Philippine Health Care Laws

REPUBLIC ACT – an act passed by the Congress of the Philippines, while the form of government is Republican
government.
■ Republic Act 349 – Legalizes the use of human organs for surgical, medical and scientific purposes.
■ Republic Act 1054 – Requires the owner, lessee or operator of any commercial, industrial or agricultural
establishment to furnish free emergency, medical and dental assistance to his employees and laborers.
■ Republic Act 1080 – Civil Service Eligibility
■ Republic Act 1082 – Rural Health Unit Act
■ Republic Act 1136 – Act recognizing the Division of Tuberculosis in the DOH
■ Republic Act 1612 – Privilege Tax/Professional tax/omnibus tax should be paid January 31 of each year
■ Republic Act 1891 – Act strengthening Health and Dental services in the rural areas
■ Republic Act 2382 – Philippine Medical Act which regulates the practice of medicines in the Philippines
■ Republic Act 2644 – Philippine Midwifery Act
■ Republic Act 3573 – Law on reporting of Communicable Diseases
■ Republic Act 4073 – Liberalized treatment of Leprosy
■ Republic Act 4226 – Hospital Licensure Act requires all hospital to be licensed before it can operative
■ Republic Act 5181 – Act prescribing permanent residence and reciprocity as qualifications for any examination
or registration for the practice of any profession in the Philippines
■ Republic Act 5821 – The Pharmacy Act
■ Republic Act 5901 – 40 hours work for hospital workers
■ Republic Act 6111 – Medicare Act
■ Republic Act 6365 – Established a National Policy on Population and created the Commission on population
■ Republic Act 6425 – Dangerous Drug Act of 1992
■ Republic Act 6511 – Act to standardize the examination and registration fees charged by the National Boards,
and for other purposes.
■ Republic Act 6675 – Generics Act of 1988
■ Republic Act 6713 – Code of Conduct and Ethical Standards for Public Officials and Employees
■ Republic Act 6725 – Act strengthening the prohibition on discrimination against women with respect to terms
and condition of employment
■ Republic Act 6727 – Wage Rationalization Act
■ Republic Act 6758 – Standardized the salaries
■ Republic Act 6809 – Majority age is 18 years old
■ Republic Act 6972 – Day care center in every Barangay
■ Republic Act 7160 – Local Government Code
■ Republic Act 7164 – Philippine Nursing Act of 1991
■ Republic Act 7170 – Law that govern organ donation
■ Republic Act 7192 – Women in development nation building
■ Republic Act 7277 – Magna Carta of Disabled Persons
■ Republic Act 7305 – The Magna Carta of public Health Workers
■ Republic Act 7392 – Philippine Midwifery Act of 1992
■ Republic Act 7432 – Senior Citizen Act
■ Republic Act 7600 – Rooming In and Breastfeeding Act of 1992
■ Republic Act 7610 – Special protection of children against abuse, exploitation and discrimination act
■ Republic Act 7624 – Drug Education Law
■ Republic Act 7641 – New Retirement Law
■ Republic Act 7658 – An act prohibiting the employment of children below 15 years of age
■ Republic Act 7719 – National Blood Service Act of 1994
■ Republic Act 7875 – National Health Insurance Act of 1995
■ Republic Act 7876 – Senior Citizen Center of every Barangay
■ Republic Act 7877 – Anti-sexual harassment Act of 1995
■ Republic Act 7883 – Barangay Health workers Benefits and Incentives Act of 1992
■ Republic Act 8042 – Migrant Workers and Overseas Filipino Act of 1995
■ Republic Act 8172 – Asin Law
■ Republic Act 8187 – Paternity Leave Act of 1995
■ Republic Act 8203 – Special Law on Counterfeit Drugs
 ■ Republic Act 8282 – Social Security Law of 1997 (amended RA 1161)
■ Republic Act 8291 – Government Service Insurance System Act of 1997 (amended PD 1146)
■ Republic Act 8344 – Hospital Doctors to treat emergency cases referred for treatment
■ Republic Act 8423 – Philippine Institute of Traditional and Alternative Medicine
■ Republic Act 8424 – Personal tax Exemption
■ Republic Act 8749 – The Philippine Clean Air Act of 1999
■ Republic Act 8981 – PRC Modernization Act of 2000
■ Republic Act 9165 – Comprehensive Dangerous Drugs Act 2002
■ Republic Act 9173 – Philippine Nursing Act of 2002
■ Republic Act 9288 – Newborn Screening Act

PRESIDENTIAL DECREE – An order of the President. This power of the President which allows him/her to act as legislators
was exercised during the Marshall Law period.

■ Presidential Decree 46 – An act making it punishable for any public officials or employee, whether of the
national or local government, to receive directly or indirectly any gifts or valuable things
■ Presidential Decree 48 – Limits benefits of paid maternity leave privileges to four children
■ Presidential Decree 69 – Limits the number of children to four (4) tax exemption purposes
■ Presidential Decree 79 – Population Commission
■ Presidential Decree 147 – Declares April and May as National Immunization Day
■ Presidential Decree 148 – Regulation on Woman and Child Labor Law
■ Presidential Decree 166 – Strengthened Family Planning program by promoting participation of private sector
in the formulation and implementation of program planning policies.
■ Presidential Decree 169 – Requiring Attending Physician and/or persons treating injuries resulting from any
form of violence.
■ Presidential Decree 223 – Professional Regulation Commission
■ Presidential Decree 442 – Labor Code Promotes and protects employees self-organization and collective
bargaining rights. Provision for a 10% right differential pay for hospital workers.
■ Presidential Decree 491 – Nutrition Program
■ Presidential Decree 539 – Declaring last week of October every as Nurse’s Week. October 17, 1958
■ Presidential Decree 541 – Allowing former Filipino professionals to practice their respective professions in the
Philippines so they can provide the latent and expertise urgently needed by the homeland
■ Presidential Decree 568 – Role of Public Health midwives has been expanded after the implementation of the
Restructed Health Care Delivery System (RHCDS)
■ Presidential Decree 603 – Child and Youth Welfare Act / Provision on Child Adoption
■ Presidential Decree 626 – Employee Compensation and State Insurance Fund. Provide benefits to person
covered by SSS and GSIS for immediate injury, illness and disability.
■ Presidential Decree 651 – All births and deaths must be registered 30 days after delivery.
■ Presidential Decree 825 – Providing penalty for improper disposal garbage and other forms of uncleanliness
and for other purposes.
■ Presidential Decree 851 – 13th Month pay
■ Presidential Decree 856 – Code of Sanitation
■ Presidential Decree 965 – Requiring applicants for Marriage License to receive instruction on family planning
and responsible parenthood.
■ Presidential Decree 996 – Provides for compulsory basic immunization for children and infants below 8 years of
age.
■ Presidential Decree 1083 – Muslim Holidays
■ Presidential Decree 1359 – A law allowing applicants for Philippine citizenship to take Board Examination
pending their naturalization.
■ Presidential Decree 1519 – Gives medicare benefits to all government employees regardless of status of
appointment.
■ Presidential Decree 1636 – requires compulsory membership in the SSS and self-employed
■ Presidential Decree 4226 – Hospital Licensure Act
PROCLAMATION – an official declaration by the Chief Executive / Office of the President of the Philippines on certain
programs / projects / situation

■ Proclamation No.6 – UN’s goal of Universal Child Immunization; involved NGO’s in the immunization program
■ Proclamation No. 118 – Professional regulation Week is June 16 to 22
■ Proclamation No. 499 – National AIDS Awareness Day
■ Proclamation No. 539 – Nurse’s Week – Every third week of October
■ Proclamation No. 1275 – Declaring the third week of October every year as “Midwifery Week”

LETTER OF INSTRUCTION – An order issued by the President to serve as a guide to his/her previous decree or order.

