NCM 11- Theoretical Foundations in Nursing PDF

NCM 11 - Theoretical foundations in Nursing Semester 1 | A.Y. 2024-2025 @vgsns_ COURSE OUTLINE 2.0 Components of a Theory I. Nursing Theory II. Development...

NCM 11 - Theoretical foundations in Nursing Semester 1 | A.Y. 2024-2025 @vgsns_ COURSE OUTLINE 2.0 Components of a Theory I. Nursing Theory II. Development Process A. -building blocks of theories Concepts -a complex mental formulation of an object, property, or event that is derived from individual perceptual experience TOPIC 1 Nursing Theory -an idea, mental image or a generalization formed and developed in the mind -basic unit in the language of theoretical thinking; can be empirical (or concrete) or 1.1 What is a Theory? abstract A theory is a quantitative evidence, a proposed relationship B. between concepts, it is considered more proven than -statements of the meaning of a word, Definitions phrase or term models, “Tested and measured” A theory helps explain an event by defining ideas or -to communicate the meaning of the concepts, explaining relationships among the concepts, and concept of a theory predicting outcomes (McEwen and Wills, 2014) -may be theoretical/conceptual or Theories offer ways of conceptualizing a discipline in a clear, operational explicit terms that can be communicated to others (Kozier, 2019) -theoretical or conceptual definitions define a particular concept Theory 2 types of Definitions: ➔ concepts-thought ; view Theoretical - Conveys the general meaning of the concept in ➔ Definitions - explain; reason Definition a manner that fits the ➔ Relationships - link theory ➔ Assumptions - guess; belief Ex. Pain is a discomfort ➔ Propositions - proposal; scheme Operational - Specifies “the activities of operations necessary to Definition measure a construct of variable” - state how concepts are 1.2 What is Nursing Theory? measured Ex. Discomfort is experienced when a patient rates pain from a 6-10 A conceptualization of some aspect of nursing range. communicated for the purpose of describing, explaining, predicting, and or prescribing nursing care (Potter, P. & Perry A., 2017, 9th ed.) ★ Important Note Nursing Theory The definition of the 4 major concepts vary in accordance with personal philosophy, scientific orientation, ➔ Helps to identify the focus, means and goals of experience in nursing, and how the experience has affected the theorist’s view of nursing. practice ➔ Offers a perspective for assessing patient’s Ex. Martha E. Rogers (Theory of Unitary Human Being) Ex. Sister Calista Roy (Adaptation theory) situations Ex. Florence Nightingale (Her experience in nursing) ➔ Helps organize, analyze and interpret data ➔ Guides knowledge development and directs education, research, and practice C. -statements that describe concepts or Assumptions connect two concepts that are factual ➔ Nursing theories address and specify relationships and are acceptable as truths and are among 4 major concepts: Person/Client, based on values and beliefs Environment, Health/Illness, and Nursing -”taken for granted” statements that determine the nature of the concepts, definitions, purpose, relationship, and structure of the theory NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 Client -recipient of nursing care -are statements supposed to be true Patient without proof or demonstration Person -individual or collective (family, Individual community) -individualized patient-centered care Example Complex entity- affected by various interrelating factors such as the mind and the body; Jean Watson (Caring theory) has the assumption that a environment conscious intention to care promotes healing and - Person’s needs are wholeness. multidimensional, therefore care must be individualized D. -the reality on “what exists in the real Phenomenon -composed of physical intellectual, world” biochemical, and psychosocial needs; a human energy field, a -aspects of reality that can be holistic being in the world; an consciously sensed or experienced open system; an integrated whole, an adaptive system; a being -to describe an idea or responses greater than the sum of its parts about an event, a situation, a process or a group of events Health -A continuum ranging from a completely healthy state where there is no disease to a completely Example: unhealthy state which results from a multifactorial phenomenon. -The ability to function independently; successful adaptation to life’s stressors; achievement of one’s life potential; unity of the mind, body and soul. -Defined in different ways by the client, the clinical setting, and the healthcare profession -Goal of nursing is geared towards optimum level of