A theory, as a general term, is a notion or an idea that explains
experience, interprets observation, describes relationships, and
projects outcomes. Theories are mental patterns or constructs
created to help understand and find
experience, organize and articulate our
questions leading to new insights.
Theory is a creative and rigorous structuring of ideas that projects a
tentative purposeful and systematic view of phenomena.
(Chinn & Kramer, 1995, p. 71)
Nursing theory is a conceptualization of some aspect of reality (invented or
discovered) that pertains to nursing. The conceptualization is articulated for
the purpose of describing, explaining, predicting or prescribing nursing care.
(Meleis, 1997, p. 12)
• Theoria (Greek word) Vision
• A theory is a conceptual system or frame work intended for some
• It composed of interrelated – concepts, models, and propositions
based on assumptions.
• They provide a framework to develop new and validate current
knowledge. They help to describe, explain and predict to
CHARACTERISTICS OF A THEORY:
• Theories can interrelate concepts in such a way as to create a different way of
looking at a particular phenomenon.
• Theories must be logical in nature.
• Theories should be relatively simple yet generalizable.
• Theories can be basis for hypotheses that can be tested.
• Theories contribute to and assist in increasing the general body of knowledge
within the discipline through the research implemented to validate them.
• Theories can be utilized by the practitioners to guide and improve their
• Theories must be consistent with other validated theories, laws and
principles but will leave open unanswered questions that need to be
• Theories are composed of concepts and propositions.
• Theories can consist of separate theories about the same phenomenon that
interrelate the same concepts but describe and explain them differently.
• Can describe a particular phenomenon; explain relationships among phenomenon
on another; or be used to produce or control a desired phenomenon.
• Theories differ from conceptual model; both can describe, explain, or predict a
phenomenon, but only theories provide specific direction to guide practice;
conceptual models are more abstract and less specific than theories but can provide
direction for practice.
CHARACTERISTICS OF A THEORY:
CATEGORISATION OF THEORIES (MELEIS)
DOMAIN CONCEPT NURSING THEORIST / WORK
Nursing clients Johnson: Behavioral System Model for Nursing
Roy : Roy Adaptation Model
Neuman: Neuman System Model
Rogers : Science of Unitary Human Beings
Interactions King: Theory of Goal Attainment
Orlando: Dynamic Nurse Patient relationship
function, process & principles
Paterson Zderad: Humanistic Nursing
Wiednenbach: Clinical Nursing Art
Nursing Therapeutics Levine: Conservation Principles of Nursing
Orem: Orem’s General Theory of Nursing
CATEGORISATION OF THEORIES
Categorization based on scope or level of abstraction:
• Philosophy or Metatheory.
• Grand Theories
•Middle Range Theories
Categorization based on purpose:
Categorization based on Source or Discipline:
• Theories and concepts used from behavioral sciences, biologic sciences, and
sociologic sciences as well as learning theories, organization and management
CATEGORISATION OF GRAND NURSING
MODELS & THEORIES
PROCESS MODELS &
MODELS & THEORIES
Abdellah Artinian and Conger Neuman
Henderson Erickson, Tomline, and
Johnson King Rogers
Paradigm is a global, general framework made up of assumptions about
aspects of the discipline held by members to be essential in development of
• Originates from two Greek words:
Meta, meaning “with” and paradigm, meaning “pattern”.
• It is the most global conceptual or philosophical
framework of a discipline or profession.
• It defines and describes relationships among major ideas
• It guides the organization of theories and models for a
COMPONENTS OF METAPARADIGM
1. Person: Refers the recipient of nursing care, including physical, spiritual,
psychological, and sociocultural components, and can include an individual,
family or community.
2. Environment: Refers to all the internal and external conditions,
circumstances, and influences affecting the person.
3. Health: Refers to the degree of wellness or illness experienced by the person.
4. Nursing: Refers to the actions, characteristics, and attributes of the individual
providing the nursing care.
Metatheory is the highest level of theory (The fourth level of theory)
Is defined by the prefix META, meaning “change in position”, “beyond”,
“on a higher level”, or “transcending,”
Refers to the body of knowledge or about a field of study such as meta
• Macro level theory
• Composed of abstract concepts in relationship.
• This facilitates description but is not capable of research verification.
MIDDLE RANGE THEORY
Theories that are both broad enough to be useful in
complex situations and appropriate for empirical testing.
Composed of less abstract conceptual frame works,
closely aligned to observable reality, thus capable of
It has categorization as:
1. High Middle Range Theory.
2. Middle Middle Range Theory.
3. Low Middle Range Theory.
Practice theories, the first level of nursing theory, describe prescriptions or
modalities for practice.
Four steps are involved to determine practice theories, which include:
• Factor isolating: to identify and describe a phenomenon;
• Factor relating: to identify and describe possible explanations or causes of
• Situation relating: to predict occurrence of a phenomenon when the cause is
• Situation producing control: to prevent occurrence of the phenomenon by
controlling or eliminating possible causes.
Virginia Henderson’s Theory
• Patients require help towards achieving independence.
• Derived a definition of nursing
• Identified 14 basic human needs on which nursing care is based.
Lydia E. Hall Theory
• Care, Cure, Core model
• Nursing care is person directed towards self love.
