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Nursing Theories & Models: Professor Sue Frost

This document discusses nursing theories and models. It defines nursing theories and models, and distinguishes between the two. It outlines several commonly used nursing models, including Roper-Logan-Tierney, Peplau, Orem, and Roy's adaptation model. It discusses how these models conceptualize the person, environment, health, and nursing. The document also provides guidance on how to critically review and apply nursing models in practice.

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163 views28 pages

Nursing Theories & Models: Professor Sue Frost

This document discusses nursing theories and models. It defines nursing theories and models, and distinguishes between the two. It outlines several commonly used nursing models, including Roper-Logan-Tierney, Peplau, Orem, and Roy's adaptation model. It discusses how these models conceptualize the person, environment, health, and nursing. The document also provides guidance on how to critically review and apply nursing models in practice.

Uploaded by

sutha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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NURSING THEORIES &

MODELS
Professor Sue Frost
By the end of this session you
should:
• Be able to explain what is meant by a model
and a theory of nursing
• understand the main features of at least two
models of nursing
• understand how to critically review a model
• Identify how the application of models to
practice influences the activity of the nurse
and the experience for the patient or client
References………………….
• Models of nursing practice. McGee P.
Stanley Thornes 1998
• Conceptual bases of professional nursing.
Leddy S. Pepper J. Lippincott 4th ed.. 1998
• Foundations of nursing practice. Hogston R
& Simpson P. Macmillan 1999 (Ch 14)
Nature of theory:

“represent a scientist’s best effort


to describe and explain
phenomena”

Pollitt & Hungler 1997


Theory……

“…is a general statement that summarizes


and organizes knowledge by proposing a
general relationship between events - if it
is a good one it will cover a large number
of events and predict events that have not
yet occurred or been observed”

Robson C.
“an internally consistent group of relational
statements (concepts, definitions &
propositions) that present a systematic
view about phenomenon and that is useful
for description, explanation, prediction and
control. A theory ….is the primary means
of meeting the goals of the nursing
profession concerned with a clearly
defined body of knowledge”
Walker & Avant 1996 (cited by Jasper M in
Hogston & Simpson))
Purpose of theory
• Support the development of knowledge
through thesis and contestability
• Explains and predicts outcomes
• Supports decision making
• Embeds goals and outcomes for the client
and by implication for the nurse
• Supports modeling of processes of nursing
Classifying theories
• Meta-theory (Theory building - values etc)
• Grand theory (Broad conceptual frameworks
- not testable e.g. Leininger theory of
transcultural care)
• Middle range theory (Narrower and testable
e.g. Peplau)
• Practice Theory(situational theory - focuses
on the way in which nursing is practised e.g.
Norton’s theory of nursing elderly people))
Typology:
• Descriptive theory: Explains through
describing relationships and patterns within
the framework (e.g. Roper et al)

• Predictive Theories: Address the


consequences of interventions (e.g.
Noddings theory of care)
The medical model
• Bio-reductionist
• Differential diagnosis: signs & symptoms
• Provision of treatment
• Scientific theory - testable and not
contestable
• Goals - cure and therapy
• Evaluation of treatment efficacy
Nursing models
• Located in social science
• Constructed
• Contestable knowledge
• Capable of change and development
• Embed values and culture
What sort of theories would you
use?
• Tony Archer (18 years) underwent surgery
to have a below knee amputation of his left
leg
• Peggy Mountford is 82 years old, lives
alone with no family and is becoming
increasingly confused and depressed
What sort of theories did you
identify?
• Physiology
• Psychology
• Sociological theory
• Nursing theories
• Descriptive theory
• Predictive theory
Metaparadigm: constructs in all
nursing theories
• The person
• the environment
• health
• nursing
Commonly used models
• Roper, Logan & Tierney (ADL)
• Peplau (interpersonal communication)
• Orem (Self-Care)
• Roy (adaptation model)
• Wolfensberger (social role valorisation)
• Carper (personal explanations)
Roper, Logan & Tierney
• Developmental model - emphasises growth &
development
• Person oriented
• Focus on change
• Sees process over time
• Sees a range of activities of daily living
changing with maturation
• Supporting and enabling
• Draws on Henderson’s work strongly
Callister Roy’s model
• Systems model - person is made up of systems
• Systems interact with the environment
• Health is equilibrium and managed systems
• Nursing is supporting adaptation to
environment
• Is holist, purposeful and unifying
• Adaptive modes: physiologic, self concept,
role function, interdependence
• Health is a process of responding positively to
environmental changes
Hildegarde Peplau
• Inter-actional model
• concerned with interpersonal relationships
• nursing is organised through building
relationships to support communication
• nurse must be able to use self
therapeutically
Dorothea Orem
• Nursing as part of a social care paradigm
• supporting client to self care
• caring as a part of moral consciousness
• care as the core and essence of nursing
• caring and community
• collective responsibilities to support and
enable
Carpers model
• Four dimensions of nursing:

empirical dimension
personal dimension
ethical dimension
aesthetic dimension
Exercise
• What does the Roper et al model suggest
about the person, environment, health,
nursing?
• What might Roy say about the person? -
how may it be different?
Roper et al
• Person: A developing maturing individual
throughout the life span moving from
dependence to independence
• Health: meeting a range of needs - health
changes with many separate facets
• Environment: Anything external to the
person and is a framework of the activities of
living
• Nursing restoring or maintaining ADL when
person cannot cope independently
Roy’s model
Person: a biopsychosocial being with a
unified system
Health: equilibrium resulting from effective
coping
Environment internal and external systems
that impact on equilibrium
Nursing: Manipulating environment to
enable coping
exercise
• How is assessment likely to be undertaken
in Roper modeling?

• How might nursing be different in a model


based on interpersonal relationships? (e.g.
Peplau)
Criticising a model
• Models are constructions & conceptual
• They enable us to explore how the nature of
nursing is defined
• Models are not facts - they evolve and emerge
• You do not “do” models - they inform your
thinking
• Models imply different nursing processes
Questioning models & theories
• What methodologies were used to develop?
(?draws on other/theories/research/evidence)
• How clear is it (overly complex jargon?)
• What does the theory say - what is the central
assertion- is it clear and coherent - is there
thesis?
• What type of theory is it? (e.g. a mid-range
theory that can be tested in practice)
• Can the theory be used
• Is this theory relevant to my area of practice
Can you…..
• explain what is meant by a model and a
theory of nursing
• understand the main features of at least two
models of nursing
• understand how to critically review a model
• Identify how the application of models to
practice influences the activity of the nurse
and the experience for the patient or client
• What is Nursing Grand Theory ?
• Grand theories are complex and broad in
scope and may incorporate numerous other
theories. They are comprised of relatively
abstract global concepts that attempt to
explain broad areas in a discipline
developed through thoughtful and insightful
appraisal of existing ideas (McEwen, 2007).

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