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Theories of Nursing Practice
3-2Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
What is a theory?
A set of concepts, definitions, relationships, and assumptions that project a systematic view of a phenomena
It may consist of one or more relatively specific and concrete concepts and propositions that purport to account for, or organize some phenomenon (Barnum, 1988)
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What are the components of a theory?
Concepts – ideas and mental images that help to describe phenomena (Alligood and Marriner-Tomey, 2002)
Definitions – convey the general meaning of the concepts
Assumptions – statements that describe concepts
Phenomenon – aspect of reality that can be consciously sensed or experienced (Meleis, 1997).
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What is a paradigm?
A model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline (Alligood and Marriner – Tomey, 2002)
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What is a domain?
The view or perspective of the discipline
It contains the subject, central concepts, values and beliefs, phenomena of interest, and the central problems of the discipline
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How does domain relate to nursing theory?
Nursing has identified its domain in a paradigm that includes four linkages:
1) person/client
2) health
3) environment
4) nursing
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Purposes of nursing theory
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What are the purposes of nursing theory?
It guides nursing practice and generates knowledge
It helps to describe or explain nursing
Enables nurses to know WHY they are doing WHAT they are doing
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Types of nursing theories
Grand theories – broad and complex
Middle-range theories- address specific phenomena and reflect practice
Descriptive theories – first level of theory development
Prescriptive theories – address nursing interventions and predict their consequences
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Why on earth do we study nursing theory?
Everyday practice enriches theory
Both practice and theory are guided by values and beliefs
Theory helps to reframe our thinking about nursing
Theory guides use of ideas and techniques
Theory can close the gap between theory and research
To envision potentialities (Gordon, Parker, & Jester, 2001)
“The study and use of nursing
theory in nursing practice must
have roots in the everyday practice
of nurses (Gordon, Parker,
and Jester, 2001).
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So how do nurses use theory in everyday 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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How do student nurses begin to use nursing theory?
By asking yourself two very important questions…..
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Student nurse questions
What is the nature of knowledge needed for the practice of nursing?
What does it mean to me to practice nursing?
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Nursing also utilizes non-nursing theories
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Commonly used non-nursing theories
Systems theory Basic Human Needs
theory Health and Wellness
Models Stress and Adaptation Developmental
Theories Psychosocial Theories
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What is the link between nursing theory and the research process?
Theory provides direction for nursing research
Relationships of components in a theory help to drive the research questions for understanding nursing
Chinn and Kramer (2004), indicate a spiral relationship between the two
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Current trends that influence nursing theory
Medical science Nursing education Professional nursing
organizations Evolving research
approaches Global concerns Consumer demands Technologies
“ Practicing nurses who despise theory are condemned to
performing a series of tasks - either at the command of a physician or in response to
routines and policies.”
Leah Curtin, RN, MS, FAAN (1989)
Former Editor, Nursing Management
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Objectives
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Some commonalities
Purpose
Concepts
Definitions
Propositions
Structured ideas
Tentative
Describe a phenomenon or occurrence
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Components/Elements of theory
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Components/Elements of theory
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Components/Elements of theory
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Characteristics of a Theory
1. Systematic, logical and coherent
(orderly reasoning,no contradictions)
2. Creative structuring of ideas
mental images of one’s experiences and create different ways of looking at a particular event or object.
3. Tentative in nature ( change over time or evolving but some remain valid despite passage of time)
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How does a theory develop?
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How does a theory develop?
3. Research theory or inductive methodMust evolve from research findings or
empirical evidence.
4. Theory research theory theories developed by other disciplines
are utilized but given unique nursing perspective. Original theory examined and given a new research findings.
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TERMINOLOGY
METAPARADIGM
- Most abstract level of knowledge. In nursing this is main concepts that encompasses the subject matter and the scope of the discipline
- Central concepts of person, environment, health and nursing
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TERMINOLOGY
Philosophy- Knowledge level which specifies the
definitions of the metaparadigm concepts in each of the conceptual models of nursing.
- Nightingale is considered philosophical approach
- Out of these philosophies theory maybe formalized
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Conceptual models
Frameworks or paradigms that provide a broad frame of reference for the systematic approaches to the phenomena with which the discipline is concerned.
-different views nursing like Roy focuses on adaptation, King on interaction and Abdellah on interventions
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theory
Group of related concepts that propose actions that guide practice
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Nursing theory
Group of related concepts that derived from the nursing models. Some derive from other nursing discipline like LEininger which comes from anthropology
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Uses of theory
1. Theory guides and improve nursing practice
Theory provides goal for nursing care
and with goals, nursing practice is rendered more effective and efficient.
theories help to focus the goals, making nurses more confident about the practice.
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Uses of theory
2. Theory guides research
according to Meleis, primary use of theory is to guide research. It validates and modifies the theory.
3. Theory contributes to the development of the disciplines body of knowledge
4. Theory enhances communication
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Historical Development
Role of nurses where questioned; what they do, for whom where and when were determined.
purpose of nursing, process of theory development was discussed
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First Conference in Nursing theory
Brought leading scholars and theorists to discuss and debate on issues regarding nursing science ad theory development.
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Historical Development
Writings of Dickoff, James and Wiedenbach “Theory in a Practice Discipline” influenced the theoretical thinking in nursing . They presented a definition of nursing theory and goals for theory development in nursing, approaches where discussed
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Categories of nursing theories
client
`
nurse
environment
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Process of Knowledge Development
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Scope of Theories
Grand Theories Middle-Range Theories
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Maslow’s Hierarchy of Needs
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