ASSIGNMENT (FOR WEB-BASED ONLY STUDENTS)  
Read the following: Animals and Nursing

Read Chapter 6 (Theoretical Foundations of Professional Nursing) in your textbook 
Professional Nursing Practice: Concepts and Perspectives and review the handout below.

THEORIST

MAJOR CONCEPTS OF THEORY

DEFINITION OF HUMAN

DEFINITION: OF ENVIRONMENT

DEFINITION OF HEALTH

 DEFINITION OF NURSING

Nightingale
(1859)

Focus is on the environment.  The nurse must place patient in best possible condition (environment) for healing to occur.

Human is not defined, but defines a patient as someone with a disease process.

The environment is all external conditions and influences affecting the life and development of organisms and capable of preventing, suppressing, or contributing to disease or death.

Absence of disease (disease is a reparative process).

The nurse provides an environment conducive to healing and health promotion (the proper use of fresh air, light, warmth, quiet, cleanliness, punctuality, diet).  

The nurse is an observer who knows what to react to, what to reverse, and what to ignore.  A nurse is any person in charge of the personal health of another.

Abdellah
(1960)

Focus is on 21 nursing problems.

Not defined

Not defined

Health is a dynamic state of human functioning where the individual constantly adapts to internal and external stressors in an attempt to achieve maximum potential for daily living.

Nursing is a service to individuals, to families, and therefore to society.  It is a non-holistic problem solving approach with 21 nursing problems based on identified health needs.

Peplau
(1962)

A psychiatric nurse

Focus is on the interpersonal relationship.  Has 4 phases--

1.   Orientation
2.   Identification
3.   Exploitation
4.   Resolution

--which facilitate the growth and development of client and nurse.

A human is an organism that strives to reduce tension generated by unmet needs that shape behavior.

The environment consists of physical demands that require manipulation on behalf of welfare of the individual or group.   Interpersonal conditions allow expression and use of cooperation in a productive way.

Health implies forward movement of personality and other ongoing human process in the direction of creative, constructive, productive, personal, community living.

Nursing supports a therapeutic growth producing relationship that proceeds through the 4 phases. The nurse assists the patient to gain intellectual and interpersonal competencies beyond that which he/she has at the point of illness.

Hall
(1966)

Focus is on Care, Core, Cure

Human is not defined, but defines a patient as having 3 aspects of being:

1.  body
2.  pathology/ treatment
3.  person.

Not defined.

Theory is illness oriented—in illness, there is a lack of full self-awareness and self-control. 

The nurse is the "body expert."  Nursing is a nurturing service built on 3 interrelated components which are utilized according to the needs of the patient:

1.  Care component: Providing care and comfort for physical well being for those who require help.

2.   Core component: Sharing with other members of the health team.

3.   Cure component: Teaching by serving as a mirror, reflecting self and self-awareness for patients.

Levine
(1967)

Focus is on illness, dependency, and the principles of conservation:

1.  Energy
2.  Structural integrity.
3.  Personal integrity
4.  Social integrity

A human is a holistic being who requires a structure, personal, and social integrity, and energy in order to be in a state of health.

Not defined, but supports Nightingale's concept of environment.

Health is defined along the wellness-illness continuum; the client seeks care only in the illness state or altered health state.  A patient is dependent.

Nursing is based on 3 assumptions:

1.  Nursing involves human interaction.

2.  Nursing recognizes that people are dependent on their relationship with others.

3.  Nursing supports or promotes the clients adjustment through interventions, conservation of unity or integrity, presented as nursing problems.

Johnson (1968)

Focus is on balance/imbalance of a behavioral system.

A human is a behavioral system consisting of interrelated and interdependent subsystems.

Not defined.

Health is defined as maintaining needs of Interrelated and interdependent subsystems.

The nurse regulates the environment to provide or maintain, supply, control behavioral responses.

Rogers
(1970)

Focus is on the principles of

1.  Complimentarily (man and  environment).

2.   Helicy (direction of change).

3.   Resonancy (change of man and environment).

A  human is synergistic, evolving, and is a field with exchange of matter and energy in orderly movements and rhythms (unitary man).

The human/environment is an energy field co-existing together with the universe.  There is continuous interaction with environment through a developmental process that is growing, evolutionary and negantropic.

Health is defined as a symphonic interaction of holistic persons and their environments.

There are rhythms throughout the developmental process that have increased complexity and diversity.

Nursing supports the science of unitary man that facilitates symphonic interaction between the holistic person and his environment.

King
(1971)

A psychiatric nurse

Focus is on human and environmental interactions and perceptions that influence life and health.

