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Leonardo Jr Magtaan Uy
Introduction
Nursing is a Professional discipline focused on the study of human health and healing through
caring. Nursing practice is based on the knowledge of nursing, which consists of its philosophies,
theories, concepts, principles, research findings and practice wisdom. Nursing theories are
patterns that guide the thinking about nursing. All nurses are guided by some implicit or explicit
theory or pattern of thinking as they care for their patients. The major reason for the development
of study of nursing theory is to improve nursing practice and therefore the health and quality of
The evolution of nursing theories and philosophies has facilitated the progression of nursing as a
autonomy when used as a guide for critical thinking and decision making. Ultimately nursing
theory and philosophy has increased knowledge development and enriched the quality of nursing
practice (McEwen & Wills, 2011). Nursing philosophy and theory are two interchangeable
terms. The philosophy a nurse has on nursing will determine the theory and model he or she
uses. Nursing philosophy explains what nursing is and gives insight to why nurses practice the
way they do. Nursing theory describes how nurses and patients are able to produce healing and
good health, by using models to explain how beliefs and aspects of health are related. Theory is
used to explain and analyze what nurses do as well as facilitate communication between nurses
and guide research and education. Nursing theory encompasses the foundations of nursing
practice past and present and provides direction for how nursing should develop in the future
model must first be defined. A theory is a supposition or system of ideas that is proposed to
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explain a given phenomenon. Concepts are the building blocks of theory, are abstract ideas or
diagram of a conceptual framework. Nursing has four basic concepts, called metaparadigms.
You can call this conceptual framework of nursing theories in general since a metaparadigm
consists of a group of related concepts. The four metaparadigms of nursing are person or client,
environment, health, and nursing. A person or client is the recipient of nursing care. Environment
is the internal or external surroundings that affect the client. Health is the degree of wellness or
well-being that the client experiences. Nursing are the attributes, characteristics, and actions of
the nurse providing care on behalf of, or in conjunction with, the client (Kozier, Erb, Berman,
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Nurses must know what they are doing, why they are doing, what may be the range of
outcomes of nursing, and indicators for measuring nursing impact (Parker, 2001). The purpose of
this paper is to find similarities and differences of ten nursing models given by ten nursing
theorists who have made major contributions in the field of nursing practice. These models are;
Watson – Philosophy and Science of Caring, Sister Calista Roy - Adaptation Model, Dorothea
Orem- Self-Care Model, Hildegard Peplau -Interpersonal Relations Model, Madeleine Leininger
- Culture Care Diversity and Universality, Imogene King-Goal Attainment Theory, Fay Abdella-
Topology of 21 Nursing Problems, and Lydia E. Hall - The Core, Care and Cure.
In this theory, the role of the nurse is to use the patient's environment to help him or her
recover and get back to the usual environment. The reason the patient's environment is important
is because it can affect his or her health in a positive or negative way. Some environmental
factors affecting health according to Nightingale's theory are fresh air, pure water, sufficient food
and appropriate nutrition, efficient drainage, cleanliness, and light or direct sunlight. If any of
these factors is lacking, it can delay the patient's recovery. Nightingale also emphasized
providing a quiet, warm environment for patients to recover in. The theory also calls for nurses
to assess a patient's dietary needs, document food intake times, and evaluate how the patient's
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Henderson's Need Theory emphasizes the importance of patient independence so that the
patient will continue to progress after being released from the hospital. Henderson described the
role of the nurse as one of the following: substitutive, which is doing something for the patient;
with the patient to do something. These roles are to help the patient become as independent as
possible. She categorized nursing activities into fourteen components based on human needs.
6. Maintain body temperature within normal range by adjusting clothing and modifying
environment.
