Theoretical Foundations of Nursing (NURS 308)

Explains concepts, relationships, outcomes
Metatheory: relationships and components of a discipline
Nursing theory: addresses an aspect of nursing
Theory: term, description, label that describes an idea or response to an intervention or situation
Phenomenon: general meaning of concepts; theoretical, conceptual, operational
Definitions: statements accepted as truth, based on values and beliefs “taken for granted”
Assumptions: thought or idea, either abstract or concrete, put into words to describe a specific phenomenon
Concepts: building blocks of theory; ideas or phenomena that can be defined and studied

Domain: perspective of a profession or discipline
Includes subject, central concepts, values and beliefs, phenomena of interest, and central problems
Domain of nursing includes nursing theory, history, education, research, and practice
Paradigm: pattern of beliefs
Conceptual framework: organizing structure to promote visualization of subject matter

Four elements: Person, Health, Environment, Nursing
Person: state of being, dynamic, as defined by the individual receiving care
Health: conditions affecting the person at home, school, work, or community
Environment: surroundings influencing health; can include social and physical factors
Nursing: care of ill, disabled, dying; health promotion, disease prevention; acts performed by nurses

Nightingale as the first theorist
Curriculum era: 1900s–1940s — emphasis on scientific content, nursing arts, social sciences, pharmacology
Research era: 1950s–1970s
Theory era: 1980s–1990s
Theory utilization: 21st century; emphasis on evidence-based practice (EBP)

Grand theory: abstract, broad in scope; complex; wide applicability
Middle-range theory: less abstract; narrower scope; more concrete and testable
Practice theory: situation-specific; highly focused on real-world nursing practice
Descriptive theories: explain phenomena
Prescriptive theories: explain and provide explicit guidance to influence practice and predict consequences
Scope progression: Grand → Middle-range → Practice (increasing specificity and testability)

Theory is necessary to advance knowledge and prescribe specific interventions to improve patient outcomes
Nursing knowledge explains the practice of nursing as distinct from medicine and other health professions

Borrowed or interdisciplinary theories explain a phenomenon specific to the discipline that developed the theory
Examples of theorists whose ideas are used in nursing: Piaget, Erikson, Kohlberg, Knowles
Systems theory as a basis for the nursing process, organizing and guiding delivery of patient-centered care
Mapping in nursing process:
- input: data collection
- output: patient’s health status
- feedback: response
- content: nursing process

Nightingale’s Environmental Theory
- Focus: Hygiene, nutrition, sanitation; manage the environment to improve patient outcomes
Peplau’s Interpersonal Theory
- Preorientation, orientation, working phase, resolution (the stages of the nurse–patient relationship)
- Interpersonal relationships involve the nurse, patient, and family
Orem’s Self-Care Deficit Nursing Theory (SCDNT)
- Emphasizes patient self-care capacities and the deficits that require nursing support
Leininger’s Culture Care Theory (Cultural Diversity)
- Focus: Culture influences everything that involves a patient; culturally congruent care
Note: The slide caption includes a non-substantive line “Pitch deck title” which is not part of the theory content and is not retained as a concept

The metaparadigm components (Person, Health, Environment, Nursing) define the scope of nursing and guide what constitutes nursing knowledge and practice
Paradigms and conceptual frameworks help organize nursing knowledge and visualization of relationships among concepts
Evolution of nursing theory reflects shifting emphasis from education and arts to evidence-based practice and theory-driven inquiry
Shared theories demonstrate how interdisciplinary ideas enrich nursing practice and research, highlighting the importance of a pluralistic theoretical foundation
Ethical and practical implications include culturally sensitive care, patient autonomy (self-care focus), and the nurse–patient–family relationship as central to care delivery
Foundational principles connect to real-world care: maintaining hygienic environments, supporting patient self-care, addressing cultural needs, and fostering therapeutic nurse–patient relationships