Lecture 1 - Scholarliness in Nursing

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NCM 100- Theoretical Foundations in Nursing scholarly tools to come up with better results.

In relation to nursing, there


should be also the synthesis and merging of communication. Example is the
LECTURE 1_SCHOLARLINESS IN NURSING ‌ nursing process- the ADPIE (Assessment, Diagnosis, Planning (client care),
Implementation, Evaluation)
On being and becoming a scholar
- A hallmark of the 1990’s because research and theory help explicate major
Scholarliness in Nursing
agreed-on nursing phenomena.
- Norms of scholarliness
*Hallmark is a very significant event in nursing, because this was the time
- Tools of scholarliness
when nursing has achieved the status of scholarly discipline. How? That’s
- Indicators of scholarliness in nursing
because nursing was able to articulate or express its mission- the goal of
Nurses as scholars Revisiting scholarship in the 21st century nursing. Nursing was able to use theoretical terms and scientific data and
nursing has well established organizations in scientific journals. From
Scholarliness in Nursing rigorous research- many changes happened before nursing was able to achieve
Scholarliness- from the word scholar, scholar is a person who pursue academic and the status of scholarly discipline.
intellectual activities particularly those that develop expertise in an area of study.
Indicators of scholarliness in Nursing
Scholarliness in Discipline
- Scholarliness is demonstrated through continuity
- Refers to the degree to which its mission is defined and based on rigorous and
*There should be a continuity of care. Refinement and modification (of
credible research and on well-developed, supported and significant theories.
concepts, researches)- Innovation
*Note: what is our goal or mission in nursing?, do we need to undergo
- Concatenation- condition wherein the distance between the creation of
researches?, do we need to utilize theories?
knowledge, corroboration and translation of knowledge in practice is
diminishing
Scholarliness
*Merging of research theory and practice. Handle clinical problems and
- Combines theory, research, philosophy and in disciplines such as nursing
research problems later on through concatenation.
practice
- Development of the National Institute of Nursing Research
*Note: when we say combines theory, research, philosophy- this is the
*Authorized under the health research act of 1985- significant milestone of
merging or the synthesis and integration between a discipline’s different
nursing
components
- Cumulative work through research and theory
- Characterized by leaps that enhance explanation and understanding of
*Cumulative- ‘tuloy-tuloy’. Example, the health of the environment=health of
phenomena
the patient, environment affect the well-being of the client
*In scholarliness, there should be creativity. We are going to link seemingly
- Development of centers of research that house scholars with expertise, interest
unrelated concepts and variables. We are going to present work or data in a
and research methodologies focused on a particular area for knowledge
creative or unique way. Example is the ‘Apple theory’ by Isaac newton- he
development.
presented his theory in the law of gravity- by the fall and bump of an apple
*There came different categories such as women’s health, vulnerable
into his head while he was sitting under an apple tree in a contemplative
population, disparities in health, and elderly care. Development in the centers
mood. Creativity is a must.-
of research
- A process and state that encompasses the norms and tools of theorizing ang
- Toward valuation and respect accorded to clinical scholars
philosophizing
* Again, achievement of scholarly discipline
*In other words, it includes not only creativity but also in scholarliness there
should be communication of ideas. You can use different theories and
Nurse as Scholars (Nursing Scholars) - Scholarliness in the discipline means flexibility regarding to its theoretical
- Types of knowers or scholars (Belenky & Colleagues): base (refinement and modification)
a. Silent knowers - Scholarliness in nursing includes the collaborative efforts of all the resources
- Nurses who tend to accept the voices of authority and thus learn to be silent within nursing to work together to develop critical and reflective thinking in
- May not be able to articulate what they know through abstract thought for students, academicians and clinicians (interdisciplinary team, collaboration of
theoretical development efforts of all resources within nursing)
*In other words, they may not have the language to articulate what they know and - Scholarliness necessitates the use of local models of excellence and the
express their analysis or interpretation of a phenomena promotion of sponsorship of novices by experts or mentors and mentorees as
b. Received knowers essential (Example just by doing the lecture without demonstration, will it be
- Believe others are capable of producing knowledge that they can follow and effective? No, especially if skill is needed, skill development. Just by merely
reproduce using lecture without working relationship between the mentor and the
- They believe in external authorities; abilities to generate knowledge but not in mentoree, it may not be tangible. There should be a return demonstration;
their own or their peers’ abilities to do the same. goal: same characteristics as the mentor or possible development
*Depend on and value the expertise of others. Examples are those who use the
work of others because they believe that the work of others are far more superior The Scholarly Tool-tools used to enhance a student’s expertise especially in research
c. Subjective knowers 1. Google Scholar-no. 1 academic search engine, lets you find research paper
- Depend on their personal experiences. for all academic disciplines for free. It provides links to full text pdf files
- Believe and depend on their own inner voices and feelings (naniniwala sa 2. Microsoft Academic- the answer of Microsoft to google scholar, it takes a
sariling kakayahan) different approach, generate for each paper index an overview page that
-Knowledge is personal, private, subjectively known and intuited allows to easily explore top citing articles and its references
-Truth is an intuitive reaction- something experienced, not thought out 3. Trello- a useful and dynamic visual aid that can be accessed by every member
*Have wisdom that holistically looks and explains complete situation of the team. Certain task can be optimized, staffing changes can be accounted
d. Procedural knowers for and everybody on the team can see where the project is going as a whole
-Depend on careful observations and procedures 4. Mendeley- a must-have in scientific research. Helps manage references and
-They communicate procedures, rules and regulations import papers from other research tools, create bibliography and citations.
*Rationalist, communicate procedures, rules and regulations suited for developing 5. Scrivener- originally intended as a tool for screenwriters and novelist
empirical or procedural theories 6. Scanmarker- a portable, digital Optical Character Recognition (OCR) reader;
e. Constructed knowers a device that can read a page of printed text and convert It into a usable data
-Knowledge as contextual
-They experience themselves as creators of knowledge and value both subjective On becoming a scholar…
and objective strategies of knowing o Passion- feeling of intense enthusiasm or desire for something. Example are
*Integrate the different twist of knowing, believe that it is a never-ending process scientist who desires to study things
of knowledge development o Confidence- feeling of self-assurance
o Composure- in control
Scholarship of integration (summary) o Ability to be a team player- flexible enough, and accept that every now and
- Our discipline is scholarly if it engages in the development of knowledge that then there are changes to be made
has some significance (or will bring benefit) to humanity and to human beings o Analytical skills
o Foresight- futuristic, ability to predict what will happen or what things will be knowledge that enable those in the profession to explain what they do for their
needed in the future patients and the reason for their action.

