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TFN: PRE-LIM and compassion FORMALEJO, CARLA N. BSN-1K 5. A code of ethics – right and wrong; moral principle Lessons 6. F...

TFN: PRE-LIM and compassion FORMALEJO, CARLA N. BSN-1K 5. A code of ethics – right and wrong; moral principle Lessons 6. Formal training within institutions of higher education 1. Module 1: Introduction to Theory and 7. Lengthy socialization to the profession Knowledge 8. Autonomy (control of professional activities) 2. Module 2: Introduction to Nursing Theory – self-regulated; self-governing or our own Introduction to Theory and Knowledge Discipline Nursing ▪ Nursing as an Academic Discipline ▪ Over the past five decades it has been ▪ Stand alone recognized as both an emerging profession ▪ Specific to academia and a branch of and academic discipline education, a department of learning, or field ▪ Has social mandate to provide health care of knowledge obeying code of behavior for clients at different points in the health- ▪ Before: nursing depended heavily on illness continuum. physiology, sociology, psychology, and medicine Occupation ▪ Discipline:  An identifiable philosophy ▪ A job or career  At least one conceptual framework (perspective) Profession  Methodologic approach ▪ Nursing as a Profession ▪ Specialized field of practice Philosophy ▪ Founded upon the theoretical structure of ▪ Nursing Philosophy the science or knowledge of that discipline ▪ Motto and the accompanying practice abilities ▪ Belief system of worldview of the profession  Practice – application of knowledge ▪ Provides perspective for practice,  Science – systematized or organized scholarship, and research body of knowledge ▪ Statement that outlines a nurse’s values, ▪ A learned vocation or occupation that has a ethics, and beliefs as well as their status of superiority and precedence within motivation for being part of the profession a division of work. ▪ It will begin the day you first think about it  Vocation – “calling” and see yourself as a nurse. ▪ All professions are occupations, but not all occupations are professions. Nursing Science Characteristics of a Profession ▪ Generate new knowledge ▪ Development of theories and practical 1. Defined and specialized knowledge base, concepts for improving how clinicians and 2. Control and authority over training and patients administer care and manage education – prescribed curriculum conditions. 3. Credentialing system or registration to ▪ Merges the world of natural, applied, and ensure competence – pass the licensure or human science into a multi-dimensional board exam lens 4. Altruistic service to society – selfless; care ▪ Gives direction to the future generation  ▪ Provides knowledge of all aspects of nursing ▪ Epistemology – the study of the theory of ▪ Application of hard sciences with a knowledge; how do we learn things compassionate aim ▪ Epistemologic questions: What do we know? ▪ Best practices in patient care What is the extent of our knowledge? How do we decide whether we know? What are the Recent Advancements in Nursing criteria of knowledge? ▪ Telehealth – method of delivering long- Ways of Knowing distance care through tablets, computers, electronic charts, and smartphones; ▪ Empirics – the scientific form of knowing; communication technology evidences; comes from observation, testing, ▪ Nursing Informatics – information and replication; use of senses management and computer science;  Sense of Hearing defines, manages, and communicates  Sense of Seeing patient care or provider data, along with the  Sense of Smelling resultant insights  Sense of Taste ▪ Photovoice – qualitative method of  Sense of Touch community-based research that uses ▪ Personal Knowledge – a priori knowledge; photographs to encourage knowledge and gained from thought alone; realizations and transformative change, especially among experiences marginalized group; patient-participants are ▪ Intuitive Knowledge – feelings and hunches; asked to capture and share photographs not guessing but relies on nonconscious pattern recognition and experience; instinct Nursing as an Art and anticipation ▪ Somatic Knowledge – soma = body ▪ Doing  Knowledge of the body in relation to ▪ Practice physical movement ▪ Both science and art  Experiential use of muscles and balance ▪ More than just knowing; it is doing to perform a physical task ▪ Bridges information from nurses to patients  Muscle memory in a skillful way  Somatic cells – body cells ▪ Application of all the science known to ▪ Metaphysical (spiritual) Knowledge – nursing presence of a higher power; spiritual ▪ Innate capacity to respond to the needs of knowing includes miracles, psychokinesis, individual extrasensory perception, and near-death ▪ To perform relational work experiences; cannot explain scientifically ▪ Involves the use of: Compassionate, Caring,  Faith & source of hope Conscientious, Competence, and Confidence ▪ Esthetics – knowledge related to beauty, ▪ Compassionate care is paramount. harmony, and expressions; incorporates art, ▪ TLF: Tender Love and Care creativity, and values ▪ Moral or Ethical Knowledge – knowledge of Knowledge Development and Nursing Science what right and wrong  Values ▪ Interface between nursing science and  Social and cultural norms of behavior research. ▪ Rationalism – use of the rational senses in ▪ Goal: to improve the nursing practice ensuring the truthfulness of a phenomenon  Rational – reasons; why? Approaches to Knowledge Development Research Methodology and Nursing Science NURSING HEARTS ▪ Scientific knowledge is generated from ▪ H - Humanistic systematic knowledge ▪ E – Excellent Communicator and ▪ Appropriate, valid, and reliable for