health -Dynamic state of being in which the developmental and behavioral potential of the individual is realized to the fullest extent possible 3.0 Paradigm Environment -Includes all possible conditions affecting the client and the setting where they go for their health care (Potter and Perry, 9th ed.2017) - Continuous interaction between 3.1 What is a Paradigm? patient and environment physical environment A paradigm is an organizing framework that contains elements (living conditions, public concepts, theories, assumptions, beliefs, values, and sanitation, air and water quality) ▪ principles that form the way a discipline interprets the factors such as IPR and social subject matter with which it is concerned. interactions; Nursing Paradgim internal environmental factors that affect health (psychological process, religious ➔ Directs the activity of the nursing profession, beliefs, sexual orientation, including knowledge, philosophy, educational personality and emotional experience, practice orientation, research responses) methodology, and literature identified with the professions. -internal and external conditions that influence the organism 3.2 Components of a Paradigm -With positive and negative effects on a person’s level of health and health care needs @vgsns_ NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 -an open system with boundaries that permit the exchange of 4.0 What is Nursing Philosophy? matter, energy, and information with human beings. Nursing protection, promotion, and 4.1 What is Philosophy? optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the Philosophy diagnosis and treatment of human response, and advocacy in the care of individuals, families, ➔ A study of problems that are ultimate, abstract and communities and populations general (nature of existence, knowledge, morality, reason and human purpose) Nurses use critical thinking skills ➔ Tries to discover knowledge and truth and attempts and integrate knowledge, to identify what is valuable and important experience, attitudes, and ➔ STATEMENT OF BELIEFS AND VALUES ABOUT standards into the individualized HUMAN BEINGS AND THEIR WORLD plan of care for each client ➔ concerned with the purpose of human life, the nature of being and reality, and the theory and Science and art, a practice limits of knowledge discipline and involves caring ➔ Intuition, introspection, and reasoning are examples of philosophical methodologies. Goals : care of the well, care of the sick, assisting with self-care activities, helping individuals attain ★ Important Note their human potential, and discovering and using nature’s law of health The Science of any discipline is tied up to its Philosophy. 8 Nature’s Law of Health 4.2 What is Nursing Philosophy? ★ NUTRITION Nursing Philosophy ★ EXERCISE ★ WATER ★ SUNLIGHT ➔ refers to the belief system of the profession and ★ TEMPERANCE provides perspectives for practice, scholarship , ★ FRESH AIR and research. ★ REST ★ TRUST Philosophy of Science in Nursing ➔ helps to establish the meaning of science through an understanding and examination of nursing 4.0 What is Nursing Science? concepts, theories, laws, and aims as they relate to nursing. Science 5.0 Purposes of Nursing Theory ➔ theoretical explanation of the subject of inquiry and the methodological process of sustaining knowledge in a discipline Education -establish the profession’s place in the university ➔ A process and a product -provides a general focus for ➔ process - is a systematic inquiry that relies on curriculum design -guides curricular decision making empirical observations of the natural world 1970’s-1980’s - nursing programs ➔ product - is the empirical knowledge that is identified major concepts in one or two nursing models grounded and tested in experience and is a result Purposes : of investigative efforts. 1. to elucidate the central meanings of the profession Nursing Science 2. to improve the status of the profession ➔ provides knowledge for all aspects of nursing. Research offers framework for generating knowledge and new ideas; ➔ the substantive discipline–specific knowledge that offer a systematic approach to focuses on the human-universe-health process identify questions for study, select variables, interpret findings, and articulated in the nursing theories and frameworks. validate nursing interventions. @vgsns_ NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 assist in discovering knowledge Clarifying and valuing form the gaps in the field of study foundation of personal ethic. Clinical To differentiate the focus of nursing from other professions. Ethical knowledge provides ethical Practice insight as to what decisions