Naga College Foundation, Inc.

College of Health Sciences

NURSING THEORIES PART 2

MODULE 5

JOHANNA MARIA DJ. CASTILLO, RN, MN

Clinical Instructor
Course Code: NCM 100

Course Title: Theoretical Foundations in Nursing

Credit Units: 3 units lecture (54 hours)

Prerequisite: NONE

Duration: 1st Semester S/Y 2020-2021

Delivery Mode: Blended

Course Description:

This course deals with the meta- concepts of person, health, environment, and
nursing as viewed by the different theorists. Likewise, it includes non-nursing theories sub
systems, developmental and change theories. It presents how these concepts and theories
serve as guide in nursing practice. It further deals with health as multi factorial phenomenon
and necessary core competencies that the nurse need to develop.

Learning Objectives:

By the end of the lecture, students will be able to:

 Describe the various non-nursing theories as applied to nursing.

 Utilize selected nursing theories and non-nursing theories in the care of clients.

Learning Plan:

Schedule Description Time Frame

Invitation to join the Google Classroom

A. Write your expectation in Nursing Theories.

B. Nursing Theories 4 hrs/meeting

Week 5
7. Pender’s Health Promotion Model
Total: 8 hrs
8. Leininger Theory of Culture Care Diversity and
Universality
9. Newman’s Theory of Health as Expanding
Consciousness
10. Parse’s Theory of Human Becoming
Pre Test:

Match ‘em up!

___1. Penders I. Theory of Human Becoming

___2. Leininger V. Theory of Health as Expanding

Consciousness

___3. Newman O. Theory of culture care diversity and

universality

___4. Parse C. Health Promotion Model: Nursing

Theories

___5. Orlando D. Theory of Deliberative Nursing Process

Lesson Proper:

Nola J Pender’s Health Promotion Model

The health promotion model (HPM) proposed by Nola J Pender (1982; revised,
1996) was designed to be a “complementary counterpart to models of health
protection.”
 It defines health as a positive dynamic state not merely the absence of disease.
Health promotion is directed at increasing a client’s level of well being.
 The health promotion model describes the multi dimensional nature of persons as
they interact within their environment to pursue health.
ABOUT THE THEORIST
 Nola J. Pender, PhD, RN, FAAN - former professor of nursing at the University of
Michigan

The model focuses on following three areas:

· Individual characteristics and experiences

· Behavior-specific cognitions and affect

· Behavioral outcomes

The health promotion model notes that each person has unique personal characteristics
and experiences that affect subsequent actions. The set of variables for behavioral specific
knowledge and affect have important motivational significance. These variables can be
modified through nursing actions. Health promoting behavior is the desired behavioral
outcome and is the end point in the HPM. Health promoting behaviors should result in
improved health, enhanced functional ability and better quality of life at all stages of
development. The final behavioral demand is also influenced by the immediate competing
demand and preferences, which can derail an intended health promoting actions.