■ LOI 47 – Directs all school of medicine, nursing, midwifery and allied medical professions and social work to
prepare, plan and implement integration of family planning in their curriculum to require their graduate to take
the licensing examination.
■ LOI 949 – Act on health and health related activities must be integrated with other activities of the overall
national development program. Primary Health Care (10-19-79)
■ LOI 1000 – Government agencies should be given preference to members of the accredited professional
organization when hiring

EXECUTIVE ORDER – an order issued by the executive branch of the government in order to implement a constructional
mandate or a statutory provision.

■ Executive Order 51 – The Milk Code

■ Executive Order 174 – National Drug Policy on Availability, Affordability, Safe, Effective and Good Quality drugs
to all
■ Executive Order 180 – Government Workers Collective Bargaining Rights Guidelines on the right to Organize
of government employee.
■ Executive Order 203 – List of regular holidays and special holidays
■ Executive Order 209 – The Family Code (amended by RA 6809)
■ Executive Order 226 – Command responsibility
■ Executive Order 503 – Provides for the rules and regulations implementing the transfer of personnel, assets,
liabilities and records of national agencies whose functions are to be devoted to the local government units.
■ Executive Order 857 – Compulsory Dollar Remittance Law

Other Important Information

■ Administrative Order 114 – Revised/updated the roles and functions of the Municipal Health Officers, Public
Health Nurses and Rural Midwives
■ ILO Convention 149 – Provides the improvement of life and work conditions of nursing personnel.
Assessment Signs
Neuro Signs
● Kernig’s sign: meningitis – pain in the hammie’s (hamstring muscles) when extending the leg or flexing the
hip
● Brudzinski sign: meningitis – the hips flex when the neck is flexed forward when laying supine

Electrolyte Signs
● Chvostek’s sign: low calcium and low magnesium – tap the cheek and the facial muscles twitch
● Trousseau’s sign: low calcium and low magnesium – the blood pressure cuff makes the hand flex forward
and look like a claw
Newborn signs
● Babinski’s reflex: the big toe dorsiflexes (or fans up and out) when the sole of the foot is stimulated (normal
in a baby <6 mths old)
● Moro/Startle reflex: when baby thinks they are falling they will put arms out and then pull arms in as if they
are “startled”
● Tonic neck/fencing reflex: turn baby’s head to LEFT side and left arm and leg will extend outward and the
RIGHT arm and leg flex up
Pregnancy signs
● Chadwick’s sign: blue-violet color of the cervix around week 6
● “Chad is blue”
● Heger’s sign: lower uterus gets soft around week 6
● Goodell’s sign: softening of the entire cervix around week 8
Gastrointestinal signs
● Cullen’s sign: bluish color around naval caused by internal bleeding like ectopic pregnancy or acute
pancreatitis
● McBurney’s sign: appendicitis – rebound tenderness in the lower right hand area of abdomen

Nursing Responsibilities for Medication Administration

● 10 Rights of Medication Administration. Understanding the 10 Rights of Drug Administration can help
prevent many medication errors. Nurses, who are primarily involved in the administration of medications,
benefit from this simplified memory aid to help guide them to administer medications safely.
● Right Drug. The first right of drug administration is to check and verify if it’s the right name and
form. Beware of look-alike and sound-alike medication names. Misreading medication names
that look similar is a common mistake. These look-alike medication names may also sound alike
and can lead to errors associated with verbal prescriptions. Check out The Joint Commission’s
list of look-alike/sound-alike drugs.
● Right Patient. Ask the name of the client and check his/her ID band before giving the
medication. Even if you know that patient’s name, you still need to ask just to verify.
● Right Dose. Check the medication sheet and the doctor’s order before medicating. Be aware of
the difference between an adult and a pediatric dose.
● Right Route. Check and verify the order (i.e., per orem, IV, SQ, IM)
● Right Time and Frequency. Check the order for when it would be given and when was the last
time it was given.
● Right Documentation. Make sure to write the time and any remarks on the chart correctly.
● Right History and Assessment. Secure a copy of the client’s history to drug interactions and
allergies.
● Right Drug Approach and Right to Refuse. Give the client enough autonomy to refuse the
medication after thoroughly explaining the effects.
● Right Drug-Drug Interaction and Evaluation. Review any medications previously given or the
diet of the patient that can yield a bad interaction to the drug to be given. Check also the expiry
date of the medication being given.
● Right Education and Information. Provide enough knowledge to the patient of what drug
he/she would be taking and what are the expected therapeutic and side effects.
5 moments of hand hygiene
​ Moment 1 - Before touching a patient
​ Moment 2 - Before a procedure
​ Moment 3 - After a procedure or body fluid exposure risk
​ Moment 4 - After touching a patient
​ Moment 5 - After touching a patient's surroundings
NURSING THEORIES
Defining Terms
The development of nursing theory demands an understanding of selected terminologies, definitions, and assumptions.
● Philosophy. These are beliefs and values that define a way of thinking and are generally known and
understood by a group or discipline.
● Theory. A belief, policy, or procedure proposed or followed as the basis of action. It refers to a logical group
of general propositions used as principles of explanation. Theories are also used to describe, predict, or
control phenomena.
● Concept. Concepts are often called the building blocks of theories. They are primarily the vehicles of thought
that involve images.
● Models. Models are representations of the interaction among and between the concepts showing patterns.
They present an overview of the theory’s thinking and may demonstrate how theory can be introduced into
practice.
● Conceptual framework. A conceptual framework is a group of related ideas, statements, or concepts. It is
often used interchangeably with the conceptual model and with grand theories.
● Proposition. Propositions are statements that describe the relationship between the concepts.
● Domain. The domain is the perspective or territory of a profession or discipline.
● Process. Processes are organized steps, changes, or functions intended to bring about the desired result.
● Paradigm. A paradigm refers to a pattern of shared understanding and assumptions about reality and the
world, worldview, or widely accepted value system.
● Metaparadigm. A metaparadigm is the most general statement of discipline and functions as a framework in
which the more restricted structures of conceptual models develop. Much of the theoretical work in nursing
focused on articulating relationships among four major concepts: person, environment, health, and nursing.

