UNIT 3 NURSING THEORIES AND CONCEPTUAL FRAMEWORK.pptx

UNIT 3:NURSING THEORIES AND CONCEPTUAL FRAMEWORK BY MADAM SALIDA JOHARI 1 Learning outcomes At the end of this session, the students should be able to : 1. Define nursing theories 2. Explain the roles of nursing theories 3. State the metaparadigm in nursing 4. Expl...

UNIT 3:NURSING THEORIES AND CONCEPTUAL FRAMEWORK BY MADAM SALIDA JOHARI 1 Learning outcomes At the end of this session, the students should be able to : 1. Define nursing theories 2. Explain the roles of nursing theories 3. State the metaparadigm in nursing 4. Explain the selected nursing theories 5. Critique nursing theories based on their understanding 2 Introduction to Nursing theories The scientific work used to develop theories expands the scientific knowledge of the profession Theories offer well –grounded rationales for how and why nurses perform specific intervention and for predicting patient behaviors and outcomes Expertise in nursing is a result of knowledge and clinical experience 3 Introduction to Nursing theories Nursing knowledge improves nursing practice by connecting theory and research Theory ,research and practice are bound together in a continues interactive relationship 4 Introduction to Nursing theories Throughout this process new information often comes to light that indicates the need to revise a theory ,and the cycle repeats (Mc Ewen and Wills ,2014) Throughout your nursing career you need to reflect and learn from your experiences to grow professionally and use well – developed theories as a basis for your approach to patient care 5 Introduction to Nursing theories What is nursing theories? A theory helps an event by defining ideas or concept ,explaining relationships among the concepts, and predicting outcomes (McEwen and Wills , 2014) In the case of nursing ,theories are designed to explain a phenomenon such as self-care or caring 6 Con’t A nursing theory conceptualizes an aspect of nursing to describe, explain , predict ,or prescribe nursing care (Meleis,2012) Theories offer a perspective for assessing the patient situation This theory help nurses to organize ,analyze and interpret data 7 Con’t Eg : if nurses use Orem’s theory in practice , nurses assess and interpret data to determine patients; self-care need ,deficits and abilities in the management of their disease Orem’s theory then guide the nurses development of patient- centered nursing interventions 8 Con’t Nursing is both a science and art The science of nursing is based of data obtained from current research Art of nursing stems from a nurse’s experience and the unique caring relationship that a nurse develops with a patient(McEwen and Wills , 2014) 9  Con’t Resear ch Practic Theory e Figure 1 : Cyclical relationship among theory ,research and practice (Adopted From McEwen M,Wills EM : Theorieical basis for nursing ,ed 4, Philadelphia ,2014 ,Wolters Kluwer Health ) 10 Con’t (Figure 2) Concepts Definitions Phenomenon Assumptions or proposition 11  Role of Nursing Theory 1. Nurses develop theories to explain the relationship among variables by testing the theory through research and applying it in practice 2. Nursing theory helps to identify the focus, means ,and goals of practice in nursing 3. Nursing theories enhance communication and accountability for patient care (Meleis,2012) 12 Components of a Theory A theory contains a set of concepts, definitions ,and assumptions or propositions that explain a phenomenon It explain how these elements are uniquely related in the phenomenon ( figure 2) These components provide a foundation of knowledge for nurses to direct and deliver caring nursing practices 13 Con’t Researchers test theories ,and as a result they gain a clearer perspective and understanding of all parts of phenomenon. Component of theory : 1. Phenomenon 2. Definitions 3. Assumption 14 1.Phenomenon Nursing theories focus on the phenomena of nursing and nursing care A phenomenon is the term ,description, or label given to describe an idea or responses about an event, a situation, a process ,a group of events or a group of situations (Meleis,2012) 15 Con’t Phenomenon may be temporary or permanent Examples of phenomenon include caring, self-care ,and patient responses to stress 16 2. Definition Theories use definitions to communicate the meaning of concepts of theory  operational definition state how concept are(Johnson and Webber,2014) Theoretical or conceptual define a particular concept ,much like what can be found based on the theorist perspective ( Meleis ,2012) 17 3. Assumption Assumption are the ‘taken for granted that explain the nature and concepts ,definition relationships and structure of theory Assumption are truths and based on values (Meleis,2012) Eg: Watson’s transpersonal caring the assumption that a conscious intention to care promotes wholeness(Watson,2010) 18 19 20 The Metaparadigm for Nursing The nursing metaparadigm allows nurses to explain what nursing is ,what nursing does , why they do (Fawcet and Desanto- Mayeda ,2013) The nursing metaparadigm includes the 4 concepts : human, environment , situation and nursing) 21 22 23 24 25 26 27 28 29 30 History of Nursing Theories The first nursing theories appeared in the late 1800s when a strong emphasis was placed on nursing education. In 1860, Florence Nightingale defined nursing in her “Environmental Theory” as “the act of utilizing the environment of the patient to assist him in his recovery.” 31 Con’t In the 1950s, there is a consensus among nursing scholars that nursing needed to validate itself through the production of its own scientifically tested body of knowledge. In 1952, Hildegard Peplau introduced her Theory of Interpersonal Relations that puts emphasis on the nurse- client relationship as the foundation of nursing practice. 32 Con’t In 1955, Virginia Henderson conceptualized the nurse’s role as assisting sick or healthy individuals to gain independence in meeting 14 fundamental needs, thus her Nursing Need Theory was developed. 33 Con’t In 1960, Faye Abdellah published her work “Typology of 21 Nursing Problems” that shifted the focus of nursing from a disease- centered approach to a patient-centered approach. ln 1962, Ida Jean Orlando emphasized the 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. 34 Con’t In 1968, Dorothy Johnson pioneered the Behavioral System Model and upheld the fostering of efficient and effective behavioral functioning in the patient to prevent illness. ln 1970, Martha Rogers viewed nursing as both a science and an art as it provides a way to view the unitary human being, who is integral with the universe. 35 Con’t ln 1971, Dorothea Orem states in her theory that nursing care is required if the client is unable to fulfill biological, psychological, developmental, or social needs. ln 1971, Imogene King‘s Theory of Goal attainment states that the nurse is considered part of the patient’s environment and the nurse-patient relationship is for meeting goals towards good health. 36 Con’t In 1972, Betty Neuman in her theory states that many needs exist, and each may disrupt client balance or stability. Stress reduction is the goal of the system model of nursing practice. In 1979, Sr. Callista Roy viewed the individual as a set of interrelated systems who strives to maintain the balance between these various stimuli. 37 Con’t ln 1979, Jean Watson developed the philosophy of caring highlighted humanistic aspects of nursing as they intertwine with scientific knowledge and nursing practice. 38 39 40 Overview of selected nursing theories 41 Overview of selected nursing theories 42 Overview of selected nursing theories 43 Overview of selected nursing theories 44 Overview of selected nursing theories 45 Critique of Nursing Theory (Practice )  Group 1 (Florence and Marta Rogers).  Group 2(Virginia Henderson and Orem) 1. You are required to discus about four Nursing leaders and their theories 2. Discuss whether are you agree or disagree with their theories(Critique the theory) 3. What are advantages and disadvantages in their theories ? 4. 15 minutes slides presentation 5. Question and Answer session 46 This Photo by Unknown Author is licensed under CC BY-NC-ND 47