7. Keep the body clean and well-groomed and protect the integument.
13. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the
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According to her theory, caring can be demonstrated and practiced by nurses. Caring for
patients promotes growth; a caring environment accepts a person as he or she is, and looks to
what he or she may become. Caring consists of carative factors. Watson's 10 carative factors are:
environment, assisting with gratification of human needs, and allowing for existential-
phenomenological forces. The first three factors form the "philosophical foundation" for the
science of caring, and the remaining seven come from that foundation. Watson's theory has four
major concepts: human being, health, environment/society, and nursing. The human being is
defined as "...a valued person in and of him or herself to be cared for, respected, nurtured,
integrated self. He, human is viewed as greater than and different from, the sum of his or her
parts." A human's health includes a high level of overall physical, mental, and social function; a
general adaptive-maintenance level of daily function; and the absence of illness or the process of
Sister Callista Roy developed the Roy Adaptation Model, which is based on the belief
that the human being is an open system. The system responds to environmental stimuli through
the cognator and regulator coping mechanisms for individuals and the stabilizer and innovator
control mechanisms for groups. The responses occur through at least one of four modes—
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responses in these modes are usually visible to others and can be identified as adaptive or
ineffective. Adaptive behaviors that need support and ineffective behaviors are then analyzed to
identify the associated stimuli. The major stimulus leading to one of these behaviors is the focal
stimulus; other stimuli that are verified as being involved are contextual, and stimuli that might
be involved but have not been verified are residual. Nursing care focuses on altering stimuli or
The central philosophy of the Self-Care Deficit Nursing Theory is that all patients want to
care for themselves, and they can recover more quickly and holistically by performing their own
self-care as much as they're able. This theory is particularly used in rehabilitation and primary
care or other settings in which patients are encouraged to be independent. The self-care requisites
identified by Dorothea Orem fall into one of three categories. The first is universal self-care
requisites, which are needs that all people have. These include things like air, water, food,
activity and rest, and hazard prevention. The second is developmental self-care requisites, which
has two sub-categories: maturational, which progress the patient to a higher level of maturation,
or situational, which prevent against harmful effects in development. The third category is health
deviation requisites, which are needs that come up based on the patient's condition. If a patient is
unable to meet their self-care requisites, a "self-care deficit" occurs. In this case, the patient's
nurse steps in with a support modality which can be total compensation, partial compensation, or
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Her focus is on the interpersonal process between a nurse and a client and the roles played
by the nurse in this process. The interpersonal process occurs in three phases: orientation, working,
and termination. In the orientation phase, the client seeks help, and the nurse assists the client to
understand the problem and the extent of the need for help. In the identification phase, the client
exploitation phase, the client derives full value from what the nurse offers through the relationship.
The client uses available services based on self-interest and needs. Power shifts from the nurse to
the client. To utilize this theory in the nursing practice, the nurse recognizes that the client moves
from one phase of dependence to independence during the nurse-patient interaction for the
the nurse’s and the client’s—to effective nursing practice. She believes that all cultures have
practices related to caring. Those practices that are common across cultures are culture care
universalities, and those that are specific to a given culture are culture care diversities. Research
findings indicate there is more diversity than universality. Leininger’s Sunrise Model depicts the
dimensions of Culture Care Diversity and Universality. The cultural and social structure
dimensions include technological, religious, philosophic, kinship, social, value and lifeway,
political, legal, economic, and educational factors. These factors influence the patterns and
expressions of caring in relation to the health of individuals, families, groups, and communities.
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The involved health systems include folk systems, nursing, and other professional systems. To
achieve culture congruent care, nursing actions are to be planned in one of three modes: culture
repatterning/restructuring. This theory can easily be applied in the nursing practice. For example,
the nurse needs to be aware that caring is common to all cultures. However, there are more
differences than similarities in the practice related to caring. Therefore, becoming familiar of
one’s culture is of utmost importance to provide the ultimate nursing care (Kozier, Erb, Berman,
Burke, 2000).
