What are 

Nursing Theories? They present an overview of the

thinking behind the theory and
Nursing theories are organized bodies of may demonstrate how theory can
knowledge to define what nursing is, what be introduced into practice.
nurses do, and why do they do it. Nursing  Conceptual framework. A
theories provide a way to define nursing conceptual framework is a group
as a unique discipline that is separate of related ideas, statements,
from other disciplines (e.g., medicine). or concepts. It is often used
It is a framework of concepts and interchangeably with
purposes intended to guide the practice the conceptual model and
of nursing at a more concrete and with grand theories.
specific level.  Proposition. Propositions are
statements that describe the
relationship between the
Nursing, as a profession, is committed to concepts.
recognizing its own unparalleled body of  Domain. Domain is the
knowledge vital to nursing practice— perspective or territory of a
nursing science. To distinguish this profession or discipline.
foundation of knowledge, nurses need to  Process. Processes are a series
identify, develop, and understand of organized steps, changes or
concepts and theories in line with functions intended to bring
nursing. As a science, nursing is based about the desired result.
on the theory of what nursing is, what
 Paradigm. A paradigm refers to
nurses do, and why. Nursing is a unique
a pattern of shared
discipline and is separate from medicine.
understanding and assumptions
It has its own body of knowledge on
about reality and the world;
which delivery of care is based.
worldview or widely accepted
value system.
Defining Terms  Metaparadigm. A metaparadigm is
the most general statement of
discipline and functions as a
Development of nursing theory demands an
framework in which the more
understanding of selected terminologies,
restricted structures of
definitions, and assumptions.
conceptual models develop. Much
of the theoretical work in
 Philosophy. Beliefs and values nursing focused on articulating
that define a way of thinking relationships among four major
and are generally known and concepts: person, environment,
understood by a group or health, and nursing.
discipline.
 Theory. A belief, policy, or History of Nursing Theories
procedure proposed or followed
as the basis of action. It The first nursing theories appeared in
refers to a logical group of the late 1800s when a strong emphasis was
general propositions used as placed on nursing education.
principles of explanation.
Theories are also used to
describe, predict, or control  In 1860, Florence
phenomena. Nightingale defined nursing in
 Concept. Concepts are often her “Environmental Theory”
called the building blocks of as “the act of utilizing the
theories. They are primarily environment of the patient to
the vehicles of thought that assist him in his recovery.”
involve images.  In the 1950s, there is a
 Models. Models are consensus among nursing
representations of the scholars that nursing needed to
interaction among and between validate itself through the
the concepts showing patterns. production of its own
 scientifically tested body of  In 1972, Betty Neuman in her
knowledge. theory states that many needs
 In 1952, Hildegard exist, and each may disrupt
Peplau introduced her Theory of client balance or stability.
Interpersonal Relations that Stress reduction is the goal of
puts emphasis on the nurse- the system model of nursing
client relationship as the practice.
foundation of nursing practice.  In 1979, Sr. Callista
 In 1955, Virginia Roy viewed the individual as a
Henderson conceptualized the set of interrelated systems who
nurse’s role as assisting sick strives to maintain the balance
or healthy individuals to gain between these various stimuli.
independence in meeting 14  In 1979, Jean Watson developed
fundamental needs, thus the philosophy of caring
her Nursing Need Theory was highlighted humanistic aspects
developed. of nursing as they intertwine
 In 1960, Faye with scientific knowledge and
Abdellah published her work nursing practice.
“Typology of 21 Nursing
Problems” that shifted the The Nursing Metaparadigm
focus of nursing from a
disease-centered approach to a
There are four major concepts that are
patient-centered approach.
frequently interrelated and fundamental
 In 1962, Ida Jean to nursing theory: person, environment,
Orlando emphasized the health, and nursing. These four are
reciprocal relationship between collectively referred to as metaparadigm
patient and nurse and viewed for nursing.
the professional function of
nursing as finding out and
meeting the patient’s immediate Person
need for help.
 In 1968, Dorothy Person (also referred to as Client or
Johnson pioneered Human Beings) is the recipient of nursing
the Behavioral System Model and care and may include individuals,
upheld the fostering of patients, groups, families, and
efficient and effective communities.
behavioral functioning in the
patient to prevent illness.
