Theoretical Foundations in Nursing

Theoretical Foundations in Nursing

• Concepts are building blocks of theories, representing phenomena of interest or abstractions of how people perceive objects.
• Defining the meaning of a word enhances understanding of phenomena.
• Characteristics of a good theory include:
  • Correlating concepts to generate different perspectives.
  • Logical structure
  • Simplicity while being broad.
  • Providing testable hypotheses for elaboration.
  • Enriching general knowledge.
  • Guidance for clinical practice.
  • Consistency with other theories.

Components and Characteristics of a Theory

• Purpose: Explicitly stated or identifiable in the theory text.
• Concepts: Expressed in language.
• Definitions: Convey the meaning of concepts within the theory.
• Relationships: Systematic connections between concepts.
• Structure: Forms a whole based on interconnections.
• Assumptions: Underlying truths shaping concepts, definitions, purpose, relationships, and structure. May not be explicitly stated.

Nursing Theory

• Refers to related concepts derived from nursing models and other disciplines.
• Guides practice, education, and research.
• Nursing as an art relies on knowledge from past experiences.
• Nursing as a science applies tested knowledge in practice settings.
• Nursing education prepares students for professional practice.

Grand Nursing Theories

• Derived from philosophies, conceptual models, and other theories.
• Less specific than middle-range theories.
• Examples include Levine, Rogers, Orem, and King.

Middle-Range Theories

• Provide answers to specific nursing practice questions.
• Address the specifics of nursing situations.
• Example theories include Mercer, Reed, Mishel, and Barker.

Nursing Paradigms

• Key elements include:
  • Person: The recipient of care (individuals, families, groups, communities).
  • Health: The experience of wellness and well-being, often related to goal achievement, adaptation and resilience.
  • Environment: Internal and external factors affecting the client (people, physical environment, significant others).
  • Nursing: The actions and characteristics of the nurse responsible for client care.

Florence Nightingale's Environmental Theory

• Focuses on the importance of the environment for maintaining health.
• Nightingale emphasized cleanliness, fresh air, pure water, efficient drainage, and light as essential elements of a supportive environment.

Margaret Jean Watson's Theory of Caring

• Caring is central to nursing.
• Emphasizes the relationship between the nurse and the patient, and includes several "carative factors."
• Theory development included the use of a nursing process.

Patricia Benner's Theory of Novice to Expert

• Describes stages of skill acquisition in nursing practice, from novice to expert.
• Recognizes experience as crucial for expert-level practice.
• Focuses on the lived experiences of health, illness, and disease, and the patient.

Other Nursing Theories:

• Rogers: Focuses on the concepts of energy fields and patterning in the human-environment interaction as well as the interconnectedness
• Orem: Highlights the person’s ability to meet their own needs and focuses on the theory of self-care which has a primary emphasis on the person.
• Newman: The model of health focuses on the person as an evolving pattern of consciousness, moving from well-being toward illness or vice versa. Health is viewed as an ongoing, expanding process.
• King: The goal-attainment emphasizes the nurse-client interactions, interpersonal process, and the shared creation and attainment of goals which is important for establishing patient goals and understanding the influence of their actions.

Implementation and Evaluation

• Various factors must be considered for implementation and evaluation of nursing care, including the patient, family or community, and the environment.

Virginia Henderson

• The theory includes the concept of 14 basic needs. This is the most widely known aspect of her theory, though there are other factors to consider as well.

Other Nursing Theories

• Parse: Focuses on the concept of "Human Becoming."
• Peplau: Emphasizes interpersonal relationships and the therapeutic process between the nurse and patient, as well as the various roles of the nurse in the care process.
• Newman: Health as consciousness in interaction, which is fluid, moving between wellness and non-wellness.
• Hildegard Peplau: Emphasizes the nurse-patient relationship.