TFN POWERPOINT Edited Last Part

1.
Phenomenon An empirical data that can

be observed.
2. Concepts Building blocks of theories

which can either be an
empirical or abstract data.
3. Conceptual Derived from a persons

own point of view.
Models
4. Paradigms Another term for
conceptual frameworks or
model.
5. Statements that the

theorist hold as factual.
Assumptions
6. Statements that imply the
relationships of concepts.
Propositions
7. A testable relationship
statement
Hypothesis
8. Research Use of systematic methods
to study a phenomenon and
create a general knowledge.
9. Induction A type of reasoning that
uses specific details to form
a general conclusion
10. A type of reasoning
wherein general conclusions
Deduction are made based from
specific concepts.
THEORETICAL FOUNDATION
THEORETICAL OF NURSING
FOUNDATION OF NURSING
I. INTRODUCTION TO NURSING THEORY
Definition:
A. THEORY
-the etymology: greek word “theoria”
-which means “contemplation, speculation”.
-From “spectator”, thea- “ a view + horan- “ to see”,

literally, “ looking at a show.
HISTORY OF
NURSING
THEORY
The emphasis was on what courses nursing
students should take , with the goal of arriving at a
standardized curriculum
CURRICULUM
ERA
This era came about as more and more nurses
embraced higher education and arrived at a common
understanding of the scientific age, that is that
research is the path of new nursing knowledge.
RESEARCH
EMPHASIS
ERA
Master’s degree programs in nursing
emerged to meet the public need for
nurses with specialized clinical nursing
education. Many of these nursing
program included a nursing research
course. It was also in this era that most
of this nursing master’s nursing
programs began to include courses in
concept development or nursing models
that introduced students to early
nursing theorist and the knowledge
development process.
RESEARCH ERA and

GRADUATE EDUCATION
ERA develop in tandem
A natural outgrowth of the research and the graduate
education eras. As our understanding of research and
knowledge development increased, it soon become obvious
that research without theory produced isolated information,
and that it was research and theory together that produced
nursing science. In the early years, doctoral education of
nursing flourished with an emphasis on nursing theory.
THEORY
ERA
Emphasis was placed on the middle range
theory for theory based nursing practice.
As well as theory development.
THEORY
UTILIZATION
ERA
An awareness of The curriculum era
the need for emphasized courses
concept and theory selection and content
development for nursing programs.
coincided with two
other significant
milestone in the The transition from
evolution of nursing vocation to profession
theory. included successive
eras of history.
In 1980’s was a The use of theory
period of major to convey an
developments in organizing structure
nursing theory and meaning for
characterized as these processes led
a transition from to this convergence
the pre- of ideas that
paradigm to the resulted in what is
paradigm recognized today as
period. the nursing theory
era.
Fawcett explains, “A
conceptual model
The theory eras provides a distinct
continues with frame of reference for
emphasis on its adherents… that
development and tells them how to
use of nursing observe and interpret
theory to the phenomena of
produce evidence interest to the
for professional discipline.”
practice.
Mid-range
theory has an
even more
specific focus Mid-range
and its more theory are more
concrete than precise.
nursing theory
in its level of
abstraction.
Theory According to:
Powers and
Knapp (1995)
defined theory as a “ set of statements that

tentatively describe, explain or predict
relationships among concepts that have been
systematically selected as an abstract
representation of some phenomenon.
Bodie and Chitty
(1993)
defined theory as “ an internally consistent

group of relational statements ( concepts,
definition and propositions) that presents a
systematic view about a phenomenon and
which is useful for description, explanation,
prediction and control”
defined theory
as “ a creative
and rigorous
structuring of Chinn and
ideas that Kramer (1995)
project a
tentative and
systematic view
of phenomenon.
“a theory, by traditional definition, is an
organized, coherent set of concepts
and their relationships to each other
that offers description, explanation and
predictions about phenomena”.
Parker
(2011)
“ a theory is a
set of
concepts,
definition,
Potter relationships
(2004) and
assumptions
that project a
systematic view
of phenomena”.
“ a reasoned proposed explanation of
an occurrence, or of something that will
occur or be produced, for which
absolute proof is lacking”.
Delaune and Ladner (2006)
“ a theory is a set concept and

prepositions that provide an
early way to view phenomena”.
Mosby (2006)
“an abstract statement formulated

to predict, explain or describe the
relationships tested by observation
and research using factual data”.
Kozier (2008)
“ a theory is a supposition or
system of ideas that is proposed
to explain a given phenomenon”.
Is a group of related concepts that
proposed actions that guide practice.
A theory implies that something has

been proven and is generally
accepted as being true.
A theory is an explanation of a set of a
related observations or events based
upon proven hypothesis and verified
multiple times by detached groups of
researchers.
Theories can correlate

concepts in such a way
as to generate a
different way of looking
at a certain fact of
phenomenon
Theories
must be
logical
in
nature.
Theories can correlate concepts in
such a way as to generate a different
way of looking at a certain fact of
phenomenon
Theories can be the
source of hypotheses
that can be tested for
it to be elaborated.
Theories should be
simple but generally
broad in nature.
Theories must be
consistent with other Theories
validated theories, laws contribute in
and principles but will enriching the
leave open unanswered general body
issues that need to be of knowledge
tested. through the
studies
Theories can be used by implemented
practitioner to direct to validate
and enhance their them.
practice.
is the term
given to the
body of
knowledge
that is used to
support
nursing B. Nursing Theory
practice.
C. Nursing
Paradigms
1. Person/Client -
refers to the direct
receivers of care
2.Environment
- pertains to
the sum of
everything
outside the
person.
3.Health -World Health
Organization(1948), defined health
as a state of complete physical,
mental, emotional, and spiritual well-
being and not merely the absence of
disease and infirmity.
4.Nursing- came from the Latin
word “nutrix”, which means “to
nourish”.
 “Nursing is an
Art: it involves the
use of compassionate Art and
caring, conscientious Science”
competence and
confidence. It further
involves the art of
serving of nurturing
and of caring for
everyone who needs
it.
Science: the nursing
profession is governed
by laws and theories that
have been scientifically
proven to be relevant to
the knowledge of human
body parts and how
these functions, disease
processes,
pharmacology and
therapeutics, nutrition,
microbiology, etc……
The International
Council of Nurses
(2002)
Defined nursing as…..

“….encompassing autonomous and collaborative
care of individuals of all ages, families, groups and
communities, sick or well and in all settings. Nursing also
includes the promotion oh health, prevention of illness,
and the care of the ill, disabled, and dying people.
Advocacy, promotion of a safe environment, research,
participation in shaping health policy and in patient and
health systems management, and education are also key
nursing role.
The Philippine
Nursing Act of
2002 (RA 9173)
Defined nursing as…..

“….the initiation and/ or performance of nursing services,
singly or in collaboration with another, to individuals, families
and communities and in any health care settings. It includes, but
not limited to, nursing care during conception, labor and
delivery, infancy, toodlerhood, preschool, school age,
adolescence, adulthood and old age. It involves the promotion
of health and prevention of illness with collaboration with other
health team members for the curative, preventive, and
rehabilitative aspect of care, restoration of health, alleviation of
suffering and when recovery is not possible, towards a peaceful
death.”
D. Conceptual Models
- it represents as equation
that describes the path or explains
the phenomenon being observed or
experienced. It describes the
variables being analyzed in a given
situation, together with the
statement of the hypothesis
concerning the relationships among
the variables model are typically
accompanied by a pictorial
representation of these variables
and their interrelationship.
II. Purpose of
Nursing Theory
A. Education: • Nursing theory is
to establish the more firmly
profession’s place established in
in the university.
education than in
clinical practice
primarily because
it was used to
establish the
profession’s place
in the university.
The Nursing 1. The major
programs of the concepts in one
1970’s and or two nursing
1980’s models
identified:
2. Organized these
3. And attempted
concepts into a
to organize the
conceptual
entire curriculum
framework.
around that
framework.
• With in this unique
framework evolved: • The goal was to:
1. Program
1. Elucidate the
objectives
2. Course objectives central meanings
3. Course of the
Description profession
4. Clinical 2. And to gain
performance status vis-à-vis
criteria other profession
• Many nursing programs have abandoned
theory-driven conceptual frameworks
because they became so torturous at times
that neither the faculty nor the students
understood clearly what was meant.
B. Research:
to help us
identify gaps in
the way we
approach
Different theoretical specific fields of
perspectives also help study such as:
create:
1. New ideas
2. Research questions
3. And interpretations
• Qualitative research in nursing and
the social sciences also came from
philosophy or the social sciences
theories.
• Critical theories in nursing help
explain how race, gender, sexual
orientation, and economic class
affect patient experiences and
health outcomes.
C. Clinical
Practice
-provides the
facilitation of
reflection,
questioning
and thinking
about what
nurses do.
• Nursing theory in a clinical setting
primarily provides the facilitation of
reflection, questioning and thinking
about what nurses do. Nurses
practice is often subordinate to
powerful institutional forces and
traditions. Therefore, any type of
framework that encourages nurses to
think about and question what they do
provide an invaluable service.
III. Interdependence of Theory and Research
• “Practice without theory, like a map without