History of Nursing Theories

The first nursing theories appeared in the late 1800s when a strong emphasis was placed on nursing education.
● In 1860, Florence Nightingale defined nursing in her “Environmental Theory” as “the act of utilizing the
patient’s environment to assist him in his recovery.”
● In the 1950s, there is a consensus among nursing scholars that nursing needed to validate itself through the
production of its own scientifically tested body of knowledge.
● In 1952, Hildegard Peplau introduced her Theory of Interpersonal Relations that emphasizes the
nurse-client relationship as the foundation of nursing practice.
● In 1955, Virginia Henderson conceptualized the nurse’s role as assisting sick or healthy individuals to gain
independence in meeting 14 fundamental needs. Thus her Nursing Need Theory was developed.
● In 1960, Faye Abdellah published her work “Typology of 21 Nursing Problems,” which shifted the focus of
nursing from a disease-centered approach to a patient-centered approach.
● In 1962, Ida Jean Orlando emphasized the reciprocal relationship between patient and nurse and viewed
nursing’s professional function as finding out and meeting the patient’s immediate need for help.
● In 1968, Dorothy Johnson pioneered the Behavioral System Model and upheld the fostering of efficient
and effective behavioral functioning in the patient to prevent illness.
● In 1970, Martha Rogers viewed nursing as both a science and an art as it provides a way to view the unitary
human being, who is integral with the universe.
● In 1971, Dorothea Orem stated in her theory that nursing care is required if the client is unable to fulfill
biological, psychological, developmental, or social needs.
● In 1971, Imogene King‘s Theory of Goal attainment stated that the nurse is considered part of the patient’s
environment and the nurse-patient relationship is for meeting goals towards good health.
● In 1972, Betty Neuman, in her theory, states that many needs exist, and each may disrupt client balance or
stability. Stress reduction is the goal of the system model of nursing practice.
● In 1979, Sr. Callista Roy viewed the individual as a set of interrelated systems that maintain the balance
between these various stimuli.
● In 1979, Jean Watson developed the philosophy of caring, highlighted humanistic aspects of nursing as they
intertwine with scientific knowledge and nursing practice.
The Nursing Metaparadigm

Four major concepts are frequently interrelated and fundamental to nursing theory: person, environment, health, and nursing.
These four are collectively referred to as metaparadigm for nursing.

Person, Nursing, Environment, and Health –

the four main concepts that make up the nursing metaparadigm.
Person

Person (also referred to as Client or Human Beings) is the recipient of nursing care and may include individuals, patients,
groups, families, and communities.

Environment

Environment (or situation) is defined as the internal and external surroundings that affect the client. It includes all positive or
negative conditions that affect the patient, the physical environment, such as families, friends, and significant others, and the
setting for where they go for their healthcare.

Health

Health is defined as the degree of wellness or well-being that the client experiences. It may have different meanings for each
patient, the clinical setting, and the health care provider.

Nursing

The nurse’s attributes, characteristics, and actions provide care on behalf of or in conjunction with the client. There are
numerous definitions of nursing, though nursing scholars may have difficulty agreeing on its exact definition. The ultimate
goal of nursing theories is to improve patient care.
You’ll find that these four concepts are used frequently and defined differently throughout different nursing theories. Each
nurse theorist’s definition varies by their orientation, nursing experience, and different factors that affect the theorist’s nursing
view. The person is the main focus, but how each theorist defines the nursing metaparadigm gives a unique take specific to a
particular theory. To give you an example, below are the different definitions of various theorists on the nursing metaparadigm
Components of Nursing Theories

For a theory to be a theory, it has to contain concepts, definitions, relational statements, and assumptions that explain a
phenomenon. It should also explain how these components relate to each other.

Phenomenon

A term given to describe an idea or response about an event, a situation, a process, a group of events, or a group of
situations. Phenomena may be temporary or permanent. Nursing theories focus on the phenomena of nursing.

Concepts

Interrelated concepts define a theory. Concepts are used to help describe or label a phenomenon. They are words or phrases
that identify, define, and establish structure and boundaries for ideas generated about a particular phenomenon. Concepts
may be abstract or concrete.

● Abstract Concepts. Defined as mentally constructed independently of a specific time or place.

● Concrete Concepts. Are directly experienced and related to a particular time or place.

Definitions

Definitions are used to convey the general meaning of the concepts of the theory. Definitions can be theoretical or
operational.

● Theoretical Definitions. Define a particular concept based on the theorist’s perspective.

● Operational Definitions. States how concepts are measured.

Relational Statements

Relational statements define the relationships between two or more concepts. They are the chains that link concepts to one
another.

Assumptions

Assumptions are accepted as truths and are based on values and beliefs. These statements explain the nature of concepts,
definitions, purpose, relationships, and structure of a theory.

Classification of Nursing Theories

There are different ways to categorize nursing theories. They are classified depending on their function, levels of abstraction,
or goal orientation.

By Abstraction

There are three major categories when classifying nursing theories based on their level of abstraction: grand theory,
middle-range theory, and practice-level theory.
Grand Nursing Theories
● Grand theories are abstract, broad in scope, and complex, therefore requiring further research for clarification.
● Grand nursing theories do not guide specific nursing interventions but rather provide a general framework and
nursing ideas.
● Grand nursing theorists develop their works based on their own experiences and their time, explaining why
there is so much variation among theories.
● Address the nursing metaparadigm components of person, nursing, health, and environment.

Middle-Range Nursing Theories

● More limited in scope (compared to grand theories) and present concepts and propositions at a lower level of
abstraction. They address a specific phenomenon in nursing.
● Due to the difficulty of testing grand theories, nursing scholars proposed using this level of theory.
● Most middle-range theories are based on a grand theorist’s works, but they can be conceived from research,
nursing practice, or the theories of other disciplines.

Practice-Level Nursing Theories

● Practice nursing theories are situation-specific theories that are narrow in scope and focuses on a specific
patient population at a specific time.
● Practice-level nursing theories provide frameworks for nursing interventions and suggest outcomes or the
effect of nursing practice.
● Theories developed at this level have a more direct effect on nursing practice than more abstract theories.
● These theories are interrelated with concepts from middle-range theories or grand theories.

By Goal Orientation
Theories can also be classified based on their goals. They can be descriptive or prescriptive.

Descriptive Theories

● Descriptive theories are the first level of theory development. They describe the phenomena and identify its
properties and components in which it occurs.
● Descriptive theories are not action-oriented or attempt to produce or change a situation.
● There are two types of descriptive theories: factor-isolating theory and explanatory theory.

