Introduction to Nursing PDF

Introduction to Nursing Prepared by: DANNY BOY R. SAGUN, RN, MAN HISTORICAL ROOTS The discipline of nursing slowly evolved from the traditional role of women, apprenticeship, humanitarian aims, religious ideals, intuition, common sense, trial and error, theories, and research, as wel...

Introduction to Nursing Prepared by: DANNY BOY R. SAGUN, RN, MAN HISTORICAL ROOTS The discipline of nursing slowly evolved from the traditional role of women, apprenticeship, humanitarian aims, religious ideals, intuition, common sense, trial and error, theories, and research, as well as the multiple influences of medicine, technology, politics, war, economics, and feminism (Jacobs & Huether 1978, Keller 1979, Brooks & Kleme-Kracht 1983, Gorenberg 1983, Perry 1985, Kidd & Momson 1988, Lynaugh & Fagin 1988). The first nurse theorist, Florence Nightingale (1969), viewed nursing as having organized concepts and social relevance distinct from medicine. Later, Henderson (1965) described nursing as a unique, complex service with independent practitioners who were authorities on nursing care. Nursing as a Profession Nursing as a Profession Nursing is not simply a collection of specific skills, and you are not simply a person trained to perform specific tasks. Nursing is a profession. No one factor absolutely differentiates a job from a profession, but the difference is important in terms of how you practice. Profession has been defined as an occupation that requires extensive education or a calling that requires special knowledge, skill and preparation. To act professionally you administer care in a conscientious and knowledgeable manner, and you are responsible to yourself and others. Nursing as a Profession A profession has the following primary characteristics: 1. A profession requires an extended education of its members, as well as a basic liberal foundation. 2. A profession has a theoretical body of knowledge leading to defined skills, abilities and norms. 3. A profession provides a specific service. 4. Members of a profession have autonomy in decision making and practice. 5. The profession as a whole has a code of ethics for practice. Nursing as a Profession Criteria of a Profession: To provide a needed service to the society To advanced knowledge on its field To protect its members and make it possible to practice effectively  Nursing is an art and science. As a professional nurse, you will learn to deliver care artfully with compassion, caring, and a respect for each client’s dignity and personhood. As a science, nursing is based on a body of knowledge that is continually changing with new discoveries and innovations. When you integrate the science and art of nursing into your practice, the quality of care you provide to your clients is at level of What is excellence that benefits clients and their families. Nursing is a profession within the healthcare sector focused on Nursing? the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Nurses practice in a wide diversity of practice areas with a different scope of practice and level of prescriber authority in each.  Nursing is caring. Nursing involves close personal contact with the recipient of care. Nursing is concerned with services that take humans into account as physiological, psychological, and sociological organisms. Characteristics Nursing is committed to promoting individual, family, of Nursing: community, and national health goals in its best manner possible. Nursing is committed to personalized services for all persons without regard to color, creed, social or economic status. Nursing is committed to involvement in ethical, legal, and political issues in the delivery of health care.  Human response is a way of looking at how individuals, families or communities react to all areas of life that influence and impact them. The nurse focus on two types of responses – Focus: reactions to actual health problems or illness (health – restoring responses) and concerns about potential Human health problems (health supporting responses). More simply the nurse focuses on the responses in both Responses sick and well persons. Human responses are dynamic or changing, as the patient progresses along the continuum between health and illness.  Must have a Bachelor of Science degree in nursing. Must be physically and mentally fit. Personal Must have a license to practice nursing in the country. Qualities A professional nurse, therefore, is a person of a Nurse who has completed a basic nursing education program and is licensed in his country to practice professional nursing.  UNIT 1: BASIC CONCEPTS OF A THEORY and NURSING THEORY Prepared by: DANNY BOY R. SAGUN, RN, MAN  Most scholars agree that it is the unique theories and perspectives used by a discipline Overview that distinguish it from other disciplines. The theories used by members of a profession of Theory clarify basic assumptions and values shared by its members and define the nature, outcome, and purpose of practice (Alligood, 2014a; Fawcett, 2012; Rutty, 1998).  