a route, is blind; theory without practice,
like a route without a map, is empty.
Nursing
Practice
Nursing Nursing
Theory Research
Two types
of Knowledge
1. Theoretical
Knowledge-
-aims to stimulate
thinking and
broaden
understanding of
the science and
practice of the
Nursing discipline.
2.
Practical
Knowledge
- on the other
hand is referred to
as the art of nursing
According to
Chinn and
Kramer (2004)
-research is
linked to theory
in two ways by
generating and
testing.
Theory-generating research
-designed to discover and describe
relationships and phenomena without
imposing predetermined notions on the
nature of the phenomena. In conducting
this type of research, the investigators
make observations with an open mind in
order to view a phenomena in a new way.
Theory-Testing Research
- utilized to determine how
accurate a theory describes a
phenomenon. The researchers already
has some predetermined notions as to
how the phenomenon is and creates a
hypothesis to test the assumptions of
the theory.
Contribution of
Nursing
Theorists
Theorist Practice Education Research
Environment Development of Invented the
Florence al aspects as excellent training “polar
integral part of system in St. Thomas diagrams” to
Nightingale nursing care: Hospital And King’s analyze and
(Environme •Good College Hospital in gather data.
ntal ventilation London.
Theory) •Proper Scientific principles
disposal control and practical
of noise experience in mastery
•Sanitation of skills.
•Water
treatments
Provides clear Author of Formulated
Hildegard design for the “Interpersonal concepts of
Peplau practice of Relations in anxiety as a means
psychiatric Nursing” which to constructively
(Psychodynam nursing aids nurses. resolve angry
ic Nursing) Emphasized the Formulated feelings through
development of effective experiential
interpersonal psychotherapeuti learning within the
relationship c methods. nurse-patient
between the relationship.
patient and the
nurse.
Nurses as Nurse’s education Recommended

Virginia direct caregiver demands universal library
Henderson help patients to understanding of Advocated
become diverse human being. research as a way
(14 independent. Designed three to improve
Components phases of curriculum practice.
of Basic development.
Nursing
Joyce
Travelbee
(Human to
Human
Relationship
Model)
 Hospice is one The focus of Utilized by
of her essential Nursing Education various authors
Joyce contributions. has shifted from a in their study of
Travelbee Asserted that disease-oriented recently
finding meaning in approach to holistic diagnosed
(Human to illness and care approach. cancer patients
Human suffering enables Stated that and their
Relationship the patient not nursing programs personal search
only to accept need to offer a of meaning.
Model) illness but it also much broader
served as a self- background in
actualizing communication
experience. techniques, values
clarifications, and
care of the dying.
Betty
Neuman
(Systems
model)
Goal directed, Holistic Additional
Betty integrated and Curriculum clarification and
holistic approach Provides as generation of
Neuman to client care effective framework testable nursing
(Systems Formulated in conceptual theories.
Neuman Nursing evolution among Guide model to
model) process Format: levels of education of enhance the
•Nursing nursing students nursing care of
Diagnosis from diploma to clients with
•Nursing Goals associate to specific
•Nursing baccalaureate physiological
Outcomes programs. stressors.
Dorothy
Johnson
(Behavioral
System
Model)
Used Focuses on Stated that
assessment, the patient as a nursing research
disorders, behavioral would”
Dorothy treatment and system and its “identify and explain
Johnson evaluation instead dysfunction.. the behavioral
of nursing Process system disorders
(Behavioral “the behavioral which arise in
System system is said to connection with
Model) determine and limit illness and develop
the interaction the rationale for the
between the means of
patient and his management.”
environment”.
Imogene
King
(Goal
Attainment
Theory)
Utilized by Nursing Her work
Imogene professionals in most curriculum served as a
specialty areas. development and theoretical
King Developed the practice basis for
(Goal Goal Oriented application in various studies.
Nursing Record Ohio state and
Attainment (GONR) which is other universities.
Theory) used to record goals
and outcomes in
patient settings.
Dorothea
Orem
(Self Care
Deficit
Theory in
Nursing)
Described Came up with Develop a number
Dorothea Nursing the idea of need of instruments for
Orem management of for a nursing- research.
(Self Care Pertussis specific knowledge The 1st instrument
Deficit Teaching self- structure. developed, named
Theory in care to diabetic Author of “ Exercise Self Care
Nursing) patients and Guides for agency (ESCA)
End-Stage Developing which is used to
Renal Failure. Curriculum for the determine the
Pain Education of capacity of patients
assessment and Practical Nurses” to care for their
control. and “Foundation selves.
of Nursing ad Its
Practice”.
Faye
Abdellah
(Typology
of 21
Nursing
Problem)
Organized and The typology Believed that
Faye systematic basis of provided evidenced-based
nursing practice. scientific body practice on
Abdellah Typology helps in of knowledge scientific data has
(Typology efficient assessment, and filled-in the a great impact in
of 21 nursing diagnosis and gaps of nursing research.
Nursing planning interventions. weaknesses in
Uses scientific nursing
Problem) basis in problem- education.
solving process.
Sr.
Callista
Roy
(Adaptatio
n Model)
Manipulating Development of Development
Sr. the stimuli and curriculum development and testing of
not the patient. in various institutions. theories.
Callista Nurses 3 vertical strands in Practice based-
Roy enhance the curriculum; research.
interaction of •The adapting person Development of
(Adaptat person and their •Health-illness programs of
ion environment •Nursing management research.
thus improving 2 horizontal strands Development of
Model) health. in curriculum; adaptation
•Nursing Process research
•Student adaptation instruments.
and Leadership
Madeleine
Leininger
(Transcultural
Nursing)
Prepares nurses to Helps produce a Focused on
prevent culture shock well-qualified cultural care
Madelein and conflicts as they faculty prepared in With
practice in different Transcultural research
e places with different Nursing to teach method of
Leininger cultures. and guide students. (ethnonursing)
Provides human Education in to examine
(Transcu care and health transcultural theories.
ltural behaviors as
background
Nursing leads to
cultural competent
Nursing) knowledge to nursing care.
understand nursing
phenomena.
Jean
Watson
(Philosophy
and
Science of
Caring)
Caring as an Author of Research must
Jean Watson essential field in “Nursing: Human focus on both
nursing. Science and subjective and
(Philosophy Example in Human Care- a objective
and Science clinical setting Theory of patients
of Caring) (Intensive Care Nursing” outcomes in
Units, Neonatal Described the knowing that
Intensive Care care of nursing as caring is
units, Pediatric aspects of the important in
and nurse-patient nursing.
Gerontological relationship
units) resulting in a
therapeutic result.
Patricia
Benner
(From Novice to
Expert:
Excellence and
Power in
Clinical Nursing
Practice)
Formulated the Learning Extended the
Patricia levels of needs at an early study of formal
competency in stage of clinical models which
Benner Nursing practice: knowledge are direct care and
(From Novice 1. Novice different from substitute
to Expert: 2. Advance those needed in knowledge used
Excellence and Beginner later stage. in nursing
Competent practice.
Power in 3. Proficient
Clinical 4. Expert
Nursing
Practice)
IV.
Significance of Theory to
Nursing as a Profession and as a
Discipline
Difference of Profession and Discipline:
Discipline –
is specific to
academia and refers
to a branch of
education, a
department of
learning or a domain
of knowledge.
Profession –
refers to a
specialized field of
practice which is
founded upon the
theoretical structure
of a science or
knowledge of that
discipline and the
accompanying
practice abilities.
 Theory is significant
 Since, the main
because it helps us to
exponent of
settle on what we know
nursing is
and what we need to
caring, that
know in the future
cannot be
measured, it is
integral to have
 It helps to differentiate the theory to
what should form the analyze and
basis of practice by explain what
clearly describing what nurses do.
nurses does and what
nursing is all about.
Criteria of a
Profession
1. Utilizes in each practice a well-
defined body of knowledge.
2.Constantly enlarge the body of

knowledge to improve education and
practice.
3.Trusts education practitioners to

institutions of higher learning.
4.Applies body of knowledge for
human and social welfare.
5.Functions autonomously in the

control of professional activity.
6. Provides for continuous growth of

the profession.
V. Categories
a.Grand Theories.
Examples:
 Martha Roger’s Science of Unitary

