Theorists In Nursing

Theorist

Focus / Development

Views of Components

Developed and described the first theory of nursing. She focused the on changing and manipulating the environment in order to put the patient in best possible conditions for nature to act. She believed that in the nurturing environment, the body could repair itself. Client’s environment is manipulated to include appropriate noise, nutrition, hygiene, light, comfort, socialization and hope.

Person: An individual with vital reparative processes to deal with disease. Environment: External conditions that affect life and individuals development. Health: Focus is on the reparative process of getting well. Nursing: Goal is to place the individual in the best condition for good healthcare.

Hildegard Peplau (1952), Interpersonal Relations in Nursing.

She identifies four phases of the nurse-client relationship namely: ORIENTATION, IDENTIFICATION, EXPLOITATION, RESOLUTION.

P: An organism striving to reduce tension generated by needs. E: The interpersonal process is always included, and psychodynamic milieu receives attention, with emphasis on the client’s culture and mores. H: Ongoing human process that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living. N: Interpersonal therapeutic process that “functions cooperatively with others human processes that make health possible for individuals in communities. Nursing is an educative instrument, a maturing force that aims to promote forward movement of personality.

Virginia Henderson (1955) The Nature of Nursing.

She identified fourteen basic needs. She postulated that the unique function of the nurse is to assist the clients, sick or well, in the performance of those activities contributing to health or its recovery, that clients would perform unaided if they had the necessary strength, will or knowledge.

P: Individual requiring assistance to achieve health and independence or a peaceful death. Mind and body are inseparable. E: All external conditions and influences that affect life and development. H: Equated with independence, viewed in terms of the client’s ability to perform 14 components of nursing care unaided: breathing, eating, drinking, maintaining comfort, sleeping, resting clothing, maintaining body temperature, ensuring safety, communicating, worshiping, working, recreation,

Florence Nightingale (1860), Notes on Nursing: What It Is, What It Is Not.

and continuing development. N: Assists and supports the individual in life activities and the attainment of independence. Faye Glenn Abdellah (1960), Patient Centered Approaches to Nursing.

To deliver nursing care for the whole individual.

P: The recipients of nursing care having physical, emotional, and sociologic needs that may be overt or covert. E: Not clearly defined. Some discussion indicates that clients interact with their environment, of which nurse is a part. H: a state when the individual has no unmet needs and no anticipated or actual impairment. N: Broadly grouped in “21 nursing problems,” which center needs for hygiene, comfort, activity, rest, safety, oxygen, nutrition, elimination, hydration, physical and emotional health promotion, interpersonal relationships, and development of self-awareness. Nursing care is doing something for an individual.

Ida Jean Orlando (1961) The Dynamic Nurse-Patient Relationship.

She believed that the nurse helps patients meet a perceived needs that the patient cannot meet for themselves. To interact with clients to meet immediate needs by identifying client behaviors, nurse’s reactions, and nursing actions to take.

P: Unique individual behaving verbally nonverbally. Assumption is that individuals are at times able to meet their own needs and at other times unable to do so. Assumption is that being without emotional or physical discomfort and having a sense of well-being contribute to a healthy state. N: Professional nursing is conceptualized as finding out and meeting the client’s immediate need for help.

Lydia Hall (1964), Nursing: What Is It?

To provide professional nursing care to people past the acute stage of illness. She conceptualized three components of Nursing: CARE, CORE, and CURE. Care represents nurturance and is exclusive to nursing. Core involves the therapeutic use of self and emphasizes the use of reflection. Cure focuses on nursing related to the physician’s order.

P: Client is composed of body, pathology, and person. People set their own goals and are capable of learning and growing. E: Should facilitate achievement of the client’s personal goals. H: Development of a mature selfidentity that assists in the conscious selection of actions that facilitate growth. N: Caring is the nurse’s primary function. Professional nursing is most important during the recuperative period.

Ernestine Wiedenbach (1964), Clinical Nursing – A Helping Art.

To assist the individuals in overcoming obstacles that prevent meeting healthcare needs. She advocated that the nurse’s individual philosophy or central

P: Any individual who is receiving help from a member of the health profession or from a worker in the field of health. E: Not specifically addressed.

purpose lends credence to nursing care. She believed that nurses meet the individual’s need for help through identification of needs, administration of help, and validation that actions were helpful. Components of clinical practice: Philosophy, Purpose, Practice and an Art.

H: Concepts of nursing, client, and need for help and their relationships imply health-related concerns in the nurse—client relationship.. N: the nurse is a functional human being who acts, thinks, and feels. All actions, thoughts, and feelings underlie what the nurse does.

Joyce Travelbee (1966, 1971), Interpersonal Aspects of Nursing.

To assist individuals, families, communities, and groups to prevent or cope with illness, regain health, finding meaning in illness, or maintaining, maximal degree of health. She further viewed that interpersonal process is a human-to-human relationship formed during illness and “experience of suffering”.

P: A unique, irreplaceable individual who is in a continuous process of becoming, evolving, and changing. H: Heath includes the individual’s perceptions of health and the absence of disease. N: An interpersonal process whereby the professional nurse practitioner assists an individual, family, or community to prevent or cope with the experience of illness and suffering, and if necessary, to find meaning in these experiences.

Martha Rogers (1970), The Science of Unitary Man.

To assist the client in achieving a maximum level of wellness. To Rogers, unitary man is an energy field in constant interaction with the environment. She asserted that human beings are more than and different from the sum if their parts; the distinctive properties of the whole are significantly different from its parts. Furthermore, she believed that human being is characterized by the capacity for abstraction and imagery, language and thought, sensation and emotion.

