CEFI Comprehensive Nursing Theory Notes

Page 1: Vision and Mission of CEFI

• Motto repeated throughout slides: “Evolve. Adapt. Overcome. CEFI is now ready.”

• VISION (est. $1973$)

  • Become the premier institution of learning beyond CALABARZON.

  • Focus on exemplary instruction, research-driven programs, and sustainable community-extension services.

  • Ultimate social ends: health, prosperity, peace.

• MISSION

  • Develop self-fulfilling, productive citizens engaged in national & international development.

  • Core values: honor, scholarship, service.

  • Raise quality of life via innovative instruction, interactive technology, competent administrators/faculty/staff.

  • Shared responsibility in building a just, stable, humane society.

Page 2: College of Nursing – Program Educational Objectives (PEO)

Within a few years after graduation CEFI Nursing alumni are expected to:

1. Be gainfully employed in diverse health-care facilities.

2. Apply knowledge & skills across specializations using the nursing process.

3. Engage in evidence-based research for nursing advancement.

4. Communicate with ease & confidence in organizations.

5. Pursue trainings, seminars, conferences, graduate programs for career growth.

6. Demonstrate safe practice with social responsibility, justice, humane regard, & commitment to service.

Page 3: Course Outline for PRELIM – Evolution of Nursing

A. Introduction to Nursing Theory

1. History of Nursing Theory

2. Significance for Discipline & Profession
   B. History & Philosophy of Science

3. Rationalism

4. Empiricism

5. Early $20^{th}$-century views

6. Emergent views
   C. Structure of Nursing Knowledge

7. Structure levels

8. Metaparadigm (Person, Health, Environment, Nursing)

9. Philosophy

10. Conceptual Models

11. Theory

12. Middle-range theory

Page 4: Nursing Philosophies (Prelim)

1. Nightingale – Environmental Theory

2. Watson – Theory of Human Caring

3. Benner – Stages of Nursing Expertise

4. Eriksson – Carative Caring Theory

Page 5: Nursing Conceptual Models (Midterm)

1. Rogers – Science of Unitary Human Beings

2. Orem – Self-Care Deficit Model

3. King – General System Framework

4. Neuman – Systems Model

5. Roy – Adaptation Model

6. Johnson – Behavioral System Model

Page 6: Nursing Theories (Midterm)

1. Peplau – Interpersonal Relations

2. Orlando – Deliberative Nursing Process

3. Travelbee – Human-to-Human Relationship

4. Hall – CORE, CARE, CURE

5. Abdellah – $21$ Nursing Problems

6. Henderson – Need Theory

Page 7: Nursing Theories (Semi-Final)

7. Pender – Health Promotion Model

8. Leininger – Culture Care Diversity & Universality

9. Newman – Health as Expanding Consciousness

10. Parse – Human Becoming / Human Caring

11. Watson – Human Caring (expanded)

12. Orlando – Nursing Process (re-emphasized)

13. Locsin – Technological Competency as Caring

Page 8: Theories Relevant to Nursing Practice (Final Term)

1. Maslow – Human Needs

2. Sullivan – Transactional Analysis

3. Von Bertalanffy – General Systems

4. Lewin – Change Theory

5. Erikson – Psychosocial Development

6. Kohlberg – Moral Development

Page 9: Local (Philippine) Nursing Theories & Models

1. Locsin – Technological Nursing as Caring

2. Agravante – CASAGRA Transformative Leadership

3. Divinagracia – COMPOSURE Model

4. Kuan – Retirement & Role Discontinuity

5. Abaquin – “PREPARE ME” Holistic Interventions

6. Laurente – Theory of Nursing Practice & Career

7. “Synchronicity in Human–Space–Time” – Nursing Engagement in Global Community

Page 10: Start of PRELIM – Evolution of Nursing

• Nursing: systematic blend of clinical practice + scientific knowledge aimed at better outcomes.

• Profession emerged mid-$19^{th}$ C.

• Catalyst: Florence Nightingale, well-educated from wealthy British family, chose nursing.

Page 11: Why Study Evolution?

• Nursing journeyed from household service to hospitals, schools, clinics.

• Oldest occupations; constant change has elevated profession, patient results, and healthcare quality overall.

• Wars & social changes = major drivers of evolution.

• Resource cited: hhtps://onlinenursing.twu.edu (typo noted).