Definitions of the term theory abound in the nursing literature. At a basic level, theory has been described as a systematic explanation of an event in which constructs and concepts are identified and relationships are proposed and Overview predictions made (Streubert & Carpenter, 2011). Theory has also been defined as a “creative of Theory and rigorous structuring of ideas that project a tentative, purposeful and systematic view of phenomena” (Chinn & Kramer, 2015, p. 255). Finally, theory has been called a set of interpretative assumptions, principles, or propositions that help explain or guide action (Young, Taylor, & Renpenning, 2001).  In their classic work, Dickoff and James (1968) state that theory is invented rather than found in Overview or discovered from reality. Furthermore, theories vary according to the number of of Theory elements, the characteristics and complexity of the elements, and the kind of relationships between or among the elements. theory, concept, and principle  WHAT IS THEORY? DEFINE THEORY IN YOUR OWN WORDS. 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 (Power and Knapp, 1955). A coherent statement or set of statements that attempts to explain observed phenomena. THEORY A comprehensive explanation of a given set of data that has been repeatedly confirmed by observation and experimentation and has gained general acceptance within the scientific community but has not been yet decisively proven. A construct that accounts for or organizes some phenomena (Barnum, 1998). A coherent group of general propositions used as principles of explanation. THEORY Examples are: What causes cancer? Hildegard Peplau's Theory of Interpersonal Relations is an excellent example of a nursing theory. The theory suggests that for a nurse-patient relationship to be successful, it must go through three phases: orientation, working, and termination.  WHAT IS CONCEPT? DEFINE CONCEPT IN YOUR OWN WORDS. CONCEPT A mental idea of a phenomenon A general idea formed in the mind A unit of thought A comprehensive idea or generalization Ex: If you're redecorating your bedroom, you might want to start with a concept, such as "flower garden" or "outer space."  WHAT IS PRINCIPLE? DEFINE PRINCIPLE IN YOUR OWN WORDS. PRINCIPLE A basic generalization that is accepted as true and that can be used as a basis for reasoning or conduct. Ex: "Be kind, for everyone you meet is fighting a battle." —Plato “Remember, nurses are like icebergs. At any one time, you are only seeing what they are actually doing.” —Ian Miller CONCEPTUAL FRAMEWORK / MODEL 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. A set of concepts and the proposition that integrate them into a meaningful configuration (Marriner-Tomey and Alligod, 1998) Composed of concepts or constructs that describe ideas about individuals, groups, situations and events of particular interest or discipline (e.g., Nursing) CONCEPTUAL FRAMEWORK / MODEL NURSING THEORY  Nursing theories are the creative products of nurses who seek (or sought) to thoughtfully describe the many aspects of nursing in ways that could be studied, evaluated, and used by other nurses. In other words, theory is an attempt to explain patterns and relationships found in nursing phenomena. Nursing Nurse theorists are people who are or have been Theory nurses, have thought deeply about how one might describe the phenomenon of nursing, and then have 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 unique as the individual(s) who created it. Nursing Theory A body of knowledge that An organized and systematic describes or explains nursing articulation of a set of and is used to support nursing statements related to questions practice in the discipline of nursing A creative and rigorous Through systematic inquiry, structuring of ideas that project nurses are able to develop a tentative purposeful, and knowledge relevant to improving systematic view of phenomena. the care of patients (Wikipedia) For the purposes of organization and ease of understanding, nursing theories can be placed into three loosely defined categories: 1. Definitions of nursing in general (philosophies) 2. Discussions of broad nursing practice areas (grand theories) 3. Assertions about specific nursing actions, processes, or concepts (middle-range theories) These are only a few of a myriad of questions and concerns addressed by nursing theories. What makes nursing What is meant by terms unique from other What is wholistic nursing What do nurses do? such as wellness and healthcare-related care? illness? professions? Do certain nursing What differentiates Is nursing a job, a Is the core of nursing actions measurably excellent nursing care vocation, a profession, or “caring” or technical skill improve client from marginal nursing a combination of all mastery? outcomes? care? three? Is nursing meant to be How should an independent Should nursing practice phenomena that cannot profession or an auxiliary formally encompass the be concretely measured component of the metaphysical? Spiritual? through the five senses medical profession? be addressed in nursing? CHARACTERISTICS OF A THEORY  CHARACTERISTICS OF A THEORY 1. INTERRELATING 4. Basis for hypotheses 2. LOGICAL in nature 3. GENERALIZABLE concepts that can be tested 5. Increasing the general 7. Consistent with other body of knowledge validated theories, laws 6. Used by the within the discipline and principles but will practitioner to guide and through the research leave open unanswered improve their practice implemented to validate questions that need to them be investigated COMPONENTS OF A THEORY COMPONENTS OF A THEORY The theory explains how these elements are uniquely related in the phenomenon. 