U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings
  • My Bibliography
  • Collections
  • Citation manager

Save citation to file

Email citation, add to collections.

  • Create a new collection
  • Add to an existing collection

Add to My Bibliography

Your saved search, create a file for external citation management software, your rss feed.

  • Search in PubMed
  • Search in NLM Catalog
  • Add to Search

The relationship of nursing theory and research: the state of the art


  • 1 Department of Nursing Science, University of Limburg, Maastricht, The Netherlands.
  • PMID: 8514934
  • DOI: 10.1046/j.1365-2648.1993.18050783.x

Recently, the relationship between theory and research has received more attention. It seems that in the past 10 to 15 years more research studies have been published that are more or less conceptualized within (nursing) theories. However, it is not always clear how the theory has been used. The purpose of this study was to analyse the role of theory in nursing practice research. To this end, papers published in six nursing journals between 1986 and 1990 have been studied. It can be concluded that, in comparison with earlier analyses, the use of theories in nursing research studies has increased (from 13% to 21%), but the use of nursing theories has not become more frequent. However, the testing of nursing theories is minimal. On the other hand, research results are being cumulated progressively in regard to theory or to other research.

PubMed Disclaimer

Similar articles

  • Orem's self-care deficit nursing theory: update on the state of the art and science. Biggs A. Biggs A. Nurs Sci Q. 2008 Jul;21(3):200-6. doi: 10.1177/0894318408320140. Nurs Sci Q. 2008. PMID: 18544779 No abstract available.
  • Nursing theory and knowledge development: a descriptive review of doctoral dissertations, 2000-2004. Spear HJ. Spear HJ. ANS Adv Nurs Sci. 2007 Jan-Mar;30(1):E1-14. doi: 10.1097/00012272-200701000-00010. ANS Adv Nurs Sci. 2007. PMID: 17299272 Review.
  • Developing specialty knowledge: the case of Australian critical care nursing. Chaboyer W, Dunn SV, Najman J. Chaboyer W, et al. Intensive Crit Care Nurs. 2000 Feb;16(1):13-7. doi: 10.1054/iccn.2000.1474. Intensive Crit Care Nurs. 2000. PMID: 10790711
  • Middle range theory: spinning research and practice to create knowledge for the new millennium. Liehr P, Smith MJ. Liehr P, et al. ANS Adv Nurs Sci. 1999 Jun;21(4):81-91. doi: 10.1097/00012272-199906000-00011. ANS Adv Nurs Sci. 1999. PMID: 10385474 Review.
  • [Production of scientific papers by nurses from public and private hospitals in the district of Sao Paulo]. Salzano ST, Stefanelli MC, Adami NP, Jorge AL, de Castro RA, Silva IA. Salzano ST, et al. Rev Esc Enferm USP. 1998 Apr;32(1):2-8. doi: 10.1590/s0080-62341998000100002. Rev Esc Enferm USP. 1998. PMID: 9668875 Portuguese.
  • Search in MeSH

LinkOut - more resources

Full text sources, miscellaneous.

  • NCI CPTAC Assay Portal

full text provider logo

  • Citation Manager

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

nursing theory research paper

  • Subscribe to journal Subscribe
  • Get new issue alerts Get alerts

Secondary Logo

Journal logo.

Colleague's E-mail is Invalid

Your message has been successfully sent to your colleague.

Save my selection

Theory and Theorizing in Nursing Science

Commentary from the nursing research special issue editorial team.

Jairath, Nalini N.; Peden-McAlpine, Cynthia J.; Sullivan, Mary C.; Vessey, Judith A.; Henly, Susan J.

Nalini N. Jairath, PhD, RN, is Editorial Board Member, Nursing Research , and Associate Professor, School of Nursing, The Catholic University of America, Washington, DC.

Cynthia J. Peden-McAlpine, PhD, ACNS, BC, is Editorial Board Member, Nursing Research , and Associate Professor, School of Nursing, University of Minnesota, Minneapolis.

Mary C. Sullivan, PhD, RN, FAAN, is Editorial Board Member, Nursing Research , and Professor, College of Nursing, The University of Rhode Island, Kingston.

Judith A. Vessey, PhD, RN, DPNP, MBA, FAAN, is Editorial Board Member, Nursing Research , and Leila Holden Carroll Endowed Professor in Nursing, William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.

Susan J. Henly, PhD, RN, FAAN, is Editor Emerita, Nursing Research , and Professor Emerita, School of Nursing, University of Minnesota, Minneapolis.

Accepted for publication December 18, 2017.

Editorial note: This paper was invited and accepted during the Editorship of Susan J. Henly.

The authors have no conflicts of interest to declare.

Corresponding author: Nalini N. Jairath, PhD, RN, The Catholic University of America, 620 Michigan Avenue NE, Nursing/Biology Room 250, Washington, DC 21029 (e-mail: [email protected] ).


Articles from three landmark symposia on theory for nursing—published in Nursing Research in 1968–1969—served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory.


The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue.


The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory, big data, and doctoral education. Using a dialogue format, the editors discussed these core questions.


The classic nursing metaparadigm (health, person, environment, nursing) was viewed as a continuing unifying element for the discipline but is in need of revision in today’s scientific and practice climates. Practice theory and precision healthcare jointly arise from an emphasis on individualization. Big data and the methods of e-science are challenging the assumptions on which nursing theory development was originally based. Doctoral education for nursing scholarship requires changes to ensure that tomorrow’s scholars are prepared to steward the discipline by advancing (not reifying) past approaches to nursing theory.


Ongoing reexamination of theory is needed to clarify the domain of nursing, guide nursing science and practice, and direct and communicate the unique and essential contributions of nursing science to the broader health research effort and of nursing to healthcare.

Full Text Access for Subscribers:

Individual subscribers.

nursing theory research paper

Institutional Users

Not a subscriber.

You can read the full text of this article if you:

  • + Favorites
  • View in Gallery

Readers Of this Article Also Read

Key issues in nursing theory: developments, challenges, and future directions, the fundamentals of care framework as a point-of-care nursing theory, empirical development of a middle range theory of caring, theory in a practice discipline: part ii. practice oriented research, theory in a practice discipline: part i. practice oriented theory.

Log in using your username and password

  • Search More Search for this keyword Advanced search
  • Latest content
  • Current issue
  • Write for Us
  • BMJ Journals

You are here

  • Volume 22, Issue 2
  • Integration of a theoretical framework into your research study
  • Article Text
  • Article info
  • Citation Tools
  • Rapid Responses
  • Article metrics

Download PDF

  • Roberta Heale 1 ,
  • Helen Noble 2
  • 1 Laurentian University , School of Nursing , Sudbury , Ontario , Canada
  • 2 Queens University Belfast , School of Nursing and Midwifery , Belfast , UK
  • Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, P3E2C6, Canada; rheale{at}laurentian.ca


Statistics from Altmetric.com

Request permissions.

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Often the most difficult part of a research study is preparing the proposal based around a theoretical or philosophical framework. Graduate students ‘…express confusion, a lack of knowledge, and frustration with the challenge of choosing a theoretical framework and understanding how to apply it’. 1 However, the importance in understanding and applying a theoretical framework in research cannot be overestimated.

The choice of a theoretical framework for a research study is often a reflection of the researcher’s ontological (nature of being) and epistemological (theory of knowledge) perspective. We will not delve into these concepts, or personal philosophy in this article. Rather we will focus on how a theoretical framework can be integrated into research.

The theoretical framework is a blueprint for your research project 1 and serves several purposes. It informs the problem you have identified, the purpose and significance of your research demonstrating how your research fits with what is already known (relationship to existing theory and research). This provides a basis for your research questions, the literature review and the methodology and analysis that you choose. 1 Evidence of your chosen theoretical framework should be visible in every aspect of your research and should demonstrate the contribution of this research to knowledge. 2

What is a theory?

A theory is an explanation of a concept or an abstract idea of a phenomenon. An example of a theory is Bandura’s middle range theory of self-efficacy, 3 or the level of confidence one has in achieving a goal. Self-efficacy determines the coping behaviours that a person will exhibit when facing obstacles. Those who have high self-efficacy are likely to apply adequate effort leading to successful outcomes, while those with low self-efficacy are more likely to give up earlier and ultimately fail. Any research that is exploring concepts related to self-efficacy or the ability to manage difficult life situations might apply Bandura’s theoretical framework to their study.

Using a theoretical framework in a research study

Example 1: the big five theoretical framework.

The first example includes research which integrates the ‘Big Five’, a theoretical framework that includes concepts related to teamwork. These include team leadership, mutual performance monitoring, backup behaviour, adaptability and team orientation. 4 In order to conduct research incorporating a theoretical framework, the concepts need to be defined according to a frame of reference. This provides a means to understand the theoretical framework as it relates to a specific context and provides a mechanism for measurement of the concepts.

In this example, the concepts of the Big Five were given a conceptual definition, that provided a broad meaning and then an operational definition, which was more concrete. 4 From here, a survey was developed that reflected the operational definitions related to teamwork in nursing: the Nursing Teamwork Survey (NTS). 5 In this case, the concepts used in the theoretical framework, the Big Five, were the used to develop a survey specific to teamwork in nursing.

The NTS was used in research of nurses at one hospital in northeastern Ontario. Survey questions were grouped into subscales for analysis, that reflected the concepts of the Big Five. 6 For example, one finding of this study was that the nurses from the surgical unit rated the items in the subscale of ’team leadership' (one of the concepts in the Big Five) significantly lower than in the other units. The researchers looked back to the definition of this concept in the Big Five in their interpretation of the findings. Since the definition included a person(s) who has the leadership skills to facilitate teamwork among the nurses on the unit, the conclusion in this study was that the surgical unit lacked a mentor, or facilitator for teamwork. In this way, the theory of teamwork was presented through a set of concepts in a theoretical framework. The Theoretical Framework (TF)was the foundation for development of a survey related to a specific context, used to measure each of the concepts within the TF. Then, the analysis and results circled back to the concepts within the TF and provided a guide for the discussion and conclusions arising from the research.

Example 2: the Health Decisions Model

In another study which explored adherence to intravenous chemotherapy in African-American and Caucasian Women with early stage breast cancer, an adapted version of the Health Decisions Model (HDM) was used as the theoretical basis for the study. 7 The HDM, a revised version of the Health Belief Model, incorporates some aspects of the Health Belief Model and factors relating to patient preferences. 8 The HDM consists of six interrelated constituents that might predict how well a person adheres to a health decision. These include sociodemographic, social interaction, experience, knowledge, general and specific health beliefs and patient preferences, and are clearly defined. The HDM model was used to explore factors which might influence adherence to chemotherapy in women with breast cancer. Sociodemographic, social interaction, knowledge, personal experience and specific health beliefs were used as predictors of adherence to chemotherapy.

The findings were reported using the theoretical framework to discuss results. The study found that delay to treatment, health insurance, depression and symptom severity were predictors to starting chemotherapy which could potentially be adapted with clinical interventions. The findings from the study contribute to the existing body of literature related to cancer nursing.

