line of Defense
- persons state of equilibrium
or the state of adaptation developed
& maintained over time and which is
considered normal for the person
2. Flexible Line of Defense
- dynamic and can be readily and
rapidly changed over a short period
of time.
- adjusts to situations that threatens the imbalance
w/in the clients stability
Stressors:
Intrapersonal
Interpersonal
Extrapersonal

12) BETTY NEUMAN:

HEALTH CARE SYSTEMS
FOCUS MODEL
of Nursing Interventions :
- keeping or maintaining the stability of the open
system which can be carried out on three levels of
prevention
APPLICATION
Very comprehensive model of nsg that outlines the
way how Ns provide HOLISTIC NURSING CARE to
pts. Emphasis is on the management of Stress thru
adequate understanding of the complex client system.
Strong Advocate of Prevention Interventions which is
congruent to the aims of modern-day nsg & Hxcare
services. It is a MUST that Ns perform thorough &
comprehensive assessment that includes ALL
aspects of the Ct.

13) SISTER CALISTA ROY:

ADAPTATION MODEL
Man is a BIOPSYCHOSOCIAL
BEING
Four (4) modes of Adaptation
Physiologic Mode
Self Concept
Role Function
Interdependence

13) SISTER CALISTA ROY:

ADAPTATION MODEL
Her Model is best exemplified in
the Nursing Process which
includes the following steps:
1. Assessment of Behavior
2. Assessment of Stimuli
3. Nursing Diagnosis
4. Goal Setting
5. Intervention
6. Evaluation

13) SISTER CALISTA ROY:

ADAPTATION MODEL
APPLICATION

Best applied in the performance of the Nursing

Process which is cyclical in nature.
The Assessment component is the Stimuli or Input
The Planning & Implementation are the Throughput
process.
The Evaluation which provides necessary feedback to the
Goal of care is the Output.
The N decides what necessary actions should be
taken next in the light of the patients response to the Nursing
Interventions. This action by the N is Adaptation in its simplest
terms
Patients adopt too. The Nursing interventions we perform
ultimately elicits a response from them. Depending on the
nature & extent of the nursing interventions, pts may or may
not actually adopt according to our expectations

14) DOROTHEA OREM:

SELF CARE AND
SELF CARE DEFICIT THEORY

Three (3) Nursing Systems based on

Art of Care of Patient Needs
1. Wholly Compensatory or
Total Compensatory
For paralyzed patients, for ICU
patients
2. Partial Compensatory
Patient performs some
nursing care needs
3. Supportive-Educative
For up and about patient

of

14) DOROTHEA OREM:

SELF CARE AND
SELF CARE DEFICIT THEORY
APPLICATION

The elements of the theory clearly emphasize

the need to understand the importance of
self- care in the Promotion and maintenance of
Health & Wellbeing.
Focus on the pts capacity/ability to perform
self-care activities in order to determine which
self-care activities to perform for the client.

The model emphasizes on Education

& Supportive Measures
Health Education very important
aspect of clinical nursing today

15) PATRICIA BENNER

NURSING EXPERTISE MODEL
Her concern is:
How do Nurses learn to
do Nursing
Experience-based skill
acquisition is safer &
quicker when it is founded on
a sound educational base
Skill refers to Nursing
interventions and Clinical
judgment skills in actual
As
the N gains
experience, Clinical knowledge
clinical
situations.
becomes a GOOD MIX of PRACTICAL &
THEORETICAL KNOWLEDGE

15) PATRICIA BENNER

NURSING EXPERTISE MODEL

LEVELS OF SKILL ACQUISITION:

1. Novice
2. Advanced Beginner
3. Competent
4. Proficient
5. Expert

15) PATRICIA BENNER

NURSING EXPERTISE MODEL
APPLICATION

Instrumental in
differentiating knowledge
development & career
progression in Nursing.
It is important for Nursing
students and professional nurses
alike to learn through Experience
or by Experiential Learning.
Learning by experience will allow
you to gain Mastery of a given
skill.

