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Tfn-reviewer - Lecture notes 1

Theoretical Foundation in Nursing (Lyceum of the Philippines University)

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PRELIMS: Reviewer in Theoretical  matriarch of modern nursing Nursing as a Science – expansion of body
Foundations of Nursing  “The act of utilizing the environment knowledge; health profession that
of the patient to assist him in his establishes itself as separate form practice
Chapter 1: The Evolution of Nursing recovery.” of medicine

Nursing Key Points Hildegard Peplau Definitions of Nursing

o Nursing continues to flourish  Mother of psychiatric nursing o Associations of Deans of

o Demand for nurses  Nursing as an art has 3 major Philippine Colleges of Nursing
o Filipino caring components: medium – art or (ADPCN) – “A dynamic dicipline. It is
intellectual creativity to bring about an art and science of caring for
Nurse – state licensed health care change, process – interaction individuals, families, groups and
professional engaged in practice of providing initiated by nurse, product – result communities geared toward
nursing care or outcome of nursing care promotion and restoration of health,
 Has 4 main goals: (1) understand the prevention of illness, alleviation of
Responsibilities of Nurses patient, condition, situation, or need; suffering, and assisting clients to
(2) enhance the patient’s capability; face death with dignity and peace. It
o Assess patient’s needs and problems (3) improve the patient’s condition or is focused on assisting the client as
o Health maintenance of healthy situation; (4) prevent recurrence of he or she responds to health-illness
individuals problem or new problem situations, utilizing the nursing
o Treatment, safety, and recovery of processes and guided by ethico-legal
acutely or chronically ill or injured Definitions of Nursing and moral principles.”
people o American Nursing Association
o Research and non-clinical functions o Virginia Henderson – “Assisting the (ANA) – “Nursing is the protection,
o Teaching and mentoring other nurses individual, sick or well, in the promotion, and optimization of
performance of those activities, health and abilities, prevention of
Scope of Work of RNs contributing to health, its recovery, illness and injury, alleviation of
promoting quality of life or to a suffering through diagnosis and
o Promote health, prevent disease peaceful death that the client would treatment of human response.
o Advocate and educate patients perform unaided if he or she had Nursing is giving direct care and
o Work with physicians necessary strength, will, or advocacy in the care off individuals,
o Administer medications knowledge. families, communities, and
o Assist clients in convalescence and o International Council of Nurses populations.”
rehabilitation (ICN) – “Nursing encompasses o Royal College of Nursing (RCN) –
o Formulate, implement, and evaluate autonomous and collaborative care “Nursing is the use of clinical
nursing care plans of individuals of all ages, families, judgment in the provision of care
o Teach patients and families about groups and communities, sick or well with health problems; and nursing
self-care and in all settings. Nursing includes helps to achieve the best possible
o Help individuals and groups take the promotion of health, prevention quality of life of individuals whatever
steps to improve health of illness, and the care of ill, disabled their disease or disability, until
and dying people. Other key nursing death.”
Nursing – from Latin words nutricia, roles include advocacy, promotion of
nutriz, nutrire, meaning nurse, nourish, safe environment, research, Nursing as a Practice – requires a synergy
cherish participation in shaping health of (1) theoretical knowledge, (2) clinical
policies and in patient and health experience, and (3) technical skill.
Nursing as an Art – use of imagination and systems management and
creativity in caring education.” Recipients of Nursing

Florence Nightingale o Patient

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 its origin refers to an  Military Nursing o Definitions – meaning of the word/

