Post on 09-Mar-2018
Theories of NursingPractice
Ramesh Kumar
Theories of NursingPractice
Ramesh Kumar
What is a theory?
A set of concepts,definitions, relationships,and assumptions thatproject a systematic viewof a phenomena
It may consist of one ormore relatively specificand concrete conceptsand propositions thatpurport to account for, ororganize somephenomenon (Barnum,1988)
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A set of concepts,definitions, relationships,and assumptions thatproject a systematic viewof a phenomena
It may consist of one ormore relatively specificand concrete conceptsand propositions thatpurport to account for, ororganize somephenomenon (Barnum,1988)
What are the components of atheory?
Concepts – ideas and mentalimages that help to describephenomena (Alligood andMarriner-Tomey, 2002)
Definitions – convey thegeneral meaning of theconcepts
Assumptions – statementsthat describe concepts
Phenomenon – aspect ofreality that can be consciouslysensed or experienced(Meleis, 1997).
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Concepts – ideas and mentalimages that help to describephenomena (Alligood andMarriner-Tomey, 2002)
Definitions – convey thegeneral meaning of theconcepts
Assumptions – statementsthat describe concepts
Phenomenon – aspect ofreality that can be consciouslysensed or experienced(Meleis, 1997).
What is a paradigm?
A model thatexplains the linkagesof science,philosophy, andtheory accepted andapplied by thediscipline (Alligoodand Marriner –Tomey, 2002)
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A model thatexplains the linkagesof science,philosophy, andtheory accepted andapplied by thediscipline (Alligoodand Marriner –Tomey, 2002)
What is a domain?
The view orperspective of thediscipline It contains the
subject, centralconcepts, values andbeliefs, phenomenaof interest, and thecentral problems ofthe discipline
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The view orperspective of thediscipline It contains the
subject, centralconcepts, values andbeliefs, phenomenaof interest, and thecentral problems ofthe discipline
How does domain relate tonursing theory?
Nursing hasidentified its domainin a paradigm thatincludes fourlinkages:1) person/client2) health3) environment4) nursing
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Nursing hasidentified its domainin a paradigm thatincludes fourlinkages:1) person/client2) health3) environment4) nursing
Purposes of nursing theory
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What are the purposes of nursingtheory?
It guides nursingpractice andgenerates knowledge It helps to describe
or explain nursing Enables nurses to
know WHY they aredoing WHAT theyare doing
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It guides nursingpractice andgenerates knowledge It helps to describe
or explain nursing Enables nurses to
know WHY they aredoing WHAT theyare doing
Types of nursing theories
Grand theories – broadand complex
Middle-range theories-address specificphenomena and reflectpractice
Descriptive theories –first level of theorydevelopment
Prescriptive theories –address nursinginterventions and predicttheir consequences
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Grand theories – broadand complex
Middle-range theories-address specificphenomena and reflectpractice
Descriptive theories –first level of theorydevelopment
Prescriptive theories –address nursinginterventions and predicttheir consequences
Why on earth do we studynursing theory?
Everyday practice enrichestheory
Both practice and theory areguided by values and beliefs
Theory helps to reframe ourthinking about nursing
Theory guides use of ideasand techniques
Theory can close the gapbetween theory and research
To envision potentialities(Gordon, Parker, & Jester,2001)
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Everyday practice enrichestheory
Both practice and theory areguided by values and beliefs
Theory helps to reframe ourthinking about nursing
Theory guides use of ideasand techniques
Theory can close the gapbetween theory and research
To envision potentialities(Gordon, Parker, & Jester,2001)
“The study and use ofnursing theory in nursing
practice must have roots inthe everyday practice of
nurses (Gordon, Parker, andJester, 2001).
“The study and use ofnursing theory in nursing
practice must have roots inthe everyday practice of
nurses (Gordon, Parker, andJester, 2001).
So how do nurses use theory ineveryday practice?
Organize patient data Understand patient data Analyze patient data Make decisions about
nursing interventions Plan patient care Predict outcomes of care Evaluate patient
outcomes(Alligood, 2001)
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Organize patient data Understand patient data Analyze patient data Make decisions about
nursing interventions Plan patient care Predict outcomes of care Evaluate patient
outcomes(Alligood, 2001)
How do student nurses begin touse nursing theory?