Example 3: the nursing role effectiveness model

In this final example, research was conducted to determine the nursing processes that were associated with unexpected intensive care unit admissions. 9 The framework was the Nursing Role Effectiveness Model. In this theoretical framework, the concepts within Donabedian’s Quality Framework of Structure, Process and Outcome were each defined according to nursing practice. 10 11  Processes defined in the Nursing Role Effectiveness Model were used to identify the nursing process variables that were measured in the study.

A theoretical framework should be logically presented and represent the concepts, variables and relationships related to your research study, in order to clearly identify what will be examined, described or measured. It involves reading the literature and identifying a research question(s) while clearly defining and identifying the existing relationship between concepts and theories (related to your research questions[s] in the literature). You must then identify what you will examine or explore in relation to the concepts of the theoretical framework. Once you present your findings using the theoretical framework you will be able to articulate how your study relates to and may potentially advance your chosen theory and add to knowledge.

  • Kalisch BJ ,
  • Parent M , et al
  • Strickland OL ,
  • Dalton JA , et al
  • Eraker SA ,
  • Kirscht JP ,
  • Lightfoot N , et al
  • Harrison MB ,
  • Laschinger H , et al

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Provenance and peer review Not commissioned; internally peer reviewed.

Patient and public involvement Not required.

Read the full text or download the PDF:

Nursing theories

Open access articles on nursing theories and models.

nursing theory research paper

Nursing Research and Theories


  • RESEARCH – Process of inquiry
  • THEORY – Product of knowledge
  • SCIENCE – Result of the relationship between research & theory
  • To effectively build knowledge to research process should be developed within some theoretical structure that facilities analysis and interpretation of findings.
  • Relationship between theory and research in nursing is not well understood.

Relationship Between Theory and Research

  • Research without theory results in discreet information or data which does not add to the accumulated knowledge of the discipline.
  • Theory guides the research process, forms the research questions, aids in design, analysis and interpretation.
  • It enables the scientist to weave the facts together.
  • The relationship is direct and positive
  • The choice of a research design depends on the question asked and the current state of theory development. (Kaiser Permanente, 2009)
  • Descriptive
  • Correlational
  • Experimental

Theories from Nursing or Other Disciplines

  • Nursing science is blend of knowledge that is unique to nursing and knowledge that is borrowed from other disciplines.
  • Debate is whether the use of borrowed theory has hindered the development of the discipline.
  • It has contributed to problems connecting research and theory in nursing.

Historical Overview of Research and Theory in Nursing

  • Florence Nightingale supported her theoretical propositions through research, as statistical data and prepared graphs were used to depict the impact of nursing care on the health of British soldiers.
  • Afterwards, for almost century reports of nursing research were rare.
  • Research and theory developed separately in nursing.
  • Between 1928 and 1959 only 2 out of 152 studies reported a theoretical basis for the research design.
  • In 1970’s growing number of nurse theorists were seeking researchers to test their models in research and clinical application
  • Grand nursing theories are still not widely used. In 1990’s borrowed theories were used more.
  • Now the focus of research and theory have moved more towards middle range theories

Purpose of Theory in Research

  • To identify meaningful and relevant areas for study.
  • To propose plausible approaches to health problems.
  • To develop or refine theories
  • Define the concepts and proposed relationships between concepts.
  • To interpret research findings
  • To develop clinical practice protocols.
  • To generate nursing diagnosis.

Bordage (2009) explainsuse of conceptual frameworks in research

  • Allow researchers to build upon one another’s work; thereby building a body of knowledge
  • Programmatic, conceptually based research helps accumulate deeper understanding over time and this moves a discipline (such as nursing) forward.

Types of theory and corresponding research

  • It is designed to develop and describe relationships between and among phenomena without imposing preconceived notations.
  • It is inductive and includes field observations and phenomenology.
  • During the theory generating process, the researcher moves by logical thought from fact to theory by means of a proposition stated as an empirical generalization.

Grounded Theory Research

  • Inductive research technique developed by Glazer and Strauss (1967)
  • Grounded theory provides a way to describe what is happening and understanding the process of why it happens.
  • Methodology – The researcher observes, collects data, organizes data and forms theory from the data at the same time.
  • Data may be collected by interview, observation, records or a combination of these techniques.
  • Data are coded in preparation for analysis.
  • Category development – Categories are identified and named
  • Category saturation – Comparison of similar characteristics in each of the categories
  • Concept development – Defines the categories
  • Search for additional categories – Continues to examine the data for additional categories
  • Category reduction – Higher order categories are selected
  • Linking of categories – The researcher seeks to understand relationships among categories
  • Selective sampling of the literature
  • Emergence of the core variable – Central theme are focus of the theory
  • Concept modification and integration – Explaining the phenomenal

Theory testing research

  • In theory testing research, theoretical statements are translated into questions and hypothesis. It requires a deductive reasoning process.
  • The interpretation determines whether the study supports are contradicts the propositional statement.
  • If a conceptual model is used as a theoretical framework for research it is not theory testing.
  • Theory testing requires detailed examination of theoretical relationships.

Theory as a conceptual framework

  • Problem being investigated is fit into an existing theoretical framework, which guides the study and enriches the value of its findings.
  • The conceptual definitions are drawn from the framework
  • The data collection instrument is congruent with the framework.
  • Findings are interpreted in light of explanations provided by the framework.
  • Implications are based on the explanatory power of a framework.

A Typology of Research

  • Experimentation
  • Deductive research
  • Quantitative research
  • The scientific method
  • Theory / hypothesis testing
  • Interpreting
  • Inductive research
  • Qualitative research
  • Phenomenological research
  • Theory generation
  • ‘Divining’; ‘heuristic’ research

Guidelines for writing about a research study’s theoretical framework

  • Introduce the framework
  • Briefly explain why it is a good fit for the research problem area
  • At the end of the literature review
  • Thoroughly describe the framework and explain its application to the present study.
  • Describe how the framework has been used in studies about similar problems
  • In the study’s methodology section
  • Explain how the framework is being operationalized in the study’s design.
  • Explain how data collection methods (such as questionnaire items) reflect the concepts in the framework.
  • In the study’s discussion section
  • Describe how study findings are consistent (or inconsistent) with the framework.
  • Offer suggestions for practice and further research that are congruent with the framework’s concepts and propositions.

The relationship between research and theory is undeniable, and it is important to recognize the impact of this relationships on the development of nursing knowledge. So interface theory and research by generating theories, testing the theories and by using it as a conceptual framework that drives the study.

  • George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed. Norwalk, Appleton and Lange.
  • Polit DF, Hungler BP. Nursing Research: Principles and Methods. Philadelphia: JB Lippincott Company; 1998.
  • Burns N, Grove SK. The practice of Nursing Research. 4th Ed. Philadelphia: WB Saunders Publications; 2001.  
  • Treece JW, Treece EW. Elements of Research in Nursing (3rded.). St. Louis: Mosby; 1982.
  • Nursing Research Series. Essentials of Science: Methods, Appraisal and Utilization. Kaiser Permanente. Northern and Southern California Nursing Research, 2009.

Home I About Us I Privacy Policy I Ad Policy I Disclaimer

Nursing Theories and Theorists: The Definitive Guide for Nurses

Nursing Theory and Theorist Definitive Guide for Nurses

In this guide for nursing theories and nursing theorists , we aim to help you understand what comprises a nursing theory and its importance, purpose, history, types, or classifications, and give you an overview through summaries of selected nursing theories.

Table of Contents

  • What are Nursing Theories?

Defining Terms

History of nursing theories, environment, definitions, relational statements, assumptions, why are nursing theories important, in academic discipline, in research, in the profession, grand nursing theories, middle-range nursing theories, practice-level nursing theories, factor-isolating theory, explanatory theory, prescriptive theories, other ways of classifying nursing theories, florence nightingale, hildegard e. peplau, virginia henderson, faye glenn abdellah, ernestine wiedenbach, lydia e. hall, joyce travelbee, kathryn e. barnard, evelyn adam, nancy roper, winifred logan, and alison j. tierney, ida jean orlando, jean watson.

  • Marilyn Anne Ray 

Patricia Benner

Kari martinsen, katie eriksson, myra estrin levine, martha e. rogers, dorothea e. orem, imogene m. king, betty neuman, sister callista roy, dorothy e. johnson, anne boykin and savina o. schoenhofer, afaf ibrahim meleis, nola j. pender, madeleine m. leininger, margaret a. newman, rosemarie rizzo parse, helen c. erickson, evelyn m. tomlin, and mary ann p. swain, gladys l. husted and james h. husted, ramona t. mercer, merle h. mishel, pamela g. reed, carolyn l. wiener and marylin j. dodd, georgene gaskill eakes, mary lermann burke, and margaret a. hainsworth, phil barker, katharine kolcaba, cheryl tatano beck, kristen m. swanson, cornelia m. ruland and shirley m. moore, wanda de aguiar horta, recommended resources, what are nursing theories.

Nursing theories are organized bodies of knowledge to define what nursing is, what nurses do, and why they do it. Nursing theories provide a way to define nursing as a unique discipline that is separate from other disciplines (e.g., medicine). It is a framework of concepts and purposes intended to guide nursing practice at a more concrete and specific level.

Nursing, as a profession, is committed to recognizing its own unparalleled body of knowledge vital to nursing practice—nursing science. To distinguish this foundation of knowledge, nurses need to identify, develop, and understand concepts and theories in line with nursing. As a science, nursing is based on the theory of what nursing is, what nurses do, and why. Nursing is a unique discipline and is separate from medicine. It has its own body of knowledge on which delivery of care is based.

The development of nursing theory demands an understanding of selected terminologies, definitions, and assumptions.

  • Philosophy. These are beliefs and values that define a way of thinking and are generally known and understood by a group or discipline.
  • Theory . A belief, policy, or procedure proposed or followed as the basis of action. It refers to a logical group of general propositions used as principles of explanation. Theories are also used to describe, predict, or control phenomena.
  • Concept. Concepts are often called the building blocks of theories. They are primarily the vehicles of thought that involve images.
  • Models. Models are representations of the interaction among and between the concepts showing patterns. They present an overview of the theory’s thinking and may demonstrate how theory can be introduced into practice.
  • Conceptual framework. A conceptual framework is a group of related ideas, statements, or concepts. It is often used interchangeably with the conceptual model and with grand theories .
  • Proposition. Propositions are statements that describe the relationship between the concepts.
  • Domain . The domain is the perspective or territory of a profession or discipline.
  • Process. Processes are organized steps, changes, or functions intended to bring about the desired result.
  • Paradigm. A paradigm refers to a pattern of shared understanding and assumptions about reality and the world, worldview, or widely accepted value system.
  • Metaparadigm. A metaparadigm is the most general statement of discipline and functions as a framework in which the more restricted structures of conceptual models develop. Much of the theoretical work in nursing focused on articulating relationships among four major concepts: person, environment, health, and nursing.

The first nursing theories appeared in the late 1800s when a strong emphasis was placed on nursing education.

