Overview: Theoretical Foundations in Nursing: Abigail N. Filio-Monge, M.A.N. Instructor

Overview:
Theoretical
Foundations
in Nursing
ABIGAIL N. FILIO-MONGE, M.A.N.
Instructor
• By giving nurses a sense of identity,
nursing theory can help patients,
managers and other healthcare
professionals to recognize the unique
contribution that nurses make to the
healthcare service (Draper 1990).
Providing a definition of nursing
theory also helps nurses to
understand their purpose and role in
the healthcare setting.
1. Definition of Terms
• Theory • Knowledge
• Concept • Phenomenon
• Principle • Nursing
• Nursing theory • Nursing paradigms
• Philosophy • Paradigm
• Conceptual models • Hypothesis
• Science • Research
Theory
• A set of statements that tentatively describe, explain,
or predict relationships among concepts that have
been systematically selected and organized as an
abstract representation of some phenomenon (Power
and Knapp, 1995). These systematic organized
perspectives serve as guides for nursing action in
administration, education, research, and practice.
• A well-substantiated explanation of some aspect of
the natural world; an organized system of accepted
knowledge that applies in a variety of
situations/hypotheses.
• An expectation of what should happen,
barring unforeseen circumstances.
• A coherent statement or set of
statements that attempts to explain
observed phenomena.
• An explanation for some phenomena
that is based on observation,
experimentation, and reasoning.
• A comprehensive explanation of a given
set of data that has been repeatedly
confirmed by observation and
experimentation and has gained general
acceptance within the scientific
community but has not been yet
decisively proven.
• A set of concepts,
definitions, relationships,
and assumptions that
project a systematic view
of a phenomena
• It may consist of one or
more relatively specific and
concrete concepts and
propositions that purport
to account for, or organize
some phenomenon
(Barnum, 1988)
• Parker (2001) A theory is an organized,
coherent set of concepts and their
relationship to each other that offers
descriptions, explanations and
predictions about phenomena.
• Kozier (2008) is a supposition or system
of ideas that is proposed to explain given
phenomenon.
Concept
• A mental idea of a phenomenon.
• A comprehensive idea or generalization.
• An idea that brings diverse elements into a

basic relationship.
• A unit of knowledge abstracted from a
set of characteristics attributed to a class
of objects, relations or entities.
• A unit of thought.
• A general idea formed in the mind.