P: Unitary man, a fourdimensional energy field. E: Encompasses all that is outside any given human field. Person exchanging matter and energy. H: Not specifically addressed, but emerges out of interaction between human and environment, moves forward, and maximizes human potential. N: A learned profession that is both science and art. The professional practice of nursing is creative and imaginative and exists to serve people.

Imogene M. King (1971, 1981), Open Systems Model, Goal Attainment Theory.

To communication to help the client reestablish a positive adaptation to his or her environment. She described nursing as a helping profession that assists individuals and groups in society to attain, maintain, and restore health. If this is not possible, nurses help individuals die with dignity. In addition, King viewed nursing as an interaction process between client and nurse whereby during perceiving, setting goals, and acting on them, transactions occur and goals are achieved.

P: Biopsychosocial being. E: Internal and external environment continually interacts to assist in adjustments to change. H: A dynamic life experience with continued goal attainment and adjustment to stressors. N: Perceiving, thinking, relating, judging, and acting with an individual who comes to a nursing situations.

Betty Neuman (1972, 1982, 1989, 1992)

To address the effects of stress and reactions to it on the

P: A client system that is composed of physiologic,

The Neuman System Model or Health Care System Model.

development and maintenance of health. The concern of nursing is to prevent stress invasion, to protect the client’s basic structure and to obtain or maintain a maximum level of wellness. The nurse helps the client, through primary, secondary, and tertiary prevention modes, to adjust to environmental stressors and maintain client stability

psychological, sociocultural, and environmental variables.

Myra Estrin Levine (1973), Conservation Model.

To use conservation activities aimed at optimal use of client’s resources. She advocated that nursing is a human interaction and proposed 4 conservation principles of nursing which are concerned with the unity and integrity of the individual. FOUR CONSERVATION PRINCIPLES:1.Conservation of energy2.Conservation of structural integrity3.Conservation of personal integrity4.Conservation of social integrity.

P: a holistic being. E: Broadly, includes all the individual’s experiences. H: The maintenance of the client’s unity and integrity. N: A discipline rooted in the organic dependency of the individual human being on his or her relationship with others.

Sister Callista Roy (1979) Adaptation Model.

To identify the types and demands placed on a client and client’s adaptation to the demands.

P: Biopsychological beign and the recipient of nursing care. E: All conditions, circumstances, and influences surrounding and affecting the development of an organism or groups of organisms. H: The person encounters adaptation problems in changing the environment. N: A theoretical system of knowledge that prescribes a process of analysis and action related to the care of the ill or potentially ill persons.

Jean Watson (1979) Nursing: Human Science and Human CareHuman Caring Model.

To focus on curative factors derived from a humanistic perspective and from scientific knowledge.

P: A valued being to be cared for, respected, nurtured, understood, and assisted, a fully functional, integrated self. E: Social environment, caring and the culture of caring affect health. H: Physical, mental, and social wellness. N: A human science of people and human health; illness experiences that are mediated by professional, personal, scientific, aesthetic, and ethical human care transactions.

Dorothy E. Johnson (1980), The Behavioral System Model for Nursing.

To reduce stress so the client can recover as quickly as possible. According to Johnson, each person as a behavioral system is

P: A system of interdependent parts with patterned, repetitive, and purposeful ways of behaving. E: All forces that affect the person

E: Internal and external forces surrounding humans at any time. H: Health or wellness exists if all parts and subparts are in harmony with the whole person. N: Nursing is a unique profession in that it is concerned with all the variables affecting an individual’s response to stressors.

Rosemarie Rizzo Parse (1981), Man-Living-Health:Theory of NursingHuman Becoming Theory.

composed of seven subsystems namely: INGESTIVE, ELIMINATIVE, AFFILIATIVE, AGGRESSIVE, DEPENDENCE, ACHIEVEMENT, and SEXUAL AND ROLE IDENTITY.In addition, she viewed that each person strives to achieve balance and stability both internally and externally and to function effectively by adjusting and adapting to environmental forces through learned pattern of response. Furthermore, She believed that the patient strives to become a person whose behavior is commensurate with social demands; who is able to modify his behavior in ways that support biologic imperatives; who is able to benefit to the fullest extent during illness from the health care professional’s knowledge and skills; and whose behavior does not give evidence of unnecessary trauma as a consequence of illness.

and that influence the behavioral system.

To focus on human as living unity and human’s qualitative participation with health experience. She emphasized free choice of personal meaning in relating value priorities, cocreating of rhythmical patterns, in exchange with the environment and contranscending in many dimensions as possibilities unfold. She also believed that each choice opens certain opportunities while closing others. Thus, referred to revealing-concealing, enablinglimiting, and connectingseparating. Since each individual makes his or her own personal choices, the role of the nurse is that of guide, not decision maker.

P: A major reason for nursing existence. E: Man and environment interchange energy to create what is in the world, and man chooses the meaning given to the situations he creates. H: A lived experience that is a process of being and becoming. N: Nursing Practice is directed toward illuminating and mobilizing family interrelationships in light of the meaning assigned to health and its possibilities as language in the cocreated patterns of relating.

H: Focus on person, not ill ness. Health is a dynamic state influenced by biologic, psychological, and social factors. N: Promotion of behavioral system, balance and stability. An art and a science providing external assistance before and during balance disturbances.