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Significance of Theory (Module 1) History shows developments in the 4. AESTHETICS or ESTHETICS – deals nursing discipline through: with the emphatic aspect of nursing Nursing Theory and the Nursing...

Significance of Theory (Module 1) History shows developments in the 4. AESTHETICS or ESTHETICS – deals nursing discipline through: with the emphatic aspect of nursing Nursing Theory and the Nursing standardization of a nursing Profession curriculum, “In a world where there is so much to Before the turn of the 20th century, people movement of learning from the be done, I felt strongly impressed that did not look at nursing as a profession nor hospital to an educational there must be something for me to do.” an academic discipline. But because of institution, - Dorothea Dix- the accomplishments in the immediate the prevalence of graduate century, nursing was already recognized education programs in EMPIRICAL KNOWING as both a profession and a discipline. nursing, and -Is the principal form relating factual and (Bautista, 2008) Theory is significant the specialization of higher descriptive knowing aimed at the because it helps us to settle on what we learning towards advancing expansion of abstract and theoretical know and what we need to know in the nursing, both as a profession explanations. future. It helps to differentiate what should and as a discipline. -Any scientific, researched-based form the basis of practice by clearly theoretical and factual information that the describing what nursing does and what Purpose of Theories nurse makes use of is under Empirical nursing is all about. In addition, because A. In Practice Knowing. the main exponent of nursing – caring – Assist nurses to describe, -Is the first primary model of knowing cannot be measured, it is vital to have the explain, and predict everyday e.g. Knowledge obtained from textbooks, theory to analyze and explain what nurses experiences. lectures, journals and online sources. do. Ideally, nursing theory should provide Serve to guide assessment, the principles that support nursing intervention, and evaluation of AESTHETIC KNOWING practice. nursing care. -Is related to understanding what is of Provide a rationale for significance to particular patients such as Nursing is important to advance the collecting reliable and valid feelings, attitudes, points of view. practice of professional nursing. In order data about the health status of -It is also the manifestation of the creative to classify a profession, it should meet clients, which are essential for and expressive styles of the nurse. some criteria. Bixler (1959) published in effective decision making and -Is used in the process of giving the American Journal of Nursing the implementation. appropriate nursing care through results of several sociological studies of Help to establish criteria to understanding professional development measure the quality of nursing the uniqueness of every patient, thus that identified nursing as one of the are. emphasizing use of creative and practical subjects for criteria-setting. These criteria: Help build a common nursing styles of care. 1. Utilizes in its practice a well-defined and terminology to use in -Focuses on empathy well-organized body of specialized communicating with other e.g. putting yourself on the shoes of your knowledge that is on the intellectual level f health professionals. Ideas are client the higher learning. developed and words defined. 2. Constantly enlarges the body of Enhance autonomy ETHICAL KNOWING knowledge it uses and improves its (independence and Requires knowledge of different of techniques of self-governance) of nursing by different philosophical positions regarding education and service by the use of defining its own independent what is good and right in making moral scientific method. functions. actions and decisions, particularly in the 3. Entrusts the education of its B. In Education theoretical and clinical components of practitioners to institutions of higher Provide a general focus for nursing. education. curriculum design. -Involves the judgment of right and wrong 4. Applies its body of knowledge in Guide curricular in relation to intentions reasons and practical services vital to human and decision-making. attributes of individuals and situations! social welfare. C. In Research -The code of morals or code of ethics that 5. Functions autonomously in the Offer a framework for leads the conduct of nurses is the main formulation of professional policy and in generating knowledge and basis of Ethical Knowing. the control of new ideas. e.g. nurse as a patient advocate professional activity thereby. Assist in discovering 6. Attracts individuals or intellectual and knowledge gaps in specific PERSONAL KNOWING personal qualities who exalt service above field of study. -Encompasses knowledge of the self in personal gain and who recognize their Offer a systematic approach to relation to others and to self. chosen occupation as a life work. identify questions for study, -Is focused on realizing, meeting and 7. Strives to compensate its practitioners select variables, interpret defining the real true self. by providing freedom of action, findings and validate nursing -It is the most difficult to master and teach. opportunity for interventions. -It is the key to comprehending health in continuous professional growth, and terms of personal well-being. economic security. FOUR WAYS OF KNOWING (MODULE e.g. self-awareness sessions 2) Nursing Theory and Nursing Discipline SUMMARY In the previous discussion on the history FOUR WAYS OF KNOWING includes: As we talk about nursing theory, we can of nursing theory, it can be deduced that 1. EMPIRICS – the scientific discipline of say that there is no single exact nursing theory played a vital role in the Nursing classification of Nursing Theory in a given advancement of nursing as a discipline. 