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Theories of Nursing Practice. 3-2 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. What is a theory?  A set of concepts, definitions,

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Presentation on theme: "Theories of Nursing Practice. 3-2 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. What is a theory?  A set of concepts, definitions,"— Presentation transcript:

1 Theories of Nursing Practice

2 3-2 Copyright 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)

3 3-3 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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).

4 3-4 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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)

5 3-5 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

6 3-6 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

7 3-7 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Purposes of nursing theory

8 3-8 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

9 3-9 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

10 3-10 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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)

11 “The study and use of nursing theory in nursing practice must have roots in the everyday practice of nurses (Gordon, Parker, and Jester, 2001).

12 3-12 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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)

13 3-13 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. How do student nurses begin to use nursing theory?  By asking yourself two very important questions…..

14 3-14 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Student nurse questions  What is the nature of knowledge needed for the practice of nursing?  What does it mean to me to practice nursing?

15 3-15 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Nursing also utilizes non-nursing theories

16 3-16 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Commonly used non-nursing theories  Systems theory  Basic Human Needs theory  Health and Wellness Models  Stress and Adaptation  Developmental Theories  Psychosocial Theories

17 3-17 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

18 3-18 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Current trends that influence nursing theory  Medical science  Nursing education  Professional nursing organizations  Evolving research approaches  Global concerns  Consumer demands  Technologies

19 “ 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

20 3-20 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Objectives Define theory and list characteristics of a theory Describe the components of a theory and its use Trace the development of a nursing theory Describe the different types of theories and examples of each.

21 3-21 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Some commonalities Purpose Concepts Definitions Propositions Structured ideas Tentative Describe a phenomenon or occurrence

22 3-22 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Components/Elements of theory 1.Purpose “Why is the theory formulated” 2.Concepts are building blocks of theory – ideas, mental images of a phenomenon, an event or object that is derived from an individual’s experience and perception

23 3-23 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Components/Elements of theory 3.Has a major concept like nursing, person, health or environment. 4. Definitions give meaning to concepts which can either be descriptive or procedural (stipulate- use of term within the theory)

24 3-24 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Components/Elements of theory Propositions are expressions of relational statements between and among the concepts. It can be expressed as statements, paradigms or figures. AKA as theoretical assertions Assumptions- accepted “truths” that are basic and fundamental to the theory. Or value assumptions where what is good or right or ought to be.

25 3-25 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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)

26 3-26 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. How does a theory develop? Four strategies of theory development Theory practice theory ( theory developed in other discipline and used in nursing situations) Practice – theory evolved from clinical practice

27 3-27 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. How does a theory develop? 3. Research theory or inductive method Must 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.

28 3-28 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

29 3-29 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

30 3-30 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

31 3-31 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. theory Group of related concepts that propose actions that guide practice

32 3-32 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Nursing theory Group of related concepts that derived from the nursing models. Some derive from other nursing discipline like LEininger which comes from anthropology

33 3-33 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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.

34 3-34 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

35 3-35 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

36 3-36 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. First Conference in Nursing theory Brought leading scholars and theorists to discuss and debate on issues regarding nursing science ad theory development.

37 3-37 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 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

38 3-38 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Categories of nursing theories client ` nurse environment

39 3-39 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Process of Knowledge Development

40 3-40 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Scope of Theories  Grand Theories  Middle-Range Theories

41 3-41 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. Maslow’s Hierarchy of Needs

42 3-42 Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.


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