Chapter 5 Theories of Nursing Practice PDF

Chapter 5 Theories of Nursing Practice Copyright © 2019 by Elsevier, Inc. All rights reserved.  Science and Theory  Science  A method of bringing together facts and giving them coherence and integrity  Scientific inquiry involves five aspects...

Chapter 5 Theories of Nursing Practice Copyright © 2019 by Elsevier, Inc. All rights reserved.  Science and Theory  Science  A method of bringing together facts and giving them coherence and integrity  Scientific inquiry involves five aspects Hypothesis Method Data collection Results Evaluation Copyright © 2019 by Elsevier, Inc. All rights reserved. 2  Critical Thinking Question 1. When analyzing the data from her research study, a nurse researcher finds that nurses who work under indirect sunlight have 20% fewer headaches, which are less severe than reported by those who work under fluorescent lighting. Which step of scientific inquiry does this action by the nurse researcher represent? A. Hypothesis B. Method C. Data collection D. Evaluation Copyright © 2019 by Elsevier, Inc. All rights reserved. 3  Science and Theory (Cont.)  Theory  A group of related concepts that explain existing phenomena and predict future events  Criteria for theory acceptance involve six factors Inclusiveness Consistency Accuracy Relevance Fruitfulness Simplicity Copyright © 2019 by Elsevier, Inc. All rights reserved. 4  Critical Thinking Question 2. For a theory to be reliable and acceptable for guiding nursing practice, another nurse should be able to duplicate the theory. Which criterion for theory acceptance deals with replication? A. Fruitfulness B. Relevance C. Accuracy D. Simplicity Copyright © 2019 by Elsevier, Inc. All rights reserved. 5  Nursing Science  Collection of data related to nursing that may be applied to the practice of nursing  Guides the practice of nursing to better serve clients Copyright © 2019 by Elsevier, Inc. All rights reserved. 6  Theories, Models, and Frameworks  Theory  An abstract generalization that presents a systematic explanation about how phenomena are interrelated  Must include at least two concepts that are related in a way that the theory explains Copyright © 2019 by Elsevier, Inc. All rights reserved. 7  Theories, Models, and Frameworks (Cont.)  Conceptual model or framework  Concepts that are assembled because of their relevance to a common theme  Conceptual framework used interchangeably with conceptual model  More loosely structured than theories  Four concepts basic to nursing that are included in models are nursing, person, health, and environment Copyright © 2019 by Elsevier, Inc. All rights reserved. 8  Nursing Theory  Guides research and practice  Basic ingredients are concepts  Examples of nursing concepts: health, stress, and adaptation  Language of nursing theory  Concept  Construct  Conceptual model  Philosophy  Theory Copyright © 2019 by Elsevier, Inc. All rights reserved. 9  Schematic Models  Demonstrate concepts, usually through a picture or visual representation of ideas  Clarify and show relationships between complex concepts  Illustrate the layout and features specific to a theory—similar to the blueprint of a building Copyright © 2019 by Elsevier, Inc. All rights reserved. 10  Levels of Theory  Range from a broad scope to a smaller, more specific scope  Grand Theory—broad in scope; describes and explains large segment of the human experience  Middle Range Theory—smaller in scope and may refer to a specific population Copyright © 2019 by Elsevier, Inc. All rights reserved. 11  Florence Nightingale: The First Nursing Theorist  Influences that directed her toward nursing theory  Classic education  Upper class life  Religion and spirituality  Era of reform throughout England Copyright © 2019 by Elsevier, Inc. All rights reserved. 12  Canons of Nursing  Theory of practice “canons of nursing”— foundation for health promotion and guidance for the practice of professional nursing  Ventilation and warming  Noise  Variety  Diet  Light  Chattering hopes and advice  Cleanliness Copyright © 2019 by Elsevier, Inc. All rights reserved. 13  Nursing Theorists  Peplau (1952)—Interpersonal relations as a nursing process: man as an organism that exists in an unstable equilibrium  Explored interpersonal relationship of the nurse and the client  Identified the client’s feelings as a predictor of positive outcomes related to health and wellness Copyright © 2019 by Elsevier, Inc. All rights reserved. 14  Nursing Theorists (Cont.)  Betty Neuman (1970)—The System Model  Focuses on the response of the client system to actual or potential environmental stressors and the use of several levels of nursing prevention interventions for attaining, retaining, and maintaining optimal client system wellness Copyright © 2019 by Elsevier, Inc. All rights reserved. 15  Nursing Theorists (Cont.)  Rogers (1970)—science of unitary human beings: humans as energy fields that interact constantly with the environment  Science of unitary man: energy fields, openness, pattern, and organization  Nurse promotes synchronicity between human beings and their universe/environment Copyright © 2019 by Elsevier, Inc. All rights reserved. 16  Nursing Theorists (Cont.)  Orem (1971)—Self-care Deficit model: Self-care, Self-care deficits, and nursing systems  Facilitates client self-care by measuring the client’s deficit relative to self-care needs  Nurse implements appropriate measures to assist the client in meeting needs by matching with an appropriate supportive intervention Copyright © 2019 by Elsevier, Inc. All rights reserved. 17  Nursing Theorists (Cont.)  Roy (1974)—Adaptation model: Assistance with the adaptation to stress to facilitate the integration process of the client  Nurse will be the change agent in assisting the individual with adaptation when an insult renders him or her in need of environmental modification  Adaptation occurs by assisting the biopsychosocial client in modifying external stimuli Copyright © 2019 by Elsevier, Inc. All rights reserved. 18  Nursing Theorists (Cont.)  Madeline Leninger (1977)—Theory of cultural care diversity and universality  Transcultural nursing and caring nursing  Concepts are aimed toward caring and the components of a culture care theory  Diversity, universality, worldview, and ethnohistory are essential to the four concepts (care, caring, health, and nursing) Copyright © 2019 by Elsevier, Inc. All rights reserved. 19  Nursing Theorists (Cont.)  Watson (1978)—Theory of Human Caring: transpersonal caring as the fulcrum: Philosophy and Science as the core nursing  Caring among nurse, environment, and client is essential to healing  Holistic outlook addresses the effect and importance of altruism, sensitivity, trust, and interpersonal skills Copyright © 2019 by Elsevier, Inc. All rights reserved. 20  Nursing Theorists (Cont.)  Newman (1979, revised 1986)—Health as expanding consciousness  Defines health as “expanding consciousness,” or increasing complexity  Theory stimulated by concern for those whom health as the absence of disease or disability is not possible  Nurse’s role: recognize person’s unique pattern of life and work within that pattern to achieve person’s goals  Every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness Copyright © 2019 by Elsevier, Inc. All rights reserved. 21  Nursing Theorists (Cont.)  Mishel (1981, revised 1997)—Uncertainty of illness  Uncertainty in illness is stress-producing and capable of contributing to negative physical and/or psychological outcomes  Uncertainty exists when client is unsure about a diagnosed illness  Four-step framework assists nurses in working with clients: stimuli frame, appraisal stage, initiation of coping mechanisms, and adaptation Copyright © 2019 by Elsevier, Inc. All rights reserved. 22  Future of Nursing Theories and Theorists  Health care concerns in the twenty-first century  Primary focus of federal and state legislative agendas  Major concerns: uninsured population, patient safety, nursing shortage, rising health care costs, technology, confidentiality issues, and advanced practice nursing Copyright © 2019 by Elsevier, Inc. All rights reserved. 23