2. ETHICS – the moral direction of time, place and setting. Much of the We can Nursing nursing arts safely say that “Discipline is dependent 3. PERSONAL – method by which nurses and sciences has continued because of upon theory.” approach their patients the nursing theorists who always seek to advance the nursing profession. Theory is Nursing as a Vocational significant because it helps us to settle on ASSUMPTION heritage more than what we know and what we need to know -Is a statement that specifies the professional vision. in the future. In order to classify a relationship or connection of factual 1960’s – debates and profession, it should meet criteria. It can concepts or phenomena. discussion regarding the also be deduced that nursing theory -Are statements that describe concepts or proper direction and played a vital role in the advancement of connect two concepts that are factual. appropriate disciple for nursing nursing as discipline. In theory, it has its -Assumptions are the “taken for granted” knowledge development. own characteristics and components. The statements that determine the nature of purposes of theories were discussed in 3 the concepts, definitions, purpose, Nursing practice is based on Nursing sub-topics which were in practice, in relationships and structure of the theory. Science education and in research. Lastly indeed, PHENOMENON 1980’S it can be said that an exemplary nurse -Defined as sets of empirical data or Pre-paradigm period to consciously or subconsciously practices experiences that can be physically Paradigm period what is called the four ways of knowing observed or tangible. Introduced an organizational (Carper, 1978). This is achieved and -It is concerned with how an individual structure for nursing realized by harnessing the nurse’s person reacts using the human senses knowledge development to the collective stores of knowledge, character concerning their surrounding nursing literature. and profound experience, a concept and assessing the different behaviors and Utilization phase of the nursing theorist call Personal-knowledge factors that affect such behavior. Theory Era – emphasis shifts or Self-knowledge (Smith, 1992; Sweney, -A phenomenon is an aspect of reality that from the development to the 1994). can be consciously sensed or use and application of what is experienced. Nursing theories known. focus on the phenomena of nursing and Curriculum Era - Moving INTRODUCTION TO NURSING THEORY nursing care. nursing education from HISTORY OF NURSING THEORY hospital-based diploma What do those pictures have in common? In NURSING, phenomena can be: programs into college and “The systematic accumulation of 1) Clinical or environmental setting of universities. knowledge is essential to progress in any nursing profession… however theory 2) Disease process Research Era and practice must be constantly 3) Client’s behavior -Research is the path to new knowledge. interactive. Theory without practice is 4) Interventions -Part of the curriculum of developing empty and practice without 5) Practices that are utilized in nursing graduate programs. theory is blind” (Cross, 1981, p. 110). theories and metaparadigm “Practice without theory, like map without GRADUATE EDUCATION ERA route is blind; theory without practice, like NURSING THEORY Masters program in nursing emerged to route without -A body of knowledge that describes or meet the need for nurses with specialized map, is empty.” explains nursing and is used to support education in nursing. nursing practice. Nursing Theory and Nursing Conceptual THEORY -An organized and systematic articulation models were included as courses in the -Is an organized system of accepted of a set of statements related to questions study of nursing. knowledge that is composed of concepts, in the discipline of nursing propositions, definitions and assumptions THEORY ERA intended to explain a set of fact, event or NURSING THEORY Outgrowth of research era. phenomena. -Is a group of interrelated concepts that Research without theory produced -It is “a creative and rigorous structuring of are developed from various studies of isolated information; however research ideas that projects a tentative, purposeful disciplines and related and theory produced and systematic view of phenomena.” experiences. nursing science. (Chinn and Kramer, 1991) -This aims to view the essence of nursing care. MID 1970’S CONCEPT -Theories are specifically contributed by Evaluation of 25 years of -An idea formulated by the mind or an different nursing theorists from different nursing research revealed that experience perceived and observed. times and ages. nursing lacked conceptual -A mental idea of a phenomenon. connections and theoretical -A comprehensive idea or generalization. frameworks. -An idea that brings diverse elements into Historical perspective of nursing MILESTONES: 1. a basic relationship. theory Standardization of curricula for nursing master’s education. 