THEORIES AND

ITS
PROPONENTS
1. Self-Care
Deficit
Theory of
Nursing
(Dorothea
E. Orem)

THEORY DESCRIPTION

THEORY ANALYSIS

THEORY EVALUATION

This theory is focused on the

clients self-care needs which
aims to make the client perform
self-care activities so that he can
live independently.
It originated from Orems goal to
upgrade the quality of nursing in
general hospitals. She assumed
the position as a curriculum
consultant of the Office of
Education, US Department of
Health, Education and Welfare
(DHEW), where she formulated
the Guidelines for Developing
Curricula for the Education of
Practical Nurses. In 1959, she
served as acting dean of the
School of Nursing at Catholic
University of America (CUA)
where she continued to
developed a concept of nursing
and self-care. Being a member of
the Nursing Models Committee at
CUA and the Improvement in
Nursing group, which was later
known as Nursing Development
Conference Group (NDCG), all of
these contributed to the
development of the theory.
Having clinical, education,
research and management
experience, she then published a
book Nursing: Concepts of
Practice. Upon retiring,
subsequent editions were
published as she continued to
work and develop the Self-Care
Deficit Nursing Theory.
The theory described different
concepts:
- Self-Care: practice of activities
in the interest of maintaining life
and healthful functioning.

In the theorys discussion,

concepts and statements
are well defined putting
emphasis on how it is
utilized in the
conceptualization of the
theory.
It is also logically organized
in a model termed as Basic
Nursing System. The
system proposed that
nursing is a human action
and that the system are
action systems formed by
nurses through the exercise
of nursing agency for
persons with heal-derived
or health-associated
limitations in self-care. The
system presented tasks and
actions done by the nurse
and the patient in 3
different subsystems such
as: wholly compensatory,
partly compensatory and
supportive-educative. In
wholly compensatory
system, the nurse performs
actions and tasks for the
patient, meaning the
patient is dependent to the
care given by the nurse.
Partly compensatory
system is where the nurse
and patient shares on
activities for the benefit of
the patient, this means that
the patient is partially
independent by himself.
Supportive- educative
system represents the
patient being dependent
but still with the guidance

Orems theory has

achieved a significant level
of acceptance by the
nursing community as
evidenced by published
material for over 600
references. Also, in a review
of research performed using
the theory, the number of
studies and the quality of
work and nursing care has
improved overtime.
PRACTICE: The first
documented use of Orems
theory in practice was in
John Hopkins Hospital in
1973 where it became the
basis for structuring
practice of nurse-managed
clinic. From there, the use
of Orems theory reached a
variety of clinical
populations and age
groups: from neonate to
elderly, health promotion
and care for the sick
together with ethnically
diverse populations. It has
also been used in Pain
control, Cardiology,
Oncology and Psychiatry
which include teaching selfcare to individuals with
diabetes mellitus and ESRD,
hemodialysis, cardiac
rehabilitation, cancer
prevention, maintaining
self-care after being
diagnosed with cancer,
positive mental health and
self-care requisite of
normalcy. The elderly

REACTION/
REALIZATION/
SUGGESTION
The theory is very
popular in the field of
nursing. I can see that
different fields and
across the lifespan can
benefit from Orems
theory. With the main
goal of assisting
patients to optimum
level of functioning, it
is a must for us nurses
to gauge on how to
intervene depending
on the patients
status. Using Orems
theory, we can easily
gauge, evaluate and
assess the patients
self-care needs and
intervene
appropriately and
promptly giving
quality care in an
accessible and
efficient manner.

- Self-Care Requisites: actions to

be performed necessary in the
regulation of and aspect of
human functioning.
- Universal Self-Care Requisites:
universally required goals to be
met through self-care and
dependent care.
- Developmental Self-Care
Requisites: promote processed
for life and maturation and
prevent conditions deleterious to
maturation
- Health Deviation Self-Care
Requisites: health deviation
determines the kinds of care
demands that requires action.
ASSUMPTIONS:
1. Human beings require
continuous inputs to themselves
and their environments to remain
alive and functioning
2. Human agency, the power to
act deliberately, is exercised in
the form of care for self and
others
3. Mature human beings
experience limitations for actions
in care
4. Human agency is exercised in
discovering, developing and
transmitting ways to identify the
needs and make inputs to self
and others
5. Group of human beings with
structured relationships tasks
and allocate responsibilities for
providing care to group members
THEORETICAL PROPOSITIONS
This theory comprised of (3)
three related theories:
1. Theory of Self-Care, which
describes why and how people
care for themselves

of the nurse regulating if he

performs the task
appropriately having
exercise true self-care.

