TFN Flashcards
1
Q
A creative & rigorous structuring of ideas that projects a tentative, purposeful and systematic view of phenomena (Chinn & Kramer,1991)
A
THEORY
2
Q
An organized system of accepted knowledge that is composed of concepts, propositions, definitions, and assumptions intended to explain a set of fact, event, or phenomena.
A
THEORY
3
Q
An organized framework of concepts and purposes designed to guide the practice of nursing.
A
NURSING THEORY
4
Q
A group of interrelated concepts that are developed from various studies of disciplines & related experiences which aims to view the essence of nursing care.
A
NURSING THEORY
5
Q
An articulated & communicated conceptualization of invented or discovered reality (central phenomena & relationships) in or pertaining to nursing for the purpose of describing, explaining, predicting or prescribing nursing care (Meleis, 1991).
A
NURSING THEORY
6
Q
3 COMPONENTS OF NURSING THEORY
(Barnum, 1994)
A
o Context – resembles environment to which nursing act takes place.
o Content – subject of the theory.
o Process – method by which the nurse acts in using nursing theory.
7
Q
The majority of nursing theories are developed by ____, but at times other ___________, such as _______have provided input into the development of nursing theories.
A
Nurses, Healthcare Professionals, Physicians
8
Q
The first nursing theories appeared in the _________ when a strong emphasis was placed on __________.
A
Late 1800’s, Nursing education
9
Q
developed to explain and describe nursing care, guide nursing practice and provide a foundation for clinical decision making
A
Nursing theories
10
Q
Division of Nursing Theories
A
-Grand Theories
-Middle-range Theories
-Nursing Practice Theories
11
Q
affect everyday nursing practice. Most nurses employ a number of theories in practice rather than using one theory exclusively. Using a variety of nursing theories during a given day, allows the nurse to choose the best theory to fit the situation.
A
Nursing theories
12
Q
CLASSIFICATION OF NURSING THEORIES
According to function by Dickoff & James, 1968
A
o Descriptive/Factor-Isolating Theory
o Explanatory/Factor-Relating Theory
o Predictive/Situation-Relating Theory
o Prescriptive/Situation-Producing Theory
13
Q
To know the properties & workings of a discipline.
A
o Descriptive/Factor-Isolating Theory
14
Q
To examine how properties, relate and thus affect the discipline.
A
o Explanatory/Factor-Relating Theory
15
Q
To calculate the relationships between properties and how they occur.
A
o Predictive/Situation-Relating Theory
16
Q
To identify under which conditions relationships occur.
A
o Prescriptive/Situation-Producing Theory
17
Q
o Can correlate concepts as to generate a different way of looking at a certain fact or phenomenon.
A
Theory
18
Q
o Must be logical in nature.
o Should be simple but generally broad in nature.
A
Theory
19
Q
o Can be a source of hypotheses that can be tested for it to be elaborated.
o Contribute in enriching the general body of knowledge through the studies implemented to validate them.
A
Theory
20
Q
o Can be used by practitioners to direct & enhance their practice.
o Must be consistent with other validated theories, laws & principles but will leave open unanswered issues that need to be tested.
A
Theory
21
Q
CLASSIFICATION OF NURSING THEORIES
According to scope
(degree or complexity of abstraction)
A
o Metatheory/Philosophy/Worldview
o Grand Theory/Macro Theory
o Middle-Range Theory/Midrange Theory
o Practice Theory/Situation-Specific Theory/Micro-Theory/Prescriptive Theory
22
Q
developed to improve the quality of care rendered by nurses to their clients. Theory development is inherent in the different nursing fields.
A
NURSING THEORIES
23
Q
Different nursing fields
A
Education
Research
Practice
24
Q
NURSING THEORIES were primarily used to develop & guide ———— in universities & institutions.
A
Nursing Education
25
Nursing theories were known to be strongly established in this field rather than in clinical practice
Field of Academics
26
In years ______________, a number of nursing programs recognized the major concepts of some nursing models, structured these concepts into a conceptual framework & built the complete curriculum around the framework (Kozier, 2008).
1970s & 1980s
27
The general purpose of theory development is to ensure adequate & quality nursing delivery & to clarify & improve the status of ________ as a __________
NURSING as a PROFESSION
28
Nursing researches are frequently based on _______________ which focus on the discovery of concepts such as pain, self-esteem & learning. It has been known that theoretical concepts from social sciences served as one of the foundations of __________.
