HANDOUT No.

1: Introduction to Theoretical purposeful and systemic view of

Foundations of Nursing phenomena. (Chinn and Kramer)
 Helps us to organize our thoughts and
I. LEARNING OUTCOMES
ideas.
At the end of this lecture, the students should be  In science, the purpose of a theory is to
able to. guide research, support existing
knowledge, or generate new knowledge.
1. Discuss the definition of theory, concept, The term theory is not restricted to the
proposition, definition and assumption. scientific world
2. Explain the significance of the nursing
theory to nursing practice. Components of the Theory
3. Learn the components of a theory and
how it applies to nursing practice. COMPONENTS
4. Classify the nursing theory according to
An idea formulated by the mind or an experience
function.
perceived and observed such as justice, love, war
5. Elucidate the purposes of a nursing
theory. and disease or ideas and mental images that help
6. Acknowledge the importance of nursing to describe phenomena (Alligood and Marriner-
as a profession, science and art. Tomey, 2002)
7. Apply the metaparadigm as to nursing,
person, health and environment.
Definition - Define

II. CONTENT is composed various descriptions which convey a

general meaning and reduces the vagueness in
The Theoretical Foundation of Nursing understanding a set of concepts.
Nursing theory provides the theoretical Example: definition of nursing formulated by
foundation of the profession. Theory defines what Peplau
nursing is, what it does and the goals or outcomes
of nursing care. Nursing is the synthesis of many Assumption- Assume
theories.
Is a statement that specifies and describes the
What is a theory? relationship or connection of factual concepts or
phenomena.
 A set of concepts, definitions,
relationships, and assumptions that Example: the assumption that all patients who
project a systematic view of a are not able to take care of the need nurses.
phenomena that may consist of one or
more relatively specific and concrete
concepts and propositions that purport
to account for, or organize some
phenomenon. (Barnum, 1988)

 An organized system of accepted

knowledge that is composed of:
Concepts, Propositions, Definitions,
Assumptions and intended to explain a
set of fact, event or phenomena.
 It is a creative and rigorous structuring of
ideas that projects a tentative,
Phenomenon- aspect of reality that can be Kozier (2008)
consciously sensed or experienced (Meleis, 1997).
"A theory is a supposition or system of ideas that
Proposition - Explains the relationships of is proposed to explain a given phenomenon?
different concepts.
Components of a Theory by Barnum (1994):
Example: children who do not want to stay in the
Context - Resembles environment to which
hospital because of their fear of injections.
nursing act takes place
is a statement that proposes a relationship
Content-Subject of the theory
between concepts. Propositional statements in a
theory represent the theorist's view of which Process - Method by which nurse acts in using
concepts fit together. nursing theory
Relationships of: Characteristics of a Theory:
- Concepts Propositions Assumption -Theories can correlate concepts in such a way as
Definition to generate a different way of looking at a certain
- Systematically Organized fact or phenomenon.
-Theory
- View -Theories must be logical in nature.
-Phenomena
-Theories should be simple but generally broad in
nature.
How Other Authors Define THEORY:
-Theories can be the source of hypotheses that
Parker (2001) can be tested for it to be elaborated.
"A theory, by traditional definition, is an -Theories contribute in enriching the general body
organized, coherent set of concepts and their of knowledge through the studies implemented to
relationship to each other that offers descriptions, validate them.
explanations and predictions about phenomena".
-Theories can be used by practitioners to direct
Potter (2004) and enhance their practice
"A theory is a set of concepts, definitions, -Theories must be consistent with other validated
relationships and assumptions that a project theories, laws, and principles but will leave open
systematic view of phenomena unanswered issues that need to be tested.
Blackwell (2005)

"It is 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 of concepts and propositions Theories are formed by linking concepts
that provide an early way to view phenomena together
 A conceptual framework links global
Mosby (2006)
concepts together.
"It is an abstract statement formulated to predict,
explain or describe the relationships among Conceptual Model
concepts, constructs or events. It is tested by  The "symbolic representation of
observation and research using factual data". empiric experience in words,
 pictorial, or graphic diagram,
mathematical notations or physical Meleis (1991) –
material. "an articulated and communicated
conceptualization of invented or discovered
What is a paradigm? reality (central phenomena and relationships)
 A model that explains the linkages of in or pertaining to nursing for the purpose of
science, philosophy, and theory describing, explaining, predicting, or
accepted and applied by the prescribing nursing care.
discipline.
(Alligood and Marriner - Tomey, 2002) Barnum (1994)-
"stated that a complete nursing theory is one
What is a domain? The view or perspective that has context, content and process
of the discipline.
 It contains the subject, central
concepts, values and beliefs,
phenomena of interest, and the
central problems of the discipline.