are To structure professional nursing possible. practice, education and research. Assist nurses to describe, explain, Can’t be tested– rest on underlying and predict everyday experiences philosophy, reasoning that can’t be Provide a rationale for collecting empirically known. reliable and valid data about the health status of the client Serve to guide assessment, intervention, and evaluation of nursing care. Esthetics Imparting meaning to what is being (Art of expressed in the encounter. Help build a common nursing terminology to use in Nursing) "relating to the here and now” communicating with other health professionals Creating unique, meaningful, deeply Help establish criteria to measure moving interactions with others the quality of nursing care. Enhance autonomy of nursing Artful ways by which nurses interact through defining its own with people and perform skilled independent functions. tasks. Can’t be replicated – it is done in the moment e.g. active listening, 5.0 Ways of Knowing authentic presence. Personal Inner experience of becoming a Knowledge whole aware self Refers to the knowledge we have of ➔ knowing that can be shared or communicated: ourselves and what we have seen words, symbols, actions, art or sounds. and experienced 5.1 4 patterns of Knowledge 5.2 Personal Knowing Emperical gain from research and objective (Science of facts; use of evidenced-based One strives to know the self & knowing another human Nursing) practice (EBP) being as a person. Draws on traditional ideas of science The creative processes of personal knowing are opening, of which reality is viewed as centering, and realizing. something that can be verified by other observers. Assumption – what is known is that Self-description personal knowing which is accessible through the senses that which can be seen, touched, heard. Retrospective the self that was (past) Predict relationships. Opening taking in the fullness of the experience with conscious awareness Ethics Focus on matters of obligations or (Moral what ought to be done. knowledge Centering the process of judgment about what should be contemplation and in nursing) introspection that forms done, what is “good” and “right” and what is “responsible”. inner personal meaning from life experiences Involves confronting conflicting values, norms, interests, or principles. Realizing process of expressing through personality, Attitudes and knowledge derived behavior, words, and deeds from an ethical framework - the real, whole self that is awareness of moral questions and consistent with what is choices. experienced in the inner life @vgsns_ NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 Publication of nursing TOPIC 2 Development Process journals, conferences, and doctoral programs 1.1 Terms and Definitions 1.2 SCIENCE & THEORY IN THE EARLY 20TH CENTURY Curriculum -Occurred during 1900-40’s era Goal: develop specialized ★ Important Note knowledge and higher ★ nursing was not recognized as an academic education. discipline or a profession ★ accomplishments of the past century led to the Standardized curricula for recognition of nursing ★ Focus was on empirical research diploma programs ★ prompted to standardize nursing education in diploma programs Addressed nursing action, skills and procedures Discipline ➔ specific to academia Empiricism -Occurred during 1950s,’60s ➔ refers to a branch of education, a department of (research to 70’s learning or a domain of knowledge era) graduate education era Profession ➔ refers to a specialized field of practice, founded Focus on psycho-social and upon the theoretical structure of the science or educational studies knowledge of that discipline and accompanying practice abilities Attempt to show its uniqueness from medicine 1.3 SCIENCE & THEORY IN THE LATE Goal: focus graduate 20TH CENTURY education on knowledge development Theorists : King, Johnsons, ★ Important Note Orem, Rogers and Roy “curriculum era” in 1900-’40s Rationalism -“theory era” 1980s-’90s Nursing education expanded from anatomy and physiology courses to include social sciences, theory-then-research pharmacology and nursing arts strategy Addressed nursing action, skills and procedures tresses the importance of reasoning as the primary method of knowledge 1.4 21st Century building Contributed to knowledge development ★ Important Note Goal: Theories guide “ Theory utilization era” nursing research and practice Provide evidence- based practice (EBP) @vgsns_ NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 ➔ E.g playing music will decrease overt pain Nursing theory as a guide for research, practice, reactions of children receiving parenteral education and