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Theoretrical Foundation of Nursing

Bs Nursing (Tarlac State University)

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1.A ____ is a set of concepts, definitions, a. Prescriptive theories

relationships, and assumptions that: b. Descriptive theories
c. Mid-ranged theories
a. A theory formulates legislation.
d. Grand theories
b. A theory explains a phenomenon.
c. A theory measures nursing functions.
d. A theory reflects the domain of nursing. 7. _____theories address nursing interventions
for a phenomenon and ______the consequence
2. The nursing paradigm identifies four of a specific nursing intervention.
linkages of interest to thse nursing profession.
These four linkages are: a. Prescriptive theories/predict the
consequence.
a. Concepts, definitions, relationships, and b. Descriptive theories/ speculate the
assumptions.
consequences.
b. The person, health, environment/situation,
and nursing. c. Reflective theories/explain the consequences.
c. The individual, groups, situations, and
interests specific to nursing. 8. Theories will be tested to describe or predict
d. Description, explanation, prediction, and client outcomes is an example of
prescription of an interrelationship of nursing.
a. Addressing nursing as a science or as
3. Although the nursing process is central to evidenced-based practice.
nursing, it is not a theory. The nursing process b. One theory will guide nursing practice.
provides a:
c. Nursing will base client care on the practice
a. The knowledge component of the discipline. of other sciences.
b. A basis for theories. d. Concepts, definitions, relationships, and
c. Systematic process for the delivery of nursing assumptions or propositions.
care.
d. Foundation for acquiring knowledge. 9. Nursing's goal is to educate the client and
family and to help the client reach mature
4. According to this theory goal of nursing is to
personality development. This focus on the
help the person adapt to the changes in
physiological needs, self-concept, role function individual, the nurse and the interactive
and interdependent relations during health and process is an example of which nursing theory?
illness.
a. Peplau's Theory
a. Watson's Theory b. Nightingale's Theory
b. Leininger's Therory c. Henderson's Theory
c. Roy's Theory d. Abdellah's Theory
d. Orem's Theory
-Peplau's focus was on the interaction between nurse
- Roy's theory deals with adaptation by meeting basic
and client, the interpersonal relationship.
physiological needs, developing a positive self-
Nightingale's was on the client's environment
concept, performing social roles and by achieving a
(hygiene, noise, nutrition). Henderson's theory
balance between dependence and independence.
defines nursing as "assisting the individual, sick, or
Watson's theory involves the philosophy and science
well, in the performance of those activities that will
of caring to meet human needs. Orem's theory is
contribute to health, recovery, or a peaceful death."
based self-care deficit and focuses on the client's self-
Abdellah's theory emphasizes the delivery of nursing
care needs. Leininger's theory deals with cultural
care for the whole person to meet the physical,
care diversity.
emotional, intellectual, social, and spiritual needs of
5. Nursing continues to grow as a profession. the client and family
Theories generate nursing knowledge and are
10. Some nursing theories use a systems
used to prescribe specific interventions to
theory as a base. As a system, the nursing
improve client outcomes. The overall goal of
process has the following components:
nursing knowledge is to explain the practice of
nursing as
a. Concepts, definitions and assumptions
b. Grand theories, middle-range theories,
a. Different and distinct from the practice of
descriptive theories and prescriptive theories
medicine, psychology, and social work.
c. Input, output, feedback and content
b. A set of complex theories.
d. Collaboration, cooperation and discipline
c. The nursing process
d. A phenomenon
11. Nursing's paradigm includes:
6. Validity and predictability of nursing
a. Health, person, environment, and theory.
interventions are related to:
b. Concepts, theory, health, and environment.

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c. Nurses, physicians, models, and client needs. behavioral sciences. This relates to which of
d. The person, health, environment/situation, the following?
and nursing.
e. All the above. a. Systems theories
b. Developmental theories
12. The nursing process is an example of an c. Interdisciplinary theories
open system. An open system d. Health and wellness model

a. Is universal and dynamic.

b. Represents a relationship between two 18. Which of the following are components of
concepts. the paradigm of nursing?
c. Interacts with the environment by
exchanging information. a. The person, health, environment, and theory
d. Does not interact with the environment. b. Health, theory, concepts, and environment
c. Nurses, physicians, health, and patient needs
13. The theory that involves care and helps the d. The person, health, environment/situation,
client attain total self-care is: and nursing

a. Roger's Therory RATIONALE: The nursing paradigm focuses on

b. Leininger's Theory person, health, environment/situation, and
c. Nightingale's Theory nursing. All the elements interact with one
d. Orem's Theory another, with the patient being central.

19. A theory is a set of concepts, definitions,

relationships, and assumptions that:
14. Evidence-based nursing practice is the end
result of a. Formulate legislation.
b. Explain a phenomenon.
a. Use of practical knowledge c. Measure nursing functions.
b. Theory-generating and theory-testing d. Reflect the domain of nursing practice.
research
c. Application of theoretical knowledge RATIONALE: Theories are designed to explain a
d. Prescriptive theory phenomenon such as self-care or caring. A
theory is a way of seeing through a "set of
15. Nursing is the diagnosis and treatment of relatively concrete and specific concepts" and
human responses to actual or potential health the propositions that describe or link the
problems. Health has different meanings for concepts.
each client and is
20. A patient with diabetes is controlling the
a. Different in the clinical setting. disease with insulin and diet. The nursing
b. Dynamic and continuously changing. health care provider is focusing efforts to teach
c. Static dependent on the nursing profession. the patient self-management. Which of the
d. Dependent on the medical profession for following nursing theories is useful in
definition. promoting self management?

16. The phenomena within this theory tend to a. Neuman

cross different nursing fields and reflect a wide b. Orem
variety of nursing care situations, such as c. Roy
uncertainty, incontinence, social support, d. Peplau
quality of life and caring. Mishel's theory
provides a basis to assist clients in coping with RATIONALE: Orem's theory of self-care provides
uncertainty and the illness response. This is an a solid theoretical background for self-
example of what theory? management for a variety of diseases. This
theory shows the nurse how to direct the patient
a. Mid-ranged toward self-management to promote health
b. Grand and/or sustain wellness.
c. Descriptive
d. Prescriptive 21. While working in a community health clinic,
it is important to obtain nursing histories and
17. To practice in today's health care get to know the patients. Part of history taking
environment, nurses need a strong scientific is to develop the nurse-patient relationship.
knowledge base in nursing and other Which of the following apply to Peplau's theory
disciplines, such as the physical, social, and when establishing the nurse-patient
relationship? (Select all that apply.)