LECTURE_2 AND 3 2. Definitions – convey the general meaning of the concepts


 Fundamentals of Theoretical Nursing *Explanation of the meaning of the concept, a word or a phrase
Theoretical Foundations in Nursing
Concepts 3. Assumptions – statements that describe concepts
Statements *Assume to describe a concept even without a proof. Examples: Cultural
Theories competence is an important component of nursing, illness and wellness are
Assumptions shaped by various factors including perception and coping skills of the client
Framework or Models
Paradigms 4. Propositions – statements that describe relationships between concepts.
Phenomenon/ Phenomena *Relationships meaning relate the different theories to one another. Example
 History of Theory Development the theory of Jim Watson, of Newman and of Orlando, analyze these theories
and find similarities. From there, a proposition can be created, relating, or
What is a Theory? stating or describing the relationship between concepts.
- A theory is a group of related concepts that propose action that guide practice.
*Group of related concepts meaning it is a system of ideas intended to exploit 5. Phenomenon – aspect of reality that can be consciously sensed or experienced
something may it be a fact or an event. (Meleis, 1997).
- A set of concepts, models, definitions, and assumptions that project a *A fact, a situation that is observed to exist or happen. Example are
systematic view of a phenomenon phenomenon such as: Gravity and tides, meteor shower, eruptions, in nursing
*Components of a theory are caring, self-care or a patient’s response to stress
- It may consist of one or more relatively specific and concrete concepts and
propositions that purport to account for, or organize some phenomenon 6. Models – are representations of the interaction among and between the
(Barnum, 1988). concepts showing patterns.
* organize some phenomenon meaning they can be tested that is to provide *serves as frameworks
support to challenge another theory or a work. To sum it up, a theory is a well
substantiated explanation of an aspect and that can incorporate laws, Types of Concepts
hypotheses and facts 1. Empirical concepts – can be observed or experienced through the senses
*Can be gained through experience, abstract thoughts contained in an object.
What are the Components of a Theory? Example: Beauty, Justice
1. Concepts – ideas and mental images that help to describe phenomena 2. Abstract concepts – are not observable (caring, hope, etc.)
(Alligood and Marriner- Tomey, 2002) *Can be understood but has no physical form. Example: Love, Success and
*A general notion, a thought, an abstract idea that occur in the mind, speech Freedom
and thought. These are fundamental building blocks of thoughts and beliefs.
With regards to mental representation, they are conceived in the mind. Conceptual Model and Framework
Example is a tree, a chair or a table, in nursing are health, wellness, illness, 0 Conceptual Model
stress and health promotion. Importance in nursing: provides the foundational
- Is made up of concepts and propositions which state the relationship between *Theories- explain person, environment… (4 metaparadigms of nursing), gives a
concepts that are generally abstract and not readily observable in the empirical perspective for assessing patients, situations and organizing data and methods for
world. analyzing and interpreting information. Example is theory of Orem which is the
- Symbolic representation of a theory, shown through diagrams or mathematical theory of Self-Care, where if used this theory of practice we are going to assess and
notations. interpret data to determine patient’s self-care needs/deficits/abilities to manage the
- Very broad ideas that form the fabric of the theory disease or situation of client. Guide nurses the design to design patient centered
* Provide coherent, unified and orderly way of envisioning related events or nursing interventions. Application of a nursing theory in practice depends on the
processes, some are physical objects, examples are models such as dummies knowledge of nursing in other theoretical models, how they relate to one another and
assembled and may be made to work like the object it represents such as in IV their use in designing nursing interventions. We need theoretical base to demonstrate
insertions, we use hands to be practiced knowledge through the use of knowledge. Helps to identify the focus the means/goals
of practice. Enhance communication Increase autonomy and accountability for care to
0 Conceptual Framework the patients.
- Structure that links concepts together, representing a unified whole. a. Defines nursing
- Explains the relationships between concepts in a logical manner, but rather b. Describes what nurses do (nursing practice)
than being based on one theory, links concepts selected from several theories, c. Provides goals or outcomes of care
research results, or from experiences. d. Enables nurses to know WHY they are doing WHAT they are doing
- Provide a focus, a rationale, and a tool for the integration and interpretation of Development of theories
information.
- Usually expressed abstractly through word models, a conceptual framework is 3 stages of theory development
the conceptual basis for many theories.
*Set of concepts and assumptions, used to make conceptual distinctions and 1. SPECULATIVE- Attempts to explain what is happening
organize ideas. Several theories, concepts and research results, from that are
2. DESCRIPTIVE- Gathers descriptive data to describe what is really happening
linked through arrows. Express key relationships between elements.
(evidence based to describe what is really happening)
Facilitates understanding on a network of ideas
3. CONSTRUCTIVE-revises old theories and develop new ones based on continuing
Nursing Theory research (use another theory to develop new ones)
- a conceptualization of some aspect of reality that pertains to nursing. The
concept is articulated for the purpose of describing, explaining, predicting, or Theory Development Process
prescribing nursing care (Meleis as cited in George, 2002).
1. THEORY-PRACTICE-THEORY: Take existing theory, apply, develop a new
- Nursing theories are "attempts to describe or explain the phenomenon
theory.
(process, occurrence and event) called nursing" (Barnum,1998)
2. PRACTICE- RESEARCH-THEORY: See what is happening, submit to
- Nursing theories are the creative products of nurses who seek to thoughtfully
research (curiosity), develop theory from results
describe relationships and interactions that exist within nursing practice.
3. THEORY-THEORY- RESEARCH/PRACTICE: Build on an initial theory to
Theories address the many questions that confront nurses daily.
develop a second theory, then apply and test it
*guide of nurse, theories are needed or vital as they guide and give meaning to
what we see applied in nursing practice There have been three reasons for the interest in theory:

