The purpose of his paper is to distinguish between nursing theories, models, and frameworks. According to Masters (2011), a conceptual model in nursing is a set of “concepts and statements that integrate concepts into a meaningful configuration” (p.48). Nursing models, therefore, help to define nursing ideas and statements in a way that may help better define relationships, including the nursing and patient relationship, and actions that nurses take within the healthcare setting (Masters, 2011). A nurse may use two or more models within a healthcare setting or practice. A model is often created as a tool that allows expression of nursing values, missions, goals, and even beliefs in a particular setting (Masters, 2011). A model may contain more general or abstract ideas than a theory (Masters, 2011). Often a model aligns with personal and organizational belief systems. The nurse and patient may have their own model from which he or she operates from. These models, may provide a frame of reference for healing and delivery of care.
A nursing theory is different from a model. A theory is best defined as an “organized, coherent and systematic articulation of a set of statements related to significant questions in nursing” (Masters, 2011, p. 48). A theory may help communicate statements and ideas in a way that is meaningful, and helps brings concepts together. One of the first people to provide a comprehensive theory in nursing was Florence Nightingale, who stated that nursing was a science involving engagement on behalf of the nurse, and the environment to help restore a patient to full recovery (Masters, 2011; Kozier Erb, Berman & Snyder, 2004). Using Florence’s theory, models of care can be developed that provide for an environment where nurses can engage and contribute more directly to patient health, considering the environment and nursing attitude as critical to patient recovery (Fawcett & DeSatomadeya, 2012). Over time, many theories have developed about care. Some include personal models, or beliefs and values about the way in which the body, mind and emotions work together to inspire holistic care (Kozier, Erb, Berman & Snyder, 2004). Theories help describe more than one philosophy or model.
A framework is a combination of theories and models that create what is often referred to as a “metaparadigm” in practice (Maters, 2011). This framework is often restricted but allows an infrastructure to develop where core ideas and theories can be integrated within the discipline of nursing. The nursing framework can only be derived at through research. Research requires theory and a model from which researchers can work with. From this researchers or scientists gather information to develop a paradigm or framework from which nursing science can effectively impact health, patients, quality of life and other relevant factors (Kozier, Erb, Berman & Snyder, 2004).
Theories, models, and frameworks are interrelated in the nursing and in other disciplines. These ideas and concepts are central to the science of nursing, and to the discipline of nursing. A person receiving care by health providers will often engage with health providers operating within a framework. Within this framework, their nurse, and other health providers may link different theories of care, and models of health care. Each of these are designed to improve patient outcomes, depending on individual and collective personal and community goals. The goal is to help predict how well care is, or how well a provider’s steps and efforts will be in engaging with patients to predict positive quality of life outcomes (Beckstead & Beckstead, 2006). The nursing profession often relies on continuing nursing research to develop new theories and models from which to operate as science and technology continue to innovate and change.
- Beckstead, J.W. & Beckstead, L.G. (2006). A multidimensional analysis of the epistemic origins
of nursing theories, models and frameworks. International Journal of Nursing, 43(1): 113-121.
- Fawcett, J. & DeSatomadeya, S. (2012). Contemporary nursing knowledge: Analysis and
evaluation of nursing models. F.A. Davis Company.
- Masters, K. (2011). Framework for Professional Nursing Practice. NY: Jones & Bartlett
- Kozier, B., Erb, G., Berman, A., & Snynder, S. (2004). The nature of nursing, fundamentals of
nursing: Concepts, processes and practices. NJ: Prentice Hall.