According to King, the patient is a social being who has three fundamental needs: the
need for health information, the need for care that seeks to prevent illness, and the need for care
when the patient is unable to help him or herself. She explains health as involving life
experiences of the patient, which includes adjusting to stressors in the internal and external
environment by using resources available. The environment is the background for human
interaction. It involves the internal environment, which transforms energy to enable people to
adjust to external environmental changes, and it involves the external environment, which is
formal and informal organizations. A nurse is considered part of the patient's environment. The
three interacting systems in her Theory of Goal Attainment are the personal system, the
interpersonal system, and the social system. Each system is given different concepts. The
concepts for the personal system are: perception, self, growth and development, body image,
space, and time. The concepts for the interpersonal system are: interaction, communication,
transaction, role, and stress. The concepts for the social system are: organization, authority,
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power, status, and decision making. According to King, the goal of the nurse is to help patients
maintain health so they can function in their individual roles. The nurse's function is to interpret
information in the nursing process, to plan, implement, and evaluate nursing care. In the nurse-
patient relationship, the nurse first uses his or her knowledge base to assess the patient and make
a diagnosis. After the diagnosis, the nurse creates a plan for interventions to solve problems that
were identified in the assessment and diagnosis. Once a care plan is created, actions are
implemented to achieve the patient's health goals. Finally, the nurse evaluates the patient to
based on an art and science that moulds the attitudes, intellectual competencies, and technical
skills of the individual nurse into the desire and ability to help people, sick or well, cope with
their health needs." The patient-centered approach to nursing was developed from Abdellah's
practice, and the theory is considered a human needs theory. It was created to help with nursing
education, so it most applicable in that area. The nursing model is intended to guide care in
hospitals, but can be applied to community nursing, as well. The model has interrelated concepts
logical in nature. Abdellah's theory identifies ten steps to identify the patient's problem and 11
nursing skills used to develop a treatment typology. The model identifies nursing as a helping
profession. Nursing care is doing something to or for a patient, or providing information to the
patient with the intention of meeting needs, increasing self-ability, or alleviating impairment. In
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Also known as "the Three Cs of Lydia Hall," Hall's theory contains three independent but
interconnected circles. The three circles are: the core, the care, and the cure. The core is the
patient to whom nursing care is directed. The core has set goals by him or herself rather than by a
healthcare provider or family and friends. The core makes decisions and behaves according to
his or her feelings and values. The cure is the attention given to the patient by the nurse and other
medical professionals. In this model, the focus of care is not only on the nurse, but on all
healthcare professionals involved in the care of the patient. The cure includes interventions or
actions geared toward treating the patient of whatever illness, disease, or disability he or she may
be suffering from. The care circle is Hall's explanation of the role of nurses in her model.
According to the theory, nurses are focused on performing the noble task of nurturing patients.
This specifically speaks to the "motherly" nature of nursing, which may include a nurse
addressing a patient's comfort issues. The role of nursing also includes educating patients, and
helping a patient meet any needs he or she is unable to meet alone. The theory puts emphasis on
the importance of the total patient rather than looking at one part or aspect. There is also
emphasis put on all three aspects of the theory (care, cure, and core circles) functioning together.
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Conclusion
essential role for understanding multifaceted human beings and related nursing phenomena. The
conceptual models and theories in nursing represent different paradigms and aspects of nursing.
However, the definitive purpose of these paradigms and the models and theories which follow
In nursing, a patient’s autonomy must be cared for just as much as any other part of the patient.
Nurses can be used as tools to support autonomy in most patient situations. Individual patients
and nursing situations are difficult to peg into one specific theory model. I believe that using a
combination of theories, as well as ethical behavior in practice, can help us to cater to each
individual patient’s needs. Nurse-led, self-care equilibrium can be achieved which is the best
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References
Smith, M.C., & Parker M.E. (2015) Nursing Theories & Nursing Practice (4th Edition).
Essays, UK. (November 2013). Nursing Theory and Philosophy Nursing Essay. Retrieved from
https://www.ukessays.com/essays/nursing/nursing-theory-and-philosophy-nursing-
essay.php?cref=1
http://currentnursing.com/nursing_theory/nursing_theorists.html
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