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D e v e l o p me n t o f N u r s i n g T h e o r i e s
This page was last updated on September 9, 2013
I n t r o d u c t i o n
Theories are a set of interrelated concepts that give a systematic view of a
phenomenon (an observable f act or event) that is explanatory & predictive in
nature.
Theories are composed of concepts, def initions, models, propositions & are
based on assumptions.
Theory gives planners tools f or moving beyond intuition to design and evaluate
health behavior and health promotion interventions based on understanding of
behavior.[Robert T. Croyle (2005)].
They are derived through two principal methods; deductive reasoning and
inductive reasoning. Nursing theorists use both of these methods.
Theory is a creative and rigorous structuring of ideas that projects a tentative,
purposef ul, and systematic view of phenomena.
A theory makes it possible to organize the relationship among the concepts to
describe, explain, predict, and control practice
De f i n i t i o n
Concepts - Concepts are basically vehicles of thought that involve images.
Concepts are words that describe objects, properties, or events & are basic
components of theory.
Types:
1. Empirical concepts
2. Inf erential concepts
3. Abstract concepts
Models are representations of the interaction among and between the
concepts showing patterns.
The terms model and theory are of ten wrongly used interchangeably,
which f urther conf ounds matters.
In nursing, models are of ten designed by theory authors to depict the
belief s in their theory (Lancaster and Lancaster 1981).
They provide an overview of the thinking behind the theory and may
demonstrate how theory can be introduced into practice, f or example,
through specif ic methods of assessment.
Models are usef ul as they allow the concepts in nursing theory to be
successf ully applied to nursing practice (Lancaster and Lancaster
1981). Their main limitation is that they are only as accurate or usef ul as
the underlying theory.
Propositions - are statements that explain the relationship between the
concepts.
Process - it is a series of actions, changes or f unctions intended to bring about
a desired result. During a process one takes systemic & continuous steps to
meet a goal & uses both assessments & f eedback to direct actions to the goal.
A conceptual framework - directs how these actions are carried out. The
delivery of nursing care within the nursing process is directed by the way
specif ic conceptual f rameworks & theories def ine the person (patient), the
environment, health & nursing.
I m p o r t a n c e o f n u r s i n g t h e o r i e s
Nursing theory aims to describe, predict and explain the phenomenon of nursing
(Chinn and Jacobs1978).
It should provide the f oundations of nursing practice, help to generate f urther
knowledge and indicate in which direction nursing should develop in the f uture
(Brown 1964).
Theory is important because it helps us to decide what we know and what we

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need to know (Parsons1949).
It helps to distinguish what should f orm the basis of practice by explicitly
describing nursing.
The benef its of having a def ined body of theory in nursing include better patient
care, enhanced prof essional status f or nurses, improved communication
between nurses, and guidance f or research and education (Nolan 1996).
The main exponent of nursing caring cannot be measured, it is vital to have
the theory to analyze and explain what nurses do.
As medicine tries to make a move towards adopting a more multidisciplinary
approach to health care, nursing continues to strive to establish a unique body
of knowledge.
This can be seen as an attempt by the nursing prof ession to maintain its
prof essional boundaries.
T h e c h a r a c t e r i s t i c s o f t h e o r i e s
Theories are:
interrelating concepts in such a way as to create a dif f erent way of looking at
a particular phenomenon.
logical in nature.
generalizable.
bases f or hypotheses that can be tested.
increasing the general body of knowledge within the discipline through the
research implemented to validate them.
used by the practitioners to guide and improve their practice.
consistent with other validated theories, laws, and principles but will leave open
unanswered questions that need to be investigated.
Ba s i c p r o c e s s e s i n t h e d e v e l o p m e n t o f n u r s i n g
t h e o r i e s
Nursing theories are of ten based on & inf luenced by broadly applicable processes &
theories. Following theories are basic to many nursing concepts.
General System Theory
It describes how to break whole things into parts & then to learn how the parts
work together in systems. These concepts may be applied to dif f erent kinds of
systems, e.g. Molecules in chemistry, cultures in sociology, and organs in
Anatomy & Health in Nursing.
Adaptation Theory
It def ines adaptation as the adjustment of living matter to other living things & to
environmental conditions.
Adaptation is a continuously occurring process that ef f ects change & involves
interaction & response.
Human adaptation occurs on three levels :
1. The internal (self )
2. The social (others) &
3. the physical (biochemical reactions)
Developmental Theory
It outlines the process of growth & development of humans as orderly &
predictable, beginning with conception & ending with death.
The progress & behaviors of an individual within each stage are unique.
The growth & development of an individual are inf luenced by heredity,
temperament, emotional, & physical environment, lif e experiences & health
status.
Co m m o n c o n c e p t s i n n u r s i n g t h e o r i e s
Four concepts common in nursing theory that inf luence & determine nursing practice are:
The person (patient).
The environment
Health
Nursing (goals, roles, f unctions)
Each of these concepts is usually def ined & described by a nursing theorist, of ten
uniquely; although these concepts are common to all nursing theories. Of the f our