Factor-Isolating Theory

● Also known as category-formulating or labeling theory.

● Theories under this category describe the properties and dimensions of phenomena.

Explanatory Theory

● Explanatory theories describe and explain the nature of relationships of certain phenomena to other
phenomena.

Prescriptive Theories

● Address the nursing interventions for a phenomenon, guide practice change, and predict consequences.
● Includes propositions that call for change.
● In nursing, prescriptive theories are used to anticipate the outcomes of nursing interventions.

Other Ways of Classifying Nursing Theories

Classification According to Meleis

Afaf Ibrahim Meleis (2011), in her book Theoretical Nursing: Development and Progress, organizes the major nurse theories
and models using the following headings: needs theories, interaction theories, and outcome theories. These categories
indicate the basic philosophical underpinnings of the theories.

● Needs-Based Theories. The needs theorists were the first group of nurses who thought of giving nursing
care a conceptual order. Theories under this group are based on helping individuals to fulfill their physical and
mental needs. Theories of Orem, Henderson, and Abdella are categorized under this group. Need theories
are criticized for relying too much on the medical model of health and placing the patient in an overtly
dependent position.
● Interaction Theories. These theories emphasized nursing on the establishment and maintenance of
relationships. They highlighted the impact of nursing on patients and how they interact with the environment,
people, and situations. Theories of King, Orlando, and Travelbee are grouped under this category.
● Outcome Theories. These theories describe the nurse as controlling and directing patient care using their
knowledge of the human physiological and behavioral systems. The nursing theories of Johnson, Levine,
Rogers, and Roy belong to this group.

Classification According to Alligood

In her book, Nursing Theorists and Their Work, Raile Alligood (2017) categorized nursing theories into four headings: nursing
philosophy, nursing conceptual models, nursing theories and grand theories, and middle-range nursing theories.
 ● Nursing Philosophy. It is the most abstract type and sets forth the meaning of nursing phenomena through
analysis, reasoning, and logical presentation. Works of Nightingale, Watson, Ray, and Benner are categorized
under this group.
● Nursing Conceptual Models. These are comprehensive nursing theories that are regarded by some as
pioneers in nursing. These theories address the nursing metaparadigm and explain the relationship between
them. Conceptual models of Levine, Rogers, Roy, King, and Orem are under this group.
● Grand Nursing Theories. Are works derived from nursing philosophies, conceptual models, and other grand
theories that are generally not as specific as middle-range theories. Works of Levine, Rogers, Orem, and King
are some of the theories under this category.
● Middle-Range Theories. Are precise and answer specific nursing practice questions. They address the
specifics of nursing situations within the model’s perspective or theory from which they are derived. Examples
of Middle-Range theories are that of Mercer, Reed, Mishel, and Barker.

List of Nursing Theories and Theorists

You’ve learned from the previous sections the definition of nursing theory, its significance in nursing, and its purpose in
generating a nursing knowledge base. This section will give you an overview and summary of the various published works in
nursing theory (in chronological order). Deep dive into learning about the theory by clicking on the links provided for their
biography and comprehensive review of their work.

Florence Nightingale

See Also: Florence Nightingale: Environmental Theory and Biography

● Founder of Modern Nursing and Pioneer of the Environmental Theory.

● Defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery.”
● Stated that nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the
proper selection and administration of diet – all at the least expense of vital power to the patient.”
● Identified five (5) environmental factors: fresh air, pure water, efficient drainage, cleanliness or sanitation, and
light or direct sunlight.

Hildegard E. Peplau

See Also: Hildegard Peplau: Interpersonal Relations Theory

● Pioneered the Theory of Interpersonal Relations

● Peplau’s theory defined Nursing as “An interpersonal process of therapeutic interactions between an
individual who is sick or in need of health services and a nurse specially educated to recognize, respond to
the need for help.”
● Her work is influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elgar Miller.
● It helps nurses and healthcare providers develop more therapeutic interventions in the clinical setting.

Virginia Henderson

See Also: Virginia Henderson: Nursing Need Theory

 ● Developed the Nursing Need Theory
● Focuses on the importance of increasing the patient’s independence to hasten their progress in the hospital.
● Emphasizes the basic human needs and how nurses can assist in meeting those needs.
● “The nurse is expected to carry out a physician’s therapeutic plan, but individualized care is the result of the
nurse’s creativity in planning for care.”

Faye Glenn Abdellah

See Also: Faye Glenn Abdellah: 21 Nursing Problems Theory

● Developed the 21 Nursing Problems Theory

● “Nursing is based on an art and science that molds 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.”
● Changed the focus of nursing from disease-centered to patient-centered and began to include families and
the elderly in nursing care.
● The nursing model is intended to guide care in hospital institutions but can also be applied to community
health nursing, as well.

Ernestine Wiedenbach

● Developed The Helping Art of Clinical Nursing conceptual model.

● Definition of nursing reflects on nurse-midwife experience as “People may differ in their concept of nursing,
but few would disagree that nursing is nurturing or caring for someone in a motherly fashion.”
● Guides the nurse action in the art of nursing and specified four elements of clinical nursing: philosophy,
purpose, practice, and art.
● Clinical nursing is focused on meeting the patient’s perceived need for help in a vision of nursing that
indicates considerable importance on the art of nursing.

Lydia E. Hall

See Also: Lydia Hall: Care, Cure, Core Theory

● Developed the Care, Cure, Core Theory is also known as the “Three Cs of Lydia Hall.“
● Hall defined Nursing as the “participation in care, core and cure aspects of patient care, where CARE is the
sole function of nurses, whereas the CORE and CURE are shared with other members of the health team.”
● The major purpose of care is to achieve an interpersonal relationship with the individual to facilitate the
development of the core.
● The “care” circle defines a professional nurse’s primary role, such as providing bodily care for the patient. The
“core” is the patient receiving nursing care. The “cure” is the aspect of nursing that involves the administration
of medications and treatments.

Joyce Travelbee

● States in her Human-to-Human Relationship Model that the purpose of nursing was to help and support an
individual, family, or community to prevent or cope with the struggles of illness and suffering and, if necessary,
to find significance in these occurrences, with the ultimate goal being the presence of hope.
● Nursing was accomplished through human-to-human relationships.
● Extended the interpersonal relationship theories of Peplau and Orlando.
Kathryn E. Barnard

● Developed the Child Health Assessment Model.

● Concerns improving the health of infants and their families.
● Her findings on parent-child interaction as an important predictor of cognitive development helped shape
public policy.
● She is the founder of the Nursing Child Assessment Satellite Training Project (NCAST), which produces and
develops research-based products, assessment, and training programs to teach professionals, parents, and
other caregivers the skills to provide nurturing environments for young children.
● Borrows from psychology and human development and focuses on mother-infant interaction with the
environment.
● Contributed a close link to practice that has modified the way health care providers assess children in light of
the parent-child relationship.

