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Rosemarie Rizzo Parse - Nursing Theorist

Most nursing theories focus on either a bio-medical approach or a bio-psychosocial-spiritual approach. And while these theories are not only valid, but often very effective, there are some nurses who would prefer to focus on the quality of life of their patients, particularly from each individual patient's perspective. The Human Becoming Theory of Nursing, developed by Rosemarie Rizzo Parse, addresses this very issue.

Biography of Rosemarie Rizzo Parse Rosemarie Rizzo Parse graduated from Duquesne University in Pittsburgh, and earned her Master's and Doctoral degrees from the University of Pittsburgh. Career of Rosemarie Rizzo Parse Parse served as a faculty member at the University of Pittsburgh, as well as the Dean of the Duquesne University School of Nursing. Between 1983 and 1993, she was a professor and coordinator of the Center for Nursing Research at the City University of New York's Hunter College. She was also a professor and the Niehoff Chair at Loyola University in Chicago from 1993 until 2006. Beginning in January 2007, she has worked as a consultant and visiting scholar at the New York University College of Nursing. Parse is the founder and current editor of Nursing Science Quarterly, and is president of Discovery International, Inc. She is also an active Fellow in the American Academy of Nursing. Throughout her career, Parse has published nine books and more than 100 articles and editorials about the nursing field. Page 1 of 74

Her awards include two Lifetime Achievement Awards given from the Midwest Nursing Research Society and the Asian American Pacific Islander Nurse's Association. A scholarship was created in her name at the Henderson State University School of Nursing, and the Society of Rogerian Scholars gave her the Martha E. Rogers Golden Slinky Award. Then, in 2008, she received the New York Times Nurse Educator of the Year Award. Some additional works written by Rosemarie Rizzo Parse are: The Nation's Health [ THE NATION'S HEALTH BY Parse, Rosemarie Rizzo ( Author ) Feb-21-2003 Community: A Human Becoming Experience Qualitative Inquiry: The Path of Sciencing Illuminations: The Human Becoming Theory In Practice And Research (NATIONAL LEAGUE FOR NURSING SERIES (ALL NLN TITLES)) Hope: An International Human Becoming Perspective (National League for Nursing Series) The Human Becoming School of Thought Nursing Science: Major Paradigms, Theories and Critiques Man-Living-Health: Theory of Nursing (A Wiley Medical Publication) Rosemarie Rizzo Parse's Contribution to Nursing Theory: Human Becoming Theory Rosemarie Rizzo Parse created the Human Becoming Theory of Nursing, which guides nurses to focus on quality of life from each person's own perspective as the goal of nursing. It presents an alternative to most of the other theories of nursing, which take a bio-medical or bio-psycho-social-spiritual approach. It was first published in 1981 as the "Man-living-health" theory, and in 1992 the name was changed to "the Human Becoming Theory." It was developed as a human science nursing theory, and the assumptions underpinning the theory come from the works of Heidegger, Sartre, and Merleau-Ponty, as well as Martha Rogers, who was a pioneer American nursing theorist. The Human Becoming Theory is a combination of biological, psychological, sociological, and spiritual factors, and states that a person is a unitary being in continuous interaction with his or her environment. It is centered around three Page 2 of 74

themes:

meaning,

rhythmicity,

and

transcendence.

The theme of meaning says that Human Becoming is choosing personal meaning in situations, and that a person's reality is given meaning through experiences he or she lives in the environment. Rhythmicity explains that Human Becoming is cocreating rhythmical patterns of relating with the universe, and that a person and the environment cocreate in rhythmical patterns. Transcendence says that Human Becoming refers to reaching beyond the limits a person sets, and that a person is constantly transforming him or herself. In terms of nursing, the Human Becoming Theory explains that a person is more than the sum of the parts, the environment and the person are inseparable, and that nursing is a human science and art that uses an abstract body of knowledge to help people. The theory allows nurses to create a stronger nurse-patient relationship because the nurse is not focused on "fixing" problems, but is viewing the patient as a whole person living experiences through his or her environment. The Human Becoming Theory of Nursing is a model that focuses on the quality of life of the patient and sees the patient not as different aspects of a whole, but as a person. This is different than many other nursing theories, and allows nurses to do what so many of them go into the nursing field to help people.

Patricia Benner Novice to Expert - Nursing Theorist


Biography and Career of Patricia Benner Benner earned her Bachelor of Arts degree in nursing from Pasadena College in 1964. She was given a Master of Science in Medical-Surgical Nursing from the University of California at San Francisco in 1970, and a Ph.D. from the University of California at Berkeley in 1982.

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In the late 1960s, Benner worked in the nursing field. This included working as a Head Nurse of the Coronary Care Unit at the Kansas City General Hospital and an Intensive Care Staff Nurse at the Stanford University Hospital and Medical Center. From 1970 until 1975, she was a Research Associate at the University of California at San Francisco School of Nursing. Following that, she was a Research Assistant to Richard S. Lazarus at the University of California at Berkeley. From 1979 until 1981, she was the Project Director at the San Francisco Consortium/University of San Francisco for a project achieving methods of intraprofessional consensus, assessment, and evaluation. Since 1982, Benner has been working in research and teaching at the University of California at San Francisco School of Nursing. Benner has published nine books, including From Novice to Expert, Nursing Pathways for Patient Safety, and The Primacy of Caring. She has also published many articles. In 1995, she was awarded the 15th Helen Nahm Research Lecture Award from the University of California at San Francisco School of Nursing. She is currently a professor emerita in the Department of Physiological Nursing at the University of California at San Francisco School of Nursing. Some of her works include: Educating Nurses: A Call for Radical Transformation Foundation for the Advancement of Teaching) (Jossey-Bass/Carnegie

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From Novice to Expert: Excellence and Power in Clinical Nursing Practice, Commemorative Edition Expertise in Nursing Practice: Caring, Clinical Judgment, and Ethics, Second Edition Clinical Wisdom and Interventions in Acute and Critical Care: A Thinking-in-Action Approach, Second Edition Interpretive Phenomenology: Embodiment, Caring, and Ethics in Health and Illness (Nurse-patient relations) New Nurses Work Entry: A Trouble Sponsorship Stress and Satisfaction on the Job Patricia Benner's Contribution to Nursing Theory: From Novice to Expert Concept Patricia Benner developed a concept known as "From Novice to Expert." This concept explains that nurses develop skills and an understanding of patient care over time from a combination of a strong educational foundation and personal experiences. Benner proposed that a nurse could gain knowledge and skills without actually learning a theory. She describes this as a nurse "knowing how" without "knowing that." She further explains that the development of knowledge in fields such as nursing is made up of the extension of knowledge through research and understanding through clinical experience. The theory identifies five levels of nursing experience: novice, advanced beginner, competent, proficient, and expert. A novice is a beginner with no experience. They are taught general rules to help perform tasks, and their rule-governed behavior is limited and inflexible. In other words, they are told what to do and simply follow instruction. The advanced beginner shows acceptable performance, and has gained prior experience in actual nursing situations. This helps the nurse recognize recurring meaningful components so that principles, based on those experiences, begin to formulate in order to guide actions. A competent nurse generally has two or three years' experience on the job in the same field. For example, two or three years in intensive care. The experience may also be similar day-to-day situations. These nurses are more aware of long-term goals, and they gain perspective from planning their own actions, which helps them Page 5 of 74

achieve

greater

efficiency

and

organization.

A proficient nurse perceives and understands situations as whole parts. He or she has a more holistic understanding of nursing, which improves decision-making. These nurses learn from experiences what to expect in certain situations, as well as how to modify plans as needed. Expert nurses no longer rely on principles, rules, or guidelines to connect situations and determine actions. They have a deeper background of experience and an intuitive grasp of clinical situations. Their performances are fluid, flexible, and highly-proficient. Benner's writings explain that nursing skills through experience are a prerequisite for becoming an expert nurse. These different levels of skills show changes in the three aspects of skilled performance: movement from relying on abstract principles to using past experiences to guide actions; change in the learner's perception of situations as whole parts rather than separate pieces; and passage from a detached observer to an involved performer, engaged in the situation rather than simply outside of it. The levels reflect movement from reliance on past principles to the use of past experience and change in the perception of the situation as a complete whole with certain relevant parts. Each step builds on the previous step as principles are refined and expanded by experience and clinical expertise. Benner's theory of From Novice to Expert changed the understanding of what it means to be an expert in the nursing field. This moves the label from a nurse with the highest pay or the most prestigious title to the nurse who provided the best care to his or her patients.

Henry (Harry) Stack-Sullivan - Nursing Theorist


Biography and Career of Henry (Harry) Stack-Sullivan Henry Stack-Sullivan who also known by the name Harry Stack-Sullivan was born on February 21, 1892 in Norwich, New York to Irish immigrant parents. His social isolation as a child may have contributed his later interest in psychiatry. After graduating from the Smyrna Union School, he spent two years at Cornell University, beginning in 1909. In 1917, Stack-Sullivan earned his medical degree from the Chicago College of Medicine and Surgery. Page 6 of 74

Between 1925 and 1929, Stack-Sullivan worked at the Sheppard Pratt Hospital, treating schizophrenic patients with treatments considered experimental. He was a founder of the William Alanson White Institute, as well as of the journal Psychiatry in 1937. From 1936 until 1947, he was the head of the Washington School of Psychiatry in Washington, D.C. In 1940, he and a colleague, Winifred Overholser, formulated guidelines used by the United States military for the psychological screening of inductees. Stack-Sullivan's writings include The Interpersonal Theory of Psychiatry (1953), Conceptions Of Modern Psychiatry(1947/1966), Schizophrenia as a Human Process (Norton Library,) (1962), and Personal Pathology (1933/1972). Stack-Sullivan died on January 14, 1949 in Paris, France.

Some of Henry Stack-Sullivan's other works are: The Psychiatric Interview (Norton Library) International Behavioural and Social Sciences Library: The Interpersonal Theory of Psychiatry (International Behavioural and Social Sciences, Classics from the Tavistock Press) Clinical Studies In Psychiatry (Norton Library) Personal Psychopathology: Early Formulations The Collected Works of Harry Stack Sullivan, M. D. The Psychiatric Interview.

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Henry Stack-Sullivan's Contribution to Nursing: Sullivan's Interpersonal Theory Stack-Sullivan is known for his Interpersonal Theory. He is considered the father of interpersonal psychiatry or interpersonal psychoanalysis. He proposed the interpersonal theory of personality. He explained the role of interpersonal relationships and social experiences in shaping personality. He also explained the importance of current life events to psychopathology. The theory further states that the purpose of all behavior is to get needs met through interpersonal interactions and to decrease or avoid anxiety. The theory identifies six developmental stages called "epochs" or "heuristic stages in development." They are: infancy, childhood, juvenile era, preadolescence, early adolescence, and late adolescence. Infancy, which takes place from birth to 18 months, focuses on the gratification of needs. Childhood occurs between 18 months and six years. The main characteristic of this stage is delayed gratification. The juvenile era is between six and nine years, and is characterized by the formation of a peer group. Preadolescence, which takes place between the ages of nine and 12 years old, is characterized by developing relationships within the same gender. Early adolescence is from 12 to 14 years old, and during this stage, people develop individual identities. Late adolescence takes place between 14 and 21 years. The main characteristic of this stage is the formation of lasting, intimate relationships. Stack-Sullivan explains three types of self: the "good me," the "bad me," and the "not me." The "good me" versus the "bad me" is based on social appraisal and the anxiety that results from negative feedback. The "not me" refers to the unknown, repressed aspect of the self. In terms of anxiety, self-system, and self-esteem, the theory explains that security operations are the measures that the individual employs to reduce anxiety and enhance security. The self-system is all of the security operations an individual uses to defend against anxiety and ensure self-esteem. This theory provides the theoretical basis for interpersonal psychotherapy to treat patients with depression and schizophrenia. Interpersonal theory proposes that, most often, depression develops in the context of adverse events. Particularly, it develops in instances of interpersonal loss. The theory also addresses techniques and approaches on psychiatric interviews.

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Katharine Kolcaba - Nursing Theorist


One of the many roles of a nurse is to make sure patients are well cared for and comfortable. After all, many people decide to go into the field of nursing to help people, and what better way to help patients than to make sure they have everything they need to be comfortable during treatment and recovery? In Katharine Kolcaba's Comfort Theory of Nursing, the focus is on patient comfort. And though her theory is relatively new, it is one that will seem to be useful in a wide variety of nursing settings.

Biography of Katharine Kolcaba Katharine Kolcaba was born in Cleveland, Ohio in 1944.