Human Being
 Margaret Newman’s Health as Expanding

Consciousness
 Rosemarie Rizzo Parce’s Theory of Human

Becoming
B. Mid-range Theory
• Lease abstract level of theoretical

knowledge and narrower because they
include details that specific to nursing
practice. ( Aligood, 1995)
Example:
Grand Theory
Imogene King’s Goal Attainment
Theory
Mid-Range Theory
Goal Attainment in adolescent
diabetic Patients in the Community
FOUR WAYS OF
KNOWING
a. Empirical
knowing
-Is the principle from
relating factual and
descriptive knowing
aimed at the expansion
of abstract and
theoretical
explanations.
• Empirical model is the first primary
model of knowing (Kenny, 1996)
• It is information source or base of
knowing
• It emphasizes scientific research is
important to nursing knowledge.
• As a part of empirics, clinical and
conceptual knowledge are the
keys to nursing practice. (Schultz
and Meleis, 1998)
• Empirical knowing focuses on
evidenced-based research for
effective and accurate
• It is where most theory and
research development is
concentrated and some
conceptual forms have better
capacity to explain nursing
phenomena than others.
B. Evidence-Based Practice
(EBP) as part of Empirical
Knowing
Involves accurate and thoughtful decision
making about health care delivery for clients.
This is based on the result of the most
relevant and supported evidence derived
from research in response to client's
preference and expectations. An
institutions will benefit if evidence-based
practice is effectively implemented and
significantly translated into nursing practice.
Practice founded on EBP can bridge the
gap on nursing practice and research to
provide basis for nurses to transform
research into quality care.
- Promotes quality care that has been
demonstrated to be effective. If
practice guidelines do not exist for a
specific problem, the nurse should
look for relevant evidence in studies,
integrate reviews and analysis and
assess the quality of evidence.
Six Characteristic of Quality Health Care
that Reinforces Aspects of EBP
•Client-centered
•Scientifically-based
•Population outcome based
•Developed through quality improvement
and benchmarking
•Individualized to client’s need
•Attuned with system policies and
resources
C. Aesthetics or Esthetics Knowing
-is related to understanding what is of
significance to particular patients such as
feelings, attitudes, points of view (Caper,
1978). Its is also the manifestation of the
creative and expressive styles of the
nurse. (Kenney, 1996)
• Aesthetics knowing focuses on empathy-
the ability for sharing or vividly
understanding another's feelings. This is
the primary form of aesthetics knowing.
• It also includes the nurse’s ability in
changing ways and manner of rendering
nursing care based on the client’s
individuals needs and perceptions.
• It is done by knowing the distinctive
individual instead as a typical stereotype
whole (Caper, 1978; Kenney 1996)
D . Ethical Knowing
- requires knowledge of different
philosophical positions regarding
what is good and right in making
moral actions and decisions,
particularly I the theoretical and
clinical components of nursing.
• The code of morals or code of
ethics that leads the conduct of
nurses is the main basis of
Ethical Knowing.
• It is deeply rooted in the

concepts of human dignity,
service and respect for life.
• Lessening suffering,
upholding and
preserving health is one
of the key elements why
nursing is a core service
in society.
• It includes all deliberate

nursing actions involving and
under the jurisdiction of
ethics and professionalism
(Kenney,1996)
E. Personal Knowing
- encompasses
knowledge of the
self in relation to
others and to self. It
involves the entirely
of the Nurse-
Patient
Relationship.
• It is the most
difficult to master
and to teach.
• It is the key to
comprehending health in
terms of personal well-
being.
• It involves therapeutic
use of self.
• It takes a lot of time to fully know the
nature of oneself in relation to the world
around.
• It stresses that human beings are not in

a fixed sate but are constantly engaged
in a dynamic state of changes.
VI. Components
Theory analysis is the
process of acquiring
knowledge of the theory.
The criteria for evaluating each

theoretical work are clarity,
simplicity, empirical precision, and
derivable consequences.
Analysis, critique and
evaluation are all methods of
studying the nursing
theoretical works critically.
In evaluating a theory, we must

consider its degree of
usefulness to guide practice,
research, education and
administration.
* “How clear is the THEORY?”
• It refers to intersubjectivity, wherein

there must be shared agreement of the
definitions of concepts within theory.
(Reynolds, 1971)
• The logical adequacy of a theory is
the logical structure of the concepts
and the statements as proposed in the
theory. (Walker and Avant, 2004)
• In evaluating the clarity of a certain
theory consistency, semantics and
structure are considered important.
• To assess these, the major concepts,
sub concepts and their definitions
are clearly identified.
• Diagrams and examples may

facilitate clarity and should be
consistent.
“How simple is the THEORY?”
A theory should be sufficiently

comprehensive and at a level of
abstraction to provide guidance, but
should have as few concepts as possible
with simplistic relation to aid clarity.
“How general is the THEORY?”
To determine the generality of a theory,

the scope of concepts and goals within
the theory are examined.
The broader the scope, the grater the

significance of the theory. (Ellis,
1968)
The more abstract the theory; the mid-
range theories can be derived.
It is defined
Empirical precision is linked
as the
to the testability and
degree in
ultimate use of theory and
which the
it refers to the “ extent that
defined
the defined concepts are
concepts
grounded in observable
are
reality”.
observable
in actual
setting
You need to examine if there is
congruence between theoretical claims and
the empirical evidence.
The theory should be able to generate

hypothesis upon which you can test.
Nursing theory guides research and
practice, generates new ideas, and
differentiates the focus of nursing
from other professions. (Chinn
and Kramer, 2002)
Organization Contribution
Parabolani Provide care during the
Brotherhood great plague in
Alexandria
Knights of St. These
John of organizations
Jerusalem were
(Also known as responsible for
the Knights of the
Hospitalers) development of
Teutonic early managerial
Knights and
Knights of administrative
Lazarus standards in
providing care
in the hospital
Knights of St. John One of the first
of Jerusalem nursing orders
Alexian
Brotherhood
Augustinian Sisters
Considered as the
patron saint of
Camillus de Lellis nurses. Order of
Christian charity
providing care for the
poor, sick. Dying and
prisoners.
Established by St.
Sisters of Charity Vincent de Paul in
France
Founded at
Keiserswerth, Germany.
Recognized the role of
Order of women in giving services
Deaconesses in the sick. It is also
initiated the
establishments of training
schools for nurses.
Nursing Year Contribution to Nursing
Leader
*** Mary 1854 Worked together with
Grant Florence Nightingale during
Seacole the Crimean War to give aid
(England) for the wounded soldiers.
Leader
Florence 1859 Referred as the “Lady with the
Nightingale Lamp” Contributed to the
(England) development of nursing
education, practice and
administration.
Leader
***Dorothea 1861 Appointed superintendent of
Lynde Dix the Female Nurses of the
(USA) Union Army during the
American Civil War
Leader
Louisa 1862- Wrote the book “Hospital
May 1863 Sketches” as she described the
Alcott works of volunteer nurses during
(USA) the civil war
Leader
*** 1861- “The Moses Of Her People”.
Harriet 1865 She served the slaves of the
Tubman underground railroad during the
(USA) Civil War.
Leader
***Walt 1862- Worked together with Louisa
Whitma 1865 Alcott during the Civil War
n
(USA)
Leader
Sojouner 1862- Worked as a nurse during the
Truth 1865 Civil War And a nurse-counselor
(USA) for the Freedman's Relief
association After
Nursing Leaders of the 20th Century
Nursing Leader Year Contribution to Nursing

***Jean Henri Dunant (Switzerland) 1862-1865 Organized the international conference
that founded the red cross during the
Geneva convention.
Lucy Osborne (Australia) 1868 Developed Australia’s first school for
nurses after training in St. Thomas
Hospital under the supervision of
nightingale when she became the
superintendent ay Sydney Hospital.
Linda Richards (USA) 1873 America’s first trained nurse
Mary Mahoney (USA) 1879 America’s first trained black nurse
Clara Barton (USA) 1812-1912 Organized and established the American

Red Cross
Mary Agnes Snively (Canada) 1884 Developed the Toronto General Hospital
School of Nursing and was the first
president of the Canadian Nurses
Association
Lillian Wald (USA) 1867-1940 Founder of Public Health Nursing she
also founded the Henry Street
Settlement and visiting nurse Service
which provided nursing services
educationally, socially and culturally

Bedford Fenwick (England) 1899 Establish the International Council Of
Nurses in Great Britain
*Clara Louise Mass (USA) 1876-1901 Worked as a contract nurse with the US
Army during the Spanish-American War
Magaret Higgins Sanger 1879-1966 Founder of Planned Parenthood which
initiated and disseminated the use of
birth control information
Lavina L. Dock (USA) 1858-1956 During the 1920, she contributed in the
19th Amendment of the Amerecan
Constitution, particularly in protest for
the rights of women during her time
Mary Breckinridge ( USA) 1881-1965 Established the Frontier nursing
Service(FNS) which started at Leslie
County, Kentucky. She also opened one
of the first midwifery training schools
during her time
Dr. Lauranne Sams ( USA) 1971 Served as the 1st President of National
Black Nurses Association
M. Lucille Kinlein (USA) 1972 First independent Nurse practitioner

Dr. Ildaura Maurillo- Rohde (USA) 1974 Served as the 1st President of National
Hispanic Nurses Association
Eddie Bernice Johnson (USA) 1992 The 1st nurse to be elected to the
United States House of Representatives
Julia R. Plotnick (USA) 1992 Served as the Chief Nurse Officer, Rear
Admiral and became an active leader in
policy coordination for the US Surgeon
General
Ada Sue Hinshaw (USA) 1993 Directed the National Center for the
Nursing Research to become the
International Institute for Nursing
Research under the National Institute
for Health
Prominent Nursing Leaders in the Philippines
Cesaria Tan •First Filipino nurse who had Masters Degree in nursing
in the United States
Socoro Sirilan •Reformed social service for Indigenous patients at San
Lazaro Hospital
Magdalena Valenzuela •First Filipino Industrial Nurse
Annie Sand •Founded the National League of Philippine Government
nurses
Cornel Elvegia Mendoza •First female Military Nurse
Loreto Tupaz •Known as the Dean of the Philippine Nursing Education
•Florence Nightingale of Iloilo
Socorro Diaz •First editor of “the Message” the first journal of
Philippine Nurses Association (PNA) previously known as
FNA (Filipino Nurses Association)
Conchita Ruiz •First editor of “The Filipino Nurses” the second journal
of the PNA.
Prominent Nursing Leaders in the Philippines
•Considered as “Florence Nightingale of the Philippines.