  • In 1860, Florence Nightingale defined nursing in her “ Environmental Theory ” as “the act of utilizing the patient’s environment to assist him in his recovery.”
  • In the 1950s, there is a consensus among nursing scholars that nursing needed to validate itself through the production of its own scientifically tested body of knowledge.
  • In 1952, Hildegard Peplau introduced her Theory of Interpersonal Relations that emphasizes the nurse -client relationship as the foundation of nursing practice.
  • In 1955, Virginia Henderson conceptualized the nurse’s role as assisting sick or healthy individuals to gain independence in meeting 14 fundamental needs. Thus her Nursing Need Theory was developed.
  • In 1960, Faye Abdellah published her work “Typology of 21 Nursing Problems,” which shifted the focus of nursing from a disease-centered approach to a patient-centered approach.
  • In 1962, Ida Jean Orlando emphasized the reciprocal relationship between patient and nurse and viewed nursing’s professional function as finding out and meeting the patient’s immediate need for help.
  • In 1968, Dorothy Johnson pioneered the Behavioral System Model and upheld the fostering of efficient and effective behavioral functioning in the patient to prevent illness.
  • In 1970, Martha Rogers viewed nursing as both a science and an art as it provides a way to view the unitary human being, who is integral with the universe.
  • In 1971, Dorothea Orem stated in her theory that nursing care is required if the client is unable to fulfill biological, psychological, developmental, or social needs.
  • In 1971, Imogene King ‘s Theory of Goal attainment stated that the nurse is considered part of the patient’s environment and the nurse-patient relationship is for meeting goals towards good health.
  • In 1972, Betty Neuman , in her theory, states that many needs exist, and each may disrupt client balance or stability. Stress reduction is the goal of the system model of nursing practice.
  • In 1979, Sr. Callista Roy viewed the individual as a set of interrelated systems that maintain the balance between these various stimuli.
  • In 1979, Jean Watson developed the philosophy of caring, highlighted humanistic aspects of nursing as they intertwine with scientific knowledge and nursing practice.

The Nursing Metaparadigm

Four major concepts are frequently interrelated and fundamental to nursing theory: person, environment, health, and nursing. These four are collectively referred to as metaparadigm for nursing .

Nursing Metaparadigm in Nursing Theories

Person (also referred to as Client or Human Beings) is the recipient of nursing care and may include individuals, patients, groups, families, and communities.

Environment (or situation) is defined as the internal and external surroundings that affect the client. It includes all positive or negative conditions that affect the patient, the physical environment, such as families, friends, and significant others, and the setting for where they go for their healthcare.

Health is defined as the degree of wellness or well-being that the client experiences. It may have different meanings for each patient, the clinical setting, and the health care provider.

The nurse’s attributes, characteristics, and actions provide care on behalf of or in conjunction with the client. There are numerous definitions of nursing, though nursing scholars may have difficulty agreeing on its exact definition. The ultimate goal of nursing theories is to improve patient care .

You’ll find that these four concepts are used frequently and defined differently throughout different nursing theories. Each nurse theorist’s definition varies by their orientation, nursing experience , and different factors that affect the theorist’s nursing view. The person is the main focus, but how each theorist defines the nursing metaparadigm gives a unique take specific to a particular theory. To give you an example, below are the different definitions of various theorists on the nursing metaparadigm:

Nursing Metaparadigm of Different Nursing Theories

Components of Nursing Theories

For a theory to be a theory, it has to contain concepts, definitions, relational statements, and assumptions that explain a phenomenon. It should also explain how these components relate to each other.

A term given to describe an idea or response about an event, a situation, a process, a group of events, or a group of situations. Phenomena may be temporary or permanent. Nursing theories focus on the phenomena of nursing.

Interrelated concepts define a theory. Concepts are used to help describe or label a phenomenon. They are words or phrases that identify, define, and establish structure and boundaries for ideas generated about a particular phenomenon. Concepts may be abstract or concrete.

  • Abstract Concepts . Defined as mentally constructed independently of a specific time or place.
  • Concrete Concepts . Are directly experienced and related to a particular time or place.

Definitions are used to convey the general meaning of the concepts of the theory. Definitions can be theoretical or operational.

  • Theoretical Definitions . Define a particular concept based on the theorist’s perspective.
  • Operational Definitions . States how concepts are measured.

Relational statements define the relationships between two or more concepts. They are the chains that link concepts to one another.

Assumptions are accepted as truths and are based on values and beliefs. These statements explain the nature of concepts, definitions, purpose, relationships, and structure of a theory.

Nursing theories are the basis of nursing practice today. In many cases, nursing theory guides knowledge development and directs education, research, and practice. Historically, nursing was not recognized as an academic discipline or as a profession we view today. Before nursing theories were developed, nursing was considered to be a task-oriented occupation. The training and function of nurses were under the direction and control of the medical profession. Let’s take a look at the importance of nursing theory and its significance to nursing practice:

  • Nursing theories help recognize what should set the foundation of practice by explicitly describing nursing.
  • By defining nursing, a nursing theory also helps nurses understand their purpose and role in the healthcare setting.
  • Theories serve as a rationale or scientific reasons for nursing interventions and give nurses the knowledge base necessary for acting and responding appropriately in nursing care situations.
  • Nursing theories provide the foundations of nursing practice, generate further knowledge, and indicate which direction nursing should develop in the future (Brown, 1964).
  • By providing nurses a sense of identity, nursing theory can help patients, managers, and other healthcare professionals to acknowledge and understand the unique contribution that nurses make to the healthcare service (Draper, 1990).
  • Nursing theories prepare the nurses to reflect on the assumptions and question the nursing values, thus further defining nursing and increasing the knowledge base.
  • Nursing theories aim to define, predict, and demonstrate nursing phenomenon (Chinn and Jacobs, 1978).
  • It can be regarded as an attempt by the nursing profession to maintain and preserve its professional limits and boundaries.
  • Nursing theories can help guide research and informing evidence-based practice.
  • Provide a common language and terminology for nurses to use in communication and practice.
  • Serves as a basis for the development of nursing education and training programs.
  • In many cases, nursing theories guide knowledge development and directs education, research, and practice, although each influences the others. (Fitzpatrick and Whall, 2005).

Purposes of Nursing Theories

The primary purpose of theory in nursing is to improve practice by positively influencing the health and quality of life of patients. Nursing theories are essential for the development and advancement of the nursing profession. Nursing theories are also developed to define and describe nursing care, guide nursing practice, and provide a basis for clinical decision-making . In the past, the accomplishments of nursing led to the recognition of nursing in an academic discipline, research, and profession.

Much of the earlier nursing programs identified the major concepts in one or two nursing models, organized the concepts, and build an entire nursing curriculum around the created framework. These models’ unique language was typically introduced into program objectives, course objectives, course descriptions, and clinical performance criteria. The purpose was to explain the fundamental implications of the profession and enhance the profession’s status.

The development of theory is fundamental to the research process, where it is necessary to use theory as a framework to provide perspective and guidance to the research study. Theory can also be used to guide the research process by creating and testing phenomena of interest. To improve the nursing profession’s ability to meet societal duties and responsibilities, there needs to be a continuous reciprocal and cyclical connection with theory, practice, and research. This will help connect the perceived “gap” between theory and practice and promote the theory-guided practice.

Clinical practice generates research questions and knowledge for theory. In a clinical setting, its primary contribution has been the facilitation of reflecting, questioning, and thinking about what nurses do. Because nurses and nursing practice are often subordinate to powerful institutional forces and traditions, introducing any framework that encourages nurses to reflect on, question, and think about what they do provide an invaluable service.

Classification of Nursing Theories

There are different ways to categorize nursing theories. They are classified depending on their function, levels of abstraction, or goal orientation.

By Abstraction

There are three major categories when classifying nursing theories based on their level of abstraction: grand theory, middle-range theory, and practice-level theory.

Levels of Nursing Theory According to Abstraction

  • Grand theories are abstract, broad in scope, and complex, therefore requiring further research for clarification.
  • Grand nursing theories do not guide specific nursing interventions but rather provide a general framework and nursing ideas.
  • Grand nursing theorists develop their works based on their own experiences and their time, explaining why there is so much variation among theories.
  • Address the nursing metaparadigm components of person, nursing, health, and environment.
  • More limited in scope (compared to grand theories) and present concepts and propositions at a lower level of abstraction. They address a specific phenomenon in nursing.
  • Due to the difficulty of testing grand theories, nursing scholars proposed using this level of theory.
  • Most middle-range theories are based on a grand theorist’s works, but they can be conceived from research, nursing practice, or the theories of other disciplines.
  • Practice nursing theories are situation-specific theories that are narrow in scope and focuses on a specific patient population at a specific time.
  • Practice-level nursing theories provide frameworks for nursing interventions and suggest outcomes or the effect of nursing practice.
  • Theories developed at this level have a more direct effect on nursing practice than more abstract theories.
  • These theories are interrelated with concepts from middle-range theories or grand theories.

By Goal Orientation

Theories can also be classified based on their goals. They can be descriptive or prescriptive .

Descriptive Theories

  • Descriptive theories are the first level of theory development. They describe the phenomena and identify its properties and components in which it occurs.
  • Descriptive theories are not action-oriented or attempt to produce or change a situation.
  • There are two types of descriptive theories: factor-isolating theory and explanatory theory .
  • Also known as category-formulating or labeling theory.
  • Theories under this category describe the properties and dimensions of phenomena.
  • Explanatory theories describe and explain the nature of relationships of certain phenomena to other phenomena.
  • Address the nursing interventions for a phenomenon, guide practice change, and predict consequences.
  • Includes propositions that call for change.
  • In nursing, prescriptive theories are used to anticipate the outcomes of nursing interventions.

Classification According to Meleis

Afaf Ibrahim Meleis (2011), in her book  Theoretical Nursing: Development and Progress , organizes the major nurse theories and models using the following headings: needs theories, interaction theories, and outcome theories. These categories indicate the basic philosophical underpinnings of the theories.

  • Needs-Based Theories. The needs theorists were the first group of nurses who thought of giving nursing care a conceptual order. Theories under this group are based on helping individuals to fulfill their physical and mental needs. Theories of Orem, Henderson, and Abdella are categorized under this group. Need theories are criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position.
  • Interaction Theories. These theories emphasized nursing on the establishment and maintenance of relationships. They highlighted the impact of nursing on patients and how they interact with the environment, people, and situations. Theories of King, Orlando, and Travelbee are grouped under this category.
  • Outcome Theories . These theories describe the nurse as controlling and directing patient care using their knowledge of the human physiological and behavioral systems. The nursing theories of Johnson , Levine , Rogers , and Roy belong to this group.

Classification According to Alligood

In her book, Nursing Theorists and Their Work, Raile Alligood (2017) categorized nursing theories into four headings: nursing philosophy, nursing conceptual models, nursing theories and grand theories, and middle-range nursing theories.