Purposes of Nursing Theory


1. Theory development contributes to knowledge building and is seen as a education from hospital-based diploma programs into colleges and
means of establishing nursing as a profession universities emerged.
2. The growth and enrichment of theory in and of itself is an important goal of *A vocation is generally a job that requires a particular set of skills
nursing, as a scholarly discipline (refined, modified, and flexible) acquired through experience or training but not necessarily dependent
3. Theory helps practicing nurses categorize and understand what is going on in on a college degree. A profession refers to the career that one opts for,
nursing practice; it helps them to predict client's response to nursing services getting extensive training and acquiring special skills to become
and is helpful in clinical decision making. eligible for a job in it. Undergo series of trainings and also dependent
*Primary purpose: to improve practice by positively influencing the quality of on a college degree.
life of patients, reciprocal/mutual/binding of theory and practice, should not
stand alone (theory put into practice, and in practice there exists the guide RESEARCH EMPHASIS ERA (1970’s)
which is the theory.
- This era came about as more and more nurses embraced higher education and
History of theory development arrived at a common understanding of the scientific age, that is, that research
is the path to new nursing knowledge. Nurses began to participate in research,
- The history of professional nursing began with Florence Nightingale. She and research courses began to be included in the nursing curricula of many
envisioned nurses as a body of educated women at a time when women were developing graduate programs (Alligood, 2006a).
neither educated nor employed in public service. century (Kalisch & Kalisch,
2003) GRADUATE EDUCATION ERA
*Florence- mother of modern nursing, known as the lady with the lamp during
the Crimean war. They see nursing as a house job and not a noble profession - Master’s degree programs in nursing emerged to meet the public need for
for those who were not educates as it involves only caring. Following her nurses with specialized clinical nursing education
service of organizing and caring for the wounded at Scutari during the - Most nursing master’s programs began to include courses in concept
Crimean war, her vision and establishment of a school of nursing at St. development or nursing models that introduced students to early nursing
Thomas’ hospital in London marked the birth of modern nursing. Nightingale theorists and the knowledge development process (Alligood, 2006a).
pioneering activities in nursing practice and subsequent writings describing
THEORY ERA/ THEORY UTILIZATION ERA (1980’s)
nursing education became a guide for establishing nursing schools in United
States at the beginning of the twentieth. - was a natural outgrowth of the research and graduate education eras.
- 1950’s- Nursing profession leaders began a serious discussion of the need to - Research without theory produced isolated information, and that it was
develop nursing knowledge apart from medical knowledge. Still, nursing as a research and theory together that produced nursing science (Batey, 1977;
vocation rather than a profession. Fawcett, 1978; Hardy, 1978)
*Theories are utilized/applied in nursing practice
CURRICULUM ERA
- The curriculum era addressed the question of what prospective nurses Nursing Philosophy
should study to learn how to be a nurse. (focus: course selection and
- describes personal beliefs or a worldview
content)
- Emphasis was on what courses nursing students should take, with the goal of - defines Nursing or discusses Nursing in a general sense
arriving at a standardized curriculum (Alligood, 2006a) - A nurse uses his or her philosophy of nursing to explain what he or she
- By the mid-1930s, a standardized curriculum had been published. believes nursing is, the role nursing plays in the health care field, and how he
or she interacts with patients.
However, it was also in this era that the idea of moving nursing
- Examples of Nursing Philosophy:
0 Florence Nightingale's Definition of Nursing
0 Virginia Hendersons's Definition of Nursing Health Person
0 Ernestine Widenbach's Helping Art of Clinical Nursing
0 Jean Watson's Theory of Human/Transpersonal Caring
0 Patricia Benner’s Philosophy of Caring, Clinical Wisdom and Ethics in *4 concepts under the nursing paradigm by Jacqueline Fawcette (1984)
Nursing Practice

LECTURE_4

Nursing Metaparadigm 4 key concepts in Nursing 1. Nursing


-Person - “... the protection, promotion, and optimization of health and abilities (3 levels of
-Health care), prevention of illness and injury, alleviation of suffering through the diagnosis
-Environment and treatment of human response, and advocacy in the care of individuals, families,
-Nursing communities, and populations (American Nurses Association).
-Caring
- Caring: Human caring as the moral ideal of nursing is the central focus of
Nursing Metaparadigm professional practice.
*Allows us to understand and explain what nursing is, what nursing does and why *Involves concern and empathy, the commitment to the clients live experience of
nurses do what they do. human health and the relationship among wellness illness and disease. Involve human
- [met″ah-par´ah-dīm] a set of concepts and propositions that sets forth the person or nurse engaged in an active partner with human care transactions with clients
phenomena with which a discipline is concerned. across lifespan
*Term was first introduced in the late 1970s appeared on 2 papers of Margaret
Hardy
- Hardy defined a metaparadigm as “a gestalt or total world view... that serves 2. Person
as way of organizing perceptions.” - the recipient of nursing care (including individual patients, groups, cultures,
*Gestalt- putting many information into one to have a total perspective or total families, and communities) (American Nurses Association)
understanding or a whole understanding of the concept being organized *Receiver are taken care of, they could be in a collective manner