 In 1970, Martha Rogers viewed Environment
nursing as both a science and
an art as it provides a way to Environment (or situation) is defined as
view the unitary human being, the internal and external surrounds that
who is integral with the affect the client. It includes all
universe. positive or negative conditions that
 In 1971, Dorothea Orem states affect the patient, the physical
in her theory that nursing care environment, such as families, friends,
is required if the client is and significant others, and the setting
unable to fulfill biological, for where they go for their healthcare.
psychological, developmental,
or social needs. Health
 In 1971, Imogene King‘s Theory
of Goal attainment states that Health is defined as the degree of
the nurse is considered part of wellness or well-being that the client
the patient’s environment and experiences. It may have different
the nurse-patient meanings for each patient, the clinical
relationship is for meeting setting, and the health care provider.
goals towards good health.
Nursing  Abstract Concepts. Defined as
mentally constructed
The attributes, characteristics, and independent of a specific time
actions of the nurse providing care on or place.
behalf of or in conjunction with, the  Concrete Concepts. Are directly
client. There are numerous definitions of experienced and related to a
nursing, though nursing scholars may have particular time or place.
difficulty agreeing on its exact
definition, the ultimate goal of nursing Definitions
theories is to improve patient care.
Definitions are used to convey the
You’ll find that these four concepts are general meaning of the concepts of the
used frequently and defined differently theory. Definitions can be theoretical or
throughout different nursing theories. operational.
Each nurse theorist’s definition varies
in accordance with their  Theoretical Definitions. Define
orientation, nursing experience, and a particular concept based on
different factors that affect the the theorist’s perspective.
theorist’s view of nursing. The person is
 Operational Definitions. States
the main focus but how each theorist
how concepts are measured.
defines the nursing metaparadigm gives a
unique take specific to a particular
theory. To give you an example, below are Relational Statements
the different definitions of various
theorists on the nursing metaparadigm: Relational statements define the
relationships between two or more
concepts. They are the chains that link
Components of Nursing Theories concepts to one another.

For a theory to be a theory it has to

Assumptions
contain a set of concepts, definitions,
relational statements, and assumptions
that explain a phenomenon. It should also Assumptions are accepted as truths and
explain how these components relate to are based on values and beliefs. These
each other. are statements that explain the nature of
concepts, definitions, purpose,
relationships, and structure of a theory.
Phenomenon
List of Nursing Theories and Theorists
A term given to describe an idea or
responses about an event, a situation, a
process, a group of events, or a group of Florence Nightingale
situations. Phenomena may be temporary or
permanent. Nursing theories focus on the  Founder of Modern Nursing and
phenomena of nursing. Pioneer of the Environmental
Theory. 
 Defined Nursing as “the act of
Concepts utilizing the environment of
the patient to assist him in
Interrelated concepts define a theory. his recovery.”
Concepts are used to help describe or  Stated that nursing “ought to
label a phenomenon. They are words or signify the proper use of fresh
phrases that identify, define, and air, light, warmth,
establish structure and boundaries for cleanliness, quiet, and the
ideas generated about a particular proper selectiozn and
phenomenon. Concepts may be abstract or administration of diet – all at
concrete. the least expense of vital
power to the patient.”
  Identified five (5) help people, sick or well, cope
environmental factors: fresh with their health needs.”
air, pure water, efficient  Changed the focus of nursing
drainage, cleanliness or from disease-centered to
sanitation, and light or direct patient-centered, and began to
sunlight. include the care of families
and the elderly in nursing
Hildegard E. Peplau care.
