Theoretical

Foundations of
Nursing
that will build the foundation of the nurse in YOU!
 Developmental Theories
Human development takes on 3
theoretical perspectives

1.Environmentalism 3.
Psychoanalyic perspective

2.
Organismic perspective

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Modern Perspective in Development
Environmentalist •The human being is an empty organism at birth
British Empiricism •The human being is passive, and development is totally achieved by experiencing the
Behaviorism environment.
Cultural Anthropology •The adults role is to shape the child according to socially accepted standards of behavior.

Organismic •The human being is active in determning its own course of development
Naturalism
Maturationism •Interaction occurs between orgaism and environment so that both are involved in varying
Cognitive Developmental degrees in the process of development.
Theory
Humanism
Ethology
Moral Development Theory

Psychanalytic The human being is not rational but is governed by emotion or appetite
Psychoanalysis Development is a process of continuous compromise between the individuals needs and
society’s expectations.

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ENVIRONMENTALISM
The view emphasizes that people grow to what they are made to be by their environments

INCLUDES:

British Empiricism Behaviorism

Cultural Anthropology

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British Empiricism
The origin of modern environmentalist perspectives can be traced to
the ideas of John Locke (1632-1704) who believed that the human
mind is a “Blank Slate” at birth, and that all knowledge of the world
comes to us through our senses. Children are uncivilized creatures
who need adults to shape them into everything they will eventually
become.

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Behaviorism
Icon John B. Watson (1878-1958) believed that the only way to understand the
human organism is through objective observation of behaviors. For him,
environmental experiences imposes itself on the person through principles of
conditioning and reinforcement. The only behavior worth studying is learned
behavior.
B.F. Skinner defined operant conditioning as a learning process that depends
on reward and punishment. He also talked about the principle of
reinforcement. According to Skinner, reinforcement or the perceived
consequences of behavior, influences the frequency with which the behavior
occurs.
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Behaviorism
Icon Albert Bandura (1960s) developed the perspective known as social
learning and the key concept is that development is guided by the
initiation or avoidance of behavior that is modeled by other people. By
observing the consequences of someone else’s action, people could
learn how to brush their teeth or how to ride a bicycle.

Howard and Tracey Lendler (1950’s-1960s) discovered

developmental differences in the ways children and adults learn and
solve problems in laboratory settings. They repeat rewarded
behaviors and delete behaviors that are not rewarded.
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Cultural Anthropology
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Margaret Mead (1901-1978) and Ruth Benedict (1887-1948)

emphasized the experiential factors in development and claimed that
different patterns of child rearing that reflect diverse cultural values
would result in a considerable variety of adult characteristics.

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 INCLUDES:

Icon Naturalism .Maturationism

ORGANISMIC
PERSPECTIVE Icon Cognitive Development Theory

Stress the importance of

factors within the organism Icon Humanism .Ethology
itself. People grow to what
they make of themselves
to be rather than what the Icon Moral Development Theory
environment makes them
 Naturalism INCLUDES:

Icon Animal feelings of pleasure & pain

(0-5 yrs)
Icon Savage sensory awareness
(5-12 yrs)

(1712-1778) Icon Rational functioning and exploration

Jean Jacques Rousseau’s (12-15 yrs)
(1712-1778) philosophy
Icon Emotional and Social interests
stresses that children are
innately good unless ( 15-20 yrs)
corrupted by society’s
evils. There are five stages
Icon Spiritual maturity during adulthood
that corresponds to the
evolution of human nature.
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Maturationism
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Hall believed that the individual development of a child repeats
the phases of human evolution and describes adolescence as
a period of “storm & stress” corresponding to a turbulent state
of western civilization.

Gesell emphasized internal biological factors in development

virtually ignoring the role of the environment. He advocated the
“Normative Tradition” of developmental analysis

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Cognitive Development Theory

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Emphasizes internal mental processes and their interactions with

the environment.

Cognitive developmentalists like Jean Piaget (1896-1980)

attempt to explain how the individual thinks and how human
processes vary.

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 Cognitive Developmental Theory by Jean Piaget
Sensorimotor infant develops physically with a gradually increase in the
(0-2 years) ability to think and use language; progresses from
simple reflex responses to repetitive behaviors to
deliberate and imaginative activity

Pre-operational child begins to understand relationships and develops basic

(2-7 years) conceptual thought stage

Concrete Operation thinking is more socialized and logical; with increased

(7-11 years) intellectual and conceptual development; begins
problem solving by use of inductive reasoning and
logical thought
Formal Operation LOGICALLY SOLVES all types of problems; thinks
(11 years – above) SCIENTIFICALLY; solves COMPLEX problems; COGNITIVE
structures mature.

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Humanism
Focus on the dignity and freedom of all individuals. Humanists like
Abraham Maslow (1890-1970), Charlotte Buhler (1893-1974) and Carl
Rogers (1902-1988) rejected the view of human nature that emphasizes
environmental control and observable actions. Instead they stressed
internal factors and self-perception

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 Hierarchy of need Theory
SELF – Abraham Maslow
ACTUALIZATION

COGNITIVE NEEDS
Fulfillment of unique
To know and understand, explain, potential
and analyze

SELF ESTEEM
Self esteem and respect; prestige

LOVE AND BELONGING

Giving and receiving affection; companionship;
group identification
AESTHETIC NEEDS
Order, beauty, and symmetry
SAFETY
Avoiding harm; security; and physical safety

PHYSIOLOGIC NEEDS
Biological needs for oxygen, water, food, sleep, sex

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Description
Maslow’s theory is based on the idea that some
of Maslow’s needs, physical as well as Psychological take
precedence over others
Hierarchy
of needs The needs are placed in a pyramid with the most
important making the base

If the basic needs are not met, the base of

the pyramid is not formed and the rest of the
needs are not achieved.
Description The first levels of needs are the deficiency
needs, those that if not met cause a deficiency,
of Maslow’s or lack that motivates a person to strive to
achieve the need.
Hierarchy
of needs The fifth level, the actualization level, is a
growth level.

