Discussion questions/comments

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Please answer each q’s using approx 150 words. I do not need APA format for this in MS Word. Please put your answer in single space, Arial, medium font. Please have reference (citation) for each answer. I realize that your policy is double spaced, but I’m requesting you to do single spaced. However I ONLY NEED 1100 words in total(which is 4 pages).


#1. What are the tenets of the metaparadigm as defined by Nightingale, Johnson, Orem, Roy, Leininger, Neuman, Rogers, and Watson? How does each theorist differ from the others?
Answer(150 words):


#2. What factors do you feel influenced the nurse theorist’s definitions and descriptions of the components of the metaparadigm in their respective models? Explain

Answer(150 words):


In addition to the above 2 discussion questions please do the following also. Below are 6 responses from my fellow classmates for question #1and 2 responses for question#2. Please “comment” (highlighted) for the “student response” using about 100 words each. Please put your answer in single space, Arial, medium font.  Please have reference (Citation) for each comment. Please # each comment for better differentiation. Thank You!

 I realize that your policy is double spaced, but I’m requesting you to do single spaced. However I ONLY NEED 1100 words in total(which is 4 pages).


#1. What is the link between concepts and theories?

Student response(1): All these theorists have slightly differentiating theories. However, they each see the patient as the central focus of care and the nurse as a pivotal person in determining whether or not that patient is brought back to wellness.  They all feel that the environment the patient is exposed to plays an important role in their health.

Many of the nursing theories are based, at least in part, on Nightingales original thoughts.  Nightingale felt that the environment was of the utmost importance and stressed cleanliness and good hygiene.

Johnson does not define environment outright but implies that it is external stimuli that creates an imbalance in the behavioral system of the patient.

Orem focuses on person self-care.  Although she does not ignore the importance of environment she places more emphasis on the patient and the nurse working together to enable the patient to provide care for themselves.

Roy’s primary goal in her theory is that of helping the patient adapt to their environment and to their current state of health. The nurse’s role is, like in so many other theories, that of assistant to the patient to reach that adaptation.

According to Leininger’s theory, culturally derived nursing care based on transcultural human care knowledge is predicted to maintain client health and well-being or to help clients face death in culturally appropriate ways.

Neuman’s theory focuses more on the nurse’s role in patient health. She emphasizes that the nurse is there to assist the patient in navigating their way through the various stressors that affect health.  This model is still popular in nursing education.

The central focus of Rogers’ life process model is unitary human beings in mutual process with their environments.  In other words, the nurse’s job is to control the interactions of the patient with their environment.

Jean Watson focuses on the person as a complex being and theorizes that the nurse is there to care for the whole person in mind, body and spirit.  She states that unless all three aspects of the patient are cared for, then health cannot be achieved.


Student response(2): All of these nursing theorists have very different theories but all of the theorists see the individual ( patient) as an important part of their theories. The patient is the basis of these theories. The nurse is an integral part of the theories and is part of helping the patient return to a better state of health. The environment is defined differently by all the theorists but is does affect the patients health in some way in all the theories.

The primary focus of Nightingale’s theory is the environment. The environment was key to the wellness of the patient. She believed a safe, clean, quiet environment would aid in the patient returning to a state of wellness.
Johnson’s theory id based on the environment. She believed that patients are in a state of disequilibrium and it is the responsibility of the nurse to help return them to a state of equilibrium. stressors were the cause of disequilibrium and the goal is to remove these stressors.
Orem’s theory primary focus is the individual and their ability to care for themselves and others. If an individual has a self-care deficit the nurse helps them overcome the deficit.
Roy’s nursing theory is based on the patient adapting to their state of health. The nurse in this theory is charged with helping the patient adapt.
Leininger’s theory is  transcultural care. She believed that nurse’s need to provide culture specific care that is based on an individuals beliefs and values.
Nueuman’s theory is the system’s model. She believed that the patient needs to be viewed and cared for holistically.
Rogers believed that the individual is affected by their environment and the goal of the nurse is to limit the interactions with the environment that can have  negative affect on the patient.
Watson’s theory is the caring theory. She believed that the patient’ s mind, body and spirit need to be cared for in order to restore them to health.  .



Student response(3): 

