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

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

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

Faye Glenn Abdellah

 Developed the 21 Nursing Problems Theory
 “Nursing is based on an art and science that molds the attitudes, intellectual
competencies, and technical skills of the individual nurse into the desire and
ability to help people, sick or well, cope with their health needs.”
 Changed the focus of nursing from disease-centered to patient-centered, and
began to include the care of families and the elderly in nursing care.
 The nursing model is intended to guide care in hospital institutions, but can
also be applied to community health nursing, as
well.

Jean Watson
 Error! Hyperlink reference not valid. She
pioneered the Philosophy and Theory of
Transpersonal Caring.
 “Nursing is concerned with promoting health, preventing illness, caring for
the sick, and restoring health.”
 Mainly concerns on how nurses care for their patients, and how that caring
progresses into better plans to promote health and wellness, prevent illness
and restore health.
 Focuses on health promotion, as well as the treatment of diseases.
 Caring is central to nursing practice and promotes health better than a
simple medical cure.

Carative Factors and Caritas Processes

Carative Factors Caritas Process

“Practice of loving-kindness and

1. “The formation of a humanistic-
equanimity within the context of
altruistic system of values”
caring consciousness”

2. “The instillation of faith-hope” “Being authentically present and

enabling and sustaining the deep
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belief system and subjective life-

world of self and one being cared
for”

“Cultivation of one’s own spiritual

3. “The cultivation of sensitivity to
practices and transpersonal self
one’s self and to others”
going beyond the ego self”

4. “Development of a helping-trust
“Developing and sustaining a helping
relationship” became “development
trusting authentic caring
of a helping-trusting, human caring
relationship”
relation” (in 2004 Watson website)

“Being present to, and supportive of,

5. “The promotion and acceptance of the expression of positive and
the expression of positive and negative feelings as a connection
negative feelings” with deeper spirit and self and the
one-being-cared for”

6. “The systematic use of the

scientific problem solving method “Creative use of self and all ways of
for decision making” became knowing as part of the caring
“systematic use of a creative process; to engage in the artistry of
problem solving caring process” (in caring-healing practices”
2004 Watson website)

“Engaging in genuine teaching-

learning experience that attends to
7. “The promotion of transpersonal
unity of being and meaning,
teaching-learning”
attempting to stay within others’
frame of reference”

“Creating healing environment at all

8. “The provision of supportive, levels (physical as well as
protective, and (or) corrective nonphysical, subtle environment of
mental, physical, societal, and energy and consciousness, whereby
spiritual environment” wholeness, beauty, comfort, dignity,
and peace are potentiated)”
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“Assisting with basic needs, with an

intentional caring consciousness,
administering ‘human care
9. “The assistance with gratification
essentials,’ which potentiate
of human needs”
alignment of mind body spirit,
wholeness, and unity of being in all
aspects of care”

10. “The allowance for existential- “Opening and attending to spiritual-

phenomenological forces” became mysterious and existential
“allowance for existential- dimensions of one’s own life-death;
phenomenological spiritual forces” soul care for self and the one-being-
(in 2004 Watson website) cared for”

Watson’s Hierarchy of Needs

Within assisting with the gratification of human needs, Watsons hierarchy of needs
begins with lower-order biophysical needs or survival needs, the lower-order
psychophysical needs or functional needs, the higher order psychosocial needs or
integrative needs, and finally the higher order intrapersonal-interpersonal need or
growth-seeking need.

 Lower Order Biophysical Needs or Survival Needs

Watson’s hierarchy of needs begins with lower-order biophysical needs or survival
needs. These include the need for food and fluid, elimination, and ventilation.
 Lower Order Psychophysical Needs or Functional Needs
Next in line are the lower-order psychophysical needs or functional needs. These
include the need for activity, inactivity, and sexuality.
 Higher Order Psychosocial Needs or Integrative Needs
The higher order psychosocial needs or integrative needs include the need for
achievement, and affiliation.
 Higher Order Intrapersonal-Interpersonal Need or Growth-seeking Need
The higher order intrapersonal-interpersonal need or growth-seeking need is the
need for self-actualization.

