Theoretical Foundation of Nursing PDF

THEORETICAL FOUNDATION OF NURSING NCM 100 Introduction to Nursing Theory - Nursing as a Profession - An occupation is a job or a career, whereas a profession is a learned vocation or occupation that has a status...

THEORETICAL FOUNDATION OF NURSING NCM 100 Introduction to Nursing Theory - Nursing as a Profession - An occupation is a job or a career, whereas a profession is a learned vocation or occupation that has a status of superiority and precedence within a division of work. - In general terms, occupations require widely varying levels of training or education, varying levels of skill, and widely variable defined knowledge bases. In short, all professions are occupations, but not all occupations are professions (Finkelman & Kenner, 2016). What is a THEORY? - A set of concepts, definitions, relationships, and assumptions that project a systematic view of a phenomena - From the Greek word “THEORIA” signifying a vision. - Nursing theory is an organized framework of concepts and purposes designed to guide the practice of nursing. - Supposition or system of ideas proposed to explain a given phenomenon - Attempt to explain relationships between concepts - Offer ways to conceptualize central interests of a discipline o Example: Freud’s theory of the Unconscious - Who develop nursing theory? The first nursing theory- 1800 – emphasis on nsg.education What are the components of a Theory? Concepts – Are ideas and mental images that help to describe phenomena (Alligood and MarrinerTomey, 2002). - It can be concrete or abstract, Thus, each concept must be specifically defined by the theorist. Definitions – Convey the general meaning of the concepts Assumptions – Statements that describe concepts Phenomenon – Aspect of reality that can be consciously sensed or Experienced (Meleis, 1997). What is a Paradigm? - Model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline. (Alligoodand Marriner –Tomey, 2002) What is a DOMAIN? - The view or perspective of the discipline contains the: o Subject o Central concepts o Values & Beliefs o Phenomena of interest o Central problems of the discipline How does domain relate to nursing theory? - Nursing has identified its domain in a metaparadigm that includes four linkages: 1. Person/client 2. Health  3. Environment 4. Nursing What are the purposes of Nursing Theory? - Guides nursing practice and generates knowledge - Helps to describe or explain nursing - Enables nurses to know WHY they are doing WHAT they are doing. - Nursing theory is the backbone of clinical care. Types of Nursing Theories: Grand theories – Broad and complex. Middle-range theories – Address specific phenomena and reflect practice. Descriptive theories – First level of theory development. Prescriptive theories – Address nursing interventions and predict their consequences. Why on earth do we study Nursing Theory? - Everyday practice enriches theory. - Both practice and theory are guided by values and beliefs. - Theory helps to reframe our thinking about nursing. - Theory guides use of ideas and techniques. - Theory can close the gap between theory and research. - To envision potentialities. So how do nurses use theory in everyday practice? - Organize patient data. - Understand patient data. - Analyze patient data. - Make decisions about nursing interventions. - Plan patient care. - Predict outcomes of care. - Evaluate patient outcomes. Metaparadigm - Represents the worldview of a discipline to consist of the concepts of person, environment, health and nursing. Paradigm organizing framework that contains. o Person – Is the recipient of nursing care and may include nursing care and may include individuals, groups, families, and communities. o Health – Is defined as the degree of wellness or well being that the client experiences o Environment – As internal and external surrounds that affect the client o Nursing – Providing care on behalf of or conjunction with the client. Professions are valued by society because the services professionals provide are beneficial for members of the society Characteristics of a profession include: 1. Defined and specialized knowledge base, 2. Control and authority over training and education, 3. Credentialing system or registration to ensure competence,  4. Altruistic service to society, 5. A code of ethics, 6. Formal training within institutions of higher education, 7. Lengthy socialization to the profession, 8. Autonomy (control of professional activities) Nursing as an Academic Discipline - Disciplines are distinctions between bodies of knowledge found in academic settings. - A discipline is “a branch of knowledge ordered through the theories and methods evolving from more than one worldview of the phenomenon of concern” (Parse, 1997, p. 74). Areas that identify nursing as a distinct discipline are as follows: - An identifiable philosophy. - At least one conceptual framework (perspective) for delineation of what can be defined as nursing. - Acceptable methodologic approaches for the pursuit and development of knowledge (Oldnall, 1995). Introduction to Science and Philosophy - Science is concerned with causality (cause and effect). The scientific approach to understanding reality is characterized by observation, verifiability, and experience; hypothesis testing and experimentation are considered scientific methods. - In contrast, philosophy is concerned with the purpose of human life, the nature of being and reality, and the theory and limits of knowledge. The importance of Theory in Nursing - It is widely believed that use of theory offers structure and organization to nursing knowledge and - Provides a systematic means of collecting data to describe, explain, and predict nursing practice. Use of theory - Also promotes rational and systematic practice by challenging and validating intuition. - Identify