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a. An interaction between the nurse and RATIONALE: Developmental theories describe

patient must develop. and predict behavior and development at
b. The patient's needs must be clarified and various phases of the life continuum, as in the
described. phase of older adulthood.
c. The nurse-patient relationship is influenced
by patient and nurse preconceptions. 25. Match the following components of systems
d. The nurse-patient relationship is influenced theory with the definition of that component.
only by the nurse's preconceptions.
A. Feedback B. Input C. Content D. Output
RATIONALE: There is continual interaction by
both the patient and the nurse throughout all 1. Data entering the system
phases of the nurse-patient relationship. Option 2. End product
4 is incorrect because the focus is only on the
nurse. 3. Data related to system functioning

22. Theory-based nursing practice uses a 4. Product and information obtained from the system
theoretical approach for nursing care. This
approach moves nursing forward as a science. A. 3. B. 1. C. 4. D. 2.
This suggests that:
26. A patient is admitted to an acute care area.
a. One theory will guide nursing practice. The patient is an active business man who is
b. Scientists will decide nursing decisions. worried about getting back to work. He has had
c. Nursing will only base patient care on the severe diarrhea and vomiting for the last week.
practice of other sciences. He is weak, and his breathing is labored. Using
d. Theories will be tested to describe or predict Maslow's hierarchy of needs, identify this
patient outcomes. patient's immediate priority.

RATIONALE: There are multiple theories for the a. Self-actualization

practice of nursing; these theories are tested to b. Air, water, and nutrition
develop the evidence to describe or predict c. Safety
patient outcomes. d. Esteem and self-esteem needs

23. To practice in today's health care 27. Which of the following is closely aligned
environment, nurses need a strong scientific with Leininger's theory?
knowledge base from nursing and other
a. Caring for patients from unique cultures
disciplines such as the physical, social, and
b. Understanding the humanistic aspects of life
behavioral sciences. This statement identifies
c. Variables affecting a patient's response to a
the need for which of the following?
stressor
a. Systems theories d. Caring for patients who cannot adapt to
b. Developmental theories internal and external environmental
c. Interdisciplinary theories demands
d. Health and wellness models
RATIONALE: Leininger's theory of transcultural
RATIONALE: As the health system evolves and nursing focuses on the patient's culture and the
the health care needs of the patient focus on impact of culture heritage on health care needs
health promotion, illness prevention, and and interventions.
treatment, more disciplines are involved in
28. Which of the following statements about
patient care. To be effective in practice nurses
theory-based nursing practice is incorrect?
need to be aware of theoretical approaches of
care arising from other disciplines and from a. Contributes to evidence-based practice
nursing. b. Provides a systematic process for designing
nursing interventions
24. Which of the following theories describe
c. Is not linked to nursing outcomes
the life processes of an older adult facing
d. Guides the nurse's assessment
chronic illness?
RATIONALE: Theory-based nursing practice
a. Systems theories
does reflect nursing outcomes. For example,
b. Developmental theories
prescriptive theories address specific nursing
c. Interdisciplinary theories
interventions and predict the patient response.
d. Health and wellness models

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29. Self-care deficit theory was proposed by: emotive channels (perceptual and information
processing, learning, judgment, and emotion)?
a. Virginia Henderson
b. Betty Neuman a. Regulator Subsystem
c. Imogene King b. Cognator Subsystem
d. Dorothea Orem c. Physiologic Mode
d. Self Concept-Group Identity Mode
30. Which theory defines nursing as the science
and practice that expands adaptive abilities 36. The "humanistic science of nursing" was
and enhances person and environment explained by:
transformation?
a. Rogers (1970)
a. Goal attainment theory b. Ida Orlando (1960)
b. Henderson's definition of nursing c. Nightingale (1860)
c. Roy's adaptation model d. Neuman (1972)
d. Faye Glen Abdelah's theory
37. Imogene King's "goal attainment theory" is
31. Typology of twenty one Nursing problems a type of:
were explained by:
a. Need theories
a. Imogene King b. Interaction theories
b. Virginia Henderson’s c. Outcome theories
c. Faye G.Abedellah d. Humanistic theories
d. Lydia E. Hall
38. Which of the following theory has used
32. "Nursing is therapeutic interpersonal "General Systems Theory" as a framework for
process". This definition was stated by: its development?

A. Hildegard Peplau a. Florence Nightingale's Environment Theory

b. Hildegard E. Peplau's Psychodynamic Nursing
B. Jean watson Theory
c. Martha E.Roger’s: Science of Unitary Human
C. Faye Glen Abdelah Beings
d. Neuman's model
D. M. Rogers
39. Transcultural Model of Nursing was
33. Which of the following statements is
proposed by:
related to Florence Nightingale?
a. Joyce Travelbee
a. Nursing is therapeutic interpersonal process.
b. Rosemarie Rizzo Parse
b. The role of nursing is to facilitate "the body’s
c. Madeleine Leininger
reparative processes" by manipulating client’s
d. Ida Jean Orlando
environment.
c. Nursing is the science and practice that expands 40. According to Neuman Systems Model, the
adaptive abilities and enhances person and increase in energy that occurs in relation to the
environment transformation degree of reaction to the stressor is termed as:
d. Nursing care becomes necessary when client is
unable to fulfill biological, psychological, a. Reconstitution
developmental, or social needs. b. Lines of resistance
c. Primary prevention
34. Which of the following is NOT a concept d. Secondary Prevention
related to Roy's Adaptation Model?
41. Which is NOT a concept explained in
A. Focal Stimuli Dorothy Johnson's Behavioral Systems Model?
B. Cognator Subsystem a. Affiliation
b. Dependency
C. Role function
c. Achievement
D. Flexible line of defense d. Energy fields

35. According to Roy's adapatation theory, 42. According to Rogers' theory "continuous
which subsystem responds through four and mutual interaction between man and
cognitive responds through four cognitive- environment' is termed as:

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a. Pattern a. Organization of patient data

b. Integrality b. Analysis of patient care
c. Resonancy c. Evaluation of patient care outcomes
d. Helicy d. All of these are correct

