SEHH2258 Nursing Theories and Models Lecture 3

SEHH2258 Fundamental Concepts of Health and Nursing - Lecture 3: Nursing Theories and Models

• Learning Outcomes:
  • Differentiate theory, concept, conceptual framework, paradigm, and metaparadigm for nursing.
  • Describe major purposes of applying nursing theories in nursing practice.
  • Identify roles of nursing theory in education, research, and clinical practice.
  • Discuss common nursing theories within the metaparadigm for nursing.

Common Terms

• Concepts: Building blocks of theories, sets of thoughts/behaviors.
• Conceptual Framework: A group of related ideas, statements, or concepts; often used interchangeably with "conceptual model" and "grand theories".

Common Terms (Continued)

• Theory: A system of ideas explaining a phenomenon. Built upon or modifies previous theories; varies by discipline.
• Paradigm: A pattern of shared understandings and assumptions about reality and the world. Includes notions of reality that are largely unconscious. Awareness of paradigms is needed when realities or world views clash, as seen in conflicts between religious doctrines and scientific discoveries.

Metaparadigm for Nursing

• Concept that can be superimposed on almost any nursing work.
• Most nursing theories are built on the metaparadigm, although with a variety of ideas within that paradigm.
• Four major metaparadigms in nursing:
  • Person
  • Environment
  • Health
  • Nursing

Metaparadigm for Nursing (Person)

• Individuals/clients who are recipients of nursing care (e.g., individuals, families, groups, communities)
• Unique and holistic beings with the potential to learn and develop through interacting with the environment.
• Have intrinsic worth and right to participate in decision-making.
• Must always be treated with respect.

Metaparadigm for Nursing (Environment)

• Internal environment includes biological, psychological, spiritual, and intellectual components.
• External environment includes social, cultural, and situational influences.
• Internal and external environments interact continuously, affecting functioning and creating positive or negative stressors.
• Creation, preservation, and conservation of a healthy environment are crucial for maintaining and promoting health.

Metaparadigm for Nursing (Health)

• A state of well-being experienced by clients at specific points in time along the health-illness continuum.
• Affected by biological, psychological, socioeconomic, developmental, political, cultural, and religious factors.
• Level of well-being depends on equilibrium within the person and between the person's interaction with the changing environment.

Metaparadigm for Nursing (Nursing)

• Holistic, client-focused, and evidence-based care at primary, secondary, and tertiary levels of healthcare.
• Promotes and maintains health for individuals, families, groups, institutions, home settings, and communities through problem-solving and collaboration with clients and other healthcare professionals.
• Relies on research-based professional knowledge and skills through the nursing process.
• Effective communication, interpersonal skills, and ethical principles are crucial.
• Quality is maintained through professional competency enhancement and continuous nursing education.

Nursing Theory

• Before 1900s, limited/no theories for nursing practice.
• As a profession, nurses need to develop concepts and theories specific to nursing.
• Nursing theory is an organized and systematic articulation of a set of statements related to questions in the discipline of nursing.

Role of Nursing Theory (Education)

• Nursing theory can organize concepts into frameworks.
• It forms the basis for curriculum development.
• Nursing theory elucidates central meanings of the profession and improves its stature.

Role of Nursing Theory (Research)

• Nursing theory helps identify philosophical assumptions and conceptual frameworks for research.
• It helps in generating new ideas, research questions, and interpretation, directly contributing to the improvement of clinical practice.

Role of Nursing Theory (Clinical Practice)

• Nursing theory identifies practice goals to improve quality of care.
• It supports clinical reflection, questioning, and thinking about nursing practices (critical thinking).
• It provides a knowledge base for appropriate acting and responding in nursing care situations (problem-solving).
• It facilitates the application of evidence-based practice.

Common Nursing Theories

• Florence Nightingale: Meeting the patient's needs within the environment (factors like ventilation, cleanliness, diet, light, etc.).
• Virginia Henderson: Patient requires help to reach independence (physical and psychological). 14 fundamental needs.
• Martha Rogers: Humans are a four-dimensional energy field interacting with the environment.
• Dorothea Orem: Self-care is a human need. Assisting clients with self-care deficits.
• Callista Roy: Humans are biopsychosocial beings existing in an environment and adapting to it.
• Betty Neuman: Humans always exist in relationships with stressors in the environment. Reconstitution is the state of adaptation to stressors.
• Jean Watson: Practice of caring is central to nursing.