Theorist Person Environment Health Nursing
Nightingale Physical, social, intellectual, emotional, and spiritual components. Physical elements external to the patient that affect the healing process and health. An innate process and the combined result of environmental, physical, and psychological factors; being able to use every power we have to use. Sick nursing or, nursing proper, and health nursing.
Johnson A behavioral system regulated and controlled by biological, psychological, and sociological factors. That which is external to the behavioral system. An elusive state held desirable by health care professionals, determined by factors defined in person. An external regulatory force that assists the individual to achieve balance and stability.
Orem A person is self-determined, and will deliberately choose to perform specific actions regardless of external pressures. Separate form the person only in our thought processes. Environmental features include physical, chemical, biological, and social classifications. A state of being sound and whole, with nothing diminished or absent. A specialized health service necessitated by an adult’s inability to maintain the amount and quality of self-care necessary for sustaining life and health.
Roy A holistic, adaptive system in constant interaction with the environment. All conditions, influences, and circumstances that affect the human development and adaptive system. A process and state of being and becoming an integrated and whole person. The science and practice of promoting adaptation for the purpose of affecting health positively.
Leininger Cultural beings are humans. Environmental context; the totality of a situation. A state of well-being that is culturally defined, valued, and practiced. A learned humanistic and scientific profession focused on human care activities to support and assist individuals or groups to maintain or regain their well-being in a culturally meaningful way.
Neuman Client or client system with five variables; physiological, psychological, developmental, sociological, and spiritual. Internal, external, and created affects on the behavioral system A continuum between wellness and illness. Purposeful interventions to retain, attain, and maintain a maximum level of optimal system wellness.
Rogers A whole that is different form the sum of its parts. An open system identified as a pandimensional energy. Environment has no boundaries and extends without spatial or temporal attributes. No specific definition, but refers to health by culture; behaviors that are of high value and low value. To promote human betterment wherever people are.
Watson A spiritual essence, transformed from body-physical to metaphysical, connecting with its soul. A caring-healing architecture transcending the whole being across time and conditions. An experience including physical, esthetic, and moral domains leading to harmony between self and others. A fundamental interaction between nurse and patient. A human science of persons.

Each theorists has a definition for each concept of the nursing metaparadigm. Other than Orem and Leininger, all the theorists identify the person as being composed of physiologic and psychologic attributes that are affected by their environments. Environment is defined as anything which is external to the person, whether created, spiritual, or qualitative in nature. Health is also defined as a level of wellness by all the theorists, with a focus on spiritual and cultural factors by Watson, Leininger, and Rogers. Nursing is described by all as an interaction to promote or maintain health and wellness, with each having a different focus as to how to achieve that goal. All the theorists address each concept of the metaparadigm equally, but may place more emphasis on a particular concept. However, each theory must incorporate each concept for implementation of their desired processes. Middle-range theories are now taking tenets from various theories to assist in nursing science and practice, proving that each theorist’s concept has meaning in the nursing profession.

Fitzpatrick, J.J. & Whall, A. (2005) Conceptual models of nursing: Analysis and application. (4th ed.). Upper Saddle River, NJ:
Prentice Hall.



Student Response(4): The tenets of the metaparadigm of nursing included in nursing theories are: person, environment, health, and nursing.  Each theorist discussed has individual view of this, and some are similar while other vary greatly.


Florence Nightingale – Person: physical, emotional and spiritual being, Environment: consisted of outside elements and components that had a direct impact on a person’s health, Health: more than just physical state, it was also a matter of spiritual well-being and the ability to utilize all we were capable of in healing or staying healthy, Nursing: anyone who showed “care” for another, it was an art, and not a science.


Johnson – Person: not as much the depth of the person’s make-up, but more the physical appearance and traits, Environment: anything outside of the person’s innate behaviors, Health: disequilibrium of forces and the affect they had on person’s state of health, Nursing: was the act of bringing a person back to their state of health by creating equilibrium for them.


Orem – Person: had more choice of actions , Environment: based on classifications in order to enhance self-care as was the basis for her theory, Health: reaching the goal of completeness and truly achieving maximum ability through self-care and minimal assistance from the nurse, Nursing: helping a patient to reach maximum functioning without assistance.


Roy – emphasizes the importance of patients adapting to their environments and the role of the nurse is to assist in this adaptation while allowing the patient to do for themselves (as shown in Orem’s theory).


Lieninger – provides emphasis on the effects of culture to the various tenets and the outcomes that result in patient care.


Neuman & Roger’s – works well with Orem in that it takes the empowering of the patient and the nurse assists in helping the patient reach the state of wellness and staying healthy.


Watson – can be coincided with Nightingale in the idea of treating the whole patient and their environment in order to fully reach the state of health for the patient.

Though all different in their individual definitions of each tenet, similarities can be seen in the overall meaning of the theories.




Student Reasponse(5):

Nightingale’s tenets of the metaparadigm include person, health, and environment. Nightingale also look to religion as she saw nursing as a calling and thought of nurses as being responsible for the personal health of someone. Johnson’s tenets of the metaparadigm were mainly nursing and the person but she also focused on health and the environment. She views nursing as a regulatory force which assists the patient in establishing/maintaining balance and stability. Orem’s tenets of the metaparadigm include nursing, person, health, and environment. She perpetuated a self care theory (self care deficit, self care theory, and the theory of the nursing system). Roy’s tenet of the metaparadigm includes nursing, person, health, and environment. She viewed the nurse’s role as one of health promotion and the promotion of adaptation. Leininger’s tenet of the metaparadigm include nursing, environment, health, and person. She believes care is directly linked to a person’s culture. Neuman’s tenet of the metaparadigm include person, health, environment, and nursing. She believes nurses serve as health coordinators. Her client system has a collaborative relationship between the patient and caregiver. Rogers’ tenet of the metaparadigm include nursing, person, health, and environment. She views nursing as the science of unitary beings. She sees nursing as a science which serves human betterment. Watson’s tenet of the metaparadigm include nursing, person, health, and environment. She does examine human spirituality.