ASSUMPTIONS OF THE HEALTH PROMOTION MODEL

The HPM is based on the following assumptions, which reflect both nursing and behavioral
science perspectives:
1. Individuals seek to actively regulate their own behavior.
2. Individuals in all their biopsychosocial complexity interact with the environment,
progressively transforming the environment and being transformed over time.
3. Health professionals constitute a part of the interpersonal environment, which
exerts influence on persons throughout their life span.
4. Self-initiated reconfiguration of person-environment interactive patterns is
essential to behavior chang
THEORETICAL PROPOSITIONS OF THE HEALTH PROMOTION MODEL
Theoretical statements derived from the model provide a basis for investigative work on
health behaviors. The HPM is based on the following theoretical propositions:
1. Prior behavior and inherited and acquired characteristics influence beliefs, affect,
and enactment of health-promoting behavior.
2. Persons commit to engaging in behaviors from which they anticipate deriving
personally valued benefits.
3. Perceived barriers can constrain commitment to action, a mediator of behavior as
well as actual behavior.
4. Perceived competence or self-efficacy to execute a given behavior increases the
likelihood of commitment to action and actual performance of the behavior.
5. Greater perceived self-efficacy results in fewer perceived barriers to a specific
health behavior.
6. Positive affect toward a behavior results in greater perceived self-efficacy, which
can in turn, result in increased positive affect.
7. When positive emotions or affect are associated with a behavior, the probability of
commitment and action is increased.
8. Persons are more likely to commit to and engage in health-promoting behaviors
when significant others model the behavior, expect the behavior to occur, and
provide assistance and support to enable the behavior.
9. Families, peers, and health care providers are important sources of interpersonal
influence that can increase or decrease commitment to and engagement in health-
promoting behavior.
10. Situational influences in the external environment can increase or decrease
commitment to or participation in health-promoting behavior.
11. The greater the commitments to a specific plan of action, the more likely health-
promoting behaviors are to be maintained over time.
12. Commitment to a plan of action is less likely to result in the desired behavior when
competing demands over which persons have little control require immediate
attention. 13. Commitment to a plan of action is less likely to result in the desired
behavior when other actions are more attractive and thus preferred over the target
behavior.
13. Persons can modify cognitions, affect, and the interpersonal and physical
environment to create incentives for health actions.
THE MAJOR CONCEPTS AND DEFINITIONS OF THE HEALTH PROMOTION MODEL
 Individual Characteristics and Experience
 Prior related behaviour
 Frequency of the similar behaviour in the past. Direct and indirect effects on the
likelihood of engaging in health promoting behaviors.
PERSONAL FACTORS
Personal factors categorized as biological, psychological and socio-cultural. These factors
are predictive of a given behavior and shaped by the nature of the target behaviour being
considered.
Personal biological factors
 Include variable such as age gender body mass index pubertal status, aerobic
capacity, strength, agility, or balance.
Personal psychological factors
 Include variables such as self esteem self motivation personal competence
perceived health status and definition of health.
Personal socio-cultural factors
 Include variables such as race ethnicity, accuculturation, education and
socioeconomic status.
 Behavioural Specific Cognition and Affect
PERCEIVED BENEFITS OF ACTION
 Anticipated positive out comes that will occur from health behaviour.
PERCEIVED BARRIERS TO ACTION
 Anticipated, imagined or real blocks and personal costs of understanding a given
behaviour
PERCEIVED SELF EFFICACY
Judgment of personal capability to organise and execute a health-promoting behaviour.
Perceived self efficacy influences perceived barriers to action so higher efficacy result in
lowered perceptions of barriers to the performance of the behavior.
ACTIVITY RELATED AFFECT
Subjective positive or negative feeling that occur before, during and following behavior
based on the stimulus properties of the behaviour itself. Activity-related affect influences
perceived self-efficacy, which means the more positive the subjective feeling, the greater
the feeling of efficacy. In turn, increased feelings of efficacy can generate further positive
affect.
INTERPERSONAL INFLUENCES
Cognition concerning behaviours, beliefs, or attitudes of the others. Interpersonal
influences include: norms (expectations of significant others), social support (instrumental
and emotional encouragement) and modelling (vicarious learning through observing
others engaged in a particular behaviour). Primary sources of interpersonal influences are
families, peers, and healthcare providers.
SITUATIONAL INFLUENCES
Personal perceptions and cognitions of any given situation or context that can facilitate or
impede behaviour. Include perceptions of options available, demand characteristics and
aesthetic features of the environment in which given health promoting is proposed to take
place. Situational influences may have direct or indirect influences on health behaviour.
Behavioural Outcome
COMMITMENT TO PLAN OF ACTION
The concept of intention and identification of a planned strategy leads to implementation
of health behaviour.
IMMEDIATE COMPETING DEMANDS AND PREFERENCES
Competing demands are those alternative behaviour over which individuals have low
control because there are environmental contingencies such as work or family care
responsibilities. Competing preferences are alternative behaviour over which individuals
exert relatively high control, such as choice of ice cream or apple for a snack
HEALTH PROMOTING BEHAVIOUR
Endpoint or action outcome directed toward attaining positive health outcome such as
optimal well-being, personal fulfillment, and productive living.