Few people ever reach the growth level and spend

their lives going up and down the pyramid meeting
the lower level needs.

(Learning-Theories.com, 2008)
 THEORITICAL FOUNDATION OF NURSING
Application to Nursing Practice
Maslow’s hierarchy of needs is easily applied to nursing practice
The theory focuses on human potential, “gives hope a chance.

The theory allows the nurse to highlight the person’s strengths instead of focusing on one’s
deficits (McEwen & Wills, 2007).
Basic needs such as air, food, drink and warmth , are the basic needs of human survival
and health.
Safety, be it with ambulation or in taking medication, is very important to nursing
Social needs are met with visiting hours and through the nurse-patient (care giver)
relationship.
Esteem and self-actualization may or may not be met in the hospital setting
The theory provides the blueprint for prioritizing client care according to a hierarchy of needs
(McEwen & Wills, 2007)
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Ethology
Describe human behavior/
development in real life Recognize the importance of
settings. Human being’s living in
harmony with their
environment.

Primary concern is the role of human

behavior in the survival of human
species.

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Ethology
The contribution of ethology to the study of human development centers
on the suggestion that human as well as lower animal behavior may have
biological origins.

The contribution of ethology to the study of human development centers

on the suggestion that human as well as lower animal behavior may
have biological origins.

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Moral Development Theory

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Lawrence Kohlberg suggested that some people reach a post-

conventional level of moral thinking where they think in terms of
universal ethical principles which take priority over society’s laws
and values.

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Kohlberg’s Moral Development
Level 1 PRECONVENTIONAL LEVEL
Stage 1 Punishment and Obedience Orientation
“I must follow the rules otherwise I will be punished”
Stage 2 Instrumental Relativist Orientation
“ I must follow the rules for the reward and favor it gives”
Level 2 CONVENTIONAL LEVEL
Stage 3 Good-Boy-Nice-Girl Orientation
“I must follow the rules so I will be accepted”
Stage 4 Society-Maintaining Orientation
“I must follow rules so there is order in the society”
Level 3 POST CONVENTIONAL LEVEL
Stage 5 Social Contract Reorientation
“I must follow rules as there are reasonable laws for it”
Stage 6 Universal Ethical Principle Orientation
“I must follow rules because my conscience tells me”
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PSYCHOANALYTIC PERSPECTIVE

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Focus on the underlying forces that motivate behavior

Sigmund Freud described a series of psychosexual stages in which

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gratification shifts from one body zone to another and the child’s
maturational level determines when the shifts will occur

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PSYCHOSEXUAL DEVELOPMENTAL THEORY
Id •Sexual and aggressive drive
•Inborn
•Operates on pleasure principle
•Primary thinking process: Imagery
•Irrational and not based on reality
Ego •Chief executive officer
•Operates on reality principle
•Secondary thinking process: logical and reality-oriented
•Major functions: adaptation to reality, modulation of anxiety, problem solving,
control and regulates instinctual dives. Use Reality Testing and Defense Mechanisms.

Superego CONSCIENCE, punishes one for something wrong that was done.
EGO-Ideal, rewards one for something good that was done.
Residue of internalized values and moral training of early childhood.

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PSYCHOSEXUAL DEVELOPMENTAL THEORY
Phases Age Ranges Developmental Focus

Oral Mouth is the major site of tension and gratification

Birth – 18 months including biting and sucking activities.
Id is present at birth.
Anal Anus and surrounding area are major source of interest.
1 1/2 yrs – 3 yrs Voluntary sphincter control is the goal.
Ego develops gradually.
Phallic Genital is the focus.
3 – 5 years Penis envy & Elektra Complex (girls).
Castration fear & Oedipus Complex (boys).
Latency Complexes are resolved. Genital focus is turned to social
5-11 extended to 13 years activities.
Formation of Superego.
Genital Development of biologic capacity for orgasm.
11-13 over lapping with previous Starts to appreciate capacity for True Intimacy.

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PSYCHOANALYTIC PERSPECTIVE
Erik Erickson described eight stages of psychosocial development
between infancy and old age. Each stage involves the resolution of a
particular crisis, achieving balance between extremes and crisis
emerges according to maturationally based time table.

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PSYCHOSOCIAL DEVELOPMENTAL THEORY
Virtue Developmental Stage Developmental Task

Drive and hope Viewing the world as safe and reliable; relationships as
TRUST vs MISTRUST nurturing, stable, and dependable
Self control & Achieving a sense of control and free will
will power AUTOMONY vs SHAME/DOUBT
Direction & Beginning development of a conscience; learning to manage
Purpose INITIATIVE vs GUILT conflict and anxiety.
Methods & Emerging confidence in own abilities; taking pleasure in
Competence INDUSTRY vs INFERIORITY accomplishments
Devotion & Formulating a sense of self and belonging
Fidelity IDENTITY vs ROLE CONFUSION
Affiliation & Forming adult, loving relationships and meaningful
Love INTIMACY vs ISOLATION attachments to others
Productivity & Being creative and productive; establishing the next
Care GENERATIVITY vs STAGNATION generation

Wisdom EGO INTEGRITY vs DESPAIR Accepting responsibility for one’s self and life

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THANK YOU!

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