3. Health
Jacqueline M Fawcett, PhD, FAAN, RN - the condition of being sound in body, mind, or spirit; especially: freedom from
Professor Emerita of Nursing physical disease or pain (Merriam Webster)
- Dr. Fawcett received her BS from Boston University, and her MSN and PhD *Interaction and interconnectedness of body mind and spirit; Encompasses whole
degrees from New York University. aspect of individual
*Persona the reason to be behind nursing metaparadigm, she persisted,
explained and was firm that there is a unified nursing discipline in terms of - Health is the absence of any disease or impairment. (Sartorius N., 2006)
knowledge development
- Health is a state that allows the individual to adequately cope with all demands of
Nursing Environment daily life (implying also the absence of disease and impairment). (Sartorius N.)
- The third definition states that health is a state of balance, an equilibrium that an - Purposes of Concept analysis in Nursing.
individual has established within himself and between himself and his social and - Purposes and usefulness of theories in Nursing Research and Practice
physical environment. (Sartorius N.) - Theoretical and knowledge development in Nursing, theory-based nursing practice,
evidence-based practice research.
-Health is a state of complete physical, mental and social well- being and not merely
the absence of disease or infirmity. (world health organization) CONCEPT ANALYSIS IN NURSING
*All aspects in good condition - Definition: Concept analysis is a formal linguistic exercise to determine
certain defining attributes. (Chon SJ. Kanho Hakhoe Chi. 1989;19(1):92-98.
4. Environment doi:10.4040/jnas.1989.19.1.92)
*Formal linguistics-linguistics that favors the use of precise definitions for
-Environment is the circumstances, objects, or conditions by which one is surrounded. grammar, semantic and in other concepts. Treats language as if it were
(Merriam Webster) composed of well-defined patterns of symbols.
-the setting or conditions in which a particular activity is carried on (Oxford
Dictionary) - According to Walker (1983) as cited by Chon (1989), the basic purpose of
*Setting: Community, clinical, intoxicated, rural area or in the city work activities concept analysis is to clarify ambiguous concepts in a theory, and to propose a
take place precise operational definition which reflects its theoretical base.
*Eg. One concept is unclear or vaguely explained, it has to be understood to
-Technical Definition: the surroundings or conditions in which a person, animal, or the conduct of CA. Concept analysis attempts to provide a simpler and more
plant lives or operates. (Oxford Dictionary) comprehensive definition based on the theory that is being reviewed