43. Watson's carative factors include all the 50. Which nurse theorist believed that "the
following, EXCEPT: beauty of medicine and nursing is the
combination of your heart, your head and your
a. Forming humanistic-altruistic value system hands and where you separate them, you
b. Instilling faith-hope diminish them."
c. Cultivating sensitivity to self and others
d. Strengthening flexible lines of defense a. Dorothea Orem
b. Hildegard Peplau
c. Betty Neuman
d. Virginia Henderson
44. The central concepts and metaparadigm of
the discipline of nursing include which of the 51. Nursing is defined as "action which assist
following? individuals, families and groups to maintain a
maximum level of wellness, and the primary
a. Person, health, nursing aim is stability of the patient/client system,
b. Person, honor, caring, nursing through nursing interventions to reduce
c. Health, nursing, person, and environment stressors.'' This definition is given by:
d. Advocacy, empathy, service and caring
A. Orem B. Peplau C. Neuman D. Rogers
45. Which of the folllowing is a nurse
characteristic identified in the AACN Synergy 52. Which nursing theorist defines environment
Model? as "the totality of the internal and external
forces which surround a person and with which
a. Complexity they interact at any given time"?
b. Predictabililty
c. Collaboration a. Dorothy Johnson
d. Stability b. Martha Rogers
c. Dorothea Orem
46. Which of the following is a patient d. Imogene King E. Betty Neuman
characteristic identified in the AACN Synergy e. Betty Neuman
Model?
53. According to Peplau's interpersonal model,
a. Advocacy during which phase of nursing process, the
b. Resiliency patient participates in goal setting and has a
c. Response to diversity feeling of belonging and selectively responds
d. Systems thinking to those who can meet his or her needs?

47. Which theorist developed a model with a A. Orientation B. Identification C. Exploitation D.

focus on the client system in relationship to Resolution
stressors?
54. Caring consists of carative factors that
a. Betty Neuman result in the satisfaction of certain human
b. Hildegard Peplau needs". This explanation was stated by:
c. Jean Watson
d. Martha Rogers a. Sister Calista Roy
b. Jean Watson
48. What is a middle range theory? c. Dorothea Orem
d. Florence Nightingale
a. A theory to bridge the gap between research and
bedside practice 55. Statements that explain the relationship
b. A theory that presents global perspectives between the concepts in a theory:
c. A theory that attempts to explain the overall
perspective of the discipline of nursing. A. Propositions B. Assumptions C. Predictions D.
d. None of the above Process

49. Using a theoretical framework to guide 56. In what era is the outcome of Nursing
nursing practice will assist the nurse in which theoretical works shift the focus to the patient?
of the following?
a. Research Era

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b. Theory Era c. Workhouse Nursing: The Story of a

c. Graduate Education Era Successful Experiment
d. Curriculum Era d. Notes on Nursing
63. This called as the moment (focal
57. This is defined as specific to academia and point in space and time) when the nurse
refers to a branch of education , a department and another person come together in
of learning or a domain of knowledge. such a way that an occasion for human
caring is created
a. Discipline a. Carative Caring
b. Vocation b. Caring Occasion
c. Profession c. Caring Moment
d. Nursing d. Caring Affair
64. Which carative factor has this
58. A nurse tries to gather / collect data so the
clinical process "Engaging in genuine
physician can have a diagnosis of the patient.
teaching-learning experience that
This example falls under what principle of
attends to unity of being and
Epistemology?
meaning,attempting to stay within
a. Rationalism other’s frames of reference."
b. Empiricism a. Helping-trusting, human care
c. Hypothesis relationship
d. Theory b. Transpersonal teaching and learning
c. Faith-hope
59. This is a set of statements that tentatively d. Sensitivity to self and others
describe, explain, or predict relationships
among concepts that have been systematically 65. The Humanistic-altruistic system of
selected & organized as an abstract value corresponds to clinical process?
representation of some phenomenon (Powers & a. Developing and sustaining a helping-
Knapp) trusting, authentic caring relationship
b. Creative use of self and all ways of
a. Philosophy knowing as part of the caring process
b. Concepts to engage in artistry of caring-healing
c. Theory practices
d. Epistemology c. Practice of loving kindness and
equanimity (self-control/composure)
60. Florence Nightingale defined nursing within context of caring
as? consciousness
a. Nursing is the art of utilizing the d. Creative use of self and all ways of
patient’s environment for his or her knowing as part of the caring process
recovery to engage in artistry of caring-healing
b. Manipulation of the environment for practices
the benefits of the patient
c. Relationship between nurse and the
patient
d. Nursing is the art of caring for the
patient to achieve fast recovery
66. One major concept of Ray’s theory and
61. The nurse is actually in control of
defined as include money, budget, insurance
the environment, physically, and
systems, limitations and guidelines imposed by
administratively and is responsible for
managed care organizations, allocation of
controlling the environment so that the
human and material resources to maintain
patient is protected from physical and
services?
psychological harm - this falls on what
component of a healthy environment? a. Legal
a. Management b. Spiritual
b. Quiet c. Economic
c. Leadership d. Technological
d. Warmth
62. Which work of Florence Nightingale 67. This describes simultaneous order and
provided guidelines to women who disorder, and order within disorder. Ray
wanted to become nurses and gave compares change in complex organizations
advice on how to “think like a nurse.” ? with this creative process and challenges
a. Notes on Hospitals nurses to step back and renew their
b. To Her Nurses

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perceptions of everyday events, to discover the c. Competent

embedded meanings d. Proficient

a. Hubble Disk Theory

b. Chaos Theory
c. Order Theory 74. In what stage of dreyfus model is where is
d. Theory of Systematic Irregularity characterized by a person who lacks
background experience of the situation he or
68. It means that everything is a whole in one she is involved in.
context and a part in another - with each part
being in the whole and the whole being in the a. Advanced Beginner
part b. Competent
c. Novice
a. Holography d. Proficient
b. Histology
c. Holotheology 75. Kari Martinsen published a ____ of a book
d. Histography with the provocative title, Caring Without Care

69. Which metaparadigm is a spiritual and a. Lit Torch

cultural being. are created by God, the Mystery b. Special Note
of Being and engage co- creatively to find c. Philosophical Brand
meaning and value? d. Notable Perspective

a. Nursing 76. It is when empathy and reflection work

b. Person together in such a way that caring can be
c. Health expressed in nursing
d. Environment
a. Person-Oriented Professionalism
70. Gain perspective from planning own actions b. Sovereign Life Utterances
based on conscious, abstract and analytical c. Moral Practice
thinking and helps to achieve greater efficiency d. Professional Judgement and Discernment
and organization.
77. All of the following are the theoretical
a. Novice assertion of Martinsen’s theory EXCEPT:
b. Advanced Beginner
c. Competent a. People are created independent and
d. Expert relational.
b. Caring is the most natural and fundamental
71. The nurse can already show an intuitive aspect of the person's existence.
grasp of the situation based on background c. These are phenomena present in the service
understanding is in what level of expertise? of life.
d. To the created belong the sovereign life
a. Proficient utterances
b. Expert
c. Advanced Beginner 78. The act of caring contains the caring
d. Competent elements which includes all of the following,
EXCEPT:
72. The ______ nurse does not rely anymore on
the analytical principles of rules, guidelines, a. Faith, Hope, and Love
and maxims to connect her understanding of b. Tending, Playing, and Learning
the situation to an appropriate action c. Understanding, Trust, and Courtesy
d. None of the above
a. Advanced Beginner
b. Proficient 79. Defined as soundness, freshness, and well-
c. Expert being. Implies being whole in body, soul, and
d. Competent spirit.

