Nasser,Nesreen Abdu

BSN1-1

Assignment1

A. Introduction to Nursing TINTRODUCTION

Nursing theory is the term given to the body of knowledge that is used to support nursing
practice.

Nursing theory is a framework designed to organize knowledge and explain phenomena in

nursing, at a more concrete and specific level.

A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions

derived from nursing models or from other disciplines and project a purposive, systematic view
of phenomena by designing specific inter-relationships among concepts for the purposes of
describing, explaining, predicting, and /or prescribing.

Each discipline has a unique focus for knowledge development that directs its inquiry and
distinguishes it from other fields of study.(Smith & Liehr, 2008).

Theory-guided, evidence-based practice is the hallmark of any professional discipline.

Nursing is a professional discipline (Donaldson & Crowley, 1978).

Almost 90% of all Nursing theories are generated in the last 20 years.

Nursing models are conceptual models, constructed of theories and concepts

A paradigm is a model that explains the linkages of science, philosophy, and theory accepted
and applied by the discipline.heory

Definition of Nursing according to:

1. The International Council for Nurses (ICN, 2002)

The ICNP® is defined as a classification of nursing phenomena, nursing actions, and nursing
outcomes that describes nursing practice. The ICNP® focuses on nursing practice, with the
acknowledgement that practice is changing and dynamic. The ICNP® reflects the ICN definition
of nursing:

Nursing encompasses autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well and in all settings. Nursing includes the promotion of
health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion
of a safe environment, research, participation in shaping health policy and in patient and health
systems management, and education are also key nursing roles (ICN, 2002).

2.American Nurses Association (ANA) ANA exists to advance the nursing profession by:

Fostering high standards of nursing practice; Promoting a safe and ethical work environment;

Bolstering the health and wellness of nurses; and Advocating on health care issues that affect
nurses and the public.

Because ANA represents the interests of all registered nurses, we are here to support you to
reach your full potential. From career development resources to lobbying Congress on the
issues that affect nurses, we are here every step of the way.

When individual nurses achieve their full potential and unite with others, ANA can accomplish
its mission

3. The Philippine Nursing Act of 2002 (RA 9173)

Comprehensive legislation regulating various aspects of nursing profession. Main objective is to

provide for protection and improvement of nursing profession by instituting measures that shall
result in relevant nursing education,human working conditions, better career prospects and
dignified existence for nurses.Inter alia provides for organization of board of
nursing,examination and registration of nurses, nursing education,nursing practice,as well as
several related matters.Repeals Nursing Act, 1991.

4. The Association of Deans of Philippine Colleges of Nursing (ADPCN)

ADPCN -PNEA is an education and training arm of the Association of Deans of Philippine
Colleges of Nursing Inc. with a vision to provide quality continuing education to Deans, Faculty
and Graduating Nursing Students.

Definition of Theory

“an organized framework of concepts and purposes designed to guide the practice of nursing”

Components of Theory
 · Statement of goal that the nurse is trying to achieve

· Set of beliefs and values

· Awareness, skills and knowledge the nurse needs to practice.

Characteristics of a theory

· interrelate concepts in such a way as to create a different way of looking at a particular

phenomenon.

· are logical in nature.

· are generalizable.

· are the bases for hypotheses that can be tested.

· increase the general body of knowledge within the discipline through the research
implemented to validate them.

· are used by the practitioners to guide and improve their practice.

· are consistent with other validated theories, laws, and principles but will leave open
unanswered questions that need to be investigated

Classification of Nursing Theories

By Abstraction

Grand Nursing Theories

These nursing theories have the broadest scope for addressing a variety of concepts and
propositions that nurses may encounter in the practice of care. They tend to be oriented around
models and conceptual frameworks for defining practice in a variety of situations and care
environments and ways of examining phenomena based on these perspectives.

Middle-Range Nursing Theories

Theories of nursing that are Middle-Range tend to be more specific in focus and offer more
concrete connections between Grand Nursing Theories and Nursing Practice. The concepts of
Middle-Range theories tend to be less abstract and tend to me more verifiable through testing.
These theories can often attempt to describe, explain, or predict certain phenomenon in clinical
practice.

Practice-Level Nursing Theories

Practice nursing theories are situation specific theories that are narrow in scope and focuses on
a specific patient population at a specific time.

Practice-level nursing theories provide frameworks for nursing interventions and suggest
outcomes or the effect of nursing practice.