1. Concepts 2. Definitions 3. Assumptions or Propositions 4. Phenomenon COMPONENTS OF A THEORY  WHAT IS CONCEPT? DEFINE CONCEPT IN YOUR OWN WORDS. CONCEPT A mental idea of a phenomenon A general idea formed in the mind A unit of thought A comprehensive idea or generalization Ex: If you're redecorating your bedroom, you might want to start with a concept, such as "flower garden" or "outer space." CONCEPT A theory also consists of interrelated concepts. These concepts can be simple or complex and relate to an object or event that comes from individual perceptual experiences (Alligood and Tomey, 2010). Example of a CONCEPT Using Neuman’s systems model (2011) as an example, there are concepts that affect the patient system. The patient system can be an individual, a group, a family, or a community. This system is an open structure that includes internal and external environmental factors. These concepts are physiological, psychological, sociocultural, developmental, and spiritual and may relate to health and wellness, illness prevention, stressors, and defense mechanisms (Meleis, 2011).  WHAT IS DEFINITION? DEFINE DEFINITION IN YOUR OWN WORDS.  DEFINITION The definitions within the description of a theory convey the general meaning of the concepts in a manner that fits the theory. These definitions also describe the activity necessary to measure the constructs, relationships, or variables within a theory (Chinn and Kramer 2004).  Example of a DEFINITION Neuman’s model uses an open systems approach to describe how patient systems deal with stressors in their environments. A stressor is any stimuli that can produce tension and cause instability within the system. For example, when patients receive a new diagnosis and perceive the diagnosis to be stressful, they may react by withdrawing or eating an improper diet. In this situation the nurse focuses on both the illness process and the patient’s response to the stressors and designs appropriate interventions.  WHAT IS ASSUMPTION? DEFINE ASSUMPTION IN YOUR OWN WORDS.  ASSUMPTIONS Assumptions are the “taken-for- granted” statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory (Meleis, 2011).  Example of ASSUMPTION Neuman’s systems model the assumptions include the following: patients are dynamic; the relationships between the concepts of a theory influence a patient’s protective mechanisms and determine a patient’s response; patients have a normal range of responses; stressors attack flexible lines of defense followed by the normal lines of defense; and the nurse’s actions focus on primary, secondary, and tertiary prevention (Neuman, 2011). WHAT IS PHENOMENON? DEFINE PHENOMENON IN YOUR OWN WORDS.  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, 2011).  PHENOMENON An aspect of reality that can be consciously sensed or experienced. Nursing theories focus on the phenomena of nursing and nursing care. Examples: caring / self-care/ client response to stress. examples COMPONENTS OF LEVINE’S KING’S GOAL A THEORY CONSERVATION ATTAINMENT MODEL THEORY CONCEPT He believes that there The concepts that are are concepts critical to that affect the nursing goal attainment in practice – nursing the “why’s” of nursing practice are; actions; 1. PERSONAL 1.CONSERVATION SYSTEMS 2. ADAPTATION 2. INTERPERSONAL 3. WHOLENESS SYSTEMS 3. SOCIAL SYSTEMS COMPONENTS OF LEVINE’S KING’S GOAL A THEORY CONSERVATION ATTAINMENT MODEL THEORY DEFINITION “Keeping together” of Defines personal the life system; that systems as individuals; individuals continuously that individuals are defend their wholeness. open, total, unique Wholeness exist when systems in constant the interactions or interaction with the constant adaptation to environment… the environment permit the assurance of integrity… COMPONENTS OF LEVINE’S KING’S GOAL A THEORY CONSERVATION ATTAINMENT MODEL THEORY ASSUMPTIONS Individuals continuously Human beings are the defend their wholeness; focus of nursing; the adaptation is an goals of nursing are ongoing process of health promotion, change…nurses maintenance and/or promote wholeness restoration; care of the through the use of sick or the injured; and conservation principle. care of the dying. COMPONENTS OF LEVINE’S KING’S GOAL A THEORY CONSERVATION ATTAINMENT MODEL THEORY PHENOMENON Include: PERSON, Include: SOCIAL NURSING, HEALTH SYSTEMS, HEALTH and ENVIRONMENT PERCEPTION, and INTERPERSONAL RELATIONSHIPS  Historical Development and Evolution of Nursing Theories  Most nursing scholars credit Florence Nightingale with being the first modern nursing theorist. Nightingale was the first to delineate what she considered nursing’s goal and practice domain, and she postulated that “to nurse” meant having charge of the personal health of someone. She believed the role of the nurse was seen as placing the client “in the best condition for nature to act upon him” (Hilton, 1997, p. 1211).  