In 1965, she earned her Nursing diploma from St. Luke's Hospital School of Nursing, then graduated from the Frances Payne Bolton School of Nursing at Case Western Reserve University in 1987. In 1997, Kolcaba earned her Ph.D. in Nursing, and received a Certificate of Authority as a Clinical Nursing Specialist. Her education specialized in Gerontology, End of Life and Long Term Care Interventions, Comfort Studies, Instrument Development, Nursing Theory, and Nursing Research. Career of Katharine Kolcaba Kolcaba is currently serving as Associate Professor of nursing at the University of Akron College of Nursing. She has received many awards, including the Cushing Robb Prize from Case Western Reserve University in 1987 for outstanding work in a Master of Science in Nursing program and the Advancement of Science Award from Midwest Nursing Research Society for End of Life and Palliative Care Nursing in Page 9 of 74

2003. In 2005, she was awarded the Mary Hanna Journalism Second Place Award in the Best Practice Category by the American Society of Perianesthesia Nurses for a co-written article published in the Journal of PeriAnesthesia Nursing. She was also given the Marie Haug Student Award for Excellence in Aging Studies from Case Western Reserve Univeristy in 1997. Most recently, she was given the Researcher of the Year award with Dr. Therese Dowd from the Delta Omega Chapter of Sigma Theta Tau in 2006. Since retiring from teaching, Kolcaba has focused on volunteering with the American Nurses Association and the Honor Society of Nursing, Sigma Theta Tau. Her publications include Comfort Theory and Practice: A Vision for Holistic Health Care and Research. Another work by Katharine Kolcaba includes: Comfort theory and its application to pediatric nursing.: An article from: Pediatric Nursing Katharine Kolcaba's Contribution to Nursing Theory: Comfort Theory Kolcaba developed her nursing theory in the 1990s. It is a middle range nursing theory designed for nursing practice, research, and education. According to her theory, patient comfort exists in three forms: relief, ease, and transcendence. These comforts can occur in four contexts: physical, psychospiritual, environmental, and sociocultural. Relief comfort usually comes in the form of pain management through medications. When medications are administered, the patient has a sense of relief from the pain. Ease comfort is focused more on the environment and psychological state of the patient. For example, after issues of anxiety are addressed and dealt with, a patient feels at ease. Finally, transcendence comfort comes when a patient is able to rise above challenges that occur in care and recovery. In this theory, the role of a nurse is to assess a patient's comfort needs and create a nursing care plan to meet those needs. As a patient's comfort needs change, the nurse's interventions change, as well. Through this method, nurses are able to ensure their patients are properly cared for, and that they are comfortable. If a patient is comfortable, he or she will feel emotionally and mentally better, which will aid in recovery.

Faye Abdellah - Nursing Theorist


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Biography and Career of Faye Glenn Abdellah Faye Glenn Abdellah was born on March 13, 1919.

Abdellah was the first nurse officer to earn the ranking of a two-star rear admiral. She was the first nurse and the first woman to serve as a Deputy Surgeon General. Her work changed the focus of nursing from disease-centered to patient-centered, and began to include the care of families and the elderly in nursing care. The Patient Assessment of Care Evaluation developed by Abdellah is now the standard used in the United States.

Her publications include Better Nursing Care Through Nursing Research and Patient-Centered Approaches to Nursing. She also developed educational materials in many areas of public health, including AIDS, hospice care, and drug addiction. She was inducted into the National Women's Hall of Fame in 2000.

Additional works written by Faye Abdellah include: Preparing Nursing Research for the 21st Century: Evolution, Methodologies, Challenges New Directions in Patient-Centered Nursing; Guidelines for Systems of Service, Education, and Research Surgeon General's Workshop, Health Promotion and Aging proceedings. March 2023, 1988 Words of Wisdom from Pivotal Nurse Leaders

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Faye Glenn Abdellah's Contribution to Nursing Theory: Twenty-One Nursing Problems According to Abdellah's Twenty-One Nursing Problems theory of nursing, "Nursing is based on an art and science that moulds the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs." The patient-centered approach to nursing was developed from Abdellah's practice, and the theory is considered a human needs theory. It was created to help with nursing education, so it most applicable in that area. The nursing model is intended to guide care in hospitals, but can be applied to community nursing, as well. The model has interrelated concepts of health and nursing problems, as well as problem-solving, which is an activity inherently logical in nature. Abdellah's theory identifies ten steps to identify the patient's problem and 11 nursing skills used to develop a treatment typology. The ten steps are: 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 make additional generalizations. Validate the patient's conclusions about his nursing problems. Continue to observe and evaluate the patient over a period of time to identify any attitudes and clues affecting his or her behavior. Explore the patient and his or her family's reactions to the therapeutic plan and involve them in the plan. Identify how the nurses feel about the patient's nursing problems. Discuss and develop a comprehensive nursing care plan. The 11 nursing skills are: observation of health status skills of communication application of knowledge

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teaching of patients and families planning and organization of work use of resource materials use of personnel resources problem-solving direction of work of others therapeutic uses of the self nursing procedure The model identifies nursing as a helping profession. Nursing care is doing something to or for a patient, or providing information to the patient with the intention of meeting needs, increasing self-ability, or alleviating impairment. In other words, helping patients become more healthy. Abdellah describes health as a state mutually exclusive of illness. There is no definition of health given by her in the theory, but she speaks to "total health needs" and "a healthy state of mind and body" in her description of nursing as a comprehensive service. The nursing process in Abdellah's Twenty-One Nursing Problems theory is: assessment, nursing diagnosis, planning, implementation, and evaluation. In the assessment phase, nursing problems provide guidelines for the collection of data. A principle underlying the problem-solving approach is that for each identified problem, pertinent data is collected. The overt or covert nature of problems necessitates a direct or indirect approach, respectively. The results of the collection of data in the assessment phase determine the patient's specific problems, which can be grouped under one or more of the broader nursing problems. This creates the nursing diagnosis. The statement of nursing problems most closely resembles goal statements. Using the goals in the framework, a nursing care planis developed and appropriate nursing interventions are determined. Putting those interventions in action is the implementation phase of the nursing process. After the interventions have been carried out, the evaluation takes place. The most

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appropriate evaluation would be the nurses progress or lack of progress toward the achievement of the goals established in the planning phase.

Phil Barker - Nursing Theorist


There are no absolutes in health care. A patient's health is fluid, and nurses often have to adapt to an individual patient's situation in order to help him or her get healthy. What works for one patient in his or her illness may not work for another patient in his or her illness. Barker's Tidal Model helps nurses care for patients in the mental health field by recognizing and working with the inevitability of change in a patient's life and environment.

Biography and Career of Phil Barker With more than 40 years experience in the field of psychiatric nursing, Phil Barker was the United Kingdom's first professor of psychiatric nursing at Newcastle University. He is currently a psychotherapist and honorary professor at the University of Dundee in Scotland. He has authored more than a dozen books, including the Tidal Model of Mental Health Recovery and Reclamation. Barker was awarded an honorary doctorate at the Oxford Brookes University in 2001. Other works written by Prof. Phillip Barker include: The Tidal Model: A Guide for Mental Health Professionals

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The Tidal Model: Developing a Person-Centered Approach to Psychiatric and Mental Health Nursing.: An article from: Perspectives in Psychiatric Care Basic Family Therapy Psychotherapeutic Metaphors: A Guide To Theory And Practice (Basic Principles Into Practice Series) Assessment in Psychiatric and Mental Health Nursing: In Search of the Whole Person Clinical Interviews With Children and Adolescents Using Metaphors In Psychotherapy Basic Child Psychiatry Residential Psychiatric Treatment of Children Patient Assessment in Psychiatric Nursing Psychiatric Nursing: Ethical Strife Psychiatric and Mental Health Nursing 2nd Edition: The craft of caring Ethical Issues in Mental Health Phil Barker's Contribution to Nursing Theory: Tidal Model The Tidal Model of nursing, created by Phil Barker, Poppy Buchanan-Barker and their colleagues, is widely used in mental health nursing. It views health and illness as fluid, and life as a journey undertaken on an ocean of experience. However, it states that patients can become physically, emotionally, or spiritually shipwrecked. This metaphor of water throughout the theory should be appreciated by nurses to help them gain a better understanding of the patient's current situation, as well as the inevitability of change. Barker's model includes six philosophical assumptions: a belief in the virtue of curiosity; recognition of the power of resourcefulness; respect for the patient's wishes; acceptance of the paradox of crisis as opportunity; acknowledging that all goals must belong to the patient; and the virtue of pursuing elegance, which means the simplest possible means should be sought. In order for the nurse to start the engagement process with the patient, six things must be accepted: recovery is possible; change is inevitable; ultimately, people know what's best for them; the patient has all the resources he or she needs to Page 15 of 74

start the recovery journey; the patient is the teacher and the helpers are the students; and the helper needs to be creatively curious, to learn what needs to be done to help the patient recover. The engagement process takes place in three domains: self, world, and others. The self domain is where people feel their experiences, and it includes an emphasis on making patients more secure through the development of a Security Plan to reduce threats to the patient and others around him or her. The world domain is where people hold their stories. The Tidal Model nurse uses a specific way of questioning to explore the patient's story, reveal its hidden meanings, the patient's resources, and find out what needs to be done to help with his or her recovery. The others domain represents the relationships of the patient, past, present, and future. This includes the patient's care team. The values of the Tidal Model are revealed in the Ten Commitments: Value the voice. That is, the patient's story is paramount. Respect the language, which means to let the patient use his or her own language. Develop genuine curiosity, or show interest in the patient's story. Become the apprentice to learn from the person being helped. Reveal personal wisdom. Patients are experts in their own stories. Be transparent. Nurses should model confidence by being transparent and helping make sure the patient always knows exactly what's being done. Use the available toolkit; the patient's story contains valuable information as to what works and what doesn't. Craft the step beyond. That is, the patient and nurse work together to construct an appreciation of what needs to be done in that moment. Give the gift of time to foster change. Know that change is constant. Each of the Ten Commitments has two Competencies associated with it. These were introduced to help with generating practice-based evidence for the Tidal Model.

Helen Erickson - Nursing Theorist

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Biography and Career of Helen C. Erickson Helen C. Erickson was born in 1936. She earned her graduate degree from the University of Michigan, Ann Arbor in the mid-1970s. It was during this time she met Evelyn M. Tomlin, and it was their discussions that began the research into the Modeling and Role Modeling Theory of nursing. In 1986, Erickson began serving as an Associate Dean of Academic Affairs at the University of South Carolina. In 2006, she edited a book that provides more in-depth information about the relationships between soul, spirit, and human form. She currently lives in Texas, where she is a Professor Emeritus at the University of Texas at Austin.

Other works written by Dr. Erickson include: Modeling and Role-Modeling: A View from the Client's World Helen C. Erickson's Contribution to Nursing Theory: Modeling and Role Modeling Theory The Modeling and Role Modeling Theory of nursing was created by Helen C. Erickson, along with Evelyn M. Tomlin and Mary Ann P. Swain. It was first published in their book, Modeling and Role Modeling: A Theory and Paradigm for Nursing, which was published in 1983. The Modeling and Role Modeling Theory draws on concepts from Piaget's Theory of Cognitive Development, Maslow's Theory of Hierarchy of Needs, Erikson's Theory of Psychosocial Stages, and Selye and Lazarus's General Adaptation Syndrome. Erickson's theory helps nurses care for their patients by recognizing each Page 17 of 74

individuals uniqueness, and focusing on the individual patient's needs. It is also a self-care method of nursing, which means it is based on the patient's perceptions of the environment, and adapts based on individual stressors for that patient. According to the theory, modeling recognizes that each patient has a unique perspective of his or her world. Modeling is a process that enables a nurse to understand that unique perspective and learn to appreciate its importance to the patient. The nurse uses the process of modeling to understand the world from the patient's perspective. The Modeling and Role Modeling Theory of nursing helps the nurse to do this by explaining some of the similarities and differences among patients. Role modeling accepts each patient regardless of his or her perspective on the world, and cares for the patient in order to work toward health. According to the nursing theory, the patient is the expert in his or her own care, and knows best in how he or she should be cared for to get back to health. In the Modeling and Role Modeling Theory, the roles of nursing are facilitation, nurturance, and unconditional acceptance. In addition, Erickson's model says that the five goals of nursing intervention are: to build trust, to promote the patient's positive orientation, to promote the patient's control, to affirm and promote the patient's strengths, and to set mutual, health-directed goals. Biography and Career of

Katie Eriksson

Katie Eriksson is a Finland-Swedish nurse. After taking nursing in 1965 to be able to practice nursing, she became a nursing instructor at Helsinki Swedish Medical Institute. She currently works as a professor of health sciences at Abo Akademi University in Vaasa, where she built a master's degree program in health sciences, and a four-year postgraduate studies program leading to a doctoral degree in health sciences. One of Katie Eriksson's works is: The Suffering Human Being

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Katie Eriksson's Contribution to Nursing Theory: Theory of Caritative Caring The Theory of Caritative Caring was developed by Katie Eriksson. This model of nursing distinguishes between caring ethics, the practical relationship between the patient and the nurse, and nursing ethics. Nursing ethics are the ethical principles that guide a nurse's decision-making abilities. Caritative caring consists of love and charity, which is also known as caritas, and respect and reverence for human holiness and dignity. According to the theory, suffering that occurs as a result of a lack of caritative care is a violation of human dignity.

