Week 1: Theoretical Foundations In Nursing PDF

THEORETICAL FOUNDATIONS IN NURSING WEEK 1 INTRODUCTION Course Description Theoretical Foundations in Nursing deals with the meta concepts of a person, health, environment and nursing as viewed by the different theorists. Likewise, it includes non-nursing theories such as systems, deve...

THEORETICAL FOUNDATIONS IN NURSING WEEK 1 INTRODUCTION Course Description Theoretical Foundations in Nursing deals with the meta concepts of a person, health, environment and nursing as viewed by the different theorists. Likewise, it includes non-nursing theories such as systems, developmental and change theories. It presents how these concepts and theories serve as guide to nursing practice. It further deals with health as a multifactorial phenomenon and the necessary core competencies that the nurse need to develop. THEORY Formal statements that are constructed in order to organize ideas and explain events. A set of interrelated constructs(concepts), definitions, and propositions that present a systematic view of phenomena by specifying relationships between variables, with the purpose of explaining and predicting the phenomena.(Kerlinger) THEORY Systematic explanation of an event in which construct and concepts are identified and relationships are proposed and predictions made (Streubert-Speziale & Carpebter, 2003) Creative and rigorous structuring of ideas that project a tentative , purposeful and systematic view of phenomena (Chinn & Kramer, 2004) A set of interpretative assumptions, principles or propositions that help explain or guide action (Young, Taylor & Repenning, 2001). TYPES OF THEORY 1. Descriptive/Factor-isolating Those that describe, observe, and name concepts, properties, and dimensions. Identifies and describes the major concepts of phenomena but does not explain how or why the concepts are related. Purpose is to provide observation and meaning regarding the phenomena. Example of descriptive theory: Kidner and Flanders –Stepans (2004) developed a theory model which described the experience of mothers whose pregnancies were complicated with HELLP syndrome ( hemolysis, elevated liver enzymes, and low platelets). A model for the HELLP syndrome: the maternal experience. Kidner MC1, Flanders-Stepans MB. Author information Abstract OBJECTIVE: To describe the experience of mothers whose pregnancies were complicated with HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) and to determine if such experiences could be clustered by common themes from which a model could emerge. DESIGN: Retrospective, descriptive, qualitative study utilizing grounded theory analysis. SETTING: Participants were interviewed in their homes via telephone. Participants were from Kansas, Maine, Maryland, Michigan, Minnesota, Mississippi, South Carolina, Utah, and Wyoming, representing both urban and rural settings. PARTICIPANTS: Nine self-selected survivors of HELLP syndrome. RESULTS: The essential structure of the experience of HELLP syndrome can be expressed as a circle of no control and not knowing, which included the five themes of premonition, symptoms, betrayal, whirlwind, and loss. The pervading emotions expressed were fear (of death), frustration, anger, and guilt. HELLP syndrome represents a unique maternal experience that can be expressed in a model. TYPES OF THEORY 2. Explanatory/Factor-relating Those that relate concepts to one another, describe the interrelationships among concepts and propositions, and specify the associations or relationships among some concepts. Example of explanatory theory: Model of chronic dyspnea (Mc Carley, 1999). In this model, dyspnea is defined and described along with physiologic antecedents of chronic dyspnea and consequences of chronic dyspnea. TYPES OF THEORY 3. Predictive/Situation-relating Achieved when the conditions under which concepts are related are stated and the relational statements are able to describe future outcomes consistently. Example: Experimental research Predict well being among breast cancer survivors TYPES OF THEORY 4. Prescriptive/Situation-producing Should describe the prescription, the consequences, the type of client, and conditions (Meleis, 2005). Those that prescribe activities necessary to reach defined goals. Address nursing therapeutics and consequences of interventions Includes propositions that call for change and predict consequences of nursing interventions. Example of prescriptive theory: Work by Auvil-Novak (1997) which presented the development of a middle range theory of chronotherapeutic intervention for postsurgical pain based on three experimental studies of pain relief among postsurgical clients. The theory uses time-dependent approach to pain assessment and provides directed nursing interventions to address postoperative pain. NURSING THEORY Creative products of nurses who seek (sought) to thoughtfully describe the many aspects of nursing in many ways that could be studied, evaluated, and used by other nurses. An attempt to explain patterns and relationships found in nursing phenomena. NURSE THEORISTS People who are or have been nurses, have thought deeply about how one might describe the phenomenon of nursing, and then tried in their own way, from their own perspective, to record their thoughts and observations based on professional and personal experiences. Each theory is as uniques as the individual who created it. NURSING PARADIGM Metaparadigm The global perspective of a discipline that identifies the primary phenomena that are of interest to that discipline and explains how the discipline deals with those phenomena in a unique manner (Fawcett, 2000). METAPARADIGM Purpose/Function: To summarize the intellectual and social missions of the discipline and place boundaries on the subject matter of that discipline. NURSING METAPARADIGM PERSON Refers to a being composed of physical, intellectual, biochemical, and psychosocial needs; A human energy field; A holistic being in the world; An open system; An integrated whole; An adaptive system; and A being who is greater than the sum of his parts. NURSING METAPARADIGM HEALTH Ability to function independently; Successful adaptation to life’s stressors; Achievement of one’s full life potentials; and Unity of mind, body and soul. NURSING METAPARADIGM ENVIRONMENT Typically refers to the external elements that affect the person; Internal and external conditions that influence the organism; Significant others with whom the person interacts; and An open system with boundaries that permit the exchange with human beings of matter, energy and information NURSING METAPARADIGM NURSING A science, an art and a practice discipline, and involves caring. Goals include:  care of the well;  care of the sick;  assisting with self-care activities;  helping individuals attain their human potential ; and  discovering and using nature’s laws of health NURSING METAPARADIGM NURSING Purposes of nursing care: placing the client in the best condition for nature to restore health promoting the adaptation of the individual facilitating the development of an interaction between the nurse and the client in which jointly set goals are met promoting harmony between the individual and the environment. facilitates, supports, and assists individuals, families, communities, and societies to enhance, maintain, and recover health to reduce and ameliorate the effects of illness. RELATIONSHIPS AMONG METAPARADIGM CONCEPTS 1. Person and health Nursing is concerned with the principles and laws that govern the life-process, well being, and optimal functioning of human beings, sick or well. RELATIONSHIPS AMONG METAPARADIGM CONCEPTS 2. Person and environment Nursing is concerned with the patterning of human behavior in interaction with the environment in normal life events and critical life situations. RELATIONSHIPS AMONG METAPARADIGM CONCEPTS 3. Health and nursing Nursing is concerned with the nursing action or processes by which positive changes in health status are effected. RELATIONSHIPS AMONG METAPARADIGM CONCEPTS 4. Person, environment and health  nursing is concerned with the wholeness or health of human beings, recognizing that they are in continuous interaction with their environment.