THEORETICAL FOUNDATIONS IN NURSING

Theory development proceeds as a scientific process.

It all starts with a simple observation that imprints something in the mind. The
simple observation causes the mind to pose related questions. Constant observation
shapes a FACT OR FACTS.

FACT
- something that is seen happening or existing
- an empirical observation; something observed using the senses, or something
experienced

Examples:
1. features of a chair (wooden, hard, with 4 legs, etc.)

A group of interrelated facts reinforce a notion or visualization of the IDEA.

IDEA
- a group of interrelated facts
- a thought, notion, impression
- a group of related facts
- an image or formulation of something imagined & visualized, of something
vaguely assumed, guessed or sensed out of related facts or observations
- a person’s conception of what is the best example of something

Examples:
1. other appearances of other chairs

When several ideas evolve, CONCEPTS are formed.

CONCEPT
- a word or cluster of words describing an object, idea or event
- an abstraction based on observation of certain behaviors or characteristics
- logistic labels that are assigned to objects or events
- the building blocks – the primary elements of a theory
- describes the essence of a thing ( what it is & what it is not )

Examples:
1. in reference to previous example about chair
chair – something to sit on (regardless of what material it is made
of, regardless of its style, etc.)

- A concept may be concrete or abstract.

a. Concrete/empirical concept
- specific to time & place
- observable or experienced through the senses

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 Examples:
concepts describing objects (desk, dog, airplane, etc)
concepts describing properties (height ,weight, gender, color,
cold, hard, body temperature, pain, etc)

b. Abstract concept
– independent of time or place
- indirectly observable/not observable

Examples: hope, love, caring, freedom, desire, job satisfaction,

health promoting behaviors

CONCEPTUAL FRAMEWORK/CONCEPTUAL MODEL

- a set of interrelated concepts that serve as building blocks of theories
- interrelated concepts or abstractions that are assembled together in some
relational scheme by virtue of their relevance to a common theme

HYPOTHESIS
- a statement of predicted relationships between two or more variables, subjected
to testing/investigation in empirical studies
- a temporary stand or prediction or guess while the investigation goes on, and
since it undergoes a scientific process, the guess is called an educated guess

ASSUMPTION
- basic principles that are accepted as being true on the basis of logic or reason
without proof or verification

Example (in reference to being a teen ager):

Almost all persons within the ages of 12-20 manifest developmental tasks
that are fairly similar ( assumption that is the basis for the Psychosocial Theory of
Growth & Development ).

THEORY
- derived from the Greek word- “Theria” which means “vision”
- a group of related concepts that propose actions that guide practice; directed by
established assumptions & principles
- a formal statement that is constructed in order to organize ideas & explain
events. It is a short hand way of solving research problems.
- abstract generalization that presents a systematic explanation about the
relationships among phenomena

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 - a systematic way of looking at the world in order to describe, explain, predict and
control it
- Proven through the years that results of testing are stably the same regardless of
innovations

Examples:
Erikson’s Theory of Growth and Development (Psychosocial Theory)

Nursing theory
- an organized and systematic articulation of a set statements related to
questions in the discipline of nursing

Examples:
Environmental Theory (Florence Nightingale)

THEORETICAL FRAMEWORK
– related concepts, the relationships of which exist and arrived at theory
level
– a set of interrelated theories that organizes the direction of a research
endeavor / scientific inquiry

COMPONENTS OF A THEORY

Purpose
The purpose of a theory explains why the theory was formulated and specifies
the context and situations in which it should be applied. The purpose might also provide
information about the sociopolitical context in which the theory was developed,
circumstances that influenced its creation, the theorist’s past experiences, settings in
which the theory was formulated, and social trends.

Concepts and Definitions

Concepts are logistic labels that are assigned to objects or events and are
considered to be the building blocks of theories. Definition defines the concept in
relation to other concepts and permits the description and classification of phenomena.
Operationally defined concepts link the concept to the real world and identify empirical
indicators of the concept that will permit observation and measurement. Theories should
include explicit conceptual definitions to describe and clarify the phenomenon and
explain how the concept is expressed in empirical reality.