- Environment/situation includes all possible condition affecting patients and the - a concept analysis can provide guidance when a concept of interest does not
settings where they go for their health care. (Fundamentals of Nursing Practice) have sufficient literature, is vaguely defined, or is not understood clearly or
when literature and research do not match
*When the situation/circumstance that a literature and research do not match it
has to be reviewed and analyzed, and concept analysis can be defined as a
Summary -Jacqueline Fawcett has named PERSON, HEALTH, NURSING, and dissection of a concept into a simpler element, meaning it has to be presented
ENVIRONMENT as the nursing metaparadigm. (Fundamentals of Nursing Practice) in a simpler manner, in smaller particles promotion of clarity, providing
*Person is the recipient or receiver of care. Health the complete physical and mental mutual understanding in nursing so that everybody involved in the nursing
wellbeing not only the absence of disease. Nursing is the practice of caring. practice/profession have a clearer view/understanding of what the concept
Environment is a situation or the setting that may influence the being of an individual. means
4 major concepts of metaparadigm by Jacqueline Fawcett
- Stages by Aarabi, Akram & Rafii, Forough & Cheraghi, Mohammad &
Ghyasvandian, Shahrzad. (2014). Nurses’ policy influence: A concept
LECTURE_5 analysis. Iranian journal of nursing and midwifery research. 19. 315-22.
*Attributes- quality or features of a certain concept
Concept analysis in Nursing *Antecedent- case or events that have existed before or that has been logically
- Definition precedes another, so it is existing already.
- Relevance of Concept analysis in Education, Research, and Clinical Practice. *Referents- thing, word or phrase that describes, denotes or stands for.
*Last stage- there is already a meaning provided. Importance of Nursing Theories
Concept analysis dissect vague concepts and theories - Nursing theory aims to describe, predict and explain the phenomenon of
nursing
- It should provide the foundations of nursing practice, help to generate further
knowledge and indicate in which direction nursing should develop in the
future. Theory is important because it helps us to decide what we know and
what we need to know
- It helps to distinguish what should form the basis of practice by explicitly
describing nursing. The benefits of having a defined body of theory in nursing
Nursing Theories are developed to improve the quality of life of care rendered include better patient care, enhanced professional status for nurses, improved
by nurses to their clients/patients communication between nurses, and guidance for research and education
*Since concept analysis would try to dissect big concepts in theories, let us talk about - The main exponent of nursing – caring – cannot be measured, it is vital to
the nursing theories which are primarily the concerned theory in our profession. NT have the theory to analyze and explain what nurses do
tries or engages in activities and knowledge development so the quality of life and - As medicine tries to make a move towards adopting a more multidisciplinary
provision of care be improved and enhanced approach to health care, nursing continues to strive to establish a unique body
of knowledge
Theory-Based Nursing Practice - This can be seen as an attempt by the nursing profession to maintain its
- Theory provides nurses with a perspective with which to view client situations, a professional boundaries
way to organize the hundreds of data bits encountered in the day-to- day care of *Purpose of theory in practice, General purposes.
clients, and a way to analyze and interpret the information. To understand what is caring it must be embedded in a theory
*Theoretical perspective allows a nurse to plan and implement care purposefully and Knowing the history of nursing we were under the umbrella of the medical field
reactively for the benefit of the patients taken care of. Able to establish own profession
Identified as a profession must be sustained, improved, maintain the standards that we
Characteristics of a Useful Theory [Robert T. Croyle (2005) have been practicing, enhance areas where we would see ourselves to be weak,
- A useful theory makes assumptions about a behavior, health problem, target practice our profession without going beyond the scope
population, or environment that are:
- Logical Purpose of Nursing Theories in Practice, Education and Research
- Consistent with everyday observations PRACTICE
- Similar to those used in previous successful programs and - Assist nurses to describe, explain, and predict everyday experiences.
- Supported by past research in the same area or related ideas. - Serve to guide assessment, interventions, and evaluation of nursing care.
*You can’t come about a new information unless you are given an idea from a - Provide a rationale for collecting reliable and valid data about the health status
previous information based from previous researches or related ideas of clients, which are essential for effective decision making and
implementation.
- Help to describe criteria to measure the quality of nursing care. - Offer a systematic approach to identify questions for study; select variables,
- Help build a common nursing terminology to use in communicating with other interpret findings, and validate nursing interventions.
health professionals. - Approaches to developing nursing theory
- Ideas are developed and words are defined. - Borrowing conceptual frameworks from other disciplines.
- Enhance autonomy (independence and self-governance) of nursing through - Inductively looking at nursing practice to discover theories/concepts to explain
defining its own independent functions. phenomena.
*One way to give meaning to a phenomena, give idea; Nursing process, guides ang - Deductively looking for the compatibility of a general nursing theory with nursing
give us idea to take care of patients; How to measure quality-based by the practice.
effectiveness of the intervention that was promoted/provided to the patient and the - Questions from practicing Nurse about using Nursing theory
like; Since we are part of the health care team it there should be an established good * Generate knowledge by basing it from a previous idea
communication/relationship, that’s why there are terminologies by which the health Research look for answers, we can identify lapses
care profession are comprehensive or can understand what terms mean-good Generate knowledge through research, possible formulate and develop new nursing
communication; Concept analysis-define vaguely expressed or explained, ability to theory from results
define words, ideas are being developed; Autonomy-ability of the group to decide for Some conceptual frameworks are non nursing, applicable in profession conceptual
itself, independence, self governance, in control/ manage of our own profession. model by Abraham Maslow Hierarchy of needs
Without order by others. Can perform nursing profession by ourselves Inductively- specific to general knowledge
Deductively- general to specific
Allows us to examine ourselves
EDUCATION

- Provide a general focus for curriculum design NOTE: 3 fields are interdependent, mutually reliant on each other. Relationship in
- Guide curricular decision making. between Helps in building nursing knowledge

*Different models were able to come up with unique terms; Primarily Prepare student
for practice as members of the professional community; Before proceeding to clinical
practice, preparation is needed (exposed to community and clinical area, and in
different setting where we would be delivering, providing and practicing our
profession

RESEARCH

- Offer a framework for generating knowledge and new ideas.