73. Kim Go just passed the recently nursing a. Nursing Ethics

licensure examiniation and is now a newly b. Health
registered professional nurse. She is in what c. Nursing
level of expertise? d. Caring Ethic

a. Novice
b. Advanced Beginner

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80. Which of the following is the work of Katie

Eriksson?

a. Philosophy and Theory of Transpersonal

Caring
b. Theory of Caritative Caring
c. Philosophy of Caring
d. Theory of Bureaucratic Caring

81. It refers to the person’s ability to adapt to

his or her environment and is made up of four
levels of integration.

a. Organismic response
b. Inflammatory Response
c. Sensory Response
d. Response to Stress

82. It it’s the process by which individuals fit

the environments in which they live

a. Wholeness
b. Conservation
c. Adaptation
d. None of the Above

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 Model- Models are representations

of the interaction among and
between the concepts showing
What are Nursing Theories? patterns. They present an overview
of the theory’s thinking and may
Nursing theories are organized bodies demonstrate how theory can be
of knowledge to define what nursing is, introduced into practice.
what nurses do, and why they do it.  Conceptual framework- A
Nursing theories provide a way to conceptual framework is a group of
define nursing as a unique discipline related ideas, statements, or
that is separate from other disciplines concepts. It is often used
(e.g., medicine). It is a framework of interchangeably with the conceptual
concepts and purposes intended to model and with grand theories.
guide nursing practice at a more  Proposition- Propositions are
concrete and specific level. statements that describe the
relationship between the concepts.
Nursing, as a profession, is committed  Domain- The domain is the
to recognizing its own unparalleled perspective or territory of a
body of knowledge vital to nursing profession or discipline.
practice—nursing science. To distinguish  Process- Processes are organized
this foundation of knowledge, nurses steps, changes, or functions
need to identify, develop, and intended to bring about the desired
understand concepts and theories in result.
line with nursing. As a science, nursing  Paradigm- A paradigm refers to a
is based on the theory of what nursing pattern of shared understanding and
is, what nurses do, and why. Nursing is assumptions about reality and the
a unique discipline and is separate from world, worldview, or widely accepted
medicine. It has its own body of value system.
knowledge on which delivery of care is  Metaparadigm- A metaparadigm is
based. the most general statement of
discipline and functions as a
Defining Terms
framework in which the more
The development of nursing theory restricted structures of conceptual
demands an understanding of selected models develop. Much of the
terminologies, definitions, and theoretical work in nursing focused
assumptions. on articulating relationships among
four major concepts: person,
 Philosophy- These are beliefs and environment, health, and nursing.
values that define a way of thinking
and are generally known and History of Nursing Theories
understood by a group or discipline.
The first nursing theories appeared in
 Theory- A belief, policy, or
procedure proposed or followed as the late 1800s when a strong emphasis
the basis of action. It refers to a was placed on nursing education.
logical group of general propositions
used as principles of explanation.  In 1860, Florence Nightingale
Theories are also used to describe, defined nursing in her
predict, or control phenomena. “Environmental Theory” as “the act
 Concept- Concepts are often called of utilizing the patient’s environment
the building blocks of theories. They to assist him in his recovery.” In the
are primarily the vehicles of thought
1950s, there is a consensus among
that involve images.
nursing scholars that nursing needed

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to validate itself through the nurse is considered part of the

production of its own scientifically patient’s environment and the nurse-
tested body of knowledge. patient relationship is for meeting
 In 1952, Hildegard Peplau goals towards good health.
introduced her Theory of  In 1972, Betty Neuman, in her
Interpersonal Relations that theory, states that many needs exist,
emphasizes the nurse-client and each may disrupt client balance
relationship as the foundation of or stability. Stress reduction is the
nursing practice. goal of the system model of nursing
 In 1955, Virginia Henderson practice.
conceptualized the nurse’s role as  In 1979, Sr. Callista Roy viewed
assisting sick or healthy individuals the individual as a set of interrelated
to gain independence in meeting 14 systems that maintain the balance
fundamental needs. Thus her between these various stimuli.
Nursing Need Theory was developed.  In 1979, Jean Watson developed
 In 1960, Faye Abdellah published the philosophy of caring, highlighted
her work “Typology of 21 Nursing humanistic aspects of nursing as
Problems,” which shifted the focus of they intertwine with scientific
nursing from a disease-centered knowledge and nursing practice.
approach to a patient-centered
approach. The Nursing Metaparadigm
 In 1962, Ida Jean Orlando Four major concepts are frequently
emphasized the reciprocal interrelated and fundamental to nursing
relationship between patient and theory: person, environment,
nurse and viewed nursing’s health, and nursing. These four are
professional function as finding out collectively referred to as
and meeting the patient’s immediate metaparadigm for nursing.
need for help.
 In 1968, Dorothy Johnson Person
pioneered the Behavioral System
 Person (also referred to as Client
Model and upheld the fostering of
or Human Beings) is the recipient
efficient and effective behavioral
of nursing care and may include
functioning in the patient to prevent
individuals, patients, groups,
illness.
families, and communities.
 In 1970, Martha Rogers viewed
nursing as both a science and an art Environment
as it provides a way to view the
unitary human being, who is integral  Environment (or situation) is
with the universe. defined as the internal and
 In 1971, Dorothea Orem stated in external surroundings that affect
her theory that nursing care is the client. It includes all positive or
required if the client is unable to negative conditions that affect the
fulfill biological, psychological, patient, the physical environment,
developmental, or social needs. such as families, friends, and
 In 1971, Imogene King‘s Theory of significant others, and the setting
Goal attainment stated that the

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for where they go for their particular phenomenon. Concepts may

healthcare. be abstract or concrete.