population is another area

where Orems theory has
been utilized including
health promotion, self-care
for independent elderly and
family caregiver stress. The
theory had been applicable
in a variety of settings and
institutions. Vancouver
Health Department
designed a populationbased care using Orems
concepts, Newark Beth
Israel made a structure on
nursing delivery and
documentation system,
Occupational Health
Nursing used it to identify
health problems, interpret
findings and draw correct
conclusions, Binghamton
General Hospital used the
theory as part of the
orientation process for the
new graduate nurses.
Today, we use this theory in
assisting in-patients in their
performance of ADLs
EDUCATION: The theory
was first articulated in
1950s and first published in
1972. Now, at least 45
schools used Orems theory
as the basis for their
curriculum such as Sinclair
School of Nursing,
University of Missouri,
Oakland University, College
of St. Benedict and
Anderson College. All of
them benefit from Orems
theory making it their
curriculum standards
RESEARCH: In the field of

2. Theory of Self-Care Deficit,

which describes and explains
why people can be helped
through nursing
3. Theory of Nursing Systems,
which describes and explains
relationships that must be
brought about and maintained
for nursing to be produced.

THEORIES AND
ITS PROPONENTS
2. Adaptation
Model
(Sister
Callista Roy)

research, Orems theory

can be classified as relating
to:
1. The development of
research
instruments for
measuring the
conceptual elements
of the theory
2. Studies test
elements of the
theory in specific
populations.

THEORY DESCRIPTION

THEORY ANALYSIS

THEORY EVALUATION

This theory is focused on the

person (human being) and its
adaptive system. Sister Callista
Roy is a member of the Sisters of
Saint Joseph of Carondelet. She
received a BA in Nursing in 1963
at Mount Saint Marys College in
Los Angeles and an MSN degree
from the University of California
in 1966. While working on her
masters degree, Roy was
inspired and challenged in a
seminar with Dorothy E. Johnson
to develop a conceptual model
for nursing. While working as a
pediatric nurse, she had noticed
the great resiliency of children
and their ability to adapt in
response to major physical and
psychological changes. Hence,
she was impressed by adaptation
as an appropriate conceptual
framework for nursing. In her

In the theorys discussion,

concepts and statements
are well defined putting
emphasis on how it is
utilized in the
conceptualization of the
theory.
It presented a model of the
persons adaptive system.
The system starts with an
INPUT [comprises of the
stimuli and the adaptation
level of the person] this is
then processed by the
CONTROL PROCESSES
[coping mechanisms,
regulator and cognator]
that interprets the stimulus.
This is then acted upon by
the EFFECTORS
[physiological function, selfconcept, role function and
interdependence] making

Roys Adaptation Model

(RAM) was used as basis for
the development of
Practice, Education and
Research that are still being
used up to this time and
provided additional
information for nursing
standards.
PRACTICE: With the use of
Roys six-step nursing
process, the nurse: (1)
assess the behaviors
manifested from the four
adaptive models; (2) assess
the stimuli for those
behaviors and categorizes
them; (3) makes a
statement or nursing
diagnosis of the persons
adaptive state; (4) sets
goals to promote

REACTION/
REALIZATION/
SUGGESTION
The theory is very
applicable across
different health care
settings. Whether in
clinical/ hospital
based, community
based or even homecare teaching. One
thing that I think may
have conflict with the
theory is the principle
of prioritization. It is in
great need that nurses
prioritize nursing
problems to intervene
the priority first
followed by other
problems. Roys model
didnt emphasize
anything on
prioritization making it
a waterloo of the
theory. But

formulation of the theory, Mount

Saint Marys College adopted the
adaptation framework as the
philosophical foundation of the
nursing curriculum. Roy
Adaptation Model (RAM) was first
presented in the literature article
published in Nursing Outlook the
year 1970 entitled, Adaptation:
A Conceptual Framework for
Nursing. She became an
associate professor and
chairperson of the Department of
Nursing at Mount Saint Marys
College until 1982 and helped
teaching in summer masters
program at the University of
Portland. She also became a
clinical nurse scholar in
neuroscience, post-doctoral
fellow at the University of
California and a nurse theorist at
Boston College School of Nursing.
Roy had published many books,
chapters and periodical articles.
She also presented numerous
lectures and workshops. The
most recent refinement of RAM is
published in 1999 book, The Roy
Adaptation Model.
The theory describes different
concepts:
- Adaptation Level: condition of
life-processes described on three
levels as integrated,
compensatory and compromised
which is constantly changing.
- Adaptation Problems: broad
areas of concern related to
adaptation. These are difficulties
related to indicators of positive
adaptation.
- Physiological-Physical Mode:
physical and chemical processes
involved in the function and