  • Nursing Philosophy . It is the most abstract type and sets forth the meaning of nursing phenomena through analysis, reasoning, and logical presentation. Works of Nightingale, Watson, Ray, and Benner are categorized under this group.
  • Nursing Conceptual Models . These are comprehensive nursing theories that are regarded by some as pioneers in nursing. These theories address the nursing metaparadigm and explain the relationship between them. Conceptual models of Levine, Rogers, Roy, King, and Orem are under this group.
  • Grand Nursing Theories. Are works derived from nursing philosophies, conceptual models, and other grand theories that are generally not as specific as middle-range theories. Works of Levine, Rogers, Orem, and King are some of the theories under this category.
  • Middle-Range Theories. Are precise and answer specific nursing practice questions . They address the specifics of nursing situations within the model’s perspective or theory from which they are derived. Examples of Middle-Range theories are that of Mercer, Reed, Mishel, and Barker.

List of Nursing Theories and Theorists

You’ve learned from the previous sections the definition of nursing theory, its significance in nursing, and its purpose in generating a nursing knowledge base. This section will give you an overview and summary of the various published works in nursing theory (in chronological order). Deep dive into learning about the theory by clicking on the links provided for their biography and comprehensive review of their work.

See Also: Florence Nightingale: Environmental Theory and Biography

  • Founder of Modern Nursing and Pioneer of the Environmental Theory. 
  • Defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery.”
  • Stated that nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet – all at the least expense of vital power to the patient.”
  • Identified five (5) environmental factors: fresh air, pure water, efficient drainage, cleanliness or sanitation, and light or direct sunlight.

See Also: Hildegard Peplau: Interpersonal Relations Theory

  • Pioneered the Theory of Interpersonal Relations
  • Peplau’s theory defined Nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse specially educated to recognize, respond to the need for help.”
  • Her work is influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow , and Neal Elgar Miller.
  • It helps nurses and healthcare providers develop more therapeutic interventions in the clinical setting.

See Also: Virginia Henderson: Nursing Need Theory 

  • Developed the Nursing Need Theory
  • Focuses on the importance of increasing the patient’s independence to hasten their progress in the hospital.
  • Emphasizes the basic human needs and how nurses can assist in meeting those needs.
  • “The nurse is expected to carry out a physician’s therapeutic plan, but individualized care is the result of the nurse’s creativity in planning for care.”

See Also: Faye Glenn Abdellah: 21 Nursing Problems Theory

  • Developed the 21 Nursing Problems Theory
  • “Nursing is based on an art and science that molds 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.”
  • Changed the focus of nursing from disease-centered to patient-centered and began to include families and the elderly in nursing care.
  • The nursing model is intended to guide care in hospital institutions but can also be applied to community health nursing, as well.
  • Developed The Helping Art of Clinical Nursing conceptual model.
  • Definition of nursing reflects on nurse-midwife experience as “People may differ in their concept of nursing, but few would disagree that nursing is nurturing or caring for someone in a motherly fashion.”
  • Guides the nurse action in the art of nursing and specified four elements of clinical nursing: philosophy, purpose, practice, and art.
  • Clinical nursing is focused on meeting the patient’s perceived need for help in a vision of nursing that indicates considerable importance on the art of nursing.

See Also: Lydia Hall: Care, Cure, Core Theory

  • Developed the Care, Cure, Core Theory is also known  as the “ Three Cs of Lydia Hall . “
  • Hall defined Nursing as the “participation in care, core and cure aspects of patient care , where CARE is the sole function of nurses, whereas the CORE and CURE are shared with other members of the health team.”
  • The major purpose of care is to achieve an interpersonal relationship with the individual to facilitate the development of the core.
  • The “care” circle defines a professional nurse’s primary role, such as providing bodily care for the patient. The “core” is the patient receiving nursing care. The “cure” is the aspect of nursing that involves the administration of medications and treatments.
  • States in her Human-to-Human Relationship Model that the purpose of nursing was to help and support an individual, family, or community to prevent or cope with the struggles of illness and suffering and, if necessary, to find significance in these occurrences, with the ultimate goal being the presence of hope.
  • Nursing was accomplished through human-to-human relationships.
  • Extended the interpersonal relationship theories of Peplau and Orlando.
  • Developed the Child Health Assessment Model .
  • Concerns improving the health of infants and their families.
  • Her findings on parent-child interaction as an important predictor of cognitive development helped shape public policy.
  • She is the founder of the Nursing Child Assessment Satellite Training Project (NCAST), which produces and develops research-based products, assessment , and training programs to teach professionals, parents, and other caregivers the skills to provide nurturing environments for young children.
  • Borrows from psychology and human development and focuses on mother-infant interaction with the environment.
  • Contributed a close link to practice that has modified the way health care providers assess children in light of the parent-child relationship.
  • Focuses on the development of models and theories on the concept of nursing.
  • Includes the profession’s goal, the beneficiary of the professional service, the role of the professional, the source of the beneficiary’s difficulty, the intervention of the professional, and the consequences.
  • A good example of using a unique basis of nursing for further expansion.
  • A Model for Nursing Based on a Model of Living
  • Logan produced a simple theory, “which actually helped bedside nurses.”
  • The trio collaborated in the fourth edition of The Elements of Nursing: A Model for Nursing Based on a Model of Living and prepared a monograph entitled The Roper-Logan-Tierney Model of Nursing: Based on Activities of Daily Living.
  • Includes maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing , controlling body temperature, mobilizing, working and playing, expressing sexuality, sleeping , and dying .

See Also: Ida Jean Orlando: Nursing Process Theory

  • She developed the Nursing Process Theory.
  • “Patients have their own meanings and interpretations of situations, and therefore nurses must validate their inferences and analyses with patients before drawing conclusions.”
  • Allows nurses to formulate an effective nursing care plan that can also be easily adapted when and if any complexity comes up with the patient.
  • According to her, persons become patients requiring nursing care when they have needs for help that cannot be met independently because of their physical limitations, negative reactions to an environment, or experience that prevents them from communicating their needs.
  • The role of the nurse is to find out and meet the patient’s immediate needs for help.

See Also: Jean Watson: Theory of Human Caring

  • She pioneered the Philosophy and Theory of Transpersonal Caring .
  • “Nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health.”
  • Mainly concerns with how nurses care for their patients and how that caring progresses into better plans to promote health and wellness, prevent illness and restore health.
  • Focuses on health promotion , as well as the treatment of diseases.
  • Caring is central to nursing practice and promotes health better than a simple medical cure.

Marilyn Anne Ray

  • Developed the Theory of Bureaucratic Caring
  • “Improved patient safety , infection control, reduction in medication errors , and overall quality of care in complex bureaucratic health care systems cannot occur without knowledge and understanding of complex organizations, such as the political and economic systems, and spiritual-ethical caring, compassion and right action for all patients and professionals.”
  • Challenges participants in nursing to think beyond their usual frame of reference and envision the world holistically while considering the universe as a hologram.
  • Presents a different view of how health care organizations and nursing phenomena interrelate as wholes and parts in the system.
  • Caring, Clinical Wisdom, and Ethics in Nursing Practice
  • “The nurse-patient relationship is not a uniform, professionalized blueprint but rather a kaleidoscope of intimacy and distance in some of the most dramatic, poignant, and mundane moments of life.”
  • Attempts to assert and reestablish nurses’ caring practices when nurses are rewarded more for efficiency, technical skills, and measurable outcomes.
  • States that caring practices are instilled with knowledge and skill regarding everyday human needs.
  • Philosophy of Caring
  • “Nursing is founded on caring for life, on neighborly love, […]At the same time, the nurse must be professionally educated.”
  • Human beings are created and are beings for whom we may have administrative responsibility.
  • Caring, solidarity, and moral practice are unavoidable realities.
  • Theory of Carative Caring
  • “Caritative nursing means that we take ‘caritas’ into use when caring for the human being in health and suffering […] Caritative caring is a manifestation of the love that ‘just exists’ […] Caring communion, true caring, occurs when the one caring in a spirit of caritas alleviates the suffering of the patient.”
  • The ultimate goal of caring is to lighten suffering and serve life and health.
  • Inspired many in the Nordic countries and used it as the basis of research, education, and clinical practice.

See Also: Myra Estrin Levine: Conservation Model for Nursing

  • According to the Conservation Model , “Nursing is human interaction.”
  • Provides a framework within which to teach beginning nursing students.
  • Logically congruent, externally and internally consistent, has breadth and depth, and is understood, with few exceptions, by professionals and consumers of health care.

See Also: Martha Rogers: Theory of Unitary Human Beings

  • In Roger’s Theory of Human Beings , she defined Nursing as “an art and science that is humanistic and humanitarian.
  • 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 nursing creatively to help better the lives of the patient.
  • A patient can’t be separated from his or her environment when addressing health and treatment.

See Also: Dorothea E. Orem: Self-Care Theory

  • In her Self-Care Theory , she defined Nursing as “The act of assisting others in the provision and management of self-care to maintain or improve human functioning at the home level of effectiveness.”
  • Focuses on each individual’s ability to perform self-care .
  • Composed of three interrelated theories: (1) the theory of self-care , (2) the self-care deficit theory, and (3) the theory of nursing systems, which is further classified into wholly compensatory, partially compensatory, and supportive-educative.

See Also: Imogene M. King: Theory of Goal Attainment

  • Conceptual System and Middle-Range Theory of Goal Attainment
  • “Nursing is a process of action, reaction and interaction by which nurse and client share information about their perception in a nursing situation” and “a process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication , they set goals, explore means, and agree on means to achieve goals.”
  • Focuses on this process to guide and direct nurses in the nurse-patient relationship, going hand-in-hand with their patients to meet good health goals.
  • Explains that the nurse and patient go hand-in-hand in communicating information, set goals together, and then take actions to achieve those goals.

See Also: Betty Neuman: Neuman’s Systems Model

  • In Neuman’s System Model , she  defined nursing as a “unique profession in that is concerned with all of the variables affecting an individual’s response to stress.”
  • The focus is on the client as a system (which may be an individual, family, group, or community) and on the client’s responses to stressors.
  • The client system includes five variables (physiological, psychological, sociocultural, developmental, and spiritual). It is conceptualized as an inner core (basic energy resources) surrounded by concentric circles that include lines of resistance, a normal defense line, and a flexible line of defense.

See Also: Sister Callista Roy:  Adaptation Model of Nursing

  • In Adaptation Model , Roy defined nursing as a “health care profession that focuses on human life processes and patterns and emphasizes the promotion of health for individuals, families, groups, and society as a whole.”
  • Views the individual as a set of interrelated systems that strives to maintain a balance between various stimuli.
  • Inspired the development of many middle-range nursing theories and adaptation instruments.

See Also: Dorothy E. Johnson:  Behavioral Systems Model

  • The Behavioral System Model defined Nursing as “an external regulatory force that acts to preserve the organization and integrate 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.”
  • Advocates to foster efficient and effective behavioral functioning in the patient to prevent illness and stresses the importance of research-based knowledge about the effect of nursing care on patients.
  • Describes the person as a behavioral system with seven subsystems: the achievement, attachment-affiliative, aggressive-protective, dependency, ingestive, eliminative, and sexual subsystems.
  • The Theory of Nursing as Caring: A Model for Transforming Practice
  • Nursing is an “exquisitely interwoven” unity of aspects of the discipline and profession of nursing.
  • Nursing’s focus and aim as a discipline of knowledge and a professional service are “nurturing persons living to care and growing in caring.”
  • Caring in nursing is “an altruistic, active expression of love, and is the intentional and embodied recognition of value and connectedness.”
  • Transitions Theory
  • It began with observations of experiences faced as people deal with changes related to health, well-being, and the ability to care for themselves.
  • Types of transitions include developmental, health and illness, situational, and organizational.
  • Acknowledges the role of nurses as they help people go through health/illness and life transitions.
  • Focuses on assisting nurses in facilitating patients’, families’, and communities’ healthy transitions.