16) LYDIA HALL

CORE, CARE, CURE MODEL

Individuals could be conceptualized in

3 Separate Domains:

1. CARE hands on bodily care

2. CORE using the self in relationship to the
client

3. CURE applying medical knowledge

Nurses function in all 3 Domains but in

different Degrees.
1. CURE limited to helping patients/families
deals w/ the measures instituted by the
physician
2. CARE exclusive for nursing
3. CORE shared w/ Social workers,
Psychologists, Clergy & other Professionals

16) LYDIA HALL

CORE, CARE, CURE MODEL
APPLICATION
Foundation for classifying the
Professional Ns functions today. Ns are able to
carry out Nursing Interventions
INDEPENDENTLY
DEPENDENTLY
INTERDEPENDENTLY

CORE maintains that it is the N responsibility

to make sure that the client receives the highest
level of care possible from all concerned Hx
Professionals. Ns ROLES: COLLABORATOR,
COORDINATOR and in COOPERATION with
other members of the HX team that pertains to
PATIENTS WELFARE.

16) LYDIA HALL

CORE, CARE, CURE MODEL
CURE clearly delineates nursing
functions that are DEPENDENT on the
members of the Medical Profession.
Interventions carried out needs a written
order from the doctor/s

CARE refers to the independent roles

& functions of the Nurse insofar as her
knowledge & skills about the patients
condition will allow her to carry on with
her Nursing Responsibilities

17) MYRA LEVINE:

FOUR CONSERVATION
PRINCIPLES OF NURSING
1. Conservation of Energy
Example: complete bed
rest without bathroom
privileges
2. Conservation of Structural
Integrity
Example: turn patient
from side to side every
two hours to avoid bed
sores

17) MYRA LEVINE:

FOUR CONSERVATION
PRINCIPLES OF NURSING
3.
Conservation
of
Personal Integrity
Example:
maintain
patients privacy
4. Conservation of Social
Integrity
Example: maintenance
of
patients
relationships

17) MYRA LEVINE:

FOUR CONSERVATION
PRINCIPLES OF NURSING
APPLICATION
Ns should be able to identify the
many Nurse-Patient activities which
are implied in the 4 Conservation
Models. It can be applied to geriatric
nursing where majority of the elderly
pts will have some problems in at least 2
of the conservation models.
Structural integrity focuses on the
bodys ability to ward of infections &
other bodily harm. It means that it is
important to keep these barriers skin &
mucous membranes - intact

18) MARJORIE GORDON:

HUMAN FUNCTIONAL HEALTH

PATTERNS
Focus is on Eleven
(11) Health Patterns
Advantage
to
the
nurse:
It enables the nurse
to determine the
clients response as
functional
or
dysfunctional

18) MARJORIE GORDON:

HUMAN FUNCTIONAL HEALTH

PATTERNS
Eleven Functional Health
Patterns

Health perception
Nutritional / Metabolic
Elimination
Activity and Exercise
Pattern
Cognitive Perceptual
Pattern

18) MARJORIE GORDON:

HUMAN FUNCTIONAL HEALTH

PATTERNS
Eleven Functional Health
Patterns
Sleep and Rest
Self perception / Self
concept
Role
Relationship
Pattern
Sexuality
/
Reproductive
Coping-StressTolerance
Value Belief Patterns

18) MARJORIE GORDON:

HUMAN FUNCTIONAL HEALTH

PATTERNS

SISTER LETTY G. KUAN

Dissertation: Retirement & Role Discontinuities
I

have grown and sown and

now I can reap the reward &
blessing of a life lived in joy
& love,
CONCEPTUAL
MODEL for I too have made
others grow
Determinants of Fruitful Aging
Prepared retirement
Health Status
Income
Family Constellation
Self-preparation

Retirement
Role Discontinuities
(Aging Process)

Change of Life

Outcome
Fruitful Retirement
And Aging

CARMENCITA ABAQUIN

Dissertation: PREPARE ME Interventions & the

Quality of Life of Advance Progressive Cancer
Patients
To Nursing may be able to
provide the care that our clients
need in maintaining their quality
of life and being instrumental in
Birthing them to External life
CONCEPTUAL FRAMEWORK

Holistic Nursing Intervention

PREPARE ME
Presence
Reminisce Therapy
Prayer
Relaxation Activities
Meditation
Value Clarification

Terminally ILL Patients

(CANCER)
Physical
Psychological
Social
Religious
Level of Independence
Environment
Spiritual

QUALITY
OF LIFE