Chapter 6 Overview of Grand Nursing Theories

Grand Nursing Theories Most complex and widest in scope of the levels of theory Attempt to explain broad areas within the discipline

Relationship of conceptual model, theory, and hypotheses.

Grand Nursing Theories—(cont.) Characteristics Composed of relatively abstract concepts Developed through thoughtful appraisal of existing ideas May incorporate other theories

Grand Nursing Theories—(cont.) Have helped develop the discipline Some believe need for grand theories is outdated.

Grand Nursing Theories—(cont.) Provide a background of philosophical reasoning Many nursing theorists are still writing, updating their work based on changes in the health care system and society.

Grand Nursing Theories—(cont.) The number of grand nursing theories leads to confusion. Many have coined their own terms also leading to confusion.

Grand Nursing Theories—(cont.) Categorizations or groupings of the theories have been attempted based on theory commonalities and worldviews. Three main groups Human needs theories (particulate–deterministic) Interactive theories (integrative, reciprocal) Unitary process theories (unitary, simultaneity)

Question Which of the following is NOT one of categorizations of grand nursing theories described in the text? Historical/generative theories Human needs theories Interactive/integrative process theories Unitary process theories

Answer A. Historical/generative Rationale: One way to organize the large number of grand nursing theories is by human needs theories, interactive or integrative process theories, and unitary process theories.

Comparison of categories (paradigms) of theories.

Human Needs Theories Also termed “particulate–deterministic” Based on the positivist view of science Stress quantitative research methods Humans are viewed a reducible (sum of parts). Change is linear and causal.

Human Needs Theories—(cont.) Humans are biopsychosocial-spiritual beings. Humans react to their environment in a causal way. Change is predictable as humans survive and adapt.

Human Needs Theories—(cont.) Earliest theorists drew from the empirical (positivist) worldview focusing on meeting needs. Early theories were developed to distinguish nursing from medicine. In needs-based theories, clients are sum of their parts. Cause of the problem can be identified, measured, and treated.

Human Needs Theories—(cont.) F. Abdellah V. Henderson D. Johnson F. Nightingale B. Neuman D. Orem

Interactive Nursing Theories Also termed integrative or reciprocal Postpositive worldview (not strictly positivistic) Recognize that reality is multidimensional and contextual Objectivity and subjectivity are desirable.

Interactive Nursing Theories—(cont.) Humans are holistic beings. Humans interact reciprocally with their environment.

Interactive Nursing Theories—(cont.) Interactive theories came after the needs-based theories. Theorists frequently use systems theory to describe interaction between client/person and environment.

Question Tell whether the following statement is true or false: Interactive/integrative process theories frequently stress that humans should be considered in the context of their environment and the theories use a systems approach.

Answer True Rationale: Interactive nursing theories recognize that reality is contextual and typically involve systems theory.

Interactive Nursing Theories—(cont.) Artinian Erickson, Tomlin, and Swain King Levine Roper, Logan, and Tierney Roy Watson

Unitary Process Theories Also termed unitary or simultaneity theories Views humans as unitary beings Humans are self-evolving and self-regulating.

Unitary Process Theories—(cont.) Humans are in constant and simultaneous interaction with a universal energy system. Humans are known by patterns of energy and distinctions from others. Change is unidirectional and unpredictable.

Question Tell whether the following is true or false: According to unitary process theory, humans are complex energy systems whose responses can be predicted.

Answer False Rationale: Unitary process theories recognize that, although humans are energy systems in constant and simultaneous interaction with their environment, because they are complex and constantly changing, change is unidirectional and unpredictable.

Unitary Process Theories—(cont.) M. Rogers R. Parse M. Newman

Online Resources http://www.sandiego.edu/academics/nursing/theory/ http://nursing-theory.org/ http://www.nurses.info/nursing_theory_accepted_theorie s.htm