I

I T A B L E O F C O N T E N T S , Preface

The Editors

Contributors

XV

xvii

xix

Part 1 Foundations of Nursing Science 1

CHAPTER 1 Philosophy of Science: An Introduction 3 E. Carol Polifroni Introduction 3 Science 4

Natural Hard Sciences 4 Soft Applied Sciences 5 Human Science 5

Scientific Method for the Physical Sciences (Traditional) 6 Aim of Science 7 Scientific Methods in Human Science 7 Criteria for Science 8

Intersubjective Testability 8 Reliability 8 Definiteness and Precision 8 Coherence 8 Comprehensiveness and Scope 9

Questions for the Practitioner 9 Philosophy 9 Philosophy of Science 11 How Do We Know? 11 Analytical Philosophy of Science 12 Continental Philosophy of Science 13

Perceived View 1 5 Chaos and Complexity Science 16 Question the Assumptions 16 Discussion Questions 17 References 17

CHAPTER2 The Evolution of Nursing Science 19 Beth L. Rodgers Introduction 19

The Impact of the Doctor of Nursing Practice Degree 20 Science and Knowledge 21

Table of Contents

Nursing As a Discipline 23 The Education of Nurses 24 Delineating the Discipline 26 The Idea of a "Professional" Discipline 27 The Emergence of Nursing Science 29 The Theory Movement in Nursing 30 The Importance of Evaluating Philosophical Ideology 32 The Search for a Nursing Paradigm 35 Conceptual Problems and Concept Development 37 The Postmodern Turn 3 8 Emerging Trends in Nursing Science 43 The Future of Nursing Knowledge Development 46 Summary 47 Discussion Questions 47 References 48

CHAPTER 3 The Essentials of the Doctor of Nursing Practice: A Philosophical Perspective 5 1 Lisa Astalos Chism Introduction 51 Overview of the Doctor of Nursing Practice Degree 52

Historical Perspectives 54 Development of the Doctor of Nursing Practice 56 Doctor of Nursing Practice Competencies 56

Focus on Essential I: Scientific Underpinnings for Practice 58 Basic Sciences 59 The Disctpline of Nursing 59 Nursing Science 60 Nursing Theory 60 Middle-Range Theory 60 Doctor of Nursing Practice Graduates and Nursing Theory 60

Doctor of Nursing Practice Graduates and Use of Other Theories 61 Dilution of the Discipline of Nursing: Philosophical Considerations

for Doctor of Nursing Practice Graduates 62 Summary 63 Exemplar 63 Acknowledgment 65 References 65

Part 2 The Structure and Function of Theory 69

CHAPTER 4 Theory as Practice 7 1 Patricia Goodson Defining Theory 71

Commonsense Theories 72 Scientific Theories 73

Theorizing and Theoretical Thinking 76 Theory as Practice 77

What Does Theory Do? 77 What Does Theory Look Like? 78

Table of Contents

Theory Versus Practice 80 Summary 84 Discussion Questions 85 References 85

CHAPTER 5 Components and Levels of Abstraction in Nursing Knowledge 87 Janie B. Butts Introduction 87 Components o f Nursing Knowledge 88

The Knowledge Holarchy 88 Using the Components in Practice 102 Summary 105 Discussion Questions 105 References 106

Part 3 Interdisciplinary Philosophies and Theories 109

CHAPTER 6 Complexity Science and Complex Adaptive Systems 11 1 Joan C. Engebretson and Joanne V. Hickey Introduction 111 Introduction to Complexity Science 112 Background 114 The Scientific Roots o f Complexity Science 116

Nonlinear Mathematics 1 16 Coupling 117 Coordination Dynamics 11 8

Complex Adaptive Systems 118 Components of Complex Adaptive Systems 11 9 Characteristics of Complex Adaptive Systems 120 Connectivity 120 Robustness and Adaptability 125

Complex Adaptive Systems, Complex Responsive Processes, and Organizations 125

Organizations as Complex Adaptive Systems 125 Organizations and Complex Responsive Processes 126 Complex Responsive Processes and Relationship-Centered

Care 127 Implications for Practice 127

Practice as Complex Adaptive Systems 127 Viewing Healthcare Organizations Through the Lens

of Complexity 128 Healthcare Organizations as Complex Adaptive Systems 124

Application to Health Care and Nursing 132 Application to Clinical Care 132 Application to Nursing 133

Summary 134 Discussion Questions 134 References 135

Table of Contents

CHAPTER 7 Critical Theory and Emancipatory Knowing 139 Peggy L. Chinn Introduction 139 Nursing's Patterns of Knowing 141 Philosophical and Theoretical Foundations of Emancipatory Knowing

in Nursing 142 Habemas's Critical Social Philosophy 143 Freire's Theory of Human Liberation 144

