Nursing Theories

4 Concepts of Central Nursing:

• Person
• Environment
• Nursing
• Health
  

Nightangle’s Environmental theory – Florence Nightangle, “the mother of modern nursing” espoused her theory focusing on the environment. She linked health with five environmental factors:
1. pure or fresh air
2. pure water
3. efficient drainage
4. cleanliness
5. light

Henderson’s Definition of Nursing- The definition of nursing given by Virginia Henderson in 1955 became a milestone in the development of nursing as discipline apart from medicine. The focus on her Nursing Concept is to help individuals and families gain independence in meeting the 14 fundamental needs;
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body wastes
4. Moving and maintaining desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining body temperature within normal range by adjusting clothing and modifying the environment
8. Keeping the body clean and well-groomed to protect the integument
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) Working in such a way that one feels a sense of accomplishment
(13) Playing or participating in various forms of recreation
(14) Learning, discovering, or satisfying the curiosity that leads to normal development and health, and using available health facilities.

Rogers’s Science of Unitary Human Beings - Martha Rogers views the person as an irreducible whole, the whole being greater than the sum of its parts. Her Key concepts in describing the individual are energy fields, openness, pattern and organization, and multidimensionality. She described the Unitary Man as:
1. Irreducible, four-dimensional energy field identified by pattern.
2. Manifesting characteristics different from the sum of the parts
3. Interacts continuously and creatively with the environment
4. Behaving as a totality
5. Participating creatively in change

Orem’s Self Care Deficit Theory – Dorothy Orem developed the self-care deficit theory that includes self-care, self-care deficit and nursing system. She believed that the self-care of the individuals and the self-care of dependents are learned behaviors that individuals initiate and perform on their own behalf to maintain life, health, and well-being. According to Rogers, there are three kinds of self-care requisites:
1. Universal requisites ( common to everybody like maintenance of air, water etc…)
2. Developmental requisites
3. Health deviation requisites

Roy’s Adaptation Model – Sister Callista Roy focuses on the individual as a biophysical adaptive system. Both the individual and the environment are sources of stimuli that require modification to promote adaptation, an ongoing purposive response. Roy identified three classes of stimuli:
1. Focal Stimulus: the internal or external stimulus most immediately confronting the person and confronting the behavior.
2. Contextual stimuli: all other internal or external stimuli present
3. Residual Stimuli: beliefs, attitudes, or traits having an intermediate effect on the person’s behavior but whose effects are not validated.

King’s Goal Attainment Theory – Imogene King based her theory from the conceptual framework of three dynamic interacting systems:
1. personal system concepts: perception, self, body image, growth and development, space and time
2. Interpersonal system concepts: interaction, communication, transaction, role, and stress.
3. Social system concepts: organization, authority, power, status, and decision making.

Neuman’s Health Care Systems Model – Betty Neuman views the client as an open system consisting of a basic structure or central core of energy resources (physiologic, psychologic, sociocultural, developmental, and spiritual) surrounded by two concentric boundaries or rings referred to as lines of resistance. She identified individual’s response to stress and the nursing interventions to be carried out on three preventive levels:
1. Primary prevention
2. Secondary prevention
3. Tertiary Prevention

Johnson’s Behavioral System Model - Dorothy Johnson defines a system as a whole that functions as a whole by virtue of the interdependence of its parts. A behavioral system is patterned, repetitive and purposeful. Johnson’s key concepts describes the individual as a behavioral system composed of seven subsystems:
1. attachment-affiliative subsystem provides survival and security.
2. Dependency subsystem promotes helping behavior that calls for a nurturing response.
3. Ingestive system satisfies appetite.
4. Eliminative subsystem excretes body wastes.
5. Sexual subsystem functions dually for procreation and gratification.
6. Achievement subsystem attempts to manipulate the environment.
7. Aggressive subsystem protects and preserves the self and society within the limits imposed by the society.

Peplau’s Psychodynamic Nursing Theory- Hildegard Peplau introduced and defined psychodynamic nursing as understanding one’s own behavior to help others identify felt difficulties and applying principles of human relations to problems arising during the experience. She also described the nurse-patient relationship in four phases:
1. Orientation – patient seeks help and the nurse assists patient to understand the problem and the extent of need for help.
2. Identification - patient assumes a posture of dependence, interdependence, and independence in relation to the nurse
3. Exploitation - patient uses available services on the basis of self interest and needs
4. Resolution - old needs and goals are put aside and new ones adopted.

Leininger’s Transcultural Care Theory – Madeleine Leininger established the transcultural nursing which she defined as a major area of nursing that focuses on comparative study and analysis of different cultures and subcultures in the world, with respect to their:
1. Caring behavior
2. Nursing care
3. Health values
4. Beliefs
5. Patterns

Watson’s Philosophy and Science of Caring – Jean Watson believes the practice of caring is central to nursing; it is a unifying focus for practice. According to her, there are two major assumptions that underlie human care (carative factors):
1. care and love constitute the primal and universal psychic energy
2. care and love are requisite for our survival and the nourishment of the society