Health  Abstract Concepts- Defined as

mentally constructed
 Health is defined as the degree of independently of a specific time or
wellness or well-being that the place.
client experiences. It may have  Concrete Concepts- Are directly
different meanings for each experienced and related to a
patient, the clinical setting, and particular time or place.
the health care provider.
Definitions- Definitions are used to
Nursing convey the general meaning of the
 The nurse’s attributes, concepts of the theory. Definitions can
characteristics, and actions be theoretical or operational.
provide care on behalf of or in  Theoretical Definitions- Define
conjunction with the client. There a particular concept based on the
are numerous definitions of theorist’s perspective.
nursing, though nursing scholars  Operational Definitions- States
may have difficulty agreeing on its how concepts are measured.
exact definition. The ultimate goal
of nursing theories is to improve Relational Statements- Relational
patient care. statements define the relationships
between two or more concepts. They
Components of Nursing Theories are the chains that link concepts to one
For a theory to be a theory, it has to another.
contain concepts, definitions, relational Assumptions- Assumptions are
statements, and assumptions that accepted as truths and are based on
explain a phenomenon. It should also values and beliefs. These statements
explain how these components relate to explain the nature of concepts,
each other. definitions, purpose, relationships, and
Phenomenon- A term given to structure of a theory.
describe an idea or response about an Why are Nursing Theories Important?
event, a situation, a process, a group of
events, or a group of situations. Nursing theories are the basis of
Phenomena may be temporary or nursing practice today. In many cases,
permanent. Nursing theories focus on nursing theory guides knowledge
the phenomena of nursing. development and directs education,
research, and practice. Historically,
Concepts- Interrelated concepts define nursing was not recognized as an
a theory. Concepts are used to help academic discipline or as a profession
describe or label a phenomenon. They we view today. Before nursing theories
are words or phrases that identify, were developed, nursing was
define, and establish structure and considered to be a task-oriented
boundaries for ideas generated about a occupation. The training and function of
nurses were under the direction and

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control of the medical profession. Let’s maintain and preserve its

take a look at the importance of nursing professional limits and
theory and its significance to nursing boundaries.
practice:  In many cases, nursing theories
guide knowledge development
 Nursing theories help recognize and directs education, research,
what should set the foundation of and practice, although each
practice by explicitly describing influences the others. (Fitzpatrick
nursing. and Whall, 2005).
 By defining nursing, a nursing
theory also helps nurses Purposes of Nursing Theories
understand their purpose and role
The primary purpose of theory in
in the healthcare setting.
nursing is to improve practice by
 Theories serve as a rationale or
positively influencing the health and
scientific reasons for nursing
quality of life of patients. Nursing
interventions and give nurses the
theories are also developed to define
knowledge base necessary for
and describe nursing care, guide
acting and responding
nursing practice, and provide a basis for
appropriately in nursing care
clinical decision-making. In the past, the
situations.
accomplishments of nursing led to the
 Nursing theories provide the
recognition of nursing in an academic
foundations of nursing practice,
discipline, research, and profession.
generate further knowledge, and
indicate which direction nursing In Academic Discipline
should develop in the future
(Brown, 1964). Much of the earlier nursing programs
 By providing nurses a sense of identified the major concepts in one or
identity, nursing theory can help two nursing models, organized the
patients, managers, and other concepts, and build an entire nursing
healthcare professionals to curriculum around the created
acknowledge and understand the framework. These models’ unique
unique contribution that nurses language was typically introduced into
make to the healthcare service program objectives, course objectives,
(Draper, 1990). course descriptions, and clinical
 Nursing theories prepare the performance criteria. The purpose was
nurses to reflect on the to explain the fundamental implications
assumptions and question the of the profession and enhance the
nursing values, thus further profession’s status.
defining nursing and increasing
In Research
the knowledge base.
 Nursing theories aim to define, The development of theory is
predict, and demonstrate nursing fundamental to the research process,
phenomenon (Chinn and Jacobs, where it is necessary to use theory as a
1978). framework to provide perspective and
 It can be regarded as an attempt guidance to the research study. Theory
by the nursing profession to can also be used to guide the research

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process by creating and testing  Grand nursing theories do not guide

phenomena of interest. To improve the specific nursing interventions but
nursing profession’s ability to meet rather provide a general framework
societal duties and responsibilities, and nursing ideas.
there needs to be a continuous  Grand nursing theorists develop their
reciprocal and cyclical connection with works based on their own
theory, practice, and research. This will experiences and their time,
help connect the perceived “gap” explaining why there is so much
between theory and practice and variation among theories.
promote the theory-guided practice.  Address the nursing metaparadigm
components of person, nursing,
In Profession health, and environment.
Clinical practice generates research
questions and knowledge for theory. In
a clinical setting, its primary Middle-Range Nursing Theories
contribution has been the facilitation of
 More limited in scope (compared to
reflecting, questioning, and thinking
grand theories) and present
about what nurses do. Because nurses
concepts and propositions at a lower
and nursing practice are often
level of abstraction. They address a
subordinate to powerful institutional
specific phenomenon in nursing.
forces and traditions, introducing any
 Due to the difficulty of testing grand
framework that encourages nurses to
theories, nursing scholars proposed
reflect on, question, and think about
using this level of theory.
what they do provide an invaluable
 Most middle-range theories are
service.
based on a grand theorist’s works,
Classification of Nursing Theories but they can be conceived from
research, nursing practice, or the
There are different ways to categorize theories of other disciplines.
nursing theories. They are classified
depending on their function, levels of Practice-Level Nursing Theories
abstraction, or goal orientation.
 Practice nursing theories are
By Abstraction situation-specific theories that are
narrow in scope and focuses on a
There are three major categories when specific patient population at a
classifying nursing theories based on specific time.
their level of abstraction: grand theory,  Practice-level nursing theories
middle-range theory, and practice-level provide frameworks for nursing
theory. interventions and suggest outcomes
Grand Nursing Theories or the effect of nursing practice.
 Theories developed at this level have
 Grand theories are abstract, broad in a more direct effect on nursing
scope, and complex, therefore practice than more abstract theories.
requiring further research for  These theories are interrelated with
clarification. concepts from middle-range theories
or grand theories.