How does domain relate to nursing theory?

Nursing has identified its domain in a
paradigm that includes four linkages: Importance of Nursing Theories
- Framework for thought in which to examine
1. person/client – Most Important situations.
2. health
3. environment - Structure for organization, analysis, and
4. Nursing decision making.
What About A NURSING THEORY? -Structure for communicating with other
Nursing Theory - nurses and other health team members.
 Is a group of interrelated concepts
that are developed from various -Assist the nursing discipline in clarifying
studies of disciplines and related beliefs, values, and goals.
experiences.

 This aims to view the essence of

nursing care.

-Help to define the unique contribution of nursing

in the care of clients.
 Theories are specifically contributed
by different nursing theorists from -Standards of clinical practice are developed out
different times and ages. of nursing theories.

A.Classification of Nursing Theories according to

 Ex. Florence Nightingale projected a
Function (Dickoff and James, 1968):
valuable relationship between health
and Example: environmental factors  Descriptive
like fresh air, sunlight and ventilation. To know the properties and workings of a
discipline
 - Merely, describes.  Are achieved when the relationships
of concepts under a certain condition
 Explanatory are able to describe future outcomes
To examine how properties relate and thus consistently.
affect the discipline.  Are generated and tested using
- Determines the cause and effect. experimental research.
Example: A Theoretical model based on the
 Predictive observation of the effects of unsanitary
To calculate relationships between properties environmental condition on the recovery of
and how they occur. the post-operative patients.
- Future Outcomes/ consequences.
Prescriptive Theories - (Situation-Producing
 Prescriptive Theories)
To identify under which conditions  Deal with nursing actions and test
relationships occur. the validity and certainty of a specific
-find Interventions. nursing intervention.
 Are commonly used in testing new
Descriptive Theories - (Factor-Isolating nursing interventions.
Theories) Example: Laurente's (1996) theory validates
 Known to be the primary level of and explains the different nursing
theory development. management in the emergency room in
 They identify and describe major relieving anxiety among its clients.
concepts of phenomena.
 They do not explain the relationship B.Classification of Nursing Theories
of the concepts. according to Range
 Their main purpose is to present a a) Grand-Range Theory
phenomenon based on the five b) Middle-Range Theory
senses together with their c) Micro-Range Theory
corresponding meaning.

Example: A descriptive research about the

Filipino nursing practices like use of herbal
medicines and other alternative forms of
treatment.
Grand Range Theory
Explanatory Theories - (Factor-Relating
Theories)  Provides an overall framework for
 The type of theory that present structuring broad, abstract ideas.
relationship among concepts and  Composed of concepts representing
propositions. global and extremely complex
 Cause and effect relationship are well phenomena.
explained using Explanatory
Theories.
Example: A research study about the factors
affecting newborns in failing to thrive.  Broad in scope and complex in
nature, they only assist nursing
Predictive Theories - (Situation-Relating research in an occasional manner.
Theories)
  Nursing researches are frequently  Is the least complex
based on middle-range theories  Contains the least complex concepts
which focus on the discovery of and narrowest in scope.
concepts such as pain, self-esteem  It deals with a small aspect of reality,
and learning. generally a set of theoretical
statements
 It has been known that theoretical  Deals with specific and narrow
concepts from social sciences served defined phenomena.
as one of the foundations in
qualitative nursing research. C. Classification of Nursing Theories
according to Orientation or focus of the
 Consist of broad conceptual theory
frameworks that reflect wide and A. Client Centered
expansive perspectives for practice B. Client-nurse Dynamics
and ways of describing, explaining, C. Client-nurse Environment
predicting and looking at nursing
phenomena. Client centered theories
 are those focused on the needs and
 They are the most complex and problems of clients which are met,
broadest in scope. resolved or alleviated by nursing
Examples: Henderson's The Nature of interventions
Nursing; Levine's The Four Conservation  This category includes theories
Principles of Nursing, Roy's Adaptation developed by the following:
Model, and Orem's Self-Care (Marriner- Nightingale, Orem, Pender, Roy,
Tomey Levine, Hall.

Middle-Range Theory – Less complex than

GTR
 Provides a perspective from which to
view complex situations and a
direction for interventions in three
levels of abstractness.

