Foundations of Nursing Theory

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Questions and Answers

What is the primary focus of Watson's Theory of Caring?

Restoring patients to health through environmental manipulation

Addressing uncertainty in illness

Patient adaptation to environmental changes

The nurse-patient caring relationship (correct)

Which level of nursing theory is least abstract and targets interventions for specific phenomena?

Grand level

Practice level (correct)

Middle-Range level

Prescriptive level

Which of the following theories primarily addresses the acquisition of skills from novice to expert?

Kolcaba's Comfort Theory

Nightingale's Environmental Theory

Roy's Adaptive Theory

Benner's Skill Acquisition Theory (correct)

What is the primary aim of Evidence-Based Nursing Practice (EBNP)?

To integrate best evidence with nurse expertise and patient values Signup and view all the answers

Which level of theory incorporates all four meta-paradigm concepts?

Grand level Signup and view all the answers

What is a characteristic of the Middle-Range level theory?

It directly guides clinical practice. Signup and view all the answers

Which of the following is an example of a prescriptive nursing theory?

Turning an immobile patient every two hours Signup and view all the answers

What important change has influenced the development of nursing's theoretical foundation over the last 50 years?

The increased focus on evidence-based practice Signup and view all the answers

What phenomenon does Kolcaba's theory primarily address?

Providing comfort to patients Signup and view all the answers

What role does Nightingale's theory emphasize in nursing?

Environmental manipulation for patient recovery Signup and view all the answers

Who is credited as the first nurse theorist and researcher?

Florence Nightingale Signup and view all the answers

What does nursing theory primarily help to define?

Nursing phenomena and relationships between them Signup and view all the answers

Which of the following does NOT belong to the nursing meta-paradigm concepts?

Caring Signup and view all the answers

What is the role of nurse researchers in relation to nursing theory?

To test and confirm or refute nursing theory Signup and view all the answers

In nursing theory, what is 'environment/situation' defined as?

Conditions affecting patients and their care settings Signup and view all the answers

What is meant by the term 'domain' in nursing?

The perspective of the nursing profession Signup and view all the answers

Which concept is described as 'the recipient of nursing care'?

Person Signup and view all the answers

How is health defined in the context of nursing theory?

A state of being defined by personal values and lifestyle Signup and view all the answers

What is the primary focus of caring in nursing?

Establishing connections and achieving positive outcomes Signup and view all the answers

Which of the following statements is true regarding nursing knowledge?

It is dynamic and evolves with new research and evidence. Signup and view all the answers

Which activity is NOT considered a part of the ANA Professional Role Activities?

Clinical diagnosis Signup and view all the answers

Which nursing degree focuses on conducting research and contributing to empirical knowledge?

Doctor of Philosophy (PhD) Signup and view all the answers

What is the goal of Standard 14: Scholarly Inquiry?

Integrating scholarship into practice Signup and view all the answers

Which competency is associated with a Bachelor of Science in Nursing (BSN)?

Assist with problem identification in nursing practice Signup and view all the answers

What characterizes deductive reasoning?

Developing specific predictions from general principles Signup and view all the answers

Nurses are the main producers of evidence for Evidence-Based Nursing Practice (EBNP) because they:

Understand patient needs and nursing practice Signup and view all the answers

At the doctoral level, which of the following is a primary responsibility of a Doctor of Nursing Practice (DNP)?

Implement and evaluate evidence-based guidelines Signup and view all the answers

What type of reasoning is primarily qualitative and involves developing generalizations from specific observations?

Inductive reasoning Signup and view all the answers

Which of the following is NOT an aspect of EBNP competencies at the Master's level?

Develop nursing theories Signup and view all the answers

What does the term 'resource stewardship' refer to in nursing professional activities?

Utilizing resources effectively and sustainably Signup and view all the answers

What type of reasoning involves drawing general conclusions from specific observations?

Inductive reasoning Signup and view all the answers

Which of the following best describes the primary use of inductive approaches in nursing research?