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By Goal Orientation Nursing Philosophies

Theories can also be classified based on Florence Nightingale

their goals. They can
 Founder of Modern Nursing and
be descriptive or prescriptive.
Pioneer of the Environmental
Descriptive Theories Theory.
 Defined Nursing as “the act of
 Descriptive theories are the first utilizing the environment of the
level of theory development. They patient to assist him in his recovery.”
describe the phenomena and identify  Stated that nursing “ought to signify
its properties and components in the proper use of fresh air, light,
which it occurs. warmth, cleanliness, quiet, and the
 Descriptive theories are not action- proper selection and administration
oriented or attempt to produce or of diet – all at the least expense of
change a situation. vital power to the patient.”
 There are two types of descriptive  Identified five (5) environmental
theories: factor-isolating factors: fresh air, pure water,
theory and explanatory theory. efficient drainage, cleanliness or
sanitation, and light or direct
sunlight.

Hildegard E. Peplau

 Pioneered the Theory of

Factor-Isolating Theory Interpersonal Relations
 Peplau’s theory defined Nursing as
 Also known as category-formulating
“An interpersonal process of
or labeling theory.
therapeutic interactions between an
 Theories under this category
individual who is sick or in need of
describe the properties and
health services and a nurse specially
dimensions of phenomena.
educated to recognize, respond to
Explanatory Theory the need for help.”
 Her work is influenced by Henry
 Explanatory theories describe and Stack Sullivan, Percival
explain the nature of relationships of Symonds, Abraham Maslow, and
certain phenomena to other Neal Elgar Miller.
phenomena.  It helps nurses and healthcare
providers develop more therapeutic
Prescriptive Theories
interventions in the clinical setting.
 Address the nursing interventions for
Virginia Henderson
a phenomenon, guide practice
change, and predict consequences.  Developed the Nursing Need Theory
 Includes propositions that call for  Focuses on the importance of
change. increasing the patient’s
 In nursing, prescriptive theories are independence to hasten their
used to anticipate the outcomes of progress in the hospital.
nursing interventions.

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 Emphasizes the basic human needs Lydia E. Hall

and how nurses can assist in
 Developed the Care, Cure, Core
meeting those needs.
Theory is also known as the “Three
 “The nurse is expected to carry out a
Cs of Lydia Hall.“
physician’s therapeutic plan, but
 Hall defined Nursing as the
individualized care is the result of
“participation in care, core and cure
the nurse’s creativity in planning for
aspects of patient care, where CARE
care.”
is the sole function of nurses,
Faye Glenn Abdellah whereas the CORE and CURE are
shared with other members of the
 Developed the 21 Nursing Problems health team.”
Theory  The major purpose of care is to
 “Nursing is based on an art and achieve an interpersonal relationship
science that molds the attitudes, with the individual to facilitate the
intellectual competencies, and development of the core.
technical skills of the individual  The “care” circle defines a
nurse into the desire and ability to professional nurse’s primary role,
help people, sick or well, cope with such as providing bodily care for the
their health needs.” patient. The “core” is the patient
 Changed the focus of nursing from receiving nursing care. The “cure” is
disease-centered to patient-centered the aspect of nursing that involves
and began to include families and the administration of medications
the elderly in nursing care. and treatments.
 The nursing model is intended to
guide care in hospital institutions but Joyce Travelbee
can also be applied to community
 States in her Human-to-Human
health nursing, as well.
Relationship Model that the purpose
Ernestine Wiedenbach of nursing was to help and support
an individual, family, or community
 Developed The Helping Art of Clinical to prevent or cope with the struggles
Nursing conceptual model. of illness and suffering and, if
 Definition of nursing reflects on necessary, to find significance in
nurse-midwife experience as “People these occurrences, with the ultimate
may differ in their concept of goal being the presence of hope.
nursing, but few would disagree that  Nursing was accomplished through
nursing is nurturing or caring for human-to-human relationships.
someone in a motherly fashion.”  Extended the interpersonal
 Guides the nurse action in the art of relationship theories of Peplau and
nursing and specified four elements Orlando.
of clinical nursing: philosophy,
purpose, practice, and art. Kathryn E. Barnard
 Clinical nursing is focused on
 Developed the Child Health
meeting the patient’s perceived
Assessment Model.
need for help in a vision of nursing
 Concerns improving the health of
that indicates considerable
infants and their families.
importance on the art of nursing.

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 Her findings on parent-child of Living and prepared a monograph

interaction as an important predictor entitled The Roper-Logan-Tierney
of cognitive development helped Model of Nursing: Based on Activities
shape public policy. of Daily Living.
 She is the founder of the Nursing  Includes maintaining a safe
Child Assessment Satellite Training environment, communicating,
Project (NCAST), which produces and breathing, eating and drinking,
develops research-based products, eliminating, personal cleansing and
assessment, and training programs dressing, controlling body
to teach professionals, parents, and temperature, mobilizing, working
other caregivers the skills to provide and playing, expressing sexuality,
nurturing environments for young sleeping, and dying.
children.
Ida Jean Orlando
 Borrows from psychology and human
development and focuses on mother-  She developed the Nursing Process
infant interaction with the Theory.
environment.  “Patients have their own meanings
 Contributed a close link to practice and interpretations of situations, and
that has modified the way health therefore nurses must validate their
care providers assess children in inferences and analyses with
light of the parent-child relationship. patients before drawing
Evelyn Adam conclusions.”
 Allows nurses to formulate an
 Focuses on the development of effective nursing care plan that can
models and theories on the concept also be easily adapted when and if
of nursing. any complexity comes up with the
 Includes the profession’s goal, the patient.
beneficiary of the professional  According to her, persons become
service, the role of the professional, patients requiring nursing care when
the source of the beneficiary’s they have needs for help that cannot
difficulty, the intervention of the be met independently because of
professional, and the consequences. their physical limitations, negative
 A good example of using a unique reactions to an environment, or
basis of nursing for further experience that prevents them from
expansion. communicating their needs.
 The role of the nurse is to find out
Nancy Roper, Winifred Logan, and and meet the patient’s immediate
Alison J. Tierney needs for help.
 A Model for Nursing Based on a Jean Watson
Model of Living
 Logan produced a simple theory,  She pioneered the Philosophy and
“which actually helped bedside Theory of Transpersonal Caring.
nurses.”  “Nursing is concerned with
 The trio collaborated in the fourth promoting health, preventing illness,
edition of The Elements of Nursing: A caring for the sick, and restoring
Model for Nursing Based on a Model health.”

