Theory based nursing practice
Helps to design and implement nursing intervention that address patient responses to health problems
Theory is the foundation of
art and science of nursing
Helps explain an event by defining ideas or concepts, explaining relations among the concepts and predicting outcomes
Conceptualizes an aspect of nursing to describe, explain, predict or prescribe nursing care.
A fact or situation that is observed to exist or happen, especially one whose cause or explanation is in question
The Domain of Nursing includes
The practical and theoretical aspect of nursing Knowledge of nursing practice Nursing history Nursing theory Education Research
A theory or a group of ideas about how something should be done, made or thought about.
Nursing Paradigm links
What nursing is
What nursing does
Why nurse’s do what they do
Identifies common areas of concern
The paradigm of nursing includes the following four links
Nursing views the person
Holistically - compromised of physical, developmental, psycho-social, cultural and spiritual components
Includes all possible conditions affecting patients and the settings in which their health care needs occur.
Nursing theory is conceptualization of some aspects of nursing that
Describes, explains, predicts, or prescribes nursing care
Self-Care Deficit Theory
Explains the factors within a patient’s living situation that support or interfere with his or her self care ability
Self care needs, deficits and abilities
Nursing theories provide nursing school with
A perspective to view patient situations, a way to organize data and a method to analyze and interpret information
Theories can be classified by
Levels of abstraction and goals of the theory
Very abstract (how do nurse's learn to do nursing - benner's model) DOES NOT provide guidance for specific nursing interventions.
Less abstract: bridge the gap between grand theories and nursing practice (focus is on phenomenon such as caring, quality of life)
Describes phenomenon such as grief or caring; speculate on why it occurs.
Do not direct nursing activities but help to explain patient assessments.
(Action oriented) identifies conditions or factors that predict phenomenon (such as grief or caring); includes the interventions and expected outcomes of care
Aka “situation-specific” theories.
Narrow in scope, such as a specific patient population at a specific time
The overall goal of nursing knowledge is to
Explain the practice of nursing as different and distinct from the practice of medicine, psychology and other health care disciplines.
Explains a phenomenon specific to the discipline that develops it: Adult learning theory and Piaget’s Cognitive development
The nursing process
(A systems theory) has a specific purpose or goals: to organize and deliver patient centered care.
The focus of nursing is caring through the environment to restore a patient to health. Stressed importance of assessment.
Ex. Fresh air, light, warmth, cleanliness, quiet and adequate nutrition.
Focused on mid-range theory of interpersonal relations between nurse, patient and the patient’s family.
Nursing is a significant, therapeutic and interpersonal process.
According to Peplau, the following phases characterize the nurse-patient interpersonal relationship
Pre-orientation (data gathering)
Orientation (defining issue)
Working Phase (therapeutic activity)
Termination (termination of relationship)
Aka Self-care Deficit theory
Defined self-care as a learned, goal-oriented activity directed toward the self in the interest of maintaining life, health, development and well-being.
Goal of self-care deficit theory is to
Increase the patient’s ability to independently meet their self-care needs.
Human caring varies among cultures in expression, process and patterns.
Social structure factors such as religion, politics, culture and tradition are significant forces affecting care and influence the patient’s health and illness patterns
Organized her theory into 14 basic needs (grand theory) of the whole person including: physiological, psychological, sociocultural, spiritual and developmental.
Neuman’s Theory (Neuman’s Systems Model)
Is based on stress and the patient’s reaction to the stressor utilizing the nursing process.
Composed of 5 concepts that interact with each other: physiological, psychological, sociocultural, developmental, spiritual.
Focuses on all levels of prevention: primary, secondary and tertiary
Transpersonal caring: based on 10 curative factors.
Transpersonal caring between the nurse and patient facilitates the patient’s ability for self-healing.
Theory of skill acquisition: Novice Advance Beginner Competent Proficient Expert
No experience, rules, strict guidelines essential
Performing tasks independently however cannot think ahead/change course or prioritize
Conscious deliberate planning, able to make ling range plans. Efficient, organized.
Can see beyond the moment, takes in the patient’s whole needs/care
Intuitive grasp. No longer needs analysis or rules. Able to recognize patterns and quickly make decisions.
The goals of theoretical knowledge
Stimulates thinking and creates a broad understanding of the “science” and practices of the nursing discipline
This type of knowledge is the “art” of nursing.
Based on the nurse’s experience in providing care to patients.
Experiential knowledge is achieved through
Personal knowledge gained through: reflection on care experiences, synthesis, and integration of the art and science of nursing
Theory Generating Reseacrh
The investigator makes observations to view a phenomenon in a new way
Theory testing research
Testing helps to develop the evidence for describing or predicting patient outcomes
As an art, the nurse relies on
Knowledge gained from practice and reflection on past experience.
As a science, nursing draws on
Scientifically tested knowledge applied in the practice setting