A human is a three- dimensional being--

1.  A reacting being
2.  A time-oriented being
3. A social being

---who functions in a social system through interpersonal relationships in terms of his/her perceptions.

The environment consists of groups of individuals joined together in a network or system of social relationships to achieve common goals.   Groups interact according to standard or norms based on a set of roles and status.

Health is a dynamic state in a life cycle of an organism that implies adaptation to stresses in the internal and external environment through optimum use of one's resources to achieve maximum potential for daily living.

Nursing is a process of action, reaction, interaction and transaction. The nurse assists individuals through interpersonal relationships in meeting basic needs throughout the life cycle.  Nurses function in social systems to promote optimal health.

Orem
(1971)

An ICU nurse

Focus is on self-care.

1.   Universal (ADL)
2.   Developmental
3.   Health deviation

A human is an integrated whole, a unit functioning biologically, symbolically, and socially, and adapting to his environment.

The human/environment is an integrated system related to self-care and can be altered only within narrow limits. 

Health is a state of wholeness or integrity of the individual, his/her  parts, and modes of functioning.

Nursing is a human service that may be continuous or periodic and has both health and illness dimensions.   Nurses provide assistance with self-care activities when an individual is unable to perform those activities through one or more approaches.

Roy
(1974)

A pediatric nurse

Focus is on the adaptation of the individual to his/her environment.

A human is a  biopsychosocial being who interacts with and adapts to and with a dynamic environment through the use of mechanisms to conserve energy and maintain equilibrium.

The environment is a dynamic source of stimuli.

Health is the satisfactory response to and coping with environmental changes.

Nurses change (alter, manipulate) stimuli in the environment) to promote an individual’s adaptation. 

Nurses accomplish this through the identification of problems in 4 modes:

1.   physiological
2.   self-concept
3.   role mastery
4.   interdependence

Henderson
(1966)

Focus is on 14 components of nursing care.

A human is a biological being with inseparable mind and body.

The environment is not clearly defined, but can act on the individual in positive or negative way.

Health is the ability to function independently in relation to 14 components.

Nursing is primarily assisting the individual (sick or well) in the performance of those activities contributing to health, recovery, or a peaceful death that he/she would perform unaided with the necessary strength, will or knowledge.  The nurse assists the individual to be independent as soon as possible.

Orlando (1972)

A psychiatric nurse

Focus is on a goal oriented approach to nurse-patient interactions.

Humans are not defined, but patients are defined as  individuals with a medical  need which they cannot meet unaided.

The environment is the time and place, or the context of the nursing situation.

Health is mental and physical comfort, and a sense of adequacy and well being when individual's needs are met.

Nursing is the act of alleviating patient inadequacies through deliberate problem-solving. Validation of patient needs is vital, and the patient is involved in the nursing process.  The nurse acts to resolve unmet needs through continuous reflection by the nurse through:

a. Observing patient behavior.
b. Assessing own reaction
c. Appropriate intervention.

Leininger
(1978)

Focus is transcultural nursing and “ethnocaring" as a phenonmena.

Individuals, groups, and societies are generators and recipients of care within their own cultural context.

The environment consists of groups of individuals who share a common belief system about care and treatment of individuals within their group.  Each group has various stressors that affect their health in unique ways.

Health is defined by the specific culture and people's viewpoint.  There is a lack of congruence between views of technology-dependent cultures and non-technology dependent cultures.

Nursing is the humanistic and scientific application of knowledge in "caring" with emphasis on unique cultural values, beliefs, and health practices.   Transcultural nursing integrates cultural views, knowledge, and experiences in applying the nursing process specific to individuals of a culture.

Parse
(1981)

Focus is on Man--Living--Health.

A human is an open, living whole being, coexisting and participating with the environment while continuously co-constituting patterns of relating as an open being.  A human freely changes situations, attaches meaning to those situations and actions, and bears responsibility for his/her decisions.

The human/environment co-creates rhythmical patterns of relating in open exchange. In  freely choosing to live certain values, the human co-constitutes by creating meaning with others and the world.

Health is extentially experienced and defined by the individual; health is an open process of “becoming” through rhythmically co-constituting in the man-environment relationship.  It transcends the possible.

Nursing focuses on optimal health as defined by the individual.  Nursing is an art and science of focusing on the individual as a living unit.   Nursing focuses on caring and dealing by assisting individuals/family in choosing among possibilities in changing the health process.   Nursing helps individuals to recognize relationships in man-environment-value context, then presents other possibilities and choices to achieve health through “becoming.”