Chapter 9

Question 1

Why Is Theory Important?

Answer 1

Nursing as a profession is strengthened when nursing knowledge is built on sound theory.

Theory is a useful tool for reasoning, critical thinking, and decision making

Question 2

refers to the most abstract aspect of the structure of nursing knowledge

Answer 2

Metaparadigm

Question 3

is a set of beliefs about the nature of how the world works.

Answer 3

Philosophy

Question 4

puts together some or all concepts of the metaparadigm.

Answer 4

Nursing philosophy

Question 5

is a more specific organization of nursing phenomena than philosophies.

Answer 5

conceptual model or framework

Question 6

provides an organizational structure that makes clearer connections between concepts.

Answer 6

“Model” or “framework”

Question 7

are more concrete descriptions of concepts that are embedded in propositions.

Answer 7

Theories

Question 8

are statements that describe linkages between concepts and are more prescriptive;
that is, they propose an outcome that is testable in practice and research.

Answer 8

Propositions

Question 9

Nightingale’s unique perspective on nursing practice

Answer 9

focused on the relationship of patients to their surroundings.

Question 10

is sensitive to the effect of the environment on the patient’s health or recovery from illness.

Answer 10

The Nightingale nurse

Question 11

The “unique function of the nurse…. is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge”

Answer 11

Henderson’s Philosophy

Question 12

She believed that all 14 basic needs are amenable to nursing care.

Answer 12

Virginia Henderson

Question 13

adopts an orientation to care from the perspective of the 14 basic needs

Answer 13

The Henderson nurse

Question 14

Henderson’s 14 Basic Needs of the Patient

Answer 14

1. Breathe normally.
2. Eat and drink adequately.
3. Eliminate body wastes.
4. Move and maintain desirable position.
5. Sleep and rest.
6. Select suitable clothes—dress and undress.
7. Maintain body temperature within normal range by adjusting clothing and modifying the environment.
8. Keep the body clean and well groomed and protect the integument (skin).
9. Avoid dangers in the environment and avoid injuring others.
10. Communicate with others in expressing emotions, needs, fears, or opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a sense of accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

Question 15

• She focused on the relationship of the nurse and the patient
• An approach that emphasized how the nurse and patient change together through transpersonal caring.

Answer 15

Jean Watson’s Philosophy

Question 16

Nursing should be concerned with spiritual matters and the inner knowledge of nurse and patient as they participate together in the transpersonal caring process. She equated health with harmony, resulting from unity of body, mind, and soul, for which the patient is primarily responsible. Illness or disease was equated with lack of harmony within the mind, body, and soul experienced in internal or external environments

Answer 16

Watson’s Philosophy

Question 17

Nursing is based on human values and interest in the welfare of others and is concerned with health promotion, health restoration, and illness prevention.

Answer 17

Watson’s Philosophy

Question 18

1. Embrace altruistic values and practice loving kindness with self and others.
2. Instill faith and hope and honor in others.
3. Be sensitive to self and others by nurturing individual beliefs and practices.
4. Develop helping-trusting-caring relationships.
5. Promote and accept positive and negative feelings as you authentically listen to another’s story.
6. Use creative scientific problem-solving methods for caring decision making.
7. Share teaching and learning that addresses the individual needs and comprehension styles.
8. Create a healing environment for the physical and spiritual self which respects human dignity.
9. Assist with basic physical, emotional, and spiritual human needs.
10. Open to mystery and allow miracles to enter.

Answer 18

Watson’s 10 Caritas Processes

Question 19

has responsibility for creating and maintaining an environment supporting human caring while recognizing and providing for patients’ primary human requirements.

Answer 19

The Watson nurse

Question 20

Environment – one that supports human caring

Person – both the patient and the nurse

Health – in terms of health promotion and illness prevention

Nursing – what nurses contribute to the encounter with the patient

Answer 20

Key aspects of nursing’s metaparadigm

Question 21

provides organizational structures for critical thinking about the processes of nursing

Answer 21

Conceptual models (or conceptual frameworks)

Question 22

– are less abstract and more formalized than the philosophies.