2. PROPOSITION MI 1800’S AND 1960’S Doctoral education for nurses -Explains the relationships of different Mid 1800’s – Nursing should be in nursing. concepts. Knowledge is distinct from Transition from vocation to medical knowledge profession. DEFINITION (Nightingale) 1980’S - The definitions within the description of a Nursing practices was based Pre-paradigm period to theory convey the general meaning of the on principles and traditions Paradigm period concepts in a manner that fits the theory. passed on through Introduced an organizational -IT is composed of various descriptions apprenticeship education and structure for nursing which convey a general meaning and common sense wisdom. knowledge development to the reduces the vagueness in nursing literature. understanding a set of concepts.  Utilization phase of the 3. It gives nurses the know-how 5. Functions autonomously in the Theory Era – emphasis shifts and practice theory better formulation of professional from the development to the problem-solving skills. policy and in the control of use and application of what is 4. Nursing theory also prepares professional activity thereby known. nurses to question values and 6. Attracts individuals of assumptions in nursing intellectual and personal CHARACTERISTICS OF A THEORY: 5. Nursing theories are valuable qualities who exalt service 1. 1. Theories can show a in research, education and above personal gain and who relationship of concepts to practice. recognize their chosen create a different way of giving 6. It identifies and defines occupation as a life work. the impression of being at a interrelated concepts 7. Strives to compensate its certain fact or phenomenon. important in nursing. practitioners by providing 2. It must be logical. 7. It also increases the nursing freedom of action, opportunity 3. It can be the source of profession’s body of for continuous professional hypotheses that can be tested knowledge. growth, and economic security 4. It contribute in elevating the 8. It guides nurses by providing a 8. Presented specific goals and general body of knowledge knowledge base, organizing achievements of the through the studies concepts, providing guidelines profession implemented to validate them. for practice and identifying 9. Nurses are recognized for the 5. It can be used by practitioners nursing care goals. contribution they make in to direct and enhance their healthcare and the society. practice. SIGNIFICANCE OF THEORY FOR 10. Nursing theory is a useful tool 6. It must be consistent with NURSING: As a Discipline and for reasoning, critical thinking, other validated theories, laws, Profession and decision making in the and principles but will leave 1. NURSING AS A DISCIPLINE nursing practice. open unanswered issues that Theories provided need to be tested. frameworks to structure How do nurses use theory in everyday curriculum practice? IMPORTANCE OF NURSING THEORIES content or to guide the 1. Aim to describe, predict and teaching of nursing practice in NURSING THEORY AND THE explain the phenomenon of nursing programs. PRACTICE OF NURSING nursing (Chinn & Jacobs, Discipline is dependent Theory assists the practicing nurse to: 1978) upon theory. Organize patient data 2. Provide the foundations of Focus on knowledge about Understand patient data nursing practice, help to how nurses function which Analyze patient data generate further knowledge concentrated on the nursing Make decisions about nursing and indicate in which direction process to a focus on what interventions nursing should develop in the nurses know and how they Plan patient care future (Brown, 1994) use knowledge to guide their Predict outcomes of care 3. Help to distinguish what thinking and decision making Evaluate patient outcomes should form the basis of while concentrating on the Professional practice requires practice by explicitly patient. a systematic approach that is describing nursing. New nursing science is focused on the patient. 4. Help provide better patient developed through Nursing theoretical works care, enhanced professional theory-based Research provide a perspective of the status for nurses, improved studies patient communication between nurses, and guidance for 2. NURSING AS A PROFESSION B. History and Philosophy of Science research and education Criteria of a profession by Bixler and (HANDOUTS 2) (Nolan, 1996) Bixler published in the American Journal Early 20th century, 5. The main exponent of of Nursing 1959 philosophers and scientists nursing-caring-cannot be 1. Utilizes in its practice a argued the use of empiricism measured. It is vital to have well-defined and well and rationalism. the theory to analyze an organized body of specialized The philosophers’ point of explain what nurses do. knowledge that is on the view is that knowledge should 6. Establish a unique body of intellectual level of higher be based on the knowledge. learning. understanding of existing 7. Maintain professional 2. Constantly enlarges the body theories while scientists boundaries in nursing. of knowledge it uses and believe that knowledge should improves its techniques of not only focus on theoretical PURPOSES OF NURSING THEORY education and service by the existence but also on 1. Nursing theory provides use of the scientific method. understanding what there is rational and knowledgeable 3. Entrusts the education of its still to be observed. reasons for nursing actions. practitioners to institutions of 2. It gives nurses the knowledge higher education. EMERGENT VIEWS base necessary for acting and 4. Applies its body of knowledge 1. 