THEORETICAL
FOUNDATION
OF NURSING
College of Nursing
NCM 200
lesson 1, part 1
Introduction to Nursing Theory:
its History and Significance
NCM 200
History of Nursing Theory
History of professional nursing began with Florence
Nightingale.
Development of nursing knowledge apart from
medical knowledge to guide nursing practice.
Nursing was based on principles and traditions that
were handed down through an apprenticeship model
of education and individual hospital procedure
manual.
NCM 200
History of Nursing Theory
Nursing practice reflected it’s vocational heritage more
than it’s professional vision.
Develop a body of specialized knowledge on which to
base nursing practice.
Strong emphasis on practice and worked throughout
the century toward the development of nursing as a
profession.
NCM 200
Curriculum Era
Address the question of what content nurse should study to
learn how to be a nurse.
Emphasis was on what courses nursing students should take,
with the goal of arriving at a standardized curriculum
The idea of moving nursing education from hospital-based
diploma programs into colleges and universities began to
emerge during this era.
Emphasized course selection and content for nursing
programs and gave way to the research era
NCM 200
Research Emphasis Era
Focused on the research process and the long-range
goal of acquiring substantive knowledge to guide
nursing practice.
Sought degrees in higher education began to emerge.
Began to participate in research and research courses
were included in nursing curricula
NCM 200
Research Emphasis Era
Awareness for the need of concept and theory
development coincided with two other milestones in the
evolution of nursing theory:
1. The standardization of curricula for nursing
master’s education by the National League for
Nursing accreditation criteria for baccalaureate
and high-degree programs.
2. The decision that doctoral education for nurses
should be in nursing
NCM 200
Graduate Education Era
Developed in tandem with the research era.
Master’s degree programs in nursing emerged to meet
the public need for specialized clinical nursing practice.
Included concepts in:
1. Concept development
2. Nursing models
3. Early nursing theorist
4. Knowledge development process
NCM 200
Graduate Education Era
Baccalaureate degree began to gain wider acceptance as:
A. Educational level for professional nursing
B. Academic discipline in higher education
Nurse researchers worked to develop and clarify a
specialized body of nursing knowledge with the following
goals:
A. Improving the quality of patient care
B. Providing a professional style of practice
C. Achieving recognition as a profession
NCM 200
Graduate Emphasis Era
Transition from vocation to profession.
Meleis (2007) noted, “theory is not a luxury in the
discipline of nursing...but an integral part of the
nursing lexicon in education, administration and
practice”
Important precursor was the acceptance of nursing as
a profession and an academic discipline in its own
right.
NCM 200
Theory Era
A natural outgrowth of the research and graduate
education eras.
Emphasis on theory development and testing.
Accelerated as early works developed as frameworks
for curricula and advanced practice guides began to
be recognized as theory
NCM 200
Theory Era
Classification of nursing models as paradigms within
metaparadigm concepts are following:
A. Person
B. Environment
C. Health
D. Nursing
The said classification united nursing theoretical works for
the discipline.
NCM 200
Theory Era
Emphasis shifted from learning about the theorist to use
of the theoretical works to generate:
a. Research questions
b. Guide practice
c. Organize curricula
NCM 200
Theory Era
Theory development emerged as a process and product of
professional scholarship and growth and sought higher
education among:
1. Nurse leaders
2. Administrators
3. Educators
4. Practitioners
NCM 200
Nursing Theory Era
The use of theory to convey an organizing structure
and meaning for these processes to the convergence
of ideas.
Fitzpatrick and Whall (1983) had said, “Nursing is on
the brink of an exciting new era"
NCM 200
Theory Utilization Era
Emphasis shifted to theory application in nursing
practice, research, education and administration.
Restored balance between research and practice for
knowledge development in the discipline of nursing.
Emphasis to produce evidence for quality professional
practice.
NCM 200
Theory Utilization Era
Types of nursing theoretical works:
1. Nursing philosophy
Sets forth the meaning of nursing phenomena
through analysis, reasoning and logical presentation
Basis for subsequent development
1. Nursing conceptual methods
Comprises nursing works by the theorist who also are
referred to as pioneers in nursing
NCM 200
Theory Utilization Era
3. Nursing Theory
derived from nursing philosophies, conceptual models
or more abstract nursing theories, or from works of
other disciplines
Developed from some conceptual framework and is
more specific than the framework
Theories may be specific to a particular aspect or
setting of nursing practice
NCM 200
Theory Utilization Era
4. Middle Range Theory
More specific focus and is more concrete than nursing theory in
its level of abstraction.
More precise , with a focus on answering specific nursing
practice questions
Address the specifics of nursing situations within the
perspective of the model or theory from which they are derived.
