TFN Notes - Theoretical Foundations in Nursing PDF

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Introduction to Nursing TheoryHISTORY OF NURSING THEORY Began with Florence Nightingale  nursing knowledge apart from medical knowledge= guide nursing practice  Based on principles and traditions that were handed down through an apprenticeship model of education and individual hospital procedure ...

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Introduction to Nursing Theory

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HISTORY OF NURSING THEORY   

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Began with Florence Nightingale nursing knowledge apart from medical knowledge= guide nursing practice Based on principles and traditions that were handed down through an apprenticeship model of education and individual hospital procedure manual Nursing practice reflects its vocational heritage Develop a body of specialized knowledge on which to base nursing practice strong emphasis on practice and nurses worked throughout the century toward the development of nursing as a profession

Baccalaureate degree began to gain wider acceptance as:  Education Level for professional nursing  Academic discipline in higher education 

HISTORICAL ERA 

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CURRICULUM ERA (1900-1940)  What CONTENT nurses should study to learn how to be a nurse  What COURSES nursing students should take  Moving nursing education from hospital-based  Colleges and universities emerge  COURSE SELECTION AND CONTENT for nursing programs RESEARCH EMPHASIS ERA (1950-1970s)  focused on the research process and the long-range goal acquiring substantive knowledge to guide nursing practice  nurses sought degrees in higher education  awareness for the need of concept and theory development coincided with two other milestones TWO MILESTONES:

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 THE STARDAIZATION OF CURRICULA FOR NURSING MASTERS EDUCATION  DOCTORAL EDUCATION OF NURSING GRADUATE EDUCATION ERA (19501970s)

tandem with the research era transition from vocation to profession masters degree programs in nursing emerged to meet the public need

THEORY ERA (1980-1990s)  a natural outgrowth of the research and graduate education eras  emphasis on theory development and testing  accelerated as early works developed as frameworks for curricula and advanced practice guides began to be recognized as theory  transition from pre-paradigm to paradigm  PRE-PARADIGM=“before scientific consensus”  PARADIGM= ideas and beliefs of a group of specialists to understand theories and models  METAPARDIGM= set of theories/ideas to provide a structure on HOW A DISCIPLINE SHOULD FUNCTION

CLASSIFICATION OF NURSING MODELS WITHIN METAPARADIGM:    

PERSON ENVIRONMENT HEALTH NURSING

EMPHASIS SHIFTED FROM LEARNING ABOUT THE THEORIST TO USE OF THE THEORETICAL WORKS TO GENERATE:  Research questions  Guide practice  Organize curricula

THEORY DEVELOPMENT EMERGED AS A PROCESS AND PRODUCT OF PROFESSIONAL SCHOLARSHIP AND GROWTH AND SOUGHT HIGHER EDUCATION AMONG:    

Nurse leaders Administration Educators Practitioners

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THEORY UTILIZATION ERA (21st Century)  existing era  emphasis shifted to theory application in nursing practice, research, education and administration  restored balance between research and the practice for knowledge development= balance research and practice  emphasis to produce evidence for quality professional practice TYPES OF NURSING THEORETICAL WORKS  NURSING PHILOSOPHY  sets forth the meaning of nursing phenomena through analysis, reasoning and logical presentation  basis for subsequent development  NURSING CONCEPTUAL MODELS/FRAMEWORKS  comprises nursing works by the theorists who also are referred to as pioneers in nursing  used to organize curricula, structure curriculum content and guide course content in nursing programs  NURSING THEORY  derived from nursing philosophies, conceptual models or more abstract nursing theories, or from works of other disciplines  developed from some conceptual frameworks and

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is more specific than the framework theories may be specific to a particular aspect or setting of nursing practice

 MIDDLE RANGE THEORY  more specific focus and is more concrete than nursing theory in its level of abstraction  more precise, with a focus on answering specific nursing practice questions  address the specifics of nursing situations within the perspective of the model or theory from which they are derived. THEY SPECIFY EACH FACTOR AS:     

