CHAPTER 2

IMPORTANCE OF NURSING THEORY

This chapter include importance of nursing theory in nursing clinical practice, nursing education
and nursing research. It will help students better understand the application of nursing theory in the
three major areas of expertise of nursing discipline.

Duration: 1.5 hours

MAJOR TOPICS
Importance of Nursing Theory in:

1. Clinical Practice
2. Nursing Education
3. Nursing Research

Activities:

1. Critical Thinking Exercises

Before you proceed…

Intended Learning Outcomes:

1. Create a conceptual model based on current needs in nursing practice, administration and
education

Key Terms:

 Clinical Practice
 Health Care Providers
 Nursing Education
 Nursing Curriculum
A. CLINICAL PRACTICE
 Assists nurse to describe, explain, & predict everyday experiences
 Serves to guide assessment, intervention, and evaluation of nursing care
 Provides a rationale for collecting reliable data about the health status of clients  essential
for decision-making & implementation
 Helps to establish criteria to measure the quality of nursing care
 Helps build a common nursing terminology to use in communicating with other HCPs
 Enhances autonomy of nursing through defining its own independent functions

B. EDUCATION
 Provides a general focus for curriculum design
 Guides curricular decision making

C. RESEARCH
 Offers a framework for generating knowledge & new ideas
 Assists in discovering knowledge gaps in the specific field of study
 Offers a systematic approach to identify questions for study, select variables, interpret
findings & validate nursing interventions
 CHAPTER 3
FOUR WAYS OF KNOWING

MAJOR TOPICS
The four ways of knowing:

1. Empirics Knowing
2. Ethical Knowing
3. Esthetics Knowing
4. Personal Knowledge

Key Terms:

 Esthetics
 Ethics
 Empirics
 Personal Knowledge

Let’s Begin!

"Nursing depends on the scientific knowledge of human behavior in health and in illness, the
esthetic perception of significant human experiences, a personal understanding of the unique
individuality of the self, and the capacity to make choices within concrete situations involving
particular moral judgments."Barbara A. Carper, 1978
FOUR WAYS OF KNOWING

1. EMPIRICAL
 denotes information gained by means of observation, experience, or experiment thus it is
objective, abstract, generally quantifiable, exemplary and verifiable
 when verified through repeated testing overtime, it is formulated into scientific generalizations,
laws, theories and principles that explain and predict.
 Most emphasized way of knowing in nursing because there is a need to know how knowledge
can be organized into laws and theories for the purpose of describing, explaining and predicting
phenomena of concern to nurses

2. ETHICS
 Being in accordance with the accepted principles of right and wrong that govern the conduct of
a profession
 In nursing, it refers to the moral code in nursing and is based on obligation to service and
respect to human life.
 Ethical knowledge occurs as moral dilemnas arise in situations of ambiguity and uncertainty and
when consequences are difficult to predict.
 Requires rational and deliberate examination and evaluation of what is good, valuable,
desirable as goals motives or characteristics.

3. AESTHETICS/ ESTHETICS
 Is a branch of philosophy dealing with the nature of beauty, art, and taste, and with the
creation and appreciation of beauty.
 Relies on perception
 It is expressive, subjective, unique and experiential rather than formal or descriptive.
 It involves sensing the meaning of the moment
 It is evident through actions, attitudes and interactions of the nurse in response to another. It is
not usually expressed in language.

4. PERSONAL
 Knowledge of the self, individual’s, private, owned
 Incorporates experience, knowing, encountering and actualizing the self within the practice.
 Personal maturity and freedom are components of personal knowledge.
 Expressed in personality
 CHAPTER 4

DEVELOPMENT PROCESS OF THEORY IN NURSING

MAJOR TOPICS
Development Process Of Theory In Nursing:
A. Rationalism
B. Empiricism
C. Science in Theory in the 20th Century
c.1 Early 20th century views of science and theory
c.2 Emergent views of science and theory in the late 20 th century

Key Terms:

 Scientist
 Philosopher
 Empiricism
 Rationalis
I. EMPIRICISM

 Knowledge can be derived only from sensory experience (seeing, feeling and hearing
facts)
 Empiricist view believes that scientific truth was discovered through g eneralizing
observed facts in natural world
 Also called the inductive method- to formulate generalizations
 Research- then- theory method
 perceived by the senses to observe & collect data

II. RATIONALISM

 Making use of reason as the appropriate method for advancing knowledge

 Uses from the cause to an effect or from a generalization to a particular instance
 Uses deductive logic
 Theory –then –research method