Nightingale received her formal training in nursing in Kaiserswerth, Germany, in 1851. Following her renowned service for the British army during the Crimean War, she returned to London and established a school for nurses. Florence According to Nightingale, formal training for nurses was necessary to “teach not only Nightingale what is to be done, but how to do it.” She was the first to advocate the teaching of symptoms and what they indicate. Furthermore, she taught the importance of rationale for actions and stressed the significance of “trained powers of observation and reflection” (Kalisch & Kalisch, 2004, p. 36).  In Notes on Nursing, published in 1859, Nightingale proposed basic premises for nursing practice. In her view, nurses were to make astute observations of the sick and their environment, record observations, and develop knowledge about factors that promoted healing. Her framework for nursing emphasized the utility of empirical knowledge, and she believed that knowledge developed and used by nurses should be distinct from medical knowledge. She insisted that trained nurses control and staff nursing schools and manage nursing practice in homes and hospitals (Chinn & Kramer, 2015; Kalisch & Kalisch, 2004).  Stages of Theory Development in Nursing Stages of Theory Development in Nursing Subsequent to Nightingale, almost a century passed before other nursing scholars attempted the development of philosophical and theoretical works to describe and define nursing and to guide nursing practice. Kidd and Morrison (1988) described five stages in the development of nursing theory and philosophy: 1. silent knowledge, 2. received knowledge, 3. subjective knowledge, 4. procedural knowledge, and 5. constructed knowledge.  Stages in the Development of Nursing Theory Stage Source of Impact on Theory and Knowledge Research Silent knowledge Blind obedience to medical Little attempt to develop theory. authority Research was limited to collection of epidemiologic data. Received knowledge Learning through listening to Theories were borrowed from others other disciplines. As nurses acquired non-nursing doctoral degrees, they relied on the authority of educators, sociologists, psychologists, physiologists, and anthropologists to provide answers to nursing problems. Research was primarily educational research or sociologic research.  Stages in the Development of Nursing Theory Stage Source of Impact on Theory and Knowledge Research Subjective knowledge Authority was internalized to A negative attitude toward foster a new sense of self. borrowed theories and science emerged. Nurse scholars focused on defining nursing and on developing theories about and for nursing. Nursing research focused on the nurse rather than on clients and clinical situations.  Stages in the Development of Nursing Theory Stage Source of Impact on Theory and Knowledge Research Procedural knowledge Includes both separate and Proliferation of approaches connected knowledge to theory development. Application of theory in practice was frequently underemphasized. Emphasis was placed on the procedures used to acquire knowledge, with focused attention to the appropriateness of methodology, the criteria for evolution, and statistical procedures for data analysis.  Stages in the Development of Nursing Theory Stage Source of Impact on Theory and Knowledge Research Constructed knowledge Combination of different Recognition that nursing types of knowledge (intuition, theory should be based on reason, and self-knowledge) prior empirical studies, theoretical literature, client reports of clinical experiences and feelings, and the nurse scholar’s intuition or related knowledge about the phenomenon of concern.  Stages in the Development of Nursing Theory Stage Source of Impact on Theory and Knowledge Research Integrated knowledge Assimilation and application Nursing theory will of “evidence” from nursing increasingly incorporate and other health care information from published disciplines literature with enhanced emphasis on clinical application as situation- specific/practice theories and middle range theories. Summary of Stages of Nursing Theory Development  Event Year Nightingale publishes Notes on Nursing 1859 American Medical Association advocates formal training for nurses 1868 Teacher’s College—Columbia University—Doctorate in Education degree for nursing 1920 Yale University begins the first collegiate school of nursing 1924 Report by Dr. Esther Brown—“Nursing for the Future” 1948 State licensure for registration becomes standard 1949 Nursing Research first published 1950 H. Peplau publishes Interpersonal Relations in Nursing 1952 University of Pittsburgh begins the first doctor of philosophy (PhD) program in nursing 1954 Health Amendments Act passes—funds graduate nursing education 1956 Process of theory development discussed among nursing scholars (works published by 1960 - 1966 1960– Abdellah, Henderson, Orlando, Wiedenbach, and others) First symposium on Theory Development in Nursing (published in Nursing Research in 1967 1968)  Event Year Symposium Theory Development in Nursing 1968 Dickoff, James, and Wiedenbach—“Theory in a Practice Discipline” 1969 First Nursing Theory Conference Second Nursing Theory Conference 1970 Third Nursing Theory Conference 1971 National League for Nursing