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 Mainly concerns with how nurses  Attempts to assert and reestablish

care for their patients and how that nurses’ caring practices when nurses
caring progresses into better plans to are rewarded more for efficiency,
promote health and wellness, technical skills, and measurable
prevent illness and restore health. outcomes.
 Focuses on health promotion, as well  States that caring practices are
as the treatment of diseases. instilled with knowledge and skill
 Caring is central to nursing practice regarding everyday human needs.
and promotes health better than a
Kari Martinsen
simple medical cure.
 Philosophy of Caring
Marilyn Anne Ray
 “Nursing is founded on caring for life,
 Developed the Theory of on neighborly love, At the same
Bureaucratic Caring time, the nurse must be
 “Improved patient professionally educated.”
safety, infection control, reduction  Human beings are created and are
in medication errors, and overall beings for whom we may have
quality of care in complex administrative responsibility.
bureaucratic health care systems  Caring, solidarity, and moral practice
cannot occur without knowledge and are unavoidable realities.
understanding of complex
Katie Eriksson
organizations, such as the political
and economic systems, and spiritual-  Theory of Carative Caring
ethical caring, compassion and right  “Caritative nursing means that we
action for all patients and take ‘caritas’ into use when caring
professionals.” for the human being in health and
 Challenges participants in nursing to suffering. Caritative caring is a
think beyond their usual frame of manifestation of the love that ‘just
reference and envision the world exists’. Caring communion, true
holistically while considering the caring, occurs when the one caring
universe as a hologram. in a spirit of caritas alleviates the
 Presents a different view of how suffering of the patient.”
health care organizations and  The ultimate goal of caring is to
nursing phenomena interrelate as lighten suffering and serve life and
wholes and parts in the system. health.
 Inspired many in the Nordic countries
Patricia Benner
and used it as the basis of research,
 Caring, Clinical Wisdom, and Ethics education, and clinical practice.
in Nursing Practice
Myra Estrin Levine
 “The nurse-patient relationship is not
a uniform, professionalized blueprint  According to the Conservation Model,
but rather a kaleidoscope of intimacy “Nursing is human interaction.”
and distance in some of the most  Provides a framework within which to
dramatic, poignant, and mundane teach beginning nursing students.
moments of life.”

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 Logically congruent, externally and  “Nursing is a process of action,

internally consistent, has breadth reaction and interaction by which
and depth, and is understood, with nurse and client share information
few exceptions, by professionals and about their perception in a nursing
consumers of health care. situation” and “a process of human
interactions between nurse and
Martha E. Rogers client whereby each perceives the
 In Roger’s Theory of Human Beings, other and the situation, and through
she defined Nursing as “an art and communication, they set goals,
science that is humanistic and explore means, and agree on means
humanitarian. to achieve goals.”
 The Science of Unitary Human  Focuses on this process to guide and
Beings contains two dimensions: the direct nurses in the nurse-patient
science of nursing, which is the relationship, going hand-in-hand with
knowledge specific to the field of their patients to meet good health
nursing that comes from scientific goals.
research; and the art of nursing,  Explains that the nurse and patient
which involves using nursing go hand-in-hand in communicating
creatively to help better the lives of information, set goals together, and
the patient. then take actions to achieve those
 A patient can’t be separated from his goals.
or her environment when addressing Betty Neuman
health and treatment.
 In Neuman’s System Model, she
Dorothea E. Orem defined nursing as a “unique
 In her Self-Care Theory, she defined profession in that is concerned with
Nursing as “The act of assisting all of the variables affecting an
others in the provision and individual’s response to stress.”
management of self-care to maintain  The focus is on the client as a
or improve human functioning at the system (which may be an individual,
home level of effectiveness.” family, group, or community) and on
 Focuses on each individual’s ability the client’s responses to stressors.
to perform self-care.  The client system includes five
 Composed of three interrelated variables (physiological,
theories: (1) the theory of self-care, psychological, sociocultural,
(2) the self-care deficit theory, and developmental, and spiritual). It is
(3) the theory of nursing systems, conceptualized as an inner core
which is further classified into wholly (basic energy resources) surrounded
compensatory, partially by concentric circles that include
compensatory, and supportive- lines of resistance, a normal defense
educative. line, and a flexible line of defense.

Imogene M. King Sister Callista Roy

 Conceptual System and Middle-  In Adaptation Model, Roy defined

Range Theory of Goal Attainment nursing as a “health care profession
that focuses on human life processes

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and patterns and emphasizes the persons living to care and growing
promotion of health for individuals, in caring.”
families, groups, and society as a  Caring in nursing is “an altruistic,
whole.” active expression of love, and is the
 Views the individual as a set of intentional and embodied
interrelated systems that strives to recognition of value and
maintain a balance between various connectedness.”
stimuli.
Afaf Ibrahim Meleis
 Inspired the development of many
middle-range nursing theories and  Transitions Theory
adaptation instruments.  It began with observations of
experiences faced as people deal
Dorothy E. Johnson
with changes related to health,
 The Behavioral System well-being, and the ability to care
Model defined Nursing as “an for themselves.
external regulatory force that acts to  Types of transitions include
preserve the organization and developmental, health and illness,
integrate the patients’ behaviors at situational, and organizational.
an optimum level under those  Acknowledges the role of nurses as
conditions in which the behavior they help people go through
constitutes a threat to the physical health/illness and life transitions.
or social health or in which illness is  Focuses on assisting nurses in
found.” facilitating patients’, families’, and
 Advocates to foster efficient and communities’ healthy transitions.
effective behavioral functioning in
Nola J. Pender
the patient to prevent illness and
stresses the importance of research-  Health Promotion Model
based knowledge about the effect of  Describes the interaction between
nursing care on patients. the nurse and the consumer while
 Describes the person as a behavioral considering the role of the health
system with seven subsystems: the promotion environment.
achievement, attachment-affiliative,  It focuses on three areas: individual
aggressive-protective, dependency, characteristics and experiences,
ingestive, eliminative, and sexual behavior-specific cognitions and
subsystems. affect, and behavioral outcomes.
 Describes the multidimensional
Anne Boykin and Savina O.
nature of persons as they interact
Schoenhofer
within their environment to pursue
 The Theory of Nursing as Caring: A health.
Model for Transforming Practice
Madeleine M. Leininger
 Nursing is an “exquisitely
interwoven” unity of aspects of the  Culture Care Theory of Diversity and
discipline and profession of nursing. Universality
 Nursing’s focus and aim as a  Defined transcultural nursing as “a
discipline of knowledge and a substantive area of study and
professional service are “nurturing

