Nursing theory

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Nursing theory is defined as "a creative and conscientious structuring of ideas that project a tentative, purposeful, and systematic view of phenomena". [1] Through systematic inquiry, whether in nursing research or practice, nurses are able to develop knowledge relevant to improving the care of patients. Theory refers to "a coherent group of general propositions used as principles of explanation". [2]

Contents

Nursing theory

Importance

In the early part of nursing's history, there was little formal nursing knowledge. As nursing education developed, the need to categorize knowledge led to development of nursing theory to help nurses evaluate increasingly complex client care situations. [3]

Nursing theories give a plan for reflection in which to examine a certain direction in where the plan needs to head. [4] As new situations are encountered, this framework provides an arrangement for management, investigation and decision-making. Nursing theories also administer a structure for communicating with other nurses and with other representatives and members of the health care team. Nursing theories assist the development of nursing in formulating beliefs, values and goals. They help to define the different particular contribution of nursing with the care of clients. [5] Nursing theory guides research and practice.

Borrowed and shared theories

Not all theories in nursing are unique nursing theories; many are borrowed or shared with other disciplines. [6] Theories developed by Neuman, Watson, Parse, Orlando and Peplau are considered unique nursing theories. Theories and concepts that originated in related sciences have been borrowed by nurses to explain and explore phenomena specific to nursing. [7]

Types

Grand nursing theories

Grand nursing theories have the broadest scope and present general concepts and propositions. [8] Theories at this level may both reflect and provide insights useful for practice but are not designed for empirical testing. This limits the use of grand nursing theories for directing, explaining, and predicting nursing in particular situations. However, these theories may contain concepts that can lend themselves to empirical testing. [9] Theories at this level are intended to be pertinent to all instances of nursing. Grand theories consist of conceptual frameworks defining broad perspectives for practice and ways of looking at nursing phenomena based on the perspectives.

Mid-range nursing theories

Middle-range nursing theories are narrower in scope than grand nursing theories and offer an effective bridge between grand nursing theories and nursing practice. They present concepts and a lower level of abstraction and guide theory-based research and nursing practice strategies. One of the hallmarks of mid-range theory compared to grand theories is that mid-range theories are more tangible and verifiable through testing. [10] The functions of middle-range theories includes to describe, explain, or predict phenomenon. Middle-range theories are simple, straightforward, general, and consider a limited number of variables and limited aspect of reality. [7]

Nursing practice theories

Nursing practice theories have the most limited scope and level of abstraction and are developed for use within a specific range of nursing situations. Nursing practice theories provide frameworks for nursing interventions, and predict outcomes and the impact of nursing practice. The capacity of these theories is limited, and analyzes a narrow aspect of a phenomenon. Nursing practice theories are usually defined to an exact community or discipline. [11]

Nursing models

Nursing models are usually described as a representation of reality or a more simple way of organising a complex phenomenon. The nursing model is a consolidation of both concepts and the assumption that combine them into a meaningful arrangement. A model is a way of presenting a situation in such a way that it shows the logical terms in order to showcase the structure of the original idea. The term nursing model cannot be used interchangeably with nursing theory.

Components of nursing modeling

There are three main key components to a nursing model: [4]

The first important step in development of ideas about nursing is to establish the body approach essential to nursing, then to analyse the beliefs and values around those.

Common concepts of nursing modeling: a metaparadigm

A metaparadigm contains philosophical worldviews and concepts that are unique to a discipline and defines boundaries that separate it from other disciplines. A metaparadigm is intended to help guide others to conduct research and utilize the concepts for academia within that discipline. The nursing metaparadigm consist of four main concepts: person, health, environment, and nursing. [12]

Each theory is regularly defined and described by a nursing theorist. The main focal point of nursing out of the four various common concepts is the person (patient). [4]

Notable nursing theorists and theories

Purposely omitted from this list is Florence Nightingale. Nightingale never actually formulated a theory of nursing science but was posthumously accredited with formulating some by others who categorized her personal journaling and communications into a theoretical framework.

Also not included are the many nurses who improved on these theorists' ideas without developing their own theoretical vision.

See also

Related Research Articles

<span class="mw-page-title-main">Hildegard Peplau</span> American nurse (1909–1999)

Hildegard E. Peplau was an American nurse and the first published nursing theorist since Florence Nightingale. She created the middle-range nursing theory of interpersonal relations, which helped to revolutionize the scholarly work of nurses. As a primary contributor to mental health law reform, she led the way towards humane treatment of patients with behavior and personality disorders.

The self-care deficit nursing theory is a grand nursing theory that was developed between 1959 and 2001 by Dorothea Orem. The theory is also referred to as the Orem's Model of Nursing. It is particularly used in rehabilitation and primary care settings, where the patient is encouraged to be as independent as possible.

Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to student nurses by experienced nurses and other medical professionals who have qualified or experienced for educational tasks, traditionally in a type of professional school known as a nursing school. Most countries offer nurse education courses that can be relevant to general nursing or to specialized areas including mental health nursing, pediatric nursing and post-operatory nursing. Courses leading to autonomous registration as a nurse typically last four years. Nurse education also provides post-qualification courses in specialist subjects within nursing.

In 1976, Sister Callista Roy developed the Adaptation Model of Nursing, a prominent nursing theory. Nursing theories frame, explain or define the practice of nursing. Roy's model sees the individual as a set of interrelated systems. The individual strives to maintain a balance between these systems and the outside world, but there is no absolute level of balance. Individuals strive to live within a unique band in which he or she can cope adequately.

