Unit III: Structure of Nursing Knowledge PDF

UNITIII: STRUCTUREOFNURSING KNOWLEDGE INTRODUCTION: Nursing profession is still under an evolution phase, a phase of receding and evolving new paradigms. Nursing theories and models provide information about definitions of nursing and nursing practice, principles that form the basis...

UNITIII: STRUCTUREOFNURSING KNOWLEDGE INTRODUCTION: Nursing profession is still under an evolution phase, a phase of receding and evolving new paradigms. Nursing theories and models provide information about definitions of nursing and nursing practice, principles that form the basis for practice, goals and functions of nursing. CONCEPTS Concepts are often called the BUILDING BLOCKS OF THEORIES. - Enhances one’s capacity to understand phenomena as it helps define the meaning of a word. Concepts are vehicles of thoughts that involve images Concepts maybe abstract (indirectly observed or intangible example love,care) or concrete (directly observed and tangible example nurse, mother, pain). EXAMPLES: Noise, Cleanliness, Ventilation, Bed and Beddings, Warmth in Nightingales Environmental Theory There are two types of concepts namely: 🞂 Abstract concepts are indirectly observed or intangible. It is independent in time and place. Examples are love, care, and freedom. 🞂 Concrete concepts are directly observed or tangible. Examples are nurse, mother and pain. DEFINITION Composed of various descriptions which convey a general meaning and reduces the vagueness in understanding a set of concepts. ❖ Conceptual definitions are meaning of the word based on how a certain theory or relevant literature perceives it to be. ❖ Operational definitions are meaning of a word based on the method of how it was measured or how the person come up with that perception. PROPOSITION Explains the relationship of different concepts ASSUMPTION A statement that specifies the relationship or connection of factual concepts or phenomena. PHENOMENON - set of empirical data or experiences that can be physically observed or tangible, such as crying, grimacing when in pain - It is concerned by how the person reacts using human senses - It could be clinical,disease process, clients behavior, interventions, practices A diagram showing the relationships of concepts, propositions, assumptions and definitions with theory and phenomena KNOWLEDGE An information, skills and expertise acquired by a person through various life , experiences, or through formal/informal learning such as formal education, self-study, vocational. The abstract or workable understanding of a subject or idea. What is known in a particular field of discipline or study. Sources of Knowledge TRADITIONAL KNOWLEDGE- is a nursing practice which is passed down from generation to generation. Its always been practiced that way. AUTHORITATIVE KNOWLEDGE-an idea by a person of authority which is perceived as true because of his or her expertise. SCIENTIFIC KNOWLEDGE-it came from a scientific method through research. They are tested and measured systematically using objective criteria. PARADIGM It is a conceptual diagram. It is a pattern. METAPARADIGM  Originates from two Greek word: Meta, meaning “with” and paradigm, meaning “pattern.  It defines and describes relationships among major ideas and values.  The highest level of knowledge. NURSING METAPARADIGM Are patterns or models used to show a clear relationship among the existing theoretical works in nursing. PERSON Refers to all human beings; the recipients of nursing care. They include individuals, patients, groups, families, and communities. ENVIRONMENTAL Factors that affect individuals internally and externally. Also includes setting where nursing care is provided. Ventilation Warmth Noise Light Cleanliness HEALTH The holistic level of wellness that the person experiences. It adresses the person’s state of well being. Goal of all nursing activity should promote client’s health. NURSING Nursing is a science, an art and a practice discipline which involves caring. Focuses on the human-environment-health process and is articulated in nursing theories and generated through nursing research. The interventions of the nurse rendering care in support of, or in cooperation with the client. Nursing is a humanistic science dedicated to compassionate concern with maintaining and promoting health and preventing illness and caring for and rehabilitating the sick and disabled. THEORY Greek word “THEORIA” – speculate 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. (Mc Ewen &. Wills, 2019) IMPORTANCE OF Nursing Theories Aim to describe, predict, and explain the phenomenon of nursing Provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future Help to distinguish what should form the basis of practice by explicitly describing nursing. Help to provide better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education. Maintains professional boundaries in nursing Purposes of theories IN PRACTICE Assist nurses to describe, explain, and predict everyday experiences Serve to guide assessment, intervention, and evaluation of nursing care Provide rationale for collecting reliable and valid data about the health status of clients Help to establish criteria to measure the quality of nursing care Help