Nursing Theories and Their Works

♣ Florence Nightingale (“Environmental Theory”)

- Nursing as “act of utilizing the environment of the patient to assist him in his recovery”
- Nightingale’s Concepts:
1. Person: Patient who is acted on by nurse; Affected by environment; has reparative powers
2. Environment: Foundation of theory; Included everything, physical, psychological, and social
3. Health: Maintaining well-being by using a person’s powers; Maintained by control of
environment
4. Nursing: Provided fresh air, warmth, cleanliness, and good diet, quiet to facilitate person’s
reparative process

♣ Virginia Henderson (“The Nature of Nursing”)

- "The unique function of the nurse is to assist the individual, sick or well, in the performance
of those activities contributing to health or its recovery (or to peaceful death) that he
would perform unaided if he had the necessary strength, will, or knowledge. And to do this
in such a way as to help him gain independence as rapidly as possible. She must in a sense,
get inside the skin of each of her patients in order to know what he needs".

♣ Dorothea Orem (“Self-Care Model”)

- Nursing is “ an art, a helping service and a technology”
- The theory includes:
♠ Self care – practice of activities that individual initiates and perform on their own behalf
in maintaining life ,health and well being
♠ Self care agency – is a human ability which is "the ability for engaging in self care"
-conditioned by age developmental state, life experience sociocultural orientation health
and available resources
♠ Therapeutic self care demand – "totality of self care actions to be performed for some
duration in order to meet self care requisites by using valid methods and related sets of
operations and actions"
♠ Self care requisites-action directed towards provision of self care.

♣ Sister Calista Roy (“Adaptation Model”)

- Nursing is “a theoretical system of knowledge that prescribes a process of analysis
and action related to the care of the ill or potentially ill person”
- Five Interrelated Essential Elements:
♠ Patiency- The person receiving care
♠ Goal of nursing- Adapting to change
♠ Health-Being and becoming a whole person
 ♠ Environment
♠ Direction of nursing activities- Facilitating adaptation

♣ Betty Neuman (“Health Care Systems Model”)

- Nursing is “a unique profession in that is concerned with all the variables affecting an
individual’s response to stressors, which are intra, inter, extra personal in nature”
- The model represents the client within the system perspective, holistically and multi-
dimensionally. It illustrates the components of five interacting client variables;
physiological, psychological, developmental, sociocultural and spiritual in relation to
environmental influences upon the client as a system consisting of basic structure, lines of
resistance and lines of defense.

♣ Martha Rogers (“Unitary Human Beings”)

- Nursing is “a humanistic science dedicated to the compassionate concern with and
maintaining and promoting health, preventing illness, and caring for and rehabilitating the
sick and disabled”

♣ Imogene King (“Goal Attainment Theory”)

- Nursing is “a helping profession that assists individuals and groups in society to
attain maintains and restores health. If this is not possible, nurses help individual die with
dignity”
- Open systems framework
- Human beings are open systems in constant interaction with the environment
- Personal System
♠ individual; perception, self, growth, development, time space, body image
♠ Interpersonal
♠ Society
- Personal System: Individual; perception, self, growth, development, time space, body
image
- Interpersonal: Socialization; interaction, communication and transaction
- Society: Family, religious groups, schools, work, peers
- The nurse and patient mutually communicate, establish goals and take action to
attain goals
- Each individual brings a different set of values, ideas, attitudes, perceptions to
exchange

♣ Hildegard Peplau (“Interpersonal Relations Model”)

- Based on psychodynamic nursing
- using an understanding of one’s own behavior to help others identify their difficulties
- Applies principles of human relations
- Patient has a felt need
♣ Peplau’s Concepts
1. Person: An individual; a developing organism who tries to reduce anxiety caused by needs;
Lives in instable equilibrium
2. Environment
3. Health: Implies forward movement of the personality and human processes toward creative,
constructive, productive, personal, and community living
4. Nursing: A significant, therapeutic, interpersonal process that functions cooperatively with
others to make health possible

♣ Jean Watson (“Philosophy and Science of Caring”)

- Caring can be demonstrated and practiced
- Caring consists of carative factors
- Caring promotes growth
- A caring environment accepts a person as he is and looks to what the person may become
- A caring environment offers development of potential
- Caring promotes health better than curing
- Caring is central to nursing

♣ Lydia Hall (“Care Core and Cure Theory”)

- The "Core, Care, and Cure" Theory was developed in the late 1960's. She postulated that
individuals could be conceptualized in three separate domains: the body (care), the illness,
(cure), and the person (core).
- Hall believed patients should receive care ONLY from professional nurses. Nursing involves
interacting with a patient in a complex process of teaching and learning. Hall was not pleased
with the concept of team nursing--she said that "any career that is defined around the work
that has to be done, and how it is divided to get it done, is a "trade" (rather than a
profession).

♣ Ida Jean Orlando (“Deliberative Nursing Process”)

- The deliberative nursing process is set in motion by the patient’s behavior
- All behavior may represent a cry for help. Patient’s behavior can be verbal or non-verbal.
- The nurse reacts to patient’s behavior and forms basis for determining nurse’s acts.
- Perception, thought, feeling
- Nurses’ actions should be deliberative, rather than automatic
- Deliberative actions explore the meaning and relevance of an action.

♣ Katherine Kolcaba (“Comfort Theory”)

- Holistic comfort is defined as the immediate experience of being strengthened
through having the needs for relief, ease, and transcendence met in four contexts of
experience (physical, psychospiritual, social, and environmental)