 High middle-range- Nurse-client-dynamics

 Middle middle-range  Focus on interaction between the
 Low middle-range nurse and client.
 This category includes theories
 Less complex and narrower in scope developed by the following: Peplau,
than grand theory and micro theory. Watson, King and Orlando.

 A more workable level, more limited Client Nurse Environment Dynamics- Latest
in scope and less variables, and domain
testable.  Focus on the interaction between
nurse and client in an environment
Ex. Peplau's Psychodynamic Nursing and that includes broader dimensions of
Orlando's Nursing Process Theory. time and space.
 As well as culture, cultural diversity,
Micro-Range Theory and universality.
  Theones of Neuman and Leininger
are discussed under this category. So how do nurses use theory in everyday
“Nursing is feeling loved, cared for, trusted practice?
and understood”. - Organize patient data
By Ramona Mercer, Nurse Scientist and -Understand patient data
Educator. -Analyze patient data
- Make decisions about nursing interventions
PURPOSES OF NURSING THEORY -Plan patient care
 Extensive base of knowledge and the -Predict outcomes of care
proper means to communicate -Evaluate patient outcomes (Alligood, 2001).
 The core structures that give
direction and purpose to those who What is Nursing?
practice it with sound basis and ideas
 It guides nursing practice and According to American Nursing Association
generates knowledge. (ANA):
 It helps to describe or explain nursing Nursing is the “diagnosis and
 Aspects of general information treatment of human responses to actual
 Serve as an excellent help in the potential health problems”.
development and expansion of
knowledge and as support in
different features of learning such as
education, research and clinical
practice.
 Helps to assure that work in
respective specialties of nursing
remains useful, relevant, influential
and complimentary to each other. As defined by the International Council of
Nurses (ICN):
 Enables nurses to know WHY they  Nursing encompasses “autonomous
are doing WHAT they are doing. and collaborative care of individuals
of all ages, families, groups and
communities, sick or well and in all
Why on earth do we study nursing theory? settings.
 Everyday practice enriches theory  Nursing includes the promotion of
 Both practice and theory are guided health, prevention of illness, and the
by values and beliefs care of ill, disabled and dying people.
 Theory helps to reframe our thinking  Advocacy, promotion of a safe
about nursing environment, research, participation
 Theory guides use of ideas and in shaping health policy and in
techniques patient and health systems
 Theory can close the gap between management, and education are also
theory and research, to envision key nursing roles.”
potentialities (Gordon, Parker, &
Jester, 2001)
-The study and use of nursing theory in Henderson’s definition of nursing is:
nursing practice must have roots in the “to assist clients in the performance
everyday practice of nurses (Gordon, Parker, of activities contributing to health, its
and Jester, 2001). recovery or peaceful death that clients will
perform unaided, if they had the necessary
will, strength or knowledge”.

According to Association of Deans of

Philippine Colleges of Nursing (ADPCN):

Nursing is “a dynamic discipline.

 It is an art and a science of
caringindividuals, families, groups
and communities geared toward Person
promotion and restoration of health,  The recipient of nursing care like
prevention of illness, alleviation of individuals, families and
suffering. communities.
 It is focused on assisting the client as
he or she responds to health-illness  Example: Nightingale proposed that
situations, utilizing the nursing the physical, intellectual, and
process and be guided by ethico-legal spiritual being of a person is not
moral principles. capable of manipulating the
environment to promote health. This
means that a person is a passive
recipient of care.

What is Nursing? Environment

Focused in supporting communities, families  the external and internal aspects of
and individuals In maintaining, restoring or life that influence the person.
achieving a state of optimum health and
functioning.
 Example: Physical environment is
emphasized by Nightingale in her
It is both a science and an art that is
theory. She focused on ventilation,
concerned
warmth, noise, light, and cleanliness.
with the quality of life as defined by the
Social environment.
clients.
Health
 The holistic level of wellness that the
What are Nursing Paradigms?
person experiences.
 Are patterns or models used to show
a clear relationship among the
 Example: Nightingale defined nursing
existing theoretical works in nursing.
as “a profession for women (a calling)
 Theories in nursing are focused on
with the goal to discover and use the
relationships among four (4) major
laws governing health in the service
concepts.
of humanity. “She believed that the
 Metaparadigms: Greek “meta” – with goal of all nursing activity should
and “paradeigma” – pattern promote client’s health.

Nursing
  Nursing- the interventions of the  It is independent of time and place.
nurse rendering care in support of, or  Examples are love, care, and
in cooperation with the client. freedom.

