Understanding Nursing Theories

What Are Nursing Theories?

Nursing theories help guide and define nursing care and provide a foundation for clinical decision-making. Some nursing theories have impacted the field of public health for hundreds of years and are still being used in modern hospitals and healthcare settings.

If you’re thinking about going to school to become a nurse, nursing theory will likely make up part of your curriculum. To help prepare yourself, read on to learn more about some of the most influential nursing theories.

The Metaparadigm of Nursing

A metaparadigm is a set of ideas that provides structure for how a healthcare discipline should function. The metaparadigm of nursing refers to the four main concepts tied to nursing theory: person, health, environment, and nursing.

Person

The “person” component of the metaparadigm focuses on the receiver of care and the people in their life. It considers a patient’s social, spiritual, and healthcare needs. The theory is that a person can be more empowered to manage their health when they have positive personal connections.

Health

The “health” concept realizes that multiple factors go into a patient’s well-being—including physical, emotional, intellectual, spiritual, and social components—and how they can be integrated to achieve optimal health outcomes.

Environment

This concept focuses on the immediate and extensive surroundings that affect a patient and how those surroundings can influence their health and wellness. It theorizes that a person can, to an extent, alter their environment to improve their health.

Nursing

This aspect of the metaparadigm recognizes the relationship between a nurse and a patient. It focuses on the nurse’s role in providing a safe and caring environment and values the high degree of service necessary to deliver the best patient health outcomes.

There are a host of different research-based nursing models and theories that drive the practice and profession at large. These theories each incorporate the concepts of the metaparadigm of nursing, with specific nursing practice being shaped by the ideas of various nursing theorists and their models for nursing education and implementation.

What Are the Types of Nursing Theories?

All nursing theories are generally organized into three levels: grand, middle-range, and practice-level. Here’s a look at each:

Grand Nursing Theories

As the name implies, any theory that is based on broad, abstract, or complex concepts may fall under this category. Grand nursing theories typically provide a high-level framework for nursing ideas rather than diving into details.

Middle-Range Nursing Theories

Middle-range theories deal with specific areas of nursing as opposed to grand theories. These areas might stem from day-to-day nursing practices, research, or theories from similar disciplines.

Practice-Level Nursing Theories

Theories categorized in this level are the most focused. They deal with situation-specific concepts that are narrow in scope and concentrate on a particular patient population.

What Are Some Examples of Nursing Theories?

Some of the most common nursing theories include the following:

Environmental Theory

Known as the first nursing theorist and the founder of modern nursing, Florence Nightingale created the Environmental Theory in 1860, and its principles are still used today. She served as a nurse during the Crimean War, where she observed a connection between patients who died and their environmental conditions.

Nightingale’s Environmental Theory identifies five environmental factors—fresh air, pure water, efficient drainage, cleanliness, and sunlight—as essential factors in human health.

Casey’s Model of Nursing

Developed by Anne Casey in 1988, Casey’s Model of Nursing is considered one of the earliest nursing theories developed specifically for child health. This theory focuses on the nurse working in partnership with the child and their family. The philosophy is that the best people to care for a child are their family members with the assistance of health professionals.

Patient-Centered Approach to Nursing

Originating in the 1940s, Faye Abdellah’s patient-centered approach helps guide nursing education and is intended to direct how care is given in hospitals. Her theory outlines 10 steps to identifying a patient’s problem and discusses key skills to develop a proper treatment. The 10 steps include the following:

• Learn to know the patient.
• Sort out relevant and significant data.
• Make generalizations about available data in relation to similar nursing problems presented by other patients.
• Identify the therapeutic plan.
• Test generalizations with the patient and then make additional generalizations.
• Validate the patient’s conclusions about their nursing problems.
• Observe and evaluate the patient over time to identify attitudes and other clues affecting their behavior.
• Explore the patient’s reaction—and that of their family—to the therapeutic plan and involve them in the plan.
• Identify how relevant nurses feel about the patient’s nursing problems.
• Discuss and develop a comprehensive nursing care plan.

Theory of Comfort

Katharine Kolcaba’s Theory of Comfort was developed in the 1990s. According to the model, patient comfort is an immediate and desirable outcome of nursing care. Kolcaba describes comfort in three forms: relief, ease, and transcendence. If a patient’s comfort needs are met, they experience a sense of relief. As a patient’s comfort needs change, their nurse’s interventions adjust accordingly.

Tidal Model

Developed by nurse and psychotherapist Phil Barker in the 1990s, this model is widely used in mental health nursing and psychiatry. It centers on the fundamental care process, emphasizing values of social relationships and connection to help others in moments of distress. The Tidal Model draws from the “Ten Commitments,” which are designed to foster effective communication, empathy, honesty, and problem-solving between patient and nurse.

Self-Care Deficit Theory

Developed by Dorothea Orem between 1959 and 2001, the self-care deficit theory posits that those in the nursing profession can enhance patient care by allowing the patient to perform as much of their own self-care as they are capable of. This nursing model views patient recovery in a maturational way, meaning that as patients become more and more able, they are encouraged to take care of themselves while relying increasingly less on direct nursing involvement.

Cultural Care Theory

Madeleine Leininger’s cultural care theory promotes the idea that patient care should be culturally congruent. In other words, care should be administered in harmony with the patient's cultural or religious beliefs, practices, and values.

Peplau’s Therapeutic Nurse-Patient Theory

Hildegard Peplau’s theory of interpersonal relations highlights the importance of the various roles that nurses take on when caring for patients. Nurses that study and apply this theory can better understand how to establish expectations, answer questions, educate on relevant topics, offer support and encouragement, and advocate for patient success.

Virginia Henderson’s Need Theory

This theory teaches the significance of patient independence, especially after they’ve received all the care and treatment needed to recover. Henderson’s theory discusses the basic activities and practices that nurses must instill in their patients so that they will continue to be in good health once they’ve left healthcare facilities and returned to their day-to-day lives. At its core, need theory underscores the importance of patient self-reliance.

Why Are Nursing Theories Important?

Nursing theories provide a structural foundation for nursing students and professionals. As the field of nursing continues to grow, nursing theories play a key role in guiding patient care toward the most favorable possible outcomes. These theories...

• Provide nurses with rationale in making crucial healthcare decisions.
• Guide evidence-based research, which may then lead to the establishment of best nursing practices and policies.
• Help nurses evaluate patient care.
• Offer nurses a clear understanding of their purpose and role in a healthcare setting.
• Help patients, their families, and other healthcare professionals recognize the invaluable contributions of nurses.

If you’re looking to become a nurse in any number of healthcare fields, consider studying at WGU. An online nursing degree program at WGU is a great way to gain a deeper understanding of nursing theories and acquire the career-relevant skills you’ll need to thrive, whether you’re an aspiring student nurse or hoping to advance in your current nursing position.

Additionally, WGU’s competency-based learning model lets you advance through coursework as quickly as you show mastery of the material, so you can potentially graduate faster and save money. Learn more today.