Development Of Nursing Practice Theory

BScn semester 2016Nursing Theories And Models

Unit oneFaculty : Ramesh kumar

2016New Life School of Nursing Karachi

BScn semester 2016Nursing Theories And Models

Unit oneFaculty : Ramesh kumar

2016New Life School of Nursing Karachi

OBJECTIVES• At the end of learner will be able to,1) What is Theory.2)Components of Theory.3)What is Paradigm.4)What is Domain.5)How does Domain Relate To Nursing Theory.6)Purposes of Nursing Theory.

• At the end of learner will be able to,1) What is Theory.2)Components of Theory.3)What is Paradigm.4)What is Domain.5)How does Domain Relate To Nursing Theory.6)Purposes of Nursing Theory.

Contin…

7)Types of Nursing Theory.8)Why on earth do we study Nursing theory.9)How do Nurses use theory in everyday

Practice.10)Classification of Nursing Theory.11)7 Nursing Theories To Practice.

7)Types of Nursing Theory.8)Why on earth do we study Nursing theory.9)How do Nurses use theory in everyday

Practice.10)Classification of Nursing Theory.11)7 Nursing Theories To Practice.

What is a theory?• A set of concepts,

definitions, relationships,and assumptions thatproject a systematic viewof a phenomena

• It may consist of one ormore relatively specificand concrete conceptsand propositions thatpurport to account for, ororganize somephenomenon (Barnum,1988)

• A set of concepts,definitions, relationships,and assumptions thatproject a systematic viewof a phenomena

• It may consist of one ormore relatively specificand concrete conceptsand propositions thatpurport to account for, ororganize somephenomenon (Barnum,1988)

What are the components of atheory?

• Concepts – ideas andmental images that help todescribe phenomena(Alligood and Marriner-Tomey, 2002)

• Definitions – convey thegeneral meaning of theconcepts

• Assumptions – statementsthat describe concepts

• Phenomenon – aspect ofreality that can beconsciously sensed orexperienced (Meleis, 1997).

• Concepts – ideas andmental images that help todescribe phenomena(Alligood and Marriner-Tomey, 2002)

• Definitions – convey thegeneral meaning of theconcepts

• Assumptions – statementsthat describe concepts

• Phenomenon – aspect ofreality that can beconsciously sensed orexperienced (Meleis, 1997).

What is a paradigm?

• A model that explains thelinkages of science,philosophy, and theoryaccepted and applied bythe discipline (Alligoodand Marriner – Tomey,2002)

• A model that explains thelinkages of science,philosophy, and theoryaccepted and applied bythe discipline (Alligoodand Marriner – Tomey,2002)

What is a domain?• The view or perspective of

the discipline• It contains the subject,

central concepts, valuesand beliefs, phenomena ofinterest, and the centralproblems of the discipline

• The view or perspective ofthe discipline

• It contains the subject,central concepts, valuesand beliefs, phenomena ofinterest, and the centralproblems of the discipline

How does domain relate to nursingtheory?

• Nursing has identifiedits domain in aparadigm that includesfour linkages:

1) person/client2) health3) environment4) nursing

• Nursing has identifiedits domain in aparadigm that includesfour linkages:

1) person/client2) health3) environment4) nursing

Purposes of nursing theory

What are the purposes of nursingtheory?

• It guides nursing practiceand generatesknowledge

• It helps to describe orexplain nursing

• Enables nurses to knowWHY they are doingWHAT they are doing

• It guides nursing practiceand generatesknowledge

• It helps to describe orexplain nursing

• Enables nurses to knowWHY they are doingWHAT they are doing

Types of nursing theories• Grand theories – broad

and complex• Middle-range theories-

address specificphenomena and reflectpractice

• Descriptive theories –first level of theorydevelopment

• Prescriptive theories –address nursinginterventions and predicttheir consequences

• Grand theories – broadand complex

• Middle-range theories-address specificphenomena and reflectpractice

• Descriptive theories –first level of theorydevelopment

• Prescriptive theories –address nursinginterventions and predicttheir consequences

Why on earth do we study nursingtheory?