Evelyn Adam

● Focuses on the development of models and theories on the concept of nursing.

● Includes the profession’s goal, the beneficiary of the professional service, the role of the professional, the
source of the beneficiary’s difficulty, the intervention of the professional, and the consequences.
● A good example of using a unique basis of nursing for further expansion.

Nancy Roper, Winifred Logan, and Alison J. Tierney

● A Model for Nursing Based on a Model of Living

● Logan produced a simple theory, “which actually helped bedside nurses.”
● The trio collaborated in the fourth edition of The Elements of Nursing: A Model for Nursing Based on a Model
of Living and prepared a monograph entitled The Roper-Logan-Tierney Model of Nursing: Based on Activities
of Daily Living.
● Includes maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal
cleansing and dressing, controlling body temperature, mobilizing, working and playing, expressing sexuality,
sleeping, and dying.

Ida Jean Orlando

See Also: Ida Jean Orlando: Nursing Process Theory

● She developed the Nursing Process Theory.

● “Patients have their own meanings and interpretations of situations, and therefore nurses must validate their
inferences and analyses with patients before drawing conclusions.”
● Allows nurses to formulate an effective nursing care plan that can also be easily adapted when and if any
complexity comes up with the patient.
● According to her, persons become patients requiring nursing care when they have needs for help that cannot
be met independently because of their physical limitations, negative reactions to an environment, or
experience that prevents them from communicating their needs.
● The role of the nurse is to find out and meet the patient’s immediate needs for help.

Jean Watson

See Also: Jean Watson: Theory of Human Caring

 ● She pioneered the Philosophy and Theory of Transpersonal Caring.
● “Nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health.”
● Mainly concerns with how nurses care for their patients and how that caring progresses into better plans to
promote health and wellness, prevent illness and restore health.
● Focuses on health promotion, as well as the treatment of diseases.
● Caring is central to nursing practice and promotes health better than a simple medical cure.

Marilyn Anne Ray

● Developed the Theory of Bureaucratic Caring

● “Improved patient safety, infection control, reduction in medication errors, and overall quality of care in
complex bureaucratic health care systems cannot occur without knowledge and understanding of complex
organizations, such as the political and economic systems, and spiritual-ethical caring, compassion and right
action for all patients and professionals.”
● Challenges participants in nursing to think beyond their usual frame of reference and envision the world
holistically while considering the universe as a hologram.
● Presents a different view of how health care organizations and nursing phenomena interrelate as wholes and
parts in the system.

Patricia Benner

● Caring, Clinical Wisdom, and Ethics in Nursing Practice

● “The nurse-patient relationship is not a uniform, professionalized blueprint but rather a kaleidoscope of
intimacy and distance in some of the most dramatic, poignant, and mundane moments of life.”
● Attempts to assert and reestablish nurses’ caring practices when nurses are rewarded more for efficiency,
technical skills, and measurable outcomes.
● States that caring practices are instilled with knowledge and skill regarding everyday human needs.

Kari Martinsen

● Philosophy of Caring
● “Nursing is founded on caring for life, on neighborly love, […]At the same time, the nurse must be
professionally educated.”
● Human beings are created and are beings for whom we may have administrative responsibility.
● Caring, solidarity, and moral practice are unavoidable realities.

Katie Eriksson

● Theory of Carative Caring

● “Caritative nursing means that we take ‘caritas’ into use when caring for the human being in health and
suffering […] Caritative caring is a manifestation of the love that ‘just exists’ […] Caring communion, true
caring, occurs when the one caring in a spirit of caritas alleviates the suffering of the patient.”
● The ultimate goal of caring is to lighten suffering and serve life and health.
● Inspired many in the Nordic countries and used it as the basis of research, education, and clinical practice.

Myra Estrin Levine

See Also: Myra Estrin Levine: Conservation Model for Nursing

● According to the Conservation Model, “Nursing is human interaction.”

● Provides a framework within which to teach beginning nursing students.
 ● Logically congruent, externally and internally consistent, has breadth and depth, and is understood, with few
exceptions, by professionals and consumers of health care.

Martha E. Rogers

See Also: Martha Rogers: Theory of Unitary Human Beings

● In Roger’s Theory of Human Beings, she defined Nursing as “an art and science that is humanistic and
humanitarian.
● The Science of Unitary Human Beings contains two dimensions: the science of nursing, which is the
knowledge specific to the field of nursing that comes from scientific research; and the art of nursing, which
involves using nursing creatively to help better the lives of the patient.
● A patient can’t be separated from his or her environment when addressing health and treatment.

Dorothea E. Orem

See Also: Dorothea E. Orem: Self-Care Theory

● In her Self-Care Theory, she defined Nursing as “The act of assisting others in the provision and
management of self-care to maintain or improve human functioning at the home level of effectiveness.”
● Focuses on each individual’s ability to perform self-care.
● Composed of three interrelated theories: (1) the theory of self-care, (2) the self-care deficit theory, and (3) the
theory of nursing systems, which is further classified into wholly compensatory, partially compensatory, and
supportive-educative.

Imogene M. King

See Also: Imogene M. King: Theory of Goal Attainment

● Conceptual System and Middle-Range Theory of Goal Attainment

● “Nursing is a process of action, reaction and interaction by which nurse and client share information about
their perception in a nursing situation” and “a process of human interactions between nurse and client
whereby each perceives the other and the situation, and through communication, they set goals, explore
means, and agree on means to achieve goals.”
● Focuses on this process to guide and direct nurses in the nurse-patient relationship, going hand-in-hand with
their patients to meet good health goals.
● Explains that the nurse and patient go hand-in-hand in communicating information, set goals together, and
then take actions to achieve those goals.

Betty Neuman

See Also: Betty Neuman: Neuman’s Systems Model

 ● In Neuman’s System Model, she defined nursing as a “unique profession in that is concerned with all of the
variables affecting an individual’s response to stress.”
● The focus is on the client as a system (which may be an individual, family, group, or community) and on the
client’s responses to stressors.
● The client system includes five variables (physiological, psychological, sociocultural, developmental, and
spiritual). It is conceptualized as an inner core (basic energy resources) surrounded by concentric circles that
include lines of resistance, a normal defense line, and a flexible line of defense.

Sister Callista Roy

See Also: Sister Callista Roy: Adaptation Model of Nursing

● In Adaptation Model, Roy defined nursing as a “health care profession that focuses on human life processes
and patterns and emphasizes the promotion of health for individuals, families, groups, and society as a
whole.”
● Views the individual as a set of interrelated systems that strives to maintain a balance between various
stimuli.
● Inspired the development of many middle-range nursing theories and adaptation instruments.

