Beverlyn Damasco BSN-1A

Theoretical Foundations in Nursing

 Dorothy Johnson
Behavioral System Model
Dorothy E. Johnson is well-known for her “Behavioral System Model,” which
was first proposed in 1968. Her model was greatly influenced by Florence
Nightingale’s book, Notes on Nursing. It advocates the fostering of efficient and
effective behavioral functioning in the patient to prevent illness and stresses the
importance of research-based knowledge about the effect of nursing care on
patients.

Person- A system of interdependent parts with patterned, repetitive, purposeful ways of

behaving. A behavioral system composed of 7 subsystems.
Environment- All forces that affect the person and that influence the behavioral system.
Health- Is reflected by the organization, interaction, interdependence and integration of subsystem of
behavioral system.
Nursing- Promotion of behavioral system balance and stability; an external regulatory force that acts to
preserve the organization and integration of the client’s behavior at optimal level under those condition which
the behavior constitutes a threat to physical or social health or which illness is found.

 Hildegard Peplau
Interpersonal Relations Theory
The theory explains the purpose of nursing is to help others identify their felt
difficulties and that nurses should apply principles of human relations to the
problems that arise at all levels of experience.
Person- Peplau defines man as an organism that “strives in its own way to reduce
tension generated by needs.” The client is an individual with a felt need.
Health- Health is defined as “a word symbol that implies forward movement of
personality and other ongoing human processes in the direction of creative, constructive, productive,
personal, and community living.”
Environment- Although Peplau does not directly address society/environment, she does encourage the nurse
to consider the patient’s culture and mores when the patient adjusts to hospital routine.
Nursing- Considers nursing to be a “significant, therapeutic, interpersonal process.” She defines it as a “human
relationship between an individual who is sick, or in need of health services, and a nurse specially educated to
recognize and to respond to the need for help.”
  Ida Jean Orlando
Deliberative Nursing Process Theory
Ida Jean Orlando developed her Deliberative Nursing Process that allows
nurses to formulate an effective nursing care plan that can also be easily adapted
when and if any complexity comes up with the patient.
Person- Orlando uses the concept of human as she emphasizes individuality and
the dynamic nature of the nurse-patient relationship. For her, humans in need are
the focus of nursing practice.
Health- In Orlando’s theory, health is replaced by a sense of helplessness as the
initiator of a necessity for nursing. She stated that nursing deals with individuals
who are in need of help.
Environment- Orlando completely disregarded environment in her theory, only focusing on the immediate
need of the patient, chiefly the relationship and actions between the nurse and the patient (only an individual
in her theory; no families or groups were mentioned). The effect that the environment could have on the
patient was never mentioned in Orlando’s theory.
Nursing- Orlando speaks of nursing as unique and independent in its concerns for an individual’s need for help
in an immediate situation. The efforts to meet the individual’s need for help are carried out in an interactive
situation and in a disciplined manner that requires proper training.

 Joyce Travelbee
Human-to-Human Relationship Model
“A nurse does not only seek to alleviate physical pain or render physical
care – she ministers to the whole person. The existence of the suffering whether
physical, mental or spiritual is the proper concern of the nurse.” Travelbee’s
formulation of her theory was greatly influenced by her experiences in nursing
education and practice in Catholic charity institutions. She concluded that the
nursing care rendered to patients in these institutions lacked compassion. She
thought that nursing care needed a “humanistic revolution”- a return to focus on
the caring functions towards the ill person.
Person- Person is defined as a human being. Both the nurse and the patient are human beings. A human being
is a unique, irreplaceable individual who is in continuous process of becoming, evolving and changing.
Health- Is subjective and objective.
- Subjective health—is an individually defined state of well-being in accord with self-appraisal of physical-
emotional-spiritual status.
- Objective health—is an absence of discernible disease, disability of defect as measured by physical
examination, laboratory tests and assessment by spiritual director or psychological counselor.
Environment- is not clearly defined. She defined human conditions and life experiences encountered by all
men as sufferings, hope, pain and illness.

 Illness – being unhealthy, but rather explored the human experience of illness
  Suffering – is a feeling of displeasure which ranges from simple transitory mental, physical or spiritual
discomfort to extreme anguish and to those phases beyond anguish—the malignant phase of disdainful
“not caring” and apathetic indifference
 Pain – is not observable. A unique experience. Pain is a lonely experience that is difficult to
communicate fully to another individual.
 Hope – the desire to gain an end or accomplish a goal combined with some degree of expectation that
what is desired or sought is attainable
 Hopelessness – being devoid of hope
Nursing- is an interpersonal process whereby the professional nurse practitioner assists an individual, family
or community to prevent or cope with experience or illness and suffering, and if necessary to find meaning in
these experiences.”

 Lydia Hall
Care, Cure, Core Theory
The Care, Cure, Core Theory of Nursing was developed by Lydia Hall, who
used her knowledge of psychiatry and nursing experiences in the Loeb Center as a
framework for formulating the theory. It contains three independent but
interconnected circles: the core, the care, and the cure.
The core is the patient receiving nursing care. The core has goals set by
him or herself rather than by any other person, and behaves according to his or
her feelings and values.
The cure is the attention given to patients by medical professionals. Hall explains in the model that the
cure circle is shared by the nurse with other health professionals, such as physicians or physical therapists.
These are the interventions or actions geared toward treating the patient for whatever illness or disease he or
she is suffering from.
The care circle addresses the role of nurses, and is focused on performing the task of nurturing
patients. This means the "motherly" care provided by nurses, which may include comfort measures, patient
instruction, and helping the patient meet his or her needs when help is needed.
Person- The individual human who is 16 years of age or older and past the acute stage of long-term illness is
the focus of nursing care in Hall’s work. The source of energy and motivation for healing is the individual care
recipient, not the health care provider. Hall emphasizes the importance of the individual as unique, capable of
growth and learning, and requiring a total person approach.
Health- Can be inferred to be a state of self-awareness with a conscious selection of behaviors that are
optimal for that individual. Hall stresses the need to help the person explore the meaning of his or her
behavior to identify and overcome problems through developing self-identity and maturity.
Environment- The concept of society or environment is dealt with in relation to the individual. Hall is credited
with developing the concept of Loeb Center because she assumed that the hospital environment during
treatment of acute illness creates a difficult psychological experience for the ill individual. Loeb Center focuses
on providing an environment that is conducive to self-development. In such a setting, the focus of the action
of the nurses is the individual, so that any actions taken in relation to society or environment are for the
purpose of assisting the individual in attaining a personal goal.
Nursing- Is identified as consisting of participation in the care, core, and cure aspects of patient care.