•Founder and the first Dean of the University of the Philippines College
of nursing (UPCN), who give way to the professional Nursing in the
Philippines.
•Professor Emeritus of UPCN
•The author of Code of Ethics for nurses (PRC BON Res. #633, 1982)
•Chairman, committee on Legal Aspect Of Nursing which created the
Dr. Julita Sotejo first Philippine Nursing Law also known as the Republic Act No. 877
S.1953
•Her Biography was written by Luz Tungpalan, Dean UPCN, entitled
Action Oriented Leadership (2001)
(Please see the appendix for the Close Encounter of the Author with
Dean Sotejo)
•First Filipino nurse with a title of nursing Superintendent Chief Nurse at
the Philippine General Hospital (PGH)
Anastacia Giron Tupaz •Founder of Filipino Nurses Association (FNA) at present known as the
Philippine Nurses Association (PNA)
Rosario Montemayor •First Prtesident of the FNA
•She was a graduate of Philippine General Hospital School of Nursing in
Delgado 1912
Past PNA Presidents
Name Year
+Mrs. Rosa Montemayor Delgado 1922-1926
+Mrs. Socorro Salamanca Diaz 1926-1932
+Mrs. Cesaria Tan 1932-1934
+Mrs. Rose Militar 1934-1936
+Mrs. Elisa Rosales Ochoa 19369-1940
+Mrs. Maria L. Tinawin 1940-1946
+Mrs. Genera S. M. De Guzman 1946-1948
+Dean Julita V. Sotejo 1948-1954
+Ms. Anne Sand 1954-1956
+Mrs. Rosario Ordiz 1956-1958
+Mrs. Luisa A. Alvarez 1958-1965
+Dr. Rosario Diamante 1965-1970
Col.. Winnie Luzon 1970-1974
Dr. Fe M. Valdez 1974-1977
Past PNA Presidents
Name Year
Mrs. Florida R. Martinez 1986
Mrs. Anesia B. Dionisio 1989-1990
Mrs. Marco Antonio C. Sto. Tomas 1991
Dr. Leda Layo-Danao 1992-1996-
Mrs. Leonila A. Flaire 1997
Dr. George C. Cordero 2000-2002
Mrs. Ruth R. Padilla 2003-2005
Dr. Marilyn D. Yap 2006
Dr. Leah Samaco Paquiz 2006-Present
Note: + Deceased
THEORITICAL CONCEPTS OF DIFFERENT
CONTEMPORARY THEORIST
THEORIST THEORY/CONCEPT
***Florence Nightingale Environmental Theory
***Virginia Henderson Definition Of Nursing
***Martha Rogers Unitary Human Being
***Sister Callista Roy Adaptation Model
***Dorothea Orem Self-Care Theory
***Imogene King Goal Attainment Theory
***Betty Nueman Health Care System Model
***Dorothy Johnson Behavioral System Model
Sigmund Freud Psychoanalytic Theory
Erik Erikson Theory of Personality Development
Lawrence Kohlberg Moral Development Theory
Jean Paiget Cognitive Development
***Madeleine Leininger Transcultural Theory
***Hildegard Peplau Interpersonal Relations in nursing
THEORITICAL CONCEPTS OF DIFFERENT
CONTEMPORARY THEORIST
THEORIST THEORY/CONCEPT
***Ida Jean Orlando Nursing Process theory
***Jean Watson Theory of Human Caring
***Myra Estrin Levine Conservation model
***Lydia Hall Core, Care, Cure theory in Nursing
***Faye Abdellah Concept of Nursing Diagnosis
Note: *** Nursing Theorist
Professional Roles Of Nurses
ROLE DESCRIPTION
Care Provider Nurses provided care and comfort for persons together with preserving the
dignity of human being. Often considered as the mothering role of nurses.
Communicator Communication facilitates understanding and collaboration of nursing actions
with their clients and other members of the health care team.
Communication also develops in rapport with the client which establishers
their cooperation.
Teacher Nurses helps the clients learn the state of their well-being and the therapies
that will be done to alleviate their conditions and provide them imaginary of
the advantages and disadvantages the action that will be done to them.
Teaching roles can also help in the development of the nursing profession
especially in the education
Counselor Nurses helps clients to cope with stress brought about their health
conditions. It also facilitate the client’s growth in all aspects; physical,
emotional, psychological and even spiritual.
ROLE DESCRIPTION
Client Advocate As an advocate, the nurse defends the clients right to be treated equally without
any harm intentionally or unintentionally. Being a client’s advocate, she ensures
that the client’s need are met. Advocacy involves promoting what is best for the
clients, ensuring that his needs are met and protecting his rights.
Change Agent As a change agent, the nurse:

•Identifies the problems
•Assesses the client's motivations and capacities for change
•Determines alternatives
•Explores the possible outcomes of the alternatives
•Assesses resources
•Determines appropriate helping roles establishes and maintains a helping
relationships
•Recognizes the phases of the change process
•Guides the client through these phases
Leader As a positive (goal-oriented) behavior involving an exchange with other people,
Leadership is an attempt to influence others. The process of influencing helps the
clients in making decisions to establish and achieve their goals towards
alleviating their conditions.
ROLE DESCRIPTION
Manager Management involves “planning, giving direction,
developing staff , monitoring operations. Giving
rewards fairly and representing both staff members
and administration as needed.”
Researcher Being a researcher is the investigative role of nurses
which further improves the nursing practice. Research
substantiates practices as they were tasted and further
studied upon.
Expanded Roles of Nurses
Nurse generalist has mastery in certain practice of nursing. The

following are examples of special areas: general nursing practice,
medical-surgical practice, pediatric-geriatric practice, college health
Nurse Generalist nursing, psychiatric and mental health nursing, nursing continuing
education and staff development and home health nursing
Nurse clinician perform direct nursing actions in specialty areas. They

may or may not have advanced educational preparations long as they
Nurse Clinician are certifies by a governing body to perform such duty
Nurse Practitioner Nurse Practitioner requires advanced educational or nursing practice
and must be certified by the governing body that they may practice
so.
Nurse Specialist Nurse specialist requires one to have master’s degree in nursing and
must have specialization in a particular field of nursing.
Florence Nightingale (1820-1910)
Modern Nursing
 Florence Nightingale , the founder of modern nursing, was born on May 12, 1820, in Florence,
Italy.
 The Nightingales were a well-educated, affluent, aristocratic Victorian Family with residences in
Derbyshire and Hampshire.
 In 1837, Nightingale wrote about her “calling” in her diary: “ God spoke to me and called me to
his service”. The nature of her calling was unclear to her some time . After she understood that
she was called to become a nurse, she was able to complete her nursing training in 1851 at
Kaiserwerth, Germany a protestant religious community with a hospital facility. She was there
for approximately 3 months, and at the end, her teachers declared her trained as a nurse.
 Only 2 years after completing her training (in 1853), she became a superintendent of the
Hospital for Invalid Gentlewomen in London.
 During the Crimean War, Nightingale received a request from Sidney Herbert to travel to
Scutari, Turkey, with a group of nurses to care for a wounded British soldiers. She arrived
there in November of 1854, accompanied by 34 newly recruited nurses who meet her criteria for
professional nursing.
 She was called The Lady of the Lamp, as immortalized in the poem “Santa Filomena” because she
made ward rounds during the night, providing emotional comfort to the soldiers.
 In Scutari, Nightingale became critically ill with Crimean fever, which might have been typhus or
brucellosis and which may have affected her physical condition for a years afterwards.
 She was rewarded funds in recognition of this work, which she used to establish schools for nursing
trainings at St. Thomas’ Hospital and King’s College Hospital in London.
 The Nightingale School began to received requests to establish new schools at hospital’s worldwide,
and Florence Nightingale’s reputation as the founder of modern nursing was establish (Lobo,1995).
 During her lifetime, Nightingale’s work was recognized through the many awards she received from her
own country and from many others.
 She was able to work onto her 80s until she lost her vision; she died in her sleep on August 13, 1910,
at age 90.
 Reared as a Unitarian, her belief that action for the benefits of others is a primary way of serving God
served as the foundation for defining her nursing work as a religious calling.
 Nightingale’s faith provided her personal strength without her life and with the belief that education was
the critical factor in establishing the profession of nursing.
 Nightingale’s theory focused on the environment.
 She defined and described in details the concepts of ventilation, warmth. Light, diet, cleanliness and
noise.
 Her theoretical work on five essential components of environmental health ( pure air, pure water,
efficient drainage, cleanliness, and light) is a relevant today as it was 150 years ago.
 Nightingale’s book Notes on Nursing was published originally in 1859, to provide women with
guidelines for caring for their loved one at home and to give advice on how to “think like a nurse”.
Nightingale’s Environmental Theory
Nightingale’s Canon
( Nightingale, 1969) Nightingale Process and Thought
Ventilation and Warmth • Check the patient’s body temperature, room
temperature, ventilation and foul odors.
• Create a plan to keep the room well-ventilated and
free of odor while maintaining the patient’s body
temperature.
Light • Check room for adequate light. Sunlight is
beneficial to the patient.
• Create and implement adequate light in the room
without placing the patient in direct light.
Cleanliness • Check room for dust, dampness and dirt
• Keep room free from dust, dampness and dirt.
Health of Houses • Check surrounding environment for fresh air, pure
water, drainage, cleanliness and light.
• Remove garbage, stagnant water and ensure clean
water and fresh air.
Noise • Check noise level in the room and
surroundings.
• Attempt to keep noise level in minimum.
Bed and Bedding • Check bed and bedding for dampness,
wrinkles and soiling.
• Keep the bed dry, wrinkle-free and lowest
height to ensure comfort.
Personal Cleanliness • Attempt to keep the patient dry and clean at