 Example: Nightingale emphasized Concrete concepts

that a nurse is responsible in  are directly observed or tangible.
promoting well-being of clients by  Examples are nurse, mother and
manipulating the environment. pain.

What is Philosophy in Nursing?

 It is the next knowledge level after Concepts
metaparadigm.
 It specifies the definition of  Concepts can be used in marking or
metaparadigm concepts in each of formulating a conceptual or an
the conceptual models of nursing. operational definition.
 It sets forth the meaning of  Conceptual definitions are the
phenomena through analysis, meaning of a word based on how a
reasoning, and logical argument. certain theory or relevant literature
 Works that specify philosophical perceives it to be.
approaches to Nursing, such as that  Examples are roles/ concepts of
of Nightingale’s, are considered as a nurse, patient care, and
philosophy. environment.
 Operational definitions are meaning
 Theory may be formed from these of a word based on the method of
philosophies such as the work of how it was measured or how the
Watson and Benner. person come up with that
 Philosophies have contributed to the perception.
knowledge development in nursing  An example of this type is the
by forming a basis for subsequent significance of pain perception and
developments especially in area of practiced nursing intervention.
human science.
Concepts Conceptual Models and Theoretical
 Are the building blocks of theories. Models
 It can come from an empirical  Theoretical models or frameworks
phenomena or any abstraction of  Are highly established set of concepts
how a person perceived an object that are testable.
that is not physically present or
observed like charity, caring,
patience.
 A concept enhances one’s capacity to
understand phenomena as it helps
define the meaning of a word.

Two types of concepts:

Abstract concepts

 are indirectly observed or intangible.

Concepts
Conceptual models or frameworks are Science
representations of an idea or body of  Science, from the Latin scientia,
knowledge based on the own understanding meaning “knowledge”, refers to any
or perception of a person or researcher on systematic knowledge or practice in a
a certain topic, phenomena or theory. discipline of study.
 In a more casual sense, science refers
They can be represented thru a diagram or in to a system of acquiring knowledge
narrative from which shows how concepts based on the scientific method.
are interrelated  It is also the organized body of
knowledge gained through research.

The scientific method includes

several steps:
-Observation
-Gathering Information/ data
-Forming Hypothesis
-Experimental Investigation
Conceptual Framework vs. Theoretical
-Conclusion or Theoretical Explanation
Framework
Scientific Method
CONCEPTUAL
It is a structure of concepts or theories which
Observation
are pulled together as a map for the study.
 Integration of knowledge and/ or
phenomenon by a rational/ sentient
THEORETICAL
being
It is a structure of concepts which exist or
Example: Elmer, a nurse-researcher observes
tested in the literature, a ready-made map
a certain nursing phenomena and makes a
for the study.
study about it.
Example 1: Hospital Stay
Gathering Information/ data
 Recognition and collecting data for a
Conceptual:
particular scientificproblem or injury.
The time during which a person is a
Example: His colleague, Dave helps him to
registered patient in a certain hospital.
gather data thru various methods.
Theoretical:
Forming Hypothesis
The total of days as patient, beginning with
 An attempt to explain or suggest a
admission
nature of a phenomenon.
day and finishing with discharge.
Example: They both make a hypothesis, an
intelligent guess on the nature of the
Example 2: Ambulation
phenomenon.
Conceptual:
To walk from one place to another or to
move about.

Theoretical:
Taking 6 steps without assistance.
Scientific Method conclusion. As new data emerges, the study
is re-examined and verified.
Observation
What Is Knowledge?
Integration of knowledge and/ or
phenomenon by a rational/  Knowledge can be defined as:
sentient being Information, skills and expertise
acquired by a person through various
Example: Elmer, a nurse-researcher observes life experiences, or through formal
a certain nursing phenomena and makes a /informal learning such as formal
study about it. education, self-study, vocational.
 The abstract or workable
Gathering Information/ data understanding of a subject or idea.
 What is known in a particular field of
Recognition and collecting data for a discipline or study
particular scientific problem or injury.  Facts and information or awareness
or familiarity gained by experience of
Example: His colleague, Dave helps him to a fact or situation.
gather data thru various methods.  There is however no single agreed
classification of knowledge
Forming Hypothesis 
Knowledge acquirement involves
An attempt to explain or suggest a nature of a several cognitive processes.
phenomenon.
KNOWLEDGE
Example: They both make a hypothesis, an
intelligent guess on the nature of the Perception
phenomenon. Association
Learning
Scientific Method (cont’d) Reasoning
Communication
Experimental Investigation
A set of examinations done to solve the
particular query raised through the
hypothesis process.

