HISTORICAL DEVELOPMENT OF THEORIES

PRIOR TO 1960s
Florence Nightingale
Notes on Nursing (mid 19th century) – reflected her beliefs, observations and practice of
nursing
Her work paved way for modern nursing
1st one to insist that formal education is needed in the preparation of a nurse

PRIOR TO 1960s
She stressed the importance of observations and recording
She recorded her observations and used statistics to support her request for
reforms
Nightingale’s theory focused on the control of the environment of individuals
requiring nursing care

PRIOR TO 1960s
She believed that disease was a reparative process, that it was nature’s
effort to remedy a process of poisoning or decay, or a reaction against the
conditions in which a person was placed
In order to prevent the disease or hasten the healing process, the nurse must
provide a clean and quiet environment with proper ventilation and lighting,
clean air free from foul odor and unnecessary noise.

PRIOR TO 1960s
She also stressed the importance of room temperature
She emphasized the need for appropriate nutrition in promoting a person’s
well-being. Her major concepts of ventilation, light, warmth, noise,
cleanliness, and diet in relation to nursing are still valid today.

PRIOR TO 1960s
Publication of the journal of Nursing Research (1952)
Encouraged nurses to pursue research, thus developing questioning attitudes
and inquiries that set the stage for conceptualization of nursing practice

1960s-1970s
Emergence of Scientific era (1960s)
The nature of practice was debated as nursing leaders recognized the need to
define nursing practice, develop nursing theory, and create a substantive body of
knowledge
Literature on Philosophy of nursing, as well as conceptual models and
frameworks proliferated
The role of the nurse came under scrutiny during this period, what they do, for
whom, where and when were determined
 1960s-1970s
Emergence of Scientific era (1960s)
The process of theory development was also discussed and was the subject of
writings of a number of nurse scholars
Symposia were also held dealing with subjects such as Theory Development in
Nursing, Nature of Science and Nursing

1960s-1970s
1969 – first conference on nursing theory was first held
Conferences brought leading scholars and theorists together to discuss and
debate on issues regarding nursing science and theory development in nursing

1960s-1970s
Writings of Dickoff, James and Wiedebach on “Theory in a Practice
Discipline” (1968)
influenced the development of theoretical thinking in nursing
they presented a definition of nursing theory and goals for theory development in
nursing
their approaches discussed iin many writings and conferences reflecting gorwing
and evolving interest in developing nursing theory

1980s
characterized by acceptance of the significance of the theory in nursing
there were less debates on whether or not to use theory, whether it is
practice or basic theory, borrowed or nursing theory

1980s to the PRESENT

characterized by publication of nurmerous books and articles on analysis,
application, evaluation and further development of nursing theories
graduate schools of nursing developed courses on how to analyze and apply
theories
Types of theories
According to orientation or focus of the theory
1. Client-centered – are those focused on the needs and problems of
clients which are met, resolved or alleviated by nursing interventions.
Examples:
Nightingale
Abdellah
Henderson
Orem
Pender
Roy
Levine
Hall
 According to orientation or focus of the theory
2. Nurse-client dynamics – focus on interaction between the nurse and
client.
Examples:
Peplau
Watson
King
Orlando

According to orientation or focus of the theory

3. Nurse-client-environment –focus on the interaction between nurse and
client in an environment that includes broader dimensions of time and space,
as well as culture, cultural diversity, and universality
Examples:
Neuman
Leininger

FRAMEWORK TO ANALYZE A NURSING THOERY

1. CONCEPTS, KEY CONCEPTS AND SUB-CONCEPTS
Person
Nursing
Health
Environment

FRAMEWORK TO ANALYZE A NURSING THOERY

2. STRUCTURE
3. FOCUS
Client-centered
Nurse-client dynamics
Nurse-client-environment dynamics
4. APPLICATION
5. LIMITATIONS

FRAMEWORK TO ANALYZE A NURSING THOERY

HENDERSON’S THEORY – DEFINITION OF NURSING
MAJOR CONCEPTS
A. PERSON/ PATIENT/ CLIENT
An individual person or client is a whole, complete and
independent being with biological, sociological, and spiritual components
which are operationalized in the 14 fundamental or basic human needs

14 fundamental or basic human needs

1. Breathe normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable position/posture
5. Sleep and rest
6. Select suitable clothes – dress and undress
7. Maintain body temperature within normal range by adjusting
clothing and modifying the environment
8. Keep the body clean & well groomed & protect the skin
9. Avoid dangers in the environment and avoid injuring others
10.Communicate with others, expressing emotions, needs,
fears, or opinions
11.Worship according to one’s faith

12.Work in such a way that there is a sense of accomplishment

13.Play or participate in various forms of recreation
14.Learn, discover or satisfy the curiosity that leads to normal
development and health, and use available health facilities

B. HEALTH
- Health is equated with independence
Individuals will achieve or maintain health if they have the necessary strength,
will or knowledge
Health is viewed in terms of the patient’s ability to independently perform the 14
basic needs

B. HEALTH
It is the “quality of health rather than the life itself, that margin of metal physical
vigor that allows the person to work most effectively and to reach his highest
potential level of satisfaction in life.”
She described health as basic to human functioning and that promotion of health
is more important than care of the sick

C. NURSING
Nursing is assisting the individual, sick or well, in the performance of those
activities contributing to the health or its recovery (or to peaceful death) so that
he would perform unaided if he had the necessary strength, will or knowledge;
and to do this in such a way as to help him gain independence as rapidly as
possible

D. ENVIRONMENT
Is the “aggregate (combination) of all the external conditions and influences
affecting life and the development of an organism”
 UNDERLYING ASSUMPTIONS
Independence is valued by the nurse and the patient , more than
dependence
Health has a meaning shared by the society at large
Individuals desire health or peaceful death and will act in such a way to
achieve this
Individuals will perform activities leading to health if they have the
knowledge, capacity or will
The individual’s goal and the nurse’s goal are congruent (similar)
UNDERLYING ASSUMPTIONS
The 14 basic needs represent the nursing’s basic functions
Nursing’s goal may be subsumed into the medical treatment plan
The major explicit assumption of Henderson’s contention that the nurse is an
independent practitioner. However, she also contends that the nurse is a
primary helper in carrying out physician’s prescriptions

RELATIONSHIP OF CONCEPTS
➢ Role of nurse
- Has a complementary-supplementary role to maintain or restore
independence in the satisfaction of the client’s 14 fundamental or basic
needs
➢ Source of difficulty
In a client-centered model, the source of difficulty resides with the client
and not with the nurse.
Clients in health care agencies have health problems that may be
subcategorized as medical, nursing, dietary, etc.
To Henderson, the source of difficulty is the lack of strength, will or
knowledge of the client

RELATIONSHIP OF CONCEPTS
➢ Intervention focus
- To Henderson, this is the deficit that is the source of the client difficulty
➢ Modes of intervention
- These are actions to replace, complete, substitute, add, reinforce, or increase
strength, will or knowledge
➢ Consequences of nursing activity
These include
1. Increased independence in satisfaction of the client’s 14 fundamental or
basic needs
2. Peaceful death

INTERRELATIONSHIP BETWEEN CONCEPTS