To study human behavior and experiences Signup and view all the answers

What is essential to assess when reviewing articles from the CINAHL database?

If it is published in a nursing journal Signup and view all the answers

Which statement accurately reflects the relationship between inductive and deductive approaches in nursing knowledge development?

Both inductive and deductive approaches are necessary. Signup and view all the answers

Which database contains comprehensive nursing literature including articles from other health disciplines?

CINAHL Signup and view all the answers

What should a nursing student ensure when selecting articles for a group assignment?

The articles are original research reports. Signup and view all the answers

Which criterion can help determine if a journal is classified as a nursing journal?

It includes the word 'nurse' or 'nursing' in the title. Signup and view all the answers

What common misconception exists regarding evidence derived from inductive methods?

Inductive approaches are undervalued in healthcare. Signup and view all the answers

What term best describes knowledge generated from learned principles in nursing education?

Deductive knowledge Signup and view all the answers

Which of the following is NOT a goal of utilizing evidence-based practice (EBP) in nursing?

Increasing hospital profits Signup and view all the answers

Study Notes

Theoretical and Scientific Foundations of Professional Nursing Practice

Florence Nightingale (FN) is considered the first nurse theorist/scientist/researcher, beginning nursing's theoretical/scientific heritage in the Crimean War (1854-1856).

What is Theory and Nursing Theory?

Theory explains events by Defining a concept involves clearly stating its meaning and characteristics to enhance understanding. In the context of nursing theory, defining is crucial as it establishes a foundation for developing knowledge that guides nursing practice. It encompasses identifying key components of phenomena pertinent to patient care, recognizing the nuances involved in human interactions, and determining the dynamics of health and illness. Through precise definitions, nursing professionals can create a common language, facilitating effective communication among practitioners and enhancing the overall quality of care delivered to patients.concepts, detailing relationships among concepts, and predicting outcomes.
Nursing theory defines and explains nursing phenomena, relationships between phenomena, and predicts outcomes, building upon nursing knowledge.

Nursing Theory, cont.

Nurse researchers/scientists test nursing theory/nursing knowledge (nursing science) to confirm or refute existing knowledge, leading to ongoing developments in the knowledge base.
This theoretical knowledge is constantly evolving.

Domain

The domain represents the perspective of a profession or discipline, providing the subject, concepts, values, and beliefs plus phenomena of interest.
Nursing's domain is broad due to the large variety of phenomena of interest, such as nursing diagnoses.

Paradigm

A paradigm links beliefs, theory, and assumptions within a discipline (e.g., nursing's focus on holistic, patient-centered care with an outcome focus).
The four recognized concepts within the nursing paradigm are person, health, environment/situation, and nursing. These are the meta-paradigm concepts of nursing.

The Meta-Paradigm Concepts of Nursing

Person: The recipient of nursing care (individual, family, group, or population).
Health: A state of being—how individuals define it related to their values, personality, and lifestyle.
Environment/Situation: All conditions affecting patients and settings of nursing care.
Nursing: A verb (action), noun (person providing care), or combination of both.

Caring

Caring is central to nursing, although it's not a meta-paradigm concept.
Caring involves understanding that people, events, and things matter and connection.
Caring is essential when seeking professional nursing guidance, impacting positive outcomes.

Four Levels of Theory/Nursing Theory

Grand level: Most abstract; sets the theoretical framework for the entire nursing discipline (e.g., Watson's theory , Roy, Orem). These theories encompass all four meta-paradigm concepts.
Middle-range level: Less abstract, focusing on clinical practice situations (e.g., relating to pain, hope, sorrow).

Levels of Theory, cont'd

Practice level: Describes interventions for a specific nursing phenomenon (e.g., what to do). This is the level of theory typically taught to undergraduate (UG) nursing students.
Prescriptive level: Very few prescriptive nursing theories; provides interventions as prescribed where the intervention is performed every time the specific condition calls for it (e.g., turning an immobile patient every two hours).