By asking yourselftwo very importantquestions…..
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By asking yourselftwo very importantquestions…..
Student nurse questions
What is the nature ofknowledge needed forthe practice of nursing?
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What does it mean to meto practice nursing?
Nursing also utilizes non-nursingtheories
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Commonly used non-nursingtheories
Systems theory Basic Human Needs
theory Health and Wellness
Models Stress and
Adaptation Developmental
Theories Psychosocial
Theories3-16Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
Systems theory Basic Human Needs
theory Health and Wellness
Models Stress and
Adaptation Developmental
Theories Psychosocial
Theories
What is the link between nursingtheory and the research process?
Theory provides directionfor nursing research
Relationships ofcomponents in a theoryhelp to drive the researchquestions forunderstanding nursing
Chinn and Kramer(2004), indicate a spiralrelationship between thetwo
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Theory provides directionfor nursing research
Relationships ofcomponents in a theoryhelp to drive the researchquestions forunderstanding nursing
Chinn and Kramer(2004), indicate a spiralrelationship between thetwo
Current trends that influencenursing theory
Medical science Nursing education Professional nursing
organizations Evolving research
approaches Global concerns Consumer demands Technologies
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Medical science Nursing education Professional nursing
organizations Evolving research
approaches Global concerns Consumer demands Technologies
“ Practicing nurses who despisetheory are condemned to
performing a series of tasks -either at the command of aphysician or in response to
routines and policies.”
“ Practicing nurses who despisetheory are condemned to
performing a series of tasks -either at the command of aphysician or in response to
routines and policies.”
Leah Curtin, RN, MS, FAAN(1989)Former Editor, NursingManagement
Objectives
Define theoryand list
characteristicsof a theory
Trace thedevelopmentof a nursing
theory
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Define theoryand list
characteristicsof a theory
Describe thecomponentsof a theoryand its use
Trace thedevelopmentof a nursing
theory
Describe thedifferent types
of theoriesand examples
of each.
Some commonalities
PurposeConceptsDefinitionsPropositionsStructured ideasTentativeDescribe a phenomenon or occurrence
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PurposeConceptsDefinitionsPropositionsStructured ideasTentativeDescribe a phenomenon or occurrence
Components/Elements oftheory
1.Purpose “Why is the theoryformulated”
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2.Concepts are building blocks oftheory – ideas, mental images of a
phenomenon, an event or object thatis derived from an individual’s
experience and perception
Components/Elements oftheory
3.Has a major concept like nursing,person, health or environment.
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4. Definitions give meaning toconcepts which can either be
descriptive or procedural (stipulate-use of term within the theory)
Components/Elements oftheory
Propositions areexpressions of
relational statementsbetween and amongthe concepts. It can
be expressed asstatements,
paradigms or figures. AKA as theoretical
assertions
Assumptions-accepted “truths”that are basic andfundamental to the
theory. Or valueassumptions wherewhat is good or right
or ought to be.
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Propositions areexpressions of
relational statementsbetween and amongthe concepts. It can
be expressed asstatements,
paradigms or figures. AKA as theoretical
assertions
Assumptions-accepted “truths”that are basic andfundamental to the
theory. Or valueassumptions wherewhat is good or right
or ought to be.
Characteristics of a Theory
1. Systematic, logical and coherent(orderly reasoning,no contradictions)
2. Creative structuring of ideasmental images of one’s experiences andcreate different ways of looking at a particularevent or object.
3. Tentative in nature ( change over time orevolving but some remain valid despitepassage of time)
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1. Systematic, logical and coherent(orderly reasoning,no contradictions)
2. Creative structuring of ideasmental images of one’s experiences andcreate different ways of looking at a particularevent or object.
3. Tentative in nature ( change over time orevolving but some remain valid despitepassage of time)
How does a theory develop?
Fourstrategies of
theorydevelopment
• Theorypractice theory( theorydeveloped inother disciplineand used innursingsituations)
• Practice – theoryevolved fromclinical practice
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Fourstrategies of
theorydevelopment
• Theorypractice theory( theorydeveloped inother disciplineand used innursingsituations)
• Practice – theoryevolved fromclinical practice
How does a theory develop?