All of the theorists focus on the care of the patient with a few exceptions to how they see best to give care. Nightingale focused on nursing as a responsibility to the patient to facilitate his or her personal health. Johnson focused on nursing serving as a regulatory mechanism for patients to achieve stability . Orem sought for nursing to assist patients in providing self care and returning the patient to the highest level possible. Roy’s focus on health promotion and adaption. Leininger’s focus was on the patient’s culture and how best to provide culturally specific care. Neuman’s focus was for nurses to act as health coordinators. Rogers focus was serving unitary beings and for nurses to assist patients to a higher state of human betterment. Watson’s focus was on patient care and spirituality.



Student response(6): Florence Nightingale contributed holistic nursing. Her nursing meta-paradigm is systematic organization of knowledge about person, health, and environmental phenomena that provides a unique perspective for the nursing discipline.

Johnson’s behavioral system model is based on Nightingale’s idea that nursing’s appropriate goal is to assist people to prevent or recover from illness or injury.

Orem’s model of self care states that nursing is to assist an individual, ill or well in the performance of activities that he or she would perform unaided if he or she had the necessary strength and capabilities.

Rogers‘s Science of Unitary Human Beings (SUHB) provides theoretical, evidence-based practical approach in providing holistic care and facilitates personal well being.

“The Roy adaptation concept of stimuli, coping mechanism, and modes of adaptation have been translated into several middle-range concepts and using measured existing and new instrument” (Nursing; Researchers from University of Massachusetts detail findings in nursing. (2009, November)).

Leininger’s transcultural nursing provides explanation of human behavior that links concept of human care and culture. Leininger’s created the theory of transcultural care diversity and universality.

Neuman’s system model represents different important aspects of health care and at the same time it presents nursing as a unique profession because of its holistic and comprehensive care approach to individual’s situation. It presents the client’s interaction with the environment and that care giver and client are in partnership to achieve optimal health care.

Watson’s model of caring provides us the postmodern transpersonal caring-healing paradigm, which emphasizes caring model that supercedes cure-disease paradigm.

Fitzpatrick, J. & Whall, A. (2005). Conceptual Models of Nursing.

Nursing; Researchers from University of Massachusetts detail findings in nursing. (2009, November). Health & Medicine Week,1681.  Retrieved November 11, 2010, from ProQuest Health and Medical Complete. (Document ID: 1903095611).

Farren, A.. (2009). An Oncology Case Study Demonstrating the Use of Rogers’s Science of Unitary Human Beings and Standardized Nursing Languages. International Journal of Nursing Terminologies and Classifications, 20(1), 34-9.  Retrieved November 11, 2010, from Research Library. (Document ID: 1656530281).


Q#2. What factors do you feel influenced the nurse theorist’s definitions and descriptions of the components of the metaparadigm in their respective models? Explain

Student response(7): I believe history, era, scientific knowledge, experiences, and successes in research have guided nursing theorist’s defining concepts. For example, Nightingale saw first hand the demise of many soldiers being left in dirty rooms with little or no air and light. Nightingale tested her theory of providing a clean and healthy environment and decreased mortality rates. Survival was the most important aspect at the time of her theory development, not cultural sensitivity or the universe as the environment.  During the middle of the twentieth century, nursing focused on the person and the effects of the environment as well, but also viewed the person as a system capable of taking care of him or her self as in Orem’s and Johnson’s theories. Theories continued to be developed with varying definitions of each metaparadigm concept, but adding another dimension to each description; spiritual, internal and external factors, created factors, etc. Later in the twentieth century humanistic and culture came to the forefront of theory development. Spirituality and a holistic approach contribute to these theories identifying culture and beliefs to be the most important part of nursing as a science. Each theory includes nursing as a means of maintaining or attaining well-being, just using different means and starting points for their interventions. Each theory has a goal for the person as well, with some theorists promoting self-care, some helping to adapt, and some tryong to determine the underlying problem.


Student Response(8): The factors that influenced nursing theorists descriptions and definitions of the components of their metaparadigms are their life experiences and their experiences in nursing either at the bedside or their educational experience. I will use a few nursing theories as an example. Jean Watson was influenced by her education as well as research she conducted. Jean has earned undergraduate and graduate degrees in nursing and phychiatric-mental health nursing. Her  PhD is in educational psychology and counseling.  Jean’s research has been in human caring and loss. These helped Jean shape her caring theory. Peplau’s nursing theories concepts and definitions are also based on her educational background. Peplau received a bachelors in interpersonal psychology and a masters in phychiatric nursing. She also received her doctorate in education curriculum. These all provided a basis for her theory development. Betty Nueman’s systems theory was developed out of her teaching experiences. The model was developed because graduate nursing students expressed a need for content that would expose them to a multitude of nursing problems before the entered in to clinical experience. All of these theorists were expose to either education or an experience that gave them a basis fro their theory. This also further influenced their descriptions and definitions of the metaparadigm.



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