THEORIST AND THEORY IN VIEW OF METAPARADIGMS

THEORY NURSING PERSON HEALTH ENVIRONMENT

• Primary concern is to define the
• Humans = “men, women, and • Condition or degree of • Vital arena that is germane to the
BETTY NEUMAN appropriate action in situations
children cared for either singly system stability system and its function
that are stress-related
or as social units” • Continuum from • 3 relevant environments: internal,
Systems Model • Aims to help the system adapt
• “Material objects” of nurses wellness to illness external, created
or adjust…
• Humans = holistic beings that
SISTER CALLISTA • Nurses = facilitators of
are in constant interaction with • Conditions, circumstances, and
ROY adaptation • State where humans
their environment influences that affect humans’
• Assess patient’s behaviors for can continually adapt to
• Use a system of adaptation to development and behavior as an
Adaptation Model of adaptation, promote positive stimuli
respond to environmental adaptive system
Nursing adaptation…
stimuli
• Behavioral system with
• External force that acts to patterned, repetitive, and
DOROTHY JOHNSON • Elusive, dynamic state • Consists of all factors that are not
preserve the organization of the purposeful ways of behaving…
influenced by biological, part of the individual’s behavior
patient’s behavior by means of • System of interdependent parts
Behavioral Systems psychological, and social system, but that influence the
imposing regulatory that requires some regularity
Model factors system
mechanisms… and adjustment to maintain
balance or equilibrium
HILDEGARD PEPLAU • “Significant, therapeutic,
• Organism that “strives in its • “A word symbol that
interpersonal process”
own way to reduce tension implies forward • Consider the patient’s culture and
Theory of • “Human relationship between
generated by needs.” movement of mores (customs, norms)
Interpersonal an individual who is sick… and a
• Individual with a felt need personality…”
Relationship nurse…”
IDA JEAN ORLANDO • Individuality and the dynamic
• Unique and independent in its • Replaced by a sense of • Focuses on patient’s immediate
nature of the nurse-patient
concerns for an individual’s helplessness need
Theory of relationship
need for help in an immediate • Initiator of a necessity • Nurse and patient only, no families
Deliberative Nursing • Humans in need are the focus
situation for nursing or groups mentioned
Process of nursing practice
JOYCE TRAVELBEE • An interpersonal process • Illness – being unhealthy
whereby the nurse assists an • Subjective health – • Suffering – feeling of
Human-to-Human individual, family, or individually defined displeasure…; malignant phase of
Relationship Model community… • Unique irreplaceable individual, state of well-being…with disdainful “not caring” and
of Nursing a one time being self-appraisal apathetic indifference
• …continuous process of • Objective health – • Pain – not observable, unique
becoming, evolving, changing absence of discernible experience; lonely experience
disease, disability, or • Hope – desire to gain an end or
defect accomplish a goal
• Hopelessness – devoid of hope

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
NURSING PERSON HEALTH ENVIRONMENT
THEORY
ERNESTINE
WIEDENBACH

• • • •
Helping Art of
Clinical Nursing
Theory
NANCY ROPER
WINIFRED LOGAN
ALISON TIERNEY
• • • •
Model of Nursing
Based on Activities
of Living
• Individual, 16 years old or older, • Dealt with in relation to the
LYDIA HALL past the acute stage of long- individual
• Identified as consisting of
term illness • Loeb Center, hospital environment
participation in the care, core, • State of self-awareness
Care, Cure, Core • Motivation of healing is during treatment of acute illness
cure aspects of patient care
Theory of Nursing individual care recipient creates a difficult psychological
• Unique experience for the ill individual
• People having 21 physical,
FAYE GLENN • The focus is on individual, family,
emotional, and sociological
ABDELLAH and society
• Art or science aiming to help nursing problems • Needs a healthy state of
• Individuals are the main focus
people cope with needs • Overt – obvious, physical needs mind
21 Nursing Problems • Society is served by serving
• Covert – hidden, emotional,
Theory individuals
sociological, interpersonal
• Sum of parts with
• Temporarily assessing individual
biopsychosocial needs
• Attainment of independence
• Biological, psychological,
• Nurses serve to make the
sociological, spiritual
patient complete, whole,
• Mind and body are inseparable
independent • Settings in which an individual
VIRGINIA and interrelated • Individual’s ability to
• Carry out the physician’s learns a unique pattern for living
HENDERSON function independently
therapeutic plan • All external conditions and
• Good health is a
• Individualized care influences that affect life and
Nursing Need Theory challenge
• Nature of nursing role is “to get development
inside the patient’s skin and
supplement his strength, will, or
knowledge according to his
needs”

