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Questions and Answers
What does the metaparadigm in nursing primarily address?
Which of the following best explains ontology in the context of nursing philosophy?
What is the role of philosophy within scientific disciplines such as nursing?
Which area of philosophy investigates how we know that something is true?
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What do nursing philosophies generally propose?
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What is the highest level of abstraction in nursing conceptual frameworks?
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In the context of nursing, which statement about concepts is true?
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Which type of theory is most specific to nursing practice and deals with precise factors?
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Which philosophical area focuses on the nature of moral conduct?
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How does research relate to nursing practice according to the described dynamic and reciprocal relationship?
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Which of the following correctly describes a grand theory in nursing?
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How does a theorist's world view affect nursing practice?
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What do philosophies in nursing primarily aim to present?
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What role do conceptual models serve within nursing theory?
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What distinguishes theories from models in nursing?
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An example of middle-range theory in nursing could be which of the following?
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What is the primary focus of the Totality Paradigm in nursing?
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Which form of knowledge in nursing is primarily concerned with moral principles?
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What challenge contributes to the theory-practice gap in nursing?
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Which aspect of nursing is emphasized by the Humanbecoming Paradigm?
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What criticism has been directed at Ida Orlando's problem-solving approach in nursing?
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What is a primary reason for the theory-practice gap in nursing?
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Which of the following best describes a disadvantage of categorization in electronic databases for nursing?
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What attribute is commonly associated with the theory-practice gap?
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Which statement reflects a common interpretation of the theory-practice gap?
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Why might some practitioners view nursing theory as irrelevant?
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What characterizes grand theories in nursing?
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Which theory emphasizes family-centered care?
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Which of the following is a key concept that represents the relationship between theory, practice, and research in nursing?
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What is a main focus of middle-range theories in nursing?
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Who proposed the theory that emphasizes the importance of the environment on health?
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Which of the following best describes descriptive theories in nursing?
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Which statement most accurately reflects a debate within the nursing paradigm?
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Which theorist is associated with interactions theories in nursing?
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Study Notes
Nursing Theory and Practice
- Nursing theory, research and practice are interconnected and influence decision-making, interventions, and evaluations in nursing.
Levels of Abstraction in Nursing Theory
- Metaparadigm: Most abstract level, addressing central nursing concepts like person, health, environment, and nursing.
- Philosophies: Present the general meaning of nursing and nursing phenomena through reasoning and logic.
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Conceptual Models (Paradigms or Frameworks): Less abstract than philosophies, provide foundations for nursing theories.
- Grand Theories: Broad, applicable to all patients, examples include Roy Adaptation Model, Orem Self-Care model, and Newman Systems Model.
- Theory: Proposes testable directions or actions.
- Middle-Range Theory: Most specific, focused on factors like age group, patient/family situation, and nurse actions.
Key Concepts in Nursing Theory
- Concepts: Abstract ideas or mental images representing phenomena, bringing forth meaning and properties of objects, events, or things.
Philosophy as a Feature of Scientific Disciplines
- Ontology: Investigates the nature of being human and reality (e.g., purpose of existence).
- Epistemology: Investigates the nature of knowledge (e.g., how we know something is true).
- Ethics: Focuses on moral conduct and judgment.
Nursing Philosophies
- Broad statements of values and beliefs, proposing general ideas about nursing's nature and concerns.
- Address one or more metaparadigm concepts in a philosophical way.
Relationship between Theory, Practice, and Research
- Theories inform practice, research refines theories, and practice tests theories, creating a continuous cycle of improvement in nursing care.
Types of Nursing Theories
- Grand Theories: Broad, abstract, not easily testable (e.g., Nightingale's theory).
- Middle-Range Theories: Narrower in scope, can be empirically tested.
- Practice-Based Theories: Directly apply to day-to-day nursing (e.g., The McGill Model by Dr. Moyra Allen).
Classifications of Nursing Theories
- By Abstraction: Conceptual models, grand theories, middle-range, and practice-level.
- By Goal: Descriptive (describes phenomena) or prescriptive (directs interventions).
Notable Models and Theories
- Florence Nightingale's foundational theory of health and environment.
- The McGill Model focuses on family-centered care.
Paradigm Debates
- Ongoing discussions about the nature of nursing knowledge (e.g., is nursing an art or science?).
- Frameworks include the Totality Paradigm (focused on health as biological balance) and the Humanbecoming Paradigm (focused on personal growth and human experience).
Ways of Knowing Beyond Science
- Nursing integrates various knowledge forms:
- Empirical (science)
- Ethical (moral knowledge)
- Personal (self-awareness)
- Aesthetic (the art of nursing)
- Emancipatory (social justice in health).
Theory-Practice Gap
- Challenges in applying theory to clinical practice, including:
- Abstract language in theory.
- Task-focused nursing practice.
- Prioritizing evidence-based practice over theoretical approaches.
- Pressure to meet institutional outcomes that do not necessarily prioritize nursing theory.
Overcoming the Theory-Practice Gap
- Better integration of theory into practice.
- Emphasis on nursing theory in graduate programs.
Branding Nursing Theory
- Raising awareness and promoting the value of nursing-specific theories across interdisciplinary fields.
Practice-Based Theory: Nursing Process
- Ida Orlando's problem-solving approach (1961): Still used today, originally had four steps without "diagnosing".
- Criticism of Orlando's approach: Too linear and rigid, potentially dehumanizing.
Nursing Diagnosis
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North American Nursing Diagnoses Association (NANDA) developed in the 1970s: List of common patient problems addressed by practicing nurses.
- Advantages: Categorization in electronic databases.
- Disadvantages: Barriers to individualized care, potentially dehumanizing labels.
Closing the Theory-Practice Gap
- Bringing theory into practice is crucial.
The Theory-Practice Gap: A Broader Perspective
- Represents a challenge in translating theoretical knowledge into practical application.
- Multiple interpretations exist, including:
- Differences between idealized practice and common practice.
- Challenges in applying general principles to specific situations.
- Difficulty in bridging the gap between abstract theory and practical application.
- Discrepancies between scientific knowledge and common practice.
- Disconnects between personal understandings of nursing and published theories.
Attributes of the Theory-Practice Gap
- Relational problems between university and clinical practice.
- Practice failing to reflect theory.
- Theory perceived as irrelevant to practice.
Reasons for the Theory-Practice Gap
- Discomfort with abstract language or alternate disciplinary values.
- Negative attitudes towards theory, viewing it as belonging to academia and not applicable to everyday practice.
- Focus on ritualistic, task-focused practice.
- Perceived incompatibility between evidence-based practice and theories.
- Pressure to meet competing outcomes that do not include or prioritize nursing theory.
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