Nursing Theory – Grand Level Examples

Nightingale: Focuses on the patient's environment; nurses manipulate the environment to restore health.
Roy: Focuses on patient adaptation to changes in physiological, self-concept, role function, and interdependence domains.
Watson: Focuses on caring; caring occurs through transpersonal nurse-patient engagement.

Watson's Theory of Caring

Watson's theory of caring is a holistic model.
It emphasizes conscious intention to care, promoting wholeness (in both the nurse and the person).
Caring relationships are vital, preserving human dignity in modern health care.

Nursing Theory – Middle Range Examples

Benner: Skill acquisition (novice to expert)
Kolcaba: Comfort
Pender: Health promotion
Mishel: Uncertainty in illness

Nursing's Theoretical Foundation

Nursing's theoretical knowledge base has expanded due to an increasing number of phenomena addressed by nurses and advanced practice registered nurses (APRNs).
Evidence-based nursing practice (EBNP) deemphasizes habits and rituals, using evidence to guide care.

Evidence-Based Nursing Practice (EBNP)

EBNP is a problem-solving approach to clinical practice.
It integrates best evidence, nurse expertise, and patient preferences to inform patient care decisions.

ANA Standards of Professional Performance

The ANA (2021) provides 12 Standards of Professional Performance alongside the 6 Standards of Practice.
Nurses and nursing students are expected to engage in professional role activities in line with their education, position, and experience.

ANA Professional Role Activities

These activities cover ethics, advocacy, equitable practice, communication, collaboration, leadership, education, scholarly inquiry, quality practice evaluation, resource stewardship, and environmental health.

Standard 14: Scholarly Inquiry

Registered nurses use scholarship, evidence, and research findings to guide their practice (ANA, 2021, p. 100).

Scholarly Inquiry/EBNP Competencies Based on Academic Preparation

BSN: Critically appraises research; utilizes best research evidence in practice; assists with problem identification in nursing.
MSN: Critically appraises and synthesizes research, implementing best evidence in practice, collaborates with research projects, and provides clinical expertise.

EBNP Competencies at the Doctoral Level

DNP: Develops, implements, evaluates, and revises protocols and guidelines, conducting clinical studies.
PhD: Conducts research, contributing to the empirical knowledge base within a specific area of study.
Post-doctoral: Implements funded research programs, mentors other PhD-prepared researchers.

Evidence for EBNP

Evidence, for scientific disciplines, is generated by research.
Registered nurses are the primary producers of evidence needed for EBNP due to their knowledge of nursing and nursing practice.

Approaches to Knowledge Development

Two approaches are deductive reasoning, which uses general principles to predict specific situations (Quantitative), and inductive reasoning, which uses specific observations to develop generalizations (Qualitative).

Inductive Nursing Knowledge

Often generated through nursing practice.
Example: Observing that hospitalized children experience anxiety when separated from their parents.

Nursing Knowledge from Deduction

Generated from learned principles.
Example: Knowing that children experience anxiety when separated from their parents, observing for signs of separation in hospitalized children.

Sources of Evidence

Not all evidence sources are credible, valid, or reliable.
Health care historically favors deductive methods presented in academic journals.
Inductive approaches, while useful when studying humans/human sciences, are not always considered as credible.

Nursing Knowledge

Both deductive and inductive reasoning are essential for understanding nursing and nursing phenomena.
Neither methodology is superior when used as a basis for nursing care or patient-centered nursing.

Evidence for the EBP Assignment & Group Presentation

Use original research reports from nursing literature for assignments.
Nursing literature encompasses published works that nurses produce.
Titles of nursing journals often include "nurse," "nurses," or "nursing"

Where to find the nursing literature

CINAHL (Cumulative Index of Nursing and Allied Health Literature) is a useful database.
Not every article within CINAHL represents nursing literature, as it also includes articles from other health disciplines.
Nurses assess articles for publication in nursing journals on the official ANA list.

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Description

Explore the theoretical and scientific underpinnings of professional nursing practice. This quiz delves into the contributions of Florence Nightingale and the ongoing evolution of nursing theory. Understand key concepts that shape nursing knowledge and its practical applications.