– more abstract than theories of nursing.

Answer 22

Models

Question 23

Orem’s Self-care Model

King’s Interacting Systems

Framework Theory and Theory of Goal Attainment

Roy’s Adaptation Model

Answer 23

Example of Models

Question 24

The model focuses on the patient’s self-care capacities and the process of designing nursing actions to meet the patient’s self-care needs

Answer 24

Orem’s Self-Care Model

Question 25

The nurse prescribes and regulates the nursing system on the basis of the patient’s self-care deficit, which is the extent to which a patient is incapable of providing effective self-care.

Answer 25

Orem’s Self-Care Model

Question 26

Theory of self-care Theory of self-care deficit Theory of nursing system

Answer 26

Orem's 3 interrelated theories

Question 27

Appropriate care for the patient is developed through a series of three operations: Diagnostic Prescriptive Regulatory

Answer 27

Orem’s Self-Care Model

Question 28

- Establishment of the nurse-patient relationship | - Assessment of patient’s baseline ability to provide adequate self-care

Answer 28

Diagnostic

Question 29

occur when therapeutic self-care requisites (based on deficits) are determined and the nurse reviews various methods, actions, and priorities with the patient

Answer 29

Prescriptive

Question 30

the nurse designs, plans, and produces a system for care (

Answer 30

Regulatory

Question 31

The theory focused on people, their interpersonal relationships, and social contexts

Answer 31

King’s Interacting Systems Framework and Theory of Goal Attainment

Question 32

The theory provides a view of people from the perspective of their interactions with other people at three levels of interacting systems

Answer 32

King’s Interacting Systems Framework and Theory of Goal Attainment

Question 33

identifies concepts that provide an understanding of individuals, personally, and intrapersonally (within the person) ***leads the nurse to pay close attention to the patient’s perceptions

Answer 33

Personal System

Question 34

deals with interactions and transactions between two or more people ***guides the nurse to explore the patient’s roles and the stresses in each role.

Answer 34

Interpersonal System

Question 35

presents concepts that consider social contacts, such as those at school, at work, or in social settings. **cues the nurse to consider influences on the patient’s decision making.

Answer 35

Social System

Question 36

is guided by concepts at the system levels.

Answer 36

King's Nurse

Question 37

The theory emphasized the importance of goal setting by the nurse and the patient (mutuality). The goal of nursing is gaining or regaining health.

Answer 37

King's Theory

Question 38

The model provides a comprehensive understanding of nursing from the perspective of adaptation.

Answer 38

Roy’s Adaptation Model

Question 39

the person’s behavioral responses are ineffective for coping.

Answer 39

When demands of environmental stimuli are too high or the person’s adaptive mechanisms are too low

Question 40

focuses on adaptation of the patient and on the environment. e.g A nurse takes time to assess patients who may not fully realize the goals of care.

Answer 40

The Roy nurse

Question 41

The nurse modifies the environment to facilitate patient adaptation.

Answer 41

Roy's Adaptation Model

Question 42

theory is a broad conceptualization of nursing phenomena.

Answer 42

Grand theory

Question 43

theory is narrower in focus and makes connections between grand theories and nursing practice.

Answer 43

Middle-range theory

Question 44

are less abstract than models and usually propose specific outcomes.

Answer 44

Theories

Question 45

Interpersonal Relations in Nursing

Answer 45

Peplau’s Theory

Question 46

The theory is based on the premise that the relationship between patient and nurse is the focus of attention, rather than the patient only as the unit of attention

Answer 46

Peplau’s Theory of Interpersonal Relations in Nursing

Question 47

- Survival of the patient | - Patient’s understanding of health problems and learning from these problems as s/he develops new behavior patterns

Answer 47

Goals of therapeutic interpersonal relationship (Peplau's Theory)

Question 48

uses a four-pronged approach to assist the patient to achieve personal growth

Answer 48

The Peplau nurse

Question 49

counselor, resource, teacher, technical expert, surrogate, and leader ***Depending on the setting, the nurse will spend more or less time in each of these roles.