the effect of this inputs

visible in the human body.
As the person reacts to the
effects of these inputs,
OUTPUT [either adaptive or
ineffective responses] takes
place sending the
FEEDBACK to the input.
The whole process was
summarized by the
Diagrammatic
representation of Human
Adaptive System. The
Human system in
composed of physiologicalphysical mode, selfconcept-group mode, role
function mode and
interdependence mode.
These 4 modes are
regulated by the coping
process. As a stimulus
enters the system, modes
as affected but through the
coping process, it forms a
behavior to regulate the
stimulus therefore forming
an adaptation to the
stimulus recognized by the
body.

adaptation; (5) implements

interventions aimed in
managing the stimuli to
promote adaptation and (6)
evaluation of the goals.
Brower and Baker considers
the model useful for it
outlines the features of the
discipline and provides
direction for practice. It has
also been used in inpatients
and outpatients settings
for it identifies the blending
of different modes. Other
areas that the model was
utilized were: cardiac care
units (CCU), sexual role
performance of alcoholics,
operating room (OR),
rehabilitation and
community health. In the
present time, it is greatly
applicable in the healthcare
sector since there are a lot
of external stimulus that
may manifests in the
society nowadays and with
the help on this model,
medical practitioners
especially nurses can have
a guide in intervening with
the goal of effective
adaptation.
EDUCATION: In nursing
education, RAM has been
incorporated in different
nursing school from the
time that it has been
published up to the present
time. Some of the school
are Saint Marys College of
Nursing, University of
Ottawa School of Nursing
and University of Miami in
Florida.

nevertheless, the
theory is still
applicable and can
have a great impact in
the practice and in the
standards of nursing
care.

activities. [oxygenation,
nutrition, elimination, activity &
rest, protection]
- Self-Concept-Group Mode: a
psychosocial mode that focuses
specifically in psychological and
spiritual aspects of the human
system
- Role Function Mode: a social
mode that focuses on the roles
the person occupies in the
society
- Interdependence Mode: focuses
on the close relationship of
people and their purpose,
structure and development.
ASSUMPTIONS:
Scientific Assumptions
1. Systems of matter and energy
progress to higher level of
complex self-organization
2. Consciousness and meaning
are constitutive of person and
environment integration
3. Awareness of self and
environment is rooted in thinking
and feeling
4. Humans by decisions are
accountable for the integration of
creative processes
5. Thinking and feeling mediate
human actions
6. System relationship include
acceptance, protection and
fostering of interdependence
7. Persons and the earth have
common patterns and integral
relationships
8. Persons and environment
transformations are created in
human consciousness
9. Integration of human and
environment meanings results in
adaptation

RESEARCH: RAM
contributed in different
areas of research namely:
development and testing of
new theories, practicebased research,
development of programs
of research and
development of adaptation
research instruments. This
lead to the discovery of
other facts essential for the
promulgation of
international nursing
standards.

Philosophical Assumptions
1. Persons have mutual
relationships with the world and
God
2. Human meaning is rooted in
an omega point convergence of
the universe
3. God is ultimately revealed in
the diversity of creation and is
the common destiny of creation
4. Persons use human creative
abilities of awareness,
enlightenment and faith
5. Persons are accountable for
the processes of deriving,
sustaining and transforming the
universe
THEORETICAL PROPOSITIONS
Roys model focused in the
concept of adaptation of the
person. Her concepts of nursing,
person, health and environment
are interrelated to the central
concept.
1. A person continually scans the
environment for stimuli
2. A response is made and
adaptation occurs
3. Adaptation may be adaptive or
ineffective
4. Adaptive response promote
integrity and help the person to
achieve goals
5. Ineffective response fail to
achieve or threaten the goals of
adaptation

THEORIES AND
ITS
PROPONENTS
3. Theory of
Comfort

THEORY DESCRIPTION
This theory of Kolcaba in focused
on the measurement ad delivery