administration medications EBP focus on individualized safety and quality health care Situation-producing (prescriptive) Goal: Nursing frameworks produce knowledge for quality care ➔ address nursing therapeutics and consequences of interventions Middle- range theory from quantitative or qualitative ➔ should describe the prescription, the approaches consequences, the type of client and conditions 2.0 Categories or Levels of C. According to Scope Theories 1.Metatheory ➔ theory about theory A. According to Chin & Kramer ➔ Focuses on broad issues such as: identifying the purposes & kinds of theory needed for nursing; developing & analyzing methods for creating MICRO, MOLECULAR & ATOMISTIC nursing theory and proposing criteria for evaluating theory ➔ Most abstract ➔ deals with a portion of a person ➔ Ex. Nursing as an academic discipline & the ➔ e.g. explanation of the physiology of the relationship of nursing to basic sciences phenomena known as pain 2. Grand Theories MACRO, HOLISTIC & MOLAR ➔ Broadest in scope and most complex ➔ theory covers a broad scope ➔ require further specification through research ➔ theories that deal with persons as whole before they can be fully tested ➔ are abstract and are not generally amenable to testing ➔ Nonspecific and comprised of relatively abstract B. According to Type/Purpose of a ➔ concepts that lack operational definitions contain summative concepts that incorporate theory by Dickoff & James smaller-range theories ➔ macro theories Factor-isolating theories (descriptive) EXAMPLE OF GRAND THEORIES ➔ describe, observe, and name concepts, properties and dimensions ★ Orem’s Self Care Deficit Model ➔ does not explain how or why the concepts are ★ Roger’s Unitary Human Beings related ★ Johnson’s Behavioral System’s Model ➔ its purpose is to provide observation and meaning ★ Roy’s Adaptation Model regarding the phenomena ★ Betty Neuman’s System Model ➔ ex… theories of GROWTH and DEVELOPMENT ★ King’s Systems Framework and Theory of Goal describe the maturation process of an individual at Attainment various ages 3. Middle Range Factor-relating theories (explanatory) ➔ Narrower focus ; more precise than grand theories ➔ relate concepts to one another ➔ focus on developing theoretical statements to ➔ attempt to tell how or why the concepts are related answer questions about nursing and may deal with cause and effect and ➔ provide the basis for generating testable correlations hypotheses related to particular nursing ➔ Ex. the effect of massage on the overt pain phenomena and to particular client populations reactions of women during the second stage of ➔ EXAMPLE Rosemarie Parse drew concepts from labor the work of Martha Rogers (Tomey and Alligood) Situation-relating (predictive/promoting/inhibiting) ➔ prediction of precise relationships between concepts ➔ experimental research is used to generate ideas @vgsns_ NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 3.0 Non-Nursing Theories 2. Systems Theory ➔ General System Theory (GST) evolved and Open 1. Abraham Maslow’s Hierarchy of System Theory (OST) formed Needs ➔ Framed by Ludewig von Bertallanfy in 1920’s and 1930’s, respectively ➔ GST focused on the physical aspect of systems, subsystems, and environments. ➔ OST focused more on their interactions, which help the whole system to be self – regulating. ➔ NURSING PROCESS – also a system; goal is to organize and deliver patient-centered care ★ Important Note ★ Nursing theories based on systems theory (Roy & Neuman) EXPLANATION OF HIERARCHY ★ System- a set of interrelated parts arranged in a unified whole 1. Physical dimension - Physiologic needs ★ Open system- interacts both internally and with ✓ Breathing, circulation, temperature, intake of food and its environment fluids, elimination of wastes, movement 2. Environmental dimension - Safety and security needs ✓ Housing, community, climate 3. Sociocultural dimension - Love and belonging needs COLOR PALETTE ✓ Relationships with others, communications with others, support systems, being part of community, feeling loved by others 4. Emotional dimension - Self-esteem needs ✓ Fear, sadness, loneliness, happiness, accepting self 5. Intellectual and spiritual dimensions - Self-actualization needs ✓ Thinking, learning, decision making, values, beliefs, fulfillment, helping others ★ Important Note ★ behavior is motivated or influenced by a hierarchy of human needs ★ Maslow’s theory allows health educators to understand why not everybody responds to the educators’ obviously beneficial and well-meaning interventions @vgsns_ NCM 11 - Theoretical Foundations for Nursing | Asst. Prof. Kathleah S. Caluscusan | A.Y. 2024-2025 @vgsns_