Example: They conduct a survey and

interview, and apply statistical treatment on
the data.

Conclusion or Theoretical Explanation

A statement explaining a set of natural
phenomena or a scientific query derived from
Experimental Investigation.

Example: Based from the result, they draw a Types of Cognitive Process
  Is an idea by a person of authority
Perception which is perceived as true because of
Achieving understanding of sensory data. his or her expertise.
Association
Combining two or more concepts/ ideas to  An example of this type of knowledge
form a new concept, or for comparison. can be seen in the clinical setting in
Learning which a nurse supervisor who is
Acquiring experience, skills, information and considered expert in the field is
values. teaching a nurse beginner on the
Reasoning proper insertion of a urinary catheter
Mental process of seeking conclusions insertion.
through reason.  The nurse supervisor is well equipped
Communication with knowledge and skills about the
Transferring data from sender to receiver procedure through experience and
using different mediums or tools of the novice nurse accept it as true
communication. because of the authority of the
expert nurse.
WHAT ARE THE SOURCES  As long as the recognized authority
maintains his or her perceived
Knowledge merges from a range of sources expertise authoritative knowledge in
which can be categorized into three namely. general is accepted.
TRADITIONAL
AUTHORITATIVE Scientific knowledge
SCIENTIFIC SOURCES.  Is a type of knowledge which came
from a scientific method through
Traditional Knowledge research.
 Is a nursing practice which is passed  These new ideas are tested and
down from generation to generation. measured systematically using
objective criteria.
 When asked about the basis of the  For example a student nurse
nursing practice the answer would be providing Tepid Sponge Bath (TSB) to
as simple as “it’s always been a patient with fever, should know the
practiced this way.” rationale (reason) behind this
procedure, which is heat transfer
 An example of a traditional through evaporation (basic physics).
knowledge that had an impact to  The underlying principle in this
nursing practice is the routine procedure is concrete example of a
changing of bed linens whether it is knowledge based from a scientific
soiled or not. point of view.
 The three sources of knowledge are
 This practice is commonly observed valuable in the body of knowledge
in an ICU setup. Even though there that represents the nursing
are no research data to support this, profession. Each of them has its own
still the practice is adopted in the strong and weak points.
hospital as an important component
of providing quality patient care.

Authoritative Knowledge TYPES OF KNOWLEDGE

Traditional and Authoritative  Clinical or environmental setting of
nursing- health center
ADVANTAGES  Disease process- stomach ulcer
 Practical to implement.  Client’s behavior- guarding behavior
DISADVANTAGES at the pain site
 Based on subjective data  Interventions- care of the client in
 Limited use in a variety of practice pain
setting  Practices that are utilized in nursing
 In nursing practice, scientific theories and metaparadigms (person,
knowledge through evidence based nursing, health and environment)
practice and research serves as the
main focus.
Nursing Theory Development
 Nursing Theories are developed to
improve the quality of care rendered
Types of Knowledge by nurses to their clients.
Scientific
 Theory development is inherent in
ADVANTAGES the different nursing fields education,
 Systematic and accurate research and practice.
 Theories it creates are less subjective
than knowledge gained by other
methods EDUCATION
 Nursing Theories were primarily used
DISADVANTAGES to develop and guide nursing
 Requires time and effort to produce education in universities and
credible results institutions.
 They were once known to be more
Phenomenon strongly established in the field of
 can be defined as sets of empirical academics rather than in clinical
data or experiences that can be practice.
physically observed or tangible such  In the 1970s and 1980s, a number of
as crying or grimacing when in pain. nursing programs recognized the
major concepts of some nursing
 it is concerned with how an models, structured these concepts
individual person reacts using he into a conceptual framework, and
human senses concerning their built the complete.
surrounding and assessing the
different behaviors and factors that
affect such behaviors.

In Nursing, phenomena can be: Education (cont’d)

  Nursing Theories were primarily used  is used in the academe to describe
to develop and guide nursing theories that clarify how social
education in universities and structures influence a wide variety of
institutions. human experiences from art to social
practices.
 They were once known to be more
strongly established in the field of  In nursing, critical theory research
academics rather than in clinical helps elaborate more on how
practice. structures such as race, gender,
sexual orientation, and economic
 In the 1970s and 1980s, a number of class affect experiences and health
nursing programs recognized the outcomes of the patients (Kozier,
major concepts of some nursing 2008)
models, structured these concepts
into a conceptual framework, and Clinical Practice
built the complete curriculum around  A nurse’s ability is enriched through
that framework (Kozier, 2008). the help of different nursing theories.