all times.
• Frequent assessment of the patient’s skin is
essential to maintain good skin integrity.
Variety • Attempt to accomplish variety in the room

and with the client.
• This is done with cards, flowers and pictures
and books. Also encourage friends or
relatives to engage in stimulating
Chattering hopes and • Avoid talking without given advice that is
advices without a fact.
• Respect the patient as a per5son and avoid
personal talk.
Taking Food • Check the diet of the patient. Note the

amount of food and fluid ingested by the
patient at every meal.
Petty Management • This ensure continuity of care.

• Document the plan of care and evaluate the
outcomes to ensure continuity.
Observation of the • Observe and record anythi9ng about the

Sick patient.
• Continue observation in the patient’s
environment and make changes in the plan of
care if needed.
Hildegard Peplau
Interpersonal Relations theory
 Often regarded by many as the “ Psychiatric nurse of the Century”.
 Hildegard Peplau was born on September 1, 1909 at Reading, Pennsylvania.
 She worked very hard for studies and successfully graduated from Pottstown,
Pennsylvania Hospital School of Nursing in 1931 and later worked as an operator
room supervisor at Pottstown Hospital.
 In 1943, she received a Bachelor of Arts in Interpersonal Psychology from

Bennington College, Verm0nt, a Master of arts in Psychiatric Nursing from
Teacher’s College, Columbia, New York, in 1947, and a Doctor of Education in
Curriculum Development from Columbia in 1953.
 Her efforts and excellent leadership skills saved the American Nurses Association
from the point of bankruptcy and moved the nursing profession towards scientific
recognition and respectability.
Hildegard Peplau
Interpersonal Relations theory
 She became a member of Army Nurse Corps and work in a neuropsychiatric hospital
in London, United Kingdom during World War II.
 Hildegard Peplau had been considered as one of the renowned nursing leaders in her
time that her writings and research are repeatedly featured at the American Journal of
Nursing from 1951 to 1960.
 Her first book, “Interpersonal Relations in Nursing” published in 1952, was one of the
firsts book that stated the need to emphasize importance of the nurse-patient
relationship in providing health care.
 Hildegard Peplau hold numerous awards.

Interpersonal Therapeutic Process
 Particularly usedful in helping psychiatric patients become receptive for theraphy.
 Often referred by Peplau as “ Psychological mothering”, it includes the following

steps.
• The Patient is accepted unconditionally as a participant in a relationship that

satisfies his needs.
• There is recognition of and response to the patient’s readiness for growth, as his
initiative; and
• Power in the relationships shifts to the patient, as the patient’s is able to delay
gratification and to invest in goal achievement.
Nursing Roles
 These roles are appropriately used by nurse in different nursing situation
and phases of Interpersonal Relationship.
Role of the Stranger
 In their initial contacts, the nurse and the patients are strangers to one another.
As the nurse attempts to know the patient better, she must treat him with
outmost courtesy, which includes acceptance of the patient as a person and due
respect in to his individuality. Thus roles coincidence with the Identification
Phase
Role of the Resource Person

 As the patient assumes a dependent role, the nurse provide specific answers to
his queries which includes health information's, advices and a simple explanation
of the health care team’s course of care. It is responsibility of the nurse to
appropr4iately change her responses to the patient's level of understanding.
Teaching Roles
 As the interaction progresses, the nurse assumes as teaching role as she
received much importance for self-care and in helping him understand the
therapeutic plan. In assuming this role, the nurse must determine how the patient
understands the subjects at hand. She must develop the discussion around the
interests of the patient and his ability to use the information provided.
Leadership Role
 Although dependent to the health care team over his care, the patient is still
considered vital in deciding as to what course his plan of care would take. The
nurse as a leader must act in behalf of the patient’s best interest and at the same
time enable him to make decisions over his own care. This is achieved through
cooperation and active participation.
Surrogate role
 The patient’s dependency for his care gives the nurse a surrogate (temporary
care giver) role. These creates an atmosphere wherein feelings previously felt,
such as feeling towards his motjer. Some relationships are reactivated and
nurture. Although the patient’s recognizes that the nurse has a similar with the
person whom he recalls from his previous relationships, the nurse must assists the
patient to make sure that her surrogate role is different and only temporary.
Counseling Roles
 Peplau believes that the counseling role has the greatest importance and
emphasis in nursing. This role strengthens the nurse-patients relationships as
nurse becomes a listening friend, an understanding family member and someone
who gives sounds and emphat9ic advices. The very core of the interpersonal
technique is for the patient to remember and to understand the experience and
how could it be integrated into his daily life.
Hildegard E. Peplau
Hilegard E. Peplau has been described as the mother of Psychiatric nursing because her theoretical
and clinical work led to development of the distinct specialty.
Peplau provided major leadership in the professionalization of nursing. She served as Executive
Director and later as President of the American Nurses Association.
She identified four(4) phases of the nurse patient relationship:

1. Orientation
2. Identification
3. Exploitation
4. Resolution
On Admission
Orientation
Identification
During Intensive
treatment Period
Exploitation
Convalescence and
rehabilitation
Resolution
Discharge
 Peplau diagrammed changing aspects of nursing-patient relationships and proposed
and described the following six (6) nursing roles:
1. Stranger 5. Surrogate
2. Resource person 6. Counselor
3. Teacher
4. Leader
Peplau’s Experiences with professionals from psychiatry, medicine, education and

sociology influenced her view of what a profession is and does and what it should be.
Her work was influenced by Freud, Maslow and Sullivan’s interpersonal relationship
theories and by the contemporaneous psychoanalytical model. She borrowed the
psychological model to synthesize her theory of interpersonal relations.
Peplau’s work is specific to the nurse-patient relationship and is categorized as a

theory for the practice nurse.
Virginia Henderson
14 Basic Human Needs
 Virginia Henderson has been called the “ First Lady of Nursing” and the “
First Truly International Nurse”
 She began her career in public nursing.
 She was the full-time instructor in nursing in Virginia.
 Halloran, a nurse theorist, wrote, “Henderson was to the twentieth century as

nightingale was to the ninetieth. Both wrote extensive works that have
influenced the world.
14 Basic Needs
 She conceptualized the 14 fundamental Needs of humans. These needs are:
1. Breathing normally.
2. Eating and drinking adequately
3. Eliminating body wastes
4. Moving and maintaining a desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining normal body temperature by adjusting clothing and modifying the
environment
8. Keeping the body clean and well groomed to promote integument (skin)
9. Avoiding dangers in the environment and avoiding injuring others.
10. Communicating with others in expressing emotions, needs, fears or opinions.
11. Worshipping according to one’s faith
12. Work in a such a way that there is a sense of accomplishments.
13. Play or participate in various forms of recreation.
14. Learn, discover or satisfy the curiosity that leads to normal development and health and
use the available health facilities.
 Henderson also emphasized the need to view the patient and his family as a single unit.
For the patient to achieve health, he must be able to meet his need to support system
(emotional needs) which in many cases provided by the family.
THE NURSE- PATIENT RELATIONSHIP
-there are three levels compromising the nurse-patient relationship.
The nurse as substitute for the patient

• the nurse served as the substitute as to what the patient lacks, such as knowledge,
will and strength in order to make him complete, whole and independent once again.
The nurse as helper for the patient

• needs are needed to achieve health, the nu8rse focuses her attention in assisting the
patient meet these needs so as to regain independence as quickly as possible.
The nurse as partner for the patient