Dorothea E. Orem
 In her Self-Care Theory, she defined Nursing as “The act of assisting others
in the provision and management of self-care to maintain or improve human
functioning at home level of effectiveness.”
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 Focuses on each individual’s ability to perform self-care.
 Composed of three interrelated theories:
o (1) the theory of self-care,
This theory focuses on the performance or practice of activities that individuals
initiate and perform on their own behalf to maintain life, health and well-being.
Self-Care Requisites
Self-care Requisites or requirements can be defined as actions directed toward
the provision of self-care. It is presented in three categories:
Universal Self-Care Requisites
Universal self-care requisites are associated with life processes and the
maintenance of the integrity of human structure and functioning.
 The maintenance of a sufficient intake of air
 The maintenance of a sufficient intake of water
 The maintenance of a sufficient intake of food
 The provision of care associated with elimination process and
excrements
 The maintenance of a balance between activity and rest
 The maintenance of a balance between solitude and social
interaction
 The prevention of hazards to human life, human functioning, and
human well-being
 The promotion of human functioning and development within social
groups in accord with human potential, known human limitations,
and the human desire to be normal
Normalcy is used in the sense of that which is essentially human and that
which is in accord with the genetic and constitutional characteristics and the
talents of individuals.
Developmental self-care requisites
Developmental self-care requisites are “either specialized expressions of
universal self-care requisites that have been particularized for
developmental processes or they are new requisites derived from a condition
or associated with an event.”
Health deviation self-care requisites
Health deviation self-care requisites are required in conditions of illness,
injury, or disease or may result from medical measures required to diagnose
and correct the condition.
 Seeking and securing appropriate medical assistance
 Being aware of and attending to the effects and results of pathologic
conditions and states
 Effectively carrying out medically prescribed diagnostic,
therapeutic, and rehabilitative measures
 Being aware of and attending to or regulating the discomforting or
deleterious effects of prescribed medical measures
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 Modifying the self-concept (and self-image) in accepting oneself as
being in a particular state of health and in need of specific forms of
health care
 Learning to live with the effects of pathologic conditions and states
and the effects of medical diagnostic and treatment measures in a
lifestyle that promotes continued personal development
o (2) the self-care deficit theory, and
This theory delineates when nursing is needed. Nursing is required when an
adult (or in the case of a dependent, the parent or guardian) is incapable of
or limited in the provision of continuous effective self-care. Orem identified
5 methods of helping:
 Acting for and doing for others
 Guiding others
 Supporting another
 Providing an environment promoting personal development in
relation to meet future demands
 Teaching another
Theory of Nursing System
This theory is the product of a series of relations between the persons:
legitimate nurse and legitimate client. This system is activated when the
client’s therapeutic self-care demand exceeds available self-care agency,
leading to the need for nursing.
Wholly Compensatory Nursing System
This is represented by a situation in which the individual is unable “to
engage in those self-care actions requiring self-directed and controlled
ambulation and manipulative movement or the medical prescription to
refrain from such activity… Persons with these limitations are socially
dependent on others for their continued existence and well-being.”
Example: care of a newborn, care of client recovering from surgery
in a post-anesthesia care unit
Partial Compensatory Nursing System
This is represented by a situation in which “both nurse and perform care
measures or other actions involving manipulative tasks or ambulation…
[Either] the patient or the nurse may have a major role in the performance of
care measures.”
Example: Nurse can assist postoperative client to ambulate, Nurse
can bring a meal tray for client who can feed himself
Supportive-Educative System
This is also known as supportive-developmental system, the person “is able
to perform or can and should learn to perform required measures of
externally or internally oriented therapeutic self-care but cannot do so
without assistance.”
Example: Nurse guides a mother how to breastfeed her baby,
Counseling a psychiatric client on more adaptive coping strategies.
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Dorothea Orem’s Theory and The Nursing Process

The Nursing Process presents a method in determining self-care deficits and
to define the roles of persons or nurse to meet the self-care demands.

 Assessment
 Diagnosis and prescription; determine why nursing is needed.
Analyze and interpret by making a judgment regarding care.
 Design of a nursing system and plan for delivery of care.
 Production and management of nursing systems.
Step 1 – Collect Data in Six Areas
1. The person’s health status
2. The physician’s perspective of the person’s health status
3. The person’s perspective of his or health health
4. The health goals within the context of life history, lifestyle, and
health status.
5. The person’s requirements for self-care
6. The person’s capacity to perform self-care
 Nursing Diagnosis & Care Plans
Step 2
 The nurse designs a system that is wholly or partly compensatory or
supportive-educative.
 The two actions are: (1) Bringing out a good organization of the
components of patients’ therapeutic self-care demands. (2) Selection
of combination of ways of helping that will be effective and
efficient in compensating for/overcoming patient’s self-care deficits.
 Implementation & Evaluation
Step 3
 Nurse assists the patient or family in self-care matters to achieve
identified and described health and health-related results. Collecting
evidence in evaluating results achieved against results specified in
the nursing system design.
 Actions are directed by etiology component of nursing diagnosis.

o (3) the theory of nursing systems, which is further classified into

wholly compensatory, partially compensatory and supportive-
educative.