Theoretical Statements
Once a concept is fully developed and presented, it can be combined with other
concepts to create statements to describe the real world. Theoretical statements, or
propositions, are statements about the relationship between two or more concepts and
are used to connect concepts to devise the theory. Statements must be formulated
before explanations or predictions can be made, and development of statements
asserting a connection between two or more concepts introduces the possibility of
analysis.
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Structure and Linkages
Structuring the theory by logical arrangement and specifying linkages of the
theoretical concepts and statements is critical to the development of theory. The
structure of a theory provides overall form to the theory. Theory structuring includes
determination of the order of appearance of relationships, identification of central
relationships, and delineation of direction, strength, and quality of relationships.
Although theoretical statements assert connections between concepts, the
rationale for the stated connections needs to be developed. Theoretical linkages offer a
reasoned explanation of why the variables in the theory may be connected in some
manner, which brings plausibility to the theory. When developed operationally, linkages
contribute to the testability of the theory by specifying how variables are connected.
Thus, conceptual arrangement of statements and linkages can lead to hypotheses.

Assumptions
Assumptions are notations that are taken to be true without proof. They are
beliefs about a phenomenon that one must accept as true to accept a theory, and
although they may not be empirically testable, they can be argued philosophically. The
assumptions of a theory are based on what the theorist considers to be adequate
empirical evidence to support propositions, on accepted knowledge, or on personal
beliefs or values.

Models
Models are schematic representation of some aspect of reality. Various media
are used in construction of models; they may be three-dimensional objects, diagrams,
geometric formulas, or words. Empirical models are replicas of observable reality (e.g.,
a plastic model of a uterus or an eye). Theoretical models represent the real world
through language or symbols and directional arrows.
Models help illustrate the processes through which outcomes occur by
specifying the relationships among the variables in graphic form where they can be
examined for inconsistency, incompleteness, or errors. By creating a model of the
concepts and relationships, it is possible to trace the effect of certain variables on the
outcome variable rather than making assertions that each variable under study is
related to every other variable. Furthermore, the model depicts a process that starts
somewhere and ends at a logical point. Using the model, a person should be able to
explain what happened, predict what will happen, and interpret what is happening.

CHARACTERISTICS OF A THEORY
1. Theories can interrelate concepts in such a way to create a different way of
looking at a particular phenomena.
2. Theories must be logical in nature.
3. Theories should be relatively simple yet generalizable.
4. Theories can be the bases for hypothesis that can be tested.
5. Theories contribute to and assist in increasing general body of knowledge within
the discipline through the research implemented to validate them.

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 6. Theories can be utilized by the practitioner to guide & improve their practice.
7. Theories must be consistent with other validated theories, laws & principles but
will leave open unanswered questions that need to be investigated.

PURPOSES OF NURSING THEORIES

1. In Education
Theory clarifies the central meanings and improves the status of the profession.

2. In Research
Theory sets limits on what questions to ask and what methods to use to pursue
answers to the questions.

3. In Clinical Practice
The primary use of theory is to guide research.

Theory provides the nurse with goals for assessment, diagnosis, and
intervention.

Theory is a tool that renders practice more efficient, more effective, and goal
directed
Language of theory provides us with common grounds for communication and with
labels and definitions for phenomena, therefore, nursing practice could be
described and explained by common concepts.

Professional autonomy and accountability are enhanced by theory use in practice.

NURSING PARADIGM

Nursing paradigms are patterns or models used to show a clear relationship

among the existing theoretical works in nursing. At present, many theories in nursing
are focused on relationships among four major concepts – person, health, nursing, and
environment. These concepts are collectively termed as metaparadigm for nursing.

A metaparadigm is the global perspective of a discipline that identifies the

primary phenomena of interest to that discipline and explains how the discipline deals
with those phenomena in a unique manner. The nursing metaparadigm embodies the
knowledge base, theory, philosophy, research, practice, and educational experience
and literature identified with the profession. These given concepts vary in accordance to
the experiences and views of different nursing theorists.

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