Theories and Frameworks for Professional Nursing Practice (2024)

Introduction

Nursing is both a science and an art. The empirical science of nursing includes both the natural sciences (e.g., biology, chemistry) and the human sciences (e.g., sociology, psychology). The art of nursing is the ability to form trusting relationships, perform procedures skillfully, prescribe appropriate treatments, and morally conduct nursing practice (Johnson, 1994). Nursing is a knowledge-based discipline significantly different from medicine. Medicine focuses on the identification and treatment of disease, whereas nursing focuses on the wholeness of human beings (Fawcett, 1993). Nursing claims the health of human beings in interaction with the environment as its domain. Knowledge is commonly defined as a general awareness or possession of information, facts, ideas, truths, or principles and an understanding of the same gained through experience or study (Encarta World English Dictionary, 2009). Nursing knowledge is the organization of the discipline-specific concepts, theories, and ideas published in the literature (both print and electronic media) and demonstrated in professional practice. Nursing’s desire to be regarded as a profession (e.g., law, medicine) was the impetus for building a substantial body of discipline-specific knowledge. Many of the existing theories emerged from the response to the simple question, “What is nursing?”

Theories and conceptual frameworks consist of the theorist’s words brought together to form a meaningful whole. Theories and frameworks provide direction and guidance for structuring professional nursing practice, education, and research. They act as a “tool for reasoning, critical thinking, and decision-making” (Alligood, 2005, p. 272). In practice, theories and frameworks help nurses describe, explain, and predict everyday experiences. They also assist in organizing assessment data, making diagnoses, choosing interventions, and evaluating nursing care. In education, a conceptual framework provides the general focus for curriculum design. In research, the framework offers a systematic approach to identifying questions for study, selecting appropriate variables, and interpreting findings. The research findings may trigger revision and refinement of the theory. Figure 5-1 illustrates the relationships among theory, practice, education, and research.

Many nurse theorists have made substantial contributions to the development of a body of nursing knowledge. Offering an assortment of perspectives, the theories vary in their level of abstraction and their conceptualization of the client, health and illness, the environment, and nursing. From a historical perspective, nursing theories reflect the influence of the larger society and illustrate increased sophistication in the development of nursing ideas. Table 5-1 presents a chronology of events related to the development of nursing theories. While this chapter provides a comprehensive overview of nursing theory, other chapters in this text will make reference to specific nursing theories as they relate to individual chapter topics.