adopts Requirement for Conceptual Framework for Nursing 1972 Curricula Key articles publish in Nursing Research (Hardy—Theories: Components, Development, and 1974 Evaluation; Jacox—Theory Construction in Nursing; and Johnson—Development of Theory) Nurse educator conferences on nursing theory 1975, 1978 Advances in Nursing Science first published 1979 Books written for nurses on how to critique theory, develop theory, and apply nursing 1980s theory Graduate schools of nursing develop courses on how to analyze and apply theory in nursing 1980s  Event Year Research studies in nursing identify nursing theories as frameworks for study 1980s Publication of numerous books on analysis, application, evaluation, and development of 1980s nursing theories Philosophy and philosophy of science courses offered in doctoral programs 1990s Increasing emphasis on middle range and practice theories for nursing 1990s Nursing literature describes the need to establish interconnections among central nursing 1990s concepts Introduction of evidence-based practice into nursing 1990s Philosophy of Nursing first published 1999 Books published describing, analyzing, and discussing application of middle range theory 2000s and evidence-based practice Introduction of the doctor of nursing practice (DNP) 2004 Growing emphasis on development of situation-specific and middle range theories in 2010+ nursing  Event Year Attention to theory utilization and development of theories to guide nursing research, 2010+ practice, education, and administration Focus on clinical application of evidence-based practice, practice-based evidence, and 2010+ translational research EVOLUTION OF NURSING THEORY EVOLUTION OF NURSING THEORY Florence Nightingale was the first nursing theorist, believing that nursing could improve a patient's environment to aid recovery and prevent complications. In the Victorian era, when Nightingale lived, nurses were taught to keep an eye on patients and report changes to the doctor (Chinn and Kramer, 2018). EVOLUTION OF NURSING THEORY Through the twentieth century, nursing became a profession, prompting American nurses to standardize nursing education in diploma programs and urge more nurses to pursue academic degrees. 1893 saw the first national assembly of nurses, and 1900 saw the inaugural issue of the American Journal of Nursing (AJN) (Alligood, 2014). The “curriculum era” of nursing was 1900–1940. During this time period, nursing education grew to incorporate social sciences, pharmacology, and “nursing arts” courses that emphasized nursing actions, skills, and procedures (Alligood, 2014). EVOLUTION OF NURSING THEORY During the 1950s, 1960s, and 1970s, nurses became increasingly interested in research and disseminating their findings. Early investigations were psychological, anthropological, or pedagogical in nature. Their opinions, ties with other professions, and roles in society were explored. Initially, nursing research avoided clinical issues based on the medical research model in order to distinguish itself from medicine. During this period, early nursing theories were formed, giving structure to nursing research. A few of the famous theorists of this time period were Johnson and King (Alligood, 2014). The nursing metaparadigm was postulated by Fawcett throughout the 1980s and 1990s theory era. Several nursing publications were published, nursing conferences were developed, and more nursing doctoral programs were offered (Alligood, 2018). EVOLUTION OF NURSING THEORY The 21st century is the age of theory application. Today's nurses try to give EBP based on theory, research, and experience. EBP focuses on quality, safe, complete care. The early big theories paved the way for the more recent middle-range ideas, which offered “evidence” for EBP and aided in its implementation. Theory utilization aligns with current national quality health care goals (Alligood, 2018). Nursing theories have evolved to reflect societal and global trends. Nightingale's theory was shaped by the wartime context. Rogers' introduction of “energy fields” was developed during the 1980s when the space shuttle program offered an attraction of space (Meleis, 2018). EVOLUTION OF NURSING THEORY Theorists drew on their own nursing education and practice experiences as well as information from philosophy, sociology, psychology, and anthropology. Many nursing theorists alter their theories to keep up with changing health care. This evolution demonstrates that theories are alive and responsive to the changing world in which we live (McEwen and Wills, 2019). Roles of nursing theories in guiding professional practice and education Roles of nursing theories in guiding professional practice and education Nursing theory forms the foundation of nursing education and practice, providing a framework for understanding the art and science of nursing. As a Nursing Student aspiring to pursue a Nursing Career and succeed, it's essential to grasp the role of Nursing Theory in shaping your education and professional practice. Roles of nursing theories in guiding professional practice and education 1. Defining Nursing Theory: Nursing Theory encompasses a set of concepts, principles, and assumptions that guide the practice of Nursing. It