Virginia Henderson - Nursing Theorist

As a patient receives treatment and is on the road to recovery, it's important that the patient is able to take care of him or herself after being released from medical care. To that end, nurses should be caring for the patient while, at the same time, be helping the patient become more independent and reach goals and milestones on the road to health. Virginia Henderson's Need Theory addresses this issue and helps nurses help patients so that they can care for themselves when they leave the healthcare facility.

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Biography of Virginia Henderson Virginia Henderson was born on November 30, 1897 in Kansas City, Missouri, and was the fifth of eight children in her family. In 1921, Henderson graduated from the Army School of Nursing at Walter Reed Hospital in Washington, D.C. In 1932, she earned her Bachelor's Degree and in 1934 earned her Master's Degree in Nursing Education, both from Teachers College at Columbia University. Henderson died on March 19, 1996. Career of Virginia Henderson After graduating from the Army School of Nursing, Henderson worked at the Henry Street Visiting Nurse Service for two years. In 1923, she started teaching nursing at the Norfolk Protestant Hospital in Norfolk, Virginia. After earning her Master's Degree, she stayed on at Teachers College as a faculty member, where she remained until 1948. After 1953, Henderson served as a research associate at the Yale University School of Nursing. Henderson received Honorary Doctoral degrees from the Catholic University of America, Pace University, the University of Rochester, the University of Western Ontario, and Yale University. In 1985, Henderson was presented with the first Christianne Reimann Prize from the International Council of Nurses. She was also an honorary fellow of the United Kingdom's Royal College of Nursing. The same year, she was also honored at the Annual Meeting of the Nursing and Allied Health Section of the Medical Library Association.

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Henderson is well known for her definition of nursing, which says, "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge." Written works by Virginia Henderson include: Nature of Nursing Principles and Practice of Nursing A Virginia Henderson Reader: Excellence in Nursing Basic Principles of Nursing Care Textbook of the Principles and Practice of Nursing, 5th Edition Virginia Henderson's Contribution to Nursing Theory: Nursing Need Theory Henderson's Need Theory emphasizes the importance of patient independence so that the patient will continue to progress after being released from the hospital. Henderson described the role of the nurse as one of the following: substitutive, which is doing something for the patient; supplementary, which is helping the patient do something; or complementary, which is working with the patient to do something. All of these roles are to help the patient become as independent as possible. She categorized nursing activities into fourteen components based on human needs. The fourteen components of Henderson's concept are as follows: Breathe normally. Eat and drink adequately. Eliminate body wastes. Move and maintain desirable postures. Sleep and rest. Select suitable clothes-dress and undress. Maintain body temperature within normal range by adjusting clothing and modifying environment. Keep the body clean and well groomed and protect the integument. Avoid dangers in the environment and avoid injuring others.

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Communicate with others in expressing emotions, needs, fears, or opinions. Worship according to one's faith. Work in such a way that there is a sense of accomplishment. Play or participate in various forms of recreation. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. While a nurse's job is to care for patients, it is also to help patients be able to care for themselves when they leave the healthcare facility. This will help ensure that the patient has fewer setbacks during recovery from the illness or injury, and will help the transition into self-care be smoother since a nurse will be helping and supervising along the way until the patient goes home. For those nurses who work in rehabilitation, Henderson's theory is one that can be easily used every day, and it will be the patients who benefit from it.

Biography and Career of

Lydia E. Hall

Lydia

E.

Hall

was

born

on

September

21,

1906

in

New

York

City.

In 1927, she earned her nursing diploma and went on to complete a Bachelor of Science in Public Health Nursing in 1937. She earned a Master's degree to teach natural sciences in 1942. Hall worked as the first director of the Loeb Center for Nursing. Her nursing experience was in clinical nursing, nursing education, research, and in a supervisory role. Hall died in 1969. Page 22 of 74

Lydia E. Hall's Contribution to Nursing Theory: Care, Cure, Core Theory of Nursing Lydia E. Hall developed the Care, Cure, Core Theory of Nursing in the late 1960s as a result of her work in psychiatry, as well as her experiences at the Loeb Center. In her career, she promoted involvement of community members in health-care issues, as well. Also known as "the Three Cs of Lydia Hall," Hall's theory contains three independent but interconnected circles. The three circles are: the core, the care, and the cure. The core is the patient to whom nursing care is directed. The core has set goals by him or herself rather than by a healthcare provider or family and friends. The core makes decisions and behaves according to his or her feelings and values. The cure is the attention given to the patient by the nurse and other medical professionals. In this model, the focus of care is not only on the nurse, but on all healthcare professionals involved in the care of the patient. The cure includes interventions or actions geared toward treating the patient of whatever illness, disease, or disability he or she may be suffering from. The care circle is Hall's explanation of the role of nurses in her model. According to the theory, nurses are focused on performing the noble task of nurturing patients. This specifically speaks to the "motherly" nature of nursing, which may include a nurse addressing a patient's comfort issues. The role of nursing also includes educating patients, and helping a patient meet any needs he or she is unable to meet alone. The theory puts emphasis on the importance of the total patient rather than looking at one part or aspect. There is also emphasis put on all three aspects of the theory (care, cure, and core circles) functioning together.

Biography and Career of

Dorothy E. Johnson

Dorothy E. Johnson was born on August 21, 1919 in Savannah, Georgia. She earned her Bachelor of Science in Nursing in 1942 from Vanderbilt University in Nashville, Tennessee. In 1948, she received her Master's degree from Harvard University.

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During her career, Johnson was an assistant professor of pediatric nursing, an associate professor of nursing, and a professor of nursing at the University of California in Los Angeles. She retired in 1978.

Works written by Dorothy Johnson include: Theory Development: What, Why, How? Barriers and Hazards in Counseling Dorothy Johnson's Contribution to Nursing: Behavior System Model Johnson is known for her Behavior System Model of Nursing, which was first proposed in 1968. The model advocates the fostering of efficient and effective behavioral functioning in the patient to prevent illness. The patient is defined as a behavioral system composed of seven behavioral subsystems. Each subsystem is comprised of four structural characteristics. An imbalance in each system results in disequilibrium. The nurse's role is to help the patient maintain his or her equilibrium. Johnson's theory of nursing defines nursing as "an external regulatory force which acts to preserve the organization and integration of the patients behaviors at an optimum level under those conditions in which the behavior constitutes a threat to the physical or social health, or in which illness is found." The goals of nursing are fourfold, according to the Behavior System Model: To assist the patient whose behavior is proportional to social demands. To assist the patient who is able to modify his behavior in ways that it supports biological imperatives. Page 24 of 74

To assist the patient who is able to benefit to the fullest extent during illness from the physician's knowledge and skill. To assist the patient whose behavior does not give evidence of unnecessary trauma as a consequence of illness. The assumptions made by Johnson's theory are in three categories: assumptions about system, assumptions about structure, and assumptions about functions. There are four assumptions about system in the model: There is "organization, interaction, interdependency and integration of the parts and elements of behaviors that go to make up the system." A system "tends to achieve a balance among the various forces operating within and upon it, and that man strive continually to maintain a behavioral system balance and steady state by more or less automatic adjustments and adaptations to the natural forces occurring on him." A behavioral system, which requires and results in some degree of regularity and constancy in behavior, is essential to man. It is functionally significant because it serves a useful purpose in social life as well as for the individual. "System balance reflects adjustments and adaptations that are successful in some way and to some degree." The four assumptions about structure and function are that: "from the form the behavior takes and the consequences it achieves can be inferred what 'drive' has been stimulated or what 'goal' is being sought." Each individual person has a "predisposition to act with reference to the goal, in certain ways rather than the other ways." This predisposition is called a "set." Each subsystem has a repertoire of choices called a "scope of action." The individual patient's behavior produces an outcome that can be observed. There are three functional requirements for the subsystems. The system must be protected from toxic influences with which the system cannot cope. Each system has to be nurtured through the input of appropriate supplies from the environment. The system must be stimulated for use to enhance growth and prevent stagnation. Page 25 of 74

These behaviors are "orderly, purposeful and predictable and sufficiently stable and recurrent to be amenable to description and explanation." Johnson's theory defines health as a purposeful adaptive response to internal and external stimuli in order to maintain stability and comfort. The main goal of nursing is to foster equilibrium within the individual patient. The practice of nursing is concerned with the organized and integrated whole, but maintaining a balance in the behavior system when illness occurs is the major focus of the career. The nursing process of the Behavior System Model of Nursing begins with an assessment and diagnosis of the patient. Once a diagnosis is made, the nurse and other healthcare professionals develop a nursing care plan of interventions and setting them in motion. The process ends with an evaluation, which is based on the balance of the subsystems.

Imogene King - Nursing Theorist


Many people decide to pursue a career in nursing because they want to be instrumental in helping patients get healthy. In order to do that, it's necessary to set health goals with the patient, then take steps to achieve those goals. Imogene King's Theory of Goal Attainment focuses on this process to aid nurses in the nursepatient relationship, helping their patients meet the goals they set for their health.

Biography of Imogene King

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Imogene King was born on January 30, 1923 in West Point, Iowa. She received her nursing diploma from St. John's Hospital School of Nursing in St. Louis, Missouri, in 1945. In 1948, she earned her Bachelor of Science in Nursing from St. Louis University, and went on to complete her Master's of Science in Nursing, also from St. Louis University in 1957. She also earned her doctoral degree from Teachers College, Columbia University in 1961. She died on December 24, 2007. Career of Imogene King Between 1966 and 1968, King worked as Assistant Chief of the Research Grants Branch of the Division of Nursing in Washington, D.C. under Dr. Jessie Scott. She was the director of the Ohio State University School of Nursing from 1968 until 1972. She was an Associate Professor from 1961 until 1966 and a Professor from 1971 until 1980 at Loyola University in Chicago. After serving as a professor at the University of South Florida's College of Nursing in Tampa, Florida from 1980 until 1990, King retired with the title Professor Emeritus. During her career, King was an active member of the District IV Florida Nurses Association, the American Nurses Association, and Sigma Theta Tau International. She was also a Fellow in the American Academy of Nursing. Some of her works include: Theory for Nursing: Systems, Concepts, Process Theory for Nursing: Systems, Concepts and Process The Language of Nursing Theory and Metatheory Toward a Theory for Nursing: General Concepts of Human Behaviour Curriculum and Instruction in Nursing: Concepts and Process Imogene King's Contribution to Nursing Theory: Theory of Goal Attainment Imogene King's Theory of Goal Attainment was first introduced in the 1960s. The basic concept of the theory is that the nurse and patient communicate information, set goals together, and then take actions to achieve those goals. It describes an interpersonal relationship that allows a person to grow and develop in order to attain certain life goals. The factors that affect the attainment of goals are roles, stress, space, and time. According to King, the patient is a social being who has three fundamental needs: the need for health information, the need for care that seeks to prevent illness, and the need for care when the patient is unable to help him or herself. She explains Page 27 of 74

health as involving life experiences of the patient, which includes adjusting to stressors in the internal and external environment by using resources available. The environment is the background for human interaction. It involves the internal environment, which transforms energy to enable people to adjust to external environmental changes, and it involves the external environment, which is formal and informal organizations. A nurse is considered part of the patient's environment. The three interacting systems in her Theory of Goal Attainment are the personal system, the interpersonal system, and the social system. Each system is given different concepts. The concepts for the personal system are: perception, self, growth and development, body image, space, and time. The concepts for the interpersonal system are: interaction, communication, transaction, role, and stress. The concepts for the social system are: organization, authority, power, status, and decision making. King's Theory of Goal Attainment defines nursing as "process of action, reaction and interaction by which nurse and patient share information about their perception in nursing situation." According to King, nursing's focus is on the care of the patient, and its goal is the health care of patients and groups of patients. According to King, the goal of the nurse is to help patients maintain health so they can function in their individual roles. The nurse's function is to interpret information in the nursing process, to plan, implement, and evaluate nursing care. In the nurse-patient relationship, the nurse first uses his or her knowledge base to assess the patient and make a diagnosis. After the diagnosis, the nurse creates a plan for interventions to solve problems that were identified in the assessment and diagnosis. Once a care plan is created, actions are implemented to achieve the patient's health goals. Finally, the nurse evaluates the patient to determine whether or not the goals were achieved. In the healthcare field, the ultimate goal in the nurse-patient relationship is to help the patient achieve his or her goals for getting healthy. By using the nursing process described in Imogene King's Theory of Goal Attainment, a nurse can be more effective in working with a patient to achieve those goals, and can truly help patients.

Madeleine Leininger - Nursing Theorist

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While it is important to look at a patient as a whole person from a physiological, psychological, spiritual, and social perspective, it is also important to take a patient's culture and cultural background into consideration when deciding how to care for that patient. After all, the values and beliefs passed down to that patient from generation to generation can have as much of an effect on that patient's health and reaction to treatment as the patient's environment and social life. The Transcultural Nursing theory developed by Madeleine Leininger is now a nursing discipline that is an integral part of how nurses practice in the healthcare field today.