See Also: Nola Pender: Health Promotion Model

  • Health Promotion Model
  • Describes the interaction between the nurse and the consumer while considering the role of the health promotion environment.
  • It focuses on three areas: individual characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes.
  • Describes the multidimensional nature of persons as they interact within their environment to pursue health.

See Also:  Madeleine M. Leininger: Transcultural Nursing Theory

  • Culture Care Theory of Diversity and Universality
  • Defined transcultural nursing as “a substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures to provide culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways.”
  • Involves learning and understanding various cultures regarding nursing and health-illness caring practices, beliefs, and values to implement significant and efficient nursing care services to people according to their cultural values and health-illness context.
  • It focuses on the fact that various cultures have different and unique caring behaviors and different health and illness values, beliefs, and patterns of behaviors.
  • Health as Expanding Consciousness
  • “Nursing is the process of recognizing the patient in relation to the environment, and it is the process of the understanding of consciousness.”
  • “The theory of health as expanding consciousness was stimulated by concern for those for whom health as the absence of disease or disability is not possible . . . “
  • Nursing is regarded as a connection between the nurse and patient, and both grow in the sense of higher levels of consciousness.
  • Human Becoming Theory
  • “Nursing is a science, and the performing art of nursing is practiced in relationships with persons (individuals, groups, and communities) in their processes of becoming.”
  • Explains that a person is more than the sum of the parts, the environment, and the person is inseparable and that nursing is a human science and art that uses an abstract body of knowledge to help people.
  • It centered around three themes: meaning, rhythmicity, and transcendence.
  • Modeling and Role-Modeling
  • “Nursing is the holistic helping of persons with their self-care activities in relation to their health . . . The goal is to achieve a state of perceived optimum health and contentment.”
  • Modeling is a process that allows nurses to understand the unique perspective of a client and learn to appreciate its importance.
  • Role-modeling occurs when the nurse plans and implements interventions that are unique for the client.
  • Created the Symphonological Bioethical Theory
  • “Symphonology (from ‘ symphonia ,’ a Greek word meaning agreement) is a system of ethics based on the terms and preconditions of an agreement.”
  • Nursing cannot occur without both nurse and patient. “A nurse takes no actions that are not interactions.”
  • Founded on the singular concept of human rights, the essential agreement of non-aggression among rational people forms the foundation of all human interaction.
  • Maternal Role Attainment—Becoming a Mother
  • “Nursing is a dynamic profession with three major foci: health promotion and prevention of illness, providing care for those who need professional assistance to achieve their optimal level of health and functioning, and research to enhance the knowledge base for providing excellent nursing care.”
  • “Nurses are the health professionals having the most sustained and intense interaction with women in the maternity cycle.”
  • Maternal role attainment is an interactional and developmental process occurring over time. The mother becomes attached to her infant, acquires competence in the caretaking tasks involved in the role, and expresses pleasure and gratification. (Mercer, 1986).
  • Provides proper health care interventions for nontraditional mothers for them to favorably adopt a strong maternal identity.
  • Uncertainty in Illness Theory
  • Presents a comprehensive structure to view the experience of acute and chronic illness and organize nursing interventions to promote optimal adjustment.
  • Describes how individuals form meaning from illness-related situations.
  • The original theory’s concepts were organized in a linear model around the following three major themes: Antecedents of uncertainty, Process of uncertainty appraisal, and Coping with uncertainty.
  • Self-Transcendence Theory
  • Self-transcendence refers to the fluctuation of perceived boundaries that extend the person (or self) beyond the immediate and constricted views of self and the world (Reed, 1997).
  • Has three basic concepts: vulnerability, self-transcendence, and well-being.
  • Gives insight into the developmental nature of humans associated with health circumstances connected to nursing care.
  • Theory of Illness Trajectory
  • “The uncertainty surrounding a chronic illness like cancer is the uncertainty of life writ large. By listening to those who are tolerating this exaggerated uncertainty, we can learn much about the trajectory of living.”
  • Provides a framework for nurses to understand how cancer patients stand uncertainty manifested as a loss of control.
  • Provides new knowledge on how patients and families endure uncertainty and work strategically to reduce uncertainty through a dynamic flow of illness events, treatment situations, and varied players involved in care organization.
  • Theory of Chronic Sorrow
  • “Chronic sorrow is the presence of pervasive grief -related feelings that have been found to occur periodically throughout the lives of individuals with chronic health conditions, their family caregivers and the bereaved.”
  • This middle-range theory defines the aspect of chronic sorrow as a normal response to the ongoing disparity created by the loss.
  • Barker’s Tidal Model of Mental Health Recovery is widely used in mental health nursing.
  • It focuses on nursing’s fundamental care processes, is universally applicable, and is a practical guide for psychiatry and mental health nursing.
  • Draws on values about relating to people and help others in their moments of distress. The values of the Tidal Model are revealed in the Ten Commitments: Value the voice, Respect the language, Develop genuine curiosity, Become the apprentice, Use the available toolkit, Craft the step beyond, Give the gift of time, Reveal personal wisdom, Know that change is constant, and Be transparent.
  • Theory of Comfort
  • “Comfort is an antidote to the stressors inherent in health care situations today, and when comfort is enhanced, patients and families are strengthened for the tasks ahead. Also, nurses feel more satisfied with the care they are giving.”
  • Patient comfort exists in three forms: relief, ease, and transcendence. These comforts can occur in four contexts: physical, psychospiritual, environmental, and sociocultural.
  • As a patient’s comfort needs change, the nurse’s interventions change, as well.
  • Postpartum Depression Theory
  • “The birth of a baby is an occasion for joy—or so the saying goes […] But for some women, joy is not an option.”
  • Described nursing as a caring profession with caring obligations to persons we care for, students, and each other.
  • Provides evidence to understand and prevent postpartum depression .
  • Theory of Caring
  • “Caring is a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility.”
  • Defines nursing as informed caring for the well-being of others.
  • Offers a structure for improving up-to-date nursing practice, education, and research while bringing the discipline to its traditional values and caring-healing roots.
  • Peaceful End-of-Life Theory
  • The focus was not on death itself but on providing a peaceful and meaningful living in the time that remained for patients and their significant others.
  • The purpose was to reflect the complexity involved in caring for terminally ill patients.
  • Also known as Wanda Horta, she introduced the concepts of nursing that are accepted in Brazil.
  • Wrote the book Nursing Process which presents relevance to the various fields of Nursing practice for providing a holistic view of the patient.
  • Her work was recognized in all the teaching institutions called the Theory of Basic Human Needs . It is based on Maslow’s Theory of Human Motivation, whose primary concept is the hierarchy of Basic Human Needs (BHN).
  • Horta’s Theory of Basic Human Needs is considered the highest point of her work, and the summary of all her research concludes sickness as a science and art of assisting a human being in meeting basic human needs, making the patient independent of this assistance through education in recovery, maintenance, and health promotion .
  • Classified basic human needs into three main dimensions – psychobiological, psychosocial and psychospiritual – and establishes a relationship between the concepts of human being, environment, and nursing.
  • The theory describes nursing as an element of a healthcare team and states that it can function efficiently through a scientific method. Horta referred this method as the nursing process .
  • She defined the nursing process as the dynamics of systematic and interrelated actions to assist human beings. It is characterized by six phases: nursing history, nursing diagnosis , assistance plan, care plan or nursing prescription, evolution, and prognosis.

Recommended books and resources to learn more about nursing theory:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

  • Nursing Theorists and Their Work (10th Edition) by Alligood Nursing Theorists and Their Work, 10th Edition provides a clear, in-depth look at nursing theories of historical and international significance. Each chapter presents a key nursing theory or philosophy, showing how systematic theoretical evidence can enhance decision making, professionalism, and quality of care.
  • Knowledge Development in Nursing: Theory and Process (11th Edition) Use the five patterns of knowing to help you develop sound clinical judgment. This edition reflects the latest thinking in nursing knowledge development and adds emphasis to real-world application. The content in this edition aligns with the new 2021 AACN Essentials for Nursing Education.
  • Nursing Knowledge and Theory Innovation, Second Edition: Advancing the Science of Practice (2nd Edition) This text for graduate-level nursing students focuses on the science and philosophy of nursing knowledge development. It is distinguished by its focus on practical applications of theory for scholarly, evidence-based approaches. The second edition features important updates and a reorganization of information to better highlight the roles of theory and major philosophical perspectives.
  • Nursing Theories and Nursing Practice (5th Edition) The only nursing research and theory book with primary works by the original theorists. Explore the historical and contemporary theories that are the foundation of nursing practice today. The 5th Edition, continues to meet the needs of today’s students with an expanded focus on the middle range theories and practice models.
  • Strategies for Theory Construction in Nursing (6th Edition) The clearest, most useful introduction to theory development methods. Reflecting vast changes in nursing practice, it covers advances both in theory development and in strategies for concept, statement, and theory development. It also builds further connections between nursing theory and evidence-based practice.
  • Middle Range Theory for Nursing (4th Edition) This nursing book’s ability to break down complex ideas is part of what made this book a three-time recipient of the AJN Book of the Year award. This edition includes five completely new chapters of content essential for nursing books. New exemplars linking middle range theory to advanced nursing practice make it even more useful and expand the content to make it better.
  • Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice This book offers balanced coverage of both qualitative and quantitative research methodologies. This edition features new content on trending topics, including the Next-Generation NCLEX® Exam (NGN).
  • Nursing Research (11th Edition) AJN award-winning authors Denise Polit and Cheryl Beck detail the latest methodologic innovations in nursing, medicine, and the social sciences. The updated 11th Edition adds two new chapters designed to help students ensure the accuracy and effectiveness of research methods. Extensively revised content throughout strengthens students’ ability to locate and rank clinical evidence.

Recommended site resources related to nursing theory:

  • Nursing Theories and Theorists: The Definitive Guide for Nurses MUST READ! In this guide for nursing theories, we aim to help you understand what comprises a nursing theory and its importance, purpose, history, types or classifications, and give you an overview through summaries of selected nursing theories.

