Major Theoretical Models - Theoretical Foundations of Nursing Practice

Question 1

All ___ models of nursing are designed to guide and shape practice.

Answer 1

conceptual

Question 2

Although their theoretical inspiration is derived directly from the practice setting, many ___ models do not capture all of what might be influencing that practice, such as societal and demographic changes, current health care belief models, and therapeutic strategies, as well as the political struggles inherent in health care delivery. The early ___ theories, therefore, reflect the issues that were shaping the role and context of nursing during those specific time frames.

Answer 2

conceptual / practice

Question 3

Whereas most later theorists drew on social and psychological theories, ___ was directly inspired by nursing practice. Writing Notes on Nursing in 1859, she described conditions necessary to promote health and healing.

Answer 3

Nightingale

Question 4

Her observations during the Crimean War led to the first set of principles for nursing practice, acknowledging the particular importance of the environment, including clean living areas, fresh air, and the presence of light.

Answer 4

Florence Nightingale

Question 5

The role of nursing care included ensuring that wounded soldiers were warm, comfortable, and adequately fed. Torres (1986) noted that ___ demonstrated how to think about patients and their environment.

Answer 5

Nightingale

Question 6

By shifting the focus from disease processes toward an environment conducive to healing, ___’s conceptualization clearly differentiated the role of nursing from that of medicine.

Answer 6

Nightingale

Question 7

Conceived the McGill model, and she and her colleagues developed it.

Answer 7

Dr. Moyra Allen

Question 8

Systematically studying actual nursing situations, ___ and her colleagues created a way of thinking about nursing that focused on promoting health. They recognized that many patients’ health concerns were best approached through changes in lifestyle.

Answer 8

Allen

Question 9

The M___ scholars focused on the individual in the context of the family and, like Nightingale, viewed nursing as complementary to medicine.

Answer 9

M-cGill

Question 10

The main features of this model were “a focus on health rather than illness and treatment, on all family members rather than the patient alone, on family goals rather than on the nurse’s, and on family strengths rather than their deficits”.

Answer 10

McGill

Question 11

A founding member of the World Health Organization committee that developed the criteria for accreditation of nursing schools.

Answer 11

Dr. Moyra Allen

Question 12

Many early theorists organized their thinking by conceptualizing the patient as representing a collection of ___.

Answer 12

needs

Question 13

This reflected a common orientation to studying the nature of people, popularized in the 1960s, in which needs, drives, and competencies were thought to hold potential for explaining human behaviour.

Answer 13

Needs theories

Question 14

Of the needs theories, ___’s (1954) hierarchy of needs was one of the best known and most influential.

Answer 14

Maslow

Question 15

The idea that complex human behaviour can be best explained as a response to the competing demands of various basic needs is featured prominently in many nursing models.

Answer 15

Needs theories

Question 16

Conceptualized the patient as a compilation of 14 basic human needs: to breathe, eat and drink, eliminate waste products, move and maintain posture, rest and sleep, dress and undress, maintain body temperature, be clean, avoid danger, communicate, worship, work, play, and learn.

Answer 16

Virginia Henderson

Question 17

Accordingly, ___ defined nursing practice as assisting the individual, sick or well, in the performance of activities that contribute to health, recovery, or a peaceful death.

Answer 17

Henderson

Question 18

___’s model has remained popular in practice because its language is familiar and easily comprehensible and because it explains how a person’s biological, psychological, social, and spiritual components combine to influence the way illness is experienced and health can be regained.

Answer 18

Henderson

Question 19

Her self-care theory, the origins of which lay in Henderson’s work, was used widely in both nursing practice and research.

Answer 19

Dorothea Orem

Question 20

Her theory addressed the ways in which people are responsible for meeting the following universal self-care requisites:

• Maintaining sufficient intake of air, water, and food
• Maintaining a balance between activity and rest, and between solitude and interaction
• Providing for elimination processes
• Preventing hazards to life, functioning, and well-being
• Promoting functioning and growth in social groups in accordance with human potential

Answer 20

Dorothea Orem

Question 21

Drawing on both human need and developmental theory, ___’s theory focused on the individual’s role in maintaining health.

Answer 21

Orem

Question 22

This theory emerged at a time when the passive role of the patient was being questioned and the health care system was beginning to shift away from full responsibility for people’s health.

Answer 22

Self-care theory

Question 23

With increased understanding of illness patterns, ___ acknowledged the effects of multiple lifestyle factors such as smoking, diet, and exercise, reminding nurses that patients can look after their own health and that they must learn to care for themselves within their families and communities.

Answer 23

Orem

Question 24

Thus, the role of the nurse, according to ___, was to act temporarily for the patient until the patient could resume a more independent role in self-care.

Answer 24

Orem

Question 25

___ theories focused on the relationships between nurses and their clients.

Answer 25

Interactionist

Question 26

These theories defined more clearly the specific human communicative and behavioural patterns by which practitioners met their patients’ needs. As the theorists reframed definitions of the nursing profession, they drew from the work of psychologists and psychoanalysts such as Harry Stack Sullivan, Abraham Maslow, and Sigmund Freud.