Implications of the Philosophy and Theory for Practice 146 Emancipatory Nursing Practice 146 Emancipatory Knowing and the Essentials of

Advanced Nursing Practice 152 Summary 155 Discussion Questions 156 References 157

CHAPTER 8 Feminist Ethics: Some Applicable Thoughts for Advanced Practice Nurses 159 Rosemarie Tong Introduction 159 Care-Focused Feminist Approaches to Ethics 160 Power-Focused Feminist Approaches to Ethics 168

Liberal Power-Focused Feminists 168 Radical Power-Focused Feminists 169 Multicultural, Global, and Third- Wave Power-Focused

Feminist Ethics 170 References 175

CHAPTER9 Theories and Methods in Ethics 177 Karen L. Rich Introduction 177 Philosophical Inquiry 177 Science: The Daughter of Philosophy 179 Methods and Outcomes of Inquiry 181

Normative Ethics 182 Meta-Ethics 182 Descriptive Ethics 182 The Fact/Value Distinction 182

Perspectives on Theory 183 Theoretical Approaches to Ethics 186

Rule-Based Theories 187 Consequentialism 189 Communitarianism 190

Summary 192 Discussion Questions 192 References 193

CHAPTER 10 Educational and Learning Theories 195 Margaret M. Braungart and Richard G. Braungart Introduction 195 Learning Theory 196

Table of Contents

Behaviorist Learning Theory 197 Classical Conditioning 199 Operant Conditioning 202

Cognitive Learning Theory 204 Gestalt Theory 206 Cognitive Development Theory 208 Information-Processing Theory 21 0 Social Learning Theory 21 1 Social Constructionism, Social Constr~ctivism,

and Social Cognition Theories 213 Psychodynamic Learning Theory 214 Humanistic Learning Theory 218 Neuropsychology and Learning 221 Using Learning Theories in Advanced Nursing Practice 223

1. What Are Effecttve Ways to Learn New Informatron or Change Attitudes and Behavior in Health Care? 225

2. How Can People Be Motivated to Learn, and Which Kznds of Experiences Facrlztate Learning? 228

3. What Are Effective Ways to Teach So That Information ana Skills Wzll Be Remembered Rather Than Forgotten and Will Transfer Correctly Outside the Immediate. Leamrng Situation? 229

Summary 230 Discussion Questions 231 References 232

CHAPTER 11 Health Behavior Theories 235 Karen Glanz, Lora E. Burke, and Barbara K. Rimer Introduction 235 The Evolution o f Health Behavior Theory 236 Trends in the Use o f Theories and Models 236 The Health Belief Model 238

Examples of Application of the Health Belief Model 240 The Theory o f Reasoned Action, the Theory o f Planned Behavior, and

the Integrated Behavioral Model 241 Examples of Application of the Theo y of Planned Behavior 242

The Transtheoretical Model and the Stages o f Change 242 Examples of Application of the Transtheoretzcal

Model of Behavror Change 243 Soc~al Cognit~ve Theory 244

Examples of Application of Social Cognitwe Theory 245 Example of Application of Self-Efficacy 245

Social Ecological Models 246 Representational Approach 247

Example of Application of the Representational Approach 248 Cross-Cutting Concepts 249

The Patimt's View of the World: Perceptions, Cognrtions, Emotions, and Habits 249

Behavior Change as a Process 250 Intention Versus Action 251

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Applications in Nursing and Nursing Research 252 Discussion Questions 252 References 253

CHAPTER 12 Theories Focused on Interpersonal Relationships 257 Sandra Nelson Introduction 257 A Sign of the Times: 1800s to 1970s 258 Interpersonal Relations 259

Hildegard Peplau (1 909-1 999): The Theory of Interpersonal Nursing 259

Ida Jean Orlando Pelletier (1926-2007): Nursing Process Discipline Theory 264

Joyce Travelbee (1 926-1 973): The Human-to-Human Relationship Model 266

A Sign of the Times: 1970s to the Present 268 HumanisdCaring 269

Josephine Paterson (2 924-Present) and Loretta Zderad (1 925-Present): Humanistic Nursrng Theory (1976) 269

Existentialism 272 Jean Watson (1 940-Present): Theo y 2 7 2 of Human Caring Margaret Newman (1933-Present): Theory of Health as Expanding

Consciousness 274 Rosemarie Rizzo Parse (Year of birth unknown-Present):

Humanbecoming Theory 276 Non-Nursing Theories Focused on Interpersonal Relationships 278

Interpersonal Relations Theory 278 Humanistic Theory 281 ExistentialismlPhenomenology 283 Positive Psychology 286 Transpersonal Psychology 288

Recovery-Oriented Systems of Care 289 "Change is enviable; Growth is optional" 289 Background 289 Conclusions about the Recovey-Oriented System of Care 295 Building a Framework for Recovery-Oriented and