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concepts, the most important is that of the person. The f ocus of nursing, regardless of
def inition or theory, is the person.
Hi s t o r i c a l p e r s p e c t i v e s a n d k e y c o n c e p t s
1. Nightingale (1860): To f acilitate the bodys reparative processes by
manipulating clients environment
2. Peplau 1952: Nursing is; therapeutic interpersonal process.
3. Henderson 1955: The needs of ten called Hendersons 14 basic needs
4. Abdellah 1960: The nursing theory developed by Faye Abdellah et al (1960)
emphasizes delivering nursing care f or the whole person to meet the physical,
emotional, intellectual, social, and spiritual needs of the client and f amily.
5. Orlando 1962: To Ida Orlando (1960), the client is an individual; with a need; that,
when met, diminishes distress, increases adequacy, or enhances well-being.
6. Johnsons Theory 1968: Dorothy Johnsons theory of nursing 1968 f ocuses on
how the client adapts to illness and how actual or potential stress can af f ect the
ability to adapt. The goal of nursing to reduce stress so that; the client can move
more easily through recovery.
7. Rogers 1970: to maintain and promote health, prevent illness, and care f or and
rehabilitate ill and disabled client through humanistic science of nursing
8. Orem1971: This is self -care def icit theory. Nursing care becomes necessary
when client is unable to f ulf ill biological, psychological, developmental, or social
needs.
9. King 1971: To use communication to help client reestablish positive adaptation to
environment.
10. Neuman 1972: Stress reduction is goal of system model of nursing practice.
11. Roy 1979: This adaptation model is based on the physiological, psychological,
sociological and dependence-independence adaptive modes.
12. Watsons Theory 1979: Watsons philosophy of caring 1979 attempts to def ine
the outcome of nursing activity in regard to the; humanistic aspects of lif e.
Cl a s s i f i c a t i o n o f n u r s i n g t h e o r i e s
A. Depending On Function (Polit et al 2001)
1. Descriptive-to identif y the properties and workings of a discipline
2. Explanatory-to examine how properties relate and thus af f ect the discipline
3. Predictive-to calculate relationships between properties and how they occur
4. Prescriptive -to identif y under which conditions relationships occur
B. Depending on the Generalisability of their principles
1. Metatheory: the theory of theory. Identif ies specif ic phenomena through
abstract concepts.
2. Grand theory: provides a conceptual f ramework under which the key
concepts and
C. Principles of the discipline can be identified.
1. Middle range theory: is more precise and only analyses a particular situation
with a limited number of variables.
2. Practice theory: explores one particular situation f ound in nursing. It identif ies
explicit goals and details how these goals will be achieved.
D. Based on the philosophical underpinnings of the theories
1. Needs theories.
2. Interaction theories.
3. Outcome theories.
4. Humanistic theories.
1. Needs theories
These theories are based around helping individuals to f ulf ill their physical and
mental needs. Needs theories have been criticized f or relying too much on the
medical model of health and placing the patient in an overtly dependent position.
2.Interaction theories
As described by Peplau (1988), these theories revolve around the relationships
nurses f orm with patients.
Such theories have been criticized f or largely ignoring the medical model of
health and not attending to basic physical needs.
3. Outcome theories"
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Outcome theories portray the nurse as the changing f orce, who enables
individuals to adapt to or cope with ill health.
Outcome theories have been criticized as too abstract and dif f icult to implement
in practice.
4. Humanistic Theories
Humanistic theories developed in response to the psychoanalytic thought that a
persons destiny was determined early in lif e.
Humanistic theories emphasize a persons capacity f or self -actualization.
Humanists believe that the person contains within himself the potential f or
healthy & creative growth.
Carl Rogers developed a person centered model of psychotherapy that
emphasizes the uniqueness of the individual.
The major contribution that Rogers added to nursing practice is the
understandings that each client is a unique individual, so, person-centered
approach now practice in nursing.
Co n c l u s i o n
Theory and practice are related.
A theory presents a systematic way of understanding events or situations.
It is a set of concepts, def initions, and propositions that explain or predict these
events or situations by illustrating the relationships between variables.
Theories must be applicable to a broad variety of situations. They are, by nature,
abstract, and dont have a specif ied content or topic area. Like empty cof f ee
cups, theories have shapes and boundaries, but nothing inside. They become
usef ul when f illed with practical topics, goals, and problems. [Robert T. Croyle
(2005)]
Re f e r e n c e s
1. Robert T. Croyle (2005). Theory at a Glance: Application to Health Promotion and
Health Behavior (Second Edition). U.S. Department of Health and Human
Services, National Institutes of Health.
2. George B. Julia , Nursing Theories- The base f or prof essional Nursing Practice ,
3rd ed. Norwalk, Appleton & Lange.
3. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis f or Nursing
Philadelphia. Lippincott Williams& wilkins.
4. Meleis Ibrahim Af af (1997) , Theoretical Nursing : Development & Progress 3rd
ed. Philadelphia, Lippincott.
5. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed.
Philadelphia, Lippincott.
6. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing Concepts
Process & Practice 3rd ed. London Mosby Year Book.
7. Vandemark L.M. Awareness of self & expanding consciousness: using Nursing
theories to prepare nurse therapists Ment Health Nurs. 2006 Jul; 27(6) : 605-15
8. Reed PG, The f orce of nursing theory guided- practice. Nurs Sci Q. 2006
Jul;19(3):22


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