Biography and Career of Madeleine Leininger Madeleine Leininger was born on July 13, 1925 in Sutton, Nebraska. She earned several degrees, including a Doctor of Philosophy, a Doctor of Human Sciences, a Doctor of Science, and is a Registered Nurse. She is a Certified Transcultural Nurse, a Fellow of the Royal College of Nursing in Australia, and a Fellow of the American Academy of Nursing. Some of Madeleine Leininger's works include: Transcultural Nursing : Concepts, Theories, Research and Practice Culture Care Diversity & Universality: A Worldwide Nursing Theory (Cultural Care Diversity (Leininger)) Page 29 of 74

Culture Care Diversity and Universality: A Theory of Nursing Madeleine Leininger: Cultural Care Diversity and Universality Theory (Notes on Nursing Theories) Caring: The Compassionate Healer Care, Discovery and Uses in Clinical and Community Nursing (Human Care & Health Series) Transcultural Nursing: Concepts, Theories, & Practices Care: The Essence of Nursing and Health (Human Care : Essentials for Nursing, Well-Being and Survival) Nursing and Anthropology Reference Sources for Transcultural Health and Nursing Madeleine Leininger's Contribution to Nursing Theory: Transcultural Nursing Madeleine Leininger's theory of Transcultural Nursing, also known as Culture Care Theory, falls under both the category of a specialty, as well as a general practice area. The theory has now developed into a discipline in nursing. The Transcultural Nursing theory first appeared in Leininger's Culture Care Diversity and Universality, published in 1991, but it was developed in the 1950s. The theory was further developed in her book Transcultural Nursing, which was published in 1995. In the third edition of Transcultural Nursing, published in 2002, the theorybased research and the application of the Transcultural theory are explained. Transcultural nursing is a study of cultures to understand both similarities and differences in patient groups. Culture is a set of beliefs held by a certain group of people, handed down from generation to generation. In transcultural nursing, nurses practice according to the patient's cultural considerations. It begins with a culturalogical assessment, which takes the patient's cultural background into consideration in assessing the patient and his or her health. Once the assessment is complete, the nurse should use the culturalogical assessment to create a nursing care plan that also takes the patient's cultural background into consideration. There are many reasons it's beneficial for nurses to use cultural knowledge of patients to treat them. First of all, it helps nurses to be aware of ways in which the patient's culture and faith system provide resources for their experiences with Page 30 of 74

illness, suffering, and even death. It helps nurses to be understanding and respectful of the diversity that is often very present in a nurse's patient load. It also helps strengthen a nurse's commitment to nursing based on nurse-patient relationships and emphasizing the whole person rather than viewing the patient as simply a set of symptoms or an illness. Finally, using cultural knowledge to treat a patient also helps a nurse to be open minded to treatments that can be considered non-traditional, such as spiritually based therapies like meditation and anointing. In the Transcultural Nursing theory, nurses have a responsibility to understand the role of culture in the health of the patient. Not only can a cultural background influence a patient's health, but the patient may be taking home remedies that can affect his or her health, as well. Leininger identified three nursing decisions and actions that achieve culturally friendly care for the patient. They are: cultural preservation or maintenance, cultural care accomodation or negotiation, and cultural care repatterning or restructuring. The nurse's assessment of the patient should include a self-assessment that addresses how the nurse is affected by his or her own cultural background, especially in regards to working with patients from culturally diverse backgrounds. The nurse's diagnosis of the patient should include any problems that may come up that involve the healthcare environment and the patient's cultural background. In addition, the nurse's care plan should involve aspects of the patient's cultural background when needed. Finally, the nurse's evaluation should include a selfevaluation of attitudes toward caring for patients from differing cultural backgrounds. In today's healthcare field, it is required for nurses to be sensitive to their patients' cultural backgrounds when creating a nursing plan. This is especially important since so many people's culture is so integral in who they are as individuals, and it is that culture that can greatly affect their health, as well as their reactions to treatments and care. Thanks to Madeleine Leininger's Transcultural Nursing theory, nurses can look at how a patient's cultural background is involved in his or her health, and use that knowledge to create a nursing plan that will help the patient get healthy quickly while still being sensitive to his or her cultural background.

Myra Estrin Levine - Nursing Theorist

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Biography and Career of Myra Estrine Levine Myra Estrine Levine was born in Chicago in 1920.

In 1944, she earned a diploma in nursing from the Cook County School of Nursing, then went on to complete her Bachelor of Science in Nursing from the University of Chicago in 1949. Her Master's of Science in Nursing was given to her from Wayne State University in Detroit in 1962. She earned an honorary doctorate from Loyola University in 1992.

While working as a nurse, Levine earned experience in oncology nursing. She was a civilian nurse at the Gardiner General Hospital, and became the Director of Nursing at Drexel Home in Chicago. She later became a clinical instructor at Bryan Memorial Hospital in Lincoln, Nebraska and administrative supervisor at the University of Chicago. She served as a chairperson of clinical nursing at her alma mater, the Cook County School of Nursing, and as a visiting professor at Tel Aviv University in Israel. She is known for her publication, Introduction to Clinical Nursing, which was first published in 1969, with additional editions printed in 1973 and 1989. Levine died in 1996. Myra Estrine Levine's Contribution to Nursing Theory: Four Conservation Principles Levine developed the Four Conservation Principles. In this model, the goal of nursing is to promote adaptation and maintain wholeness using the principles of conservation. The model guides nurses to focus on the influences and responses at the level of the organism. Nurses accomplish the theory's goal through the conservation of energy, structure, and personal and social integrity. Page 32 of 74

According to Levine, every individual has a unique range of adaptive responses. They vary by heredity, age, gender or the challenges that come with experiencing an illness. The responses are the same, but the timing and manifestation of the responses are unique to each individual pulse rate. Adaptation is an ongoing process of change in which the patient is able to maintain his or her integrity while staying within the realities of the environment. This is achieved through the "frugal, economic, contained and controlled use of environmental resources by the individual in his or her best interest." Wholeness exists when the patient's interaction with the environment allows integrity to be assured. Wholeness is promoted by the use of the conservation principle. Conservation is the product of adaptation. It is the achievement of a balance of energy supply and demand that is within the unique biological realities of the individual patient. The conservation principle has four aspects: conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity. Conservation of energy refers to balancing how energy goes in and out of the body to avoid fatigue. It includes adequate rest, nutrition, and exercise. Conservation of structural integrity refers to maintaining or restoring the physical body and promoting physical healing. The conservation of personal integrity recognizes the patient's need for recognition, respect, self-awareness, and self-determination. In this area, for example, a nurse will honor a patient's need for personal space. The conservation of social integrity addresses the patient's interactions and relationships with other people, such as in a family, community, or religious group. In this theory, nursing is a profession and an academic discipline, and should be studied and practiced in harmony with all disciplines that make up the health sciences. Nursing involves engaging in human interactions. Levine states that the goal of nursing is to promote wholeness, while realizing that every individual requires a unique cluster of activities to achieve wholeness. The patient's individual integrity is his or her concern, and it is the nurse's responsibility to assist him or her to defend and seek the realization of that individual integrity. Levine offers nine models of guided assessment in the Four Conservation Principles theory of nursing. They are: vital signs

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body movement and positioning meeting personal hygiene needs pressure gradient system in nursing interventions nursing determination in provision of nutritional needs pressure gradient system in nursing local application of hot and cold administration of medicine establishing an aseptic environment The nursing process used in this model is: Assessment Trophicognosis Hypothesis Interventions Evaluation

Kurt Lewin - Nursing Theorist

Biography of Kurt Lewin Kurt Lewin was born on September 9, 1890 in Germany to a Jewish family. In 1905 the family moved to Berlin, and Lewin entered the University of Freiburg to study medicine, but decided to study biology instead, prompting him to transfer to the University of Munich, where he became involved in women's rights and the socialist movement. When World War I began, he served in the German army. After an injury, he returned home and finished his Ph.D. at the University of Berlin under the supervision of Carl Stumpf. Lewin emigrated to the United States in August of 1933, and in 1940, he became a naturalized citizen. Lewin died February 12, 1947 in Massachusetts. Page 34 of 74

Career of Kurt Lewin Lewin spent six months as a visiting professor at Stanford University in 1930. After his immigration, he worked at Cornell University and for the Iowa Child Welfare Research Station at the University of Iowa. Later, he was the director of the Center for Group Dynamics at the Massachusetts Institute of Technology. In 1946, while at MIT, Lewin was asked by the director of the Connecticut State Inter Racial Commission for help in finding an effective way to combat religious and racial prejudices. He set up a workshop to conduct a "change" workshop, which laid the foundation for sensitivity training. This led to the establishment of the National Training Laboratories in Bethel, Maine. Following World War II, Lewin was involved in the psychological rehabilitation of former displaced persons camps occupants at Harvard Medical School with Dr. Jacob Fine. He also helped Eric Trist and A. T. M. Wilson establish the Tavistock journal, Human Relations. He also taught at Duke University for a time. Some of Kurt Lewin's works include: Resolving Social Conflicts and Field Theory in Social Science: Field theory in social science: Selected theoretical papers Principles Of Topological Psychology A Dynamic Theory Of Personality - Selected Papers Frustration and Regression: An Experiment With Young Children (Studies in Play and Games)

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The Complete Social Scientist: A Kurt Lewin Reader Kurt Lewin's Contribution to Nursing Theory: Change Theory Considered the father of social psychology, Kurt Lewin developed the nursing model known as Change Theory. He theorized a three-stage model of change that is known as the "unfreezing-change-refreeze model" that requires prior learning to be rejected and replaced. It states behavior as "a dynamic balance of forces working in opposing directions." The three concepts identified in Lewin's Change Theory are driving forces, restraining forces, and equilibrium. Driving forces are forces that push in a direction that causes change to occur. They facilitate change because they push the person in the desired direction. They cause a shift in the equilibrium towards change. Restraining forces are those forces that counter driving forces. They hinder change because they push the person in the opposite direction. They cause a shift in the equilibrium which opposes change. Equilibrium is a state of being where driving forces equal restraining forces and no change occurs. Equilibrium can be raised or lowered by changes that occur between the driving and restraining forces. This model of nursing consists of three distinct stages which are vital to the theory. They are unfreezing, moving to a new level or changing (or movement), and refreezing. Unfreezing is the process which involves finding a method of making it possible for people to let go of an old pattern that was, in some way, counterproductive. It is necessary to overcome the strains of individual resistance and group conformity. It can be achieved by the use of three methods. First, increase the driving forces that direct behavior away from the existing situation or status quo. Second, decrease the restraining forces that affect movement negatively. Third, find some combination of the first two methods. The second stage involves a process of change in feeling, behavior, thought, or all three, that is more productive in some way. The refreezing stage involves establishing the change as a habit so it becomes the standard. Without the refreezing stage, the old ways can easily return.

Ramona Mercer - Nursing Theorist


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The relationship between a mother and child is an important one. The foundation of this relationship is the basis for how the mother and child grow and change together, as well as how the child develops individually. Many nurses work in the perinatal field in order to help foster this relationship, andnursing theory can give them the resources and tools to do it. Nurses can help women develop their maternal roles with the help of Ramona Mercer's Maternal Role Attainment Theory.

Biography and Career of Ramona Mercer Ramona Mercer has served as the head nurse in pediatrics and staff nurse in intrapartum, postpartum, and newborn nursery units. For over 30 years, she has done research into parenting in low- and high-risk situations and transition into the maternal role. She authored Perspectives on Adolescent Health Care, Transitions in a Woman's Life, and Parents at Risk. In 1990, she received the American Nurses Foundation's Distinguished Contribution to Nursing Science Award. Mercer is a professor emeritus in the department of family health care nursing at the University of California in San Francisco. She spends her time teaching and writing to educate others about perinatal and maternal nursing. Some of Ramona Mercer's works can be found below: Parents at Risk First-Time Motherhood: Experiences from Teens to Forties Becoming a Mother: Research on Maternal Identity from Rubin to the Present (Springer Series: Focus on Women) Nursing Care for Parents at Risk Page 37 of 74

Transitions in a Women's Life: Major Life Events in Developmental Context (Springer Series, Focus on Women) Perspectives on Adolescent Health Care Ramona Mercer's Contribution to Nursing Theory: Maternal Role Attainment Theory The Maternal Role Attainment Theory, a mid-range theory, was developed to serve as a framework for nurses to provide appropriate health care interventions for nontraditional mothers in order for them to successfully adopt a strong maternal identity. Though this theory can be used throughout pregnancy and after childbirth to help mothers connect with their babies, it can also be beneficial for adoptive mothers, foster mothers, or others who have had nontraditional motherhood unexpectedly, such as taking care of a relative or friend's child as the result of a death. The process helps the mother form an attachment to the infant, which in turn helps the infant form an attachment with the mother. This helps in the building of the mother-child relationship as the infant grows. The primary concept of this theory is the developmental and interactional process, which occurs over a period of time. In the process, the mother bonds with the infant, acquires competence in general caretaking tasks, and comes to express joy and pleasure in the maternal role. The nursing process follows four stages of acquisition in the Maternal Role Attainment Theory. First is the anticipatory stage, which addresses the social and psychological adaptation to the maternal role, and learning expectations. Second is the formal stage, which is the assumption of the role at birth, and addresses behaviors guided by others in the mother's social system and network. For example, "My mother always said..." Third is the informal stage, in which the mother develops her own ways of mothering not conveyed by her social system. Finally, the fourth stage is the personal stage, in which the mother experiences harmony, confidence, and competence in her maternal role.