1. The use of experimentation responding appropriately in in practical services that are to gain new knowledge nursing care situations. vital to human and social emerged during this period as welfare. nurses strive to base their  actions on evidence and which is the use of scientific data. INDUCTIVE TYPE OF 2. Positivism, which encloses the REASONING use of both logical reasoning In nursing, the use of and empiricism, became empiricism is highly important prevalent during this era in the in the assessment of patients discovery of truth for the all throughout the entire development of science. nursing process 3. Empirical and objective data co-exist as the focus of interest of study as one of each need to be tested in order to determine as to what is true or what is not. WHAT IS PHILOSOPHY IN 4. As a result of the different NURSING? point of views during this Philosophy is the next period, the growth of new knowledge level after scientific knowledge metaparadigm. commenced. This is evident C. Structure of Nursing Knowledge It specifies the definition of with the emergence of radical Types of Nursing Theoretical Works metaparadigm concepts in thinking – rationalism and Nursing philosophies each of the conceptual models empiricism. Nightingale of nursing. Nursing science and theory in the late Watson It sets forth the meaning of 20th century Ray phenomena through analysis, The development of Benner reasoning, and logical knowledge in the late 20th Martinsen argument. century was mainly affected by Eriksson CONCEPTS the different nursing leaders Basically, concepts are the and theorist of the early 20th Nursing conceptual models building blocks of theories. century. Levine It can come from an empirical The evolution of Nursing Rogers phenomena or any abstraction Science throughout the time Orem of how a person perceived an was further studied and tested King object that is not physically that led to the contemporary Neuman present or observed like practices in nursing. Roy charity, caring, patience. The role of nurses became Johnson more defined depending on 2 TYPES OF CONCEPTS the different fields of expertise Nursing theories 1. ABSTRACT CONCEPTS as time progressed. Boykin and Schoenhofer 2. CONCRETE CONCEPT Nursing, as it continually Meleis evolves, brings into being the Pender 1. Abstract Concepts different theories that guides Leininger -Is directly observed and intangible clinical practice. Newman -Independent of time and place Parse RATIONALISM Erickson, Tomlin, and Swain 2. Concrete concepts It makes use of reason gained Husted and Husted -Is directly observed but tangible thru expert study, tested theory Examples: mother, nurse, & pain and established facts to Middle-range nursing theories evidently prove something. Mercer CONCEPTS can be used in making or Deductive type of reasoning Mishel formulating a conceptual or an operational is used to generate rationalist Reed definition. view which starts from the Wiener and Dodd 1. CONCEPTUAL DEFINITIONS general to specific Eakes, Burke, and Hainsworth 2. OPERATIONAL DEFINITIONS Barker Kolcaba 1. Conceptual Definitions Beck -Meaning of a word based on what a Swanson certain theory perceives it to be. Ruland and Moore Examples: roles of a nurse, environment WHAT ARE NURSING PARADIGMS 2. Operational Definitions Are patterns or models used to show a -Meaning of a word based on what a clear relationship among the existing certain theory perceives it to be or a theoretical works in method of how it is measured and how a EMPIRICISM nursing. person comes up with it. Makes use of objective and At present, many theories in nursing are Examples: significance of pain perception tangible data or those that are focused on relationships among four perceived by the senses to major concepts observe and collect data. Metaparadigms: Greek “meta” – with CONCEPTUAL MODELS AND These data are then used to and “paradeigma – pattern) THEORETICAL MODELS formulate general knowledge,  Theoretical Models or Frameworks are highly established set of concepts that are testable. Conceptual models or frameworks Are representations of an idea or body of knowledge based on the own understanding or perception of a person or researcher on a certain topic, phenomena or theory. Scope of theories The nurse is functioning human being. As such, she not only acts, but she thinks and feels as well. (Ernest Wiedenbach/Nurse Theorist) 3 CATEGORIES THAT RELATE TO THE SCOPE OF A THEORY 1. GRAND THEORIES Conceptual structures that are nearly as abstract as the nursing models from which they are derived, but propose outcomes based on use and application of the model in the nursing practice. Broadest in scope, representing universal and broad nursing phenomena. 2. MIDDLE-RANGE THEORIES Lower in level of abstraction than grand theories, they offer a more direct application to research and practice. Are known to have a narrower and detailed focus compared to grand theories. Specific to nursing practice and specify the area of practice, age range of the patient, nursing action or intervention and proposed outcome. 3. MICRO-RANGE THEORIES Known to be the most concrete and narrow in scope Situation-specific and limited to particular populations or fields of practice