Theories developed at this level have a more direct effect on nursing practice as compared to
more abstract theories.

These theories are interrelated with concepts from middle-range theories or grand theories.

Classification of nursing theories

By Goal Orientation

descriptive theories are the first level of theory development. They describe the phenomena
and identify its properties and components in which it occurs. descriptive theories are not
action oriented or attempt to produce or change a situation. - there are two types of
descriptive theories: factor-isolating theory and explanatory theory.

Factor-Isolating Theory

- also known as category-formulating or labeling theory.

- theories under this category describe the properties and dimensions of phenomena

Explanatory Theory

- describe and explain the nature of relationships of certain phenomena to other phenomena.

Prescriptive Theories

address the nursing interventions for a phenomenon, guide practice change, and predict
consequences.

- includes propositions that call for change.

- in nursing, prescriptive theories are used to anticipate the outcomes of nursing

interventions.
Definition of Phenomenon

In Nursing, phenomena can be:

A phenomenon is a real-life noticeable event that can be explained by human perceptions.

Phenomenon exist in the real world…but not recognized to exist by any humans or named by
scientists, it is the role of science to discover, identify, and delineate general features of
phenomenon in order to gain systematic descriptions and explations about them (Kim, 2010).
Within current research, …phenomena have been predominatly described and understood
through quantified articulations that give the reader a structural understanding of the
phenomenon, but the more embodied or “contextual” human qualities of a phenomenon are
often not visible (Wertz, et al., 2011). Phenomenon offers a variety of dimensions that are
embedded with specific meanings in its sensible context. Such dimensions are subject to
personal interpretations and must be unraveled using phenomenological investigation to
understand the complexities of human experience.

Theory Development

Nursing Theory and Professional Development While exploring different nursing theories and
the many aspects of professional development, it is important to reflect on what I have
learned. It is even more important to take the knowledge I have gained throughout this
course and apply it to my future as a nursing student and an RN. Each theory, depending on
whether or not you agree with it, can play an important role in how each nurse tackles each
day. The different strengths and weakness a nurse has professionally also plays a big role in
the workplace. Nursing is a combination of learned and unlearned concepts. Skills are learned
in the classroom, as well as on the job.

Four strategies of theory development in nursing according to Meleis

The development of the discipline of nursing has gone through four stages: theorizing,
developing a syntax, concept development, and philosophical debate. These stages helped in
shaping the characteristics of the discipline as a human science, a practice science, a science
with social goals to empower nurses to provide effective and quality care, and one in which
gender differences and the need for understanding minorities are areas of primary concern.
Further theoretical development in the discipline will be driven by population needs and will
be characterized by reaching out to meet the integrative and interdisciplinary nature of these
needs. Sources of theories of the future are practice, theory and research. It is anticipated
that two models will evolve to guide the development of phenomenon-driven theories in the
future and that third generation theorists will utilize these models.

Additionally, Meleis (1997) stated that nursing theory provides insights about nursing
practice situations and research and gives direction to nursing practice. Thus, nursing theory is
viewed as contributing to a well-founded basis for nursing practice (Chinn & Kramer, 1995)
and it is useful in describing nursing phenomena, in analyzing and explaining relationships
among those phenomena, in predicting consequences, and in prescribing actions (Chinn &
Jacobs, 1987, Meleis, 1997).

Uses of theory in Nursing

The primary purpose of theory in the profession of nursing is to improve practice by positively
influence the health and quality of life of patients. Nursing theories are also developed to
define and describe nursing care, guide nursing practice, and provide a basis for clinical
decision making. The accomplishments of nursing in the past led to the recognition of nursing
in academic discipline, research, and profession.

Historical Development of Nursing Theories

From The writings of Florence Nightingale

The first nursing theories appeared in the late 1800s when a strong emphasis was placed on
nursing education.

In 1860, Florence Nightingale defined nursing in her “Environmental Theory” as “the act of
utilizing the environment of the patient to assist him in his recovery.”

In the 1950s, there is a consensus among nursing scholars that nursing needed to validate
itself through the production of its own scientifically tested body of knowledge.
 In 1952, Hildegard Peplau introduced her Theory of Interpersonal Relations that puts
emphasis on the nurse-client relationship as the foundation of nursing practice.

In 1955, Virginia Henderson conceptualized the nurse’s role as assisting sick or healthy
individuals to gain independence in meeting 14 fundamental needs, thus her Nursing Need
Theory was developed.