Middle ranged, Qualitative Nursing Research
29
A NURSE’s _________is enriched through the help of different NURSING THEORIES.
ability
30
________ strengthen professional independence by guiding the deepest & most important part of their practice.
Nursing theories
31
always critical in assisting nurses to facilitate questions, reflections & critical thinking in every aspect of care.
Nursing theories
32
is significant because it helps us to settle on what we know and what we need to know in the future.
It helps to differentiate what should form the basis of practice by clearly describing what nursing does and what nursing is all about.
THEORY
33
main exponent of Nursing
caring
34
______provide the principles that support nursing practice
NURSING THEORY
35
As _______tries to make a move towards adopting a more multi-disciplinary approach to health care, ____________continues to strive to establish a unique body of knowledge
Medicine, Nursing
36
The commitment to _____ is helpful to the nurse-patient relationship because it provides an organized, educated approach to nursing practice.
theory-based practice
37
______requires a systematic approach that is focused on the patient. Nursing theoretical works provide a perspective of the patient.
Professional practice
38
Theory helps Nurses to : (T or F)
* Organize, examine & analyze patient’s data
* Make decisions about effective & efficient nursing interventions
* Make a S-M-A-R-T (Specific, Measurable, Attainable, Realistic & Time-bounded) plan of care
* Predict & evaluate outcomes of care
T
39
CRITERIA OF PROFESSION:
(William Shephered, 1948)
40
logical, systematic, & coherent way to solve problems and answer questions
It is a collection of facts known in area and the process used to obtain that knowledge
science
41
studies concepts that structure thought processes, foundations, and presumptions.
Philosophy
42
a branch of philosophy that is concerned with the nature and scope of knowledge; the ‘theory of knowledge’
* The power of reason and power of sensory experience (Gale)
EPISTEMOLOGY
43
the power of sensory experience & experimentation
* Research-then-theory
EMPIRICISM
44
* Francis Bacon believed that _______was discovered through the generalization of observed facts in the natural world; a posteriori
scientific knowledge
45
_____makes use of objective & tangible data or those that are perceived by the senses (smell, sight, taste & feeling) to observe & collect data
These data are then used to formulate general knowledge, which is the use of ______
EMPIRICISM , INDUCTIVE-TYPE OF REASONING
46
highly important in the assessment of patients throughout the entire nursing process.
Enpiricism
47
In philosophy, the view that all concepts originate in experience, that all concepts are about or applicable to things that can be experienced, or that all rationally acceptable beliefs or propositions are justifiable or knowable only through experience
EMPIRICISM
48
the power of reason or logic which emphasizes the importance of a priori reasoning (from general to specific/from cause to effect) as the appropriate method for advancing knowledge
* Theory-then-research strategy
RATIONALISM
49
makes use of reason gained through expert study, tested theory & established facts to evidently prove something. It emphasizes the use of REASONING for the main purpose of knowing the harm or benefits of an act to an individual
RATIONALISM
50
used to generate rationalist view which starts from the GENERAL TO SPECIFIC knowledge
DEDUCTIVE TYPE OF REASONING
51
A belief or theory that opinions and actions should be based on reason and knowledge rather than on religious belief or emotional response.
RATIONALISM
52
The arrival of nursing as a ______ and a "____" and the central importance of nurses to hospitals was clearly evidenced in the architecture of grand and imposing nursing schools that were attached to hospitals.
profession, calling
53
They were deliberately designed with impressive entrances and private rooms, as well as lobby and recreational areas (nurses)
"women of refinement"
54
knowledge should be based on the understanding of existing theories
Philosophers point of view
55
knowledge should not only focus on theoretical existence but also an understanding what there is still to be observed
scientists
56
* The use of _____to gain new knowledge emerged during this period as nurses strive to base their actions on evidence and scientific data
experimentation
57
which encloses the use of both logical reasoning & empiricism, became prevalent during this era in the discovery of truth for the development of science
* POSITIVISM
58
co-exist as the focus of interest of study ads one of each need to be tested in order to determine as to what is true or what is not
* EMPIRICAL & OBJECTIVE DATA
59
radical thinking
RATIONALISM & EMPIRICISM
60
His major thesis stated that empirical knowledge was arranged in different patterns at a given time and in a given culture.