• Something understood or retained in the
mind, from experience, reasoning,
and/or imagination; a generalization or
abstraction of a particular set of
instances or occurrences.
– Examples: person, health, environment,
nursing
Principle
• A basic generalization that is accepted as
true and that can be used as a basis for
reasoning or conduct.
Nursing Theory
• A body of knowledge that describes or
explains nursing and is used to support
nursing practice.
• An organized and systematic articulation
of a set of statements related to
questions in the discipline of nursing.
• Is a set of concepts, definitions, relationships
and assumptions or propositions derived from
nursing models or from other disciplines and
project a purposive systematic view of
phenomena by designing specific inter-
relationships among concepts for the purposes
of describing, explaining, predicting and/or
prescribing.
Philosophy
• The most basic beliefs, concepts, and
attitudes of an individual or group
• An analysis of the grounds of and
concepts expressing fundamental beliefs
• Is the next knowledge level after
metaparadigm. It specifies the definition
of metaparadigm concepts.
•A search for a general
understanding of values and reality
by chiefly speculative rather than
observational means
Conceptual frameworks/models
• A set of interrelated concepts that symbolically
represents and conveys a mental image of a
phenomenon. Conceptual models of nursing
identify concepts and describe their
relationships to the phenomena of central
concern to the discipline: person, environment,
health and nursing (Power and Knapp, 1995).
• A set of concepts and the propositions
that integrate them into a meaningful
configuration (Marriner-Tomey and
Alligood, 1998)
• Composed of concepts or constructs
that describe ideas about individuals,
groups, situation and events of particular
interest or discipline (e.g. Nursing)
Science
• The organized body of knowledge gained through
research.
Knowledge
• Information, skills and expertise
acquired by a person through
formal/informal learning.
Phenomenon
• A sets of empirical data or experiences
that can be physically observed or
tangible such as crying or grimacing
when in pain.
Nursing
• Nursing encompasses autonomous and
collaborative care of individuals of all
ages, families, groups and communities,
sick or well and in all settings. It includes
the promotion of health, the prevention
of illness, and the care of ill, disabled and
dying people. (WHO)
Paradigm
• In science and philosophy, a
paradigm is a distinct set of
concepts or thought patterns,
including theories, research
methods, postulates, and standards
for what constitutes legitimate
contributions to a field.
Hypothesis
Research
• Research comprises "creative and
systematic work undertaken to
increase the stock of knowledge,
including knowledge of humans,
culture and society, and the use of
this stock of knowledge to devise
new applications."
2. Importance of Nursing
Theory
• It helps to distinguish what should form
the basis of practice by explicitly
describing nursing.
• This can be seen as an attempt by the
nursing profession to maintain its
professional boundaries.
• Nursing theory aims to describe, predict and
explain the phenomenon of nursing (Chinn and
Jacobs 1978).
• It provides the foundations of nursing practice,
help to generate further knowledge and
indicate in which direction nursing should
develop in the future (Brown 1964).
• Theory is important because it helps us to
decide what we know and what we need to
know (Parsons1949).
3. Characteristics of a
Theory
1. Systematic, logical and coherent
(orderly reasoning, no contradictions)
2. Creative structuring of ideas mental
images of one’s experiences and create
different ways of looking at a particular
event or object.
3. Tentative in nature ( change over time
or evolving but some remain valid
despite passage of time)
4. Interrelate concepts in such a way as to
create a different way of looking at a
particular phenomenon.
5. Are logical in nature.
6. Are generalizable.
7. Are the bases for hypotheses that can
be tested.
8. Increase the general body of knowledge
within the discipline through the
research implemented to validate them.
6. Are used by the practitioners to guide
and improve their practice.
7. Are consistent with other validated
theories, laws, and Principles but will
leave open unanswered questions that
need to be investigated.
4. Components of Theory
• Concepts
Concepts Definitions
• Definitions
• Assumptions
Phenomenon
• Phenomenon
Assumptions or
Propositions
Concepts
• A theory is composed of interrelated concepts.
• Concepts help to describe or label phenomena.
Definitions
• The definition within the description of a
theory convey the general meaning of the
concepts in a manner that fits the theory.
These definitions also describe the activity
necessary to measure the constructs,
relationships, or variables within a theory.
(Chinn and Kramer 2004)
Assumptions
• Are statements that describe concepts or
connect two concepts that are factual.
Assumptions are the “taken for granted”
statements that determine the nature of the
concepts, definitions, purpose, relationships
and structure of the theory.
Phenomenon
• A phenomenon is an aspect of reality that can
be consciously senses or experienced. (Meleis,
1997). Nursing theories focus on the
phenomena of nursing and nursing care.
• Examples of phenomena in nursing include
caring, self-care and client responses to stress.
Why on earth do we study
nursing theory?
• Everyday practice enriches theory
• Both practice and theory are guided by values and
beliefs
• Theory helps to reframe our thinking about nursing
• Theory guides use of ideas and techniques
• Theory can close the gap between theory and research
• To envision potentialities (Gordon, Parker, & Jester,
2001)
5. Purposes Of Nursing Theory
In Relation To:
• Education
– nursing theory was used primarily to
establish the profession’s place in the
university.
– provide a general focus for curriculum
design.
– guide curricular decision making.
• Research
– nursing research identifies the philosophical
assumptions or theoretical frameworks
from which it proceeds.
– offer a framework for generating
knowledge and new ideas.
– assist in discovering knowledge gaps in
specific field of study.
– offer a systematic approach to identify
questions for study, select variables,
interpret findings and validate nursing
interventions.
• Practice
– the primary contribution of nursing theory
when employed in a clinical setting is the
facilitation of reflection, questioning, and
thinking about what nurses do.
– assist nurses to describe, explain, and
predict everyday experiences.
– serve to guide assessment,
intervention, and evaluation of
nursing care.
– provide a rationale for collecting
reliable and valid data about the
health status of clients, which are
essential for effective decision
making and implementation.
– help to establish criteria to measure the
quality of nursing care.
– help build a common nursing terminology to
use in communicating with other health
professionals. Ideas are developed and
words defined.
– enhance autonomy (independence and self-
governance) of nursing by defining its own
independent functions.
• Experience without theory is blind, but theory without
experience is mere intellectual play. Immanuel Kant
6. Nursing Paradigms
• Nursing has a model or paradigm that explains
the linkages of science, philosophy, and theory
that is accepted and applied by the discipline.
The elements of nursing paradigm direct the
activity of the nursing profession, including
knowledge development, philosophy, theory,
educational experience, research, practice and
literature identified with the profession
(Alligood and Marriner-Tomey, 2002).
• Are patterns or models used to show a
clear relationship among the existing
theoretical works in nursing.
Nursing
Person Health Environment

7. Uses of Theory
• Theory guides and improve nursing practice.
• Theory provides goal for nursing care and with goals, nursing
practice is rendered more effective and efficient.
• Theories help to focus the goals, making nurses more
confident about the practice.
• Theory guides research
• It validates and modifies the theory.
• Theory contributes to the development of the disciplines
body of knowledge.
• Theory enhances communication.
8. Types of Nursing Theory
• META-THEORY - the theory of theory. Identifies specific
phenomena through abstract concepts.
• GRAND THEORIES – broad and complex
• MIDDLE-RANGE THEORIES- address specific phenomena and
reflect practice
• PRACTICE THEORY - explores one particular situation found in
nursing. It identifies explicit goals and details how these goals
will be achieved.
• Descriptive theories – first level of theory development
• Prescriptive theories – address nursing interventions and predict
their consequences
Metatheory
• For nursing theory, it is the most global
(abstract) type of nursing theory.
• It integrates the relation of the nursing
variables identified in the nursing
metaparadigm as the concepts of
person, environment, health, and
nursing
Grand Nursing Theory
• These theories have the broadest scope and present
general concepts and propositions.
• Theories at this level may both reflect and provide
insights useful for practice but are not designed for
empirical testing.
• Grand theories consist of conceptual frameworks
defining broad perspectives for practice and ways of
looking at nursing phenomena based on the
perspectives.
Mid-Range Nursing Theories
• These theories are narrower in scope than
grand nursing theories and offer an effective
bridge between grand nursing theories and
nursing practice.
• They present concepts and propositions at a
lower level of abstraction and hold great
promise for increasing theory-based research
and nursing practice strategies.
Nursing Practice Theories
• Nursing practice theories have the most
limited scope and level of abstraction and are
developed for use within a specific range of
nursing situations.
• Nursing practice theories provide frameworks
for nursing interventions, and predict
outcomes and the impact of nursing practice.
9. Four ways of knowing
• Empirical
• Ethical
• Aesthetics
• Personal

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• A comprehensive idea or generalization.

• An idea that brings diverse elements into a

• A general idea formed in the mind.

Person Health Environment

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