Leininger Theory of Culture Care Diversity and Universality

 Madeleine Leininger is considered as the founder of the theory of transcultural

nursing.
 Her theory has now developed as a discipline in nursing.
 Evolution of her theory can be understood from her books:
o Culture Care Diversity and Universality (1991)
o Transcultural Nursing (1995)
 o Transcultural Nursing (2002)
 Transcultural nursing theory is also known as Culture Care theory.
 Theoretical framework is depicted in her model called the Sunrise Model (1997).
ABOUT THE THEORIST
 One of the first nursing theorist and transcultural global nursing consultant.
 MSN - Catholic University in Washington DC.
 PhD in anthropology - University of Washington.
 She developed the concept of transcultural nursing and the ethnonursing research
model.
 For more details: http://en.wikipedia.org/wiki/Madeleine_Leininger
DEFINITIONS
Transcultural Nursing
 Transcultural nursing is a comparative study of cultures to understand similarities
(culture universal) and difference (culture-specific) across human groups
(Leininger, 1991).
Culture
 Set of values, beliefs and traditions, that are held by a specific group of people and
handed down from generation to generation.
 Culture is also beliefs, habits, likes, dislikes, customs and rituals learn from one’s
family.
 Culture is the learned, shared and transmitted values, beliefs, norms and life way
practices of a particular group that guide thinking, decisions, and actions in
patterned ways.
 Culture is learned by each generation through both formal and informal life
experiences.
 Language is primary through means of transmitting culture.
 The practices of particular culture often arise because of the group's social and
physical environment.
 Culture practice and beliefs are adapted over time but they mainly remain constant
as long as they satisfy needs.
Religion
 Is a set of belief in a divine or super human power (or powers) to be obeyed and
worshipped as the creator and ruler of the universe.
Ethnic
 refers to a group of people who share a common and distinctive culture and who
are members of a specific group.
Ethnicity
 a consciousness of belonging to a group.
Cultural Identify
 the sense of being part of an ethnic group or culture
Culture-universals
 commonalities of values, norms of behavior, and life patterns that are similar
among different cultures.
Culture-specifies
 values, beliefs, and patterns of behavior that tend to be unique to a designate
culture.
Material culture
 refers to objects (dress, art, religious arti1acts)
Non-material culture
 refers to beliefs customs, languages, social institutions.
Subculture
 composed of people who have a distinct identity but are related to a larger cultural
group.
Bicultural
 a person who crosses two cultures, lifestyles, and sets of values.
Diversity
 refers to the fact or state of being different. Diversity can occur between cultures
and within a cultural group.
Acculturation
  People of a minority group tend to assume the attitudes, values, beliefs, find
practices of the dominant society resulting in a blended cultural pattern.
Cultural shock
 the state of being disoriented or unable to respond to a different cultural
environment because of its sudden strangeness, unfamiliarity, and incompatibility
to the stranger's perceptions and expectations at is differentiated from others by
symbolic markers (cultures, biology, territory, religion).
Ethnic groups
 share a common social and cultural heritage that is passed on to successive
generations.,
Ethnic identity
 refers to a subjective perspective of the person's heritage and to a sense of
belonging to a group that is distinguishable from other groups.
Race
 the classification of people according to shared biologic characteristics, genetic
markers, or features. Not all people of the same race have the same culture.
Cultural awareness
 It is an in-depth self-examination of one's own background, recognizing biases and
prejudices and assumptions about other people.
Culturally congruent care
 Care that fits the people's valued life patterns and set of meanings -which is
generated from the people themselves, rather than based on predetermined
criteria.
Culturally competent care
 is the ability of the practitioner to bridge cultural gaps in caring, work with cultural
differences and enable clients and families to achieve meaningful and supportive
caring.
Nursing Decisions
Leininger (1991) identified three nursing decision and action modes to achieve culturally
congruent care.
1. Cultural preservation or maintenance.
2. Cultural care accommodation or negotiation.
3. Cultural care repatterning or restructuring.