- Assist in discovering knowledge gaps in the specific field of study.
Patterns of knowing

*Consider that there has to be sources of how we are going to perform


duties/procedures expected of us
*1955 nursing scholars engaged in researches that generated knowledge we are
utilizing today, how nursing theory developed; Late 1980 rest period  4 Patterns of Knowing in Nursing
- Empirical
Theory-Based Nursing Practice Evidence-Based Practice Research - Ethical
- Aesthetic
*Theory development in nursing we have this - Personal
- 5th pattern of knowing the unknown
The principal objective of research around which all of the other goals revolve is
primarily to produce new knowledge and add to the existing body of knowledge in Barbara A. Carper (April 24, 1931- May 9, 2002)
- Dr. Carper earned her bachelor’s degree in nursing at Texas Woman’s
specific area of science. Knowledge that could be directly applicable for practice or
University in 1959, one of the earliest 4-year nursing programs in Texas.
knowledge that needs further verification before application. In the sense of evidence
- She earned a nurse Anesthetist certificate at the University of Michigan
base practice research promotes the quality of care that is being demonstrated to be Medical School in Ann Arbor.
effective. There is a problem-solving approach here, testing theories based on the - After several years of practice as a Nurse Anesthetist, she went to Teacher’s
most reliable evidence in clinical expertise and patients’ preferences to answer the College Columbia for a Masters, and then an EdD degree, where she
question. There are 6 characteristics of characteristic of quality healthcare that completed the research that resulted in the conceptualization of nursing’s
reinforce the aspects of EBP client centered, scientifically based, population outcome fundamental Patterns of knowing. She held faculty positions in Texas, Maine
based, individualized to client needs, system policies and resources. EBP involve and North Carolina until her retirement in 1999.
*Responsible in coining, developing or conceptualizing patterns of knowing.
accurate and thoughtful decision making about health care delivery for clients based
Originally 4, but as time goes by with the works of scholars with their
on the results of the most relevant and support evidence derived from research research/analysis, they were able developed and formulate and conceptualize
other patterns sources and ways of knowing.
TBP: generate new body of knowledge
She is a scholar that has greatly contributed in nursing
EBP: discover new effective ideas or modality by which we can improve or promote Fundamental Patterns of Knowing
the quality of care that we are providing for our patients. Practice founded can reach
the gap of nursing and practice or nursing practice and research to provide bases for 1. EMPIRICAL KNOWING- The SCIENCE of Nursing.
nurses to transition or to transform research into quality care. *Science-knowledge from the careful study of structure, and behavior of the physical
world especially by watching, measuring, and doing experiments, and the
Perform well in providing care for patients by following and performing based on the development of theories that describe the results of these activities.
theories had in the profession as basis for our interventions and provision of care for There is knowledge from activities or behaviors involving the use of senses, involving
practicality, and testing with measurement, experiment and development of theories.
our patient and it is highly possible as well to be theorist providing new knowledge.

