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N U R S I N G T H E O R I E S

•PHILOSOPHIES •CONCEPTUAL MODELS•VALUES &•APPROACHES

Nursing in 21st Century

Nursing is recognised as an academic discipline and a profession.

A move towards theory-based practice made contemporary nursing more meaningful and significant by shifting nursing’s focus from vocation to an organised profession.

More significance of evidence based practice. Struggle to increase the knowledge base. Theoretical works gained more importance

What is a theory?

Theory is an organised, coherent, and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole.

A theory is a group of related concepts that propose action that guide practice.

Theories offer ways of looking at a dicipline in clear explicit terms that can be communicated to others.

DEFENITION : THEORY

• Set of interpretative assumptions, principles or propositions that help explain or guide action (Young, Taylor,& Repenning, 2001)

• Creative and rigorous structuring of ideas that project a tentative purposeful and systematic view of phenomena (Chinn & Krammer, 2003)

DEFENITION :NURSING THEORY

• A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting or prescribing.

DEFENITION :NURSING THEORY

• Nursing theory is defined as a conceptualization of some aspects of nursing reality communicated for the purpose of describing phenomena, explaining relationship between phenomena, predicting consequences or prescribing nursing care.

• Theory is "a creative and rigorous structuring of ideas that projects a tentative, purposeful, and systematic view of phenomena".

Components of a theory

CONCPTS DEFINITIONS

ASSUMPTIONS PHENOMINA

NURSINGTHEORY

THEORIES ARE STUDIED UNDER

FOUR HEADINGS

MetaparadigmNursing PhilosophiesConceptual modelsTheory Approach

METAPARADIGMWith Pattern……

METAPARADIGM

• Metaparadigm is the most global philosophical or conceptual framework of a profession.

• It is the ideology within which the theories, knowledge and process for knowing find meaning and coherence

• The word originated from two Greek words ‘meta’ meaning ‘with’ and ‘paradigm’ meaning ‘pattern’.

The four concepts considered to be central to nursing are:

• Nursing theories address and specify relationship among four major abstract concepts referred to as metaparadigm of nursing.

• Person or client.The recipient of nursing care.

• Environment.The internal and external surroundings that affect the client.

The four concepts considered to be central to nursing are:

• Health.The degree of wellness or wellbeing that the client experiences.

• Nursing.The attributes, characteristics and actions of the nurse providing care on behalf of or in conjugation with the client.

NURSING PHILOSOPHYLove and pursuit of wisdom….

PHILOSOPHIES

Philosophy is defined as follows:• Love and pursuit of wisdom by intellectual means

and moral self-discipline.• Investigation of the nature, causes, or principles

of reality, knowledge, or values, based on logical reasoning rather than empirical methods.

• Statement of believes and values about human beings and their world.

NURSING PHILOSOPHY

• Nursing philosophy has been described as “a statement of foundational and universal assumptions, believes and principles about the nature of knowledge and thought and about the nature of the entities represented in the metaparadigm. (Reed, 1995)

Nursing Theory & PhilosophiesTheory Philosophy

Florence Nightingale’s Legacy of caring

Focuses on nursing and the patient environment relationship.

Virginia Henderson’s Definition of Nursing

Patients require help towards achieving independence.

Jean Watson’s Philosophy and Science of caring

Caring is a universal, social phenomenon that is only effective when practiced interpersonally considering humanistic aspects and caring.

CONCEPTUAL MODELConcept….

Conceptual Model….Conceptual Framework….

CONCEPT

• Concepts are phenomena that occur in nature or in thought.

• Concept is defined as abstract term derived from particular attributes (Kerlinger 1986) and a symbolic statement describing a phenomena or class of phenomena (Kim 2000).

• Concepts are formulated in words that enable people to communicate their meanings about relationships in the world.

CONCEPTUAL FRAMEWORK & MODELS

• Conceptual framework is a group of related concepts. It gives a overall view or orientation to focus thoughts. It can be considered as an umbrella under which many concepts can exist.

• Conceptual models It is a term used interchangeably with conceptual framework. It is a graphical illustration or diagram of conceptual framework.

IMPORTANCE OF CONCEPTS IN NURSING

• Models are representations of the interaction among and between the concepts

• Conceptual frame work directs how the actions are carried out.

• They provide an overview of the thinking behind the theory and may demonstrate how theory can be introduced into practice.

• Models are useful as they allow the concepts in nursing theory to be successfully applied to nursing practice

APPROCHES TO NURSING THEORIES

General System Theory –

It describes how to break whole things into parts & then to learn how the parts work together in “systems”. Eg: Molecules in chemistry, cultures in sociology, and organs in Anatomy & Health in Nursing.

Adaptation Theory –

It defines adaptation as the adjustment of living matter to other living things & to environmental conditions. Adaptation is a continuously occurring process that effects change &involves interaction & response.

Human adaptation occurs on three levels The internal (self) , The social (others) & The physical

(biochemical reactions)

Developmental Theory –

It outlines the process of growth & development of humans as orderly & predictable, beginning with conception & ending with death.

The progress & behaviors of an individual within each stage are unique.

CLASSIFICATION OF NURSING THEORIES

Depending On Function

• DescriptiveTo identify the properties and workings of a discipline

• ExplanatoryTo examine how properties relate and thus affect the discipline

• PredictiveTo calculate relationships between properties and how they occur

• Prescriptive To identify under which conditions relationships occur.

Depending on the Generalisability of their principles.

• Metatheory: The theory of theory. Theory about a theory. Focuses on broader issues. Focus on generating knowledge.

• Grand theory: (Macro Theories)Very broader in nature. Attempt to explain very broader areas in a discipline and may include many theories.

Depending on the Generalisability of their principles.

• Middle range theory: is specific and deal with a limited number of concepts and a limited aspect of real world.

• Practice theory: (Micro Theory)explores one particular situation found in nursing. It identifies explicit goals and details how these goals will be achieved.

Based on the philosophical underpinnings of the theories

• Needs theoriesThese theories are based around helping individuals to fulfill their physical and mental needs.

• Interaction theoriesThese theories revolve around the relationships nurses form with patients.

Based on the philosophical underpinnings of the theories

• Outcome theoriesThese portray the nurse as the changing force, who enables individuals to adapt to or cope with ill health

• Humanistic TheoriesHumanistic theories developed in response to the psychoanalytic thought that a person’s destiny was determined early in life. Humanistic theories emphasize a person’s capacity for self-actualization.

VALUES OF NURSING THEORIES

The characteristics of theories

• Interrelating concepts in such a way as to create a different way of looking at a particular phenomenon.

• Logical in nature. • Generalizable. • Bases for hypotheses that can be tested. • Increasing the general body of knowledge within the

discipline through the research implemented to validate them.

• Used by the practitioners to guide and improve their practice. • Consistent with other validated theories, laws, and principles

but will leave open unanswered questions that need to be investigated.

Importance of nursing theories

• Nursing theory aims to describe, predict and explain the phenomenon of nursing .

• It provides the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future.

• Theory is important because it helps us to decide what we know and what we need to know .

• It helps to distinguish what should form the basis of practice by explicitly describing nursing.

Importance of nursing theories

• The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education

• As medicine tries to make a move towards adopting a more multidisciplinary approach to health care, nursing continues to strive to establish a unique body of knowledge.