• the nurse and the patient formulate the care plan together. Both as an advocate and
as a resource-person, the nurse can empower the patient to make effective decisions
regarding care plans.
THE NURSE-PHYSICIAN RELATIONSHIP
 Henderson asserted that nurses function independently from physicians.
 Nurses do not allow doctor’s order; rather they follow in a philosophy which allows
physicians to give orders to patients or other healthcare team members.
THE NURSE AS A MEMBER OF THE HEALTHCARE
TEAM
 The nurse as member of the healthcare team, works and contribute in carrying out
the total program of care.
 Working interdependently does not include taking order member’s role and
responsibility.
 Henderson believed that nursing process is a problem- solving process that could
be used to answer the patient’s needs, the steps involved are not that strange to
nursing alone.
ASSESSMENT PHASE
• the nurse would assess the 14 fundamental needs of the patients and check
which one is lacking of fully met. She gathers data by observing, smelling,
feeling or hearing. To complete this phase, the nurse uses the critical
thinking and analyzes every data collected to come up with a clear picture of
the condition of the patient.
PLANNING PHASE
• involves giving the plan of care to meet the needs and personality of the patient.
It must serve as the record at the same time must fit in the prescribed plan made by
the physician. To make the plan same with the goals of the healthcare team, the
roles and responsibility of each professional members must be included and
integrated to the care plan.
IMPLEMENTATION PHASE
• the nurses uses the 14 basic needs in answering the factors that are contributing
the illness state of the patient. These intervention are focused on the maintaining
health, to cover from illness or to aid to peaceful death.
EVALUATION PHASE
• The nurse and the patient review the relationships and decides whether the
goals are met or not. The nurse also assess if the patient attained independence
and if health is achieved.
Virginia Henderson
 Virginia Henderson viewed patient as an individual who requires help toward

achieving independence and completeness or wholeness of mind and body.
 She envisioned the practice of nursing as independent from the practice of

physicians and acknowledge her interpretation of nurse’s function as a synthesis of
many influences.
 Her work is based on

1. Thorndike, an American Psychologist
2. Her student experiences with Henry House Visiting nurse Agency
3. Her experience in rehabilitation nursing
4. Orlando’s conceptualization of deliberate nursing action
 Henderson emphasized the art of nursing and identified 14 proposed basic human
needs on which nursing care is based.
 She identified the three (3) levels of nurse-patient relationship in which the
nurse acts as follows:
1. A substitute for a patient.
2. A helper to the patient.
3. A partner with a patient.
 The nurse through the interpersonal process must in a sense get “inside the
skin” of each of her patients in order to know what help is needed
 Although she believed that the functions of nurses and physicians overlap,
Henderson asserted that the nurse works in interdependence with other
health professionals and with the patients.
Faye Glenn Abdellah
 Faye Glenn Abdellah is recognized as a leader in the deve3lopment of nursing

research and nursing as a profession within the Public Health Service (PHS)and
as an international expert on health problems.
 She been active in professional associations devoted to nursing and has been a
prolific author, with more than 150 publications to her credit.
 Abdellah was the first woman and nurse Deputy Surgeon General (1982-1989)
 Abdellah views nursing as both an art and a science that molds the attitude,
intellectual competence and technical skills of an individual nurse into desire and
ability to help individuals cope with their health needs, whether they are ill or well.
 She formulated 21nursing problems based on a review of nursing research studies

1. To maintain good hygiene and physical comfort.
2. To promote optimal activity; exercise, rest, sleep
3. To promote safety through prevention of accident, injury or other trauma and through prevention of
the spread of infection.
4. To maintain good body mechanics and prevent the correct deformity.
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition for all the body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognized the physiologic responses of the body to the disease conditions- pathologic,
physiologic and compensatory.
10. To facilitate the maintenance of regulatory mechanism and functions.
11. To facilitate the maintenance of sensory functions.
12. To identify and accept positive and negative expressions, feelings, and reactions.
13. To identify and accept interrelatedness of emotions and inorganic illness.
14. To facilitate the maintenance of effective verbal and nonverbal communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress toward achievements an personal spiritual goals.
17. To create or maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical, emotional and developmental
needs.
19. To accept the optimum possible goals in the light of limitations, physical and emotional.
20. To use community resources as an aid in resolving problems that arise from illness.
21. To understand the role of social problems as influencing factors in the cause of illness.
 She used Henderson’s 14 basic human needs and nursing research to
establish the classifications of nursing problems.
 Her work differs from that of Henderson in that Abdellah’s problems are
formulated in terms of nursing-centered services, which are used to
determined the patient’s needs.
 Her contribution to nursing theory development consists of a systematic

analysis of research reports conducted to formulate the 21 nursing
problems that served as an early guide for comprehensive nursing care.
Faye Glenn Abdullah
 In march 13, 1919, Faye Glenn Abdellah was born in New York City.
 She finished her basic nursing education, magna cum laude in 1942 from Fitkin
Memorial Hospital School of Nursing, in Neptune, New Jersey.
 She obtained her Bachelor of Science in 1945,her Master of Arts in 1947 and
her Doctor Education in 1955 in the Teachers College at Columbia University.
 She became famous and celebrated when she became the first nurse and first
woman to serve as Deputy Surgeon General Of the United States. The
surgeon General is basically the leader of the United States Public Health
Service Commissioned Corps and thus the main spokesperson on issue on Public
Health.
 She was inducted into the US National Women’s Hall of Fame in 2000.
Faye Glenn Abdellah
 It was in 1960 that she was profoundly influenced by the desire to promote client-
centered all- inclusive nursing care, thus making the idea of Nursing as true
Humanitarian service to individuals, to families and therefore to the society.
 According to her, Nursing is grounded as an arts and science that molds the
attitudes, intellectual capabilities and technical know-how of the individual nurse into
the desire and the capacity to assist people, sick or well, and deal to with their health
needs.
 As a complete humanitarian service, nursing includes the following;
 Be acquainted with the nursing problems of the patients

 Choose the definite courses of action to make in the scope of relevant nursaing
principles.
 Make available continuous care of the individuals entire health needs.
 Give continuous care to relieve pain and discomfort and provide immediate security
for individuals.
 Regulate the total nursing care plan to meet the patient's tailored needs.
1. To maintain good hygiene and physical comfort.
2. To promote optimal activity; exercise, rest, sleep
3. To promote safety through prevention of accident, injury or other trauma and through prevention of
the spread of infection.
4. To maintain good body mechanics and prevent the correct deformity.
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition for all the body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognized the physiologic responses of the body to the disease conditions- pathologic,
physiologic and compensatory.
10. To facilitate the maintenance of regulatory mechanism and functions.
11. To facilitate the maintenance of sensory functions.
12. To identify and accept positive and negative expressions, feelings, and reactions.
13. To identify and accept interrelatedness of emotions and inorganic illness.
14. To facilitate the maintenance of effective verbal and nonverbal communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress toward achievements an personal spiritual goals.
17. To create or maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical, emotional and developmental
needs.
19. To accept the optimum possible goals in the light of limitations, physical and emotional.
20. To use community resources as an aid in resolving problems that arise from illness.
21. To understand the role of social problems as influencing factors in the cause of illness.
Ernestine Wiedenbach
o Ernestine Wiedenbach is known for her work in theory development and maternal
infant nursing.
o She develop her theory when she was teaching maternal nursing at the School of
Nursing, Yale University.
o She directed the major curriculum in maternal and new born health nursing when the
Yale School of Nursing established a master’s degree program and is the author of
books used widely in nursing education.
o Wiedenbach’s orientation is a philosophy of nursing that guides the nurse’s actions

in the art of nursing.
o Wiedenbach’s specified four (4) elements of clinical nursing:

1. Philosophy
2. Purpose
3. Practice
4. Art
o She postulated that clinical nursing is directed toward meeting the patient’s
perceived need for help.
o Her vision of nursing reflects the period when considerable emphasis was placed on
the art of nursing.
o She followed Orlando’s theory of deliberate rather than automatic nursing and
incorporated the steps of the nursing process.
o Wiedenbach propose that nurses identify patient’s need for help in the following
ways:
1. Observing behaviors consistent or inconsistent with their comfort.

2. Exploring the meaning of their behavior.
3. Determining the cause of their discomfort or incapability.
4. Determining whether they can resolve their problems or have a need for help.
Lydia Hall
o Lydia Hall was a rehabilitation nurse who used her philosophy of nursing to establish the
Loeb Center for Nursing and Rehabilitation at Montefiore Hospital in New York and
served as administrative director of the Loeb Center from the time of its opening in 1963 until
her death in 1969.
o Using three interlocking circles to represent aspects of the patients and nursing functions.
Hall proposed that nursing functions differ. The care circle represent the patient’s body, the
cure circles represents the disease’s that affects the patient's physical system, and the core
circles represents the inner feelings and management of a person.
The Person
Social Sciences Therapeutic use of self-
aspects of nursing
“The Core”
The Disease
The Body Pathological and Therapeutic Sciences
Natural and Biological Sciences intimate Seeing the patient and family through the
bodily care--- medical care---
aspects of nursing Aspect of nursing
“The Cure”
“The Care”
o Hall believed that professional nursing care hastened recovery and that as less
medical care was needed, more professional nursing care and teaching were
necessary.
o Hall stressed the autonomous function of nursing.
o Her conceptualization encompasses adult patients who have passed the acute
stage of illness.
o The goal for the patient is rehabilitation and success in self- actualization and self-
love.
Joyce Travelbee
 Joyce Travelbee was born in 1926, was a psychiatric nurse, educator and
writer.
 She started a doctoral program in Florida in 1973.
 She was not able to finish the program because she died late at the prime age
of 47 after a brief sickness.
 Nursing care needed a “humanistic revolution”- a return to focus on