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practice focused on comparative  Human Becoming Theory

cultural care (caring) values, beliefs,  “Nursing is a science, and the
and practices of individuals or groups performing art of nursing is practiced
of similar or different cultures to in relationships with persons
provide culture-specific and universal (individuals, groups, and
nursing care practices in promoting communities) in their processes of
health or well-being or to help people becoming.”
to face unfavorable human  Explains that a person is more than
conditions, illness, or death in the sum of the parts, the
culturally meaningful ways.” environment, and the person is
 Involves learning and understanding inseparable and that nursing is a
various cultures regarding nursing human science and art that uses an
and health-illness caring practices, abstract body of knowledge to help
beliefs, and values to implement people.
significant and efficient nursing care  It centered around three themes:
services to people according to their meaning, rhythmicity, and
cultural values and health-illness transcendence.
context.
Helen C. Erickson, Evelyn M.
 It focuses on the fact that various
Tomlin, and Mary Ann P. Swain
cultures have different and unique
caring behaviors and different health  Modeling and Role-Modeling
and illness values, beliefs, and  “Nursing is the holistic helping of
patterns of behaviors. persons with their self-care activities
in relation to their health . . . The
Margaret A. Newman
goal is to achieve a state of
 Health as Expanding Consciousness perceived optimum health and
 “Nursing is the process of contentment.”
recognizing the patient in relation to  Modeling is a process that allows
the environment, and it is the nurses to understand the unique
process of the understanding of perspective of a client and learn to
consciousness.” appreciate its importance.
 “The theory of health as expanding  Role-modeling occurs when the
consciousness was stimulated by nurse plans and implements
concern for those for whom health as interventions that are unique for the
the absence of disease or disability is client.
not possible . . . “
Gladys L. Husted and James H.
 Nursing is regarded as a connection
Husted
between the nurse and patient, and
both grow in the sense of higher  Created the Symphonological
levels of consciousness. Bioethical Theory
 “Symphonology (from ‘symphonia,’ a
Greek word meaning agreement) is a
system of ethics based on the terms
and preconditions of an agreement.”
Rosemarie Rizzo Parse

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 Nursing cannot occur without both chronic illness and organize nursing
nurse and patient. “A nurse takes no interventions to promote optimal
actions that are not interactions.” adjustment.
 Founded on the singular concept of  Describes how individuals form
human rights, the essential meaning from illness-related
agreement of non-aggression among situations.
rational people forms the foundation  The original theory’s concepts were
of all human interaction. organized in a linear model around
the following three major themes:
Antecedents of uncertainty, Process
of uncertainty appraisal, and Coping
with uncertainty.
Ramona T. Mercer
Pamela G. Reed
 Maternal Role Attainment—Becoming
a Mother  Self-Transcendence Theory
 “Nursing is a dynamic profession  Self-transcendence refers to the
with three major foci: health fluctuation of perceived boundaries
promotion and prevention of illness, that extend the person (or self)
providing care for those who need beyond the immediate and
professional assistance to achieve constricted views of self and the
their optimal level of health and world (Reed, 1997).
functioning, and research to enhance  Has three basic concepts:
the knowledge base for providing vulnerability, self-transcendence,
excellent nursing care.” and well-being.
 “Nurses are the health professionals  Gives insight into the developmental
having the most sustained and nature of humans associated with
intense interaction with women in health circumstances connected to
the maternity cycle.” nursing care.
 Maternal role attainment is an Carolyn L. Wiener and Marylin J.
interactional and developmental Dodd
process occurring over time. The
mother becomes attached to her  Theory of Illness Trajectory
infant, acquires competence in the  “The uncertainty surrounding a
caretaking tasks involved in the role, chronic illness like cancer is the
and expresses pleasure and uncertainty of life writ large. By
gratification. (Mercer, 1986). listening to those who are
 Provides proper health care tolerating this exaggerated
interventions for nontraditional uncertainty, we can learn much
mothers for them to favorably adopt about the trajectory of living.”
a strong maternal identity.  Provides a framework for nurses
to understand
Merle H. Mishel how cancer patients stand
 Uncertainty in Illness Theory uncertainty manifested as a loss
 Presents a comprehensive structure of control.
to view the experience of acute and  Provides new knowledge on how
patients and families endure

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uncertainty and work strategically  Theory of Comfort

to reduce uncertainty through a  “Comfort is an antidote to the
dynamic flow of illness events, stressors inherent in health care
treatment situations, and varied situations today, and when comfort
players involved in care is enhanced, patients and families
organization. are strengthened for the tasks
ahead. Also, nurses feel more
Georgene Gaskill Eakes, Mary satisfied with the care they are
Lermann Burke, and Margaret A. giving.”
Hainsworth  Patient comfort exists in three forms:
 Theory of Chronic Sorrow relief, ease, and transcendence.
 “Chronic sorrow is the presence of These comforts can occur in four
pervasive grief-related feelings that contexts: physical, psychospiritual,
have been found to occur environmental, and sociocultural.
periodically throughout the lives of  As a patient’s comfort needs change,
individuals with chronic health the nurse’s interventions change, as
conditions, their family caregivers well.
and the bereaved.” Cheryl Tatano Beck
 This middle-range theory defines the
aspect of chronic sorrow as a normal  Postpartum Depression Theory
response to the ongoing disparity  “The birth of a baby is an occasion
created by the loss. for joy—or so the saying goes […]
But for some women, joy is not an
Phil Barker option.”
 Barker’s Tidal Model of Mental  Described nursing as a caring
Health Recovery is widely used in profession with caring obligations to
mental health nursing. persons we care for, students, and
 It focuses on nursing’s fundamental each other.
care processes, is universally  Provides evidence to understand and
applicable, and is a practical guide prevent postpartum depression.
for psychiatry and mental health Kristen M. Swanson
nursing.
 Draws on values about relating to  Theory of Caring
people and help others in their  “Caring is a nurturing way of relating
moments of distress. The values of to a valued other toward whom one
the Tidal Model are revealed in the feels a personal sense of
Ten Commitments: Value the voice, commitment and responsibility.”
Respect the language, Develop  Defines nursing as informed caring
genuine curiosity, Become the for the well-being of others.
apprentice, Use the available toolkit,  Offers a structure for improving up-
Craft the step beyond, Give the gift to-date nursing practice, education,
of time, Reveal personal wisdom, and research while bringing the
Know that change is constant, and discipline to its traditional values and
Be transparent. caring-healing roots.

Katharine Kolcaba

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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.

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