build a common nursing terminology to use in communicating with other health professionals. Ideas are developed and words defined. Enhance autonomy of nursing by defining its own independent functions. IN EDUCATION Provide a general focus for curriculum design. Guide curricular decision making. IN RESEARCH Offer a framework for generating knowledge and new ideas. Assist in discovering knowledge gaps in specific field of study. Offer a systematic approach to identify questions for study. INTERDEPENDENCE OF THEORY AND RESEARCH  The relationship between nursing theory and nursing research helps in building nursing knowledge. According to Meleis 1997 Nursing knowledge is composed of both: 1. Theoretical Knowledge-Aims to stimulate thinking and broaden understanding of the science and practice of the nursing discipline. 2. Practical Knowledge-Referred to as the art of nursing. NURSING PHILOSOPHIES ENVIRONMENTAL THEORY – Florence Nightingale Developed and described the first theory of nursing. Notes on Nursing: WHAT IT IS , WHAT IT IS NOT and NOTES ON HOSPITALS. She focused on changing and manipulating the environment in order to put the patient in the best possible contributions for nature to act. She believed that in the nurturing environment, the body could repair itself. She linked with environmental factors: (1.) fresh air, (2) light, (3) Cleanliness, (4) Hygiene, (5) Proper nutrition. STAGES OF NURSING EXPERTISE- PATRICIA BENNER NOVICE No background experience (e.g. nursing student that’s why we are guided by our clinical instructors. ADVANCED BEGINNER - This stage pertains to the newly graduate nurses. COMPETENT Has 2-3 years of experience which he /she which demonstrates planning and organizational abilities. PROFICIENT Has 3-5 years of experience which he/she perceives situations as a whole. Has a holistic understanding of the client which improves decision making. EXPERT Flexible and highly proficient performance which he/she no longer rely on rules, regulations , or maxims to connect his/her understanding of the situation to appropriate action. THEORY OF HUMAN CARING- JEAN WATSON 1. Practice human kindness. 2. Instill faith and hope. 3. Nurture individual spiritual beliefs and practices. 4. Develop helping-trusting relationships. 5. Promote and accept the expression of positive and negative feelings. 6. Use creative and scientific problem solving methods for decision making. 7. Perform teaching and learning that address individual needs and learning styles. 8. Create a healing environment for the physical and spiritual self which respects human dignity. 9. Assist with physical, emotional, and spiritual needs. 10. Allow rooms to miracles to take place CONCEPTUAL MODELS SELF-CARE DEFICIT THEORY DOROTEA OREM SELF-CARE -Practice of activities that individual initiates and perform in their own behalf in maintaining life, health, and well-being. SELF-CARE AGENCY - Individual’s ability to perform self-care activities. SELF-CARE REQUISITES Action directed towards provision of self care THERAPEUTIC SELF-CARE DEMAND - “Totality of self-care actions to be performed for some duration in order to meet self acre requisites by using valid methods and related sets of operations and actions” BETTY NEUMAN Focuses on stress and stress reduction Primarily concerned with effects of stress on health Stressors are any forces that alters the system’s stability GOAL ATTAINMENT THEORY- Imogene King Describes the importance of the participation of all individual in decision making as well as choices, alternatives, and outcomes of nursing care. It pertains to the importance of interaction, perception, communication, transaction, self, role, stress, growth and development, time, and personal space. Reflects King’s belief that the practice of nursing is differentiated from other health care profession by what nurses do with and what they do for individuals. The nurse and the patient/client communicates, information in order to set goals mutually and then acts to attain those goals. NURSING THEORIES INTERPERSONAL RELATIONS THEORY - HILDEGARD PEPLAU 4 PHASES OF NURSE PATIENT RELATIONSHIP 1. ORIENTATION 2. IDENTIFICATION 3. EXPLOITATION 4. RESOLUTION NURSING NEED THEORY 14 COMPONENTS - VIRGINIA HENDERSON Breathe normally. Eat and drink adequately. Eliminate body wastes. Move and maintain desirable postures. Sleep and rest. Select suitable clothes-dress and undress. Maintain body temperature within normal range by adjusting clothing and modifying environment. Keep the body clean and well groomed and protect the integument. Avoid dangers in the environment and avoid injuring others. Communicate with others in expressing emotions, needs, fears, or opinions. Worship according to one’s faith. Work in such a way that there is a sense of accomplishment. Play or participate in various forms of recreation. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities THE CORE, CARE, CURE- LYDIA HALL NURSING CARE CAN BE DELIVERED ON THREE INTERLOCKING LEVELS 1. Care- hands on bodily care 2. Core- using self in relationship to patient 3. Cure- seeing the patient and family through medical care. MIDDLE-RANGE THEORY MATERNAL ROLE ATTAINMENT THEORY- RAMONA MERCER Anticipatory stage Formal Stage Informal Stage Personal Stage