Page 12: Introduction to Nursing Theories

• Theories shape education, practice, patient interaction.

• Developed across centuries; continue to evolve.

• Guide explains: what theory is, who practices, levels & concepts, notable theorists.

Page 13: Definition of Nursing Theory

• Body of knowledge supporting practice.

• Framework that organizes knowledge & explains phenomena at specific, concrete level.

• Contains concepts, definitions, relationships, assumptions to describe/explain/predict/prescribe.

Page 14-16: History of Nursing Theory (Middle Ages → $18^{th}$ C.)

• Early perception: feminine occupation; mostly untrained women & nuns.

• Religious orders (e.g., Alexian Brothers $1259$; Hospitaller Brothers $1550$) pioneered organized care.

• Key milestones:
  • $1645$ Jeanne Mance – Hôtel-Dieu de Montréal, first hospital in N. America.
  • $1761$ Pennsylvania Hospital opened (Franklin & Bond).
  • $1775$ Revolutionary War: Congress mandates $1$ nurse per $10$ patients.

Page 17-19: Wars & Formal Education

• Crimean War ($1853–1856$): Nightingale’s sanitation ↓ mortality dramatically; founded training school $1860$.

• U.S. Civil War ($1861–1865$): $2000+$ nurses; rich diaries.

• First U.S. training school $1872$; Linda Richards first graduate; early programs exploited students (free labor).

• $1970s$ shift from $3$-yr diplomas → $2$-yr ADN & $4$-yr BSN; growth of Master’s & Doctorate.

Page 20-25: Nursing Global Timeline (Selected)

• $1751$ first U.S. hospital; $1775–1783$ wartime nursing under Washington.

• $1783$ James Derham buys freedom with nursing earnings.

• $1841$ Dorothea Dix advocates for mentally ill.

• $1859$ “Notes on Nursing”. $1861$ uniforms begin.

• $1881$ Clara Barton → American Red Cross.

• $1901$ NZ mandates registration; $1902$ Ellen Dougherty first RN.

• $1908$ U.S. Naval Nursing Corps; National Association of Colored Graduate Nurses.

• $1914–1918$ World War I: Navy Corps + Red Cross.

• $1922$ Philippine Nurses Association founded.

• $1950$ first ICUs; Critical Care specialty.

• $1956$ first MSN (Columbia Univ.).

• $1965$ first Nurse Practitioner program.

• $1967$ first hospice (Saunders).

• $1972$ First RN in U.S. Congress (E.B. Johnson).

Page 26: Significance of Theoretical Works

• Provide most comprehensive/systematic nursing knowledge.

• Discipline = body of academic knowledge (BSN, MSN, PhD).

• Profession = specialized practice grounded in that knowledge.

Page 27-29: History & Philosophy of Science – Rationalism

• Emphasis on a priori reasoning & deductive logic.

• “Theory-then-research” (Reynolds $1971$).

• Example chain:
  $\text{Theory} \rightarrow \text{Hypothesis} \rightarrow \text{Data} \rightarrow \text{Analysis} \rightarrow \text{Accept/Reject}$

Page 30-33: Empiricism

• Knowledge via sensory experience; inductive method (“research-then-theory”).

• Key proponent: Francis Bacon.

• Skinner (behaviorism) argued to gather data before theorizing.

• Inductive chain example:

  1. Specific observation → 2. Pattern → 3. General conclusion.

Page 34-35: $20^{th}$-Century Scientific Views

• Early $1900s$: focus on theory structure vs empirical work; Logical Positivism dominates (Comte).

• Late $1900s$: emergent epistemology views science as ongoing, theory-evolving process.

Page 36: Structure of Nursing Knowledge

1. Metaparadigm – Person, Environment, Health, Nursing.

2. Philosophy – e.g., Nightingale’s.

3. Conceptual Models – e.g., Neuman Systems.

4. Theory – e.g., “Optimal Client Stability”.

5. Middle-range theory – targeted applications (e.g., community wellness for healthy aging).

Page 37: Metaparadigm Elements Detailed

• Person: recipient of care.

• Health: quality/wellness + access to care.

• Environment: surroundings; sanitation.

• Nursing: responsibilities addressing physical, mental, social, emotional, spiritual needs.

Page 38-39: Nursing Philosophy

• Personal statement of values, ethics, beliefs, motivation.