Answer 26

Interactionist theories

Question 27

This psychiatric specialist defined the core of nursing care as the interpersonal relationship between the nurse and the patient.

Answer 27

Hildegard Peplau

Question 28

Building upon the ideas of psychoanalyst Harry Stack Sullivan, ___ depicted the practice of nursing as an interactive and therapeutic relationship. ___ felt that such relationships allowed nurses to challenge the practice of long-term stays in large inpatient psychiatric hospitals and to envision supporting patients to achieve independent living. “

Answer 28

Peplau x2

Question 29

According to ___, a nurse was “an investigator, prober, interpreter, and reporter, using the rich data they extract from the patient concerning his life. They develop insights, his and hers, into the meaning of a patient’s behaviour and help the patient recognize and change patterns that obstruct achievement of his goals”.

Answer 29

Peplau

Question 30

“The kind of person each nurse becomes makes a substantial difference in what each patient will learn as he is nursed through his experience with illness” was said by:

Answer 30

Hildegard Peplau

Question 31

An early advocate of an orderly and systematic approach to care, ___ created a way of thinking about nursing care that directed nurses toward preventing illness and maintaining health interpersonally.

Answer 31

Peplau

Question 32

Writing in the late 1960s and early 1970s, ___ also viewed nursing care as an interpersonal process. In contrast to Peplau’s more psychoanalytic orientation, ___ drew on a school of thought known as existential philosophy to guide her theorizing.

Answer 32

Travelbee x2

Question 33

___ viewed the “client” as including not only the individual but also the individual’s family and community, and she articulated the role of the nurse as assisting clients to “prevent or cope with the experience of illness and suffering and, if necessary, to find meaning in these experiences”.

Answer 33

Travelbee

Question 34

___ emphasized that nurses must recognize the humanity of their clients, suggesting that even the term patient should be regarded as a stereotypical categorization.

Answer 34

Travelbee

Question 35

Recognizing the reciprocity of human interaction, ___ focused attention on the communication that occurs between nurses and their clients as an important vehicle for finding meaning in illness.

Answer 35

Travelbee

Question 36

Influenced by Dorothy Johnson, as well as by earlier interactionist theorists (George, 1995), Canadian theorist ___ ___ (1979, 1980) articulated the essence of nursing as a helping process.

Answer 36

Evelyn Adam

Question 37

From her perspective, the nurse played a complementary-supplementary role in supporting the patient’s strength, knowledge, and will.

Answer 37

Evelyn Adam

Question 38

___’s model drew on Henderson’s framework of basic human needs and extended it into a model that would explain not only how nurses conceptualized the patient but also how they applied that knowledge in the context of a helping relationship characterized by empathy, caring, and mutual respect.

Answer 38

Adam

Question 39

In the 1970s and 1980s, as conceptual models of nursing became more sophisticated and structured, several theorists drew on general ___ theory for guidance in conceptualizing the complexity of human health.

Answer 39

systems

Question 40

___ theory approaches helped nurses recognize that intervention in any one part of a system would produce consequent reactions in other parts, as well as in the system as a whole.

Answer 40

systems

Question 41

Her nursing model identified the individual as a behavioural system with seven subsystems, each of which has a goal, a set of behaviours, and a choice.

Answer 41

Dorothy Johnson

Question 42

The behavioural systems model developed at the University of ___ ___ School of Nursing was inspired by Johnson’s model and developed by a committee led by Margaret Campbell that included several of Johnson’s former students.

Answer 42

British Columbia

Question 43

Broadening the view of human experience on the basis of behavioural drives, the ___ model depicted the behavioural system as being composed of nine basic human needs, each of which is shaped by the psychological and sociocultural environment within which it is expressed.

Answer 43

UBC

Question 44

In this model, needs were considered universal and therefore fundamental to human experience, the specific goals toward which needs-related human behaviour was directed and the strategies for achieving those goals were recognized as unique to individuals and their particular physiological, psychological, or social circumstances.

Answer 44

UBC model

Question 45

Thus, the UBC model provided a structure by which general knowledge about human health and illness could be combined with particular knowledge about each individual patient. In accordance with the tenets of general systems theory, the goal of nursing practice was balance of the behavioural system. The nurse’s role was to foster, protect, sustain, and teach (Campbell, 1987) and thereby bring about not only system balance but also stability and optimal health.

Answer 45

UBC

Question 46

___’s approach to theorizing about nursing differed from that of other systems theorists in that it did not rely on concepts concerning needs and drives, nor did it break the system into any component parts. .

Answer 46

Neuman

Question 47

She understood the person to be a physiological, psychological, sociocultural, developmental, and spiritual being and oriented the attention of the nurse to the “client system” in a healthcare-oriented and holistic manner.