Betty Neuman - Nursing Theorist


It's important to look at a patient from a holistic perspective. A patient is not simply the illness or injury being treated, but an entire person. In fact, every aspect of a patient can contribute to how that patient deals with treatment and recovery, and it should all be considered when caring for the patient. In Betty Neuman's nursing theory, patients are cared for from a holistic perspective in order to ensure they are cared for as people and not simply ailments. Page 38 of 74

Biography of Betty Neuman Born in Lowel, Ohio in 1924, Betty Neuman earned her diploma as a Registered Nurse in 1947 from the Peoples Hospital School of Nursing in Akron, Ohio. She went on to complete her Bachelor of Science in Nursing in 1957 and her Master of Science in Mental Health, both from the University of California-Los Angeles in 1966. She also earned a Ph.D. in clinical psychology from Pacific Western University in 1985. In 1992, Neuman was given an Honorary Doctorate of Letters at the Neumann College in Aston, Pennsylvania. Finally, in 1998, the Grand Valley State University in Michigan gave her an Honorary Doctorate of Science. Career of Betty Neuman After earning her Masters degree, Neuman began working as a nurse. Specifically, she was a pioneer in nursing involvement in community mental health. While she was developing her systems model, she was working as a lecturer at the University of California-Los Angeles in community health nursing. Due to her work in nursing, Neuman was named as an Honorary Member of the Fellowship of the American Academy of Nursing. Betty Neuman's first book, The Neuman Systems Model, was published in 1982. The book included nursing process format and care plans, and was a total approach to client care. Newer editions were published in 1989, 1995, 2002, and 2010. After the publication of her model, Neuman spent her time educating nurses and professors about it through her work as an author and speaker. Some additional works include: Page 39 of 74

Blueprint for Use Administration

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Betty Neuman's Contribution to Nursing Theory: Neuman Systems Model In 1970 she began developing her Systems Model as a way to teach introductory nursing to students by giving them a holistic view of patients that included the physiological, psychological, sociological, and developmental aspects. It was first developed as a graduate course guide, and in 1972, the May/June edition of Nursing Research published "A model for teaching total person approach to patient problems." In 1974, Neuman's model was refined and published in Conceptual Models for Nursing Practice. It was classified as a systems model, and was titled "The Betty Neuman Health-Care Systems Model: A Total Person Approach to Patient Problems." In this publication, the term "patient" was replaced with the term "client." The Neuman Systems Model is based on the patient's relationship to stress, reaction to it, and reconstitution factors that are dynamic. The Neuman Systems Model is universal in nature, which allows it to be adapted to a variety of situations, and to be interpreted in many different ways. The central philosophy of Neuman's nursing theory consists of energy resources that are surrounded by three things: several lines of resistence, which represent the internal factors helping the patient fight against a stressor; the normal line of defense, which represents the patient's equilibrium; and the flexible line of defense, which represents the dynamic nature that can rapidly change over a short time. In the Neuman Systems Model, the nurse's role is to keep the system's stability by using three levels of prevention. The first is primary prevention, which protects the normal line and strengthens the flexible line of defense. The secondary prevention is used to strengthen the internal lines of resistence, which reduces the reaction and increases resistence factors. Finally, tertiary prevention readapts, stabilizes, and protects the patient's return to wellness after treatment.

Margaret Newman - Nursing Theorist


Biography and Career of Margaret A. Newman Margaret A. Newman was born on October 10, 1933. She earned her Bachelor's degree in 1962 from the University of Tennessee and her Master's degree in 1964 from the University of California. While working toward her graduate degree,

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Newman served as a joint director of nursing of a clinical research center, as well as an assistant professor of nursing at the University of Tennessee in Memphis.

She received a doctorate from New York University in 1971. Newman then taught at New York University until 1977. In the fall of 1977, she accepted the position of professor-in-charge of graduate study in nursing at Penn State University. In 1984, Newman began working as a nurse theorist at the University of Minnesota, and she retired from teaching in 1996. Newman is a fellow in the American Academy of Nursing. She has been honored as an outstanding alumna by both the University of Tennessee and New York University. She received the Distinguished Scholar in Nursing Award from New York University, the Founders Award for Excellence in Nursing Research from Sigma Theta Tau International, and the E. Louise Grant Award for Nursing Excellence from the University of Minnesota. Transforming Presence: The Difference That Nursing Makes Health As Expanding Consciousness (National League for Nursing Series (All Nln Titles) A Developing Discipline: Selected Works of Margaret Newman (National League for Nursing Series (All NLN Titles)) Theory Development in Nursing Margaret A. Newman's Contribution to Nursing Theory: Health as Expanding Consciousness

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The initial idea for Newman's Health as Expanding Consciousness Theory came together as a result of an invitation to speak at a conference on nursing in 1978. It stems from Rogers' Theory of Unitary Human Beings. It was stimulated by concern for those for whom the absence of disease or disability is not possible. Newman was also influenced by Bentov's concept of the evolution of consciousness, Young's Theory of Process, and Bohm's Theory of Implicate. This grand theory of nursing claims that every person in every situation, regardless of how disordered and hopeless it may seem, is part of the universal process of expanding consciousness, which is a process of becoming more of oneself, finding greater meaning in life, and of reaching new dimensions of connectedness with other people and the world. Newman's theory makes six assumptions. They are: Health encompasses conditions heretofore described as illness, or, in medical terms, pathology. These pathological conditions can be considered a manifestation of the total pattern of the individual patient. The pattern of the individual patient that eventually manifests itself as pathology is primary, and exists prior to structural or functional changes. Removal of the pathology in itself will not change the pattern of the individual patient. If becoming ill is the only way an individual patient's pattern can manifest itself, then that is health for that individual patient. Health is an expansion of the consciousness. According to Newman, "The theory of health as expanding consciousness (HEC) was stimulated by concern for those for whom health as the absence of disease or disability is not possible. Nurses often relate to such people: people facing the uncertainty, debilitation, loss and eventual death associated with chronic illness. The theory has progressed to include the health of all persons regardless of the presence or absence of disease. The theory asserts that every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness - a process of becoming more of oneself, of finding greater meaning in life, and of reaching new dimensions of connectedness with other people and the world." Humans are open to the whole energy system of the universe and constantly Page 42 of 74

interacting with the energy. With the process of interaction, humans are evolving their individual patterns of whole. According to Newman, the pattern of the individual patient is essential. The expanding consciousness is pattern recognition. How a disease manifests in an individual patient depends on the pattern of that patient, so the pathology of the disease exists before the symptoms appear. By this logic, the removal of the symptoms of the disease will not change the patient's individual structure or pattern. The model also addresses the interrelatedness of time, space, and movement. Time and space are the temporal pattern of the patient, and have a complementary relationship. People are constantly changing through time and space, which is movement, which shows a unique pattern of reality. According to Newman, nursing is the process of recognizing the patient in relation to the environment, and it is the process of the understanding of consciousness. The nurse helps patients understand how to use the power they have within in order to develop a higher level of consciousness. Therefore, it helps to realize the process of disease, its recovery, and its prevention. Nursing is seen as a partnership between the nurse and patient, and both grow in the sense of higher levels of consciousness.

Florence Nightingale - Nursing Theorist


Florence Nightingale is the most recognized name in the field of nursing. Her work was instrumental for developing modern nursing practice, and from her first shift, she worked to ensure patients in her care had what they needed to get healthy. Her Environmental Theory changed the face of nursing to create sanitary conditions for patients to get care. Biography of Florence Nightingale Florence Nightingale was born in 1820 in Italy to a wealthy British family. She was raised in the Anglican faith, and believed the God called her to be a nurse. This call came to her in February 1837 while at Embley Park.

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She announced her intention to become a nurse in 1844. Her mother and sister were angry at her decision, but Nightingale stood strong. She worked hard to learn about nursing, despite society's expectation that she become a wife and mother. In fact, she rejected a suitor because she thought it would interfere with her nursing career. In 1853, she accepted the position of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London. She held this position until October 1854. The income given to her by her father during this time allowed her to pursue her career and still live comfortably. Though Nightingale had several important friendships with women, including a correspondence with an Irish nun named Sister Mary Clare Moore, she had little respect for women in general, and preferred friendships with powerful men. She died in 1910. Career of Florence Nightingale Nightingale is best known for her pioneering work in the field of nursing. She tended to wounded soldiers during the Crimean War. She became known as the "Lady with the Lamp" because of her night rounds. While nursing soldiers during the war, Nightingale worked to improve nutrition and conditions in the wards. Many injured soldiers were dying from illnesses separate from their injuries, such as typhoid, cholera, and dysentery. Nightingale made changes on the wards or started the process by calling the Sanitary Commission. Her work led to a reduction in the death rates of injured soldiers from 42% to 2%. Nightingale believed the deaths were the result of poor nutrition, inadequate supplies, and the soldiers being dramatically overworked. After collecting evidence that pointed to unsanitary conditions as a major cause of death, Nightingale worked to improve sanitation in army and civilian hospitals during peacetime. Page 44 of 74

After the Crimean War, she established a nursing school at St. Thomas' Hospital in London in 1860. The first nurses trained at this school began working in 1865 at the Liverpool Workhouse Infirmary. It was the first secular nursing school in the world, and is now part of King's College London. Her work laid the foundation for modern nursing, and the pledge all new nurses take was named after her. Nightingale wrote Notes on Nursing (1859), which was the foundation of the curriculum for her nursing school and other nursing schools. This short text was considered the foundation of nursing education, and even sold well to the public. She also wrote Notes on Hospitals, Notes on Matters Affecting the Health, and Efficiency and Hospital Administration of the British Army. Nightingale spent the rest of her career working toward the establishment and development of nursing as a profession, paving the way for nursing in its current form. In 1883, Nightingale was given the Royal Red Cross by Queen Victoria. In 1907, she was the first woman to receive the Order of Merit. In 1908, she was given the Honorary Freedom of the City of London. International Nurses Day is celebrated on her birthday. Some of Florence Nightingale's works are: Notes On Nursing Notes on Nursing What It Is, and What It Is Not Florence Nightingale - to her Nurses (new edition) Florence Nightingale's Notes on Nursing and Notes on Nursing for the Labouring Classes: Commemorative Edition with Historical Commentary Florence Nightingale: Letters from the Crimea Florence Nightingale: Measuring Hospital Care Outcomes Organizing of Nursing Florence Nightingale's Contribution to Nursing Theory: Environmental Theory Florence Nightingale is attributed with establishing the modern practice of nursing. She also contributed to the field with nursing theories still used today. One of her nursing theories is the Environmental Theory, which incorporates the patients' surrounding environment in his or her nursing care plan. In this theory, the role of the nurse is to use the patient's environment to help him Page 45 of 74

or her recover and get back to the usual environment. The reason the patient's environment is important is because it can affect his or her health in a positive or negative way. Some environmental factors affecting health according to Nightingale's theory are fresh air, pure water, sufficient food and appropriate nutrition, efficient drainage, cleanliness, and light or direct sunlight. If any of these factors is lacking, it can delay the patient's recovery. Nightingale also emphasized providing a quiet, warm environment for patients to recover in. The theory also calls for nurses to assess a patient's dietary needs, document food intake times, and evaluate how the patient's diet affects his or her health and recovery. Determining a patient's environment for recovery based on his or her condition or disease is still practiced today, such as in patients suffering from tetanus, who need minimal noise to keep them calm and prevent seizures.

Ida Jean Orlando - Nursing Theorist


Regardless of how well thought out a nursing care plan is for a patient, obstacles to the patient's recovery may come up at any time. This may cause problems for the original nursing care plan, and it's the nurse's job to know how to deal with those obstacles so the patient can continue to recover and stay on the path to health. Ida Jean Orlando's Deliberative Nursing Process is a nursing theory that allows nurses to create an effective nursing care plan that can also be easily adapted when and if any complications arise with the patient.