individual suffering any form  Professional Nursing phrase/ term
of discomfort or pain o Historical Eras in Nursing  Theoretical definitions –
 those who seek care Education general or abstract meaning
 person who is waiting for or  Curriculum Era of the word/ concepts in a
undergoing medical  Research Era manner that fits the theory
treatment and care  Graduate Education Era  Operational definitions –
o Consumer  Theory Era concrete meaning of the word
 individual or group of people necessary to measure a
or community that uses a Chapter 3: The Emergence of Theory concept, construct, or
service or commodity variable used in the study
 those who use healthcare What is a theory? o Propositions – theorems or
products or services statements derived from axioms:
 Ex: person who undergoes  A set of concepts, definitions, statements/ assertions from which
liposuction relationships, and assumptions that statements of theory can be logically
o Client project a systematic view of a derived
 Individuals, families, groups phenomena o Phenomenon – aspect of reality
and communities who need  It may consist of one or more that can be consciously sensed or
or require health services relatively specific and concrete experienced; exists in real world
regardless of health care concepts and propositions that o Concepts – ideas or complex
needs purport to account for, or organize
formulation of object, property or
 Approach in professional some phenomenon (Barnum, 1988)
events; idea, mental image, or
manner  A group of related concepts that
generalization
 Ex: new mother asking for propose actions that guide practice.
 Abstract concepts –
advice how to breastfeed  Systematic way of looking at the
complex ideas completely
world in order to describe, explain,
independent of time or place;
Historical Foundations of Professional predict and control it.
ex: temperature
Nursing  Concrete concepts – simple
Theory
or measurable and specific to
o Nursing Periods time and place; ex: body
 Intuitive Period –  “Theoria” - vision
 Established paradigm that explains temperature
instinctive; given to women;
“maskipaps/ maski-papaano” all or much of data available and
Classification of Concepts
 Apprenticeship Period – offers valid predictions that can be
on-the-job training or tested
o Empirical – can be readily observed;
internship ex: chair, desk
Components of a Theory
 Educated Period – o Inferential – indirectly observable;
Kaisersworth and Nightingale ex: pain, blood pressure
 A set of well-defined constructs or
led the way; developed caring o Abstract – not observable; ex:
concepts.
systems for sick and stress, wellness
 A set of propositions that specify the
wounded; emphasis on clean
relationships among the constructs.
environment and good Types of Theories
 Hypotheses, conjectures that test the
sanitation
relationship between the constructs
o Nursing Themes o Descriptive - to know the properties
and propositions.
 Superstitions and Witchcraft and workings of a discipline
 Earliest Organized Nursing o Explanatory – to examine how
Elements of a Theory
 Dark Ages of Nursing properties relate and thus affect the
 Golden Age of Nursing discipline

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o Predictive – to calculate the Model – provides outline for which theory o Practice goals – intends to
relationships between properties and depicts function of a phenomenon accomplish/ achieve
how they occur o Tentativeness – never absolute
o Prescriptive – to identify under Conceptual model – represents a structure; o Research
which conditions relationships occur description of how something works or is put o Creativity in practice theory and
together research
Metaparadigm – It specifies the main o Progression from conceptual
concepts that encompass the subject and Theoretical model – suggests function or
framework to theory
the scope of a discipline explains the sequence of events from which
the phenomenon occurred Nursing theory should have context –
4 Concepts of Metaparadigm environment in which nursing action takes
Nursing theory – presents some aspect of
place, content – subject matter of theory,
o Person – the recipient of care reality communicated for the purpose of
and process – method the nurse uses in
Environment – the internal and describing nursing phenomena and a group
o applying the theory.
external surroundings that affect the of related concepts that derived from the
client nursing models Three areas where nursing theory can
o Health – the degree of wellness or have an impact
Construct - is a concept that has been
well-being that the client experiences
invented to suit a special purpose and 1) In clinical practice - assists nurses
o Nursing – the attributes,
measurable and can be observed in relation to describe, explain, and predict daily
characteristics and actions of the
to another construct experiences
nurse providing care on behalf of in
conjunction with the client 2) In education – integrates an eclectic
Phenomena - observable facts that can be body of knowledge
perceived through the senses and explained; 3) In research – framework for
Paradigm – model that explains linkages of
extraordinary remarkable events or person generating knowledge and new ideas
science, philosophy, and theory accepted
and applied by the discipline (Alligood and
Proposition - are theoretical statements Chapter 21: The Environment Theory
Marriner – Tomey, 2002); represents global
that specify the proposed relationship of
issues about individuals, groups, situations,
concepts of a theory Florence Nightingale
and events of interest to the profession
Principle - the ultimate source of origin or  05/12/1820 – 08/13/1910
Domain - the view or perspective of the
cause of something; a law of nature as  Matriarch of modern nursing
discipline; it contains the subject, central
formulated and accepted by the mind  Her Environmental Theory was first
concepts, values and beliefs, phenomena of
explained in her books – Notes on
interest, and the central problems of the
Hospital (1859) and Notes in
discipline Chapter 4: The Nature of Nursing Nursing: What It Is and What It Is
Theory Not (1859)
How does domain relate to nursing
 Coxcomb or cocks’ comb model –
theory? Conceptual framework – background or circular histogram which convinced
o Nursing has identified its domain in a historical basis of concepts or variables queen victoria that the soldiers were
paradigm that includes four linkages: not dying from war wounds but from
1. person/client Theoretical framework – theory or preventable diseases
2. health derivable theories relevant to the study  Edward and Frances Nightingale
3. environment  She was named after her birthplace –
4. nursing Six Types of Nursing Theory Definitions Florence Italy
 She was called “The Lady with a
Conceptual paradigm – diagram that o Structure – form and style uses
Lamp”, during Crimean War,
mentally and visually presents and interprets shapes and arrows because she made rounds during the
underlying theory night