Answer 47

Betty Neuman

Question 48

Considered the client system to have innate factors consistent with being human, as well as unique factors that characterized each individual person.

Answer 48

Betty Neuman

Question 49

According to ___, each client had a unique set of response patterns determined and regulated by a core structure.

Answer 49

Neuman

Question 50

She believed that because the person was vulnerable to environmental stressors, the role of the nurse ought to focus on actual and potential stressors and, ultimately, prevention.

Answer 50

Betty Neuman

Question 51

In contrast to most other systems theorists, she considered the client not as a behavioural system but rather as an adaptive one.

Answer 51

Sister Callista Roy

Question 52

Her model depicted four modes of adaptation: physiological needs, self-concept, role function, and interdependence.

Answer 52

Sister Callista Roy

Question 53

She viewed the person as a biopsychosocial being in constant interaction with a changing environment.

Answer 53

Sister Callista Roy

Question 54

___ conceptualized the person as an adaptive system with two major internal processes by which to adapt: the cognator and the regulator subsystems. ___ used these mechanisms to describe and explain the interconnectedness of all aspects of human adaptation and to conceptualize the role of the nurse in managing the stimuli that influence that adaptation.

Answer 54

Roy X2

Question 55

The theorists who identified their work as belonging to the simultaneity paradigm considered their theories to be fundamentally distinct from the practice, needs, interactionist, and systems theories and these theories were called:

Answer 55

simultaneity theories.

Question 56

Although ___ theories were first articulated long before the paradigm debate arose and before the terms ___ and totality were used to categorize the theories, the language of ___ has become prominent in distinguishing this group of nursing theories from others.

Answer 56

simultaneity x3

Question 57

A characteristic feature of these theories is what Rogers (1970) called the unitary human being.

Answer 57

Simultaneity

Question 58

Previous theorists had sought to identify aspects of the individual that not only represented an abstract conceptualization of the whole but also provided a comprehensive understanding of the person in terms of his or her parts (such as problems, needs, or goals). In contrast, the ___ theorists viewed the individual as an entirely irreducible whole, inherently and “holographically” connected with the universal environment. These theories represented a distinctive approach to articulating an understanding of the client of nursing as well as nursing’s role in relation to that client.

Answer 58

simultaneity

Question 59

Her model was revolutionary in presenting the client not simply as a person but as an energy field in constant interaction with the environment, which itself was also an irreducible energy field, coextensive with the universe.

Answer 59

Martha Roger

Question 60

According to ___, who based her theory on her interpretations of evolving ideas in physics, the role of nursing was to focus on the life process of a human being along a time-space continuum.

Answer 60

Rogers

Question 61

An early proponent of pattern recognition, ___ believed that pattern gave the energy field its identity and its distinguishing characteristics.

Answer 61

Rogers

Question 62

The objective of nursing practice became one of helping clients reach their maximum health potential in the context of constant change and to develop what ___ referred to as homeodynamic unity within diversity.

Answer 62

Rogers

Question 63

Her theory of “man-living-health,” later termed human becoming theory and over time evolving into the human becoming school of thought, was another view of the individual as a unitary being who is “indivisible, unpredictable, and everchanging” and “a freely choosing being who can be recognized through paradoxical patterns co-created all-at-once in mutual process with the universe”.

Answer 63

Rosemarie Parse

Question 64

According to ___’s perspective, the caring presence of nurses and their particular patterns of relating support individuals in the human “becoming” process.

Answer 64

Parse

Question 65

Within ___’s nursing theory, the goal of nursing is articulated not in traditional definitions of health but rather as the notion of people in a continuous process of making choices and changing health priorities.

Answer 65

Parse

Question 66

According to ___’s theory, nurses engage with people in their process of “becoming” through the application of three core processes referred to as explicating, dwelling with, and moving beyond.

Answer 66

Parse

Question 67

Considered the individual to be a totality who can be viewed as a transpersonal self.

Answer 67

Jean Watson

Question 68

According to ___, in contrast to depictions of the individual as a body and an ego, it is more useful to understand the individual as “an embodied spirit; a transpersonal transcendent evolving consciousness; unity of mind-body spirit; person-nature-universe as oneness, connected”.

Answer 68

Watson

Question 69

She believed that nurses must do far more than deal with physical illness: they must attend to their primary function, which is caring.

Answer 69

Jean Watson

Question 70

From ___’s perspective, caring infuses all aspects of a nurse’s role and draws attention to nursing acts as embodying an aesthetic that facilitates both healing and growth.

Answer 70

Watson

Question 71

A dialogue representing the dynamic interaction between theorizing and clinical practice (often termed ___) has started to emerge.

Answer 71

praxis

Question 72

For some theorists, this notion of ___ represents a blend of what has been described as the art and science of nursing. For others, it reflects a call to engaging with knowledge in a reflexive manner that invokes emancipation and fuels action.

Answer 72

praxis