Trauma-Informed Nursing Care 295 Back to the Future 298 Discussion Questions 299 References 299

CHAPTER 13 Environmental Philosophy and Theories 307 Steven J. Vanderheiden Introduction 307 Ecological Limits Theories 309 Environmental Value Theories 31 1 Holistic Theories 313 Justice Theories 315 Summary 316

Table of Contents

Discussion Questions 317 References 3 17

CHAPTER 14 Economic Theories 3 19 Sherry Hartman Introduction 3 19 The Hlstory and Beginnings o f Mainstream Economics 321 Assumptions o f Economic Theory 325 Concepts, Relationships, and Principles in Economic Theories 326

Markets 326 The Production Possibilrty Curve 327

.Demand 327 Utility 328 Supply 329 Equilrbrium 330 Elasticity 331

Market Failure 331 Assessing Assumptions for Valldity 332 Economic Analys~s o f Clinical and Managerial Interventions 334

Cost Analysrs 335 Conclusion 336 Discussion Questions 337 References 3 37

CHAPTER 15 Theories of Organizational Behavior and Leadership 339 Sandra Bishop Introduction 339 Classical Organization Theory 339

Frederick Winslow Taylor: Principles of Scientific Management 340 Henri Fayol: General Principles of Administrahon 341 Max Weber: Bureaucratic Theory 342

Neoclassical Organization Theories 342 Human Resource Theory: The Hawthorne Experrments 342 The Economy of Incentives 343 The Proverbs of Admrnistration 344

Modern Organization Theories 345 Contrngency Theory 345 Organizational Configuration Framework 347 General Systems Theory 348 Change Theory 349 Theories X , Y, and Z 350

Summary 353 References 353

CHAPTER 16 Theoretical Approaches to Quality Improvement 355 Patsy Anderson Introduction 355 Florence Nightingale 356 Ernest Codman 357

Table of Contents

Avedis Donabedian 358 W. Edwards Deming 359 Joseph M. Juran 363 Philip B. Crosby 364 Summary 369

Quality Is Driven by Organization Leaders 369 Customer-Mindedness Permeates the Organization 364 An Emphasis on Process Improvement 369 F o w l Process Improvement Methods and Tools 370 Involvement of All Employees 370

Resources 370 Discussion Questions 372 References 372

Part 4 Select Nursinq Models and Theories 375

CHAPTER 17 Models and Theories Focused on Nursing Goals and Functions 377 Kathleen Masters Introduction 377 The Environmental Model o f Nurslng: Florence Nightingale 378

Background 378 Nightrngale's 13 Canons Central to the Environmental Model

of Nurszng 3 79 Major Concepts of the Environmental Model of

Nursing According to Nightingale 380 Analysrs of Ntghtingale's Environmental Model of Nursing 381 Discussion 382

Fourteen Components of Basic Nursing Care: Virginia Henderson 383

Background 3 83 Henderson's 14 Components of Nursing Care 383 Nursing Care and Henderson's 14 Components

of Nursing 384 Major Concepts of Nursing According to Henderson 387 Analysrs of Henderson's Definition of Nursing and 14

Components of Nursing 388 Discussion 390

The Behavioral System Model: Dorothy Johnson 391 Background 391 Johnson's Behavioral System Model 391 Major Concepts of Nursing According to Johnson 393 Analysts of the Behavioral System Model 395 Discussion 397

The Health Promotion Model: Nola J. Pender 397 Background 397 Pender's Health Promotion Model 397 Major Concepts o f Nursing According to Pender 399

Table of Contents

Analysis of the Health Promotion Model 400 Discussion 402

Summary 402 Discussion Questions 402 References 403

CHAPTER 18 Modeb and Theories Focused on a Systems Approach 407 Martha V. Whetsell, Yolanda M. Gonzalez, and Maria Elisa Moreno-Fergusson Introduction 407 General Systems Theory 407 The Roy Adaptation Model 408

The History 408 The Philosophy and Assumptio~s 409 The Model 41 0 Application of the Model to Education, Research, and Practice 41 6

The King Conceptual System and Theory o f Goal Attainment 416 The History 41 6 The Philosophy 417 The Models 41 7 Nursing Application of King's Conceptual System and

Theory of Goal Attainment 421 The Neuman Systems Model 422

The Evolution of the Neuman Systems Model 422 The Philosophy 423 The Model 423 Neuman's Perception o f Nursing 427 Education 428 Practice 428 Research 429 Contributions to Nursing 430

Analysis o f the Models 430 Summary 431 Discussion Questions 432 References 432

CHAPTER 19 Models and Theories Focused on Human Existence and Universal Energy 435 Violet M. Malinski Introduction 435 Rogers' Science o f Unitary Human Beings 436