certain standards for nursing practice. - Identify settings in which nursing practice should occur and the characteristics of what the model’s author considers recipients of nursing care. - Identify distinctive nursing processes and technologies to be used, including parameters for client. - Assessment, labels for client problems, a strategy for planning, a typology of intervention, and criteria for evaluation of intervention outcomes. - Direct the delivery of nursing services. - Serve as the basis for clinical information systems, including the admission database, nursing orders, care plan, progress notes, and discharge summary. - Guide the development of client classification systems. - Direct quality assurance programs. Assumptions - Are beliefs about phenomena one must accept as true to - Accept a theory about the phenomena as true. Borrowed or shared theory – Is a theory developed in another discipline that is not adapted to the worldview and practice of nursing. Concept – Concepts are the elements or components of a phenomenon necessary to understand the phenomenon. They are abstract and derived from impressions the human mind receives about phenomena through sensing the environment. Epistemology - Theories of knowledge or how people come to have knowledge. Historical Evolution of Nursing 1. Period of Intuitive Nursing/Medieval Period - In this period, nursing was considered to be “untaught” and instinctive. It was considered as a function of women and there is no evident caregiving trainings. It is also in this period where primitive men believed that illness was caused by the invasion of the victim’s body of evil spirits. 2. Period of Apprentice Nursing/Middle Ages - Nursing was developed by religious orders. - It is in this period that Nursing care was performed without any formal education and by people who were directed by more experienced nurses (on the job training). 3. Period of Educated Nursing/Nightingale (Era 19 th- 20th Century) - Cremian Civil War. 4. Period of Contemporary Nursing (20th Century) - In this period, Licensure of nurses started alongside: specialization of Hospital and diagnosis, training of Nurses in diploma program, development of baccalaureate and advance degree programs, scientific and technological development as well as social changes mark this period. Nursing - The word came from a Latin word “nutrix“ means to NOURISH. Is Nursing Profession an Art or Science) - Nursing profession was both an art and science. - The science of nursing is easily noticeable and it is very critical for each one to know. If you are a nurse, you must know the Patient-based nursing care plan (NCP). You must also know the disease mechanisms of all diseases, medications, and management from asides. Nurses also need to be up to date on new policies, practices, and procedures. Moreover, they need to know how to manipulate new diagnostic equipment and machines. - On the other hand, the art of nursing is more than a great deal of science. It is more than just knowing; it is doing. It bridges information from nurses to patients in a skillful way. It is the application of all the science known to nursing to give the utmost care the patient needs. History of Nursing Theory - The history of professional nursing began with Florence Nightingale. It was Nightingale who envisioned nurses as a body of educated women at a time when women were neither educated wounded in Scutari, during the Crimean War, her vision and establishment of a School  of Nursing at St. Thomas’ Hospital in London marked the birth of modern nursing. Nightingale’s pioneering activities in nursing practice and subsequent writings describing nursing education became a guide for establishing nursing schools in the United States at the beginning of the twentieth century. Importance of Nursing Theory 1. Education 2. Research 3. Clinical practice 4. Conceptual models Types of Theory According to Scope 1. GRAND THEORY - Broadest in scope. - Represents the most abstract level of development. - Addresses the broad phenomena of concern within the discipline. 2. MIDDLE-RANGE THEORY - Addresses more concrete and more narrowly defined phenomena. - Intended to answer questions about nursing phenomena yet they did not cover the full range. 3. MICRO-RANGE THEORY - Concrete and narrow in scope. It explains a specific phenomenon of concern about a discipline. Types of Theory According to Function 1. DESCRIPTIVE – To identify properties and workings of a discipline 2. EXPLANATORY – To examine how properties relate and thus affect the discipline 3. PREDICTIVE – To calculate relationships between properties and how they occur 4. PRESCRIPTIVE – To identify under which conditions relationships occur Two types of Knowledge 1. THEORETICAL KNOWLEDGE – Aims to stimulate thinking and broaden understanding of the science and practice of the nursing discipline 2. PRACTICAL KNOWLEDGE – On the other hand is referred to as the art of nursing. The Eras of Nursing Knowledge 1. CURRICULUM ERA (1900-1940) – Nursing education shifted from hospital based diploma programs into college and universities. 2. RESEARCH EMPHASIS ERA (1950-1970) – This era implies that research was a path to new knowledge. It is in this era where research became part of the curricula of developing graduate programs. 3. GRADUATE EDUCATION ERA (1950-1970) – In this era, master’s program in nursing emerged in order to meet the need for nurses with specialized education training. Nursing theory and Conceptual Models were included as courses. 4. THEORY ERA (1980-1990) – It is the era as the outgrowth of research era. Research produced without theory produced isolated information while research produced with theory produced nursing science. 5. THEORY UTILIZATION ERA ( 21ST Century) – Nursing frameworks produce knowledge (evidence for quality of care).