the Collaborator purpose of the discipline ▪ A – Adaptive to Evolving Technological ▪ Methodologic Pluralism – quantitative + and Entrepreneurial Healthcare qualitative approach; “Mix Method” Demands Quantitative Approach ▪ R – Responsive to Changes as Lifelong Learners, Grounded in Scientific ▪ Measuring, analyzing, replicating, and Evidence applying the knowledge gained ▪ T – Transformation Leaders ▪ S – Skillful in Nursing Care with Integrity, Qualitative Approach Cultural Sensitivity, With Legal and ▪ Phenomenology – lived experiences Ethical Competence ▪ Aspects of human values, culture, and Introduction to Nursing Theory relationships ▪ Social experience Theory ▪ Give meaning to human life ▪ Set of statements that tentatively describe, Nursing as a Practice Science explain, or predict relationships among concepts that have been systematically ▪ Requires research that is applied and selected and organized as an abstract clinical representation of a phenomena ▪ Generates and tests theories related to ▪ Closest explanation but not 100% true health of human beings ▪ It is the level before the “law” level ▪ Ex: Big Bang Theory and Psychosexual Theory Nursing as a Human Science Sigmund Freud ▪ Issues related to behavior and culture ▪ Biology and Physiology ▪ “Father of Psychology” ▪ Explanatory variables for human health and ▪ Psychosexual Theory – libido; law of illness gratification ▪ Anthropology – study culture, religion ▪ Fixation – hindi nasatisfy yung needs Nursing Theories ▪ What, How, and Why ▪ Organized body of knowledge to define what nursing is, what nurses do, and why do they do it. ▪ Way to define nursing as a unique discipline separate from other disciplines ▪ Promotion of care and independence ▪ Intended to guide the practice of nursing History of Nursing Theories ▪ The first nursing theories appeared in the ▪ 1970 late 1800s when a strong emphasis was ▪ Nursing as both science and art placed on nursing education. Dorothea Orem Florence Nightingale ▪ 1971 ▪ 1860 ▪ Nursing care is required if the client is ▪ “Environmental Theory” – the act of utilizing unable to fulfill biological, psychological, the environment of the patient to assist him developmental, or social needs. in his recovery; food, air, and water ▪ 1950s – consensus among nursing scholars Imogene King that nursing needed to validate itself ▪ 1971 Hildegard Peplau ▪ Theory of Goal Attainment ▪ 1952 Betty Neuman ▪ “Theory of Interpersonal Relations” – nurse- ▪ 1972 client relationship as the foundation of ▪ Many needs exist, and each may disrupt nursing practice client balance or stability. Stress reduction Virginia Henderson is the goal of the system model of nursing practice. ▪ 1955 ▪ “Nursing Need Theory” – 14 fundamental Sr. Callista Roy needs ▪ 1979 ▪ Health promotion; to gain independence ▪ Individual as a set of interrelated system Faye Abdellah who strives to maintain the balance between these various stimuli. ▪ 1960 ▪ “Typology of 21 Nursing Problems” – from a Jean Watson disease-centered approach to a patient- ▪ 1979 centered approach ▪ Philosophy caring highlighted humanistic Ida Jean Orlando aspects of nursing as they intertwine with scientific knowledge and nursing practice ▪ 1962 ▪ Caring science ▪ Reciprocal relationship between patient and nurse and viewed the professional function of nursing as finding out and meeting the patient’s immediate need for help ▪ Process – step-by-step Dorothy Johnson ▪ 1968 ▪ “Behavioral System Model” ▪ Efficient and effective behavioral functioning in the patient to prevent illness Matha Rogers  the theory ▪ Accompanied by pictorial representation of the variables and their interrelationships Conceptual Framework ▪ Set of interrelated concepts that Components of a Theory symbolically represents and conveys mental I. Concepts images of a phenomenon II. Definitions ▪ Conceptual models of nursing identify III. Assumptions concepts and describe their relationships to IV. Phenomenon the phenomena of central concern to the discipline: Person, Health, Environment, Concept Nursing (PHEN) ▪ Building blocks of theories ▪ Vehicles of thought that involve images ▪ Words or phrases that are used to represent the phenomenon observed or experience; identify, define, and establish structure and boundaries for ideas ▪ May be abstract or concrete - Abstract – hindi nahahawakan Definition Hypothesis ▪ Conveys the general meaning of the concepts ▪ An educated guess based upon observation ▪ Two types of definition: ▪ Can be supported or proven false by  Theoretical Definition – concepts are experimentation or continued observation defined in the dictionary or based on the theorist’s perspective Theoretical Model  Operational Definition – how concepts are used or will be used within the ▪ Representations of the interaction among context; using your own words and between the concepts showing patterns ▪ Present an overview of the thinking behind  Assumption ▪ More limited scope ▪ Less abstraction ▪ Assume – root word ▪ Address specific phenomena or concepts ▪ Statements that describe concepts or and reflect practice connect two concepts that are factual ▪ More precise and highly specific in nursing ▪ “taken for granted” statements ▪ “Best of both worlds” – easy applicability in practice and abstract enough to be Phenomenon scientifically interesting ▪ Describe an idea or responses about am ▪ Easier to apply as frameworks for research event, situation, a process, a group of events studies or situations. Practice Theory Classification of Nursing Theories ▪ Called as “Situation-specific theories, ▪ Based on scope refers to complexity and prescription theories” degree of abstraction ▪ Least complex and “action-oriented” ▪ Abstract – mahirap iapply sa practice ▪ More specific than Middle range theories and produce specific directions for practice ▪ Limited to specific populations or fields of practice Metatheory ▪ Meta – beyond ▪ A.k.a Nursing Philosophies ▪ Theories whose subject matters are some other theories (theories about theories) ▪ Describe the philosophical bases of the discipline Types of Purpose of Theory ▪ Highest level of theory in terms of I. Factor-isolating theories (descriptive abstraction; very difficult for practical theories) application II. Factor-relating theories (explanatory Grand Theory theories) III. Situation-relating theories (predictive ▪ Describe the comprehensive conceptual theories or promoting or inhibiting theories) frameworks IV. Situation-producing theories (prescriptive ▪ A.k.a Nursing Conceptual Models theories) ▪ Broad in scope and complex; requires further specification through research before they Factor-isolating theories (descriptive theories) can be tested ▪ Describe, observe, and name concepts, ▪ Broad, nonspecific, and general areas and properties, and dimension but does not concepts explain how or why concepts are related. ▪ Lack operation definitions ▪ Descriptive research techniques including Middle-Range Theory concept analysis, case studies, literature  review phenomenology, ethnography, and grounded theory Factor-relating theories (explanatory theories) ▪ Related concepts to one another; describe interrelationships among concepts or proposition Basic Processes in the Development of Nursing ▪ How or why the concepts are related and may Theories deal with cause and effect and correlations or rules that regulate interactions. I. General System Theory ▪ Developed by correlational research II. Adaptation Theory III. Developmental Theory Situation-relating theories (predictive, promoting, or inhibiting theories) General System Theory ▪ Predict occurrences of a phenomenon when ▪ Describes how to break whole things into the cause is present parts and then learn how the parts work ▪ Used experimental research together in “systems” Situation-producing theories (prescriptive theories) Adaptation Theory ▪ Address nursing therapeutics and ▪ Describes adaptation as the adjustment of consequences of interventions living matter to other living things and to ▪ “Prevents” occurrence of the phenomenon by environmental conditions controlling or eliminating possible causes ▪ Adaptation – a continuously occurring process that effects change and involves Nursing Theories Classification According to Meleis interaction and response I. Needs Theories ▪ Human adaptation occurs on three levels: II. Interaction Theories  The internal (self) III. Outcome Theories  The social (others)  The physical (biochemical reactions) Needs Theories Developmental Theory ▪ Based around helping individuals to fulfill their physical and mental needs ▪ Outlines the process of growth and development of humans as orderly and Interaction Theories predictable, beginning with conception and ending with death ▪ Revolve around the relationships nurses ▪ Each stage are unique form with patients ▪ Influenced by heredity, temperament, emotional, physical environment, life Outcome Theories experiences and health status ▪ Nurse as the changing force, who enables Nursing Metaparadigm individuals to adapt to or cope with ill health I. Person II. Environment III. Health IV. Nursing  Person  Serve to guide assessment, intervention, and evaluation of ▪ Client or human being nursing care ▪ Recipient of nursing care  Provide rationale for collecting ▪ Individuals, patients, groups, families, and reliable and valid data communities  Help to establish criteria to measure the quality of nursing care Environment  Help build nursing terminology to ▪ Situation use in communication with other ▪ Internal and external surrounds that affect professional the client  Enhance autonomy (independence ▪ Positive and negative conditions, physical and self-governance) of nursing environment (families, friends, and ▪ In Education significant others), and the setting  Provide general focus for curriculum design Health  Guide curricular decision making ▪ In Research ▪ Degree of wellness or well-being that the  Offer framework for generating client experiences knowledge and new ideas ▪ State of complete physical, mental,  Assist in discovering knowledge gaps emotional, social, and spiritual well-being in specific field of study and not necessarily the absence of disease  Offer a systematic approach to or infirmity identify questions for study, select variables, interpret findings and Nursing validate nursing interventions. ▪ Central to all nursing theories Nursing Defined ▪ Describe what nursing is, what nurses do, and how nurses interact with clients International Council of Nurses ▪ Nursing encompasses autonomous and Nursing Process Defined collaborative care of individuals of all ages, ▪ Nursing process is the method used to families, groups, communities, sick or well assess and diagnose needs, plan outcomes, and in all settings. and interventions, implement interventions, American Nurses Association and evaluate the outcomes of the care ▪ Nursing is the protection, promotion, and provided. optimization of health and abilities, ▪ ADPIE prevention of illness and injury  Assessment  Diagnosis Royal College of Nursing  Planning ▪ Use of clinical judgement in the provision of  Implementation care  Evaluation Virginia A. Henderson (1991) Purposes of Theories ▪ Assist the individual, sick or well, in the performance of those activities contributing ▪ In practice to health or its recovery  Assist nurses to describe, explain and predict everyday experiences