 The nursing model is intended
 Pioneered the Theory of to guide care in hospital
Interpersonal Relations institutions, but can also be
 Peplau’s theory defined Nursing applied to community health
as “An interpersonal process of nursing, as well.
therapeutic interactions
between an individual who is Lydia E. Hall
sick or in need of health
services and a nurse especially  Developed the Care, Cure, Core
educated to recognize, respond Theory also known as the “Three
to the need for help.” Cs of Lydia Hall.“
 Her work is influenced by Henry  Hall defined Nursing as the
Stack Sullivan, Percival “participation in care, core
Symonds, Abraham Maslow, and and cure aspects of patient
Neal Elgar Miller. care, where CARE is the sole
 Helps nurses and healthcare function of nurses, whereas the
providers develop more CORE and CURE are shared with
therapeutic interventions in other members of the health
the clinical setting. team.”
 The major purpose of care is to
Virginia Henderson achieve an interpersonal
relationship with the
 Developed the Nursing Need individual that will facilitate
Theory the development of the core.
 Focuses on the importance of  The “care” circle defines the
increasing the patient’s primary role of a professional
independence to hasten their nurse such as providing bodily
progress in the hospital. care for the patient. The
“core” is the patient receiving
 Emphasizes the basic human
nursing care. The “cure” is the
needs and how nurses can assist
aspect of nursing which
in meeting those needs.
involves the administration of
 “The nurse is expected to carry
medications and treatments.
out a physician’s therapeutic
plan, but individualized care
is result of the nurse’s Joyce Travelbee
creativity in planning for
care.”  States in her Human-to-Human
Relationship Model that the
Faye Glenn Abdellah purpose of nursing was to help
and support an individual,
family, or community to prevent
 Developed the 21 Nursing
or cope with the struggles of
Problems Theory
illness and suffering and, if
 “Nursing is based on an art and necessary, to find significance
science that molds the in these occurrences, with the
attitudes, intellectual ultimate goal being the
competencies, and technical presence of hope.
skills of the individual nurse
 Nursing was accomplished
into the desire and ability to
through human-to-human
relationships.
  Extended the interpersonal Patricia Benner
relationship theories of Peplau
and Orlando.  Caring, Clinical Wisdom, and
Ethics in Nursing Practice
Ida Jean Orlando  “The nurse-patient
relationship is not a uniform,
 She developed the Nursing professionalized blueprint but
Process Theory. rather a kaleidoscope of
 “Patients have their own intimacy and distance in some
meanings and interpretations of of the most dramatic, poignant,
situations and therefore nurses and mundane moments of life.”
must validate their inferences  Attempts to assert and
and analyses with patients reestablish nurses’ caring
before drawing conclusions.” practices during a time when
 Allows nurses to formulate an nurses are rewarded more for
effective nursing care efficiency, technical skills,
plan that can also be easily and measurable outcome.
adapted when and if any  States that caring practices
complexity comes up with the are instilled with knowledge
patient. and skill regarding everyday
 According to her, persons human needs.
become patients requiring
nursing care when they have Katie Erikson
needs for help that cannot be
met independently because of  Theory of Carative Caring
their physical limitations,  “Caritative nursing means that
negative reactions to an we take ‘caritas’ into use when
environment, or have an caring for the human being in
experience that prevents them health and suffering […]
from communicating their needs. Caritative caring is a
 The role of the nurse is to manifestation of the love that
find out and meet the patient’s ‘just exists’ […] Caring
immediate needs for help. communion, true caring, occurs
when the one caring in a spirit
Jean Watson of caritas alleviates the
suffering of the patient.”
 She pioneered the Philosophy  The ultimate goal of caring is
and Theory of Transpersonal to lighten suffering and serve
Caring. life and health.
 “Nursing is concerned with  Inspired many in the Nordic
promoting health, preventing countries, and used as the
illness, caring for the sick, basis of research, education,
and restoring health.” and clinical practice.
 Mainly concerns on how nurses
care for their patients, and Myra Estrin Levine
how that caring progresses into
better plans to promote health  According to the Conservation
and wellness, prevent illness Model, “Nursing is human
and restore health. interaction.”
 Focuses on health promotion, as  Provides a framework within
well as the treatment of which to teach beginning
diseases. nursing students.
 Caring is central to nursing  Logically congruent, is
practice and promotes health externally and internally
better than a simple medical consistent, has breadth as well
cure. as depth, and is understood,
with few exceptions, by
 professionals and consumers of situation, and through
health care. communication, they set goals,
explore means, and agree on
Martha E. Rogers means to achieve goals.”
