Theoretical Foundations of Nursing: A Historical Overview

Nursing is a profession that has been influenced by various theories and models throughout its history. These theories and models provide a framework for understanding, explaining, and guiding nursing practice and research. In this paper, some of the most influential nursing theorists and their contributions will be discussed, focusing on the following topics:

Module 1: Research and Nightingale
Florence Nightingale is widely regarded as the founder of modern nursing. She was a pioneer in the use of statistics and evidence-based practice to improve health outcomes and quality of care. She also advocated for environmental factors, such as sanitation, ventilation, and nutrition, to prevent disease and promote healing. Nightingale’s Notes on Nursing (1860) is considered one of the first nursing textbooks, and her Environmental Theory is still relevant today.

Module 2: Peplau, Henderson, and Orem
In the mid-20th century, nursing shifted from a task-oriented approach to a more interpersonal and holistic one. Peplau, Henderson, and Orem were among the first nursing theorists to emphasize the importance of the nurse-patient relationship, the role of the nurse as a teacher and a helper, and the self-care abilities of the patient. Peplau’s Interpersonal Theory (1952) introduced the concept of the therapeutic use of self and the phases of the nurse-patient relationship. Henderson’s Definition of Nursing (1966) described the 14 basic needs of the patient and the functions of the nurse. Orem’s Self-Care Deficit Theory (1971) explained how the nurse can assist the patient to meet their self-care requisites and achieve optimal health.

Module 3: Johnson, Orlando, and the 1950s-60s
Johnson, Orlando, and other nursing theorists in the 1950s-60s developed conceptual models that aimed to define the domain and scope of nursing as a distinct discipline. Johnson’s Behavioral System Model (1968) viewed the patient as a behavioral system composed of seven subsystems that interact with the environment. Orlando’s Nursing Process Theory (1961) proposed a dynamic and individualized approach to nursing practice based on the nurse’s observation, inference, validation, and action.

Module 4: King and Rogers
King and Rogers were among the first nursing theorists to adopt a systems perspective and a humanistic orientation in their models. King’s Goal Attainment Theory (1971) focused on the mutual goal setting and attainment between the nurse and the patient within three interacting systems: personal, interpersonal, and social. Rogers’ Science of Unitary Human Beings (1970) emphasized the irreducible wholeness and uniqueness of each human being and their continuous interaction with the environment.

Module 5: Roy, Neuman, and the 1970s
Roy, Neuman, and other nursing theorists in the 1970s incorporated concepts from general systems theory, adaptation theory, and stress theory in their models. Roy’s Adaptation Model (1976) defined nursing as a process of promoting adaptation of the patient in four adaptive modes: physiological, psychological, social, and spiritual. Neuman’s Systems Model (1972) described nursing as a process of preventing stressors from affecting the stability of the patient’s system or restoring it to an optimal level of wellness.

Conclusion
The theoretical foundations of nursing provide a rich source of knowledge and guidance for nursing practice and research. By understanding the historical development and evolution of these theories and models, nurses can appreciate their contributions to the profession and apply them to their own situations.

## Module 6: Leininger, Newman, and Watson

– Madeleine Leininger developed the Culture Care Theory of nursing,
which states that nursing is a transcultural phenomenon that requires knowledge and understanding of different cultures and their care practices.
She also introduced the concepts of culture,
subculture,
worldview,
ethnohistory,
culturalogical assessment,
cultural care preservation,
cultural care accommodation,
cultural care repatterning,
and cultural care universality.

– Margaret Newman developed the Health as Expanding Consciousness Theory of nursing,
which views health as a dynamic process of expanding awareness and pattern recognition in the patient’s life.
She also introduced the concepts of consciousness,
movement,
space-time,
pattern,
praxis,
and transformation.

– Jean Watson developed the Human Caring Theory of nursing,
which states that nursing is a human-to-human relationship that is guided by carative factors and transpersonal caring moments.
She also introduced the concepts of caring,
carative factors,
caritas processes,
transpersonal caring relationship,
caring occasion/caring moment,
and clinical caritas processes.

## Module 7: Parse, Erickson, and Tomlin & Swain

– Rosemarie Parse developed the Human Becoming Theory of nursing,
which views the patient as a unitary human being who co-creates health with the environment.
She also introduced the concepts of human becoming,
meaning,
rhythmicity,
transcendence,
co-creating,
structuring meaning multidimensionally,
co-transcending with possibles,
and cotransforming with the emerging power.

– Helen Erickson, Evelyn Tomlin, and Mary Ann Swain developed the Modeling and Role-Modeling Theory of nursing,
which views the patient as a holistic adaptive system who strives to achieve self-care, self-awareness, and self-healing.
They also introduced the concepts of modeling,
role-modeling,
adaptation potential,
affiliative needs,
nurturant needs,
self-concept mode,
physiological mode, and interdependence mode.

## Module 8: Theories of the 1980s and 1990s

– The 1980s and 1990s was a period of diversity and innovation in nursing theory and research. Some of the theories that emerged during this time include:
– Phil Barker’s Tidal Model of nursing, which views the patient as an expert in their own recovery and uses metaphors of water, waves, and tides to describe the process of healing.
– Katharine Kolcaba’s Comfort Theory of nursing, which views comfort as a desirable outcome of nursing care and defines it as the state of ease and relief from distress.
– Cheryl Tatano Beck’s Postpartum Depression Theory of nursing, which explains the etiology, risk factors, symptoms, and interventions for postpartum depression in women.
– Kristen Swanson’s Caring Theory of nursing, which defines caring as a nurturing way of relating to a valued other and identifies five caring processes: knowing, being with, doing for, enabling, and maintaining belief.
– Cornelia Ruland and Shirley Moore’s Peaceful End-of-Life Theory of nursing, which identifies four indicators of a peaceful death: pain-free status, comfort, dignity, and closeness to significant others.

# References

– Alligood, M. R. (2018). Nursing theorists and their work (9th ed.). Elsevier.
– Chinn, P

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