The age group of the patient The family situation The health condition The location of the patient The action of the nurse

SIGNIFICANCE OF NURSING THEORY  DISCIPLINE = specific to academia and refers to a branch of education, a department of learning, or domain of knowledge  PROFESSION = refers to a specialized field of practice, founded upon the theoretical structure of the science or knowledge of the discipline and accompanying practice abilities  This emphasis led into the theory era that moved nursing toward the goal of developing nursing knowledge to guide nursing practice  The discipline and the profession are inextricably linked and failure to recognize and separate them from each other anchors nursing in a vocational view rather than a professional view.  The discipline is dependent on theory for its continued existence.

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Nursing can be just vocational or nursing can be a discipline with a professional style of theory-based practice. Nurses moved from the functional focus (emphasizing on what nurses can do) to patient focus (emphasizing what nurses know for decision-making and action)

6. Attracts individuals with intellectual and personal qualities of exalting service above personal gain who recognize their chosen occupation as a life work. 7. Strives to compensate its practitioners by providing freedom of action, opportunity for continuous professional growth and economic security

FORMS OF BASIS IN RECOGNIZING NURSING AS A DISCIPLINE:  KNOWLEDGE OF PERSON  HEALTH  ENVIRONMENT  

Every discipline or field of knowledge includes theoretical knowledge Nursing as an academic discipline depends on the existence of nursing knowledge

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SIGNIFICANCE FOR THE PROFESSION    

Theory is essential for the existence of nursing as an academic discipline Theory is also vital to the practice of professional nursing Higher degree nursing is recognized as a profession today Nursing was the subject of numerous studies by sociologist who used the criteria for a profession.

Nursing is recognized as a profession and emphasis is placed on the relationship between nursing theoretical works and achievement of status as a profession. The use of substantive knowledge for the theory- based evidence for nursing is a quality that is characteristic of their practice. The commitment to the theory-based evidence for practice is beneficial to patients in that it guides systematic, knowledgeable care.

SCIENCE   

Latin “scientia” means knowledge a systematically organized body of knowledge about a particular subject is performing the process of observation, description, investigation and theoretical explanation of natural phenomenon

KNOWLEDGE CRITERIA FOR DEVELOPMENT OF THE PROFESSIONAL STATUS OF NURSING:

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1. Utilizes in its practice a well-defined and well organized body of specialized knowledge that is on the intellectual level of higher learning.

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2. Constantly enlarges the body of knowledge it uses and improves its techniques of education and service through use of the scientific method. 3. Entrust the education of its practitioners to institutions of higher education. 4. Applies its body of knowledge in practical services vital to human and social welfare. 5. Functions autonomously in the formulation of professional policy and thereby in the control of professional activity.

general awareness, understanding, or possession of information, facts, ideas, truths or principles information, skills, and expertise acquired by a person through various experiences or through formal/informal learning

SOURCES OF KNOWLEDGE  

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TRADITIONAL- nursing practice is passed down from generation to generation AUTHORITATIVE- an idea by a person of authority which is perceived as true because of his or her expertise SCIENTIFIC- knowledge came from scientific method through research, most punctual

THEORY

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An organize system of accepted knowledge composed of concepts, propositions, definition, and assumptions intended to explain a set of facts, events, or phenomena Proposed to explain a given phenomena Group of related concepts that propose actions that guide practice

CONCEPT   

Idea, belief, view, notion, thought, perception, impression Building blocks of theories Enhances capacity to define the meaning

Mint green- factual concept Patients who are dehydrated need increased oral fluid intake or IV fluid therapy

PHENOMENON  

Occurrence that can be observes Something notable; excite people’s interest and curiousity

PHILOSOPHY  

Beliefs and values about human beings and their worlds Concerned with the purpose of human life, the nature of being and reality, theory and limits of knowledge