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Theory:
• Energy resources: physiologic, psychologic, sociocultural, developmental, spiritual
• Lines of resistance: first line of defense, second line of defense
• Stressors: intrapersonal, interpersonal, extrapersonal
• Levels of prevention: primary, secondary, tertiary

Major Concepts:
• Open system
• Created environment
“Nursing is a unique profession that • Client system – composed of five system variables (same as energy resources)
BETTY NEUMAN
is concerned with all of the • Basic client structure – core
variables affecting an individual’s • Lines of resistance
Systems Model
response to stress” • Flexible line of defense
• Preventive interventions: primary, secondary tertiary
• Reconstitution
• Level of stability

Nursing Process:
• Three-Step Nurisng Process (B-ADPIE): Assessment; Diagnosis, Planning, Implementation; Evaluation
• Assessment – looks at stressors, and variables
• DPI – goals and interventions are determined; Interventions: independent, dependent, interdependent
• Evaluation – goal met, goal unmet, goal partially met
Theory:
• Nursing Process (2A DGI E): Assessment of Behavior, Assessment of Stimuli, Nursing Diagnosis, Goal
Setting, Intervention, Evaluation
• Stimuli: focal, contextual, residual
• Four adaptive modes: physiological-physical, self-concept group identity, role function, interdependence
SISTER CALLISTA
• Physiological-physical: basic need, complex processes
ROY
• Roles: primary, secondary, tertiary

Adaptation Model of
Major Concepts:
Nursing
• Health
• Adaptation
• Adaptive responses
• Ineffective responses
• Adaptation levels: integrated, compensatory, compromised

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
• Born August 21, 1919 in Savannah, Georgia
• Early proponent of nursing as a science and art
• 1959 – effective nursing care = key concepts from basic and applied sciences
• 1961 – nursing care facilitated the client’s maintenance of a state of equilibrium
• Stress = internal or external = tensions or disturbances
• In order to return to a state of equilibrium, 1. Reduce stressful stimuli, 2. Support natural and adaptive
processes

Theoretical Sources:
• Nightingale’s belief that nursing’s goal is to help individuals prevent or recover from disease or injury
“Nursing is an external force that • Science and art = should focus on the patient as an individual
acts to preserve the organization of • System – consisting of interrelated parts functioning together to form a whole
the patient’s behavior by means of • Believed that a nurse should use the behavioral system as their knowledge base
imposing regulatory mechanisms or
by providing resources while the Theory:
DOROTHY JOHNSON patient is under stress” • 7 Subsystems of Human Behavior: attachment, achievement, aggressive, dependence, sexual,
ingestive, eliminative
Behavioral Systems • Three functional requirements: Each subsystem must be:
Model 1. Protected from noxious influences with which the system cannot cope
“All the patterned, repetitive, 2. Nurtured through the input of appropriate supplies from the environment
purposeful ways of behaving that 3. Stimulated for use to enhance growth and prevent stagnation
characterize each person’s life
make up an organized and Major Concepts:
integrated whole, or a system” • Behavior
• System: organization, interaction, interdependency, integration
• Behavioral system
• Subsystems
• Equilibrium
• Tension
• Stressor

Theory Assumptions:
• Assumptions about system
• Assumptions about structure
• Assumptions about functions

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
“Nursing is the interpersonal • “Mother of Psychiatric Mental Health Nursing”, “Nurse of the Century”
therapeutic process of functioning • Served as Executive Director and President of ANA
HILDEGARD PEPLAU
cooperatively with other human • 1850s – first nursing theory textbook since Nightingale’s work: credentialing, advanced nursing practice,
processes that make health psychodynamics, etc.
Theory of
possible for individuals in • Four psychobiological experiences: needs, frustrations, conflicts, anxieties
Interpersonal
communities through education
Relationship
that aims to promote forward Theory:
movement of personality” • 4 Phases of the Nurse-Patient Relationship: Orientation, Identification, Exploitation, Resolution
• 6 Proposed Nursing Roles: Stranger, Resource, Teaching, Counseling, Surrogate, Active Leadership
Background:
• Developed her theory from a study at Yale, integrating mental health concepts into basic nursing curriculum
• Theory focuses on how to produce improvement in patient’s behavior
• Proposed that patients have their own meanings and interpretations, therefore nurses must validate before
drawing conclusions

Theory:
• Stresses the reciprocal relationship of patient and nurse
• 1961 – Orlando: persons become patients when they have needs that they can’t meet independently
because of various factors
• Unmet needs = distress or feelings of helplessness
• Positive correlation between: length of time patient experiences unmet needs, and degree of distress =
IDA JEAN ORLANDO immediacy is emphasized
“Nursing is a profession that seeks • Role of nurse is to find out and meet the patient’s immediate need for help
Theory of to find out and meet the patient’s • 2006 – Schmieding
Deliberative Nursing immediate need for help” • 2011 – Abraham: fall reduction
Process
Nursing Process Theory: Three basic elements
• Behavior of the patient
• Reaction of the nurse
• Nursing actions which are designed for the patient’s benefit