Dorothy E. Johnson

See Also: Dorothy E. Johnson: Behavioral Systems Model

● The Behavioral System Model defined Nursing as “an external regulatory force that acts to preserve the
organization and integrate the patients’ behaviors at an optimum level under those conditions in which the
behavior constitutes a threat to the physical or social health or in which illness is found.”
● Advocates to foster efficient and effective behavioral functioning in the patient to prevent illness and stresses
the importance of research-based knowledge about the effect of nursing care on patients.
● Describes the person as a behavioral system with seven subsystems: the achievement, attachment-affiliative,
aggressive-protective, dependency, ingestive, eliminative, and sexual subsystems.

Anne Boykin and Savina O. Schoenhofer

● The Theory of Nursing as Caring: A Model for Transforming Practice

● Nursing is an “exquisitely interwoven” unity of aspects of the discipline and profession of nursing.
● Nursing’s focus and aim as a discipline of knowledge and a professional service are “nurturing persons living
to care and growing in caring.”
● Caring in nursing is “an altruistic, active expression of love, and is the intentional and embodied recognition of
value and connectedness.”

Afaf Ibrahim Meleis

● Transitions Theory
● It began with observations of experiences faced as people deal with changes related to health, well-being,
and the ability to care for themselves.
● Types of transitions include developmental, health and illness, situational, and organizational.
● Acknowledges the role of nurses as they help people go through health/illness and life transitions.
● Focuses on assisting nurses in facilitating patients’, families’, and communities’ healthy transitions.
Nola J. Pender

See Also: Nola Pender: Health Promotion Model

● Health Promotion Model

● Describes the interaction between the nurse and the consumer while considering the role of the health
promotion environment.
● It focuses on three areas: individual characteristics and experiences, behavior-specific cognitions and affect,
and behavioral outcomes.
● Describes the multidimensional nature of persons as they interact within their environment to pursue health.

Madeleine M. Leininger

See Also: Madeleine M. Leininger: Transcultural Nursing Theory

● 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 to provide
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 regarding nursing and health-illness caring practices,
beliefs, and values to implement significant and efficient nursing care services to people according to their
cultural values and health-illness context.
● It focuses on the fact that various cultures have different and unique caring behaviors and different health and
illness values, beliefs, and patterns of behaviors.

Margaret A. Newman

● Health as Expanding Consciousness

● “Nursing is the process of recognizing the patient in relation to the environment, and it is the process of the
understanding of consciousness.”
● “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 . . . “
● Nursing is regarded as a connection between the nurse and patient, and both grow in the sense of higher
levels of consciousness.

Rosemarie Rizzo Parse

● Human Becoming Theory

● “Nursing is a science, and the performing art of nursing is practiced in relationships with persons (individuals,
groups, and communities) in their processes of becoming.”
● Explains that a person is more than the sum of the parts, the environment, and the person is inseparable and
that nursing is a human science and art that uses an abstract body of knowledge to help people.
● It centered around three themes: meaning, rhythmicity, and transcendence.

Helen C. Erickson, Evelyn M. Tomlin, and Mary Ann P. Swain

● Modeling and Role-Modeling

 ● “Nursing is the holistic helping of persons with their self-care activities in relation to their health . . . The goal is
to achieve a state of perceived optimum health and contentment.”
● Modeling is a process that allows nurses to understand the unique perspective of a client and learn to
appreciate its importance.
● Role-modeling occurs when the nurse plans and implements interventions that are unique for the client.

Gladys L. Husted and James H. Husted

● Created the Symphonological Bioethical Theory

● “Symphonology (from ‘symphonia,’ a Greek word meaning agreement) is a system of ethics based on the
terms and preconditions of an agreement.”
● Nursing cannot occur without both nurse and patient. “A nurse takes no actions that are not interactions.”
● Founded on the singular concept of human rights, the essential agreement of non-aggression among rational
people forms the foundation of all human interaction.

Ramona T. Mercer

● Maternal Role Attainment—Becoming a Mother

● “Nursing is a dynamic profession with three major foci: health promotion and prevention of illness, providing
care for those who need professional assistance to achieve their optimal level of health and functioning, and
research to enhance the knowledge base for providing excellent nursing care.”
● “Nurses are the health professionals having the most sustained and intense interaction with women in the
maternity cycle.”
● Maternal role attainment is an interactional and developmental process occurring over time. The mother
becomes attached to her infant, acquires competence in the caretaking tasks involved in the role, and
expresses pleasure and gratification. (Mercer, 1986).
● Provides proper health care interventions for nontraditional mothers for them to favorably adopt a strong
maternal identity.

Merle H. Mishel

● Uncertainty in Illness Theory

● Presents a comprehensive structure to view the experience of acute and chronic illness and organize nursing
interventions to promote optimal adjustment.
● Describes how individuals form meaning from illness-related situations.
● The original theory’s concepts were organized in a linear model around the following three major themes:
Antecedents of uncertainty, Process of uncertainty appraisal, and Coping with uncertainty.

Pamela G. Reed

● Self-Transcendence Theory
● Self-transcendence refers to the fluctuation of perceived boundaries that extend the person (or self) beyond
the immediate and constricted views of self and the world (Reed, 1997).
● Has three basic concepts: vulnerability, self-transcendence, and well-being.
● Gives insight into the developmental nature of humans associated with health circumstances connected to
nursing care.

Carolyn L. Wiener and Marylin J. Dodd

● Theory of Illness Trajectory

● “The uncertainty surrounding a chronic illness like cancer is the uncertainty of life writ large. By listening to
those who are tolerating this exaggerated uncertainty, we can learn much about the trajectory of living.”
 ● Provides a framework for nurses to understand how cancer patients stand uncertainty manifested as a loss of
control.
● Provides new knowledge on how patients and families endure uncertainty and work strategically to reduce
uncertainty through a dynamic flow of illness events, treatment situations, and varied players involved in care
organization.

Georgene Gaskill Eakes, Mary Lermann Burke, and Margaret A. Hainsworth

● Theory of Chronic Sorrow

● “Chronic sorrow is the presence of pervasive grief-related feelings that have been found to occur periodically
throughout the lives of individuals with chronic health conditions, their family caregivers and the bereaved.”
● This middle-range theory defines the aspect of chronic sorrow as a normal response to the ongoing disparity
created by the loss.

Phil Barker

● Barker’s Tidal Model of Mental Health Recovery is widely used in mental health nursing.
● It focuses on nursing’s fundamental care processes, is universally applicable, and is a practical guide for
psychiatry and mental health nursing.
● Draws on values about relating to people and help others in their moments of distress. The values of the Tidal
Model are revealed in the Ten Commitments: Value the voice, Respect the language, Develop genuine
curiosity, Become the apprentice, Use the available toolkit, Craft the step beyond, Give the gift of time, Reveal
personal wisdom, Know that change is constant, and Be transparent.

