Introduction to Nursing Theories Nursing 210 Spring 2004

1. Introduction to Nursing TheoriesNursing 210Spring 2004 Curlissa Mapp RN, BSN Georgia Baptist College of Nursing of Mercer University

2. “ 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

3. WHY STUDY NURSING THEORY? • WHAT DOES THE PRACTICING NURSE WANT FROM NURSING THEORY?

4. What is the nature of knowledge needed for the practice of nursing? What it means to practice nursing? Nursing must examine:

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

6. Reasons for Studying Nursing Theory • Everyday practice enriches theory • Practice and theory guided by values and beliefs • Reframe thinking about nursing • Theory guides use of ideas and techniques • Close gap between theory and research • Envision potentialities (Gordon, Parker, Jester, 2001)

7. Nursing Theory and the Practicing Nurse • Theory assists the practicing nurse to: • 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)

8. STURUCTURAL HIERARCHY OF NURSING KNOWLEDGE: COMPONENTS & LEVEL OF ABSTRACTIONS Metaparadigm Most Abstract Philosophies Conceptual Models Theories Most Concrete Empirical Indicators

9. METAPARADIGM - Global concepts that identify the phenomena of interest • Global propositions that describe the concepts • Global propositions that state the relations between the concepts (Fawcett, 2000)

10. FUNCTION OF THE METAPARADIGM • Summarize the intellectual and social missions of a discipline and place a boundary on the subject matter of that discipline

11. Phenomena of interest to nursing is represented by Four Central Concepts Person 2. Environment 3. Health 4. Nursing METAPARADIGM

12. PHILOSOPHIES • A statement encompassing claims about a phenomena of central interest to a discipline, claims about how a phenomena comes to be known and claims about what the members of a discipline value

13. FUNCTION OF PHILOSOPHIES • To Communicate: • What people assume to be true in relation to the phenomena of interest to a discipline. (Christensen & Kenney, 1990) - What people believe regarding the development of knowledge about those phenomena

14. Florence Nightingale’s work is an example of a philosophy Example of philosophical statement “ the individual … behaves purposefully, not in a sequence of cause and effect.” (Roy, 1988, p. 32) PHILOSOPHIES

15. Word or phrase that summarizes the essential characteristics or properties of a phenomenon Abstract idea (i.e. Hope, love, desire, pain, body temperature) Derived from impressions the human mind receives about phenomena through sensing the environment (McEwen & Willis, 2002) CONCEPTS

16. CONCEPTS • Are equivalent of bricks in a wall and lend structure to science (Hardy, 1973, Wuest, 1994) • Are defined for each specific use the writer or researcher makes of the term (Hardy, 1973)

17. CONCEPTS • When operationalized become variables used in hypotheses to be tested in research. • Explicate subject matter of theories of a discipline

18. CONCEPTUAL MODELS • A set of abstract and general concepts and propositions that integrate those concepts into a meaningful configuration. (Lippitt, 1973; Nye & Berardo, 1981)

19. FUNCTION OF CONCEPTUAL MODELS • Frameworks or paradigms that provide “a broad frame of reference for systematic approaches to the phenomena with which the discipline is concerned. (Tomey & Alligood, 2002)

20. EXAMPLE CONCEPTUAL MODELS - King’s General Systems Framework - Roy’s Adaptation Model

21. Word structures that provide a specific view on nursing through the interrelationship of concepts in the structure. VERBAL – worded statements, a form closely related to knowledge development SCHEMATIC – diagrams, drawings, graphs or pictures that facilitate understanding CONCEPTUAL MODELS

22. A group of related concepts that propose action that guides practice Consist of one or more relatively specific and concrete concepts and propositions that purport to account for or organize some phenomenon (Barnum, 1998) THEORIES

23. FUNCTION OF THEORIES Primary Purpose: To Generate Knowledge

24. GRAND THEORY - More abstract and broad in scope MIDDLE-RANGE THEORY - More concrete and narrower in scope Theories vary in their level of abstraction and scope

25. Describes or Explains Nursing Enable nurses to know WHY they are doing WHAT they are doing Nursing Theory

26. EMPIRICAL INDICATORS • A very concrete and specific real world proxy for a middle-range theory concept; • An actual instrument, experimental condition or clinical procedure that is used to observe or measure a middle-range theory concept (Fawcett, 2002)

27. FUNCTION OF EMPIRICAL INDICATORS • Provide the means by which middle-range theories are generated or tested • Indicators that are experimental conditions or clinical procedures tell the researcher or clinician exactly what to do ( protocols or scripts that direct actions in a precise manner) (Fawcett, 2002)

28. SUMMARY