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CHAPTER 1 Introduction to Nursing Theory: Its History, Significance, and Analysis 11

generates new ideas, and differentiates the focus Globally, nurses are recognizing the rich heritage
of nursing from that of other professions (Chinn & of the works of nursing theorists, that is, the philoso-
Kramer, 2011). Ellis (1968) indicates that to be con- phies, conceptual models, theories, and middle-
sidered useful, “it is essential for theory to develop range theories of nursing. The publication of this
and guide practice . . . theories should reveal what text in multiple (at least 10) languages reflects the
knowledge nurses must, and should, spend time pur- global use of theory. The contributions of global
suing” (p. 220). theorists present nursing as a discipline and provide
The five criteria for the analysis of theory—clarity, knowledge structure for further development. The
simplicity, generality, accessibility, and importance— use of theory-based research supports evidence-
guide the critical reflection of each theoretical work based practice. There is worldwide recognition of
in Chapters 6 to 36. These broad criteria facilitate the rich diversity of nursing values the models rep-
the analysis of theoretical works, whether they are resent. Today we see added clarification of the theo-
applied to works at the level of philosophies, concep- retical works in the nursing literature as more and
tual models, theories, or middle-range theories. more nurses learn and use theory-based practice.
Most important, the philosophies, models, theories,
and middle-range theories are used broadly in all
Summary areas—nursing education, administration, research,
This chapter presents an introduction to nursing and practice.
theory with a discussion of its history, significance, There is recognition of normal science in the
and analysis. A nurse increases professional power theoretical works (Wood, 2010). The scholarship
when using theoretical research as systematic evi- of the past 3 decades has expanded the volume
dence for critical thinking and decision making. of nursing literature around the philosophies, mod-
When nurses use theory and theory-based evidence els, theories, and middle-range theories. Similarly,
to structure their practice, it improves the quality of the philosophy of science has expanded and fos-
care. They sort patient data quickly, decide on appro- tered nursing knowledge development with new
priate nursing action, deliver care, and evaluate out- qualitative approaches. As more nurses have ac-
comes. They also are able to discuss the nature of quired higher education, understanding of the im-
their practice with other health professionals. Con- portance of nursing theory has expanded. The use
sidering nursing practice in a theory context helps of theory by nurses has increased knowledge devel-
students to develop analytical skills and critical opment and improved the quality of nursing prac-
thinking ability and to clarify their values and as- tice (Alligood, 2010a; Alligood, 2011b; Chinn &
sumptions. Theory guides practice, education, and Kramer, 2011; Fawcett & Garity, 2009; George,
research (Alligood 2014, in press; Chinn & Kramer, 2011; Im & Chang, 2012; Reed & Shearer, 2012;
2011; Fawcett, 2005; Meleis, 2007). Wood, 2010).

POINTS FOR FURTHER STUDY
n Donaldson, S. K., & Crowley, D. M. (1978). The disci- n Judd, D., Sitzman, K., & Davis, G. M. (2010). A his-
pline of nursing. Nursing Outlook, 26(2), 1113–1120. tory of American nursing. Boston: Jones & Bartlett.
n Fawcett, J. (1984). The metaparadigm of nursing: n The Nursing Theory Page at Hahn School of
current status and future refinements. Image: The Nursing, University of San Diego: Retrieved from:
Journal of Nursing Scholarship, 16, 84–87. http://www.sandiego.edu/ACADEMICS/nursing/
n Kalisch, P. A., & Kalisch, B. J. (2003). American theory.
nursing: A history (4th ed.). Philadelphia: Lippincott
Williams & Wilkins.