Barrett's Power as Knowing Participation in Change 439 Other Rogerian-Based Practice Examples 441 Rogerian Research 441 Applications in Advanced Practice Nursing:

Science of Unitary Human Beings 444 Newman's Theory o f Health as Expanding Consciousness 446

Newman Praxis 453 Applications in Advanced Practice Nursing: Health as Expanding

Consciousness 455

Table of Contents

Rosemarie Rizzo Parse's Humanbecoming School of Thought 457 Humanbecoming Research 460 Applications in Advanced Practice Nursing: Humanbecoming

Theory 463 Summary 467 Discussion Questions 467 References 467

CHAPTER 20 Models and Theories Focused on Competencies and Skills 473 Mary W. Stewart Introduction 473 From Novice to Expert (Patricia Benner) 474

Application of the Novice-to-Expert Model 478 The American Association of Critical-Care Nurses Synergy

Model for Patient Care 479 Application of the AACN Synergy Model for Patient Care 487

Relationship-Based Care: A Model for Transforming Practice 489 Application of the Relationship-Based Care Model 493

Conclusion 495 Discussion Questions 495 References 496

CHAPTER21 Theories Focused on Caring 499 Joanne R. D u f b Introduction 499 The Nursing as Caring Theory (Anne Boykin

and Savina Schoenhofer) 500 The Theory of Human Caring (Jean Watson) 502 The Middle-Range Theory of Caring (Kristen Swanson) 505 The Quality-Caring Model (Joanne R. Duffy) 506 Conclusion 512 Discussion Questions 513 References 514

CHAPTER22 Models and Theories Focused on Culture 517 Larry Purnell Introduction 5 17 Overview of Cultural Models and Theories 517 Essential Terminology Related to Culture 519 Cultural Self-Awareness 520 Selected Cultural Models and Theories 521

The Campinha-Bacote Model 521 The Giger and Davidhizar Model 522 The Papadopoulos, Tilki, and Taylor Model 523 Leininger's Cultural Care Diversity and Universality

Theory and Model 524 Spector's HEALTH Traditions Model 525

The Purnell Model for Cultural Competence 525 Assumptions of the Purnell Model 527

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Table of Contents

Variant Cultural Characteristics 527 Cultural Competence According to the Purnell Model 528 Description of the Purnell Model 528 Macro Aspects of the Purnell Model 530 Domains of the Purnell Model and the Organizing Framework 531

Individual Professional Cultural Competence 549 Cultural-General Competence 551 The Clinical Encounter 551 Langaage 552

Organizational Cultural Competence 552 Governance and Administration 553 Language 554

Conclusion 555 References 556

CHAPTER23 The Praxis Theory of Suffering 559 Janice M. Morse Introduction 559 The Praxis Theory o f Suffering 560

The Development of the Praxis Theory of Suffering 560 The Components of the Praxis Theory of Suffering 563 Enduring 564 Transition 568 Emotional Suffering 570 Coming Out of Suffering '572

Comfort and Comforting 579 The Comforting Interaction 580 Compendium of Comforting Strategies 583

Summary 583 Discussion Questions 584 References 584 Appendix 23-1 Reference List for Table 23-1 587

Part 5 Tools for Integrating and Disseminating Knowledge in Advanced Nursing Practice 591

CHAPTER 24 Theory Testing and Theory Evaluation 593 Jacqueline Fawcett Introduction 593 The Science and Art o f Theory Development 593

Theories 594 Types o f Theories 594 Empirical Indicators and Other Empirical Methods 596 Conceptual Models 597 Conceptual-Theoretical-Empirical Structures for Theory

Deuelopment 597 Conceptual-Theoretical-Empirical Structures for Theory

Generation 598

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Creating Conceptual-Theoretical-Empiricai Structures for Theory Generation 599

Conceptual-Theoretical-Empirical Structures for Theory Testing 599 Creating Conceptual-Theoretical-Empirical Structures for

Theory Testing 601 Partnerships for Theory Development 602

The Science and Art o f Theory Evaluation 602 Step I : Evaluation of the Conceptual-Theoretical-Empirical

Linkages 602 Step 2: Evaluation of the Theory 604 Step 3: Evaluation of the Empirical Research Methods 607 Step 4: Evaluation of the Research Findings 608 Step 5: Evaluation of the Utility and Soundness of the

Conceptual Model 609 Conclusion 610 References 610

CHAPTER 25 Using Theory in Evidence-Based Advanced Nursing Practice 6 13 Jacqueline Fawcett Introduction 613 Theory and Evidence 613 Translational Research 614 Types o f Theories, Research, and Practice Tools 614 Translating Theories into Practical Actions 617

First Step 61 7 Second Step 61 8 Third, Fourth, and Fifth Steps 61 8 Sixth Step 627 Seventh Step 627

Conclusion 627 References 627

Index 631