Biography of Ida Jean Orlando Ida Jean Orlando was a first generation Irish American born in 1926. She received her nursing diploma from New York Medical College at the Lower Fifth Avenue Hospital School of Nursing. She earned her Bachelor of Science in Public Health from St. John's University in Brooklyn, and her Master of Arts Degree in Mental Health Nursing from Teachers College,

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Columbia University. She is married to Robert Pelletier and lives in the Boston area. Career of Ida Jean Orlando Orlando was an associate professor at Yale School of Nursing, and while there, served as the Director of the Graduate Program in Mental Health Psychiatric Nursing. It was also at Yale that she was project investigator of a National Institute of Mental Health grant. The research from this grant led to Orlando's development of the Deliberative Nursing Process published in The Dynamic Nurse-Patient Relationship: Function, Process, and Principles (NLN Classics in Nursing Theory) in 1961. She also worked as the director of a research project at McLean Hospital in Belmont, Massachusetts. This research led to the publication of The Discipline and Teaching of Nursing Process (an evaluative study) in 1972. Orlando has served as a board member of Harvard Community Health Plan. Ida Jean Orlando's Contribution to Nursing Theory: Deliberative Nursing Process Ida Jean Orlando's Deliberative Nursing Process is set in motion by the behavior of the patient. According to the theory, all patient behavior can be a cry for help, both verbal and non-verbal, and it is up to the nurse to interpret the behavior and determine the needs of the patient. The Deliberative Nursing Process has five stages: assessment, diagnosis, planning, implementation, and evaluation. In the assessment stage, the nurse completes a holistic assessment of the patient's needs. This is done without taking the reason for the encounter into consideration. The nurse uses a nursing framework to collect both subjective and objective data about the patient. The diagnosis stage uses the nurse's clinical judgment about health problems. The diagnosis can then be confirmed using links to defining characteristics, related factors, and risk factors found in the patient's assessment. The planning stage addresses each of the problems identified in the diagnosis. Each problem is given a specific goal or outcome, and each goal or outcome is given nursing interventions to help achieve the goal. By the end of this stage, the nurse will have a nursing care plan. In the implementation stage, the nurse begins using the nursing care plan. Finally, in the evaluation stage, the nurse looks at the progress of the patient toward the goals set in the nursing care plan. Changes can be made to the nursing care plan based on how well (or poorly) the patient is progressing toward the goals. If any Page 47 of 74

new problems are identified in the evaluation stage, they can be addressed, and the process starts over again for those specific problems. The goal of this model is for a nurse to act deliberately rather than automatically. This way, a nurse will have a meaning behind the action which means the patient gets care geared specifically toward his or her needs at that time. This nursing process is also one that can easily be adapted to different patients with different problems, and can be stopped at anytime, depending on the patient's progress or health. This makes Orlando's theory universal for the nursing field. Nursing care has to be flexible. Not only does a nursing care plan depend on the needs of the patient at the time of admittance, but it also needs to be able to change when and if any complications come up during the treatment and recovery process. Ida Jean Orlando's Deliberative Nursing Process directly addresses this need for flexibility, and helps nurses focus on the patient rather than simply sticking to a nursing care plan no matter what.

Dorothea Orem - Nursing Theorist


In some situations, patients are encouraged to be more independent. This can be especially true in rehabilitation settings, in which patients are transitioning out of being cared for by physicians and nurses and back home to exclusive self-care. In these cases, the Self-Care Deficit Nursing Theory can be applied to help patients be more independent and prepare to be released from the healthcare facility where they are being cared for.

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Biography of Dorothea E. Orem Dorothea E. Orem was born in 1914 in Baltimore, Maryland. In the early 1930s, she earned her nursing diploma from the Providence Hospital School of Nursing in Washington, D.C. She went on to complete her Bachelor of Science in Nursing in 1939 and her Master's of Science in Nursing in 1945, both from the Catholic University of America in Washington, D.C. Dorothea Orem died on June 22, 2007. Career of Dorothea E. Orem Dorothea Orem had a distinguished career in nursing. She earned several Honorary Doctorate degrees. She was given Honorary Doctorates of Science from both Georgetown University in 1976 and Incarnate Word College in 1980. She was given an Honorary Doctorate of Humane Letters from Illinois Wesleyan University in 1988, and a Doctorate Honoris Causae from the University of Missouri in Columbia in 1998. She was also given many awards during her career: the Catholic University of America Alumni Achievement Award for Nursing Theory in 1980, the Linda Richards Award from the National League for Nursing in 1991, and was named an honorary Fellow of the American Academy of Nursing in 1992. One of the works written by Dorothea Orem is: Nursing: Concepts of Practice Dorothea Orem: Self-Care Deficit Theory (Notes on Nursing Theories) Dorothea E. Orem's Contribution to Nursing Theory: Self-Care Deficit Nursing Theory (SCDNT)

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The Self-Care Deficit Nursing Theory, also known as the Orem Model of Nursing, was developed by Dorothea Orem between 1959 and 2001. It is considered a grand nursing theory, which means the theory covers a broad scope with general concepts that can be applied to all instances of nursing. The central philosophy of the Self-Care Deficit Nursing Theory want to care for themselves, and they are able to recover holistically by performing their own self-care as much as they're particularly used inrehabilitation and primary care or other patients are encouraged to be is that all patients more quickly and able. This theory is settings in which independent.

The self-care requisites identified by Dorothea Orem fall into one of three categories. The first is universal self-care requisites, which are needs that all people have. These include things like air, water, food, activity and rest, and hazard prevention. The second is developmental self-care requisites, which has two subcategories: maturational, which progress the patient to a higher level of maturation, or situational, which prevent against harmful effects in development. The third category is health deviation requisites, which are needs that come up based on the patient's condition. If a patient is unable to meet their self-care requisites, a "self-care deficit" occurs. In this case, the patient's nurse steps in with a support modality which can be total compensation, partial compensation, or education and support. One of the benefits of Dorothea Orem's Self-Care Deficit Nursing Theory is that it can easily be applied to a variety of nursing situations and patients. The generality of its principles and concepts make it easily adaptable to different settings, and nurses and patients can work together to ensure that the patients receive the best care possible, but are also able to care for themselves. Thanks to Dorothea Orem's dedication to nursing, as well as her hard work in the field, nurses can use her theory today to care for patients and make their transition from the hospital or fulltime care facility to their own home much smoother.

Nola Pender - Nursing Theorist


One of the roles of nurses is to help patients learn to care for themselves and make healthy choices. By participating in their own self-care, patients can prevent illnesses and diseases and help ensure they have better overall health. One nursing theory that helps patients prevent illnesses through their behavior and choices is the Health Promotion Model, which was developed by nursing theorist Nola Pender. Page 50 of 74

Biography and Career of Nola Pender Pender attended Michigan State University to earn her bachelor and master's degrees in 1964 and 1965, respectively. She earned her Ph.D. from Northwestern University in 1969. She received a Lifetime Achievement Award from the Midwest Nursing Research Society in 2005. She was awarded an honorary doctorate of science degree in 1992 from Widener University. She was given a Distinguished Alumni Award from the Michigan State University School of Nursing in 1972. She has many publications in a variety of texts and journals, including six editions of Health Promotion in Nursing Practice (6th Edition) . Pender has served as a member of a number of organizations. She is also a cofounder of the Midwest Nursing Research Society, and currently serves as a trustee. She is currently a professor emerita in the Division of Health Promotion and Risk Reduction at the University of Michigan School of Nursing, and serves as a Distinguished Professor at Loyola University Chicago's School of Nursing. She is currently retired, and spends her time consulting on health promotion research nationally and internationally. Nola Pender's Contribution to Nursing Theory: Health Promotion Model Nola Pender developed her Health Promotion model, often abbreviated HPM, after seeing professionals intervening only after patients developed acute or chronic health problems. She became convinced that patients' quality of life could be improved by the prevention of problems before this occurred, and health care dollars could be saved by the promotion of healthy lifestyles. After researching Page 51 of 74

current models and discovering that most focused on negative motivation, she developed a model that focused on positive motivation. The first version of the model appeared in literature in 1982. It was revised in 1996 based on changing theoretical perspectives and empirical findings. The purpose of the model is to assist nurses in understanding the major determinants of health behaviors as a basis for behavioral counseling to promote healthy lifestyles. Pender's theory encourages scholars to look at variables that have been shown to impact health behavior. It uses research findings from nursing, psychology, and public health into a model of health behavior. The model can be used as a foundation to structure nursing protocols and interventions. In practices, nurses should focus on understanding and addressing the variables most predictive of given health behaviors. There are five key concepts in the Health Promotion Model: person, environment, nursing, health, and illness. The person is a biophysical organism shaped by the environment, but also seeks to create an environment in which human potential can be fully expressed. Because of this, the relationship between person and environment is reciprocal. Individual characteristics and life experiences shape behaviors. The environment is described as the social, cultural, and physical context in which life unfolds. It can be manipulated by the individual to create a positive context of cues and facilitators for health-enhancing behaviors. The role of nursing is a collaboration among patients, families, and communities to create the best conditions for the expression of optimal health and high-level well-being. Health is defined as the actualization of human potential through goal-directed behavior, self-care, and relationships with others with necessary adjustments made to maintain relevant environments. Illnesses are discrete events in the life that can hinder or facilitate the patient's continuing quest for health. The model is based on the following assumptions: People try to create conditions of living through which they can express their unique human potential. People have the capacity for reflective self-awareness, including assessment of their own competencies. People value positive growth, and strive to find a balance between stability and change. People seek to actively regulate their own behavior. Page 52 of 74

People interact with their environment, transforming it and themselves over time. Nurses and other health professionals make up a part of the interpersonal environment, which exerts influence on people throughout their lifespan. Self-initiated reconfiguration of the interactive patterns between people and their environments is necessary for a change in behavior. The model is based on the following theoretical propositions: Behavior and characteristics influence beliefs, affect, and enactment of healthpromoting behavior. People commit to engaging in behaviors from which they anticipate deriving personally valued benefits. Barriers can constrain commitment to action. Competence to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior. Greater perceived self-efficacy results in fewer barriers to a specific health behavior. Positive affect toward a behavior results in greater perceived self-efficacy. When positive emotions are associated with a behavior, the probability of commitment and action is increased. People are more likely to commit to health-promoting behaviors when others model the behavior, expect it to occur, and provide support to enable it. Families, peers, and health care providers are important sources of interpersonal influence that can increase or decrease commitment to health-promoting behavior. Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior. The greater the commitment to a specific plan of action, the more likely healthpromoting behaviors are to be maintained over time. Commitment to a plan of action is less likely to result in the desired behavior when competing demands over which persons have little control require immediate attention. Commitment to a plan of action is less likely to result in the desired behavior when other actions are more attractive and thus preferred over the target behavior. Page 53 of 74

People can modify cognitions, affect, interpersonal influences, and situational influences to create incentives for health-promoting behavior.

Hildegard Peplau - Nursing Theorist


Many people enter the healthcare field because they want to work with people. For these nurses, it is the nurse-patient relationship that is one of the most important things. By understanding the nurse-patient relationship, nurses can be better quipped to work with their patients and, ultimately, provide better care for them. Hildegard Peplau's model of nursing focuses on that nurse-patient relationship and identifies the different roles nurses take on when working with patients.

Biography of Hildegard Peplau Hildegard Peplau was born in 1909 in Pennsylvania. As a child, she saw the devastating effects of the flu epidemic in 1918, which greatly influenced how she understood how illness and death impacted families. She graduated from the Pottstown, Pennsylvania School of Nursing in 1931 and worked as a staff nurse in Pennsylvania and New York City. After a summer position led to Peplau being recommended to work as a school nurse at Bennington College in Vermont, she earned her Bachelor's Degree in Interpersonal Psychology in 1943. She earned her Master's and Doctoral degrees from Teacher's College, Columbia University, and was certified in psychoanalysis at the William Alanson White Institution of New York City.

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Peplau died on March 17, 1999. Career of Hildegard Peplau After earning her Bachelor's Degree, Peplau studied psychological issues at Chestnut Lodge, a private psychiatric facility, with Erich Fromm, Frieda FrommReichmann, and Harry Stack Sullivan. This led to Peplau's life long work, which extended Sullivan's interpersonal theory to be used in the nursing field. From 1943 to 1945 Peplau served as an Army Corps Nurse. Being stationed at the 312th Field Station Hospital in England allowed her the opportunity to work with leading figures in American and British psychiatry. In the early 1950s, she created and taught the first classes for graduate nursing students at Teachers College. She was a member of the faculty of the College of Nursing at Rutgers University between 1954 and 1974, where she created the first graduate program for clinical specialists in psychiatric nursing. In the 1950s and 1960s, she offered summer workshops for nurses across the United States where she taught interpersonal concepts and interviewing techniques, as well as individual, family, and group therapy. Peplau worked with the World Health Organization by serving as an advisor, and was a visiting professor at universities throughout the United States and around the world. She served as a consultant to the United States Surgeon General, the United States Air Force, and the National Institutes of Mental Health. She also participated in policy-making groups for the United States government. After retiring from her position at Rutgers, Peplau helped create the first European graduate nursing program at the University of Leuven in Belgium, where she was a visiting professor in 1975 and 1976. Some of Hildegard Peplau's works include: Interpersonal Relations Psychodynamic Nursing In Nursing: A Conceptual Frame of Reference for

Interpersonal Theory in Nursing Practice: Selected Works of Hildegard E. Peplau Basic principles of patient counseling ;: Extracts from two clinical nursing workshops in psychiatric hospitals A Glance Back in Time.: An article from: Nursing Forum

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On Semantics.(psychiatric nursing): An article from: Perspectives in Psychiatric Care The Psychiatric Nurse--Accountable? To Whom? For What?: An article from: Perspectives in Psychiatric Care Psychotherapeutic Strategies.: An article from: Perspectives in Psychiatric Care Hildegard Peplau's Contribution to Nursing Theory: The Theory of Interpersonal Relations Peplau's model for nursing, which helped later nursing theorists and clinicians develop more therapeutic interventions, includes seven nursing roles, which show the dynamic character roles typical in clinical nursing. The Seven Nursing Roles are: the stranger role, in which the nurse receives the patient the way a stranger is met in other situations, and provides an atmosphere to build trust; the resource role, in which the nurse answers questions, interprets data, and gives information; the teaching role, in which the nurse gives instructions and provides training; the counseling role, in which the nurse helps the patient understand the meaning of current circumstances, as well as provides guidance and encouragement in order for change to occur; the surrogate role, in which the nurse acts as an advocate on behalf of the patient; the active leadership role, in which the nurse helps the patient take responsibility for meeting treatment goals; and the technical expert role, in which the nurse provides physical care for the patient and operates equipment. For those who become nurses to work with people, studying Hildegard Peplau's model of nursing can be very useful. By better understanding the seven roles of nursing, they can apply different roles in different situations, which will ensure that their patients receive the best care possible, and will ultimately speed along treatment and recovery.