ABSTRACT CONCEPT   

Indirectly observed Independent on time an place Love, care and freedom

CONCRETE CONCEPT   

Directly observed Specific time and place Medication, watcher, chair

PROPOSITION 

Explains the relationship of different concepts

Example: Children don’t want to stay in the hospital because of their fear of injections DEFINITION 

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Composed of various descriptions which convey general meaning and reduces the vagueness in understanding a set of concepts Gives distinct characteristics to differ from one to another

ASSUMPTION 

Specifies the relationship or connection of factual concepts or phenomena

EXAMPLE Yellow- concrete concept

CHARACTERISTICS OF THEORY 1. CORRELATE CONCEPTS to generate a different way of looking ar a certain fact or phenomenon 2. SHOULD BE LOGICAL IN NATURE Logic- orderly reasoning  Sequential and consistently use within the theory 3. SHOULD BE SIMPLE Parsimonous- simple terms that describes, explains, or presicts a wide range of phenomena 4. SOURCE OF HYPOTHESES that can be tested for it to be elaborade 5. CONTRIBURE TO ENRICHING THE GENERAL BODY OD KNOWLEDGE that studies implemented to validate them 6. USED BY PRACTIONERS to direct/enhance their practice 7. MUST BE CONSISTENT

TYPES OF THEORIES 

DESCRIPTIVE (Factor-Isolating) Theories

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know the properties of a discipline but do not explain the relationship of concepts  describe how things really are EXPLANATORY (Factor-Relating) theories  Examine how properties relate PREDICTIVE (Situation-Relating) Theories - calculate relationships between properties and how they occur PRESCRIPTIVE (Situaion-Producing) Theories  How peoples or things should function  Opposite of descriptive theories

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THE METAPARADIGM OF NURSING  

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COMPONENTS OF A THEORY (CCP)   

CONTEXT CONTENT PROCESS- method or actual practices of nurses

NURSING THEORY  

PURPOSES OF NURSING THEORY 

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 ENVIRONMENTAL THEORY  THEORY OF HUMAN CARING  “Nurses have to provide care when patients cannot take care of themselves” NURSING THEORIES AND MODELS

NURSING PARDIGM 

PATTERNS or MODELS to show clear relationship among the theoretical world in nursing

METAPARADIGM  

Greek “meta”-with; “Paradeigma”pattern Main conepts encompassing the subject matter and the scope of discipline

PERSON  Recipient of nursing care ENVIRONMENT  Internal and external conditionds and circumstances and influences affecting the person HEALTH  Degree of wellness and illness NURSING  Actions, characterstics, and attribues, of the inbidual providing nursing care

THE IMPORTANCE OF NURSING CARE THEORY

Support nursing practice Derive from nursing models

EXAMPLES OF A NURSING THEORY:

Organizing conceptual or philosophical framework Defines and describes the relationships among the major ideas and values

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EDUCATION  Provide a general focus for curriculum  Guide curricular decision-making RESEARCH  Offers framework for generating knowledge and new ideas  Discovery of knowledge in a specific field of study  Offers a systematic approach in indentifying questions CLINICAL PRACTICE  Assist nurses to describe, explain, and predict everyday experiences  Serve to guide assessment, implementation, and evaluation of nursing care  Provide rationale  Establish criteria to measure the quality of nursing care  Build common terms (derived in nursing theories)  Clarify beliefs  Define the unique contributions of nursing care  Enhance the autonomy in nursing

RELATIONSHIPS BETWEENN:

 THEORY AND RESEARCH A. VALIDATES AND MODIFIES THEORY B. STIMULATES EXPLORATION

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 THEORY AND PRACTICE A. GUIDES PRACTICE B. PROVIDES INSIGHTS ABOUT NURSING PRACTICE SITUATIONS C. SHAPES THEORY  RESEARCH AND PRACTICE A. DEVELOPS PRACTICE

FLORENCE NIGHTINGALE    

Mother of Nursing Lady with the lamp Comfort of the soldiers Responsible for improving conditions in hospital and making nursing as job