3. Research theory or inductive methodMust evolve from research findings or
empirical evidence.
4. Theory research theorytheories developed by other disciplines
are utilized but given unique nursingperspective. Original theory examinedand given a new research findings.
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3. Research theory or inductive methodMust evolve from research findings or
empirical evidence.
4. Theory research theorytheories developed by other disciplines
are utilized but given unique nursingperspective. Original theory examinedand given a new research findings.
TERMINOLOGY
METAPARADIGM- Most abstract level of knowledge. In
nursing this is main concepts thatencompasses the subject matter and thescope of the discipline
- Central concepts of person, environment,health and nursing
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METAPARADIGM- Most abstract level of knowledge. In
nursing this is main concepts thatencompasses the subject matter and thescope of the discipline
- Central concepts of person, environment,health and nursing
TERMINOLOGY
Philosophy- Knowledge level which specifies the
definitions of the metaparadigm conceptsin each of the conceptual models ofnursing.
- Nightingale is considered philosophicalapproach
- Out of these philosophies theory maybeformalized
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Philosophy- Knowledge level which specifies the
definitions of the metaparadigm conceptsin each of the conceptual models ofnursing.
- Nightingale is considered philosophicalapproach
- Out of these philosophies theory maybeformalized
Conceptual models
Frameworks or paradigms that provide abroad frame of reference for thesystematic approaches to thephenomena with which the discipline isconcerned. -different views nursing like Roy focuses
on adaptation, King on interaction andAbdellah on interventions
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Frameworks or paradigms that provide abroad frame of reference for thesystematic approaches to thephenomena with which the discipline isconcerned. -different views nursing like Roy focuses
on adaptation, King on interaction andAbdellah on interventions
theory
Group of related conceptsthat propose actions thatguide practice
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Group of related conceptsthat propose actions thatguide practice
Nursing theory
Group of related concepts that derivedfrom the nursing models. Some derivefrom other nursing discipline likeLEininger which comes fromanthropology
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Group of related concepts that derivedfrom the nursing models. Some derivefrom other nursing discipline likeLEininger which comes fromanthropology
Uses of theory
1. Theory guides and improve nursingpractice
Theory provides goal for nursing careand with goals, nursing practice isrendered more effective and efficient.theories help to focus the goals, makingnurses more confident about thepractice.
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1. Theory guides and improve nursingpractice
Theory provides goal for nursing careand with goals, nursing practice isrendered more effective and efficient.theories help to focus the goals, makingnurses more confident about thepractice.
Uses of theory
2. Theory guides researchaccording to Meleis, primary use oftheory is to guide research. It validatesand modifies the theory.
3. Theory contributes to the developmentof the disciplines body of knowledge
4. Theory enhances communication
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2. Theory guides researchaccording to Meleis, primary use oftheory is to guide research. It validatesand modifies the theory.
3. Theory contributes to the developmentof the disciplines body of knowledge
4. Theory enhances communication
Historical Development
Role of nurses wherequestioned; whatthey do, for whomwhere and whenwere determined. purpose of nursing,
process of theorydevelopment wasdiscussed
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Role of nurses wherequestioned; whatthey do, for whomwhere and whenwere determined. purpose of nursing,
process of theorydevelopment wasdiscussed
First Conference in Nursing theory
Brought leading scholars and theorists to discussand debate on issues regarding nursingscience ad theory development.
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Historical Development
Writings of Dickoff,James and Wiedenbach“Theory in a PracticeDiscipline” influencedthe theoretical thinking innursing . They presenteda definition of nursingtheory and goals fortheory development innursing, approacheswhere discussed
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Writings of Dickoff,James and Wiedenbach“Theory in a PracticeDiscipline” influencedthe theoretical thinking innursing . They presenteda definition of nursingtheory and goals fortheory development innursing, approacheswhere discussed
Categories of nursing theories
client nurse
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`environment
Process of KnowledgeDevelopment
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Scope of Theories
Grand Theories Middle-Range Theories
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Grand Theories Middle-Range Theories
Maslow’s Hierarchy of Needs
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