provides a framework for understanding the scope of nursing, its purpose, and its unique contribution to healthcare. Nursing theories are developed by nurse theorists and scholars, based on their observations, experiences, and Research findings. Roles of nursing theories in guiding professional practice and education 2. Enhancing Nursing Education: Nursing theory plays a vital role in Nursing Education. It helps nursing students to develop a comprehensive understanding of the profession, its values, and its evolving body of knowledge. By studying nursing theories, students gain insight into the holistic nature of patient care, the importance of evidence-based practice, and the significance of critical thinking and clinical judgment in nursing. Roles of nursing theories in guiding professional practice and education 3. Guiding Nursing Practice: Nursing Theory is not confined to the classroom; it guides Nursing Practice in various Healthcare settings. By understanding nursing theories, nurses can provide high-quality, patient-centered care that is grounded in evidence and informed by theoretical frameworks. Nursing theories help nurses assess patients, plan interventions, implement care, and evaluate outcomes in a systematic and holistic manner. Roles of nursing theories in guiding professional practice and education 4. Promoting Evidence-Based Practice: Nursing theory serves as a bridge between research and practice, promoting evidence-based nursing care. It guides nurses in incorporating research findings and best practices into their decision-making process. By understanding nursing theories, nurses can critically appraise Research Studies, apply evidence- based interventions, and contribute to the advancement of nursing knowledge. Roles of nursing theories in guiding professional practice and education 5. Enhancing Critical Thinking and Clinical Judgment: Nursing theory fosters critical thinking and clinical judgment Skills, which are essential for nursing practice. By applying nursing theories, nurses can analyze complex patient situations, identify relevant data, make sound clinical judgments, and implement appropriate nursing interventions. Nursing theories provide a framework for nurses to assess the needs of patients, prioritize care, and adapt their approach based on individual circumstances. Roles of nursing theories in guiding professional practice and education 6. Understanding the Nurse-Patient Relationship: Nursing theories emphasize the significance of the nurse- patient Relationship in providing quality Care. They provide insights into effective communication, therapeutic relationships, and the unique role of the nurse in promoting health and well-being. By understanding nursing theories, nurses can establish trust, demonstrate empathy, and engage in patient-centered care. Roles of nursing theories in guiding professional practice and education 7. Influencing Healthcare Policy and Leadership: Nursing theory has the potential to influence Healthcare policy, Leadership, and the advancement of the nursing profession. By understanding and applying nursing theories, nurses can advocate for changes in healthcare systems, contribute to policy Development, and assume leadership roles in healthcare organizations. Nursing theories provide a framework for addressing healthcare challenges and shaping the future of Nursing Practice. Roles of nursing theories in guiding professional practice and education 8. Application in the Philippine Nursing Licensure Exam: Understanding Nursing Theory is essential for success in the Philippine Nursing Licensure Exam and any nursing licensure exam. The exam tests not only practical nursing skills but also theoretical knowledge. By grasping nursing theories, you can analyze exam questions, apply theoretical concepts to patient scenarios, and demonstrate your understanding of nursing principles in the context of the exam. Classification of Theories in Nursing Classification of Theories in Nursing Scope of Theory Type or Purpose of Theory MetaTheory Descriptive (Factor-Isolating) Theories Grand Theories Explanatory (Factor-Relating) Theories Middle Range Theories Predictive (Situation-Relating) Theories Practice Theories Prescriptive (Situation-Producing) Theories Classification of Theories in Nursing Under SCOPE of THEORY Classification of Theories in Nursing Scope of Theory 1. Metatheory 2. Grand Theories 3. Middle Range Theories 4. Practice Theories Comparison of the scope of nursing theories  Metatheory: Refers to a theory about theory. Theories whose subject matter are SOME OTHER THEORIES. Classification of Used to generate knowledge and theory development Theories in Used as a criteria to analyze and evaluate theories Nursing In nursing, metatheory focuses on broad issues such as the processes of generating knowledge and theory development, and it is a forum for debate within the discipline (Chinn & Kramer, 2015; Powers & Knapp, SCOPE of THEORY 2011). Philosophical and methodologic issues at the metatheory or worldview level include identifying the purposes and kinds of theory needed for nursing, developing and analyzing methods for creating nursing theory, and proposing criteria for evaluating theory (Hickman, 2011; Walker & Avant, 2011).  