MAJOR CONCEPTS [Leininger (1991)]

 Illness and wellness are shaped by a various factors including perception and
coping skills, as well as the social level of the patient.
 Cultural competence is an important component of nursing.
 Culture influences all spheres of human life. It defines health, illness, and the
search for relief from disease or distress.
 Religious and Cultural knowledge is an important ingredient in health care.
 The health concepts held by many cultural groups may result in people choosing
not to seek modern medical treatment procedures.
 Health care provider need to be flexible in the design of programs, policies, and
services to meet the needs and concerns of the culturally diverse population,
groups that are likely to be encountered.
 Most cases of lay illness have multiple causalities and may require several different
approaches to diagnosis, treatment, and cure including folk and Western medical
interventions..
 The use of traditional or alternate models of health care delivery is widely varied
and may come into conflict with Western models of health care practice.
 Culture guides behavior into acceptable ways for the people in a specific group as
such culture originates and develops within the social structure through inter
personal interactions.
 For a nurse to successfully provide care for a client of a different cultural or ethnic
to background, effective intercultural communication must take place.
APPLICATION TO NURSING
 To develop understanding, respect and appreciation for the individuality and
diversity of patients beliefs, values, spirituality and culture regarding illness, its
meaning, cause, treatment, and outcome.
  To encourage in developing and maintaining a program of physical, emotional and
spiritual self-care introduce therapies such as ayurveda and pancha karma.
HEALTH PRACTICES IN DIFFERENT CULTURES
Use of Protective Objects
 Protective objects can be worn or carried or hung in the home- charms worn on a
string or chain around the neck, wrist, or waist to protect the wearer from the evil
eye or evil spirits.
Use of Substances .
 It is believed that certian food substances can be ingested to prevent illness.
 E.g. eating raw garlic or onion to prevent illness or wear them on the body or hang
them in the home.
Religious Practices
 Burning of candles, rituals of redemption etc..
Traditional Remedies
 The use of folk or traditional medicine is seen among people from all walks of life
and cultural ethnic back ground.
Healers
 Within a given community, specific people are known to have the power to heal.
Immigration
 Immigrant groups have their own cultural attitudes ranging beliefs and practices
regarding these areas.
Gender Roles
 In many cultures, the male is dominant figure and often they take decisions related
to health practices and treatment. In some other cultures females are dominant.
 In some cultures, women are discriminated in providing proper treatment for
illness.
Beliefs about mental health
 Mental illnesses are caused by a lack of harmony of emotions or by evil spirits.
 Problems in this life are most likely related to transgressions committed in a past
life.
Economic Factors
 Factors such as unemployment, underemployment, homelessness, lack of health
insurance poverty prevent people from entering the health care system.
Time orientation
 It is varies for different cultures groups.
Personal Space
 Respect the client's personal space when performing nursing procedures.
 The nurse should also welcome visiting members of the family and extended family.
NURSING PROCESS AND ROLE OF NURSE
 Determine the client's cultural heritage and language skills.
 Determine if any of his health beliefs relate to the cause of the illness or to the
problem.
 Collect information that any home remedies the person is taking to treat the
symptoms.
 Nurses should evaluate their attitudes toward ethnic nursing care.
 Self-evaluation helps the nurse to become more comfortable when providing care to
clients from diverse backgrounds
 Understand the influence of culture, race &ethnicity on the development of social
emotional relationship, child rearing practices & attitude toward health.
 Collect informationabout the socioeconomic status of the family and its influence on
their health promotion and wellness
 Identifiy the religious practices of the family and their influence on health
promotion belief in families.
 Understanding of the general characteristics of the major ethnic groups, but always
individualize care.
 The nursing diagnosis for clients should include potential problems in their
interaction with the health care system and problems involving the effects of
culture.
 The planning and implementation of nursing interventions should be adapted as
much as possible to the client's cultural background.
 Evaluation should include the nurse's self-evaluation of attitudes and emotions
toward providing nursing care to clients from diverse sociocultural backgrounds.
 Self-evaluation by the nurse is crucial as he or she increases skills for
interaction. .
CONCLUSION
 Nurses need to be aware of and sensitive to the cultural needs of clients.
 The practice of nursing today demands that the nurse identify and meet the cultural
needs of diverse groups, understand the social and cultural reality of the client,
family, and community, develop expertise to implement culturally acceptable
strategies to provide nursing care, and identify and use resources acceptable to the
client (Andrews & Boyle, 2002).