THEORY ANALYSIS
In the theorys discussion,
concepts and statements

THEORY EVALUATION
Kalcobas theory is still
quite new in the knowledge

REACTION/
REALIZATION/
SUGGESTION
The theory is
somewhat new to the

(Katharine
Kolcaba)

of comfort in patients particularly

the elderly. Katherine Kolcaba
received a diploma in nursing
from St Lukes Hospital School of
Nursing in Cleveland. She
practiced for many years in
medical-surgical nursing, longterm care and home care. She
graduated in the first RN to MSN
class at Frances Payne Bolton
School of Nursing, Case Western
Reserve University (CWRU) with
a specialty in gerontology. While
going to school, she assumes a
head nurse position in a
dementia unit. In her exposure to
that unit, she began theorizing
about the outcome of comfort.
Together with her philosopher
husband, they diagrammed the
aspect of comfort,
operationalized comfort as the
outcome of care, contextualize
comfort in the midrange theory
and tested theory in an
interventional study. She worked
with different nurses and
researchers, students who gave
her feedbacks and research
societies presentation that
contributed in the development
of her theory.
COMFORT: defined as the state
that is experienced by recipients
of comfort measures.
Types of Comfort:
- Relief: the state of a receipient
who had had a specific need met
- Ease: the state of calm and
contentment
- Transcendence: the state in
which an individual rise above
the problem of pain
Contexts of Comfort:
- Physical: pertaining to bodily

are well defined putting

emphasis on how it is
utilized in the
conceptualization of the
theory.
Kolcaba states that she
developed the Theory of
Comfort using these three
types of reasoning:
1. INDUCTION: occurs when
generalizations are built
from a number of specific
observed instances. As
nurses came across with
different signs and
manifestations, they
become familiar with
implicit or explicit concepts,
terms, propositions and
assumptions.
2. DEDUCTION: is a form of
logical reasoning in which
specific conclusions are
inferred from more general
to specific.
3. RETRODUCTION: is a
form of reasoning that
originates ideas.
There were 2 models by
Kolcaba. First is the MidRange Theory of Comfort
which elicited 4 Lines and
the Comfort Theory
adapted for research
outcomes. The models form
an algorithm of the process
of rendering comfort. She
presented factors that
affect and hinder comfort
perceptions and also
stipulated interventions and
essential factors in the
delivery of comfort. Thus,
making it an effective
model to be followed in

of nursing compared to
other theories formulated.
Nevertheless, it was still
recognized as something
which had a contribution to
the standards of nursing
practice namely:
PRACTICE: the theory is
recognized increasingly by
students in the clinical
areas as they choose it to
be a guiding framework for
their studies which include
nurse midwifery, cardiac
catheterization, critical
care, hospice, infertility,
radiation therapy and
orthopedic nursing. In the
advances of the theory,
Kalcoba discussed through
a website that it can also be
utilized in home care,
chronic pain, massage
therapy, pediatrics,
oncology and perioperative.
In the practice today,
comfort for patients is one
of the priorities in
healthcare delivery
especially in post-operative
and oncology. Pain and
restlessness being its
number one enemy can
activate chemical response
leading to other physiologic
symptoms thus making
comfort as one of our
priority and utilizing these
models and assist us in the
comfort measures.
EDUCATION: Following the
guidelines for teaching
comfort,
The Theory of Comfort was

nursing profession and

the principles are not
yet widely use in the
present time. But for
me, I find it very
beneficial especially in
the clinical setting.
Most of the diseases
acquired by patients
has pain and stress at
different degrees and
levels. With the use of
this model, comfort
can be easily rendered
by bedside nurses
following the
algorithm and diagram
of comfort.

sensations
- Psychospiritual: pertaining to
internal awareness of self
- Environmental: pertaining to
the external surroundings,
conditions and influences
- Social: pertaining to
interpersonal, family and societal
relationships.
ASSUMPTIONS:
1. Human beings have holistic
responses to stimuli
2. Comfort is a desirable holistic
outcome that is germane to the
discipline of nursing
3. Human beings strive to meet
their basic comfort needs to have
them met
4. Enhanced comfort strengthen
patients to gage in HSBs of their
choice
5. Patients who are empowered
to actively engage in HSBs are
satisfied with their healthcare
6. Institutional Integrity is based
on a value system oriented to
the recipients of care
THEORETICAL PROPOSITIONS:
1. Nurses identify unmet comfort
needs to their patients, design
comfort measures to address
those needs and seek to enhance
their patients comfort which is
the immediate desirable
outcome
2. Enhanced comfort is directly
and positively related to
engagement in HSBs, which is
the subsequent desired outcome
3. When persons have the proper
support to engage fully in HSBs,
such as rehabilitation and/or
recovery program, institutional
integrity is enhanced as well.