Answer 49

The nurse assumes these roles (Peplau's Theory)

Question 50

The theory is about how nurses process their observations of patient behavior and about how they react to patients based on inferences from patients’ behavior.

Answer 50

Orlando’s Nursing Process Theory

Question 51

It is specific to nurse-patient interactions

Answer 51

Orlando’s Nursing Process Theory

Question 52

The goal of the nurse is to determine and meet patients’ immediate needs and to improve their situation by relieving distress or discomfort.

Answer 52

Orlando’s Nursing Process Theory

Question 53

It emphasized deliberate action (rather than automatic action).

Answer 53

Orlando’s Nursing Process Theory

Question 54

nurse individualize care for each patient by

Answer 54

The Orlando nurse

Question 55

- Attending to behavior - Confirming with patient ideas and inferences the nurse draws from interactions - Identifying pressing needs

Answer 55

Individualized care

Question 56

The theory improves nurse effectiveness by allowing the nurse to get to the “bottom line” more quickly. Thus, it saves time and energy for both patient and nurse.

Answer 56

Orlando’s Nursing Process Theory

Question 57

Nursing Process Theory

Answer 57

Orlando's Theory

Question 58

Culture Care Diversity and Universality

Answer 58

Leininger’s Theory

Question 59

Planning care based on knowledge that is culturally defined, classified, and tested and then used to provide culturally congruent care

Answer 59

Transcultural nursing

Question 60

The theory considers the impact of culture on all aspects of human life, with particular attention to health and caring practices.

Answer 60

Leininger’s Theory of Transcultural nursing

Question 61

Nursing care is focused on culture care preservation, accommodations, or re-patterning depending on the patient’s need.

Answer 61

Leininger’s Theory of Transcultural nursing

Question 62

theories are neither overly broad nor narrow in scope. They incorporate a limited number of concepts and focus on a specific aspect of nursing. They typically merge practice and research

Answer 62

Middle Range Theories of Nursing

Question 63

Theory was based on couples experiencing miscarriages

Answer 63

Swanson’s Caring Theory

Question 64

studied men with prostate cancer who were watchfully waiting for advancing their disease rather than seeking aggressive therapies

Answer 64

Mishel’s Uncertainty in Illness Theory

Question 65

based on qualitative research on politically and economically powerless or those who were vulnerable as a function of advanced disease

Answer 65

Jezewski’s Cultural Brokering Theory

Question 66

notes that death and dying is a social phenomenon that involves a wide range of human responses across a variety of settings

Answer 66

Dobratz Theory of Psychological Adaptation in Death and Dying

Question 67

- are built on one or more specific conceptual models or concepts. 2000: Beavis and Watson 2006: Lewis

Answer 67

The nursing curricula

Question 68

from applied vocation dependent on knowledge from other disciplines to its current stage of development with its own knowledge base.

Answer 68

Nursing Profession Evolution

Question 69

when nurses intentionally structure their practice around a particular nursing theory and use it to guide them as they use the nursing process to assess, plan, diagnose, intervene, and evaluate nursing care

Answer 69

Theory-based practice occurs

Question 70

(4) Benefits of Theory-Based Practice

Answer 70

1. It shapes theoretical orientation to practice. 2. It facilitates the transmission of nursing knowledge. 3. It contributes to professional autonomy. It is a nursing-based guide for practice, education, and research. 4. It helps develop analytical skills, challenges thinking, and clarifies values and assumptions.

Question 71

- enable nurses to improve the quality of care and understand how evidence-based practice influences improved patient outcomes

Answer 71

Research findings

Question 72

During a home visit, a nurse assesses the client and attempts to identify factors that prevent attainment of client’s ability to comply with treatment regimen. The nurse most likely uses: 1. King’s interacting systems framework 2. Orem’s self-care model 3. Roy’s adaptation model 4. Watson’s philosophy

Answer 72

2. Orem’s self-care model