Myra Estrin Levine

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 According to the Conservation Model, “Nursing is human interaction.”
 Provides a framework within which to teach beginning nursing students.
 Logically congruent, is externally and internally consistent, has breadth as
well as depth, and is understood, with few exceptions, by professionals and
consumers of health care.

Nursing’s role in conservation is to help the person

with the process of “keeping together” the total
person through the least amount of effort. Levine
(1989) proposed the following four principles of
conservation.

1. The conservation of energy of the

individual.- refers to balancing energy input
and output to avoid excessive fatigue. It
includes adequate rest, nutrition and exercise.

Examples: Availability of adequate rest;

Sustenance of adequate nutrition

2. The conservation of the structural integrity of the individual.- refers to

maintaining or restoring the structure of body preventing physical
breakdown and promoting healing.
Examples: Assist patient in ROM exercise; Preservation of patient’s
personal hygiene
3. The conservation of the personal integrity of the individual.- recognizes
the individual as one who strives for recognition, respect, self-awareness,
selfhood, and self-determination.
Example: Acknowledge and preserve patient’s space needs
4. The conservation of the social integrity of the individual.- exists when a
patient is recognized as someone who resides within a family, a community,
a religious group, an ethnic group, a political system, and a nation.
Example: Help the individual to preserve his or her place in a family,
community, and society.

“The conservation principles do not, of course, operate singly and in isolation from
each other. They are joined within the individual as a cascade of life events,
churning and changing as the environmental challenge is confronted and resolved in
each individual’s unique way. The nurse as a caregiver becomes part of that
environment, bringing to every nursing opportunity his or her own cascading
repertoire of skill, knowledge, and compassion. It is a shared enterprise and each
participant is rewarded.” (Levine, 1989)

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

Dorothy E. Johnson
 The Behavioral System Model defined Nursing as “an
external regulatory force which acts to preserve the
organization and integration of the patients’ behaviors at
an optimum level under those conditions in which the
behavior constitutes a threat to the physical or social
health, or in which illness is found.”
 Advocates the fostering of efficient and effective
behavioral functioning in the patient to prevent illness
and stresses the importance of research-based
knowledge about the effect of nursing care on patients.
 Describes the person as a behavioral system with seven
subsystems: the achievement, attachment-affiliative, aggressive-protective,
dependency, ingestive, eliminative, and sexual subsystems.
7 Subsystems of the Behavior System Model
Johnson identifies seven subsystems in the
Behavioral System Model. They are:
7 Johnson's Behavioral System Model
 Attachment or affiliative subsystem
-is the “social inclusion intimacy and the
formation and attachment of a strong social
bond.” It is probably the most critical because it
forms the basis for all social organization. On a
general level, it provides survival and security.
Its consequences are social inclusion, intimacy,
and the formation and maintenance of a strong social bond
 Dependency subsystem
-is the “approval, attention or recognition and physical assistance.” In the
broadest sense, it promotes helping behavior that calls for a nurturing
response. Its consequences are approval, attention or recognition, and
physical assistance. Developmentally, dependency behavior evolves from
almost total dependence on others to a greater degree of dependence on self.
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A certain amount of interdependence is essential for the survival of social
groups.
 Ingestive subsystem
-is the “emphasis on the meaning and structures of the social events
surrounding the occasion when the food is eaten.” It should not be seen as
the input and output mechanisms of the system. All subsystems are distinct
subsystems with their own input and output mechanisms. The ingestive
subsystem “has to do with when, how, what, how much, and under what
conditions we eat.”
 Eliminative subsystem
-states that “human cultures have defined different socially acceptable
behaviors for excretion of waste, but the existence of such a pattern remains
different from culture to culture.” It addresses “when, how, and under what
conditions we eliminate.” As with the ingestive subsystem, the social and
psychological factors are viewed as influencing the biological aspects of this
subsystem and may be, at times, in conflict with the eliminative subsystem.
 Sexual subsystem
-is both a biological and social factor that affects behavior. It has the dual
functions of procreation and gratification. Including, but not limited to,
courting and mating, this response system begins with the development of
gender role identity and includes the broad range of sex-role behaviors.
 Aggressive subsystem
-relates to the behaviors concerning protection and self-preservation,
generating a defense response when there is a threat to life or territory. Its
function is protection and preservation. Society demands that limits be
placed on modes of self-protection and that people and their property be
respected and protected.
 Achievement subsystem
-provokes behavior that tries to control the environment. It attempts to
manipulate the environment. Its function is control or mastery of an aspect
of self or environment to some standard of excellence. Areas of achievement
behavior include intellectual, physical, creative, mechanical, and social
skills.