• 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 (Gordon, Parker, &

Jester, 2001)

• 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 (Gordon, Parker, &

Jester, 2001)

So how do nurses use theory ineveryday 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(Alligood, 2001)

• Organize patient data• Understand patient data• Analyze patient data• Make decisions about

nursing interventions• Plan patient care• Predict outcomes of care• Evaluate patient

outcomes(Alligood, 2001)

Classification of nursing theories

• A. Depending On Function• Descriptive-to identify the properties and workings of a discipline• Explanatory-to examine how properties relate and thus affect the

discipline• Predictive-to calculate relationships between properties and how

they occur• Prescriptive -to identify under which conditions relationships occur

• B. Depending on the Generalisability of theirprinciples

• Metatheory: the theory of theory. Identifies specific phenomenathrough abstract concepts.

• Grand theory: provides a conceptual framework under which thekey concepts and build up.

• A. Depending On Function• Descriptive-to identify the properties and workings of a discipline• Explanatory-to examine how properties relate and thus affect the

discipline• Predictive-to calculate relationships between properties and how

they occur• Prescriptive -to identify under which conditions relationships occur

• B. Depending on the Generalisability of theirprinciples

• Metatheory: the theory of theory. Identifies specific phenomenathrough abstract concepts.

• Grand theory: provides a conceptual framework under which thekey concepts and build up.

7 Nursing Theories To Practice

• Virginia Henderson• Martha Rogers• Dorothea E. Orem• Betty Neuman• Hildegard Peplau• Madeleine Leininger• Patricia Benner

• Virginia Henderson• Martha Rogers• Dorothea E. Orem• Betty Neuman• Hildegard Peplau• Madeleine Leininger• Patricia Benner

1) VirginiaHenderson

• Often called "the Nightingale ofModern Nursing," Hendersonwas a noted nursing educatorand author. Her "Need Theory"was based in practice and hereducation. She emphasized theimportance of increasing aclient's independence topromote their continued healingprogress after hospitalization.Her definition of nursing wasone of the first to mark thedifference between nursing andmedicine.

• Often called "the Nightingale ofModern Nursing," Hendersonwas a noted nursing educatorand author. Her "Need Theory"was based in practice and hereducation. She emphasized theimportance of increasing aclient's independence topromote their continued healingprogress after hospitalization.Her definition of nursing wasone of the first to mark thedifference between nursing andmedicine.

Contin…..• The unique function of the nurse is to assist

the individual, sick or well, in the performanceof those activities contributing to health or itsrecovery (or to peaceful death) that he wouldperform unaided if he had the necessarystrength, will, or knowledge. And to do this insuch a way as to help him gain independenceas rapidly as possible. She must in a sense, getinside the skin of each of her patients in orderto know what he needs."

• The unique function of the nurse is to assistthe individual, sick or well, in the performanceof those activities contributing to health or itsrecovery (or to peaceful death) that he wouldperform unaided if he had the necessarystrength, will, or knowledge. And to do this insuch a way as to help him gain independenceas rapidly as possible. She must in a sense, getinside the skin of each of her patients in orderto know what he needs."

2) MarthaRogers:

• Rogers honed her theorythrough many years ofeducation. She was not onlya diploma nurse, she held aMaster's of Public Healthfrom Johns HopkinsUniversity and completed herDoctorate of Nursing there aswell. She saw nursing as botha science and an art. Rogers'theory is known as that ofthe Unitary Human Beings.

• Rogers honed her theorythrough many years ofeducation. She was not onlya diploma nurse, she held aMaster's of Public Healthfrom Johns HopkinsUniversity and completed herDoctorate of Nursing there aswell. She saw nursing as botha science and an art. Rogers'theory is known as that ofthe Unitary Human Beings.

Contin….

• Nursing seeks to promote symphonic interactionbetween the environment and the person, tostrengthen the coherence and integrity of thehuman beings, and to direct and redirect patternsof interaction between the person and theenvironment for the realization of maximumhealth potential. Her development of thisabstract system was strongly influenced by anearly grounding in arts and background of sciencealong with her keen interest in space

• Nursing seeks to promote symphonic interactionbetween the environment and the person, tostrengthen the coherence and integrity of thehuman beings, and to direct and redirect patternsof interaction between the person and theenvironment for the realization of maximumhealth potential. Her development of thisabstract system was strongly influenced by anearly grounding in arts and background of sciencealong with her keen interest in space

3) Dorothea E.Orem

• Known as the Self-CareTheory, Orem's vision ofhealth is a statecharacterized by wholenessof developed humanstructures and of bodilyand mental functioning. Itincludes physical,psychological,interpersonal and socialaspects.

• Known as the Self-CareTheory, Orem's vision ofhealth is a statecharacterized by wholenessof developed humanstructures and of bodilyand mental functioning. Itincludes physical,psychological,interpersonal and socialaspects.