Michel Foucault’s
61
in his Phenomenology of the Social World, argued that scientists seeking to understand the social world could not cognitively know an external world that is independent of their own life experiences.
Alfred Schutz
62
the objectivism of science precluded adequate apprehension of the world
Phenomenology
63
set forth phenomenology
Edmund Husserl (1859-1938)
64
A phenomenological approach reduces observations or text to the meanings of phenomena, independent of their particular occasions. (Who)
Edmund Husserl
65
In 1977, he argued an intellectual revolution in philosophy that emphasized that the history of science was replacing formal logic as the major analytical tool in the philosophy of science.
Richard D. Brown
66
a process of continuing research rather than as a product focused on findings.
science
67
emphasis shifted to understanding scientific discovery and process as theories change over time.
emergent epistemology
68
they view phenomena objectively, collect data, and analyze them to inductively propose a theory (Brown,1977).
empiricists
69
maintained that a pre-supposed theoretical framework influences perception; however, theories are not the single determining factor of the scientist’s perception.
(Brown,1977).
70
Brown identified the following three different views of the relationship between theory and observation
1. Scientists are merely passive observers of occurrences in the empirical world. Observable data consist of objective truth waiting to be discovered.
2. Theories structure what the scientist perceives in the empirical world.
3. Pre-supposed theories and observable data interact in the process of scientific investigation
71
Afaf Meleis characterized the years of progress in nursing in four stages:
1.Practice
2.Education and Administration
3.Research
4.Development of Nursing Theory
72
developed the first theory of nursing practice in her book, Interpersonal Relations in Nursing
Hildegard Peplau
73
FOUR FUNDAMENTAL PATTERNS OF KNOWLEDGE IN NURSING (Barbara Carper, 1978)
1.Empirical knowledge (nursing science)
2.Esthetic knowledge (nursing as an art)
3.Moral knowledge (ethics in nursing)
4.Personal knowledge (therapeutic use of self)
74
vital parts in development of the structure of nursing knowledge
FOUR C’s
75
STRUCTURE OF NURSING KNOWLEDGE
FOUR C’s
* Caring
* Competence
* Conscience
* Creativity
76
a set of theories or ideas that provide structure for how a discipline should function
META-PARADIGM
77
For a nursing discipline, metaparadigm consist of four basic concepts that address the patient as a whole:
1. the person
2. patient’s health and well-being
3. the patient’s environment
4. the nursing responsibilities
78
degree of wellness or well-being
health
79
internal and external surrounds that affect the client
environment
80
recipient of nursing care
person
81
attributes, characteristics, and actions of the nurse providing care on behalf of or in conjunction with the client.
nursing
82
* focuses on the receiver of care
* also includes family members and other groups important to the patient
* the care structure considers the person’s spiritual, social needs & health care needs
* the resulting health outcome is attributed to how the person interacts with these physical and social connections
person component
83
* the extent of wellness and health care access that a patient has
* characterized as one with multiple dimensions in a constant state of motion
* health and wellness cover a person’s lifespan and genetic makeup, & how the physical, emotional, intellectual, social and spiritual well-being is integrated in health care for maximum health benefits
health component
84
* involves the delivery of optimal health outcomes for the patient through a mutual relationship in a safe and caring environment
nurisng component
85
* focuses on the surroundings that affect the patient
* consists of internal and external influences
* interactions with family, friends & other people
* physical & social factors such as economic conditions, geographic locations, culture, social connections & technology
environment component
86
is a statement, sometimes written, that declares a nurse's beliefs, values, and ethics regarding their care and treatment of patients while they are in the nursing profession
a philosophy of nursing
87
representation of an idea or body of knowledge based on the understanding of a person or a researcher of a certain topic/phenomena/theory provides a coherent, unified and orderly way of envisioning related events or processes relevant to a discipline (Fawcett 2005)
CONCEPTUAL MODELS & FRAMEWORK
88
conceptual models:
-word structure
-verbal
-schematic
89
provide specific view on nursing through the interrelationship of concepts in the structure
word structure
90
worded statements, a form closely related to knowledge development.