Margaret Newman’s Health As Expanding Consciousness

 The theory of health as expanding consciousness stems from Rogers' theory of

unitary human beings.
 The theory of health as expanding consciousness was stimulated by concern for
those for whom health as the absence of disease or disability is not possible,
(Newman, 2010).
 The theory has progressed to include the health of all persons regardless of the
presence or absence of disease, (Newman, 2010).
 The theory asserts that every person in every situation, no matter how disordered
and hopeless it may seem, is part of the universal process of expanding
consciousness – a process of becoming more of oneself, of finding greater meaning
in life, and of reaching new dimensions of connectedness with other people and the
world, (Newman, 2010).
BACHGROUND OF THE THEORIST
 Born on October 10, 1933.
 Bachelor’s degree - University of Tennessee in 1962
 Master’s degree - University of California in 1964
 Doctorate - New York University in 1971
 She has worked in - University of Tennessee, New York University, Pennsylvania
State University, University of Minnesotat, University of Minnesota
 Link to her Biography
THEORY DEVELOPMENT
She was influenced by following theorists:
 Martha Rogers
o Martha Roger’s theory of Unitary Human Beings was the main basis of the
development of her theory, Health as Expanding Consciousness
 Itzhak Bentov – The concept of evolution of consciousness
 Arthur Young – The Theory of Process
 David Bohm – The Theory of Implicate
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 the pathology in itself will not change the pattern of the indivdual
5. If becoming ill is the only way an individual's pattern can manifest itself, then that
is health for that person
 6. Health is an expansion of consciousness.
DESCRIPTION OF THE THEORY
 “The theory of health as expanding consciousness (HEC) was stimulated by concern
for those for whom health as the absence of disease or disability is not possible.
Nurses often relate to such people: people facing the uncertainty, debilitation, loss
and eventual death associated with chronic illness. The theory has progressed to
include the health of all persons regardless of the presence or absence of disease.
The theory asserts that every person in every situation, no matter how disordered
and hopeless it may seem, is part of the universal process of expanding
consciousness – a process of becoming more of oneself, of finding greater meaning
in life, and of reaching new dimensions of connectedness with other people and the
world” (Newman, 2010).
 Humans are open to the whole energy system of the universe and constantly
interacting with the energy. With this process of interaction humans are evolving
their individual pattern of whole.
 According to Newman understanding the pattern is essential. The expanding
consciousness is the pattern recognition.
 The manifestation of disease depends on the pattern of individual so the pathology
of the diseases exists before the symptoms appear so removal of disease symptoms
does not change the individual structure.
 Newman also redefines nursing according to her nursing is the process of
recognizing the individual in relation to environment and it is the process of
understanding of consciousness.
 The nurse helps to understand people to use the power within to develop the higher
level of consciousness.
 Thus it helps to realize the disease process, its recovery and prevention.
 Newman also explains the interrelatedness of time, space and movement.
 Time and space are the temporal pattern of the individual, both have
complementary relationship.
 Humans are constantly changing through time and space and it shows unique
pattern of reality.
NURSING PARADIGMS
Health
 “Health and illness are synthesized as health - the fusion on one state of being
(disease) with its opposite (non-disease) results in what can be regarded as
health”.
Nursing
 Nursing is “caring in the human health experience”.
 Nursing is seen as a partnership between the nurse and client, with both grow in
the “sense of higher levels of consciousness”
Human
 “The human is unitary, that is cannot be divided into parts, and is inseparable from
the larger unitary field”
 “Persons as individuals, and human beings as a species are identified by their
patterns of consciousness”…
 “The person does not possess consciousness-the person is consciousness”.
 Persons are “centers of consciousness” within an overall pattern of expanding
consciousness”
Environment
 Environment is described as a “universe of open systems”
STRENGTHS AND WEAKNESSES
Strengths
 Can be applied in any setting
 “Generates caring interventions”
W eaknesses
 Abstract
 Multi-dimensional
 Qualitative
 Little discussion on environment
CRITIQUE
Clarity
 Semantic clarity is evident in the definitions, descriptions, and dimensions of the
concepts of the theory.
Simplicity
 The deeper meaning of the theory of health as expending consciousness is complex.
 The theory as a whole must be understood, nut just the isolated concepts.
Generality
 The theory has been applied in several different cultures
 It is applicable across the spectrum of nursing care situations.
Empirical Precision
 Quantitative methods are inadequate in capturing the dynamic, changing nature of
this theory.
Derivable Consequences
 Newman's theory provides an evolving guide for all health-related disciplines.
CONCLUSION
Newman's theory can be conceptualized as
 A grand theory of nursing
 Humans can not be divided into parts
 Health is central to the theory and is seen “and is seen as a process of developing
awareness of self and the environment”
 “Consciousness is a manifestation of an evolving pattern of person-environment
interaction”