Behavioral System Model and The Nursing Process

The nursing process of the Behavior System Model of Nursing begins with
an assessment and diagnosis of the patient. Once a diagnosis is made, the
nurse and other healthcare professionals develop a nursing care plan of
interventions and setting them in motion. The process ends with an
evaluation, which is based on the balance of the subsystems.

Sister Callista Roy

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

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

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

Hildegard E. Peplau

 Pioneered the Theory of Interpersonal Relations

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

Ida Jean Orlando

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

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

Madeleine M. Leininger
 Culture Care Theory of Diversity and Universality
 Defined transcultural nursing as “a substantive area of study and practice
focused on comparative cultural care (caring) values, beliefs, and practices
of individuals or groups of similar or different cultures with the goal of
providing culture-specific and universal nursing care practices in promoting
health or well-being or to help people to face unfavorable human conditions,
illness, or death in culturally meaningful ways.”
 Involves learning and understanding various
cultures with regard to nursing and health-illness
caring practices, beliefs, and values with the
intention to implement significant and efficient
nursing care services to people according to their
cultural values and health-illness context.
 Focuses on the fact that various cultures have
different and unique caring behaviors and different
health and illness values, beliefs, and patterns of
behaviors.

Rosemarie Rizzo Parse

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

Joyce Fitzpatrick
 Life Perspective Rhythm Model -developed September 18, 2013
specialized her model from Martha Rogers' Theory of Unitary Human
beings.

Major Assumptions

 "The process of human development is characterized by rhythms that occur

within the context of continuous person-environment interaction."
 Nursing activity focuses on enhancing the developmental process toward
health.
 A central concern of nursing science and the nursing profession is the
meaning attributed to life as the basic understanding of human existence.
 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.

Core Concepts

Rhythm Model includes four content concepts and they are:

 person
 health
 wellness-illness and
 metaparadigm.

Person

 Person includes both self and others.

 Person is seen as an open system , a unified whole characterized by a basic
human rhythm.
 The model recognizes individuals as having unique biological,
psychological, emotional, social, cultural, and spiritual attitudes.

Health

 Health is a dynamic state of being that results from the interaction of person
and the environment.
 'a human dimension under continuous development,
a heightened awareness of the meaningfullness of
life.
 Optimum health is the actualization of both innate
and obtained human potential gathered from
rewarding relationships with others, goal directed
behavior, and expert personal care.

Wellness-llness
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 Professional nursing is rooted in the promotion of wellness practices.
 Nursing - "A developing discipline whose central concern is the meaning
attached to life (health)
 Primary purpose of nursing is the promotion and maintenance of an
optimal level of wellness.

Metaparadigm

 It refers to the transitions through basic metaparadigm concepts of person,

environment, health and nursing.

Conclusion

Life Perspective Rhythm Model is a complex nursing model which contribute to

nursing knowledge by providing taxonomy for identifying and labeling nursing
concepts to allow for their universal recognition and communication with others.

Anne Boykin and Savina O. Schoenhofer

 The Theory of Nursing as Caring: A Model for Transforming Practice
 Nursing is an “exquisitely interwoven” unity of aspects of the discipline
and profession of nursing.
 The focus and aim of nursing as a discipline of knowledge and a
professional service is “nurturing persons living caring and growing in
caring.”
 Caring in nursing is “an altruistic, active expression of
love, and is the intentional and embodied recognition of
value and connectedness.”

Margaret A. Newman
 Health as Expanding Consciousness
 “Nursing is the process of recognizing the
patient in relation to the environment, and it is
the process of the understanding of
consciousness.”
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 “The theory of health as expanding consciousness was stimulated by
concern for those for whom health as the absence of disease or disability
is not possible . . . “
 Nursing is regarded as a connection between the nurse and patient, and
both grow in the sense of higher levels of consciousness.