Introduction to Nursing Theories Nursing 210 Spring 2004 Curlissa Mapp RN, BSN Georgia Baptist College of Nursing of Mercer University

“ Practicing nurses who despise theory are condemned to performing a series of tasks - either at the command of a physician or in response to routines and policies.” Leah Curtin, RN, MS, FAAN (1989) Former Editor, Nursing Management

WHY STUDY NURSING THEORY? WHAT DOES THE PRACTICING NURSE WANT FROM NURSING THEORY?

Nursing must examine: What is the nature of knowledge needed for the practice of nursing? What it means to practice nursing?

The study and use of nursing theory in nursing practice must have roots in the everyday practice of nurses (Gordon, Parker, Jester, 2001)

Reasons for Studying Nursing Theory Everyday practice enriches theory Practice and theory guided by values and beliefs Reframe thinking about nursing Theory guides use of ideas and techniques Close gap between theory and research Envision potentialities (Gordon, Parker, Jester, 2001)

Nursing Theory and the Practicing Nurse Theory assists the practicing nurse to: 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)

STURUCTURAL HIERARCHY OF NURSING KNOWLEDGE: COMPONENTS & LEVEL OF ABSTRACTIONS Metaparadigm Philosophies Conceptual Models Theories Empirical Indicators Most Abstract Most Concrete

METAPARADIGM - Global concepts that identify the phenomena of interest -Global propositions that describe the concepts -Global propositions that state the relations between the concepts (Fawcett, 2000)

FUNCTION OF THE METAPARADIGM Summarize the intellectual and social missions of a discipline and place a boundary on the subject matter of that discipline

METAPARADIGM Phenomena of interest to nursing is represented by Four Central Concepts 1.Person 2. Environment 3.Health 4.Nursing

PHILOSOPHIES A statement encompassing claims about a phenomena of central interest to a discipline, claims about how a phenomena comes to be known and claims about what the members of a discipline value

FUNCTION OF PHILOSOPHIES To Communicate: -What people assume to be true in relation to the phenomena of interest to a discipline. (Christensen & Kenney, 1990) - What people believe regarding the development of knowledge about those phenomena

PHILOSOPHIES Florence Nightingale’s work is an example of a philosophy Example of philosophical statement “ the individual … behaves purposefully, not in a sequence of cause and effect.” (Roy, 1988, p. 32)

CONCEPTS Word or phrase that summarizes the essential characteristics or properties of a phenomenon Abstract idea (i.e. Hope, love, desire, pain, body temperature) Derived from impressions the human mind receives about phenomena through sensing the environment (McEwen & Willis, 2002)

CONCEPTS Are equivalent of bricks in a wall and lend structure to science (Hardy, 1973, Wuest, 1994) Are defined for each specific use the writer or researcher makes of the term (Hardy, 1973)

CONCEPTS When operationalized become variables used in hypotheses to be tested in research. Explicate subject matter of theories of a discipline

CONCEPTUAL MODELS A set of abstract and general concepts and propositions that integrate those concepts into a meaningful configuration. (Lippitt, 1973; Nye & Berardo, 1981)

FUNCTION OF CONCEPTUAL MODELS Frameworks or paradigms that provide “a broad frame of reference for systematic approaches to the phenomena with which the discipline is concerned. (Tomey & Alligood, 2002)

EXAMPLE CONCEPTUAL MODELS - King’s General Systems Framework - Roy’s Adaptation Model

CONCEPTUAL MODELS Word structures that provide a specific view on nursing through the interrelationship of concepts in the structure. VERBAL – worded statements, a form closely related to knowledge development SCHEMATIC – diagrams, drawings, graphs or pictures that facilitate understanding

THEORIES A group of related concepts that propose action that guides practice Consist of one or more relatively specific and concrete concepts and propositions that purport to account for or organize some phenomenon (Barnum, 1998)

FUNCTION OF THEORIES Primary Purpose: To Generate Knowledge

Theories vary in their level of abstraction and scope GRAND THEORY - More abstract and broad in scope MIDDLE-RANGE THEORY - More concrete and narrower in scope

Nursing Theory Describes or Explains Nursing Enable nurses to know WHY they are doing WHAT they are doing

EMPIRICAL INDICATORS A very concrete and specific real world proxy for a middle- range theory concept; An actual instrument, experimental condition or clinical procedure that is used to observe or measure a middle-range theory concept (Fawcett, 2002)

FUNCTION OF EMPIRICAL INDICATORS Provide the means by which middle-range theories are generated or tested Indicators that are experimental conditions or clinical procedures tell the researcher or clinician exactly what to do ( protocols or scripts that direct actions in a precise manner) (Fawcett, 2002)

SUMMARY