Isabel Hampton Robb - Nursing Theorist


Nursing begins with education. Before you can practice as a nurse, you have to learn what it means to be a nurse, as well as the specifics of how to carry out the duties of your role as a nurse in the field. One of the important contributors to the area of nursing education was Isabel Hampton Robb. Her work in nursing has led to her being thought of as a founder of modern American nursing theory, and many of the standards she implemented are still in place today. Page 56 of 74

Biography of Isabel Hampton Robb Isabel Hampton Robb was born in 1860. In 1883, she graduated from the Bellevue Hospital Training School for Nurses. While working at Johns Hopkins, she met and married Dr. Hunter Robb. She resigned from her position to move with him to his new position as a professor of gynecology at Case Western Reserve University. Robb died in 1910. Career of Isabel Hampton Robb Robb was one of the founders of modern American nursing theory, and an important leader in nursing history. She first worked as a nurse in Rome, then returned to the United States, where she accepted a position as the superintendent of nursing at the Cook County Hospital nursing school in Chicago, Illinois. In 1889, Robb was appointed as the head of the new Johns Hopkins School of Nursing. It was in this position that she published the text Nursing Its Principles and Practice. . When Robb followed her husband to Case Western Reserve University, she used it as an opportunity to work with Clevelend's Lakeside Hospital Training School for Nurses, as well as write two books: Nursing Ethics: For Hospital and Private Use (Classic Reprint) , which was originally published in 1900, and Educational Standards for Nurses With Other Addresses on Nursing Subjects , which was originally published in 1907. During her career she also served as President of the American Society of Superintendents of Training Schools for Nurses, which is now known as the National

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League for Nursing, and of the organization that became the American Nurses Association. She was also a founder of the American Journal of Nursing. Isabel Hampton Robb's Contribution to Nursing Theory: Nursing Education Robb's most notable contribution to nursing was in the field of education. The reforms she put into place set standards for nursing education, and most of them are still followed today. Specifically, she developed and implemented a grading policy for nursing students that required nurses to prove their abilities in order to be awarded qualifications. She was an advocate for reducing the long hours involved in training nurses, as well as improving education in nursing schools. It is thanks to Isabel Hampton Robb that nursing education is what it is today. Because of the work Robb did in improving nursing education, patients are able to get better care, and nurses are more prepared to enter their careers after earning their degrees. Her passion for nursing education changed standards, and her ideas and contributions have withstood the test of time, despite the rapid advancements that occur in the healthcare field.

Martha Rogers - Nursing Theorist


There are many people who believe that a person and his or her environment are integral to each other. That is, a patient can't be separated from his or her environment when addressing health and treatment. By practicing nursing with this view of the coexistence of the human and his or her environment, a nurse can apply Martha E. Rogers's Science of Unitary Human Beings to treat patients and help them in the process of change toward better health.

Biography of Martha E. Rogers Page 58 of 74

Martha E. Rogers was born in 1914 in Dallas, Texas. She received her nursing diploma from the Knoxville General Hospital School of Nursing in 1936, then earned her Public Health Nursing degree from George Peabody College in Tennessee in 1937. Her Master's degree was from Teachers College at Columbia University in 1945, and her Doctorate in Nursing was given to her from Johns Hopkins University in Baltimore in 1954. Rogers died on March 13, 1994. Career of Martha E. Rogers Rogers worked as a professor at New York University's School of Nursing. She was also a Fellow for the American Academy of Nursing. Her publications include: Theoretical Basis of Nursing (1970), Nursing Science and Art: A Prospective (1988),Nursing: Science of Unitary, Irreducible, Human Beings Update (1990), and Vision of Space Based Nursing (1990). Other works written by Martha E. Rogers include: An Introduction to the Theoretical Basis of Nursing Educational revolution in nursing. By Martha E. Rogers. Published by Macmillan. 1961 Edition Reveille in Nursing Martha E Rogers: Her Life and Her Work Martha E. Rogers' Contribution to Nursing Theory: Science of Unitary Human Beings Patients are considered "unitary human beings," who cannot be divided into parts, but have to be looked at as a whole. According to Rogers's model, patients have the capacity to participate knowingly in the process of change. The environment is also irreducible, and coexists with unitary human beings. In this model, humans are viewed as integral with the universe. That is, the patient and his or her environment are one. Rogers defined health as an expression of the life process. To that end, illness and health are part of the same continuum, and the events occurring throughout the patient's life show how the patient is achieving his or her health potential. The basic characteristics that describe the life process of the patient are: energy field, openness, pattern, and pan dimensionality. The energy field is the fundamental unit of all, both the living and unliving. It provides a way to view the patient and his or her environment as wholes, and it continuously changes in intensity, density, and extent. Openness refers to the fact that the human and environmental fields are constantly exchanging their energies. That is, there are no Page 59 of 74

boundaries that block the flow of energy between fields. Pattern is the distinguishing characteristic of an energy field that is seen as a single wave. It's an abstraction, and simply serves to give identiy to the field. Pan dimensionality is a domain that has no spatial or temporal attributes. Nursing in the Science of Unitary Human Beings contains two dimensions: the science of nursing, which is the knowledge specific to the field of nursing that comes from scientific research; and the art of nursing, which involves using the science of nursing creatively to help better the life of the patient. In this model, the role of the nurse is to serve people. Rogers also proposes noninvasive modalities for nursing, such as therapeutic touch, humor, music, meditation and guided imagery, and even the use of color. The interventions of nurses are meant to coordinate the rhythm between the human and environmental fields, help the patient in the process of change, and to help patients move toward better health. The practice of nursing, according to Rogers, should be focused on pain management, and supportive psychotherapy for rehabilitation. It is often important to look at both the patient as a whole person, and the patient's environment when treating the patient for an injury or illness. Martha E. Rogers's Science of Unitary Human Beings addresses the importance of the environment as an integral part of the patient, and uses that knowledge to help nurses blend the science and art of nursing to ensure patients have a smooth recovery and can get back to the best health possible.

Nancy Roper - Nursing Theorist


One draw of the field of nursing is the ability for nurses to individualize their care plans for their patients. In order to ensure that unique patients are able to get healthy, they need nursing care plans as unique as they are. This means assessment and evaluation of each patient before and during care. Nancy Roper's desire to become a nurse started in childhood, and as a result of her experiences and education, she, along with two of her colleagues, developed the Roper-LoganTierney Model of Nursing to assess patients' level of independence and provide the best individualized care for them.

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Biography and Career of Nancy Roper Nancy Roper was born on September 29, 1918 in Wetheral, Cumberland. Her mother was a nanny, and when Roper started her career after life-long plans to become a nurse, she studied to be a registered sick children's nurse. She then took her general training. It was during her training that she began to develop her nursing model. In 1943, she became a state registered nurse and was offered a post as a staff nurse in teaching. When she was later offered a senior tutor position at Cumberland Infirmary, Roper insisted on qualifying as a teacher first. She earned a sister tutor's diploma in 1950 from London University, and started overseas experience with a Royal College of Nursing study tour to Belgium in 1954. She was an examiner for the General Nursing Council, and worked on updating Oakes' Dictionary for Nurses, which appeared in 1961. After 30 years as a nurse and nurse educator, Roper became a self-employed lexicographer and author in 1964. Roper began her investigation into the concept of a core of nursing in her studies at Edinburgh University in 1970, thanks to a British Commonwealth Nurses Fellowship, which led to the initial publication of her model of nursing. Roper passed away in Edinburgh on October 5, 2004.

Other works by Nancy Roper are: The Roper-Logan-Tierney Model of Nursing: Based on Activities of Living Page 61 of 74

Elements of Nursing: A Model for Nursing Based on A Model of Living New American Pocket Medical Dictionary Principles of Nursing in Process Context Principles of Nursing Learning to Use the Process of Nursing Nancy Roper's Contribution to Nursing Theory: Roper-Logan-Tierney Model of Nursing Roper's model of nursing was originally published in 1976, and revised in 1985 and 1990. The most recent revision occurred in 1998. The initial purpose of the model was to be an assessment used throughout the patient's care, but has become the norm in nursing in the United Kingdom to only use it as a checklist during admission. It is usually used to determine how a patient's life has changed because of an illness or hospital admission rather than as a way to plan for increased independence and quality of life. The Roper-Logan-Tierney Model of Nursing is the most widely-used model of nursing used in the United Kingdom, and used particularly well in medical and surgical settings. The model is based upon activities of living, which evolved from the work of Virginia Henderson in 1966. The activities of daily living are the key to the model, which seeks to define "what living means." The discoveries about what living means are categorized into the activities of living to promote maximum independence through complete assessment, which leads to interventions that further support independence in areas that may be difficult or impossible for the patient on his or her own. The model assesses the patient's level of independence in relation to the activities of living, which then helps the nurse and health care team to develop a nursing care plan based on the patient's individual abilities and levels of independence. To be most effective, the patient should be assessed upon admission, as well as evaluated throughout care. That way, changes can be made to the care plan, if needed. The activities of living listed in the model are: maintaining a safe environment communication

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breathing eating and drinking elimination washing and dressing temperature control mobilization working and playing expressing sexuality sleeping death and dying The factors that influence activities of living are biological, psychological, sociocultural, environmental, and politicoeconomic. These factors make the model holistic, and if they are not included in assessment, it will be both incomplete and flawed. The biological factor is the impact of the overall health; the psychological factor is the impact of emotion, cognition, spiritual beliefs, and the ability to understand; the sociocultural factor is the impact of society and culture experienced by the individual; the environmental factor considers the impact of the environment on the patient, as well as the patient's impact on the environment; and the politicoeconomic factor is the impact of the government, politics, and economy on the activities of daily living.

Sister Callista Roy - Nursing Theorist


Though there are hard and fast answers in the healthcare field, it is also adaptive and nurses need to be flexible in order to provide the best care for their patients. After all, each patient is different and should be cared for based on the individual needs of that particular patient. To better understand the adaptive nature of nursing, it would help to study Sister Callista Roy's Adaptive Model of Nursing.

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Biography of Sister Callista Roy Sister Callista Roy was born in 1939 in Los Angeles. In 1963, she earned a Bachelor of Arts Degree in Nursing from Mount St. Mary's College in Los Angeles. In 1966, she earned a Master's Degree in Pediatric Nursing from the University of CaliforniaLos Angeles. She also earned a Master's Degree in Sociology in 1973, and went on to complete a Doctoratal degree in Sociology in 1977. She is a sister of St. Joseph of Carondelet. Career of Sister Callista Roy After working as a staff nurse and in administrative positions at St. Mary's Hospital in Tucson, Arizona, and St. Joseph's Hospital in Lewiston, Idaho, Roy joined the faculty of Mount St. Mary's College in 1996. She also served as Department Chair between 1971 and 1982. While working at the University of Portland, Roy helped create a Master's program in Nursing. And at the Connell School of Nursing, she was involved in developing a Ph.D. program in Nursing. She also served as a visiting professor to colleges around the world, including La Sabana University in Colombia, the University of Lund in Sweden, and the University of Conception in Chile. Between 2003 and 2006, Roy served on the Board of the International Network for Doctoral Education. She is also Faculty Senior Nurse Scientist at the Yvonne L. Munn Center for Nursing Research at Massachusetts General Hospital. Since developing her Adaptation Model of Nursing, Roy has had over 100 publications, which includes 11 books with translations in 12 languages. She has been awarded four Honorary Doctoral degrees, has several teaching awards, and won national awards from STTI, NANDA, and NLN. In 1995, Mount St. Mary's Page 64 of 74

College awarded Roy the Carondelet Medal for her contributions to the nursing field. In 1978, she was elected to the American Academy of Nursing, and is still an active Fellow. The following are some of Callista Roy's works: Generating Middle Range Theory: From Evidence to Practice Nursing Knowledge Development and Clinical Practice By Callista Roy - The Roy Adaptation Model: 3rd (third) Edition Roy Adaptation Model-Based Research: 25 Years of Contributions to Nursing Science Roy Adaptation Model-Based Research: 25 Years of Contributions to Nursing Science Introduction to Nursing: An Adaptation Model Theory Construction in Nursing: An Adaption Model Sister Callista Roy's Contribution to Nursing Theory: Adaptation Model of Nursing Developed by Roy in 1976, the Adaptation Model of Nursing asks three central questions: Who is the focus of nursing care? What is the target of nursing care? and When is nursing care indicated? This model looks at the patient from a holistic perspective. The three concepts of her model are the human being, adaptation, and nursing. Under the concept of adaptation are four modes: physiological, self concept, role function, and interdependence. The physiological mode deals with the maintenance of the physical body. This includes basic human needs such as air, water, food, and temperature regulation. The function of the mode of self-concept is the need for the maintenance of the mind. The person's perceptions of his or her physical and personal self are included in this mode. Social integrity is emphasized in the role function mode. This addresses people's adaptations to different role changes that occur throughout a lifetime. The interdependence mode also addresses social integrity. This mode deals with the balance between independence and interdependence in a person's relationships with other people. According to Roy's model, the goal of nursing is to promote adaptation of the patient during illness and health in all four of the modes. The nurse's actions begin Page 65 of 74

with assessment on two levels. First, the nurse makes a judgment as to the presence or absence of maladaptation. Second, the nurse focuses on the stimuli influencing the patient's maladaptive behavior. The nurse then takes actions to promote adaptation by manipulating the environment, elements of the patient system, or both as part of their nursing care plan. Nursing is not rigid. And by applying Roy's Adaptive Model of Nursing to your nursing practice, you can be sure that the care you give your patients will be the highest quality you can provide for that individual patient in his or her individual situation.