LECTURE_6 2. PERSONAL KNOWING- The PERSONAL Knowledge

3. AESTHETIC KNOWING- The ARTS of Nursing.


*Aesthetic- decorations, ornamentals, graceful, elegant, beautiful, attractive, pleasing - NURSING is considered as an interpersonal process. THERAPEUTIC USE
OF SELF
4. ETHICAL KNOWING- The MORAL Component. *Interpersonal process- knowing of self, identify strengths, weakness,
*Moral component-good and evil, involve judgement of right and wrong doing in shortcomings, what is best from you and best that you can give. Kilalanin ang
relation to intention, reason and attribute of individuals and situations. sarili bago ang iba through self-awareness. Extensive acknowledgement of
Ethical knowing- requires knowledge of different philosophical positions regarding self. Necessary as it make you know when you’re ready. Self-awareness to
what is good and right and making moral action and decisions particularly in the deliver well care to patients later on. Therapeutic use of self- ability to use
theoretical and clinical components of nursing your own personality, insights, perceptions or judgement as part of the
therapeutic process. Example: you’re a jolly person, you use it in taking care
Empirical knowing of patients, and it may be good for your patients perhaps. Describes an
*Late 1950s the term nursing science was barely used in literature but there is a sense individual’s plan of using his/her personality/insight/perceptions/judgement as
of urgency, because when you try to practice part of the therapeutic process.
Empirical- objective described as based on testing and experience, when we try to
describe something there has to be an evidence/testing/experienced especially when - PERSONAL KNOWLEDGE is concerned with the knowing, encountering
talking about a phenomena and other circumstances. You can’t explain something and actualizing the concrete, individual self.
without valid information, or facts to be presented. Principal form of relating factual
and descriptive knowing in the expansion of abstract and theoretical explanation. Aesthetic knowing
Example: knowledge obtained from textbooks, lectures, journals, and online *AK- make you say “ganito pala ang gagawin ko dapat”
resources. When you try to explain something, you have to research or to look into Uncover something on the long run be creative, artistic, able to discover something in
evidence to expand explanation or to dig deeper to how you are going to express and experience
describe what is expected from you. Engagement in research activities, as there is a - “ART” - manual or technical skills involved in nursing practice
scientific method to produce a desired study result, to find out/discover something. - APPRENTICE SYSTEM imitative learning style and the acquisition of
Being able to practice/experience/perform interventions based on EBP (involvement knowledge by accumulation of unrationalized experiences.
of accurate and thoughtful decision making about health care delivery of our client - An aesthetic experience involves the creation and/or appreciation of a
since it has been tested or proven and based on experience, effective in terms of singular, particular, subjective expression of imagined possibilities or
intervening the condition of the patient) or based from acceptable clinical practices equivalent realities that “resist projection into the discursive form of
(tested, with evidence why it is good to apply) language”
*Related to understanding what is significant to particular patients such as
- … sense of urgency feelings, attitudes, POVs, according to Carper. Manifestation if creative and
- There seem to be general agreement that there is a critical need for knowledge expressive styles of the nurse.
about the empirical world, knowledge that is systematically organized into Art of nursing- how you perform or put into practice the creative form of your
general laws and theories for the purpose of describing, explaining and new discoveries. Giving appropriate nursing care to understand the uniqueness
predicting phenomena of special concern to the discipline of nursing. of every patients (personal knowing).
