Gloria A.

Hagopian, RN, EdD 6/10/2014 1

Nursing Theorists
Gloria A. Hagopian, RN, EdD 6/10/2014 2
Definitions
Theory- a set of related statements that
describes or explains phenomena in a
systematic way
Concept-a mental idea of a phenomenon
Construct- a phenomena that cannot be
observed and must be inferred
Gloria A. Hagopian, RN, EdD 6/10/2014 3
Definitions
Proposition- a statement of
relationship between concepts

Conceptual model- made up of
concepts and propositions
Gloria A. Hagopian, RN, EdD 6/10/2014 4
Nursing Theorists
Florence Nightingale, Hildegard
Peplau, Virginia Henderson, Fay
Abdella, Ida Jean Orlando, Dorothy
Johnson, Martha Rogers, Dorothea
Orem, Imogene King, Betty Neuman,
Sister Calista Roy, Jean Watson,
Rosemary Rizzo Parse, Madeleine
Leininger, Patricia Benner
Gloria A. Hagopian, RN, EdD 6/10/2014 5
Concepts in the
nursing metaparadigm
Person
Recipient of care, including physical,
spiritual, psychological, and sociocultural
components
Individual, family, or community
Gloria A. Hagopian, RN, EdD 6/10/2014 6
Concepts in the nursing
metaparadigm
Environment
All internal and external conditions,
circumstances, and influences affecting
the person
Gloria A. Hagopian, RN, EdD 6/10/2014 7
Concepts in the nursing
metaparadigm
Health
Degree of wellness or illness experienced
by the person
Gloria A. Hagopian, RN, EdD 6/10/2014 8
Concepts in the nursing
metaparadigm
Nursing
Actions, characteristics and attributes of
person giving care
Gloria A. Hagopian, RN, EdD 6/10/2014 9
Florence Nightingale
Environmental Theory
First nursing theorist
Unsanitary conditions posed health hazard
(Notes on Nursing, 1859)
5 components of environment
ventilation, light, warmth, effluvia, noise
External influences can prevent, suppress or
contribute to disease or death
Gloria A. Hagopian, RN, EdD 6/10/2014 10
Nightingales Concepts
Person
Patient who is acted on by nurse
Affected by environment
Has reparative powers

Environment
Foundation of theory. Included
everything, physical, psychological, and
social
Gloria A. Hagopian, RN, EdD 6/10/2014 11
Nightingales Concepts
Health
Maintaining well-being by using a
persons powers
Maintained by control of environment

Nursing
Provided fresh air, warmth, cleanliness,
good diet, quiet to facilitate persons
reparative process
Gloria A. Hagopian, RN, EdD 6/10/2014 12
Hildegard Peplau
Interpersonal Relations
Model

Gloria A. Hagopian, RN, EdD 6/10/2014 13
Hildegard Peplau
Interpersonal
Relations Model
Based on psychodynamic nursing
using an understanding of ones own
behavior to help others identify their
difficulties
Applies principles of human relations
Patient has a felt need
Gloria A. Hagopian, RN, EdD 6/10/2014 14
Peplaus Concepts
Person
An individual; a developing
organism who tries to reduce anxiety
caused by needs
Lives in instable equilibrium
Environment- Not defined
Gloria A. Hagopian, RN, EdD 6/10/2014 15
Peplaus Concepts
Health
Implies forward movement of the
personality and human processes
toward creative, constructive,
productive, personal, and
community living
Gloria A. Hagopian, RN, EdD 6/10/2014 16
Peplaus Concepts
Nursing
A significant, therapeutic,
interpersonal process that functions
cooperatively with others to make
health possible
Involves problem-solving
Gloria A. Hagopian, RN, EdD 6/10/2014 17
Virginia Henderson
Gloria A. Hagopian, RN, EdD 6/10/2014 18
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.
Gloria A. Hagopian, RN, EdD 6/10/2014 19
Virginia Henderson
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.
Gloria A. Hagopian, RN, EdD 6/10/2014 20
Virginia Henderson
She 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 young mother, the
mouthpiece for those too weak or
withdrawn to speak, and so on.
Gloria A. Hagopian, RN, EdD 6/10/2014 21
Fay Abdella- Topology of
21 Nursing Problems
Gloria A. Hagopian, RN, EdD 6/10/2014 22
Fay Abdella
Topology of 21 Nursing
Problems
A list of 21 nursing problems
Condition presented or faced by the
patient or family.
Problems are in 3 categories
physical, social and emotional
The nurse must be a good problem
solver
Gloria A. Hagopian, RN, EdD 6/10/2014 23
Abdellas Concepts
Nursing
A helping profession
A comprehensive service to meet patients
needs
Increases or restores self-help ability
Uses 21 problems to guide nursing care
Health
Excludes illness
No unmet needs and no actual or
anticipated impairments

