Nursing Knowledge Chapter 11 pp. 121-130 Introduction Chapter 11 discusses works of Meleis and Im. They promote “situation-specific theory” as a form of nursing theory. Situation-specific theories address clinical problems nurses encounter. The author of the book argues that situation-specific theories are not adequate for nursing theory. They are not developed around grand and middle-range theories. Basically these situation specific theories are more clinical and practical approach to nursing theory

Afaf Meleis She wanted to develop substance for the field of nursing. Her work moved away from discipline- framing theories and new grand theories to practical needs of nursing. She wanted theories that empowered nurses, the discipline, and clients Meleis is an Egyptian-American nursing scientist and educator. Her published work started in the 1980s. Meleis thought nursing inquiry must be politically and morally engaged. She discussed an alliance between feminism and nursing. She wanted “gender-sensitive knowledge” She attempted to re-orient the nursing discipline from at top-down approach on the metaparadigm and grand theory to a bottom-up structure that began with a commitment to the profession.

Situation-Specific Theories Theories that focus on specific nursing phenomena. Reflect clinical practice. Im and Meleis proposed that situation-specific theories could be the discipline of nursing. Their goal was to bridge the relevance gap. Meleis said the future of nursing will move away from nursing-specific theories and move towards integration into the health sciences. They would bridge the relevance gap by promoting theories with direct clinical relevance. Consistent with making a contribution to knowledge of health, a common aspiration for the nursing discipline

Postnursing Theory Inquiry Donaldson wrote an essay about breakthroughs in scientific research. She defined a breakthrough by 3 criteria: if the contribution was mostly to nursing it changed current thinking of health phenomenon and if other scholars acknowledged it came from nursing. She identified 60 breakthroughs in 11 research areas. These studies were done without reference to nursing grand theory or conceptual models. They did not fit the standard models for nursing research.

Donaldson’s research examples Mastectomy Quint-Benoliel studied 21 women who underwent mastectomy. The research focused on emotional and social aspects of surgery. This situation-specific theory was later applied to all patients with terminal illness. Pain Management Jean Johnson’s research hypothesized against the background of the gate-control theory of pain. She tested patients response to a painful stimuli. She found that distress and sensation to pain were to some degree independent. Mastectomy was well established as a surgical procedure by 1950 The literature focused on the physiology more than the psychological aspects. Quint-Benoliel studied 21 women who underwent mastectomy. This is an example of how nursing knowledge grew from a specific focus to application to a larger area. Pain Management Johnson applied a blood pressure cuff as her pain stimulus. There were 4 groups and each were given different information regarding what they would experience. One was given false information, the others were given partial information, and one group was given a full and accurate description of what was going to be done.

Conclusion The author of the book concludes that while these two examples do meet some criteria of situation-specific theories, neither qualify completely. Quint-Benoliel;’s research started with mastectomy patients and grew to include all patients with life threatening illness. Johnson’s research on pain is a universal health phenomenon. The author says that situation-specific theories are limited in their levels of nursing abstract and the degree to which they can generalize across contexts. Some nursing research will be situation-specific, but not all research should develop this way.

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