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 She defines and describes in o Philosophy – an attitude toward life o Practice

detail the concepts of and reality that evolves from each o Art
ventilation, warmth, light, diet, nurse beliefs and code of conduct,
cleanliness and noise which are motivates the nurse to act, guides Prescriptive Theory
components of the environment. her thinking about what she is to do
 Her concern about her healthy and influences her decision 1) Central purpose
surroundings included not only o Practice – overt action directed by 2) Prescription
the hospital setting but also disciplined thoughts and feelings 3) Realities
extended to private homes of toward meeting the patient’s need
patients and to the physical for help, constitutes the practice of Chapter 22: The Definition of Nursing
living condition of the poor. clinical nursing
o Purpose – which the nurse wants to Virginia Henderson
Nightingale’s Environment Elements accomplish through what she does is
 11/30/1897 – 03/19/1996
the overall goal toward which she is
1) Pure or fresh air  Mother of modern nursing
striving
2) Light (esp. direct sunlight)  Defined nursing which was then
o Art – the application of knowledge
3) Pure water, food, and nutrition adapted by International Council of
and skill to bring about desired Nursing (ICN)
4) Cleanliness results
5) Efficient drainage
Nursing - the unique function of a nurse is
Nursing - the reason the nurse came into to assist the individual, sick or well in the
Nursing - is having the responsibility for being is that there is a patient who needs for
someone else’s health performance of those activities contributing
help to health or its recovery (or to peaceful
Person - referred to the person as the death) that he would perform unaided if he
Person - an individual should want to be
patient. Nurses performed tasks to and for had the necessary strength, will knowledge
healthy, comfortable, and capable and when
the patient and controlled the patient’s and to do this in such a way to help him gain
unimpeded, he strives by his own efforts to
environment to enhance recovery independence as rapidly as possible;
achieve such status
viewed health in terms of the patient’s
Health - is being well and using every power Health - is neither defined nor discussed in ability to perform the 14 components of
that the person has to the fullest extent. Weidenbach Model nursing care unaided
Envisioned the maintenance of health
through the prevention of disease via Environment - it is implied that the Person - viewed the patient as an individual
environment control environment may produce obstacles who requires assistance to achieve health
resulting in the person experiencing a need and independence or peaceful death
Environment - those elements external to for help
and which affect the health of the sick and Health - patient’s ability to perform the 14
healthy person Three Main Points in Weidenbach’s components of nursing care unaided. The
Theory quality of health rather than life itself, is the
Chapter 25: The Helping Art of Clinical margin of mental/physical vigor that allows a
Nursing Nursing is a: person to work effectively and to reach
highest potential level of satisfaction in life
Ernestine Weidenbach 1) Concept and Philosophy
2) Mothering Profession Environment - Henderson did not give her
 08/18/1900 – 03/08/1998 3) Helping Service own definition of environment. Instead she
 The Helping Art of Clinical used the Webster’s New Collegiate
Nursing (1964) Key Elements to Clinical Nursing Dictionary, 1961 which defined environment
as “the aggregate of all the external
Nursing 4 Components o Philosophy conditions and influences affecting the life
o Purpose and development of an organism”

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14 Fundamental Needs 1) Embrace humanistic-altruistic system Faye Glenn Abdellah