the caring function towards the illness person.
 The travelbee’s mentor, Ida Jean Orlando is one of her influences in

her theory.
 She stated that the purpose of nursing is to “assist an individual, family or
community to prevent or cope to the experience of illness and suffering and if
necessary, to find meaning in this experiences.’
 Her human to human relationship model, the nurse and the patient
undergoes the following series of interactional phases.
1. Original Encounter
this is described as the first impression by the nurse of the sick person
and vice-versa.
2. Emerging Identities
this phase is described by the nurse and the patient perceiv9ing each
other as unique individuals. At the same time, the link of relationship begins
to form.
3. Empathy
this phase is described as the ability to share in the person’s
experience. The result of the emphatic process is the ability to expect the
behaviour of the individual with whom he or she emphatized.
4. Sympathy
sympathy happens when the nurse wants to lessen the cause of the
patient’s suffering. It goes beyond empathy.
5. Rapport
described as nursing interventions that lessens the patient’s suffering.
The sick person shows trust and confidence in the nurse. “ A nurse is able
to establish rapport because she possesses the necessary knowledge and
skills required to assists ill persons and because she is able to perceived,
respond to and appreciate the uniqueness of the ill human being”.
Interactional phases are in consecutive order and developmentally achieved
by the nurse and the patient as their relationship with one another goes
deeper and more therapeutic.
Joyce Travelbee
o Joyce Travelbee presented her Human-Human Relationship theory in her book,

Interpersonal Aspects of Nursing (1966,1971)
o She proposed that the goal of nursing was to assist an individual, family or
community to prevent or cope with the experiences of illness and suffering and if
necessary, to find meaning in these experiences, with the ultimate goal being the
presence of hope.
o She proposed that the nursing was accomplished through Human to Human
Relationships that began with;
1. The original encounter, which progressed through stages of
2. Emerging identities
3. Developing feelings of empathy
4. Sympathy until
5. The nurse and the patient attained rapport in the final stage.
o Trevelbee believed that it was as important to sympathize as it was to
emphasize if the nurse and the patient were to develop the human to human
relationship.
o Travelbee’s emphasis on caring stressed empathy, sympathy, rapport and

the emotional aspects of nursing .
Kathryn E. Barnard
• Kathryn E. Barnard is an active researcher, educator, and consultant who

was published extensively since the mid-1960’s about improving the health
infants and their families.
• She began her work by studying mentally and physically handicapped

children and adults, move into studying the activities of the well child and
then expanded her work to include methods the growth and development of
children and mother-infant relationship and how the environment an
influence the course of development for children and families.
• She is the founder of the Nursing Child Assessment Satellite Training
Project (NCAST), which provides healthcare workers around the globe
with guidelines for assessing infant development and parent-child
interactions.
• Barnard theory borrows from psychology and human development and

focuses on mother-infant interaction with the environment.
• Her theory is based on scales designed to measure the effects of feeding,

teaching and environment.
Evelyn Adam
• Evelyn Adam is a Canadian nurse who started publishing in the mid1970’s.
• She uses a model that she learned from Dorothy Johnson.
• In her book, To Be a Nurse, she applies Virginia Henderson’s definition

of nursing to Johnson’s model and identifies the assumptions, beliefs and
values as well major units.
• She includes the goal of the profession, the beneficiary of professional

service, the role of the professional, the source of the beneficiary's
difficulty, the intervention of the professional and the consequences.
Nancy Roper, Winifred W. Logan, and Alison
J. Tierney
• Nancy Roper as a practical theorist who produced a simple nursing theory, “ which
actually helped bedside nurse”.
• In the model of Nursing, the ALs include maintaining a safe environment,

communicating, breathing, eating and drinking, eliminating, personal cleansing and
dressing, controlling body temperature, mobilizing, working and playing, expressing
sexuality, sleeping and dying.
• The five groups of factors that influenced the ALs are biological, psychological,
sociocultural, environmental and politico economic.
• Individuality of living is the way in which the individuals attends to the ALs in regard
to the individual’s place in a life span. On the dependence-independence continuum,
and as influenced bi biological, psychological, socio-cultural, environmental and
politico economic factors.
• Individualizing is accomplish by using the process of nursing, which involves
four phases:
1. Assessing
2. Planning
3. Implementing
4. Evaluating
• The process is simply a method of logical thinking and it should be used

with an explicit nursing model.
Ida Jean (ORLANDO) Pelletier
 Ida Jean Orlando develop her theory from a study that she conducted at
Yale University School of Nursing on integrating mental health concepts
into a basic nursing curriculum.
 Orlando’s theory stress the reciprocal relationship between patient and

nurse.
 What the nurse and the patient say and do affects them both.
 Orlando views the professional functions of nursing as finding out and

meeting the patient’s immediate need for help.
 Orlando’s theory remains one of the most effective practice theories and is
especially helpful to new nurses as they begin their practice.
SYSTEMTHEORY
BETTY NEUMAN’S
System model in nursing
 Betty Neuman was born in 1924 on a farm near Lowell, Ohio. Her father was
a farmer and her mother was a homemaker.
Growing up in a rural Ohio, she develop love for the land and her compassion
for the people in need. Neuman’s initial nursing was completed with the double
honors at People’s Hospital School of nursing (no General hospital).
In California, she worked in variety of nursing roles that includes hospital staffs
and head nurse, school nurse and industrial nurse.
She had been interested in human behavior; therefore she attended the
university of California at Los Angeles (UCLA) with the double major in Public
Health and Psychology.
BETTY NEUMAN’S
She completed her Baccalaureate Degree with honors in Nursing in 1957 and
then helped established and manage her husband’s medical practice.
In 1966, she received her Master’s Degree in Mental Health, Public Health
Consultation from UCLA.
She received a Doctoral Degree in Clinical Psychology from Pacific Western

University in 1985.
She is a Fellow of the American association of Marriage and Family.
System model in nursing
 Client Variables
can be one or combination of the following: physiological, sociocultural,
developmental and spiritual, these variable function to achieve stability in relation to
the environmental stressors experienced by the client.
Lines of Resistance
act when the normal Line of the Defense is invaded by too much
stressor, producing alterations in the client’s health. It acts to facilitate coping
to overcome the stressors that are present within the individual.
 Normal Line of Defense

must act in coordination with the normal wellness state. It must reflect
the actual range of responses that are normally acted by clients in response to
many stressors. It is the baseline in determining the level of wellness of client
within the continuum of health.
Flexible Line of Defense

serves as the boundaries for the Normal Line of Defense to adjusts
to situations that threaten the imbalance within the client’s stability. It
expanded the range of normal defense from becoming invade by the stressors
thus increasing its protection.
 Reconstitution
is the adjustments state from the degree of reaction. It is a state of
going back to the actual state of health before the illness occurred.
Stressors
are forces that produce tensions, alterations or potentials problem
causing instability within the clients system. Identifying the stressors help
nurses to appropriately use actions to address and help solve the produced
problems.
Stressors can be:
1. Intrapersonal- occurs with the self and comprises of man as a psycho
spiritual being.
2. Interpersonal- occurs between two or more individual and consists of man
as a social being.
 Reaction
are the outcomes or produced results of certain stressors and actions
of the lines resistance of a client. It can be positive or negative depending on
the degree of reaction the client produces to adjust and adapt with the
situation.
Negentropy- is set towards stability or wellness
Egentropy-is set towards disorganization of the system producing illness.

Prevention
is used to attain balance within the continuum of health.
3 Levels of Prevention
1. Primary Prevention
focuses on foreseeing the result of an act or situation and preventing its
unnecessary effects as possible. It also aims to strengthen the capacity of a
person to maintain an optimum level functioning while being interactive with the
environment, like health, promotion and disease prevention.
2.Secondary Prevention
focuses on helping alleviate the actual existing effect of an actions that
altered the balance of health of a person. It aims to produce environmental
influences that lead to the decline of the level of functioning of a person and
strengthen or restoring a person’s resistance after the illness exposure.
3.Tertiary Prevention
focuses on actual treatments or adjustments to facilitate the strengthening of
person after being exposed to a certain disease or illness. It aims to prevent the
regression or reoccurrence of the illness in the manner of rehabilitation, as in the
case of disability avoidance and physical therapy.
Dorothy Johnson
Behavioral System Model
Dorothy Johnson was born in savannah, Georgia, in 1919. the youngest in a family of seven.
Obtained her Bachelor of Science in Nursing degree from Vanderbilt University, Nashville,
Tennessee and her Masters in Public Health from Harvard University in Boston, Massachusetts.
Most of her education career was in Pediatric Nursing at the University of California, Los Angeles.
Dorothy Johnson has influenced nursing through her publications since the 1950s.
Johnson made her cause on the importance of Research-Based knowledge about the
effect of nursing care on clients.
In 1992, Johnson uttered that much of her thinking was influenced by Florence
Nightingale.
In the 1950s and 1960s, as Johnson enlarged her model, an escalating number of
observational studies on child and adult behavior patterns were available
All these experiences influenced Johnson in the developmental of her Behavioral