Rosemarie Rizzo Parse’s Human Becoming Theory

 The Parse theory of human becoming guides nurses In their practice to focus on
quality of life as it is described and lived (Karen & Melnechenko, 1995).
 The human becoming theory of nursing presents an alternative to both the
conventional bio-medical approach and the bio-psycho-social-spiritual (but still
normative) approach of most other theories of nursing.(ICPS)
 The human becoming theory posits quality of life from each person's own
perspective as the goal of nursing practice.(ICPS)
 Rosemarie Rizzo Parse first published the theory in 1981 as the "Man-living-health"
theory (ICPS)
 The name was officially changed to "the human becoming theory" in 1992 to
remove the term "man," after the change in the dictionary definition of the word
from its former meaning of "humankind."
ABOUT THE THEORIST
 Educated at Duquesne University, Pittsburgh
 MSN and Ph.D. from University of Pittsburgh
 Published her theory of nursing, Man-Living-Health in 1981
 Name changed to Theory of Human Becoming in 1992
 Editor and Founder, Nursing Science Quarterly
 Has published eight books and hundreds of articles about Human Becoming Theory
 Professor and Niehoff Chair at Loyola University, Chicago
THEORY DEVELOPMENT
 The human becoming theory was developed as a human science nursing theory in
the tradition of Dilthey, Heidegger, Sartre, Merleau-Ponty, and Gadamer and
Science of Unitary Human Beings by Martha Rogers .
 The assumptions underpinning the theory were synthesized from works by the
European philosophers, Heidegger, Sartre, and Merleau-Ponty, along with works by
the pioneer American nurse theorist, Martha Rogers.
 The theory is structured around three abiding themes: meaning, rhythmicity, and
transcendence.
ASSUMPTIONS
About man
 The human is coexisting while coconstituting rhythmical patterns with the universe.
  The human is open, freely choosing meaning in situation, bearing responsibility for
decisions.
 The human is unitary, continuously coconstituting patterns of relating.
 The human is transcending multidimensionally with the possibles
About Becoming
 Becoming is unitary human-living-health.
 Becoming is a rhythmically coconstituting human-universe process.
 Becoming is the human’s patterns of relating value priorities.
 Becoming is an intersubjective process of transcending with the possibles.
 Becoming is unitary human’s emerging
Three Major Assumptions of Human Becoming
 Meaning
o Human Becoming is freely choosing personal meaning in situations in the
intersubjective process of living value priorities.
o Man’s reality is given meaning through lived experiences
o Man and environment cocreate
 Rhythmicity
o Human Becoming is cocreating rhythmical patterns of relating in mutual
process with the universe.
o Man and environment cocreate ( imaging, valuing, languaging) in rhythmical
patterns
 Transcendence
o Human Becoming is cotranscending multidimensionally with emerging
possibles.
o Refers to reaching out and beyond the limits that a person sets
o One constantly transforms
SUMMARY OF THE THEORY
 Human Becoming Theory includes Totality Paradigm
o Man is a combination of biological, psychological, sociological and spiritual
factors
 Simultaneity Paradigm
o Man is a unitary being in continuous, mutual interaction with environment
 Originally Man-Living-Health Theory
NURSING PARADIGMS AND PARSE'S THEORY
 Person
o Open being who is more than and different from the sum of the parts
 Environment
o Everything in the person and his experiences
o Inseparable, complimentary to and evolving with
 Health
o Open process of being and becoming. Involves synthesis of values
 Nursing
o A human science and art that uses an abstract body of knowledge to serve
people
SYMBOL OF HUMAN BECOMING THEORY

