Nursing theories aid in the direction and definition of nursing care and provide a basis for clinical decision-making. While some nursing theories have been used in public health for hundreds of years, many are still used in today’s hospitals and healthcare contexts.
A metaparadigm is a collection of ideas that define how a health care discipline should operate. This term in nursing refers to the four main concepts associated with the nursing theory.
Person
The person component focuses on the person receiving care and the people in their life, taking into account the patient’s social, spiritual, and healthcare needs. According to the theory, when people have positive personal connections, they are more empowered to manage their health.
Health
The health concept recognizes the various factors that contribute to a patient’s well-being, such as physical, emotional, intellectual, spiritual, and social components, and how they can be integrated to achieve the best health outcomes.
Environment
This concept relies on the patient’s environment and how it can influence their health and wellness. It states that a person’s environment can be changed to improve their health.
Nursing
This aspect of the metaparadigm acknowledges the relationship between a nurse and a patient. It stresses the role of a nurse in providing a safe and caring environment, as well as the high level of service required to provide the best patient health outcomes.
Based on nursing research, there are many different nursing theories and models that drive the nursing profession and nursing practice at large all over the world. Each of these theories incorporates concepts from the nursing metaparadigm, with the particular nursing practice being formed by the ideas of the nursing theorists who created the different models as nursing education and implementation strategies.
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Types of Nursing Theories
All nursing theories fall into grand, middle, and practice levels. Here’s a breakdown of each:
Grand Nursing Theories
- Grand theories are conceptual, broad in scope, and complex, necessitating additional research for clarification.
- Grand nursing theories do not direct specific nursing interventions but provide a broad framework and nursing concepts.
- Grand nursing theorists create their works according to their own experiences and time, which explains why there is such a wide range of theories.
- Address the components of the nursing metaparadigm of person, nursing, health, and environment.
Middle-Range Nursing theories
- More restricted in scope (in comparison to grand theories) and present concepts and propositions at a lower level of abstraction. They are concerned with a specific phenomenon in nursing.
- Nursing researchers proposed to use this level of theory due to the difficulty of testing grand ideas.
- Most of the middle-range theories account for the works of a grand theorist, but they can also be conceived through research, nursing practice, or other disciplines’ theories.
Practice-level Nursing theories
- Practice nursing theories are situational theories with a limited scope that focus on a particular patient population at a fixed time.
- Practice-level Nursing theories generate foundations for nursing interventions and predict the effects of nursing practice.
- Theories created at this level directly impact nursing practice more directly than theories developed at a higher level.
- These theories link to concepts from middle-range or grand theories.
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What Are Some Nursing Theories Examples?
There are numerous nursing theories, but here are a few examples:
Environment theory
Florence Nightingale, the first nursing theorist and the founder of modern nursing, developed the Environmental Theory in 1860. In the Crimean War, she worked as a nurse and noticed a link between patients who died and their environmental conditions. As a result, the Environment Theory came into being. Florence Nightingale identifies five environmental factors as critical to human health: fresh air, pure water, efficient drainage, cleanliness, and sunlight.
Casey’s Nursing Model
Casey’s Model of Nursing, developed in 1988 by Anne Casey, is regarded as one of the oldest nursing theories specifically developed for child health nursing. The philosophy is that a child’s family, with the assistance of health professionals, is the best person to care for them. This theory emphasizes the nurse’s collaboration with the child and their family.
Patient-Centered Approach to nursing
Faye Abdellah’s patient-centered Approach was developed in the 1940s to aid nursing education and is now used to guide hospital care. Her theory outlines ten steps for determining a patient’s problem and then expands into additional skills for developing a treatment. The ten steps are as follows:
- Get to know your patient.
- Sort through the data to find what is relevant and essential.
- Make broad generalizations based on available data about similar nursing problems presented by other patients.
- Determine the therapeutic strategy.
- Test the generalizations with the patient, and produce other generalizations.
- Validate the patient’s findings of their nursing issues.
- Monitor and evaluate the patient over time to identify any attitudes or clues influencing their behaviour.
- Investigate reactions to the therapeutic plan and involve the patient’s and their family’s in the plan
- Determine the nurses’ perspectives on the patient’s nursing issues.
- Discuss and create an all-inclusive nursing care plan.
Theory of Comfort
In the 1990s, Katharine Kolcaba developed her Theory of Comfort. The model states that comfort is an immediate desirable goal of nursing care. Kolcaba distinguished three types of comfort: relief, ease, and transcendence. When you meet patients’ comfort needs, they feel relieved. A change in patient’s comfort needs changes the nurse’s interventions.
The Tidal Model
This model, developed in the 1990s by the nurse and psychotherapist Phil Barker, is widely used in psychiatric and mental health nursing. It deals with the primary care process and draws on values about human relationships to assist others in times of distress. The Tidal Model is based on ten commitments: value the voice, respect the language, cultivate genuine curiosity, become the apprentice, use the available toolkit, craft the step beyond, give the gift of time, reveal personal wisdom, recognize that change is constant, and be transparent.
Self-care deficit theory
Self-care deficit theory, developed by Dorothea Orem between 1959 and 2001, is a health care theory. This nursing model believes that people want to take care of themselves and that nurses can improve patient care by allowing patients to do as much of their self-care as possible. The Orem self-care nursing model is designed to assist patients in their recovery by guiding them through the recovery process in a maturational manner. As the patient’s ability grows, the patient can do more of their care.
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Cultural Care Theory
Madeleine Leininger’s Cultural Care Theory is based on the notion that patient care should be culturally consistent. It explains that care should be compatible with the patients’ cultural or religious beliefs, practices, and values.
Importance of Nursing Theories
Health care theories provide a foundation for nursing students and professionals, just as they do for all professions. As the field of nursing expands, theories play an important role in structuring patient care—but that’s only the beginning. More reasons why nursing theories are essential include:
- Provide nurses with justification for their healthcare decisions.
- Direct evidence-based research, which results in best practices and policies.
- Assist nurses in evaluating patient care
- Improve nurses’ understanding of their purpose and role in the healthcare setting.
- Follow nursing best practices
- Give nurses a distinct identity that distinguishes nursing practice from medical practice.
- Assist patients and other healthcare professionals in recognizing the importance of nurses’ contributions.
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