Other resources related to nursing theory:

  • Betty Neuman: Neuman Systems Model
  • Dorothea Orem: Self-Care Deficit Theory
  • Dorothy Johnson: Behavioral System Model
  • Faye Abdellah: 21 Nursing Problems Theory
  • Florence Nightingale: Environmental Theory
  • Hildegard Peplau: Interpersonal Relations Theory
  • Ida Jean Orlando: Deliberative Nursing Process Theory
  • Imogene King: Theory of Goal Attainment
  • Jean Watson: Theory of Human Caring
  • Lydia Hall: Care, Cure, Core Nursing Theory
  • Madeleine Leininger: Transcultural Nursing Theory
  • Martha Rogers: Science of Unitary Human Beings
  • Myra Estrin Levine: The Conservation Model of Nursing
  • Nola Pender: Health Promotion Model
  • Sister Callista Roy: Adaptation Model of Nursing
  • Virginia Henderson: Nursing Need Theory

Suggested readings and resources for this study guide :

  • Alligood, M., & Tomey, A. (2010). Nursing theorists and their work, seventh edition (No ed.). Maryland Heights: Mosby-Elsevier.
  • Alligood, M. R. (2017).  Nursing Theorists and Their Work-E-Book . Elsevier Health Sciences.
  • Barnard, K. E. (1984). Nursing research related to infants and young children. In  Annual review of nursing research  (pp. 3-25). Springer, Berlin, Heidelberg.
  • Brown, H. I. (1979).  Perception, theory, and commitment: The new philosophy of science . University of Chicago Press. [ Link ]
  • Brown M (1964) Research in the development of nursing theory: the importance of a theoretical framework in nursing research. Nursing Research.
  • Camacho, A. C. L. F., & Joaquim, F. L. (2017). Reflections based on Wanda Horta on the basic instruments of nursing. Rev Enferm UFPE [Internet], 11(12), 5432-8.
  • Chinn, P. L., & Jacobs, M. K. (1978). A model for theory development in nursing.  Advances in Nursing Science ,  1 (1), 1-12. [ Link ]
  • Colley, S. (2003). Nursing theory: its importance to practice. Nursing Standard (through 2013), 17(46), 33. [ Link ]
  • Fawcett, J. (2005). Criteria for evaluation of theory. Nursing science quarterly, 18(2), 131-135. [ Link ]
  • Fitzpatrick, J. J., & Whall, A. L. (Eds.). (1996).  Conceptual models of nursing: Analysis and application . Connecticut, Norwalk: Appleton & Lange.
  • Kaplan, A. (2017).  The conduct of inquiry: Methodology for behavioural science . Routledge. [ Link ]
  • Meleis, A. I. (2011).  Theoretical nursing: Development and progress . Lippincott Williams & Wilkins.
  • Neuman, B. M., & Fawcett, J. (2002). The Neuman systems model .
  • Nightingale F (1860) Notes on Nursing. New York NY, Appleton.
  • Perão, O. F., Zandonadi, G. C., Rodríguez, A. H., Fontes, M. S., Nascimento, E. L. P., & Santos, E. K. A. (2017). Patient safety in an intensive care unit according to Wanda Horta’s theory. Cogitare Enfermagem, 22(3), e45657.
  • Peplau H (1988) The art and science of nursing: similarities, differences, and relations. Nursing Science Quarterly
  • Rogers M (1970) An Introduction to the Theoretical Basis of Nursing. Philadelphia PA, FA Davis.

50 thoughts on “Nursing Theories and Theorists: The Definitive Guide for Nurses”

Great work indeed

Amazing and simple post I have ever come across about nursing theories.

Thank you for the simplicity

where do i find the reference page in apa format?

The reference listed below the article is in APA format.

i love this. insightful. Comprehensive ,Well researched .

Thank you for these theories they are a life saver and simplified. My school require us to write about 2 nursing theorist from memory for a Comprehensive exam in which if you do not pass it you are required to wait for a year to retake the exam.

Merci beaucoup, puisque je suis très satisfait.

I’m pleased to congratulate you about your work! I really appreciate it! From: Cameroon

An entire’s semester worth of a nursing theory class, expertly and succinctly summarized in one paper. I wish my instructor were as easy to understand. Good work.

I thought this was in a chronological order based on their published works date? Then why Orlando’s theory comes at the later part? Can someone englighten me please because I am making a timeline for our project.

Great job. Very clear and succinct.

I like it. Well explained!

easy to understand and very helpful

thankyou very much.

The article was beneficial to me to understand nursing theories

This is amazing and I love it so enriching!

Thanks for the article may God bless you more Plus More Power and Protection

Thanks so much

Please can someone help me with a nursing theory related to “teamwork” please

Thank you so much !

I loved the text and saw that the nursing theorist Wanda Aguiar Horta, a Brazilian nurse and great theorist regarding basic human needs, was not included.

I suggest reviewing and including it to be more complete.

If you need, I can help with inclusion!

Best Regards

Hi João Carlos, we’d love to hear about her work. Please send us the details via our contact page: https://nurseslabs.com/contact/

Excellent study guide! Detailed, Informative and Valued! Thank you!

hi can someone help me which theorist can relate in Ear, Nose, Throat nursing care.

Wonderful contribution of shared knowledge- now how do we get the word out for nurses that are not able to afford a BSN?

Thanks for the work. It’s very helpful

This has helped me understand theories a bit better, however, there is one that is eluding me. Where does the normative theory fit in?

very educative.I have understood theories more than before.Thanks

hard work. great work in deed

I love reading your material, plain concise and easy

Very informative, more knowledgeable about the theorist

Thank you for your information. This material is great and when I have looked for material for nursing theory. I got is material with complete

A big hand of applause 👏🏿 This is a treasure for nurses of the world. Thank you so much

Hi G. ALex,

Wow, thanks for the awesome feedback! 😊 Super glad you found it to be a treasure. Just curious, was there a particular section that stood out to you or something you’d love to see more of? Always keen to hear what resonates with fellow nurses!

This is really hard work put together in a very easy to understand way.Thank you so much.It came handy

Hi Sigala, Thanks a ton for noticing the effort! 😊 Super happy to hear it came in handy for you. If you ever have suggestions or topics you’d like to see, give me a shout. Cheers to making things understandable!

Absolutely helpful. Thank you.

So glad to hear the nursing theories guide was a hit for you! 😊 If you have any other topics or questions in mind, just give a shout. Always here to help. Keep rocking your studies! Thanks Ishe!

Am happy, to read these theories, very educating. Am going to make use of it when caring for my patients. GREAT NURSES GREAT! I LOVE YOU ALL.

Hi Eboh, I’m thrilled to hear you’re excited about applying these nursing theories in practice! They can really enhance the care we provide. It’s all about putting that knowledge to good use. By the way, which theory resonated with you the most, or which do you see being most applicable in your day-to-day patient care?

How do I relate one of the theories to effective management of intravenous lines? Which theory and how to relate to the above?

Hi wanted to ask you who wrote this page who is the autor because i need to write them on footnotes and i can’t find autor of the page,neither the year it was published. Thank you. Btw this article was really helpful i never understood nursing theories this good.

Hey there Innaya, I’m glad to hear the article on nursing theories was so helpful to you! Here’s how you can cite it in APA format:

Vera, M. (2019, September 11). Nursing Theories and Theorists: The Definitive Guide for Nurses Nurseslabs. https://nurseslabs.com/nursing-theories/

If you need any more help with citations or have other questions, feel free to ask. Happy to assist!

Please is there an app I could download all these from?

Hi Felicia, Thanks for your interest! As of now, we don’t have a dedicated app for downloading our content. However, our website is mobile-friendly, so you can easily access all our resources from your smartphone or tablet browser.

wonderful insights, and very precise and easy to understand, I even got to know and learn about other new theorists of Nursing I didn’t know before.

Thank you so much for this wonderful work.

Its so amazing and very helpful. Please how can I cite any of these theory using Vancouver?

thanls for good informatiom need to explain example

Leave a Comment Cancel reply

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

  • Advanced Search
  • Journal List
  • HHS Author Manuscripts

Logo of nihpa

The Evolution of Nursing Research

Jacqueline m. stolley.

Trinity College of Nursing, Moline, Illinois

THE RESEARCH CULTURE in nursing has evolved in the last 150 years, beginning with Nightingale’s work in the mid-1850s and culminating in the creation of the National Institute of Nursing Research (NINR) at the National Institues of Health (NIH). This article highlights nursing’s efforts to facilitate the growth of the research culture by developing theory, establishing the importance of a research-based practice, advancing education, and providing avenues for dissemination of research. Similarities with the chiropractic profession are discussed, along with a commentary by Cheryl Hawk, D.C, Ph.D.


The development of a research culture in nursing in many ways parallels that of chiropractic, and by reviewing key aspects of the evolution of the science of nursing, there are lessons to be learned, and mistakes to be avoided. Nursing research has changed dramatically in the past 150 years, beginning with Florence Nightingale in the 19th century. Clearly, nursing research has not always had the influence and significance it holds today. In fact, for a number of years after Nightingale’s work, little is found in the literature concerning nursing research. This is perhaps due to the past perception of nursing as an apprenticeship in a task-oriented caring profession ( 1 ). Although research was conducted with respect to nursing education and administration in the first half of the 20th century, it was not until the 1950s that nursing research began the advancement that has been seen in the past three decades. This is due to many factors: an increase in the number of nurses with advanced academic preparation, the establishment of vehicles for dissemination of nursing research, federal funding and support for nursing research, and the upgrading of research skills in faculty and students. This article provides a brief review of the development of research in nursing, and along with it, the theory that has guided that process.


As with other practice professions, nursing requires a knowledge foundation that is based on theory and derived from systematic research. The first nursing theorist, Florence Nightingale, created detailed reports of both medical and nursing matters as chief nurse for the British in the Crimean War in the mid-1850s. Nightingale noted that “… apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion” (p. 6) ( 2 ). As a result, Nightingale’s conceptualization of nursing included the need to have an understanding of the laws of nature, the prevention of disease, and the use of personal power. She viewed persons as both physical and spiritual beings, emphasizing the importance of the environment and the need to care for the patient, not the disease. With her emphasis on the environment, changes in nutrition, hydration, and sanitation resulted, and mortality rates dropped drastically during the Crimean War ( 3 ). In subsequent years, Nightingale developed “laws of nursing” that formed the basis for nursing science and guided nursing education in the United States from 1850 to the 1950s ( 4 ).

In the 1960s, nursing theory was used to guide teaching rather than research or practice. This was a natural outgrowth of nursing’s earlier focus on education and professional identity. Additionally, the National League for Nursing (the professional accrediting body) stipulated a conceptual framework for curriculum. Paradigmatic concepts integral to nursing were identified as person, environment, health , and nursing ( 5 – 7 ), and scientific energies were spent developing curriculum that corresponded to existing theories ( 7 ). At this point in time, nurse educators began to urge students to “care for the whole person” and textbooks underscored the importance of “holism” in nursing, with subtitles such as “The Biopsychosocial Approach.” Nurse authors acknowledged multiple causality in human illness, but all too often research, curricula, and textbooks reflected linear cause-and-effect models rather than multivariate approaches.

The 1950s and 1960s saw the development of theories explaining the art and science of nursing. Hildegard Peplau published Interpersonal Relations in Nursing ( 8 ) in 1952, based on her work as a psychiatric nurse. Other theories. included Levine’s Conservation Principles of Nursing ( 9 ) in, 1967; Roger’s Introduction to the Theoretical Basis of Nursing ( 10 ) in 1970, and The Science of Unitary Man ( 11 ) in 1980, followed by The Science of Unitary Human Beings, a Paradigm for Nursing ( 12 ) in 1983. Imogene King published A Theory for Nursing: Systems, Concepts, Process ( 13 ) in 1981, and Sister Calista Roy published her adaptation model ( 14 ) in 1980. These “grand” theories were complex and key concepts were hard to measure empirically. Thus it was difficult to test these early nursing theories through research. With the emphasis on clinical nursing research, the recent trend has been to develop and test midrange theories that describe patient problems and nursing practice.