Contin…

• Her major assumptions included that peopleshould be self-reliant and responsible for theirown care and the care of others in their family.She said that a person's knowledge ofpotential health problems is necessary forpromoting self-care behaviors. Orem definednursing as an art, a helping service and atechnology.

• Her major assumptions included that peopleshould be self-reliant and responsible for theirown care and the care of others in their family.She said that a person's knowledge ofpotential health problems is necessary forpromoting self-care behaviors. Orem definednursing as an art, a helping service and atechnology.

4) BettyNeuman:

• The System Model,developed by Neuman,focuses on the response ofthe client system to actualor potential environmentalstressors and the use ofseveral levels of nursingprevention intervention forattaining, retaining andmaintaining optimal clientsystem wellness.

• The System Model,developed by Neuman,focuses on the response ofthe client system to actualor potential environmentalstressors and the use ofseveral levels of nursingprevention intervention forattaining, retaining andmaintaining optimal clientsystem wellness.

Contin…• Neuman defines the concern of nursing is

preventing stress invasion. If stress is notprevented then the nurse should protect theclient's basic structure and obtain or maintaina maximum level of wellness. Nurses providecare throughprimary, secondary andtertiary prevention modes.

•

• Neuman defines the concern of nursing ispreventing stress invasion. If stress is notprevented then the nurse should protect theclient's basic structure and obtain or maintaina maximum level of wellness. Nurses providecare throughprimary, secondary andtertiary prevention modes.

•

5) HildegardPeplau:

• Four phases definePeplau's InterpersonalTheory or nursing. Shedefines the nurse/patientrelationship evolvingthroughorientation,identification, exploitationand resolution. She viewsnursing as a maturing forcethat is realized as thepersonality develops througheducational, therapeutic, andinterpersonal processes.

• Four phases definePeplau's InterpersonalTheory or nursing. Shedefines the nurse/patientrelationship evolvingthroughorientation,identification, exploitationand resolution. She viewsnursing as a maturing forcethat is realized as thepersonality develops througheducational, therapeutic, andinterpersonal processes.

Contin…

• Nurses enter into a personal relationship withan individual when a felt need is present.Peplau's model is still very popular withclinicians working with individuals who havepsychological problems.

• Nurses enter into a personal relationship withan individual when a felt need is present.Peplau's model is still very popular withclinicians working with individuals who havepsychological problems.

6) MadeleineLeininger:

• One of the newer nursingtheories, TransculturalNursing first appeared in1978. According toLeininger, the goal ofnursing is to provide carecongruent with culturalvalues, beliefs, andpractices. Leininger statesthatcare is the essence ofnursing and the dominant,

• One of the newer nursingtheories, TransculturalNursing first appeared in1978. According toLeininger, the goal ofnursing is to provide carecongruent with culturalvalues, beliefs, andpractices. Leininger statesthatcare is the essence ofnursing and the dominant,

Contin…

distinctive and unifying feature. She says therecan be no cure without caring, but that theremay be caring with curing. Health carepersonnel should work towards anunderstanding of care and the values, healthbeliefs, and life-styles of different cultures,which will form the basis for providing culture-specific care.

distinctive and unifying feature. She says therecan be no cure without caring, but that theremay be caring with curing. Health carepersonnel should work towards anunderstanding of care and the values, healthbeliefs, and life-styles of different cultures,which will form the basis for providing culture-specific care.

7) PatriciaBenner:

• From Novice to Expert isprobably the simplestnursing theory tounderstand. Bennerdescribes five levels ofnursing experience:novice,advanced beginner,competent, proficient andexpert. The levels reflect amovement from relianceon abstract principles tothe use of past concreteexperience.

• From Novice to Expert isprobably the simplestnursing theory tounderstand. Bennerdescribes five levels ofnursing experience:novice,advanced beginner,competent, proficient andexpert. The levels reflect amovement from relianceon abstract principles tothe use of past concreteexperience.

Contin…

• She proposes that a nurse could gainknowledge and skills without ever learning thetheory. Each step builds on the previous oneas the learner gains clinical expertise. Simplyput, Benner says experience is a prerequisitefor becoming an expert. Benner published her"Novice to Expert Theory" in 1982.

• She proposes that a nurse could gainknowledge and skills without ever learning thetheory. Each step builds on the previous oneas the learner gains clinical expertise. Simplyput, Benner says experience is a prerequisitefor becoming an expert. Benner published her"Novice to Expert Theory" in 1982.