FIVE MAJOR COMPONENTS OF A HEALTHFUL ENVIRONMENTS     

PROPER VENTILATION ADEQUATE LIGHT SUFFICIENT WARM CONTROL OF NOISE CONTROL OF EFFLUVIA (NOXIOUS ODORS)

FIVE COMPONENTS OF ENVIRONMENTAL HEALTH ACCORDING TO NIGHTINGALE 

NIGHTINGALE’S NURSING THEORY  

Utilizing the patient’s environment to assist him in his recovery Initiative to configure environmental settings

THEORY BASIS: The interrelationship of a healthful environment with nursing THEORY GOAL: NURSES HELP PATIENTS RETAIN THEIR OWN VITALITY THREE TYPES OF ENVIRONMENT 

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PHYSICAL  Physical elements where the patient of being treated  Affect all other aspect od the enviration  Cleanliness, ventilation, noise, light, temperature, drainage, electricity PSYCHOLOGICAL  Provide stress-free surroundings  Affective by a negative physical environment causes STRESS  Involves communication with the person, about the person, and about other person SOCIAL

People surrounding the patient Involves collecting data about illness and disease prevention Consist of a person’s home or hospital room, as well as the total community that affects the patient’s specific environment

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PURE AIR  Proper ventilation  Cause disease or recovery  Measuring body temperature by palpation of extremities PURE WATER EFFICIENT DRAINAGE CLEANLINESS LIGHT

QUIET AND DIET 

Take the preferences of the patient

NIGTINGALE 13 CANONS/PRINCIPLES 1. VENTILATION AND WARMTH 2. HEALTH OF HOUSES (PURE WATER, PURE AIR, EFFICIENT DRAINAGE, CLEANLINESS) 3. PETTY MANAGEMENT (NOT KNOWING HOW TO MANAGE WHAT YOU DO WHEN YOU ARE THERE AND WHAT SHALL BE DONE WHEN YOU ARE NOT THERE) 4. NOISE 5. VARIETY (PROVIDE OTHERS ACTIVITIES) 6. TAKING FOOD (DIET, HOW MUCH FOOD THE PATIENT EATS) 7. WHAT FOOD 8. BED AND BEING (CLEAN THE BED 12HRS, PROVIDES PILLOW) 9. LIGHT (DIRECT SUNLIGHT HAS PURIFYING EFFECT TO THE PATIENT)

10. CLEANLINESS OF ROOM AND WALLS 11. PERSONAL CLEANLINESS 12. CHATTERING HOPES AND ADVICES 13. OBSERVATION OF THE SICK (TREATMENT AND RECOMMENDATION OF PATIENT) METAPARADIGM IN NURSING  

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PERSON (PATIENT)  Recipient of care ENVIRONMENT  External conditions and forces  Verbal and Non-verbal interactions with the person HEALTH  State of being well  Diseases viewed as reparative proves instituted by nature  NATURE= GOD  Nature= environment NURSING  Aims to provide fresh air

NIGHTINGALE’S ASSUMPTIONS 1. NURSING IS SEPARATE FROM MEDICINE 2. NURSES SHOULD BE TRAINES 3. THE ENVIRONMENT IS IMPORTANT 4. THE DISEASE PROCESS IS NOT IMPORTANT TO NURSING 5. NURSING SHOULD SUPPORT THE ENVIRONMET TO ASSIST THE PATIENT IN HEALING 6. BACKUP WITH RESEARCH 7. NURSING IS BOTH AN EMPERICAL SCIENCE AND AN ART 8. NURSING’S CONCERN IS WITH THE PERSON IN THE ENVIRONMENT 9. THE PERSON IS INTERACTINF WITH THE ENVIRONMENT 10. SICK AND WELL ARE GOVERNED BY THE SAME LAWS AND HEALTH 11. THE NURSE SHOULD BE OBSERVANT AND CONFIDENTIAL...