providing comfort for the

patient in need.

applied to nursing care of

older adults and reported
by Cox (1998) that the
theory proved to be easy to
understand and apply for
student nurses and
provided and effective
method to assess and
address holistic comfort
needs. The theory hence is
not limited to gerontological
or advances practice
education.
RESEARCH: In the field of
research, an entry in the
Encyclopedia of Nursing
Research speaks to the
importance of measuring
comfort as a nursingsensitive outcome. Using
the taxonomic structure of
comfort as a guide, Kolcaba
developed a General
Comfort Questionnaire to
measure holistic comfort in
a sample hospital and
community participants.
Having 24 negative and 24
positive questions and
using a Likert type format,
the questionnaire
demonstrated a
Croncbachs alpha of 0.88.
Hence, it provided a map of
the content domain of
comfort.

THEORIES AND
ITS
PROPONENTS
4. Theory of
Uncertainty
in Illness
(Mele
Mishel)

THEORY DESCRIPTION
Merle H. Mishel graduated with a
BA in Boston University and
received her MS in psychiatric
nursing from the University of
California. She also completed
her MA and PhD in social
psychology at Claremont
Graduate school with her
dissertation research supported
by an individual National
Research Service Award for the
Perceived Ambiguity in Illness
Scale later named the Mischel
Uncertainty in Illness Scale. The
original scale has been used as
the basis for three additional
scales: (1) a community version
for chronically ill individuals who
are not hospitalized or receiving
active medical care, (2) a
measure of parents perception
of uncertainty with regards to
their childs illness experience
and (3) a measure of uncertainty
in spouses or other family
members when another member
of the family is acutely ill. She
practiced as a psychiatric nurse
and faculty in the Department of
Nursing at the California State
University. She also became the
Division Head of Mental Health
Nursing. Subsequently, she also
presented her paper at the
National Institute of Nursing
Research (NINR) in which she

THEORY ANALYSIS
In the theorys discussion,
concepts and statements
are well defined putting
emphasis on how it is
utilized in the
conceptualization of the
theory.
The theory presented the
Model of Perceived
Uncertainty in Illness which
explained that uncertainty
is brought about by the
Stimuli Frame which can
either be a symptom
pattern, event familiarity
and event congurecy. The
absence of knowledge on
these components plus the
absence of structure
providers can lead to
uncertainty. Uncertainty can
result to inferences and
illusion of the illness which
can be perceived as danger
and opportunity. Coping
mechanisms act upon these
perceived elements to
convert uncertainty to
adaptation which is the end
point of the model. The
theory presented a
concrete flow of how
uncertainty can affect an
illness perception. It also
stipulated how uncertainty

THEORY EVALUATION
Mishels theory is being
utilized as basis for
different fields of the
nursing profession.
PRACTICE: Mishels theory
describes a phenomenon
experienced by some acute
and chronically ill
individuals and their
families. It has taken a
great leap from research to
practice. According to
Hilton, the theory applies in
prescribing how to assess
and intervene with patients
experiencing uncertainty. A
concrete example is a
patient recovering from a
cardiac event. Patients with
uncertainty often
misinterpret unclear
physical symptoms
resulting to overprotection
and limitation of physical
activity that could be
essential to their recover. In
addition, Wurzbach used
the theory in the certainty
vs uncertainty of a woman
hospitalized with a lump in
her breast. Having the
proper assessment,
management strategies
were formulated and
nursing interventions.