In 1859, Nightingale used the battlefield hospitals of the Crimean War as her research laboratory, using an epidemiological process to describe the morbidity and mortality of sick and injured soldiers. Her pioneering epidemiological research and statistical methodology (documenting the relationship between the environment and health status of soldiers) was the hallmark of scientific investigation in nursing ( 4 , 15 ).

An historical review from 1900 to 1949 reveals that nursing research in the United States (see Table 1 ) was in its infancy, focusing on nursing education, nurses, nursing students, and ways to organize nurses’ work. As noted earlier, at this time, nursing theory was discussed solely as a means of developing and organizing educational curriculum. Early educators were unable to develop educational programs that both represented a nursing perspective and helped students focus on nursing concepts and problems rather than medical concepts and problems. In the first half of this century, groups were formed to answer such questions as: what is nursing, what do nurses do, and how unique is nursing from other health science disciplines? Professional debates raged as to whether nursing was merely a “poor stepsister” of medicine or whether it was part of the biological, natural, or physical sciences ( 4 ). Research during this period was essentially nonexistent in terms of nursing practice.

Nursing: Historical Developments in Nursing Theory and Research

1850Florence Nightingale: first nurse researcher; first nurse theorist
Late 1800s–1900‘Dark Ages’
Nursing viewed as an apprenticeship
Little focus on research-based practice
1900–1949 (AJN) published
Research focus: nursing education and administration
Questions: What is nursing? What do nurses do? How is nursing unique?
Debates: nursing vs. medicine as separate disciplines
1950sGrowing emphasis on need to identify a body of nursing knowledge
journal established (1952)
American Nurses Foundation
Federal support for funding
1960sNumber of nurse researchers miniscule
Early funding for nursing doctorate education — “hyphenated nurse”
Emphasis on nursing’s rightful place in the university setting
Nursing theory to guide practice: person, environment, health, and nursing
Beginning of “Grand” Theory development
1970sNursing educators aware of need to develop new knowledge
American Nurses’ Association (ANA) Commission on Nursing Research
Journals published: , and
Increase in doctoral programs in nursing education
1980s (CURN) project published
National Center for Nursing for Nursing Research (NCNR) established within the
National Institutes of Health (NIH)
Journals published: and
Research focus: patients and patient behavior
Empirical modes of inquiry (logical positivitist)
Beginnings of qualitative research (phenomenology and ethnography
Better preparation for nurse researchers
Federal funding $16.2 million at NCNR
1990s published
Clinical Practice Guidelines (AHCPR)
journal published
NCNR renamed the National Institute for Nursing Research (NINR) in 1993
Nursing doctoral programs in 65 institutions
Emphasis on clinical research
Research-based practice-research utilization, evidence-based practice
Multiple modes of inquiry
Emphasis on explanatory and predictive-level studies (vs. descriptive and exploratory)
published in 1998
Federal funding $55 million at NINR
1995–1999Community-based nursing models
NINR research priorities: effectiveness of nursing interventions in HIV/AIDS; cognitive impairment; living with chronic illness; biobehavioral factors related to immunocompetence
2000Chronic illnesses
NINR research priorities: quality and cost effectiveness of care; health promotion and disease prevention; management of symptoms; adaptation to new technologies; health disparities; palliative care at the end of life budget: over $70 million

It was not until the 1980s that nursing devoted a sizeable portion of its research effort to patients and patient behavior, an emphasis that emerged logically as nurses began to recognize the interplay between behavior and rehabilitation or recovery from illness. Historically, nurses searched for single causative agents when promoting health or preventing illness, even as they acknowledged the contributions of multiple other factors. Predominant modes of inquiry relied on early in the development of a culture of nursing research were empirical (logical positivist). Nurse researchers modeled themselves after colleagues in the basic and biomedical sciences, perhaps in an effort to seek scientific validation. Only during the 1980s and 1990s did nurses increasingly use qualitative research methods, such as phenomenology and ethnography, to explain complex human phenomena. Therefore, nurse researchers are just beginning to respond to the need to view human problems in less reductionistic terms when the research questions call for a holistic combination of quantitative and qualitative research methodologies ( 16 ). Over the past two decades, many nurses have pursued further education, consultation, or research to enhance their understanding and ability to respond constructively to patient behavior. For example, by the mid-1980s, there was a sizable increase in nursing studies of individuals and families experiencing developmental, environmental, or illness-generated crisis situations involving both acute and long-term stress responses ( 17 – 20 ).

During the 1990s, nursing practice underwent a clinical revolution in response to societal, medical, scientific, and technologic advances. Changes in nursing practice began to result from nursing research (e.g., research-based practice guidelines) as the efforts of individuals both in and outside of nursing (e.g., National Academy of Science, National Institute for Nursing Research, and major foundations) coalesced to stimulate and support clinical nursing research. Concurrently, there was a new surge of interest among nurses themselves in redefining the problems of their practice and delineating the gaps in knowledge underpinning their practice base. As noted earlier, the current decade has been marked by interest in multiple modes of inquiry (qualitative and quantitative) for a practice discipline which must address complex human phenomena. In the past, the type of research questions most often addressed through nursing research were of a descriptive or exploratory nature. However, nurse researchers are now going beyond “what is” and “how” questions and are addressing more explanatory or predictive-level questions using methodologically rigorous experimental and quasi-experimental designs as they redefine clinical problems and systematically address gaps in their knowledge base. After becoming established in the research arena, nursing researchers have expanded to incorporate and collaborate on interdisciplinary studies, health care systems and health services research, and taxonomies such as Nursing Intervention Classification (NIC) ( 21 ) and Nursing Outcomes Classification (NOC) ( 22 ). The taxonomies represent efforts to define what nurses do and outcomes sensitive to nursing interventions.

The culture of nursing research has now advanced to the point where consideration can be given not just to the conduct of research, but also to its application in practice. The conduct of research is not the end, but rather a means through which practice is improved by utilizing research findings. Research utilization is the process of conveying and applying research-based knowledge to impact or change existing practices in the health care system ( 23 ). The primary components of research utilization involve summarizing knowledge generated through research; imparting the research knowledge to nurses, other health professionals, policymakers, and consumers of health care; and accomplishing desired outcomes for patients, their families, and health care providers and agencies. Models for research utilization were developed in the 1970s, beginning with the Western Interstate Commission for Higher Education in Nursing (WCHEN) Regional Program for Nursing Development ( 24 ). Other models include the Conduct and Utilization of Research in Nursing (CURN) project ( 25 ), the Stetler/Marram model ( 26 ), the retrieval and application of research in nursing (RARIN) model ( 27 ) and the Iowa model of research in practice ( 28 ). The primary goal of research utilization programs is to make research findings an integral part of nursing practice, assuring research-based care delivery models. Research utilization is an excellent model for application of research findings to practice by advanced practice nurses.

An important trend is the use of research findings to serve as the basis for treatment decision making called evidence-based practice ( 29 ). Using this process, a question involving treatment is developed, and determination of the adequacy of current research is made. If the research base is adequate, it is synthesized, protocols are developed and applied, and evaluation is completed. Through these efforts, the nursing profession, in partnership with other professions, bridges the gap between research and practice to improve patient care.


Early nursing education took place in hospital training programs (nursing diploma), modeled on Florence Nightingale’s work in the United Kingdom ( 30 ). In 1915, nursing’s educational accrediting body, the National League for Nursing (NLN) called for university-level education. Baccalaureate programs in nursing emerged in 1923 at Yale University and Western Reserve University, but the majority of nursing education took place in hospital-based diploma programs. In 1971, the first community college programs for nursing education opened, providing graduates with an associate degree in nursing. Today, entry into nursing practice takes place primarily in associate degree programs, with baccalaureate programs second. Gradually, diploma programs have decreased in number, and few exist today. Associate degree programs may introduce nursing students to research, but baccalaureate programs included nursing research in the upper division curriculum. From 1900 to the 1960s, most nursing leaders obtained their graduate-level preparation in schools of education ( 30 ). For many years, the Master’s degree was considered the terminal degree in nursing.

The number of nurses whose career was devoted to research was miniscule in the 1960s. Indeed, even by the 1970s only about 400 nurses in the United States held a doctoral degree ( 31 ). In 1955, the Nursing Research Grants and Fellowship Program of the Division of Nursing, United States Public Health Service (USPHS) was established. This program awarded grants for nursing research projects, nursing research fellowships, and nurse-scientist graduate training ( 32 ). Early funding was for nurses to obtain their doctorates in fields outside of nursing, because there were no nursing doctoral programs available. As a result, nurse-physiologists, nurse-anthropologists, and so forth emerged in the field. They were educated to conduct research, but often stayed in the field of their doctorate and did not apply their research efforts to nursing care problems.The emphasis during this period continued to be on establishing nursing’s rightful place in the academic setting of the university. As nursing became integrated into university life during the 1970s, nursing faculty became aware of their responsibility to develop new knowledge, and in many university-based schools of nursing, faculty members began to prepare both themselves and their students to become investigators ( 33 ).

Currently, three types of doctoral degrees in nursing are available. A Nursing Doctorate (ND), first established at Case Western Reserve University in 1979, was designed to be equivalent to the Doctor of Medicine degree, providing students preparation for the practice of generalized nursing and future leadership, but not for advanced practice. Professional doctorates, Doctor of Nursing Science (DNS, DNSc, DSN), emphasized advanced clinical, administrative, or policy-related practice and leadership. The Doctor of Nursing Science degree focuses on applied rather than basic research, and on applying and testing new knowledge in practice. Although the Doctor of Philosophy (PhD) was first available to nurses at Teachers College at Columbia University in the 1920s, interest in doctoral education was rekindled in the 1970s. The number of doctoral programs in nursing has increased from zero in the 1950s to over 65 institutions, three-fourths of which are academic doctorates (PhD) that prepare graduates for a lifetime of scholarship and research ( 34 ). More recently, nurses in academic settings have been encouraged to obtain postdoctoral research training with support available through both individual (F32) and institutional (T32) traineeships through the National Institutes of Health (NIH).


Several factors stimulated the growth of nursing research in the 1980s and 1990s. Perhaps the most important factor was the creation in 1986 of the National Center for Nursing Research (NCNR) in the United States Public Health Service (USPHS). The development of this Center resulted from intense political action by the American Nurses’ Association (ANA) ( 23 ). The primary aim of the NCNR was “the conduct, support, and dissemination of information regarding basic and clinical nursing research, training and other programs in patient care research” (p. 2) ( 35 ). Prior to the establishment of the NCNR, most of the federal funds supporting research were designated for medical studies that concentrated on the diagnosis and cure of disease. Thus, creation of the NCNR was a major achievement for nurse researchers. In 1993, the NCNR became the National Institute of Nursing Research (NINR), strengthening nursing’s position by giving the Center institute status within the NIH. This advance served to put nursing into the mainstream of research activities and on more equal status with scientists and other health professions. With the establishment of the Center and then the Institute, federal funding for nursing research has grown. In 1986, the NCNR had a budget of $16.2 million. In 1996, the budget for the NINR was about $55 million ( 1 ), more than a threefold increase over a decade. The NINR elected to foster five research priorities for 1995 through 1999: community-based nursing models, effectiveness of nursing interventions in HIV/AIDS, cognitive impairment, living with chronic illness, and biobehavioral factors related to immunocompetence ( 22 ).