Gloria A. Hagopian, RN, EdD 6/10/2014 24
Abdellas Concepts
Person
One who has physical, emotional, or
social needs
The recipient of nursing care.
Environment
Did not discuss much
Includes room, home, and community
Gloria A. Hagopian, RN, EdD 6/10/2014 25
Ida Jean Orlando
Deliberative Nursing Process

Gloria A. Hagopian, RN, EdD 6/10/2014 26
Ida Jean Orlando
Deliberative Nursing Process
The deliberative nursing process is set in
motion by the patients behavior
All behavior may represent a cry for help.
Patients behavior can be verbal or non-
verbal.
The nurse reacts to patients behavior and
forms basis for determining nurses acts.
Perception, thought, feeling
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Ida Jean Orlando
Deliberative Nursing
Process
Nurses actions should be deliberative,
rather than automatic
Deliberative actions explore the
meaning and relevance of an action.
Gloria A. Hagopian, RN, EdD 6/10/2014 28
Dorothy Johnson
Behavioral Systems Model
Gloria A. Hagopian, RN, EdD 6/10/2014 29
Dorothy Johnson
Behavioral Systems Model
The person is a behavioral system
comprised of a set of organized,
interactive, interdependent, and
integrated subsystems
Constancy is maintained through
biological, psychological, and sociological
factors.
Gloria A. Hagopian, RN, EdD 6/10/2014 30
Dorothy Johnson
Behavioral Systems
Model

A steady state is maintained through
adjusting and adapting to internal and
external forces.
Gloria A. Hagopian, RN, EdD 6/10/2014 31
Johnsons 7 Subsystems
Affiliative subsystem
social bonds
Dependency
helping or nuturing
Ingestive
food intake
Eliminative
excretion
Gloria A. Hagopian, RN, EdD 6/10/2014 32
Dorothy Johnson
Behavioral Systems
Model 7 Sub Systems
Sexual
procreation and gratification
Agressive
self-protection and preservation
Achievement
efforts to gain mastery and control
Gloria A. Hagopian, RN, EdD 6/10/2014 33
Johnsons Concepts
Person
A behavioral system comprised of
subsystems constantly trying to maintain
a steady state
Environment
Not specifically defined but does say
there is an internal and external
environment
Gloria A. Hagopian, RN, EdD 6/10/2014 34
Dorothy Johnson
Behavioral Systems
Model
Health
Balance and stability.
Nursing
External regulatory force that is indicated
only when there is instability.
Gloria A. Hagopian, RN, EdD 6/10/2014 35
Martha Rogers
Unitary Human Beings
Gloria A. Hagopian, RN, EdD 6/10/2014 36
Martha Rogers
Unitary Human Beings
Energy fields
Fundamental unity of things that are
unique, dynamic, open, and infinite
Unitary man and environmental field
Universe of open systems
Energy fields are open, infinite, and
interactive
Gloria A. Hagopian, RN, EdD 6/10/2014 37
Martha Rogers
Unitary Human Beings
Pattern
Characteristic of energy field
A wave that changes, becomes complex
and diverse
Four dimensionality
A nonlinear domain with out time or
space
Gloria A. Hagopian, RN, EdD 6/10/2014 38
Rogers Definitions
Integrality
Continuous and mutual interaction
between man and environment
Resonancy
Continuous change longer to shorter
wave patterns in human and
environmental fields
Gloria A. Hagopian, RN, EdD 6/10/2014 39
Martha Rogers
Unitary Human Beings
Helicy
Continuous, probabilistic, increasing
diversity of the human and
envrionmental fields.
Characterized by nonrepeating
rhymicities
Change
Gloria A. Hagopian, RN, EdD 6/10/2014 40
Dorothea Orem
Self-Care Model
Gloria A. Hagopian, RN, EdD 6/10/2014 41
Dorothea Orem
Self-Care Model
Self-care comprises those activities
performed independently by an
individual to promote and maintain
person well-being