<span class="mw-page-title-main">Madeleine Leininger</span>

Madeleine Leininger was a nursing theorist, nursing professor and developer of the concept of transcultural nursing. First published in 1961, her contributions to nursing theory involve the discussion of what it is to care.

<span class="mw-page-title-main">Nurse–client relationship</span>

The nurse–client relationship is an interaction between a nurse and "client" (patient) aimed at enhancing the well-being of the client, who may be an individual, a family, a group, or a community.

<span class="mw-page-title-main">Gerontological nursing</span> Specialty of nursing pertaining to older adults

Gerontological nursing is the specialty of nursing pertaining to older adults. Gerontological nurses work in collaboration with older adults, their families, and communities to support healthy aging, maximum functioning, and quality of life. The term gerontological nursing, which replaced the term geriatric nursing in the 1970s, is seen as being more consistent with the specialty's broader focus on health and wellness, in addition to illness.

Transcultural nursing is how professional nursing interacts with the concept of culture. Based in anthropology and nursing, it is supported by nursing theory, research, and practice. It is a specific cognitive specialty in nursing that focuses on global cultures and comparative cultural caring, health, and nursing phenomena. It was established in 1955 as a formal area of inquiry and practice. It is a body of knowledge that assists in providing culturally appropriate nursing care.

Evidence-based nursing (EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using evidence-based practice (EBP) as a foundation. EBN implements the most up to date methods of providing care, which have been proven through appraisal of high quality studies and statistically significant research findings. The goal of EBN is to improve the health and safety of patients while also providing care in a cost-effective manner to improve the outcomes for both the patient and the healthcare system. EBN is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. The evidence used to change practice or make a clinical decision can be separated into seven levels of evidence that differ in type of study and level of quality. To properly implement EBN, the knowledge of the nurse, the patient's preferences, and multiple studies of evidence must all be collaborated and utilized in order to produce an appropriate solution to the task at hand. These skills are taught in modern nursing education and also as a part of professional training.

<span class="mw-page-title-main">Nursing</span> Health care profession

Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses can be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialties with differing levels of prescription authority. Nurses comprise the largest component of most healthcare environments; but there is evidence of international shortages of qualified nurses. Nurses collaborate with other healthcare providers such as physicians, nurse practitioners, physical therapists, and psychologists. There is a distinction between nurses and nurse practitioners; in the U.S., the latter are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications unlike the former. They practice independently in a variety of settings in more than half of the United States. Since the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.

<span class="mw-page-title-main">Holistic nursing</span> Medical care practice

Holistic nursing is a way of treating and taking care of the patient as a whole body, which involves physical, social, environmental, psychological, cultural and religious factors. There are many theories that support the importance of nurses approaching the patient holistically and education on this is there to support the goal of holistic nursing. The important skill to be used in holistic nursing would be communicating skills with patients and other practitioners. This emphasizes that patients being treated would be treated not only in their body but also their mind and spirit.. Holistic nursing is a nursing speciality concerning the integration of one's mind, body, and spirit with his or her environment. This speciality has a theoretical basis in a few grand nursing theories, most notably the science of unitary human beings, as published by Martha E. Rogers in An Introduction to the Theoretical Basis of Nursing, and the mid-range theory Empowered Holistic Nursing Education, as published by Dr. Katie Love. Holistic nursing has gained recognition by the American Nurses Association (ANA) as a nursing specialty with a defined scope of practice and standards. Holistic nursing focuses on the mind, body, and spirit working together as a whole and how spiritual awareness in nursing can help heal illness. Holistic medicine focuses on maintaining optimum well-being and preventing rather than just treating disease.

Carl O. Helvie was an American registered nurse and Professor Emeritus of Nursing at Old Dominion University. Helvie is known for his development and implementation of the Helvie Energy Theory of Nursing and Health.

Katharine Kolcaba is an American nursing theorist and nursing professor. Dr. Kolcaba is responsible for the Theory of Comfort, a broad-scope mid-range nursing theory commonly implemented throughout the nursing field up to the institutional level.

Patricia Sawyer Benner is a nursing theorist, academic and author. She is known for one of her books, From Novice to Expert: Excellence and Power in Clinical Nursing Practice (1984). Benner described the stages of learning and skill acquisition across the careers of nurses, applying the Dreyfus model of skill acquisition to nursing practice. Benner is a professor emerita at the University of California, San Francisco UCSF School of Nursing.

Nola J. Pender is a nursing theorist, author, and academic. She is a professor emerita of nursing at the University of Michigan. She created the Health Promotion Model. She has been designated a Living Legend of the American Academy of Nursing.

Marie Schuber Manthey is an American nurse, author, and entrepreneur. She is recognized as one of the originators of Primary Nursing, an innovative system of nursing care delivery.

Kolcaba's theory of comfort explains comfort as a fundamental need of all human beings for relief, ease, or transcendence arising from health care situations that are stressful. Comfort can enhance health-seeking behaviors for patients, family members, and nurses. The major concept within Katharine Kolcaba's theory is the comfort. The other related concepts include caring, comfort measures, holistic care, health seeking behaviors, institutional integrity, and intervening variables.

The Purnell Model for Cultural Competence is a broadly utilized model for teaching and studying intercultural competence, especially within the nursing profession. Employing a method of the model incorporates ideas about cultures, persons, healthcare and health professional into a distinct and extensive evaluation instrument used to establish and evaluate cultural competence in healthcare. Although the Purnell Model was originally created for nursing students, the model can be applied in learning/teaching, management, study and practice settings, within a range of nations and cultures.

Winifred W. Logan is a British Nurse theorist who was co-author of the Roper-Logan-Tierney model of nursing, and became an executive director of the International Council of Nurses, and Chief Nurse in Abu Dhabi.

References

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