In designing activities or nursing case, it should be individualistic, per
Personal knowing person/patient
- Personal Knowledge as a fundamental pattern of knowing in nursing is the - Empathy: an important mode in the aesthetic pattern of knowing.
most problematic, the most difficult to master and to teach. *Empathy- capacity for participating in vicariously experiencing another’s
*Every individual is unique, hence there is something exemplary or makes feeling. Putting yourself in the shoes of others to imagine the feelings and
identity different from the others. experiences of the patients, understanding what is going on with the patient.
Compassion, mercy and understanding to others. Example: patient asking person about it, so we have to understand the background of the patient to know
about condition, realized the patient is illiterate, by being creative explain what influenced the care of patient, there should be an exploration/exposure of
patient condition through asking others, explanation of medical terms making alternative means of health to patient. To enable care to all people
the patient understand. Creative and appreciate the person (artistic) …Social political knowing consists of two levels, firstly the social political
context of the person (nurse and the patient) and secondly, the social political
Ethical knowing context as a practice profession.
*Requires an understanding of how to connect and motivate people where they
- Ethics: Ethos - Greek word; a system of moral principles:
are. Understanding of what messages would be most effective in pushing
*Ethics-things dealing with values relating to human conduct with respect to
someone’s matter or eliciting a strong emotional response.
the rightness and wrongness of certain actions and to the goodness and
badness of the motives in ends of such actions Emancipatory knowing (Chinn and Kramer)
- Obligations or What ought to be done …foundational to developing reflexivity in clinical practice.
*Purpose of us nurses, guided with the moral code that guides us with the *Root: Emancipate- freeing yourself from the string or control or power of another.
ethical conduct of nurses that is based on the primary principle of obligation
embodied in the concepts of service to people and of course respect to human Reflexivity- fact that one is able to examine his/her feelings, reactions, and motives.
life. It is deeply rooted on the concepts of human dignity, service and respect “Bakit ko ba ginagawa to? Ano ba ang ginagawa ko? Why am I doing this and what is
for life. Inclusion of deliberate nursing actions involving and under the his reaction in terms of the daily counteractive?
jurisdiction of ethics and professionalism. Know what we should do in the
nursing practice Patterns of knowledge- where we are able to derive or obtain our knowledge thus
facilitate us in performing well in involving ourselves in the provision of care to our
Unknowing (toward another pattern of knowing in nursing Patricia Munhall, patients. Contribute to the future articulation and development of nursing
1993)
…Unknowing is a condition of openness
…This pattern of unknowing focused herein on the intersubjective whole between
patient and nurse is applicable as well to learning in a more formal sense.
*Unknowing-lack of awareness or knowledge. Art of unknowing enables a nurse
to understand with empathy, the actual essence of meaning and experience has for
patient. Improve and enhance nursing care procedure/plan to your patient.
Intersubjective-coined by a philosopher, concept used to describe the space of
shared understanding or common ground between persons where in people as
individual subjects collaboratively create and share meaning.
“ah ganun pala, yun pala yun”. Know what is unknown; Openness- I never
thought about it that way; wonderment of coming upon an unknown
Socio-Political knowing (Jill White, 1995)
…Sociopolitical Knowing is a core strength of professional nursing.
*Essential to an understanding of all the others. Example-taking care of patient
from a far flung area, with no understanding as there is no knowledge by that

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