 Focuses on this process to
 In Roger’s Theory of Human guide and direct nurses in
Beings, she defined Nursing as the nurse-patient relationship,
“an art and science that is going hand-in-hand with their
humanistic and humanitarian. patients to meet the goals
 The Science of Unitary Human towards good health.
Beings contains two dimensions:  Explains that the nurse and
the science of nursing, which patient go hand-in-hand in
is the knowledge specific to communicating information, set
the field of nursing that comes goals together, and then take
from scientific research; and actions to achieve those goals.
the art of nursing, which
involves using the science of Betty Neuman
nursing creatively to help
better the life of the patient.  In Neuman’s System Model,
 A patient can’t be separated she defined nursing as a
from his or her environment “unique profession in that is
when addressing health and concerned with all of the
treatment. variables affecting an
individual’s response to
Dorothea E. Orem stress.”
 The focus is on the client as a
 In her Self-Care Theory, she system (which may be an
defined Nursing as “The act of individual, family, group, or
assisting others in the community) and on the client’s
provision and management of responses to stressors.
self-care to maintain or  The client system includes five
improve human functioning at variables (physiological,
home level of effectiveness.” psychological, sociocultural,
 Focuses on each individual’s developmental, and spiritual)
ability to perform self-care. and is conceptualized as an
 Composed of three interrelated inner core (basic energy
theories: (1) the theory of resources) surrounded by
self-care, (2) the self-care concentric circles that include
deficit theory, and (3) the lines of resistance, a normal
theory of nursing systems, line of defense, and a flexible
which is further classified line of defense.
into wholly compensatory,
partially compensatory and Sister Callista Roy
supportive-educative.
 In Adaptation Model, Roy
Imogene M. King defined nursing as a “health
care profession that focuses on
 Conceptual System and Middle- human life processes and
Range Theory of Goal Attainment patterns and emphasizes
promotion of health for
 “Nursing is a process of
individuals, families, groups,
action, reaction and
and society as a whole.”
interaction by which nurse and
client share information about  Views the individual as a set
their perception in a nursing of interrelated systems who
situation” and “a process of strives to maintain balance
human interactions between between various stimuli.
nurse and client whereby each  Inspired the development of
perceives the other and the many middle-range nursing
 theories and of adaptation with the intention to implement
instruments. significant and efficient
nursing care services to people
Dorothy E. Johnson according to their cultural
values and health-illness
 The Behavioral System context.
Model defined Nursing as “an  Focuses on the fact that
external regulatory force which various cultures have different
acts to preserve the and unique caring behaviors and
organization and integration of different health and illness
the patients’ behaviors at an values, beliefs, and patterns
optimum level under those of behaviors.
conditions in which the
behavior constitutes a threat Margaret A. Newman
to the physical or social
health, or in which illness is  Health as Expanding
found.” Consciousness
 Advocates the fostering of  “Nursing is the process of
efficient and effective recognizing the patient in
behavioral functioning in the relation to the environment,
patient to prevent illness and and it is the process of the
stresses the importance of understanding of
research-based knowledge about consciousness.”
the effect of nursing care on  “The theory of health as
patients. expanding consciousness was
 Describes the person as a stimulated by concern for those
behavioral system with seven for whom health as the absence
subsystems: the achievement, of disease or disability is not
attachment-affiliative, possible . . . “
aggressive-protective,  Nursing is regarded as a
dependency, ingestive, connection between the nurse
eliminative, and sexual and patient, and both grow in
subsystems. the sense of higher levels of
consciousness
Madeleine M. Leininger

 Culture Care Theory of

Diversity and Universality
 Defined transcultural
nursing as “a substantive area
of study and practice focused
on comparative cultural care
(caring) values, beliefs, and
practices of individuals or
groups of similar or different
cultures with the goal of
providing culture-specific and
universal nursing care
practices in promoting health
or well-being or to help people
to face unfavorable human
conditions, illness, or death
in culturally meaningful ways.”
 Involves learning and
understanding various cultures
with regard to nursing and
health-illness caring
practices, beliefs, and values