verbal
91
diagrams, drawing, graphs or pictures that facilitate understanding.
schematic
92
* Self: Nurses promote personal health and wellness
* Healthcare Consumer: Nurses emphasize the interpersonal helping relationship while practicing holistic, culturally congruent care
* Profession: Nurses invest and commit to the advancement of professional nursing
caring
93
* Self: Nurses utilize logical, analytical, intuitive, and creative thinking
* Healthcare Consumer: Nurses utilize critical thinking to make sound clinical decisions
* Profession: Nurses act as advocates and change agents
critical thinking
94
* Self: Nurses understand their own personal attributes, values and beliefs
* Healthcare Consumer: Nurses recognize human experiences, needs and responses in varying states of health
* Profession: Nurses understand the theories, research, issues, trends, and forces that shape the practice of nursing.
knowledge
95
* Self: Nurses develop and maintain the cognitive, interpersonal, and psychomotor skills for safe, effective nursing care
* Healthcare Consumer: Nurses demonstrate professional standards of practice using evidence-based practice to deliver safe, effective nursing care
* Profession: Nurses understand and abide by the legal and ethical aspects of practice set forth by professional standards and policy.
competence
96
* Self: Nurses promote self-awareness to enhance interactions
* Healthcare Consumer: Nurses share and exchange information in collaboration with the healthcare consumer
* Profession: Nurses communicate appropriately with colleagues and stakeholders
communication
97
* Self: Nurses develop professional attributes and values through ongoing self-assessment, self-determination, and life-long learning
* Healthcare Consumer: Nurses advocate for healthcare consumers
* Profession: Nurses shape and influence the profession and global health through active involvement in health care policy
professionalism
98
reflect particular views of person, health, environment, nursing & other concepts that contribute to the development of a body of knowledge specific to nursing.
nursing theory
99
types of theories: most abstract to least
grand, middle range, practice
100
Purpose of nurisng theories
* Enlightening and Understanding – Descriptive theories
* Explanation and Prediction – Explanatory theories
* Control and Manipulation – Prescriptive theories
101
Descriptive theories
* Enlightening and Understanding
102
Explanatory theories
* Explanation and Prediction
103
Prescriptive theories
* Control and Manipulation
104
TYPES OF THEORY BY SCOPE
o GRAND THEORIES
o MIDDLE-RANGE THEORIES
105
made up of concepts representing common & extremely complex phenomena. A general framework for creating & structuring broad & abstract ideas
o GRAND THEORIES
106
made up of a limited number of concepts and propositions that are written at a relatively concrete and specific level. They are generated or tested by means of research, and are used as the evidence for practice activities, such as assessment and intervention
o MIDDLE-RANGE THEORIES
107
Theory of Florence Nightingale
Environmental Theory
108
Foundation of Nightingale’s Theory
(THE ENVIRONMENT)
109
o all the external conditions and forces that influence the life and development of an organism
Environmental Theory
110
o external influences and conditions can prevent, suppress, or contribute to disease or death
Environmental Theory
111
o her goal is to help the patient retain his own vitality by meeting his basic needs through control of the environment
o FLORENCE NIGHTINGALE
(ENVIRONMENTAL THEORY)
112
TYPES OF ENVIRONMENT:
o PHYSICAL ENVIRONMENT
o PSYCHOLOGICAL ENVIRONMENT
o SOCIAL ENVIRONMENT
113
consists of physical elements where the patient is being treated. It influences the psychological and social environments of the person
Physical environment
114
It requires various activities to keep the mind active. It involves communication with the person, about the person, and about other people
Psychological environment
115
person’s home or hospital room, as well as the total community
Social environment
116
THE TEN MAJOR CONCEPTS OF THE ENVIRONMENT THEORY
(NIGHTINGALE'S CANONS)
VVCLOFSBPH
o Ventilation and warming
o Light and noise
o Cleanliness of the area
o Health of houses
o Bed and bedding
o Personal cleanliness
o Variety
o Offering hope and advice
o Food
o Social considerations
117
o Nurses was “to keep the air he breathes as pure as the external air, without chilling”
o Nightingale was very concerned about “noxious air” or “effluvia” or foul odors that came from environment
o Nightingale stressed the importance of room temperature. The patient should not be too warm or too cold
VENTILATION AND WARMING
118
foul odors
effluvia or noxious air
119
o She viewed that direct sunlight was what patients wanted
o Although acknowledging a lack of scientific rationale for it, she noted that light has “quite real and tangible effects upon the human body”
light
120
o She stated that patients should never be waked intentionally or accidentally during the first part of sleep
o She asserted that whispered or long conversations about patients are thoughtless and cruel.