Jean Watson’s Theory
• Philosophy and Science of caring. Caring is a universal, social phenomenon
that is only effective when practiced interpersonally considering
humanistic aspects and caring. Caring is central to the essence of nursing.
The 10 care factors included in the original work are the following:
1. Formation of a humanistic-altruistic system of values.
2. Instillation of faith-hope.
3. Cultivation of sensitivity to one’s self and to others.
4. Development of a helping-trusting, human caring relationship.
5. Promotion and acceptance of the expression of positive and negative
6. Systematic use of a creative problem-solving caring process.
7. Promotion of transpersonal teaching-learning.
8. Provision for a supportive, protective, and/or corrective mental, physical,
societal, and spiritual environment.
9. Assistance with gratification of human needs.
10. Allowance for existential-phenomenological, spiritual forces.
Faye G. Abedellah’s Theory
• Typology of twenty one Nursing problems .
• Patient’s problems determine nursing care
Ernestine Wiedenbach Theory
• The helping art of clinical nursing
• Helping process meets needs through the art of individualizing care.
• Nurses should identify patients ‘need-for –help’ by:
– Understanding client behaviour
– Identifying cause of discomfort
• Determining if clients can resolve problems or have a need for help
Dorothea E. Orem’s Theory
• Dorothea E. Orem’s Self care deficit theory in nursing.
• Self–care maintains wholeness.
• Three Theories:
– Theory of Self-Care
– Theory of Self-Care Deficit
– Theory of Nursing Systems
• Nursing Care:
– Wholly compensatory (doing for the patient)
– Partly compensatory (helping the patient do for himself or herself)
• Supportive- educative (Helping patient to learn self care and
emphasizing on the importance of nurses’ role
Myra Estrin Levine’s Theory
• Myra Estrin Levine’s: The conservation model
• Proposed that the nurses use the principles of conservation of:
– Client Energy
– Personal integrity
– Structural integrity
– Social integrity
• A conceptual model with three nursing theories –
• Therapeutic intention
Martha E. Roger’s Theory
• Martha E.Roger’s: Science of unitary human beings.
• Person and environment are energy fields that evolve negentropically
• Nursing is a basic scientific discipline
• Nursing is using knowledge for human betterment.
• The unique focus of nursing is on the unitary or irreducible human being
and the environment (both are energy fields) rather than health and
• Dorothy E.Johnson’s Behavioural system model
• Individuals maintain stability and balance through adjustments and
adaptation to the forces that impinges them.
• Individual as a behavioural system is composed of seven subsystems: the
subsystems of attachment, or the affiliative, dependency, achievement,
aggressive, ingestive-eliminative and sexual.
• Disturbances in these causes nursing problems.
Sister Callista Roy‘s
• Sister Callista: Roy‘s Adaptation model.
• Stimuli disrupt an adaptive system
• The individual is a biopsychosocial adaptive system within an
• The individual and the environment provide three classes of stimuli-the
focal, residual and contextual.
• Through two adaptive mechanisms, regulator and cognator, an individual
demonstrates adaptive responses or ineffective responses requiring
• Betty Neuman’s : Health care systems model
• Neuman’s model includes intrapersonal, interpersonal and extrapersonal
• Nursing is concerned with the whole person.
• Nursing actions (Primary, Secondary, and Tertiary levels of prevention)
focuses on the variables affecting the client’s response to stressors.
• Imogene King’s Goal attainment theory.
• Transactions provide a frame of reference toward goal setting.
• Major concepts (interaction, perception, communication, transaction,
role, stress, growth and development)
• Perceptions, Judgments and actions of the patient and the nurse lead to
reaction, interaction, and transaction (process of nursing).
Hildegard E. Peplau
• Hildegard E. Peplau: Psychodynamic Nursing Theory
• Interpersonal process is maturing force for personality.
• Stressed the importance of nurses’ ability to understand own behaviour to help
others identify perceived difficulties.
• The four phases of nurse-patient relationships are:
– 1. Orientation
– 2. Identification
– 3. Exploitations
– 4. Resolution
• The six nursing roles are:
– 1. Stranger
– 2. Resource person
– 3. Teacher
– 4. Leader
– 5. Surrogate
– 6. Counselor
• Interpersonal process alleviates distress.
Ida Jean Orlando’s
• Ida Jean Orlando’s Nursing Process Theory
• Nurses must stay connected to patients and assure that patients get what
they need, focused on patient’s verbal and non verbal expressions of need
and nurse’s reactions to patient’s behaviour to alleviate distress.
• Elements of nursing situation:
– Nurse reactions
• Nursing actions
Kathryn E. Barnard’s
• Kathryn E. Barnard’s Parent Child Interaction Model
• Growth and development of children and mother–infant relationships
• Individual characteristics of each member influence the parent–infant
system and adaptive behaviour modifies those characteristics to meet the
needs of the system.
• Madeleine Leininger’s Transcultural nursing, culture-care theory.
• Caring is universal and varies transculturally.
• Major concepts include care, caring, culture, cultural values and cultural
• Caring serves to ameliorate or improve human conditions and life base.
• Care is the essence and the dominant, distinctive and unifying feature of
• Nola J.Pender’s :The Health promotion; model
• Promoting optimum health supersedes disease prevention.
• Identifies cognitive, perceptual factors in clients which are modified by
demographical and biological characteristics, interpersonal influences,
situational and behavioural factors that help predict in health promoting