Katharine Kolcaba

● Theory of Comfort
● “Comfort is an antidote to the stressors inherent in health care situations today, and when comfort is
enhanced, patients and families are strengthened for the tasks ahead. Also, nurses feel more satisfied with
the care they are giving.”
● Patient comfort exists in three forms: relief, ease, and transcendence. These comforts can occur in four
contexts: physical, psychospiritual, environmental, and sociocultural.
● As a patient’s comfort needs change, the nurse’s interventions change, as well.

Cheryl Tatano Beck

● Postpartum Depression Theory

● “The birth of a baby is an occasion for joy—or so the saying goes […] But for some women, joy is not an
option.”
● Described nursing as a caring profession with caring obligations to persons we care for, students, and each
other.
● Provides evidence to understand and prevent postpartum depression.

Kristen M. Swanson

● Theory of Caring
● “Caring is a nurturing way of relating to a valued other toward whom one feels a personal sense of
commitment and responsibility.”
● Defines nursing as informed caring for the well-being of others.
● Offers a structure for improving up-to-date nursing practice, education, and research while bringing the
discipline to its traditional values and caring-healing roots.

Cornelia M. Ruland and Shirley M. Moore

 ● Peaceful End-of-Life Theory
● The focus was not on death itself but on providing a peaceful and meaningful living in the time that remained
for patients and their significant others.
● The purpose was to reflect the complexity involved in caring for terminally ill patients.

Wanda de Aguiar Horta

● Also known as Wanda Horta, she introduced the concepts of nursing that are accepted in Brazil.
● Wrote the book Nursing Process which presents relevance to the various fields of Nursing practice for
providing a holistic view of the patient.
● Her work was recognized in all the teaching institutions called the Theory of Basic Human Needs. It is
based on Maslow’s Theory of Human Motivation, whose primary concept is the hierarchy of Basic Human
Needs (BHN).
● Horta’s Theory of Basic Human Needs is considered the highest point of her work, and the summary of all her
research concludes sickness as a science and art of assisting a human being in meeting basic human needs,
making the patient independent of this assistance through education in recovery, maintenance, and health
promotion.
● Classified basic human needs into three main dimensions – psychobiological, psychosocial and
psychospiritual – and establishes a relationship between the concepts of human being, environment, and
nursing.
● The theory describes nursing as an element of a healthcare team and states that it can function efficiently
through a scientific method. Horta referred this method as the nursing process.
● She defined the nursing process as the dynamics of systematic and interrelated actions to assist human
beings. It is characterized by six phases: nursing history, nursing diagnosis, assistance plan, care plan or
nursing prescription, evolution, and prognosis.

NURSING THEORISTS
IMPORTANT THEORISTS
1. Florence Nightingale - Environment theory
2. Hildegard Peplau - Interpersonal theory
3. Virginia Henderson - Need Theory
4. Fay Abdella - Twenty One Nursing Problems
5. Ida Jean Orlando - Nursing Process theory
6. Dorothy Johnson - System model
7. Martha Rogers -Unitary Human beings
8. Dorothea Orem - Self-care theory
9. Imogene King - Goal Attainment theory
10. Betty Neuman - System model
11. Sister Calista Roy - Adaptation theory
12. Jean Watson - Philosophy and Caring Model
13. Madeleine Leininger -Transcultural nursing
14. Patricia Benner - From Novice to Expert
15. Lydia E. Hall - The Core, Care and Cure
16. Joyce Travelbee - Human-To-Human Relationship Model
17. Margaret Newman - Health As Expanding Consciousness
18. Katharine Kolcaba - Comfort Theory
19. Rosemarie Rizzo Parse - Human Becoming Theory
20. Ernestine Wiedenbach - The Helping Art of Clinical Nursing

1. FLORENCE NIGHTINGALE- ENVIRONMENTAL THEORY

● First nursing theorist
● Unsanitary conditions posed health hazard (Notes on Nursing, 1859)
● 5 components of environment
 ● ventilation, light, warmth, effluvia, noise
● External influences can prevent, suppress or contribute to disease or death.
Nightingale’s Concepts
1. Person
● Patient who is acted on by nurse
● Affected by environment
● Has reparative powers
2. Environment
● Foundation of theory. Included everything, physical, psychological, and social
3. Health
● Maintaining well-being by using a person’s powers
● Maintained by control of environment
4. Nursing
● Provided fresh air, warmth, cleanliness, good diet, quiet to facilitate person’s reparative process

2. HILDEGARD PEPLAU -INTERPERSONAL RELATIONS MODEL

● Based on psychodynamic nursing
● using an understanding of one’s own behavior to help others identify their difficulties
● Applies principles of human relations
● Patient has a felt need

Peplau’s Concepts
1. Person
● An individual; a developing organism who tries to reduce anxiety caused by needs
● Lives in instable equilibrium
2. Environment
● Not defined
3. Health
● Implies forward movement of the personality and human processes toward creative, constructive, productive,
personal, and community living
4. Nursing
● A significant, therapeutic, interpersonal process that functions cooperatively with others to make health possible
● Involves problem-solving

3. VIRGINIA HENDERSON -THE NATURE OF NURSING

"The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to
health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or
knowledge. And to do this in such a way as to help him gain independence as rapidly as possible. She must in a sense, get
inside the skin of each of her patients in order to know what he needs".

4. FAY ABDELLA- TOPOLOGY OF 21 NURSING PROBLEMS

● A list of 21 nursing problems
● Condition presented or faced by the patient or family.
● Problems are in 3 categories
● physical, social and emotional
● The nurse must be a good problem solver

Abdella’s Concepts
1. Nursing
● A helping profession
● A comprehensive service to meet patient’s needs
● Increases or restores self-help ability
● Uses 21 problems to guide nursing care
2. Health
 ● Excludes illness
● No unmet needs and no actual or anticipated impairments
3. Person
● One who has physical, emotional, or social needs
● The recipient of nursing care.
4. Environment
● Did not discuss much
● Includes room, home, and community

5. IDA JEAN ORLANDO- DELIBERATIVE NURSING PROCESS

● The deliberative nursing process is set in motion by the patient’s behavior
● All behavior may represent a cry for help. Patient’s behavior can be verbal or non-verbal.
● The nurse reacts to patient’s behavior and forms basis for determining nurse’s acts.
● Perception, thought, feeling
● Nurses’ actions should be deliberative, rather than automatic
● Deliberative actions explore the meaning and relevance of an action.

6. DOROTHY JOHNSON-BEHAVIORAL SYSTEMS MODEL

● The person is a behavioral system comprised of a set of organized, interactive, interdependent, and integrated
subsystems
● Constancy is maintained through biological, psychological, and sociological factors.
● A steady state is maintained through adjusting and adapting to internal and external forces.

