TFN 1-1.docx

What is the essence of nursing today? Over the years, nursing is described as both an "art" and a "science". The art of nursing practice is grounded in scientific principles. Nursing theories provided the scientific and professional foundation to nursing knowledge development. Moreover, nursing the...

What is the essence of nursing today? Over the years, nursing is described as both an "art" and a "science". The art of nursing practice is grounded in scientific principles. Nursing theories provided the scientific and professional foundation to nursing knowledge development. Moreover, nursing theories reinforce the nursing profession's emphasis on evidence-based practice (EBP)- practice with meaning. Theory without practice is empty; practice without theory is blind. CONCEPT Mental idea of a phenomenon. A comprehensive idea or generalization. An idea that brings diverse elements into a basic relationship. A unit of thought "A general idea formed in the mind. PRINCIPLE A basic generalization that is accepted as true and that can be used as a basis for reasoning or conduct. THEORY A set of statements that tentatively describe, explain, or predict relationships among concepts that have been systematically selected and organized as an abstract representation of some phenomenon. An explanation for some phenomenon that is based on observation, experimentation, and reasoning. IMPORTANCE OF NURSING THEORIES 1\. Aim to describe, predict and explain the phenomenon of nursing. 2\. Provide the foundation of nursing practice. 3\. Help provide better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education. 4\. Establish unique body of knowledge. CONCEPTUAL FRAMEWORK/MODEL A set of interrelated concepts that symbolically represents and conveys a mental image of a phenomenon. \*Conceptual models of nursing identify concepts and describe their relationships to the phenomena of central concern to the discipline: person, environment, health and nursing. COMPONENTS OF A THEORY Concepts Definitions Assumptions Phenomenon CONCEPTS ➤A theory is composed of interrelated concepts. ➤Concepts help to describe or label phenomena. Example: 1\. Levine's conservation model in nursing practice; a\. Conservation b\. Adaptation c\. Wholeness DEFINITIONS ➤The definitions within the description of a theory convey the general meaning of the concepts in a manner that fits the theory Example: 1. Levine's conservation model defines CONSERVATION as the keeping together of the life system; that individuals continuously defend their wholeness. Accordingly, WHOLENESS exists when the interactions or constant adaptations to the environment permit the assurance of integrity. ADAPTATION defines as an ongoing process of change whereby individual retain their integrity within the realities of their environment. ASSUMPTIONS ➤Are statements that describe concepts or connect two concepts that are factual. Example: 1. The assumptions in Levine's Conservation Model are that; individuals continuously defend their wholeness; adaptation is an ongoing process of Change; nursing is human interaction; nurses promote Wholeness through the use of conservation principle. PHENOΜΕΝΟΝ ➤Is an aspect of reality that can be consciously sensed or experienced. Example: 1\. Caring 2\. Self-care 3\. Client response to stress 4 Major Concepts 1. Person repers to all human, (recipients of th nursing care) individuals, families, communities, and groups. 2- Environment -- factors that affect individual internally and externally. -settings where nursing care is is provided Internal- depression, anxiety. Problems, stress External -- water, foods, shelter, disaster, clothing 2. Health-addresses the person's stale of ned being. "Health is a state of complete physical, mental and well-being and not merely the absence of disease or Infirmity. 3. Nursing-central to all nursing theories. Nursing is what nurses do and how nurses interact with client. Essence of Nursing: caring Non-Nursing Theories used in nursing GROWTH AND DEVELOPMENT The developmental theories focus on the growth (addition of new skills or components) and development (refinement, expansion or improvement of existing skills or components) of an individual throughout the life span. 1. GROSS MOTOR DEVELOPMENT (Cephalocaudal) Age Developmental Milestone Observation 1. month 2. Head lag 1. months 2. Lift head 3. months 4. Lift head and chest 5. months 6. Roll over-risk for fall 7. months 8. Sit with support 7 months Bounce foot/bouncing-stretch leg muscle and strengthen muscles- preparation for standing and walking 9. months 10. Sit without support 9 months Crawl 11. months 12. Stand with support 11 months Cruising-two hands hold by the mother 13. months 14. Stand without support Walk with support- using 1 hand to hold 15. months 16. Walk without support 17. months 18. Jumping 3 years old Running Riding tri-bike FINE MOTOR DEVELOPMENT Age Developmental Milestone Observation 1-3 monthsp Close fist Arm movement 5 months Close and open hands Grasp object/hold To give: rattle toy 7 months Hold and transfer object (crude pincer grasp) 9 months Near pincer grasp -- use thumb pointing finger- accumulate tiny objects-risk for aspiration, choking and poisoning 12 months Throw balls-promote walking 2 years old Drawing Line draw 3 years old Circle/curve draw 4 years old Square/rectangle draw 5 years old Triangle, Diamond draw 6 years old All shapes can be draw Language Development Age Language observed 1-2 months Cry-open mouth Wild cry (normal) High pitch cry (abnormal)- s/s of increase ICP (increase intracranial pressure-7-15 mmhg) 3 months Cooing sound 4 months Vowel sounds (a,e,I,o,u) sound produce 5 months Consonant sound 7 months Closed mouth loud cry (mmmmmm cry) 9 months 2 vocabulary words (mama and papa) 12 months 4 words verbalized Mama, papa + 2 words -- depending on the mother's teaching CHANGE THEORY (KURT LEWINS) 3 MAJOR CONCEPTS 1\. Driving forces- are those that push in a direction that causes change occur. 2\. Restraining forces- are those forces that counter the driving forces. 3\. Equilibrium -- is a state of being where driving forces equal restraining forces and no change occurs. 3 STAGES OF CHANGE THEORY 1. Unfreezing- is the process which involves finding a method of making it possible for people to let go of the old pattern that was somehow counterproductive. 3 methods to achieve unfreezing increase the driving forces that direct behavior away from the existing behavior. decrease the restraining forces that negatively affect the movement from the existing equilibrium. combination of the two methods 2. Change stage-moving to a new level. The change of thought, feeling, behavior to a more productive way. 3. Refreezing-establishing the change as the new habit so that it now becomes the standard operating procedure. MAJOR ASSUMPTIONS ✓ People grow and change throughout their lives. This growth and change are evident in the dynamic nature of basic human needs and how they are met. ✓ Change happens daily. ✓ Reactions to change are grounded in the basic human needs for self-esteem, safety and security. ✓ Change involves modification or alteration.