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

A nursing diagnosis may be part of the nursing process and is a clinical judgment about individual, family, or community experiences/responses to actual or potential health problems/life processes. Nursing diagnoses foster the nurse's independent practice compared to dependent interventions driven by physician's orders. Nursing diagnoses are developed based on data obtained during the nursing assessment. A problem-based nursing diagnosis presents a problem response present at time of assessment. Risk diagnoses represent vulnerabilities to potential problems, and health promotion diagnoses identify areas which can be enhanced to improve health. Whereas a medical diagnosis identifies a disorder, a nursing diagnosis identifies the unique ways in which individuals respond to health or life processes or crises. The nursing diagnostic process is unique among others. A nursing diagnosis integrates patient involvement, when possible, throughout the process. NANDA International (NANDA-I) is body of professionals that develops, researches and refines an official taxonomy of nursing diagnosis.

<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 Roper, Logan and Tierney model of nursing is a model of nursing care based on activities of living (ALs). It is extremely prevalent in the United Kingdom, particularly in the public sector. The model is named after the authors – Nancy Roper, Winifred W. Logan and Alison J. Tierney

<span class="mw-page-title-main">Nursing process</span>

The nursing process is a modified scientific method which is a fundamental part of nursing practices in many countries around the world. Nursing practise was first described as a four-stage nursing process by Ida Jean Orlando in 1958. It should not be confused with nursing theories or health informatics. The diagnosis phase was added later.

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 of college of nursing. 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-operative nursing. Nurse education also provides post-qualification courses in specialist subjects within nursing.

Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.

<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.

Florence Nightingale (1820–1910), considered the founder of educated and scientific nursing and widely known as "The Lady with the Lamp", wrote the first nursing notes that became the basis of nursing practice and research. The notes, entitled Notes on Nursing: What it is, and What it is Not (1860), listed some of her theories that have served as foundations of nursing practice in various settings, including the succeeding conceptual frameworks and theories in the field of nursing. Nightingale is considered the first nursing theorist. One of her theories was the Environmental Theory, which incorporated the restoration of the usual health status of the nurse's clients into the delivery of health care—it is still practiced today.

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 health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. Shortages of qualified nurses are found in many countries.

<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.

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.

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.

Rozzano Locsin is a Filipino American Professor of Nursing at Tokushima University, a Professor Emeritus of Florida Atlantic University, and a visiting professor at universities in Thailand, Uganda, and the Philippines.

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 (1931)is a British Nurse theorist who is 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.

A nurse scientist is a registered nurse with advanced education and expertise in nursing research. These professionals play a critical role in advancing nursing knowledge, improving patient care, and shaping the future of the nursing profession. Highly educated and specialized, nurse scientists conduct research to generate new knowledge about nursing care, employing a deep understanding of nursing theory, research methodologies, and clinical practice. Nurse scientists are essential contributors to the development of new nursing interventions and practices. Their skills extend beyond academic settings and these advanced nurses work in hospitals, research institutes, and community organizations. Through their efforts, nurse scientists have a profound impact on the quality of healthcare, contributing significantly to the improvement of patient care and the overall advancement of the nursing profession. They possess advanced qualifications, typically holding a Ph.D. in nursing or a related field, demonstrating expertise not only in research principles and methodology but also in-depth content knowledge within a specific clinical area. The primary focus of the role is to provide leadership in the development, coordination and management of clinical research studies; provide mentorship for nurses in research; lead evaluation activities that improve outcomes for patients participating in research studies; contribute to the overall health sciences literature. Nurse scientists have been regarded as knowledge brokers. They participate in nursing research.

References

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