REACTION/
REALIZATION/
SUGGESTION
The theory is
appropriate especially
in the clinical setting.
Uncertainty is evident
when an individual
experiences a
symptom that they are
unfamiliar with. They
tend to think too much
of the possible causes
and disease process
that they are
experiencing. With
this, it is appropriate
to have right
interventions for
uncertainty to further
educate patients on
the normal signs that
they might have
versus the signs to be
reported. Having been
educated and well
coped, they will start
to work hand in hand
with the healthcare
provider towards
adaptation and
wellness.

received a Research Merit Award

followed by different awards that
lead to the development of her
study and theory.
UNCERTAINTY: is the inability to
determine the meaning of illnessrelated events that occur when
the decision-maker is unable to
assign definite value to objects
or events and/or is unable to
predict outcomes accurately.
COGNITIVE SCHEMA: persons
subjective interpretation of
illness, treatment and
hospitalization.
STIMULI FRAME: form and
composition of the stimuli that a
person perceives, when are then
structured into a cognitive
schema
STRUCTURE PROVIDERS:
resources available to assists the
person in the interpretation of
the stimuli frame
COGNITIVE CAPACITIES:
information-processing abilities
of a person, reflecting both
innate capabilities and
situational constraints.
ASSUMPTIONS:
1. Uncertainty is a cognitive
state, representing the
inadequacy of an existing
cognitive schema to support the
interpretation of illness-related
events
2. Uncertainty is an inherently
neutral experience, neither
desirable nor aversive until it is
appraised
3. Adaptation represents the
continuity of an individuals usual
biophysical behavior and is the
desired outcome of coping efforts

is converted to adaptation
to ease the feeling and
bring patient to wellness.

EDUCATION: The theory has

been widely used by
graduate students in the
field of health and medical
practice. These thesis and
dissertations used Mishels
framework as the topic of
their concept analysis and
for critique of midrange
nursing theory. Mishel is
also invited as guest
speaker at nursing schools
presenting both empirical
findings and the process of
theory development for
audiences.
RESEARCH: a large body of
knowledge has been
generated by researchers
using the Uncertainty in
Illness Theory and scales.
They have used it in their
inquiry on samples of
women with cancer as they
test psychoeducational
nursing interventions
derived from theoretical
model in samples of adults
with breast and prostate
cancers. They have also
used the theory in
explaining psychological
responses of people
experiencing uncertainty in
illness.

to reduce uncertainty
4. The relationships between
illness events, uncertainty,
appraisal, coping and adaptation
are linear and unidirectional
THEORETICAL PROPOSITIONS:
1. Uncertainty occurs when a
person cannot adequately
structure or categorize an illnessrelated event because there is a
lack of sufficient cues.
2. Uncertainty takes the form of
ambiguity, complexity lack or
inconsistent information and
unpredictability
3. As symptom pattern, event
familiarity and event congruence
increase, uncertainty decreases.
4. Structure providers decrease
uncertainty by promoting
interpretation of events
5. Uncertainty appraised as
danger prompts coping efforts
directed at reducing uncertainty
and managing emotional arousal
6. Uncertainty appraised as
opportunity prompts coping
efforts directed at maintaining
the uncertainty
7. The influence of uncertainty
on psychological outcomes is
mediated by the effectiveness of
coping efforts to reduce
uncertainty
8. When uncertainty appraised
as danger cannot be effectively
reduced, coping strategies can
be employed to manage the
emotional response
9. The longer the uncertainty
continues in the illness, the more
unstable the mode of functioning
becomes
10. Under conditions of enduring
uncertainty, individuals may

develop a new, probabilistic

perspective in life
11. The process of integrating
continual uncertainty into a view
of life can be blocked or
prolonged by structure providers
who do not support probabilistic
thinking
12. Prolonged exposure to
uncertainty appraised as danger
can lead to intrusive thoughts,
avoidance and severe emotional
distress.

THEORIES AND
ITS
PROPONENTS
5. Model of
Health
(Margaret
A. Newman)

THEORY DESCRIPTION
Margaret A. Newman earned her
first bachelors degree in home
economics and English at Baylor
University in Texas. Her second
bachelors degree in nursing
from University of Tennessee.
After that, she received her
masters degree in medicalsurgical nursing and teaching
from University of California and
earned her PhD in Nursing
science and rehabilitation
nursing from New York University.
She became a professor and
earned academic ranks from
different universities in the

THEORY ANALYSIS
In the theorys discussion,
concepts and statements
are well defined putting
emphasis on how it is
utilized in the
conceptualization of the
theory.
The theory presented a
model of Newmans Theory
of Expanding
Consciousness incorporated
with Youngs stages of
human evolution. The
intersection of movementspace-time represents the

THEORY EVALUATION
Newmans theory of health
has influenced greatly in
the field of practice,
education and research.
PRACTICE: In Newmans
view, the responsibility of
professional nursing
practice is to establish a
primary relationship with
the client. Having been said
this, she reiterated that
the goal of nursing is not
to make people well, or to
prevent their getting sick,
but to assist people to