III. EARLY 20TH CENTURY VIEWS OF SCIENCE AND THEORY

 Philosophers focused on the analysis of theory structure

 Scientists  focused on empirical research knowledge should not only be based on
existing understanding but what is still to be observed
 MAJOR DEVELOPMENTS:
- Experimentation
- Positivism believes that empirical research and logical analysis (deductive and
inductive were two approaches that would produce scientific knowledge
- EMPIRICAL & OBJECTIVE DATA co-exist

IV. EMERGENT VIEWS OF SCIENCE AND THEORY IN THE LATE 20TH CENTURY

 Emphasized that science was a process of continuously building research rather than a
product of findings emphasis shifted to understanding scientific discovery and process as
theories change over time
 A new epistemology challenging the empiricist view proposing that theories play an
important role in determining what the scientists observe and how it is interpreted an
observation is influenced by the values and ideas in the mind of the observer
 Three different views of the relationship between theories and observation:
1. Scientists are merely passive observers of occurrences in the empirical world.
Observable data are objective truth waiting to be discovered.
2. Theories structure what the scientist perceives in the empirical world
3. Presupposed theories and observable data interact in the process of scientific
investigation.
 Science is ongoing process  as the best approach to patient care based upon current
science may change with time. (When hew problems or a new way to interpret observation
emerges, a change in the way we think and do things occurs.)
 CHAPTER 5

CATEGORIES OF THEORIES

MAJOR TOPICS
 Micro-range(Practice Theories)
 Middle range theories
 Grand theories
 Non-Nursing Theories
-Human Need theory
-Systems Theory
-Change Theory

Key Terms:
 Micro Range Theories
 Middle Range Theories
 Grand Theories
Let’s Begin!

MICRO RANGE THEORY

 Also known as practice theory

 is a linking of concrete concepts into a statement that can be examined in practice and
research
 Concepts used are narrowly defined, list specific goal and action
 Least complex in nature and more specific than middle range
 Provide specific directions and limited to specific populations
 Examples: Social Learning theory, Stress and Coping

MIDDLE RANGE THEORY

 Deals with portion of nursing’s total concern but not with the totality of the discipline
 They are moderately abstract and inclusive but are composed of concepts and
propositions that are measurable
 Middle Range Theories are considered to be more helpful to nursing practice
 They have narrower focus than grand theory, more precise than grand theories & focus
on developing theoretical statements to answer questions about nursing
 Middle range theories covers such concepts as pain, symptoms management, cultural
issues and health promotion
 Examples: Theory of adaptation to chronic pain (Dunn, 2004), Theory of caregiver
stress( Tsai,2003)

GRAND THEORY

 Any theory which attempts an overall explanation of human experiences

 Abstract and do not easily lend themselves to application or testing
 Tend to include views on person, health and environment to create a perspective of
nursing
 Several well-known nursing theorists whose grand theories have served as a basis for
practice and research
 Grand Theories does not prescribe actions but rather provide structural framework
 Examples: Madeleine Leininger’s CULTURAL CARE, DIVERSITY & UNIVERSALITY; Betty
Neuman’s HEALTH CARE SYSTEMS MODEL; Imogene King’s GOAL ATTAINMENT
THEORY; Florence Nightingale’s ENVIRONMENTAL THEORY

NON NURSING THEORIES

1. HUMAN NEEDS THEORY

  The physiological needs.  oxygen, water, protein, salt, sugar, calcium, and other
minerals & vitamins. the need to maintain a pH balance (getting too acidic or base will
kill you) and temperature.  there’s the needs to be active, to rest, to sleep, to get rid of
wastes (CO2,  sweat, urine, and feces), to avoid pain, and to have sex.

 The safety and security needs.  When physiological needs are largely taken care of. You
will become increasingly interested in finding safe circumstances, stability, protection.

 The love and belonging needs.  When physiological needs and safety needs are, a third
layer starts to show up.  You begin to feel the need for friends, a sweetheart, children,
affectionate relationships in general, even a sense of community.

 The esteem needs.  Next, we begin to look for a little self-esteem. (FAME,GLORY SELF-
RESPECT)

 Self-actualization - continuous desire to fulfill potentials, to “be all that you can be.” 
They are a matter of becoming the most complete, the fullest, “you” -- hence the term,
self-actualization.

2. SYSTEMS THEORY

 Considers a system as a set of independent and interacting parts.

  The main goal is to study general principles of system functioning to be applied to all
types of system in all fields of research

3. CHANGE THEORY

 Provides the ability to identify strategic communication needs and allows identification of
the obstacles to the accomplishment of change
 Teaches patience in the achievement of change as well as the importance of flexibility
on the part of management in achieving change objectives.
 Concept that change is constant but resistance to change is normal