noise
121
closely related to the presence of pure air, pure water, efficient drainage, cleanliness and light
HEALTH OF HOUSES
122
o Cleanliness outside the house affect the health of the persons inside
CLEANLINESS OF THE AREA
123
o Nightingale noted that an adult in health exhales about three pints of moisture through the lungs and skin in a 24-hour period. This organic matter enters the sheets and stays there unless the bedding is changed and aired frequently
o She believed that the bed should be placed in the lightest part of the room and placed so the patient could see out of a window. She also reminded the caregiver never to lean against, sit upon, or unnecessarily shake the bed of the patient
BED AND BEDDING
124
o The need for cleanliness is extended to the patient, the nurse and the environment
o Nightingale viewed the functions of the skin is important, believing that many disease “disorders” caused breaks in the skin
o Every nurse ought to wash her hands very frequently during the day
PERSONAL CLEANLINESS
125
o She discussed the need for changes in color and form, including bringing the patient brightly-colored flowers or plants
o She also advocated rotating 10 or 12 paintings and engravings each day, week, or month to provide variety for the patient
o Nightingale also advocated reading, needlework, writing, and cleaning as activities to relieve the sick of boredom
VARIETY
126
o False hope was depressing to patients, and caused them to worry and become fatigued later
o She believed that sick persons should hear good news that would assist them to become healthier
CHATTERING HOPES AND ADVICES
127
o Nightingale noted that individuals desire different foods at different times of the day and that frequent small servings may be more beneficial to the patient than a large breakfast or dinner
o She urged that no business be done with patients while they are eating because this was distraction
NUTRITION AND TAKING FOOD
128
o Nightingale supported the importance of looking beyond the persons to the social environments in which he or she lived
o She observed that generations of families lived and died in poverty
SOCIAL CONSIDERATIONS
129
ENVIRONMENTAL FACTORS:
o Pure fresh air
o Pure water
o Effective drainage
o Cleanliness
o Light (especially direct sunlight)
130
“to keep the air he breathes as pure as the external air without chilling him.”
o Pure fresh air –
131
“well water of a very impure kind is used for domestic purposes. And when epidemic disease shows itself, persons using such water are almost sure to suffer.”
o Pure water –
132
“all the while the sewer maybe nothing but a laboratory from which epidemic disease and ill health is being installed into the house.”
o Effective drainage –
133
“the greater part of nursing consists in preserving cleanliness.”
o Cleanliness –
134
“the usefulness of light in treating disease is very important.”
o Light (especially direct sunlight) –
135
PARADIGM
NURSING
HEALTH
PERSON
ENVIRONMENT
136
* It is different from medicine and the goal of nursing is to place the patient in the best possible condition for nature to act.
* _______is the "activities that promote health which occur in any care giving situation. They can be done by anyone
nursing
137
* “not only to be well but maintaining well- being by using a person’s power to the fullest extent”. ____ is maintained by controlling the environmental factors to prevent disease.
health
138
considered as dys-ease or the absence of comfort. Health and _____are the focus of nurse, who helps a person through the healing process
* Disease
139
a patient; affected by environment. ____is multidimensional, composed of biological, psychological, social and spiritual components.
person
140
* "Poor or difficult environments led to poor health and disease”. “Environment could be altered to improve conditions so that the natural laws would allow healing to occur."
environment
141
Nightingale’s focus on the ______ as being a vital part of patient care began when caring for those injured and sick during the _____ (Payne, 2010)
environmental setting
Crimean War in 1854
142
_____ creates a basis to which nurses today can follow with the practice of patient care. Such ideas are stated here: “Nightingale delved into the most basic needs of human beings and all aspects of environment (e.g., clean air, water, food, housing).
Florence Nightingale’s Environmental Model
143
______such as light, music, relaxation, aromatherapy, touch, music therapy, pet therapy, health nutrition, and exercise” (Dossey, 2010).