Johnson’s 7 Subsystems
● Affiliative subsystem - social bonds
● Dependency - helping or nuturing
● Ingestive - food intake
● Eliminative - excretion
● Sexual - procreation and gratification
● Aggressive - self-protection and preservation
● Achievement - efforts to gain mastery and control

Johnson’s Concepts
1. Person
● A behavioral system comprised of subsystems constantly trying to maintain a steady state
2. Environment
● Not specifically defined but does say there is an internal and external environment
3. Health
● Balance and stability.
4. Nursing
● External regulatory force that is indicated only when there is instability.

7. MARTHA ROGERS -UNITARY HUMAN BEINGS

Energy fields
● Fundamental unity of things that are unique, dynamic, open, and infinite
● Unitary man and environmental field
Universe of open systems
● Energy fields are open, infinite, and interactive
Pattern
● Characteristic of energy field
● A wave that changes, becomes complex and diverse
Pandimensionality
● A nonlinear domain with out time or space
Roger’s Definitions
Integrality
● Continuous and mutual interaction between man and environment
Resonancy
● Continuous change longer to shorter wave patterns in human and environmental fields
Helicy
● Continuous, probabilistic, increasing diversity of the human and envrionmental fields.
● Characterized by nonrepeating rhymicities
● Change

8. DOROTHEA OREM- SELF-CARE MODEL

● Self-care comprises those activities performed independently by an individual to promote and maintain person
well-being
● Self care agency is the individual’s ability to perform self care activities
● Self- care deficit occurs when the person cannot carry out self-care
● The nurse then meets the self-care needs by acting or doing for; guiding, teaching, supporting or providing the
environment to promote patient’s ability
● Wholly compensatory nursing system-Patient dependent
● Partially compensatory- Patient can meet some needs but needs nursing assistance
● Supportive educative-Patient can meet self care requisites, but needs assistance with decision making or knowledge

9. IMOGENE KING-GOAL ATTAINMENT THEORY

● Open systems framework
● Human beings are open systems in constant interaction with the environment
● Personal System
● individual; perception, self, growth, development, time space, body image
● Interpersonal
● Society
● Personal System
● Individual; perception, self, growth, development, time space, body image
● Interpersonal
● Socialization; interaction, communication and transaction
● Society
● Family, religious groups, schools, work, peers
● The nurse and patient mutually communicate, establish goals and take action to attain goals
● Each individual brings a different set of values, ideas, attitudes, perceptions to exchange

10. BETTY NEUMAN - HEALTH CARE SYSTEMS MODEL

● The person is a complete system, with interrelated parts
● maintains balance and harmony between internal and external environment by adjusting to stress and defending
against tension-producing stimuli
● Focuses on stress and stress reduction
● Primarily concerned with effects of stress on health
● Stressors are any forces that alter the system’s stability
● Flexible lines of resistance - Surround basic core
● Internal factors that help defend against stressors
● Normal line of resistance - Normal adaptation state
● Flexible line of defense - Protective barrier, changing, affected by variables
● Wellness is equilibrium
Nursing interventions are activates to:
● strengthen flexible lines of defense
● strengthen resistance to stressors
● maintain adaptation
11. SISTER CALISTA ROY - ADAPTATION MODEL
Five Interrelated Essential Elements
1. Patiency- The person receiving care
2. Goal of nursing- Adapting to change
3. Health-Being and becoming a whole person
4. Environment
5. Direction of nursing activities- Facilitating adaptation
● The person is an open adaptive system with input (stimuli), who adapts by processes or control mechanisms
(throughput)
● The output can be either adaptive responses or ineffective responses

12. JEAN WATSON - PHILOSOPHY AND SCIENCE OF CARING

● Caring can be demonstrated and practiced
● Caring consists of carative factors
● Caring promotes growth
● A caring environment accepts a person as he is and looks to what the person may become
● A caring environment offers development of potential
● Caring promotes health better than curing
● Caring is central to nursing

WATSON’S 10 CARATIVE FACTORS

● Forming humanistic-altruistic value system
● Instilling faith-hope
● Cultivating sensitivity to self and others
● Developing helping-trust relationship
● Promoting expression of feelings
● Using problem-solving for decision making
● Promoting teaching-learning
● Promoting supportive environment
● Assisting with gratification of human needs
● Allowing for existential-phenomenological forces

Watson’s Concepts
● Person
● Human being to be valued, cared for, respected, nurtured, understood and assisted
● Environment
● Society
● Health
● Complete physical, mental and social well-being and functioning
● Nursing
● Concerned with promoting and restoring health, preventing illness

13. ROSEMARY PARSE - HUMAN BECOMING THEORY

● Human Becoming Theory includes Totality Paradigm
● Man is a combination of biological, psychological, sociological and spiritual factors
● Simultaneity Paradigm
● Man is a unitary being in continuous, mutual interaction with environment
● Originally Man-Living-Health Theory

Parse’s Three Principles

● Meaning
● Man’s reality is given meaning through lived experiences
● Man and environment cocreate
● Rhythmicity
 ● Man and environment cocreate ( imaging, valuing, languaging) in rhythmical patterns
● Cotranscendence
● Refers to reaching out and beyond the limits that a person sets
● One constantly transforms
● Person
● Open being who is more than and different from the sum of the parts
● Environment
● Everything in the person and his experiences
● Inseparable, complimentary to and evolving with
● Health
● Open process of being and becoming. Involves synthesis of values
● Nursing
● A human science and art that uses an abstract body of knowledge to serve people

14. MADELEINE LEININGER - CULTURE CARE DIVERSITY AND UNIVERSALITY

● According to transcultural nursing, the goal of nursing care is to provide care congruent with cultural values, beliefs,
and practices
● Sunrise model consists of 4 levels that provide a base of knowledge for delivering cultural congruent care.
● Cultural care preservation
● help maintain or preserve health, recover from illness, or face death
● Cultural care accommodation
● help adapt to or negotiate for a beneficial health status, or face death
● Cultural care re-patterning
● help restructure or change lifestyles that are culturally meaningful

15. PATRICIA BENNER - FROM NOVICE TO EXPERT

● Described 5 levels of nursing experience and developed exemplars and paradigm cases to illustrate each level
1. Novice
2. Advanced beginner
3. Competent
4. Proficient
5. Expert
● Levels reflect:
● movement from reliance on past abstract principles to the use of past concrete experience as paradigms
● change in perception of situation as a complete whole in which certain parts are relevant

16. LYDIA E. HALL - THE CORE, CARE AND CURE

● The theory contains of three independent but interconnected circles:
1. the core,
2. the care and
3. the cure
● The core is the person or patient to whom nursing care is directed and needed. The core has goals set by himself
and not by any other person. The core behaved according to his feelings, and value system.
● The care circle explains the role of nurse
● The cure is the attention given to patients by the medical professionals.