Research  Theories thoroughly guide critical

 Experts constantly believed that thinking and decision-making in
research in nursing was inspired from clinical nursing practice.
different theoretical assumptions or
conceptual frameworks in the past.  Nurses will have a better
understanding on the basis and
 Through the evolution of technology, nature of their work and be able to
ideas, and emerging nursing issues, express it clearly in collaboration
interpretations and perspectives are with other professionals.
generated to provide answers to
questions encountered in practice.
 Nursing Theories strengthen
professional independence by
 The development of clear
guiding the deepest and most
understanding about the quality of
life as well as the management of important part of their practice.
symptoms is an indication that
conceptual perspectives are  Nursing Theories are always critical in
constantly improving. assisting nurses to facilitate
questions, reflections and critical
thinking in every aspect of care.
- For example, the application of
Leininger’s Transcultural Nursing
Theory for developing culturally
similar strategies is useful to nurses
working with suspected child
maltreatment cases.

Critical theory
Nursing also utilizes non-nursing theories
Commonly used non-nursing theories  Historical Development of Nursing
Theories: Significant Events
 Systems theory
 Basic Human Needs theory  Nightingale until the 50’s, Florence
 Health and Wellness Models Nightingale Notes on Nursing control
 Stress and Adaptation of the environment to care for the
Developmental Theories individual (ventilation, light, warm,
 Psychosocial Theories noise absence or reduction,
cleanliness & diet)
Interdependence of Theory and Research  1952 Nursing Research Journal
 Practice without theory, like map publication
without route, is blind, theory  1960’s nature of nursing practice was
without practice, like route without debated, defined nursing practice, or
map, is empty.” develop nursing theory, and created
Theory Development in Nursing: Historical a substantive body of knowledge.
Overview  Historical Development
 Where do I begin? Florence  Proliferation of conceptual models
Nightingale and frameworks, and philosophy of
 Considered first modern nursing nursing.
theorist  Examples: Abdellah 21 nursing
 First one to delineate what is problems and Hall’s Core, care and
considered the nursing goal and cure (person,body,disease)
practice domain. “Placing the client  1969 first conference on nursing
in the -best condition for nature to theory
act upon him”
 Historical Development
 Taught about symptoms and what
they indicate, rationale for actions  Role of nurses where questioned;
and trained powers of observation what they do, for whom where and
and reflection when were determined. Purpose of
nursing, process of theory
development was discussed.
 First Conference in nursing theory
 Brought leading scholars and
theorists to discuss and debate on
issues regarding nursing science ad
theory development.

 Historical Development
  Writings of Dickoff, James and  Authority was internalized and a new
Wiedenbach “Theory in a Practice sense of self emerged.
Discipline” influenced the theoretical  Negative attitude toward borrowed
thinking in nursing. sciences or theories
 They presented a definition of  Defining on nursing and developing
nursing theory and goals for theory theories about and for nursing
 Research focused on the nurse rather
development in nursing, approaches
on the clients and clinical situations.
were discussed.
4. Procedural Knowledge Includes both
separate and connected knowledge
 Proliferation of approaches to theory
 Historical Development development applying theory in
practice was frequently
 1980’s characterized by acceptance underemphasized.
of the significance of theory in  Emphasis was on procedures used to
nursing. acquire knowledge, with over
 Less debates on whether or not to attention to appropriateness of
use theory, practice theory or methodology the criteria for
borrowed ones. evolution and statistical procedures
 More and more publication up to the 5. Constructed Knowledge
present.  Integration of different types of
Stages of Theory Development according to knowledge ( intuition, reason and
Kidd and Morrison self-knowledge)Nursing theory based
1. Silent Knowledge stage. on empirical studies theoretical
literature client reports, clinical
 Blind obedience to medical authority experiences and nurses scholar
 Training schools were hospital based, intuition.
emphasis on carrying out physicians
orders and few books, depended on
physicians diagnosis, exploited as
workers and as students
 .Persisted for more than 80 years
2. Received Knowledge Stage

 Learning through listening to others

 Nursing now challenged to be in the
university as opposed to
apprenticeship that happens to most
hospital programs.
 Nurses acquired non nursing degrees
relying on the authority of educators,
sociologist, psychologists,
physiologists, and anthropologists to
provide answers to nursing problems.

3. Subjective Knowledge stage