Self care agency is the individuals
ability to perform self care activities
Gloria A. Hagopian, RN, EdD 6/10/2014 42
Dorothea Orem
Self-Care Model
Self- care deficit occurs when the
person cannot carry out self-care

The nurse then meets the self-care
needs by acting or doing for;guiding,
teaching, supporting or providing the
environment to promote patients
ability
Gloria A. Hagopian, RN, EdD 6/10/2014 43
Dorothea Orem
Self-Care Model
Wholly compensatory nursing system
Patient dependent
Partially compensatory
Patient can meet some needs but needs
nursing assistance
Supportive educative
Patient can meet self care requisites, but
needs assistance with decision making or
knowledge
Gloria A. Hagopian, RN, EdD 6/10/2014 44
Imogene King
Goal Attainment Theory
Gloria A. Hagopian, RN, EdD 6/10/2014 45
Imogene King
Goal Attainment Theory
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
Gloria A. Hagopian, RN, EdD 6/10/2014 46
Imogene King
Goal Attainment Theory
Personal System
Individual; perception, self, growth,
development, time space, body image
Interpersonal
Socialization; interaction, communication
and transaction
Society
Family, religious groups, schools, work,
peers
Gloria A. Hagopian, RN, EdD 6/10/2014 47
Imogene King
Goal Attainment Theory
The nurse and patient mutually
communicate, establish goals and take
action to attain goals
Gloria A. Hagopian, RN, EdD 6/10/2014 48
Imogene King
Goal Attainment Theory
Each individual brings a different set
of values, ideas, attitudes, perceptions
to exchange
Gloria A. Hagopian, RN, EdD 6/10/2014 49
Betty Neuman
Systems Model
Gloria A. Hagopian, RN, EdD 6/10/2014 50
Betty Neuman
Health Care
Systems Model
The person is a complete system, with
interrelated parts
maintains balance and harmony
between internal and external
environment by adjusting to stress
and defending against tension-
producing stimuli
Gloria A. Hagopian, RN, EdD 6/10/2014 51
Betty Neuman
Health Care
Systems Model
Focuses on stress and stress reduction
Primarily concerned with effects of
stress on health
Stressors are any forces that alter the
systems stability
Gloria A. Hagopian, RN, EdD 6/10/2014 52
Betty Neuman
Health Care
Systems Model
Flexible lines of resistance
Surround basic core
Internal factors that help defend against
stressors
Normal line of resistance
Normal adaptation state
Flexible line of defense
Protective barrier, changing, affected by
variables
Gloria A. Hagopian, RN, EdD 6/10/2014 53
Betty Neuman
Systems Model
Wellness is equilibrium

Nursing interventions are activites to:
strengthen flexible lines of defense
strengthen resistence to stressors
maintain adaptation
Gloria A. Hagopian, RN, EdD 6/10/2014 54
Sister Calista Roy
Adaptation Model
Gloria A. Hagopian, RN, EdD 6/10/2014 55
Sister Calista Roy
Adaptation Model
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
Gloria A. Hagopian, RN, EdD 6/10/2014 56
Sister Calista Roy
Adaptation Model
The person is an open adaptive system
with input (stimuli), who adapts by
processes or control mechanisms
(throughput)

