1. Chapter 5 Theories of Nursing Practice

2. Science and Theory Science
A method of bringing together facts and giving them coherence and integrity
Scientific inquiry involves five aspects:
Hypothesis
Method
Data collection
Results
Evaluation

3. Science and Theory Theory
A group of related concepts that explain existing phenomena and predict future events
Criteria for theory acceptance involve six factors:
Inclusiveness
Consistency
Accuracy
Relevance
Fruitfulness
Simplicity

4. Nursing Science
Collection of data related to nursing that may be applied to the practice of nursing
Guides the practice of nursing to better serve clients

5. Theories, Models, and Frameworks
Theory
An abstract generalization that presents a systematic explanation about how phenomena are interrelated
Must include at least two concepts that are related in a way that the theory explains

6. Theories, Models, and Frameworks
Conceptual model or framework
Deals with concepts that are assembled because of their relevance to a common theme
Conceptual framework is used interchangeably with conceptual model.
More loosely structured than theories
Four concepts basic to nursing that are included in models are nursing, person, health, and environment.

7. Nursing Theory Guides research and practice
Basic ingredients are concepts.
Examples of nursing concepts include health, stress, and adaptation.
Language of nursing theory:
Concept
Construct
Conceptual model
Philosophy
Theory

8. Schematic Models
Demonstrate concepts, usually through a picture or visual representation of ideas
Clarify and show relationships between complex concepts
Illustrate the layout and features specific to a theory—similar to the blueprint of a building

9. Levels of Theory
Range from a broad scope to a smaller, more specific scope

10. Theory of Unpleasant Symptoms

11. Florence Nightingale: The First Nursing Theorist
Influences that directed her toward nursing theory:
Classic education
Upper class life
Religion and spirituality
Era of reform throughout England

12. Canons of Nursing
Theory of practice “Canons of Nursing”—foundation for the promotion of health and guidance for the practice of professional nursing
Ventilation and warming
Noise
Variety
Diet
Light
Chattering hopes and advice
Cleanliness

13. Nursing Theorists Peplau (1952)
Explored interpersonal relationship of the nurse and the client
Identified the client’s feelings as a predictor of positive outcomes related to health and wellness

14. Nursing Theorists Rogers (1970)
Science of unitary man: energy fields, openness, pattern, and organization
Nurse promotes synchronicity between human beings and their universe/environment.

15. Nursing Theorists Newman (1979, revised 1986)
Defines health as "expanding consciousness," or increasing complexity
Theory stimulated by concern for those whom health as the absence of disease or disability is not possible
Nurse’s role is to recognize the person’s unique pattern of life and to work within that pattern to achieve the person’s goals.
Every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness.

16. Nursing Theorists Orem (1971)
Facilitates client self-care by measuring the client’s deficit relative to self-care needs
Nurse implements appropriate measures to assist the client in meeting needs by matching with an appropriate supportive intervention.

17. Nursing Theorists Roy (1974)
Nurse will be the change agent in assisting the individual with adaptation when an insult renders him or her in need of environmental modification.
Adaptation will occur by assisting the “biopsychosocial” client in modifying external stimuli.

18. Roy’s Adaptation Model

19. Nursing Theorists Watson (1978)
Caring among nurse, environment, and client is essential to healing.
Holistic outlook addresses the impact and importance of altruism, sensitivity, trust, and interpersonal skills.

20. Nursing Theorists Mishel (1981, revised 1997)
Uncertainty in illness is a stress-producing incident that is capable of contributing to negative physical and/or psychologic outcomes.
Uncertainty exists when the client is unsure about a diagnosed illness.
Four-step framework assists nurses in working with clients: stimuli frame, appraisal stage, initiation of coping mechanisms, and adaptation.

21. Future of Nursing Theories and Theorists
Health care concerns in the 21st century
Primary focus of federal and state legislative agendas
Major concerns: uninsured population, patient safety, nursing shortage, rising health care costs, technology, confidentiality issues, advanced practice nursing

22. Future of Nursing Theories and Theorists
Nursing theories in the 21st century
Established nursing theories will be reevaluated and modified to answer important health care questions.
Will embrace complex issues such as genetics, computers, noninvasive surgery, robotics, decreasing energy sources, increasing pollutants under a thinning ozone layer, environmental hazards, new diseases, and antibiotic-resistant illness