System Model.
Behavioral System Model
Johnson believes that each individual has a focusing and repeating ways of acting
which covers a behavioral system distinct to that individual.
These behaviors are logical, fixed, predictable and adequately secure and persistent
to be satisfying to depiction and clarification.
Johnson identifies the seven subsystems with the Behavioral System Model. These
subsystems were originally in Johnson’s 1968 paper presented at Vanderbilt
University. The seven subsystems are considered to be interrelated, thus changes in
one subsystem affect all the subsystem.
Seven Behavioral System Model
1. The attachment or Affilliative Subsystem

is well-known as the earliest response system to expand in the individual.
The most favorable functioning of the affilliative system allows social inclusion,
closeness and the pattern and continuance of a strong public bond.
Attachment to a noteworthy caregiver has been found to be important to the
survival of an infant.
2. The dependency subsystem

is distinguished from the attachment or the affilliative subsystem.
Dependency behavior are actions that trigger nurturing behaviors from other
individuals in environment. The product of the dependency behavior is consent,
interest or appreciation and physical support.
3. The Ingestive subsystem

related the behavior surroundings the ingestion of food. It is associated in the
biological system. The perspective is in the significance and arrangement of the
social events surrounding the occasion when food is eaten. Behaviors related to the
ingestion of food may relate to more what is socially satisfactory in a specified
culture, than to the biological necessities of the human being.
4. The Eliminative Subsystem

relates to the behavior surroundings the secretion of wastes products from
the body. Johnson’s conclude this may be tricky to separate from a biological
system perspective. However, as with behaviors surroundings the ingestion of food,
there are socially adequate behaviors for time and place for human to excrete waste.
Human cultures have defined different socially acceptable behaviors for excretion
of waste, but a continuation of such an outline remains from culture to culture.
5. The Sexual subsystem

imitates behaviors related to procreation or reproduction. Both biological and
social factors are involved behaviors in the sexual system. again, the behaviors are related
to culture and vary from culture to culture. Behaviors vary according to the gender of the
individual. The key is that the goal in the all society has the same outcome-behaviors
suitable to the society at large
6. The Aggressive Subsystem

relates to the behaviors concerned with defense and self-preservation. Johnson
sees the aggressive subsystem as one that creates defensive responses from the
individual when life or territory is threatened. The aggressive subsystem does not
includes those behaviors with the primary purpose of injuring others individuals, but rather
those whose purpose is to protect and conserve self and society.
7. The Achievement Subsystem

contains behaviors that attempts to control the environment.
Intellectual, physical, mechanical, imaginative and communal skills are some of
the areas that Johnson distinguished. Other areas of personal
accomplishments or success may also be integrated in this subsystem.
Imogene King
Goal Attainment Theory
Imogene King earned a diploma in nursing from St. John’s Hospital of Nursing in St. Louis,
Missouri, in 1945.
From 19478 to 1958, King worked as an instructor in Medical-Surgical Nursing and as an

assistant director at St’ john’s Hospital’s of Nursing. She earned an MSN (1957) from St.
Louis University and a Doctor of Education (1961) from Teachers College, Columbia
University, New York.
King was awarded an honorary Ph D from Southern Illinois University in 1980.
In 1981, the manuscript for her second book entitled A theory for Nursing: Systems, Concepts,
Process was published. She authored a multiple book chapters and articles in professional journals
and a third book, Curriculum and Instruction in Nursing, was published in 1986.
Currently, she is the one of the founding members of a nursing organizations, the King
International Nursing Group (KING), established to facilitate the spread and use of her
interacting system framework, Theory of Goal attainment, and related theories.
The theory focuses on creating a positive behavior that can be adapted both by the nurse and
client to achieve goals established by the clients with the help of the nurse.
Interacting Systems Framework
This level are independent and at the same time co-exist to influenced over-all nursing practice.
1.Personal – how the nurse views and integrate self based from personal goals and beliefs.
2.Interpersonal- how the nurse interrelates with a co-worker or patient, particularly in nurse-
patient relationship.
3.Social- how the nurse interacts with co-workers, superiors, subordinates and the client
environment in general
Goal Attainment Theory
1. Action- is a means of behavior or activities that are towards the accomplishment of certain act.it
is both physical and mental.
2.Reaction –is a form of reacting or a response to a certain stimuli.
3.Interaction – is any situation wherein the nurse relates and deals with a clientele or patient.
4.Open System- is the absence of the boundary existence, where a dynamic interaction between
the internal and external environment can exchange information without barriers or hindrances.
Proposition of King’s Goal Attainment Theory
King gave proposal wherein goal attainment is possible if the nurse will fulfill several
conditions:
If a continues accuracy is currently is a nurse-patient interaction, a

transaction will happen.
If a nurse and patient will build a transactions, goals will be achieved
If goals are achieved, satisfaction will happen
If goals are met, efficient nursing care will happen
If transactions are done in a nurse-client interaction, growth and
development will increase
If role anticipation and performance in the nurse and patient are the same,
transactions will happens
If role disagreement happens in both nurse and patient, stress would be the
result.
If nurse with exceptional skills and knowledge correspond adequate
information to the patient, the same goals and accomplishments will happen.
Dorothea Orem
Self-Care Deficit theory in Nursing
Dorothea Elizabeth Orem, one of the America’s Foremost nursing Theorist, was
born in Baltimore, Maryland in 1914.
Her early nursing experience included operating room nursing, private duty nursing
(home and hospital), hosp[ital staff nursing on pediatric and adult medical;-surgical units,
evening supervisor in the emergency room, and biological science teaching.
Self Care
ia an activity that promotes a person’s well-being. It is perform by the
persons who are aware of the time frames on behalf of maintaining life,
continuing personal development and a healthy functional living.
Self Care
is an activity that promotes a person’s well-being. It is perform by the persons who are aware of
the time frames on behalf of maintaining life, continuing personal development and a healthy functional
living.
Self-Care Requisites
are insights of actions or requirements that a person would ne able to meet and perform in
order to achieve well-being . These are reasons for many actions of self-care must be undertaken. The
two elements of self-care requisites are:
1. The factors to be controlled or managed to keep as aspects of human functioning and development
within the norms compatible with life, health and personal well-being and;
2. The nature of the required action.
Universal Self-Care Requisites

-these are universally set goals that must be undertaken in order an individual to function in scope of a
healthy living. The eight self-care requisites common in men, women and children are the following:
• Maintenance of sufficient intake of air.
• Maintenance of sufficient intake of food
• Maintenance of sufficient intake of water
• Provision of care associated with elimination
• Maintenance of balance between activity and rest.
• Maintenance of balance between solitude and social interaction
• Prevention of hazards to human life, human functioning and human well-being; and
• Promotion of human functioning and development.
KEY AREAS OF RESPONSIBILITY

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1.

Phenomenon An empirical data that can

2. Concepts Building blocks of theories

3. Conceptual Derived from a persons

5. Statements that the

I. INTRODUCTION TO NURSING THEORY

-the etymology: greek word “theoria”

-which means “contemplation, speculation”.

-From “spectator”, thea- “ a view + horan- “ to see”,

RESEARCH ERA and

defined theory as a “ set of statements that

defined theory as “ an internally consistent

“ a theory is a set concept and

“an abstract statement formulated

A theory implies that something has

Theories can correlate

Defined nursing as…..

Defined nursing as…..

• “Practice without theory, like a map without

Nurses as Nurse’s education Recommended

2.Constantly enlarge the body of

3.Trusts education practitioners to

5.Functions autonomously in the

6. Provides for continuous growth of

 Martha Roger’s Science of Unitary

 Margaret Newman’s Health as Expanding

 Rosemarie Rizzo Parce’s Theory of Human

• Lease abstract level of theoretical

• It is deeply rooted in the

• It includes all deliberate

• It stresses that human beings are not in

The criteria for evaluating each

In evaluating a theory, we must

• It refers to intersubjectivity, wherein

• Diagrams and examples may

A theory should be sufficiently

To determine the generality of a theory,

The broader the scope, the grater the

The theory should be able to generate

Nursing Leader Year Contribution to Nursing

Mary Mahoney (USA) 1879 America’s first trained black nurse

Clara Barton (USA) 1812-1912 Organized and established the American

Nursing Leader Year Contribution to Nursing

Nursing Leader Year Contribution to Nursing

•Considered as “Florence Nightingale of the Philippines.

Change Agent As a change agent, the nurse:

Nurse generalist has mastery in certain practice of nursing. The

Nurse clinician perform direct nursing actions in specialty areas. They

 Nightingale’s theory focused on the environment.

Personal Cleanliness • Attempt to keep the patient dry and clean at

Variety • Attempt to accomplish variety in the room

Taking Food • Check the diet of the patient. Note the

Petty Management • This ensure continuity of care.

Observation of the • Observe and record anythi9ng about the

 Hildegard Peplau was born on September 1, 1909 at Reading, Pennsylvania.

 In 1943, she received a Bachelor of Arts in Interpersonal Psychology from

Interpersonal Relations theory

 Hildegard Peplau hold numerous awards.

 Often referred by Peplau as “ Psychological mothering”, it includes the following

• The Patient is accepted unconditionally as a participant in a relationship that

Role of the Resource Person

She identified four(4) phases of the nurse patient relationship: