Faye Glenn Abdellah developed a list of 21 unique nursing problems related to human needs,
demonstrating the Nurse as a problem solver who provides care for the whole individual. She has
helped transform the practice of nursing and raised its standards by introducing scientific
research into nursing and patient care.
Her more than 150 publications, including her seminal works, Better Nursing Care Through
Nursing Research and Patient-Centered Approaches to Nursing, changed the focus of nursing
theory from a disease-centered to a patient-centered approach and moved nursing practice
beyond the patient to include care of families and the elderly. Her Patient Assessment of Care
Evaluation method to evaluate health care is now the standard for the nation.
“Practice model of nursing for health for all.”
Benner, Patricia - Humanistic Model
Patricia Benner was interested in the Dreyfus model of skill acquisition and applied it to nursing.
Her area of concern was not how to do nursing but, rather, "how do nurses learn to do nursing?"
Changes in the Dreyfus Model of Skill Acquisition are presented for the four stages studied
(Advanced-beginner, competent, proficient, and expert) along with educational strategies for
each stage. Examines the links between skills of involvement and expert clinical practice.
Dr. Benner is an internationally noted researcher and lecturer on health, stress and coping, skill
acquisition and ethics. Her work has had wide influence on nursing both in the United States and
internationally, for example in providing the basis for new legislation and design for nursing
practice and education for three states in Australia. She was recently elected an honorary fellow
of the Royal College of Nursing. Her work has influence beyond nursing in the areas of clinical
practice and clinical ethics.
Boykin, Anne and Schoenhofer, Savina - Theory, Nursing As Caring.
The theory of Nursing As Caring is a general or grand nursing theory that can be used as a
framework to guide nursing practice. The theory is grounded in several key assumptions:
1. persons are caring by virtue of their humanness
2. persons live their caring moment to moment
3. persons are whole or complete in the moment
4. personhood is living life grounded in caring
5. personhood is enhanced through participating in nurturing relationships with caring
others
6. nursing is both a discipline and a profession (Boykin & Schoenhofer, 2001, p.11).
The most basic premise of the theory is that all humans are caring persons, that to be human is to
be called to live one’s innate caring nature. Developing the full potential of expressing caring is
an ideal and for practical purposes, is a lifelong process.
Juliette Corbin and Anselm Strauss - Trajectory Model
The Corbin and Strauss Trajectory Model proposed that nursing care should differ along a
trajectory of eight phases to meet patients' and families' needs.
Chronic Illness Theory - Nursing 765, Lecture Notes, Chronic Illness. - Old
Dominion University, School of Nursing .
Re-thinking stroke rehabilitation: the Corbin and Strauss chronic illness trajectory
framework (Burton. C.R. 2000. Journal of Advanced Nursing 32, 3 p 595-602) (PDF
Document)
Hope and the Illness Trajectory - The concept of illness trajectory
Considers the time from diagnosis through the various perturbations of disease progression and
remission.
Corbin and Strauss’ different phases:
“Comeback” from the initial illness.
“Stable phase” (during which the patient’s function is maintained).
“Unstable phase” (during which there is disease recurrence).
“Downward trajectory” (during which the person’s ability to function is in decline
and results ultimately in death). (Corbin and Strauss, 1991)
Duldt-Battey, Bonnie Weaver - Humanistic Nursing Communication Theory.
Humanistic Nursing Communication Theory and Ethics of Humanistic Nursing Communication
Theory by B. W. Duldt-Battey (as B. W. Duldt) were developed to bring into nursing the
knowledge base of the Communication and Human Relations disciplines. The theories are
believed to be consistent with holistic and humanistic theoretical paradigms and are designed to
be used in conjenction with other theories.
The Humanistic Nursing Communication Theory and Ethics of Humanistic Nursing
Communication Theory emphasize the interpersonal relationships between the nurse, patient,
peers and colleagues. Two tools have been developed to conduct research based on these
theories: the Nursing Communication Observation Tool (NCOT) and the Job-Satisfaction-
Communication-Importance (JSCI).
Erickson, Tomlin and Swain - Modeling and Role-Modeling theory.
Modeling is the process by which the nurse develops an image of the client’s world, giving the
nurse ability to understand the world from the client’s perspective, and Role-Modeling occurs
when the nurse plans interventions to role-model health behaviors congruent with the client’s
worldview (Erickson et al., 1998) The theory is based on adaptation and through a specific
assessment of adaptive potential, the Adaptive Potential Assessment Model (APAM), the nurse
is guided to assess the client’s strengths, areas of positive adaptation, and state of arousal
(Erickson & Swain, 1982). Professional nursing from within this framework requires that the
nurse build a model of the client’s world and from within that model the nurse must role-model
health behaviors to assist the client regain/attain health. Nursing care is planned only after
discussion and mutually agreed-upon goals of care.
Fitzpatrick, Joyce - The four content concepts that comprise Fitzpatrick’s theory are person,
health, wellness-illness and metaparadigm.
According to Fitzpatrick, the identification and labeling of concepts allows for recognition and
communication with others, and the rules for combining those concepts permits thoughts to be
shared through language. Thus the concepts within a classification system sanction the
organization of ideas. Recognition occurs when what is observed is placed into previously
learned classes, or categories, on the basis of observed characteristics. It is therefore important to
remember that classification system development parallels knowledge development in a
discipline. Moreover, the taxonomies of nursing diagnoses, interventions, and outcomes provide
an anchoring framework for nursing knowledge.
The four content concepts that comprise Fitzpatrick’s theory are person, health, wellness-illness
and metaparadigm. These concepts are defined as follows:
Person: The term person integrates the concepts of both self and others, and recognizes
individuals as having unique biological, psychological, emotional, social, cultural, and spiritual
attitudes. They thrive on honor and dignity, self-evaluation and growth and development.
Throughout a person’s life, many factors develop within a social setting and interact with a
multitude of environments that can significantly influence that person’s health and wellness.
Health: Health is a dynamic state of being that results from the interaction of person and the
environment. Optimum health is the actualization of both innate and obtained human potential
gleaned from rewarding relationships with others, goal directed behavior, and expert personal
care. Adjustments can be made on an “as needed” basis in order to maintain stability and
structural integrity. A person's state of health can vary from wellness to illness, disease, or
dysfunction, and it changes continuously throughout the person's life span.
Wellness-Illness: Professional nursing is rooted in the promotion of wellness practices, the
attentive treatment of those who are acutely or chronically ill or dying, and restorative care of
people during convalescence and rehabilitation. Other dimensions of professional nursing
include the teaching and evaluation of those who perform or are learning to perform nursing
functions, the support and conduction of research to extend knowledge and practice, and the
management of nursing practice in health care delivery systems. Nursing is a practice discipline
and a profession that is based upon a synthesized body of knowledge, which is derived from
inquiry and clinical evaluation promoting wellness and diminishing illness. Professional nurses
acquire and maintain current knowledge, are willing to participate in peer review and other
activities that insure quality of care, and communicate effectively with recipients of care and
other health care providers. Thus the nursing practice centers on the application of this body of
knowledge in an effort to maintain, restore, or enhance the interactions between people and their
environment.
Metaparadigm: Transition is one of the core concepts of nursing theory, derived from and
related to the basic metaparadigm concepts of person, environment, health and nursing. While
much of the research in nursing has been focused on assisting individuals in their life transitions,
whether through phases of growth and development, or experiences with health and illness, the
conceptualizations of the nursing profession as focused on transitions has not been adequately
researched.
Hall, Lydia Eloise - Core, Care and Cure Circles.
The "Care, Core, and Cure" Theory was developed in the late 1960's. She postulated that
individuals could be conceptualized in three separate domains: care (hands on bodily care), core
(using the self in relationship to the patient), and cure (applying medical knowledge).
Hall believed patients should receive care ONLY from professional nurses. Nursing involves
interacting with a patient in a complex process of teaching and learning. Hall was not pleased
with the concept of team nursing--she said that "any career that is defined around the work that
has to be done, and how it is divided to get it done, is a "trade" (rather than a profession).
Nursing functions in all three of the circles (core, care, and cure) but shares them to different
degrees with other disciplines. For example, the nurse's function in the cure circle is limited to
helping patients/families deal with the measures instituted by the physician. She felt that the care
circle was exclusive to nursing. The core circle was shared with social workers, psychologists,
clergy, etc.
Henderson, Virginia Avernal - "assisting individuals to gain independence in relation to the
performance of activities contributing to health or its recovery".
Virginia Henderson defined nursing as "assisting individuals to gain independence in relation to
the performance of activities contributing to health or its recovery" (Henderson, 1966, p. 15).
She categorized nursing activities into 14 components, based on human needs. She described the
nurse's role as substitutive (doing for the person), supplementary (helping the person), or
complementary (working with the person), with the goal of helping the person become as
independent as possible.
Husted, Gladys and Husted, James - Symphonological Bioethical Theory
Symphonological bioethical theory holds:
The health care professional is the agent of a patient acting to restore the patient’s
agency. Agency being the power to initiate actions.
For a practice-based ethic, the patient is the center of a health care professional’s
attention.
The health care professional/patient agreement and fidelity to this agreement is the basis
of all benevolence and cooperation in the health care setting.
There are standards of bioethical action that are preconditions and, therefore, sub-
agreements of the health care professional/patient agreement. Ethical action is action in
accordance with these standards. Such actions satisfy bioethical responsibilities.
Symphonology guides the analysis of any particular dilemma by establishing a perspective from
which a professional can perceive and understand a patient. This then guides the information
gathering process, provides a method through which the analysis is performed, and directs the
manner in which a health are professional interacts with a patient.
Dorothy Johnson - Behavioral System Model
The major premise of the Johnson (1980) Behavioral System Model is that the eight subsystems
(domains) are interactive, interdependent and integrated. Relationships among the subsystems
were hypothesized, placing the Aggressive/Protective subsystem centrally as having direct and
indirect relationships to the other seven subsystems.
"Johnson states that a nurses should use the behavioral system as their knowledge base;
comparable to the biological system that physicians use as their base of knowledge (Lobo, 1995).
The reason Johnson chose the behavioral system model is the idea that "all the patterned,
repetitive, purposeful ways of behaving that characterize each person's life make up an organized
and integrated whole, or a system" (other). Johnson states that by categorizing behaviors, they
can be predicted and ordered. Johnson categorized all human behavior into seven subsystems
(SSs): Attachment, Achievement, Aggressive, Dependence, Sexual, Ingestive, and Eliminative.
Each subsystem is composed of a set of behavioral responses or tendencies that share a common
goal. These responses are developed through experience and learning and are determined by
numerous physical, biological, psychological, and social factors. Four assumptions are made
about the structure and function of each SS. These four assumptions are the "structural elements"
common to each of the seven SSs."
Kalofissudis Ioannis - Complexity Nursing Theory
The Complexity Integration Nursing Theory provides a different pathway in order to socialize
nurses into the profession, creating a world that can be perceived as objective and real by
reaffirming the whole and real nature of our existence, by decoding the unconscious and
promoting the meaningful interconnectedness with the others.
King, Imogene - Open Systems Theory.
The central focus of King’s framework is man as a dynamic human being whose perceptions of
objects, persons, and events influence his behavior, social interaction, and health (King, 1971).
King’s conceptual framework includes three interacting systems with each system having its own
distinct group of concepts and characteristics. These systems include personal systems,
interpersonal systems, and social systems. King’s basic assumption maintained that nursing is a
process that involves caring for human beings with health being the ultimate goal (Torres, 1986).
The three systems that constitute King’s conceptual framework provided the basis for the
development of her Theory of Goal Attainment.
Levine, Myra Estrin - Conservation Model.
Defined nursing as supportive & therapeutic interventions based on scientific or therapeutic
knowledge. Nursing actions based on four principles: conservation of energy, structural integrity,
personal integrity, & social integrity.
Meleis, Afaf - Transitions Theory
Transitions involve a process of movement and change in fundamental life patterns, which are
manifested in all individuals. Transitions cause changes in identities, roles, relationships,
abilities, and patterns of behavior. Outcomes of transitional experiences are influenced by
environmental factors interacting with the individual's perceptions, resources, and state of well-
being. Negotiating successful transitions depends on the development of an effective relationship
between the nurse and client. This relationship is a highly reciprocal process that affects both the
client and nurse.
Developmental transitions represent maturational processes that progress from birth to death.
Health-illness transitions are those biopsychosocial and spiritual changes that influence an
individual's interaction with and ability to adapt to the environment. Nursing therapeutics are
actions designed to facilitate healthy adaptation and to prevent unhealthly outcomes for clients
experiencing these transitions. Professional nursing practice is based on critical thinking, mastery
of knowledge and skill, integration of theories and research, and a commitment to lifelong
learning. Ongoing professional development is necessary to maintain excellent nursing care,
promote the nurse's growth, and continue the advancement of the nursing profession.
Neuman, Betty - Systems Theory.
The Neuman Systems Model was originally developed in 1970 at the University of California,
Los Angeles, by Betty Neuman, Ph.D., RN. The model was developed by Dr. Neuman as a way
to teach an introductory nursing course to nursing students. The goal of the model was to provide
a wholistic overview of the physiological, psychological, sociocultural, and developmental
aspects of human beings. After a two-year evaluation of the model, it was published in Nursing
Research (Neuman & Young, 1972).
The Neuman Systems Model is a unique, systems-based perspective that provides a unifying
focus for approaching a wide range of nursing concerns. The Neuman Systems Model is a
comprehensive guide for nursing practice, research, education, and administration that is open to
creative implementation…(and) has the potential for unifying various health-related theories,
clarifying the relationships of variables in nursing care and role definitions at various levels of
nursing practice. The multidimensionality and wholistic systemic perspective of the Neuman
Systems Model is increasingly demonstrating its relevance and reliability in a wide variety of
clinical and educational settings throughout the world. (Betty Neuman, 2002)
Newman, Margaret A. - Health as Expanding Consciousness.
The theory of health as expanding consciousness stems from Rogers’ theory of unitary human
beings. Rogers’ assumptions regarding patterning of persons in interaction with the environment
are basic to the view that consciousness is a manifestation of an evolving pattern of person-
environment interaction.
Consciousness is defined as the informational capacity of the system (in this case, the human
being); that is, the ability of the system to interact with the environment (Bentov, 1978).
Consciousness includes not only the cognitive and affective awareness normally associated with
consciousness, but also the interconnectedness of the entire living system, which includes
physiochemical maintenance and growth processes as well as the immune system. This pattern of
information, which is the consciousness of the system, is part of a larger, undivided pattern of an
expanding universe.
Florence Nightingale Environmental Adaptation Model
Florence Nightingale set out to define nursing. Although her approach is deceptively simple
(what nursing is and what it is not), the implications of her theoretical work are profound and
have relevant meaning today at many levels of nursing practice. At the literal level, we can say
that Nightingale believed nursing is about Environmental Manipulation, Nutrition, and
Conservation of Patient Energy. Further, she also tells us what nursing is not: Nursing is not
limited to, nor defined by medical acts.
Orem, Dorothea E. - Self-Care Deficit Theory (SCDNT).
The basic premise of the model is that individuals can take responsibility for their health and the
health of others. In a general sense, individuals have the capacity to care for themselves or their
dependents.
Parse, Rosemarie R. - Theory of Human Becoming
Rosemarie Rizzo Parse first published the theory in 1981 as the "Man-living-health" theory. The
name was officially changed to "the human becoming theory" in 1992 to remove the term "man,"
after the change in the dictionary definition of the word from its former meaning of
"humankind." The theory is structured around three abiding themes: meaning, rhythmicity, and
transcendence.
The first theme, MEANING, is expressed in the first principle of the theory, which states that
"Structuring meaning multidimensionally is cocreating reality through the languaging of valuing
and imaging." This principle means that people coparticipate in creating what is real for them
through self-expression in living their values in a chosen way.
The second theme, RHYTHMICITY, is expressed in the second principle of the theory, which
states that "Cocreating rhythmical patterns of relating is living the paradoxical unity of revealing-
concealing and enabling-limiting while connecting-separating." This principle means that the
unity of life encompasses apparent opposites in rhythmic patterns of relating. It means that in
living moment-to-moment one shows and does not show self as opportunities and limitations
emerge in moving with and apart from others.
The third theme, TRANSCENDENCE, is expressed in the third principle of the theory, which
states that "Cotranscending with the possibles is powering unique ways of originating in the
process of transforming." This principle means that moving beyond the "now" moment is forging
a unique personal path for oneself in the midst of ambiguity and continuous change.
Paterson, Josephine and Zderad, Loretta - Humanistic Nursing Theory.
Humanistic nursing practice theory proposes phenomenology, a descriptive approach to
participants in the nursing situation as a method for studying, interpreting, and attesting the
nature and meaning of the lived events...Words and conceptualized ideas are the tools of
phenomenology. Protection of distinct persons and meaningful communications can be
augmented through the utilization of abstractions, metaphors, analogies, and parables. So
humanistic nurses, as practitioners and researchers, are inherently responsible for their manner of
being, responding, and consciously sculpturing knowledge into words.
Riehl-Sisca, Joan - Self-concept construct.
Joan Riehl Sisca claims that the self-concept refers to a "global, relatively constant self-
perception that an individual holds and it changes only gradually" (as cited in Marriner-Tomey,
1989, p. 255). The idea of an all inclusive self-concept construct makes the same historical
mistake as the unidimensional model and in fact the Sisca definition is that of a unidimensional
model. A global approach to the structure of self-concept cannot account for the variation within
the dimensions initially evidenced by the Shavelson et al. model (1976).
Rogers, Martha Elizabeth - The Science of Unitary Human Beings.
The Science of Unitary Human Beings provides a radical vision of nursing reality. It provides a
framework for nursing practice, education and research that promises a move away from the
previously predominant medical model approach to the delivery of nursing care. The framework
provides an alternative to the traditional view of nursing which could be described as
reductionistic, mechanistic and analytic. It has been said that it has "guided nursing out of a
concrete, static, closed system world view" (Smith, 1989) and as a result has started to
challenged many preconceived ideas about nursing. Indeed, when the theoretical framework was
first published, it was "in clear contradiction to all the nursing theories in use at that time"
(Sarter, 1988a).
Roper, Nancy, Logan, Winifred W. & Tierney, Alison J. - Theory of Nursing.
Human physiological and psychosocial behaviour essential to maintain life underpins Roper et
al's activities of living model. Originating in Britain, the model stresses continual patient
assessment, facilitation of the patient's normal activities of living and individualised care.
This model incorporates a life span approach, wherein the characteristics of the person are
considered with respect to prior development, current level of development, and likely future
development (Safarino, 1990). In conjunction with the life span approach an
independence/dependence continuum is used. The model then incorporates a set of twelve
activities of living (AL's), which represent those activities engaged in by individuals whether
sick or well. Together these elements are referred to as "a model of living". When using the
model of living in conjunction with the nursing process a model of nursing is utilised. The AL's
are as follows:
1. Maintaining a safe environment
2. Breathing
3. Communication
4. Mobilising
5. Eating and Drinking
6. Eliminating
7. Personal cleansing and dressing
8. Maintaining body temperature
9. Working and playing
10. Sleeping
11. Expressing sexuality
12. Dying
Assessment of the patient/client is made within each AL and taking into account the lifespan /
independence/dependence continuum a plan of care is formulated.
Roy, Callista - Adaptation Theory.
The major concepts are the person or group as an adaptive system; the environment as internal
and external stimuli; health as being and becoming whole and integrated; and nursing as the art
and science of promoting adaptation. The philosophic and scientific assumptions are basic
underlying concepts. The model aims to direct nursing practice, research and education. The
widespread us of the model in each of these areas is well documented, for example, in all areas
of practice, all levels of education, and in quantitative and qualitative research.
Dr. Roy is best known for developing and continually updating the Roy Adaptation Model as a
framework for theory, practice, and research in nursing. Two recent publications that Dr. Roy
considers of great significance are The Roy Adaptation Model (second edition) written with
Heather Andrews (Appleton & Lange) and The Roy Adaptation Model-Based Research:
Twenty-five Years of Contributions to Nursing Science being published as a research monograph
by Sigma Theta Tau.
"The model provides a way of thinking about people and their environment that is useful in any
setting. It helps one prioritize care and challenges the nurse to move the patient from survival to
transformation." Sr. Calista Roy
Travelbee, Joyce - "Human to Human Relationship Model"
"Human to Human Relationship Model"
Travelbee's experience in initial psych nursing practice at a Catholic charity hospital led her to
believe that the care given in these type of institutions lacked compassion. She felt nursing
needed a "humanistic revolution" and a renewed focus on caring as central to nursing--she
warned that if this didn't happen, consumers might seek a "new and different kind of health care
worker."
Watson, Jean - Theory of Caring.
Caring science encompasses a humanitarian, human science orientation to human caring
processes, phenomena and experiences. Caring science includes arts and humanities as well as
science. A caring science perspective is grounded in a relational ontology of being-in-relation,
and a world view of unity and connectedness of All. Transpersonal Caring acknowledges unity
of life and connections that move in concentric circles of caring - from individual, to others, to
community, to world, to Planet Earth, to the universe.
Wiedenbach, Ernestine - Prescriptive theory: a situation producing theory.
Wiedenbach believed that there were 4 main elements to clinical nursing. They included: a
philosophy, a purpose, a practice and the art.
Wiedenbach conceptualizes nursing as the practice of identification of a patient’s need for help
through observation of presenting behaviors and symptoms, exploration of the meaning of those
symptoms with the patient, determining the cause(s) of discomfort, and determining the patient’s
ability to resolve the discomfort or if the patient has a need for help from the nurse or other
healthcare professionals. Nursing primarily consists of identifying a patient’s need for help. If
the need for help requires intervention, the nurse facilitates the medical plan of care and also
creates and implements a nursing plan of care based on needs and desires of the patient. In
providing care, a nurse exercises sound judgment through deliberative, practiced, and educated
recognition of symptoms. The patient’s perception of the situation is an important consideration
to the nurse when providing competent care (Sitzman & Eichelberger 2003)