REACTION/
REALIZATION/
SUGGESTION
The theory had a great
impact in the nursing
profession and
practice as it
presented a different
view of health in the
course of a disease
and non-disease
continuum. It
contributed a lot in the
field of practice,
education and
research. I suggest
that the theory be
used more in different
nursing subspecialty

United States. Given different

awards by established and
renowned universities in her
research excellence.
Above all this, Newmans early
personal experience emanated in
the development of the Theory of
Health. Her mothers struggle
with amyotrophic lateral sclerosis
sparked her interest in nursing.
From her experience evolved the
idea that illness reflected the
life patterns of the person and
that what was needed was the
recognition of that pattern and
acceptance of it for what it
meant to that person. The life
experience triggered her
beginning maturation toward
theory development in nursing.
Concepts stipulated to the theory
presentation are as follows:
- Health: encompasses disease
and nondisease. It can be
regarded as the evolving pattern
of the person and the
environment.
- Pattern: information that
depicts the whole understanding
of the meaning and relationships
at once. It is a fundamental
attribute f all there us and gives
unity in diversity.
- Consciousness: informational
capacity of the system and the
ability of the system to interact
with the environment.
- Movement: means whereby one
perceives reality and therefore, is
a means of becoming aware of
self.
- Time and Space: have a
complementary relationship in
theory. The concept of space is
inextricably linked to the concept

person as a center of
consciousness and varies
from person to person,
place to place and time to
time. Newman stated that
the crucial task is to be able
to see the concepts of
movement-time-space in
relation to each other as
patterns of evolving
consciousness. Newman
drew heavily on the
theoretical work of Young.
The central theme of the
model is the self or the
universe. The essential
nature is undefinable, but
the beginning and the end
are characterized by
complete freedom and
unrestricted choice. She
also stated that we come
into being from a state of
consciousness, are bound in
time, find our identity in
space and through
movement learn the law of
the way things work and
make choices that
ultimately take us beyond
space and time to a state of
absolute consciousness

utilize the power that is

within them as they evolve
toward higher level of
consciousness. Doberneck
used Newmans mode to
work with caregivers of
chronically ill people;
Marchione investigated and
report the meaning of
disabling events in the
families making a
disturbance in time, space
and movement as a result;
Kalb applied it in the clinical
management of pregnant
women hospitalized for
complications of maternalfetal health making the
mother as the choice maker
for the care of the child;
Endo also studied and
applied Newmans model in
the pattern of recognition
as nursing intervention with
adults with cancer.
Numerous NursePractitioners and scientist
used the theory to
incorporate the concepts in
their nursing practice or to
elaborate the theory in
research. In the present
time, it has been utilized as
we, nurse-practitioner,
make sure that we coincide
time, space and movement
in considering the health of
our patients.
EDUCATION: In this aspect,
Newman stated that
Nurses need to be free to
relate to patients in an
ongoing partnership that is
not limited to a particular
place or time. She also

such as medicalsurgical, pediatrics

and across the
lifespan of a human
being.

of time. When ones life space is

decreased, as by either physical
or social immobility, ones time is
increased.
ASSUMPTIONS:
1. Health encompasses
conditions heretofore described
as illness or, in medical terms,
pathology
2. These pathological conditions
can be considered a
manifestation of the total pattern
of the individual
3. The pattern of the individual
that eventually manifests itself
as pathology is primary and
exists prior to structural or
functional changes
4. Removal of pathology in itself
will not change the pattern of the
individual
5. If becoming ill is the only way
to way an individuals pattern
can manifest itself, then that is
health for that person
6. Health is the expansion of
consciousness
THEORETICAL PROPOSITIONS:
1.Movement is a means whereby
space and time become a reality
2. Movement is a reflection of
consciousness
3. Time is a function of
movement
4. Time is a measure of
consciousness

said that teaching the

method associated with the
theory also teaches the
students a practice method
that is congruent with the
theory. Newmans theory
provided some content into
a model called the Healing
Web to integrate nursing
education and nursing
service.
RESEARCH: a lot of research
papers used Newmans
model as their basis for
their study such as:
occurrence of depression in
the elderly and decreased
subjective time; duration of
time as an index to
consciousness in a study of
institutionalized elderly;
and differences in
consciousness with regard
to time and movement,
with results supporting the
concept of expanding
consciousness. All of these
utilized Newmans theory in
their research design.