Major Concepts:
• Need
• Presenting behavior of patient
• Immediate reactions
• Nursing process discipline
• Automatic nursing actions
• Deliberative nursing actions
Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
• Born 1926; psychiatric nurse, educator, writer
• 1956 – BSN, Louisiana State University
• 1959 – MS Nursing, Yale University
• 1973 – incomplete Doctorate because she died at 47 years old
• 1966, 1971 – first book: Interpersonal Aspects of Nursing
• 1969 – second book: Intervention in Psychiatric Nursing

Theory:
“…human-to-human relationship is • Spiritual values = perception of illness
the means through which the • Her model emphasizes: empathy, sympathy, rapport, emotional aspects
purpose of nursing is fulfilled”
Theoretical Sources:
JOYCE TRAVELBEE
• Catholic charity institutions
“A nurse is able to establish • Ida Jean Orlando – “The nurse is responsible for helping the patient avoid and alleviate the distress of
Human-to-Human
rapport…” unmet needs”
Relationship Model
• Viktor Frankl – theory of logotherapy (…reoriented toward the meaning of his life)
of Nursing

“A nurse does not only seek to Major Concepts:

alleviate physical pain or render • Therapeutic use of self
physical care…” • Communication
• Nurse-patient interaction
• Logical form
• Rapport
• Four interlocking phases (phases of experience): Original encounter, Emerging identities, Empathy,
Sympathy

Metaparadigm:
• Health: subjective health, objective health
• Environment: illness, suffering, pain, hope, hopelessness

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
• Experienced in the field of maternity nursing

Theory:
• Four elements in the Art of Nursing: Philosophy, Purpose, Practice, Art
• Philosophy (essential components): 1. Reverence for life, 2. Respect for the dignity, worth, autonomy, and
individuality of each human being, 3. Resolution to act on personally and professionally held beliefs
ERNESTINE • Art (includes): 1. Understanding the patient’s needs and concerns, 2. Developing goals and actions, 3.
“Nursing is the art of nurturing or
WIEDENBACH Directing activities
caring for someone in a motherly
fashion”
Helping Art of • Ways to identify patient’s need for help: Observing behavior…, Exploring the meaning of their behavior,
Clinical Nursing Determining the cause of discomfort or incapacity, Determining whether they can resolve problems
Maternity nursing
Theory
Major Concepts:
• The patient
• Need-for-help
• Clinical judgment
• Sound decisions
• Nursing skills
• Skills – characterized by harmony of movement, precision, and effective use of self
Theory:
• Life span approach – prior development, current level of development, likely future development
• Independence/Dependence continuum is used; 12 activities of living, whether sick or well
• 12 Activities of Living = Model of Living: maintaining a safe environment, breathing, communication,
mobilizing, eating and drinking, eliminating, personal cleansing and dressing, maintaining body temperature,
working and playing, sleeping, expressing sexuality, dying
NANCY ROPER • 5 factors that influence ADLs: biological, psychological, sociocultural, environmental, politico-economic
WINIFRED LOGAN • Health is a reflection of the person’s ability to perform the ADL
ALISON TIERNEY • Nursing Process: Assessing, Planning, Implementing, Evaluating
“Nursing is the practice of
assisting patients live through life”
Model of Nursing Major Concepts:
Based on Activities • Individuality of living
of Living • The activities of living
• Life span
• Dependence-independence continuum

Application:
• Theory of the Elements of Nursing: A Model Based on a Model of Living – importance of
developmental assessment and individualizing patient care
Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
• Born September 21, 1906 in New York City
• Died February 27, 1969
• Research in the field of rehabilitation of chronically ill patients
• Loeb Center for Nursing and Rehabilitation, Bronx, NYC
• She believed patients should receive care only from professional nurses; not pleased with team nursing

Theory:
• Care – sole function of nurses; Core, Cure – shared with other members of the health team
• Major purpose of care = achieve interpersonal relationship = development of the core
“Nursing is a distinct body of • Assumptions: motivation for healing exists within the patient; three aspects of nursing are interrelated and
knowledge that provides nursing
interact; and the circles change in size depending on patient’s progress
care to patients who are in need
of nursing care in support of
Major Concepts:
medical interventions, in
• Three Cs of Lydia Hall: Care, Cure, Core Theory
collaboration with other members
of the health team, or exclusively
LYDIA HALL CARE CURE CORE
and independently by the nurse
The disease, seeing the patient
itself” The body, intimate bodily care The person, therapeutic use of self
Care, Cure, Core and family through medical care
Theory of Nursing Refers to the role of nurses in
“There is nothing simple about Refers to medical interventions Refers to recipient of care
nurturing patients
patients who are complex human
Pathological and therapeutic
beings, or a nurse who is also Exclusive to nursing Social sciences
sciences
complex and who finds herself
Shared with physicians, physical Shared with social workers,
involved in the complexities of “Motherly care” provided by nurses
therapists, etc. psychologists, clergy, etc.
disease and health process in a
Applying medical knowledge The core has goals set by himself
complex helping relationship”

