theory
a useful tool for reasoning, critical thinking, and decision making
metaparadigm
refers to the most abstract aspect of the structure of nursing knowledge
metaparadigm of nursing
consists of the major concepts of the discipline-person, environment, health, and nursing
philosophy
a set of beliefs about the nature of how the world works
a nursing philosophy puts together some or all concepts of the __________.
metaparadigm
a conceptual model or framework
is a more specific organization of nursing phenomena than philosophies
model or framework
provides an organizational structure that makes clearer connections between concepts
____________ are more concrete descriptions of concepts that are embedded in propositions.
theories
propositions
statements that describe linkages between concepts and are more prescriptive; that is, they propose an outcome that is testable in practice and research
a set of beliefs about the nature of how the world works
philosophy
puts together some or all concepts of the metaparadigm
nursing philosophy
she focused on the relationship of the nurse and the patient
Watson's philosophy
an approach that emphasized how the nurse and patient change together through transpersonal caring
Watson's philosophy
has responsibility for creating and maintaining an environment supporting human caring while recognizing and providing for patient's primary human requirements
the watson nurse
key aspects of nursing's metaparadigm
environment, person, health, nursing
provides organizational structures for critical thinking about the processes of nursing
conceptual models (conceptual frameworks)
are less abstract and more formalized than the philosophies
models
are more abstract than theories of nursing
models
the model focuses on the patient's self-care capacities and the process of designing nursing actions to meet the patient's self-care needs
Orem's self-care model
the nurse prescribes ad regulates the nursing system on the basis of the patient's self-care deficit, which is the extent to which a patient is incapable of providing effective self-care
Orem's self-care model
theory of self-care
theory of self-care deficit
theory of nursing system
Orem's self-care model
appropriate care for the patient is developed through a series of three operations:
diagnostic: establishment of the nurse-patient realtionsip
assessment of patient's baseline ability to provide adequate self-care
prescriptive: occur when therapeautic sel
Orem's self-care model
the theory focused on people, their interpersonal relationships, and social contexts with three interacting systems: personal, interpersonal, and social
within these 3 systems, she identified concepts that provide a conceptual structure describing the pro
King's interacting systems framework and theory of goal attainment
the theory provides a view of people from the perspective of their interactions with other people at three levels of interacting systems
king's interacting systems framework and theory of goal attainment
personal system identifies concepts that provide an understanding of individuals, personally, and intrapersonally (within the person)
king's interacting systems framework and theory of goal attainment
interpersonal system deals with interactions and transactions between two or more people
king's interacting systems framework and theory of goal attainment
social system presents concepts that consider contacts, such as those at school, at work, or in social settings
king's interacting systems framework and theory of goal attainment
the king nurse is guided by concepts at the system levels
-personal system leads the nurse to play close attention to the patient's perceptions
-interpersonal system guides the nurse to explore the patient's roles and the stresses in each role
-social sys
king's interacting systems framework and theory of goal attainment
the theory emphasized the importance of goal setting by the nurse and the patient (mutuality). the goal of nursing is gaining or regaining health
king's interacting systems framework and theory of goal attainment
the model provides a comprehensive understanding of nursing from the perspective of adaptation
-when demands of environmental stimuli are too high or the person's adaptive mechanisms are too low, the person's behavioral responses are ineffective for copin
Roy's adaptation model
focuses on adaptation of the patient and on the environment
-the nurse modifies the environment to facilitate patient adaptation
the roy nurse
grand theory is a broad conceptualization of nursing phenomena
grand-to-middle range theories
middle-range theory is narrower in focus and makes connections between grand theories and nursing practice
grand-to-middle range theory
theories are less abstract than models and usually propose specific outcomes
grand-to-middle theories
examples:
-peplau's theory of interpersonal relations in nursing
-orlando's nursing process theory
-leininger's theory of culture care diversity and universality
grand-to-middle range theories
the theory is based on the promise that the relationship between patient and nurse is the focus of attention, rather than the patient only as the unit of attention
Peplau's theory of interpersonal relations in nursing
Goals of therapeutic interpersonal relationship
-survival of the patient
-patient's understanding of health problems and learning from these problems as s/he develops new behavior patterns
Peplau's theory of interpersonal relations in nursing
the nurse uses a four-pronged approach to assist the patient to achieve personal growth
Peplau's theory of interpersonal relations in nursing
the nurse assumes these roles: counselor, resource, teacher, technical expert, surrogate, and leader
Peplau's theory of interpersonal relations in nursing
depending on the setting, the nurse will spend more or less time in each of these roles
Peplau's theory of interpersonal relations in nursing
the theory is about how nurses process their observations of patient behavior and about how they react to patients based on inferences from patient's behavior
Orlando's nursing process theory
-it is specific to nurse-patient interactions
-the goal of the nurse is to determine and meet patients' immediate needs and to improve their situation by relieving distress or discomfort
-it emphasized deliberate action (rather than automatic action)
Orlando's nursing process theory
the nurse individualize care for each patient by:
-attending to behavior
-confirming with patient ideas and inferences the nurse draws from interactions
-identifying pressing needs
Orlando's nursing process theory
the theory improves nurse effectiveness by allowing the nurse to get to the "bottom line" more quickly. Thus, it saves time and energy for both patient and nurse
Orlando's nursing process theory
transcultural nursing
-planning care based on knowledge that is culturally defined, classified, and tested and then used to provide culturally congruent care
Leininger's theory of culture care diversity and universality
the theory considers the impact of culture on all aspects of human life, with particular attention to health and caring practices
Leininger's theory of culture care diversity and universality
nursing care is focused on culture care preservation, accommodations, or re=patterning depending on the patient's need
Leininger's theory of culture care diversity and universality
the outcome of culturally congruent nursing care is health and well-being for the patient
Leininger's theory of culture care diversity and universality
neither overly broad nor narrow in scope
-they incorporate a limited number of concepts and focus on a specific aspect of nursing
-they typically merge practice and research
Middle-range theories of nursing
theory was based on couples experiencing miscarriages
middle range theories of nursing
studied men with prostate cancer who were watchfully waiting for advancing their disease rather than seeking aggressive therapies
Mischel's uncertainty in illness (middle range theories in nursing)
based on qualitative research on politically and economically powerless or those who were vulnerable as a function of advanced disease
Jezewski's cultural brokering theory (middle range)
notes that death and dying is a social phenomenon that involves a wide range of human responses across a variety of settings
Dobratz theory of psychological adaptation in death and dying
occurs when nurses intentionally structure their practice around a particular nursing theory and use it to guide them as they use the nursing process to assess, plan, diagnose, intervene, and evaluate nursing care
theory-based practice
1. it shapes theoretical orientation to practice
2. it facilitates the transmission of nursing knowledge
3. it contributes to professional autonomy, it is a nursing-based guide for practice, education, and research
4. it helps develop analytical skills, c
Benefits of theory-based practice