of values
1) Breathing normally 2) Instill faith, hope, and honor with  03/13/1919 – 02/24/2017
2) Eating and drinking adequately others  First woman and nurse to be Deputy
3) Eliminating body wastes 3) Cultivate sensitivity in one’s self and Surgeon General
4) Moving and maintain desirable in others by nurturing beliefs and
position practices “Revolutionary” Procedures in Nursing
5) Sleeping and resting 4) Establish a helping-trusting-caring Care
6) Selecting suitable clothes relationship
7) Maintaining body temperature within 5) Promote and accept positive and o Progressive Patient Care
normal range negative feelings as one actively o Coronary Care Unit
8) Keeping the body clean and well- listen to other’s story o Patient Assessment of Care
groomed 6) Use creative and systematic Evaluation (PACE)
9) Avoiding dangers in the environment scientific problem-solving method for o Diagnostic Related Groups (DRG)
10) Communicating with others caring decision-making o Gerontological Nursing Care
11) Worshipping according to one’s faith 7) Promote and share interpersonal
12) Working in such a way that one feels teaching-learning that addresses the 3 Categories of the 21 Nursing
a sense of accomplishment individual’s needs and Problems
13) Playing/ participating in various comprehension styles
forms of recreation 8) Create a healing environment for the 1) Basic Care Needs
14) Learning, discovering, or satisfying physical and spiritual self which 2) Sustenal Care Needs
the curiosity that leads to normal respects dignity 3) Remedial and Restorative Care
development and health and using 9) Assist with basic physical, emotional, Needs
available health facilities and spiritual human needs
10)Allow for existential- Covert Nursing Problem – is a concealed
Chapter 28: Philosophy and Science of phenomenological forces and be or hidden condition faced by the patient or
Caring open to mystery and for miracles to family which the nurse can assist him to
enter meet through the performance of her
Margaret Jean Watson professional functions
Nursing - is a human science of people and
 06/10/1940 – human health illness experiences that are Overt Nursing Problem – is an apparent
 Caring is the essence of nursing mediated by professional, personal, condition faced by the patient or family
practice scientific, aesthetic, and ethical human care which the nurse can assist or them to meet
transactions through the performance of her professional
Caring Theory functions
Person - is a valued person in and of him to
“Caring is the essence of nursing practice.” be cared for, respected, nurtured, Nursing - is a helping profession; nursing
understood, and assisted care is doing something to or for the person
3 Major Elements of her Theory or providing information to the person with
Health - refers to unity and harmony within the goal of meeting needs, increasing or
1) Carative factors restoring their self-help ability alleviating an
the mind, body, and soul
2) Transpersonal caring relationship impairment
3) Caring occasion or caring moment Environment - provides the values that
determines how one should behave and Person - describes people as having
Caritas - to cherish and to give special physical, emotional, and sociological needs.
what goals one should strive toward
loving attention These needs may be overt, largely
Chapter 24: The Patient-Centered consisting of physical needs or covert
Ten Primary Carative Factors consisting of emotional and social needs;
Nursing
people are helped by the identification and

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alleviation of the problems they are of methods for helping and understanding
experiencing patient roles in self-care

Health - the state when the individual has Nursing System - series and sequences of
no unmet needs and no anticipated or actual deliberate practical actions of nurses
impairments performed at times in coordination with
actions of their patients to know and meet
Environment - least discussed concept in the components of their patient’s
Abdellah’s Model; the home and the therapeutic self-care demands and to protect
community that the patient comes from is and regulate the exercise or development of
also the environment patient’s self-care agency

Chapter 8: The Self-Care Deficit Theory Three Nursing Systems

Dorothea Orem 1) Compensatory system - for people

who are socially dependent on others
 06/15/1914 – 06/22/2007 for their existence and well being
 Published Nursing Concepts of 2) Partially compensatory system -
Practice (1971) both nurse and patient perform care
measures
General Theory of Nursing 3) Supportive/ educative
development system - where the
o Theory of self-care person is able to perform or can and
o Theory of self-care deficit should learn to perform required
o Theory of nursing system measures of self-care but cannot do
so without assistance
Self-Care - the practice of activities that
maturing and mature persons initiate and Nursing – nursing is giving of direct
perform within frames, on their own behalf, assistance to persons who are unable to
and in the interest of maintaining life and meet their self-care needs, developed
healthful functioning and continuing through nursing education and experiences
personal development and wellbeing
Health – health and healthy are terms used
Self-Care Requisites - a formulated and to describe living things; wellness is the
expressed insight about actions to be integrity of the individual
performed that are known to be necessary; it
constitutes the formalized purposes of self- Person – a person has the capacity to
care reflect, symbolize and use symbols

o Universal Self-care Requisites Environment – the components are

o Developmental Self-care Requisites environmental factors, environmental
o Health Deviation Self-care requisites elements, conditions, and developmental
environment
Self-Care Deficit - the relationship between
the action capabilities of individuals and
their demands for self-care; when self-care
requisites are expressed in terms of actions
limitations, provides guides for the selection

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