The output can be either adaptive
responses or ineffective responses
Gloria A. Hagopian, RN, EdD 6/10/2014 57
Jean Watson
Philosophy and Science of
Caring
Gloria A. Hagopian, RN, EdD 6/10/2014 58
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
Gloria A. Hagopian, RN, EdD 6/10/2014 59
Jean Watson
Philosophy and
Science of Caring
A caring environment offers
development of potential
Caring promotes health better
than curing
Caring is central to nursing
Gloria A. Hagopian, RN, EdD 6/10/2014 60
Watsons 10 Carative
Factors
Forming humanistic-altruistic
value system
Instilling faith-hope
Cultivating sensitivity to self and
others
Gloria A. Hagopian, RN, EdD 6/10/2014 61
Watsons 10 Carative
Factors
Developing helping-trust
relationship
Promoting expression of feelings
Using problem-solving for
decision making
Gloria A. Hagopian, RN, EdD 6/10/2014 62
Watsons 10 Carative
Factors
Promoting teaching-learning
Promoting supportive environment
Assisting with gratification of human
needs
Allowing for existential-
phenomenological forces
Gloria A. Hagopian, RN, EdD 6/10/2014 63
Watsons Concepts
Person
Human being to be valued, cared
for, respected, nurtured, understood
and assisted
Environment
Society
Gloria A. Hagopian, RN, EdD 6/10/2014 64
Jean Watson
Philosophy and
Science of Caring
Health
Complete physical, mental and
social well-being and functioning
Nursing
Concerned with promoting and
restoring health, preventing illness
Gloria A. Hagopian, RN, EdD 6/10/2014 65
Rosemary Parse
Human Becoming Theory
Human Becoming Theory includes
Totality Paradigm
Man is a combination of biological,
psychological, sociological and spiritual
factors
Simultaneity Paradigm
Man is a unitary being in continuous,
mutual interaction with environment
Originally Man-Living-Health Theory
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Parses Three Principles
Meaning
Mans reality is given meaning through
lived experiences
Man and environment cocreate
Rhythmicity
Man and environment cocreate ( imaging,
valuing, languaging) in rhythmical
patterns
Gloria A. Hagopian, RN, EdD 6/10/2014 67
Parses Three Principles
Cotranscendence
Refers to reaching out and beyond
the limits that a person sets
One constantly transforms
Gloria A. Hagopian, RN, EdD 6/10/2014 68
Rosemary Parse
Human BecomingTheory
Person
Open being who is more than and
different from the sum of the parts
Environment
Everything in the person and his
experiences
Inseparable, complimentary to and
evolving with
Gloria A. Hagopian, RN, EdD 6/10/2014 69
Rosemary Parse

Health
Open process of being and becoming.
Involves synthesis of values
Nursing
A human science and art that uses an
abstract body of knowledge to serve
people
Human BecomingTheory
Gloria A. Hagopian, RN, EdD 6/10/2014 70
Madeleine Leininger
Culture Care Diversity and
Universality
Based on transcultural nursing, whose
goal is to provide care congruent with
cultural values, beliefs, and practices
Sunrise model consists of 4 levels that
provide a base of knowledge for
delivering cultural congruent care
Gloria A. Hagopian, RN, EdD 6/10/2014 71
Madeleine Leininger
Culture Care Diversity
Modes of nursing action
Cultural care preservation
help maintain or preserve health, recover
from illness, or face death
Cultural care accommodation
help adapt to or negotiate for a beneficial
health status, or face death
Cultural care re-patterning
help restructure or change lifestyles that are
culturally meaningful
Gloria A. Hagopian, RN, EdD 6/10/2014 72
Patricia Benner
From Novice to Expert
Gloria A. Hagopian, RN, EdD 6/10/2014 73
Patricia Benner
From Novice to
Expert
Described 5 levels of nursing
experience and developed exemplars
and paradigm cases to illustrate each
level

Gloria A. Hagopian, RN, EdD 6/10/2014 74
Patricia Benner
From Novice to
Expert
Levels reflect:
movement from reliance on past abstract
principles to the use of past concrete
experience as paradigms
change in perception of situation as a
complete whole in which certain parts are
relevant
Gloria A. Hagopian, RN, EdD 6/10/2014 75
Patricia Benner
From Novice to
Expert
Novice
Advanced beginner
Competent
Proficient
Expert
Gloria A. Hagopian, RN, EdD 6/10/2014 76
Importance of Theoretical
Frameworks
Foundation of any profession is the
development of a specialized body of
knowledge. Theories should be
developed in nursing, not borrow
theories form other disciplines
Gloria A. Hagopian, RN, EdD 6/10/2014 77
Next Steps
Responsibility of nurses to know and
understand theorists
Critically analyze theoretical
frameworks