Grand Theories: Grand theories are the most complex and broadest Classification of in scope. Theories in They attempt to explain broad areas within a Nursing discipline and may incorporate numerous other theories. The term macrotheory is used by some authors to SCOPE of THEORY describe a theory that is broadly conceptualized and is usually applied to a general area of a specific discipline (Higgins & Moore, 2000; Peterson, 2017).  Grand Theories: (continuation) Grand theories are nonspecific and are composed of relatively abstract concepts that lack operational definitions. Classification of Their propositions are also abstract and are not Theories in generally amenable to testing. Nursing Grand theories are developed through thoughtful and insightful appraisal of existing ideas as opposed to empirical research (Fawcett & SCOPE of THEORY DeSanto-Madeya, 2013). The majority of the nursing conceptual frameworks (e.g., Orem, Roy, and Rogers) are considered to be grand theories. Chapters 6 through 9 discuss many of the grand nursing theories.  Middle Range Theories: Middle range theory lies between the grand nursing Classification of models and more circumscribed, concrete ideas (practice or situation-specific theories). Theories in Middle range theories are substantively specific Nursing and encompass a limited number of concepts and a limited aspect of the real world. SCOPE of THEORY They are composed of relatively concrete concepts that can be operationally defined and relatively concrete propositions that may be empirically tested (Higgins & Moore, 2000; Peterson, 2017; Whall, 2016).  Middle Range Theories: (continuation) Classification of Theories in A middle range theory may be: (1) a description of a particular phenomenon, Nursing (2) an explanation of the relationship between phenomena, or SCOPE of THEORY (3) a prediction of the effects of one phenomenon or another (Fawcett & DeSanto-Madeya, 2013).  Practice Theories: Classification of Practice theories are also called situation-specific Theories in theories, prescriptive theories, or microtheories and are the least complex. Nursing Practice theories are more specific than middle range theories and produce specific directions for SCOPE of THEORY practice (Higgins & Moore, 2000; Peterson, 2017; Whall, 2016).  Practice Theories: (continuation) Classification of They contain the fewest concepts and refer to specific, easily defined phenomena. Theories in They are narrow in scope, explain a small aspect of Nursing reality, and are intended to be prescriptive. They are usually limited to specific populations or SCOPE of THEORY fields of practice and often use knowledge from other disciplines. Examples of practice theories developed and used by nurses are theories of postpartum depression, infant bonding, and oncology pain management.  Classification of Theories in Nursing Under Type or Purpose of Theory  Descriptive (Factor-Isolating) Theories: Descriptive theories are those that describe, Classification of observe, and name concepts, properties, and Theories in dimensions. Nursing Descriptive theory identifies and describes the major concepts of phenomena but does not explain how or why the concepts are related. Type or Purpose The purpose of descriptive theory is to provide of Theory observation and meaning regarding the phenomena. It is generated and tested by descriptive research techniques including concept analysis, case studies, literature review phenomenology, ethnography, and grounded theory (Young et al., 2001).  Explanatory (Factor-Relating) Theories: Factor-relating theories, or explanatory theories, are those that relate concepts to one another, Classification of describe the interrelationships among concepts or Theories in propositions, and specify the associations or relationships among some concepts. Nursing They attempt to tell how or why the concepts are related and may deal with cause and effect and Type or Purpose correlations or rules that regulate interactions. They are developed by correlational research and of Theory increasingly through comprehensive literature review and synthesis. An example of an explanatory theory is the theory of health-related outcomes of resilience in middle adolescents (Scoloveno, 2015).  Predictive (Situation-Relating) Theories: Classification of Theories in Situation-relating theories are achieved when the conditions under which concepts are related are Nursing stated and the relational statements are able to describe future outcomes consistently. Type or Purpose Situation-relating theories move to prediction of precise relationships between concepts. of Theory Experimental research is used to generate and test them in most cases.  Prescriptive (Situation-Producing) Theories: Classification of Situation-producing theories are those that Theories in prescribe activities necessary to reach defined Nursing goals. Prescriptive theories address nursing therapeutics and consequences of interventions. Type or Purpose They include propositions that call for change and of Theory predict consequences of nursing interventions. They should describe the prescription, the consequence(s), the type of client, and the conditions (Meleis, 2012). Any question?