 Black and white = opposite paradox significant to ontology of human becoming and
green is hope
 Center joined =co created mutual human universe process at the ontological level &
nurse-person process
 Green and black swirls intertwining = human-universe co creation as an ongoing
process of becoming
STRENGTH AND WEAKNESSES
Strengths
 Differentiates nursing from other disciplines
 Practice - Provides guidelines of care and useful administration
 Useful in Education
  Provides research methodologies
 Provides framework to guide inquiry of other theories (grief, hope, laughter, etc.)
Weaknesses
 Research considered to be in a “closed circle”
 Rarely quantifiable results - Difficult to compare to other research studies, no
control group, standardized questions, etc.
 Does not utilized the nursing process/diagnoses
 Negates the idea that each person engages in a unique lived experience
 Not accessible to the novice nurse
 Not applicable to acute, emergent care
APPLICATION OF THE THEORY
Nursing Practice
 A transformative approach to all levels of nursing
 Differs from the traditional nursing process, particularly in that it does not seek to
“fix” problems
 Ability to see patients perspective allows nurse to “be with” patient and guide them
toward desired health outcomes
 Nurse-person relationship cocreates changing health patterns
Research
 Enhances understanding of human lived experience, health, quality of life and
quality of nursing practice
 Expands the theory of human becoming
 Builds new nursing knowledge about universal lived experiences which may
ultimately contribute to health and quality of life
CRITIQUE
 Congruence with personal values
o Nurse must subscribe to this world view to truly use it
 Congruence with other professional values
o Complements and competes with other health care professionals’ values
o Exoteric foundations
o Esoteric utility
 Congruence with social values
o Fulfills society’s expectations of nursing role
 Social Significance
o Makes a substantial difference in the lives of clients and nurses

Activities

1. Interview a family/relative/friend with a master’s or doctorate degree in nursing

and focus your discussion on how his/her degree helped in practice as a nurse and
as an educator. Use phone, messenger or any other social media platform
whichever you prefer.
Post Test

Match ‘em up!

___1. Penders I. Theory of Human Becoming

___2. Leininger V. Theory of Health as Expanding

Consciousness

___3. Newman O. Theory of culture care diversity and

universality

___4. Parse C. Health Promotion Model: Nursing

Theories

___5. Orlando D. Theory of Deliberative Nursing Process

Answer

References:

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