They specify each factor as:
a. The age group of the patient d. The location of the patient
b. The family situation e. The action of the nurse
c. The health condition
NCM 200
Theory Utilization Era
Nursing Nursing Middle Range
Nursing Theories
Philosophies Conceptual Models Nursing Theories
Mercer
Boykin and
Mishel
Schoenhofer
Levine Reed
Nightingale Meleis
Rogers Wiener and Dodd
Watson Pender
Orem Eakes, Burke and
Ray Leininger
King Hainsworth
Benner Parse
Neuman Barker
Martinsen Erikson, Tomlin
Roy Kalkaba
Erikson and Swain
Johnson Beck
Husted and
Swanson
Husted
Ruland and Moore
NCM 200
HISTORICAL ERAS OF NURSING’S SEARCH FOR SPECIALIZED KNOWLEDGE
Major
Historical Era Emphasis Outcomes Emerging Goal
Question
What curriculum
Standardized Develop specialized
Curriculum Era: 1900- content should Courses included in
curricula for knowledge and
1940s student nurses nursing programs.
diploma programs. higher education.
study to be nurses?
What is the focus Problem studies Isolated studies do
Research Era: 1950- Role of nurses and
for nursing and studies of not yield unified
1970s what to research.
research? nurses. knowledge.
Carving out an
What knowledge is Nurses have an Focus graduate
Graduate Education advanced role and
needed for the important role in education on
Era: 1950-1970s basis for nursing
practice of nursing? health care. knowledge.
practice.
NCM 200
HISTORICAL ERAS OF NURSING’S SEARCH FOR SPECIALIZED KNOWLEDGE
Major
Historical Era Emphasis Outcomes Emerging Goal
Question
How do these Nursing theoretical
There are many Theories guide
Theory Era: 1980- frameworks guide works shift the
ways to think about nursing research
1990s research and focus to the
nursing. and practice.
practice? patient.
Nursing
Middle-range
What new theories Nursing theory frameworks
theory may be
Theory Utilization are needed to guides research, produce
from quantitative
Era: 21st century produce evidence practice, education knowledge
or qualitative
foe quality care? and administration. (evidence) for
approaches
quality care.
lesson 1, part 2
Significance of Nursing Theory
NCM 200
Significance of Nursing Theory
DISCIPLINE- specific to academia and refers to a
branch of education, a department of learning, or
domain of knowledge
PROFESSION- refers to a specialized field of practice,
founded upon the theoretical structure of the science
or knowledge of the discipline and accompanying
practice abilities.
NCM 200
Significance for the Discipline
This emphasis led into theory development era that
moved nursing toward the goal developing nursing
knowledge to guide nursing practice.
The discipline and the profession are inextricably
linked and failure to recognize and separate them from
each other anchors nursing in a vocational rather than
a professional view.
NCM 200
Significance for the Discipline
The significance of theory for the discipline of nursing-
the discipline is dependent on theory for its continued
existence.
Nursing can be vocational or nursing can be discipline
with a professional style of theory-based practice.
Nurses moved from the functional focus, with an
emphasis on what nurses do, to patient focus,
emphasizing what nurse know for thought, decision
making and action.
NCM 200
Significance for the Discipline
Forms of basis in recognizing nursing as discipline:
a. Knowledge of person
b. Health
c. Environment
Every discipline or field of knowledge includes
theoretical knowledge.
Nursing as academic discipline depends on the
existence of nursing knowledge.
NCM 200
Significance for the Profession
Theory is essential for the existence of nursing as an
academic discipline.
Theory is also vital to the practice of professional
nursing.
Higher degree nursing is recognized as a profession
today.
Nursing was the subject of numerous studies by
sociologist who used the criteria for a profession.
NCM 200
Significance for the Profession
Criteria for development of the professional status of nursing:
1. Utilizes in its practice a well-defined and well organized
body of specialized knowledge (that) is on the
intellectual level of higher learning.
2. Constantly enlarges the body of knowledge it uses and
improves its techniques of education and service
through use of the scientific method.
3. Entrust the education of its practitioners to institutions
of higher education.
NCM 200
Significance for the Profession
Criteria for development of the professional status of nursing:
4. Applies its body of knowledge in practical services vital to
human and social welfare.
5. Functions autonomously in the formulation of professional
policy and thereby in the control of professional activity.
6. Attracts individuals with intellectual and personal qualities
of exalting service above personal gain who recognize their
chosen occupation as a life work.
7. Strives to compensate its practitioners by providing
freedom of action, opportunity for continuous professional
growth and economic security.
NCM 200
Significance for the Profession
Nursing is recognized as a profession and emphasis is
placed on the relationship between nursing theoretical
works and achievement of status as a profession.
The use of substantive knowledge for the theory-based
evidence for nursing is a quality that is characteristic of
their practice.
The commitment to the theory-based evidence for
practice is beneficial to patients in that it guides
systematic, knowledgeable care
FIN.
thank you for listening.