The NINR’s strategic plan for the next millenium includes funding nursing research on chronic illnesses (e.g., improving adherence to chemotherapy, pain relief), quality and cost effectiveness of care, health promotion and disease prevention, management of symptoms (e.g., gender differences in response to therapeutics, managing the pain cycle), health disparities (e.g., cultural sensitivity), adaptation to new technologies (e.g., transplants), and palliative care at the end of life. Special allocations and Requests for Applications (RFA) have facilitated research in these target areas, although investigator-initiated research topics are funded if they are significant to nursing or patient care. The projected budget for NINR for the year 2000 is over $70 million, which is approximately distributed as follows: 73% for extramural research project grants; 8% for pre- and postdoctoral training; 3.5% for career development; 3.5% for Core Centers in specialized areas of research inquiry; 3% for the intramural program. Planning research for the next 5 years and into the next century is a welcome challenge for the NINR and the scientific community ( 36 ).


Significant milestones in the development of nursing science began in the mid-1950s (see Table 1 ). From 1950 to 1959, there was growing emphasis on the need to identify a body of knowledge for the developing profession of nursing in order to justify its presence in post-World War II universities ( 37 ). Not only was the first journal of Nursing Research established in 1952; several textbooks related to nursing research were also published. Another critical step in the evolution of the culture of nursing science was the establishment of the American Nurses Foundation by the American Nurses Association specifically to promote nursing research. During the 1950s, regional research conferences were instituted for the first time, and federal support of nursing research began ( 4 , 33 , 37 ). All these elements were essential to the development of a science of nursing.

Several new nursing research journals, including Applied Nursing Research (ANR), were instituted in the late 1980s. ANR publishes research reports of special significance to nurse clinicians ( 1 ). Increasingly, clinical specialty (i.e., Heart and Lung, Journal of Gerontological Nursing ) journals are publishing data-based articles as well.

Another important event in the development and dissemination of nursing theory and research was the creation of the Annual Review of Nursing Research in 1983. This publication includes critical analyses of research pertinent to nursing and health, including nursing practice, nursing care delivery, nursing education, and the nursing profession. Chapters systematically assess knowledge development in nursing, encourage the use of research findings in practice, and provide direction for future research ( 22 ). More recently, scholars have joined to create the Encyclopedia of Nursing Research ( 38 ), a publication that provides a comprehensive overview of research studies, the history of nursing research, and the evolution of theory development in nursing.

The next century challenges nursing research with critical imperatives for improving health care. Changes in our nation’s population and their needs and expectations will impact the direction of nursing research. Consumers are becoming more involved in managing their own health care, and practitioners are continually adjusting to new technologies as well as innovative health care systems. The broad spectrum of nursing research encompasses both clinical and basic investigations with the patient as the central focus. Nursing must concentrate on making certain that our valuable scientific findings are incorporated into practice and focus on developing the next generation of nurse researchers ( 36 ).

The research culture in chiropractic is similar to where nursing research was in its early years. To move chiropractic research forward will require many of the same changes that occurred in nursing, such as educational advancement, collaboration in academic settings, federal acknowledgement and support, and development of more avenues for research dissemination to practitioners. Just as nursing had to overcome significant barriers such as attitudes and low educational and professional status, so, too, will the chiropractic profession have to strive to develop a research tradition in order to integrate research as part of its practice culture.


  1. Nursing Research Paper Sample

    nursing theory research paper

  2. Nursing Research Paper Sample

    nursing theory research paper

  3. Nursing Theory, Research, and Evidence-Based Practice Essay

    nursing theory research paper

  4. NSG 502 Week 5 Nursing Theory Analysis paper

    nursing theory research paper

  5. Nursing Theory Paper

    nursing theory research paper

  6. Nursing Research Paper Example

    nursing theory research paper


  1. Nursing Theory and its Contributers Part 2


  3. Nursing Theory Creative Assignment

  4. Introduction to Nursing theory in urdu| Post-Rn 2nd semester| Unit#01,part#1| Nursing theory

  5. Nursing Theory and Evolution

  6. What is Fuzzy Set Theory #Fuzzy Set Theory in Urdu / Hindi Lecture # 38


  1. How could nurse researchers apply theory to generate knowledge more efficiently?

    Ultimately, when nurse researchers conduct theory-guided research carefully and delineate how they did so in their publications, then their research could inform nursing practice efficiently as well as add to our existing knowledge of describing, explaining, and predicting clinical problems. .

  2. Usefulness of nursing theory-guided practice: an integrative review

    Abstract. Background: Nursing theory-guided practice helps improve the quality of nursing care because it allows nurses to articulate what they do for patients and why they do it. However, the usefulness of nursing theory-guided practice has been questioned and more emphasis has been placed on evidence-based nursing and traditional practice.

  3. Nursing research: A marriage of theoretical influences

    Eighteen of the PhD theses were based on theoretical approaches from philosophy, ethics, pedagogy, medicine or biology as a primary perspective. Nursing theories, in their conventional definition, have a limited presence in the theses examined. Keywords: doctoral students, nurses, nursing, PhD, research, The University of Edinburgh.

  4. Key Issues in Nursing Theory: Developments, Challenges, and ...

    Detours and dead ends for theory development involved metatheory debates and specific events. Challenges identified relate to rapid changes in society, healthcare, and science. A pathway for the future is presented in a figure with its description of the structure of nursing knowledge. Discussion: The potential of this structure for developing ...

  5. Expanding the theoretical understanding in Advanced Practice Nursing

    Nursing theories are essential to the continuing evolution of the discipline of nursing. Postgraduate programs in nursing and research must be encouraged to use and further develop nursing theories to facilitate the advancement of nursing care in education, research, and practice.

  6. Orem's Self-Care Deficit Nursing Theory: Relevance and Need for

    The purpose of this article is to highlight the relevance of Orem's Self-Care Deficit Nursing Theory (SCDNT) in contemporary and future practice, explicitly within the global self-care movement and interprofessional healthcare. The authors discuss the relevance and important strengths within Orem's nursing theory and recommend theoretical refinement within the context of significant ...

  7. Editorial: Unique or Borrowed Theory in Nursing Research

    If concepts and theories from other discipline are utilized, then a rationale for their use needs to be clearly articulated. "Unfortunately, very few nurses have made any attempts to present a rationale for the use of borrowed theories as guides for nursing practice or research by linking the theory with a nursing conceptual model" ( Fawcett & DeSanto-Madeya, 2013, p. 17).

  8. Usefulness of nursing theory‐guided practice: an integrative review

    How does nursing theory-guided practice benefit patients, nurses and health care systems? Find out in this integrative review of the latest evidence.

  9. A Book Review of Nursing Theories and Nursing Practice (5th ed

    The primary audiences for the book are undergraduate, master's, and doctoral students as well as nurses seeking to enrich their professional practice. The first two sections of the book lay a foundation by introducing the conceptual and theoretical underpinnings of the discipline of nursing and answering the question: Why do we need nursing theories? The reading level, graphics, and tables ...

  10. Nursing theories: Foundation for nursing profession

    This paper highlights the importance of nursing theories as the foundation for nursing profession.

  11. A practice‐based model to guide nursing science and improve the health

    The purpose of this paper is to describe a model to guide nursing science in a clinical practice‐based setting. Exemplars are provided to highlight the application of this nursing research model, which can be applied to other clinical settings ...

  12. The relationship of nursing theory and research: the state of the art

    To this end, papers published in six nursing journals between 1986 and 1990 have been studied. It can be concluded that, in comparison with earlier analyses, the use of theories in nursing research studies has increased (from 13% to 21%), but the use of nursing theories has not become more frequent.

  13. Theory and Theorizing in Nursing Science

    iversary of publication of these seminal works in nursing theory. Objective The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue. Approach The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory ...

  14. Using a theoretical framework in a research study

    The theoretical framework is a blueprint for your research project 1 and serves several purposes. It informs the problem you have identified, the purpose and significance of your research demonstrating how your research fits with what is already known (relationship to existing theory and research). This provides a basis for your research ...

  15. Use of Nursing Theory to Guide Doctoral Research: An Exploratory Study

    It is unclear whether doctoral nursing students are using nursing theory to guide their research. This descriptive, exploratory study involved a review of 747 doctoral papers to determine whether nursing students are using nursing or non-nursing theory to guide their research.

  16. Nursing Theory and Research

    The Nursing Theory Page is a collaborative effort by an international group interested in developing a collection of resources about nursing theories throughout the world. The project began on 21 May 96 and will always be a work in progress. The Nursing Theory Page simply links pages built and maintained by others who have knowledge about a theory.

  17. PDF Nursing Theory Paper Colton Williams Helena College University of Montana

    Nursing Theory PaperColton WilliamsHelena College Universit. of MontanaThis pap. r was prepared for NRSG 250, taught by Deb Rapaport. Nursing Theory PaperThere are many. urs. dern n. rsing" and "The first nursing theorist" (currentnursing.com,2012). Her theory is mainly ba. ed on environmental factors, such as, "light, clea.

  18. Theory-Based Advanced Nursing Practice: A Practice Update on the

    Many researchers have commended the self-care deficit nursing theory (SCDNT) developed by Orem as a means of improving patients' health outcomes through nurses' contributions. However, experimental research has investigated specific aspects of SCDNT, ...

  19. Current Nursing

    The relationship between research and theory is undeniable, and it is important to recognize the impact of this relationships on the development of nursing knowledge. So interface theory and research by generating theories, testing the theories and by using it as a conceptual framework that drives the study.

  20. Journal of Research in Nursing: Sage Journals

    Journal of Research in Nursing publishes quality research papers on healthcare issues that inform nurses and other healthcare professionals globally through linking policy, research and development initiatives to clinical and academic excellence. View full journal description. This journal is a member of the Committee on Publication Ethics (COPE).

  21. Nursing Theories and Theorists: The Definitive Guide for Nurses

    In this guide for nursing theories, we aim to help you understand what comprises a nursing theory and its importance, purpose, history, types or classifications, and give you an overview through summaries of selected nursing theories.

  22. The Evolution of Nursing Research

    In the 1960s, nursing theory was used to guide teaching rather than research or practice. This was a natural outgrowth of nursing's earlier focus on education and professional identity. Additionally, the National League for Nursing (the professional accrediting body) stipulated a conceptual framework for curriculum. Paradigmatic concepts integral to nursing were identified as person ...

  23. Nursing Research and Practice

    Nursing Research and Practice focuses on all areas of nursing and midwifery. The journal focuses on sharing data and information to support evidence-based practice.