Joyce Travelbee - Nursing Theorist


Biography and Career of Joyce Travelbee Joyce Travelbee was born in 1926 and is known for her work as a nursing theorist. In 1956, Travelbee earned her Bachelor of Science in Nursing degree from Louisiana State University. She was given a Master of Science in Nursing degree in 1959 from Yale University. Her career dealt predominantly withpsychiatric nursing and education. She worked as a psychiatric nursing instructor at the DePaul Hospital Affiliate School in New Orleans, Louisiana, and worked later in the Charity Hospital School of Nursing in Louisiana State University, New York University, and the University of Mississippi.

Travelbee

died

in

1973

at

the

age

of

47.

Some of Joyce Travelbee's works include: Page 66 of 74

Travelbee's Intervention in Psychiatric Nursing: A One-To-One Relationship Interpersonal Aspects of Nursing Intervention in Psychiatric Nursing: Process in the One-To One Relationship Joyce Travelbee's Contribution to Nursing Theory: Human-to-Human Relationship Model Travelbee developed the Human-to-Human Relationship Model of Nursing. The theory was presented in her book,Interpersonal Aspects of Nursing, which was published in 1961. The assumptions of the model are based on Soren Kierkegaard's philosophy of existentialism and Viktor Frankl's logotherapy. Existentialism places the accountability for people's choices in life on the people who make those choices. Logotherapy, which was first proposed in Frankl's Man's Searching for Meaning (1963), is a form of psychotherapy that makes the assumption that fulfillment is the best protection against emotional instability. The main concepts of the nursing theory are suffering, meaning, nursing, hope, communications, self-therapy, and a targeted intellectual approach. Each of these concepts is defined by Travelbee to help nurses understand the model. Suffering ranges from a feeling of unease to extreme torture, and varies in intensity, duration, and depth. The role of nursing in Travelbee's theory is to help the patient find meaning in the experience of suffering, as well as help the patient maintain hope. Hope is defined as a faith that can and will bring change that will bring something better with it. It has six characteristics: It is strongly associated with dependence on other people. It is oriented with the future. It is linked to elections from several alternatives or escape routes out of its situation. The desire to possess any object or condition, to complete a task or have an experience. Confidence that others will be there for one when you need them.

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The hoping person is in possession of courage to be able to acknowledge its shortcomings and fears and go forward toward its goal. Travelbee believed nursing should be accomplished through human relationships that begin with the original encounter, progress through the stages of emerging identities, and lead to the development of empathy and sympathy. The nursepatient relationship is essential to successful patient care, and this relationship is established by an interaction process. Building the patient-nurse relationship takes place in five phases: the original encounter, the visibility of personal or emerging identities, empathy, sympathy, and the establishment of mutual understanding and a rapport. In this theory, health is both subjective and objective. Subjective health is an individually-defined state of well being in accordance with self-appraisal of the physical-emotional-spiritual status. Objective health, on the other hand, is the absence of any discernible disease, disability, or defect as measured by physical examination, lab tests, and assessment by a spiritual director or psychological counselor. This theory has greatly influenced hospice nursing in that hospice nurses focus on the relationships with their patients to improve quality of life.

Jean Watson - Nursing Theorist


Many men and women enter the nursing field because they see it as a career that cares about people. Compassion is often a trait required of nurses, since taking care of patients' needs is their primary purpose. Jean Watson'sPhilosophy and Science of Caring addresses how nurses care for their patients, and how that caring translates into better health plans to help patients get healthy.

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Biography and Career of Jean Watson Jean Watson was born in a small town in the Appalachian Mountains of West Virginia in the 1940s. Watson graduated from the Lewis Gale School of Nursing in 1961, and then continued her nursing studies at the University of Colorado at Boulder. She earned her bachelor's degree in 1964, a Master's degree in psychiatric and mental health nursing in 1966, and a Ph.D. in educational psychology and counseling in 1973. She served as Dean of Nursing at the University Health Sciences Center and was the President of the National League for Nursing. She is a fellow of the American Academy of Nursing. Her books include Nursing: The Philosophy and Science of Caring, Revised Edition , which was published in 2008. She currently holds an endowed chair at the University of Colorado, and in 2008, she created the Watson Caring Science Institute to help spread her nursing theory and ideas. Watson has six honorary degrees, including an International Honorary Doctorate from the University of Montreal in Quebec, Canada in 2003, and an Honorary Doctor of Sciences in Nursing from the University of Victoria in British Columbia, Canada in 2010. Some of Jean Watson's other works include: Human Caring Science: A Theory of Nursing, Second Edition (Watson, Nursing: Human Science and Human Care) Nursing: Human Science And Human Care (Watson, Nursing: Human Science and Human Care) Page 69 of 74

Caring Science as Sacred Science Assessing and Measuring Caring in Nursing and Health Science: Second Edition (Watson, Assessing and Measuring Caring in Nursing and Health Science) Creating a Caring Science Curriculum: An Emancipatory Pedagogy for Nursing Toward a Caring Curriculum: A New Pedagogy for Nursing Postmodern Nursing and Beyond, 1e Measuring Caring: International Research on Caritas as Healing The Ethics of Care and the Ethics of Cure: Synthesis in Chronicity Linking Medical Care and Community Services: Practical Models for Bridging the Gap The Caritas Path to Peace: A Guidebook for Creating World Peace with Caring, Love, and Compassion (Volume 1) Jean Watson's Contribution to Nursing Theory: Philosophy and Science of Caring Jean Watson's Philosophy and Science of Caring addresses how nurses express care to their patients. Caring is central to nursing practice, and promotes health better than a simple medical cure. She believes that a holistic approach to health care is central to the practice of caring in nursing. According to Watson, caring, which is manifested in nursing, has existed in every society. However, a caring attitude is not transmitted from generation to generation. Instead, it's transmitted by the culture of the nursing profession as a unique way of coping with its environment. According to her theory, caring can be demonstrated and practiced by nurses. Caring for patients promotes growth; a caring environment accepts a person as he or she is, and looks to what he or she may become. Caring consists of carative factors. Watson's 10 carative factors are: forming humanistic-altruistic value systems, instilling faith-hope, cultivating a sensitivity to self and others, developing a helping-trust relationship, promoting an expression of feelings, using problem-solving for decision-making, promoting teaching-learning, promoting a supportive environment, assisting with gratification of human needs, and allowing for existential-phenomenological forces. The first three factors form the "philosophical foundation" for the science of caring, and the remaining seven come from that foundation. Page 70 of 74

Within assisting with the gratification of human needs, Watson orders the needs. Lower-order biophysical needs include food and fluid, elimination, and ventilation. Lower-order psychophysical needs include activity-inactivity and sexuality. Higherorder psychosocial needs include achievement, affiliation, intrapersonalinterpersonal need, and self-actualization. Watson's theory has four major concepts: human being, health, environment/society, and nursing. The human being is defined as "...a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. He, human is viewed as greater than and different from, the sum of his or her parts." A human's health includes a high level of overall physical, mental, and social function; a general adaptive-maintenance level of daily function; and the absence of illness or the process of efforts that will lead to an absence of illness. Watson's nursing process parallels the scientific research process. The first step is assessment. This involves observation, identification and review of the problem, and the formulation of a hypothesis. Next, the nurse creates a care plan to determine how variables will be examined, as well as what data should be collected and how. Step three is intervention. This is the implementation of the developed plan and includes the collection of the data. Finally, the nurse conducts an evaluation. This is the examination of the data and results of the intervention, and the interpretation of the results. This may lead to an additional hypothesis. One advantage to Watson's Philosophy and Science of Caring theory is that it creates a generalized framework for nursing that can be applied to a variety of situations and patients. It also places the patient in the context of the family, community, and culture. The patient is the focus of practice rather than the technology. However, the "looseness" of Watson's framework can also be a drawback in instances when something more structured is needed for the care of a patient.

Ernestine Wiedenbach
Biography and Career of Ernestine Wiedenbach Ernestine Wiedenbach was born in 1900 in Hamburg, Germany, and her family moved to New York in 1909. She earned a Bachelor of Arts from Wellesley College in 1922 and her Registered Page 71 of 74

Nurse's license from the John Hopkins School of Nursing in 1925. She got her Masters of Arts from Teachers College, Columbia University in 1934. In 1946, Wiedenbach earned a certificate in nurse-midwifery from the Maternity Center Association School for Nurse-Midwives in New York, and taught there until 1951. In 1952, she joined the faculty of Yale University as an instructor in maternity nursing. She became an assistant professor of obstetric nursing in 1954. When the Yale School of Nursing established a master's degree program, she became an associate professor and was the director of the major in maternal and newborn health nursing.

She published Family-Centered Maternity Nursing in 1958 and Communication: Key to Effective Nursing (128p) in 1982. Wiedenbach died in 1998. Ernestine Wiedenbach's Contribution to Nursing: The Helping Art of Clinical Nursing Ernestine Wiedenbach developed the conceptual model of nursing called the Helping Art of Clinical Nursing, which was influenced by the works of Ida Orlando. In her model of nursing, she explains that nursing is the practice of identification of a patient's need for help through the observation of presenting behaviors and symptoms, exploration of the meaning of those symptoms with the patient, determining the cause of discomfort, and determining the patient's ability to resolve the discomfort or if the patient has a need for help from the nurse or other health care professionals. The goal of nursing consists primarily of identifying a patient's need for help. The need for help is defined as "any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that Page 72 of 74

affect health and wellness." Need-for-help must be based on the individual patient's perception of his or her own situation. Wiedenbach's theory identifies the patient as "any individual who is receiving help of some kind, be it care, instruction or advice from a member of the health profession or from a worker in the field of health." A patient is any person who has entered the healthcare system and is receiving help, which means he or she does not need to be ill. A person receiving health-related education would qualify as a patient. The theory identifies four main elements in clinical nursing: a philosophy, a purpose, a practice, and the art. The nurse's philosophy is his or her attitude and belief about life, and how that affects reality for him or her. The three essential components Wiedenbach associated with a nursing philosophy are reverence for life; respect for the dignity, worth, autonomy, and individuality of each human being; and the resolution to act on personally and professionally held beliefs. The nurse's purpose is that which the nurse wants to accomplish through her actions. It encompasses all of the activities directed toward the overall good of the patient. The practice of nursing consists of the observable nursing actions affected by beliefs and feelings about meeting the patient's need for help. The art of nursing includes understanding the patient's needs, developing goals and actions intended to enhance the patient's ability, and directing the activities related to the medical plan to improve the patient's condition. The nurse's focus is also on the prevention of complications related to reoccurrence or the development of new concerns. Nursing skills are carried out to achieve a specific patient-centered purpose rather than the completion of the skill itself being the end goal. Skills are made up of a variety of actions, and characterized by harmony of movement, precision, and effective use of self. The theory explains that knowledge encompasses all that has been perceived and grasped by the human mind. It may be factual, speculative, or practical. A nurse uses two types of judgment in dealing with patients: clinical and sound. Clinical judgment represents the nurse's likeliness to make sound decisions, which Page 73 of 74

are based on differentiating fact from assumption and relating them to effect. Sound judgment is the result of disciplined functioning of emotions, and improves with expanded knowledge and increased professional Wiedenbach's prescriptive theory is based on three factors:

cause and mind and clarity of purpose.

The central purpose which the practitioner recognizes as essential to the particular discipline. The prescription for the fulfillment of the central purpose. The realities in the immediate situation that influence the central purpose.

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