• Core ethics: 1 Autonomy, 2 Beneficence, 3 Non-maleficence, 4 Justice, 5 Fidelity, 6 Veracity, 7 Accountability.

• Reflects individual approach to role, interaction, and field contribution.

Page 40-42: Conceptual Models

• Comprised of concepts & propositions; depict how complex systems work.

• Not equated to theory but can draw on multiple theories.

• Example: Orem’s Self-Care Deficit Theory – independence aids recovery; four nursing roles: Acting, Guiding, Supporting, Environment-Providing.

• Definitions:
  • Concept – basic idea (e.g., Income).
  • Proposition – relational statement testable for truth (e.g., “Higher income → better health”).
  • Assumption – accepted without proof.

Page 43-45: Theory & Its Importance

• Theory: systematic statement explaining phenomena.

• Goals: describe, predict, explain; provide practice foundation; direct future development.

• Helps decide known vs unknown; defines professional boundaries.

• Practical application aligned with ADPIE:
  • Organize → Understand → Analyze → Decide → Plan → Predict → Evaluate.

Page 46: Middle-Range Theory

• Limited variables, testable, broad utility.

• Examples: Peplau’s Interpersonal Theory; Roy’s Adaptation Model guiding a Family Center.

Page 47: Reminder Slide – “Nursing Theorists and Their Works” ($1973$ header reference).

Page 48-58: Florence Nightingale – Environmental Theory

Biography

• Born $12\,May\,1820$ Florence, Italy; raised in Derbyshire.

• Divine call $7\,Feb\,1837$; remained single to serve.

• Died $13\,Aug\,1910$ London.

• First post: St. Harvey Hospital, London.

• Crimean War: led $38$ nurses to Scutari (Turkey); sanitation reforms.

• First woman member Royal Statistical Society; Order of Merit $1907$.
  Education

• Home-schooled; training in Alexandria & Kaiserswerth.
  Honors

• First female Order of Merit recipient; Crimean monument; Royal Statistical Society Fellow; ASA honorary member.
  Quotes (sample):
  • “To be a good nurse one must be a good woman…”.
  • “Till a married woman can be a possession of her own property there can be no love or justice.”
  Major Contributions

• Superintendent for Gentlewomen Establishment.

• Founded Nightingale School (St. Thomas’ Hospital).

• Wrote “Notes on Nursing” (first textbook).
  Statistics & Graphics

• Devised Model Hospital Statistical Form.

• Pioneered polar-area diagram (“coxcomb”) & pie chart.
  Environmental Theory – 10 Key Points

1. Clean air & thermoregulation.

2. Direct sunlight; minimize noise.

3. Cleanliness of rooms.

4. Well-constructed facilities.

5. Fresh bedding.

6. Patient hygiene & nurse hand-washing.

7. Mental stimulation (books, flowers).

8. Optimistic yet honest nurse attitude.

9. Small frequent meals; undisturbed eating.

10. Consider patient’s living context.

Page 59-60: Jean Watson – Theory of Human Caring

• Defines nursing as human science of persons & health-illness experiences mediated by professional, personal, scientific, esthetic, ethical transactions.

• Human as valued whole > sum of parts.

• Caring regenerates life energies; promotes self-actualization for both nurse & patient; central to practice.

Page 61: Patricia Benner – Stages of Nursing Expertise (adapted from Dreyfus)

1. Novice – no experiential background.

2. Advanced Beginner – marginally acceptable; new grads.

3. Competent – $2–3$ yrs similar situations.

4. Proficient – holistic grasp; guided by maxims.

5. Expert – intuitive, deep situational understanding; minimal reliance on rules.

Page 62-64: Katie Eriksson – Carative Caring Theory

• Caring = tending, playing, learning in faith, hope, love.

• Ontological view: human = body + soul + spirit.

• Health = vitality & wholeness.

• Ultimate goal: alleviate suffering, enhance dignity.

• Carative ethics: “being there,” unconditional love/compassion; accompany vulnerable persons.

Page 65: Pender – Health Promotion Model (behavior-specific cognition & affect)

F. Situational Influences (place, social, time)

• Personal perceptions of context influencing behavior facilitation or impediment.

• Covers options, demand characteristics, esthetic features.

• Exert direct or indirect effects on health-promoting behaviors.

These page-structured notes encapsulate every stated major & minor point, definitions, historical facts, theoretical frameworks, ethical principles, and illustrative examples required for a comprehensive review of the provided transcript.