• Care Circle: nurturing = mothering + teaching-learning activities

• Cure Circle: administration of medications; geared towards treating the patient
• Core Circle: social, emotional, spiritual, intellectual needs; gain self-identity and maturity
• Reflective Technique
• Motivations
• Biological crisis

Strength: complete and logical; in all circles, the nurse is present

Weakness: plain and simple; age requirement (16 years old and above); focus is purely on the individual himself

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
• Born March 13, 1919 in NYC
• May 6, 1937 – German hydrogen-fueled airship Hindenburg exploded over Lakehurst
• Nursing diagnosis
• Two-star rear admiral, Deputy surgeon general
• Used Henderson’s 14 Basic Human Needs
• Three degrees: BSN (1945), MA Psych (1947), EdD (1955)
• Taught “120 Principles of Nursing Practice”
• Met Lucile Petry Leone (first Nurse Officer)
• Nursing education should be based on research

Major Concepts:
• Individual
• Health
FAYE GLENN “Nursing is based on art and
• Society
ABDELLAH science that molds the attitudes,
• Nursing problems: Overt, Covert
intellectual competencies, and
• Problem-solving
21 Nursing Problems technical skills of the individual
Theory nurse into the desire and ability to
Theory:
help people, sick or well, cope
• Four Categories: Basic Needs, Sustenal Care Needs, Remedial Care Needs, Restorative Care Needs
“Nurse-centered” with their help needs”
• Three Categories (Typology of 21 Nursing Problems): 1. Physical, sociological, and emotional needs of
patients; 2. Types of interpersonal relationships between the patient and nurse; 3. Common elements of
patient care
• 10 Steps to Identify the Patient’s Problems
• 11 Nursing Skills to Develop a Treatment Typology
• Nursing as a Comprehensive Service (10)
• Focus Care Pendulum

Nursing Process:
• Assessment, Nursing Diagnosis, Planning, Nursing Interventions, Evaluation

Theory Analysis, Strengths, Weaknesses, Conclusion:

• (/@_@)/ _|___|_

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024
 THEORIST AND
QUOTES
THEORY
Background:
• Born 1897, Died March 19, 1996
• “The Nightingale of Modern Nursing” “Modern-Day Mother of Nursing” “The 20th Century Florence
Nightingale” “The First Lady of Nursing”

Theory:
• Emphasized on increasing the patient’s independence
• Categorized nursing activities into 14 components, based on human needs
• Nurse’s Role: Substitutive, Supplementary, Complementary
• 3 Levels of Nurse-Patient Relationships: Substitutive (substitute, doing for the person), Supplementary
(helper, helping the person), Complementary (partner, working with the person)
• 14 Components of Nursing Needs Theory: Physiological components, Psychological Aspects of
Communicating and Learning, Spiritual and Moral, Sociologically Oriented to Occupation and Recreation
• Aka: physiological needs, psychological needs, spiritual needs, sociological needs
“The unique function of the nurse
is to assist the individual, sick or
Major Concepts:
well, in the performance of those
VIRGINIA • Patient
activities contributing to health or
HENDERSON • Nurse
its recovery (or to peaceful death)
• Independence
that he would perform unaided if
Nursing Need Theory • Empathic understanding
he had the necessary strength,
will or knowledge. And to do this
“Patient-centered” Nursing Process:
in such a way as to help him gain
• Assessment, Nursing Diagnosis, Planning, Nursing Interventions, Evaluation
independence as rapidly as
possible”
Characteristics:
• Interrelation of concepts
• Logical, simple, generalizable
• Applicable to all ages
• Maslow’s Hierarchy of Needs

Limitations:
• Lack of conceptual linkage, lack of interrelation of factors
• No concept of the holistic nature of human beings (also Abdellah’s)
• “Peaceful death”, dying process

Strengths: Widely accepted; applicable to all individuals of all ages (unlike Hall’s)
Weaknesses: Absence of conceptual diagram; little explanation on the dying process or in providing “peaceful
death”

Araña, A.M. // BSN1-26 // Theoretical Foundations of Nursing Modules 7-12 // 1st Sem AY 2023-2024