In 1960, Faye Abdellah published her work “Typology of 21 Nursing Problems” that shifted
the focus of nursing from a disease-centered approach to a patient-centered approach.

In 1962, Ida Jean Orlando emphasized the reciprocal relationship between patient and nurse
and viewed the professional function of nursing as finding out and meeting the patient’s
immediate need for help.

In 1968, Dorothy Johnson pioneered the Behavioral System Model and upheld the fostering
of efficient and effective behavioral functioning in the patient to prevent illness.

In 1970, Martha Rogers viewed nursing as both a science and an art as it provides a way to
view the unitary human being, who is integral with the universe.

In 1971, Dorothea Orem states in her theory that nursing care is required if the client is
unable to fulfill biological, psychological, developmental, or social needs. Imogene King‘s
Theory of Goal attainment states that the nurse is considered part of the patient’s
environment and the nurse-patient relationship is for meeting goals towards good health.

In 1972, Betty Neuman in her theory states that many needs exist, and each may disrupt
client balance or stability. Stress reduction is the goal of the system model of nursing practice.
 In 1979, Sr. Callista Roy viewed the individual as a set of interrelated systems who strives to
maintain the balance between these various stimuli.

In 1979, Jean Watson developed the philosophy of caring highlighted humanistic aspects of
nursing as they intertwine with scientific knowledge and nursing.

In 1980's

- research focus: patients and patient behavior

- empirical modes of inquiry (logical positivitist)

- beginnings of qualitative research (phenomenology and ethnography

- better preparation for nurse researchers

- federal funding $16.2 million at NCNR

In 1990s

- healthy People 2000 published

- clinical Practice Guidelines (AHCPR)

- clinical Nursing Research journal published

- NCNR renamed the National Institute for Nursing Research (NINR) in 1993

- nursing doctoral programs in 65 institutions

- emphasis on clinical research

- research-based practice-research utilization, evidence-based practice

- multiple modes of inquiry

- emphasis on explanatory and predictive-level studies (vs. descriptive and exploratory)

- encyclopedia of Nursing Research published in 1998

- federal funding $55 million at NINR

 In 1995–1999

- community-based nursing models

- NINR research priorities: effectiveness of nursing interventions in HIV/AIDS; cognitive

impairment; living with chronic illness; bio-behavioral factors related to immune-competence

- chronic illnesses

Significance of Nursing to the Profession

- Nursing theories are the basis of nursing practice today. In many cases, nursing theory
guides knowledge development and directs education, research, and practice. Historically,
nursing was not recognized as an academic discipline or as a profession we view it today.
Before nursing theories were developed, nursing was considered to be a task-oriented
occupation. The training and function of nurses were under the direction and control of the
medical profession. Let’s take a look at the importance of nursing theory and its significance
to nursing practice:

- nursing theories help recognize what should set the foundation of practice by explicit
describing nursing.

- by providing a definition of nursing, nursing theory also helps nurses to understand their

purpose and role in the healthcare setting.

- theories serve as a rationale or scientific reasons for nursing interventions and give nurses
the

knowledge base necessary for acting and responding appropriately in nursing care situations.

- nursing theories provide the foundations of nursing practice, helps generate further

knowledge, and indicate in which direction nursing should develop in the future (Brown,
1964).

- by providing nurses a sense of identity, nursing theory can help patients, managers, and
other
healthcare professionals to acknowledge and understand the unique contribution that nurses

make to the healthcare service (Draper, 1990).

- nursing theories prepare the nurses to reflect on the assumptions and question the values
in

nursing, thus further defining nursing and increasing knowledge base.

- nursing theories aim to define, predict, and demonstrate the phenomenon of nursing
(Chinn

and Jacobs, 1978).

- it can be regarded as an attempt by the nursing profession to maintain and preserve its

professional limits and boundaries.

- in many cases, nursing theories guide knowledge development and directs education,

research, and practice although each influence the others. (Fitzpatrick and Whall 2005).r

REFERENCES

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2 - https://www.nursingworld.org/ana/about-ana/

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https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/
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4- http://www.adpcn-inc.org/

1-2- http://currentnursing.com/nursing_theory/nursing_theories_overview.html

1,2 - https://guides.library.uwm.edu/c.php?g=832418&p=5943166

UWM Libraries Research and Course Guides: Nursing Theory: Middle-Range Nursing Theories

Topical overview and research resources for Nursing Theories

guides.library.uwm.edu