Integrative modalities/therapies
144
The Environment model can be intended to use in any hospital setting. t or f
t (Critical Care, Hospice or even in the OB.)
145
o MARGARET JEAN WATSON's theory
(THEORY OF HUMAN CARING)
146
The nursing model of watson states that “______is concerned with promoting health, preventing illness, caring for the sick, and restoring health.” It focuses on ____, as well as the_____.
nursing
health promotion
treatment of dseases
147
_____is central to nursing practice and promotes health better than a simple medical cure. can be demonstrated and practiced by nurses. promotes growth;
Caring
148
accepts a person as he or she is and looks to what he or she may become.
a caring environment
149
A _____________________ is central to the practice of caring in nursing.
holistic approach to health care
150
“Dr. Watson drew parts of her theory from nursing writers like ________________ as well as from works of psychologists and philosophers.” (Theory Description, n.d.)
Florence Nightingale
151
“Watson's theory is one based on the _________ that recognizes the spiritual and ethical dimensions relevant to the ____________.” (Theory Description, n.d.)
human interactive process
human care process
152
Dr. Watson states that though her life’s work had been to live out her theory, she did not fully understand her purpose until she was involved in a freak accident where she lost her ____.2015
eye sight
153
WATSON’S HIERARCHY OF NEEDS
o Lower Order Biophysical Needs or Survival Needs
o Lower Order Psychophysical Needs or Functional Needs
o Higher Order Psychosocial Needs or Integrative Needs
o Higher Order Intrapersonal-Interpersonal Need or Growth-seeking Need
154
(food and fluid, elimination, and ventilation)
o Lower Order Biophysical Needs or Survival Needs
155
(activity, inactivity, and sexuality)
o Lower Order Psychophysical Needs or Functional Needs
156
(achievement, and affiliation)
o Higher Order Psychosocial Needs or Integrative Needs
157
(self-actualization)
o Higher Order Intrapersonal-Interpersonal Need or Growth-seeking Need
158
(1) Caring can be effectively demonstrated and practiced only ________.
(1) Caring can be effectively demonstrated and practiced only interpersonally.
159
(2) Caring consists of ______ that result in the satisfaction of certain human needs.
carative factors
160
(3) _______promotes health and individual or family growth.
Effective caring
161
(4) ______ accept the patient as he or she is now, as well as what he or she may become.
Caring responses
162
(5) A _______is one that offers the development of potential while allowing the patient to choose the best action for him or herself at a given point in time.
caring environment
163
A _______is complementary to the science of curing.
science of caring
164
(7) The _____ is central to nursing.
practice of caring
165
how many assumptions do watson have
7
166
WATSON DEFINED THREE OF THE FOUR METAPARADIGM CONCEPTS IN NURSING
o Human being
o Health
o Nursing
167
as a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; a fully functional integrated self; viewed as greater than and different from the sum of his or her parts.
Human being –
168
as a high level of overall physical, mental, and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness, or the presence of efforts leading to the absence of illness.
o Health –
169
as a science of persons and health-illness experience that are mediated by professional, personal, scientific, and ethical care interactions.
o Nursing –
170
did Watson devised the fourth metaparadigm? (environment)
No, but devised 10 caring needs (specific carative factors)
171
o Patricia Benner, RN, PhD, FAAN, FRCN
(STAGES OF NURSING EXPERTISE)
172
expert nurses develop skills and understanding of patient care over time through a proper educational background as well as a multitude of experiences
(STAGES OF NURSING EXPERTISE)
173
The theory is not focused on how to be a nurse, rather on how nurses acquire nursing knowledge – one could gain knowledge and skills (“knowing how”), without ever learning the theory (“knowing that”)
(STAGES OF NURSING EXPERTISE)
174
Benner used this as a foundation for her work.
DREYFUS MODEL OF SKILL ACQUISITION
175
who created dreyfus model
brothers STUART AND HUBERT DREYFUS:
176
Dreyfus model stages
Stage 1: Novice
Stage 2: Advanced Beginner
Stage 3: Competent
Stage 4: Proficient
Stage 5: The Expert
177
Just tell me what I need to do and I'll do it."
o Generally, applies to student Nurse
o Can also apply to experienced nurse in an area or situation of unfamiliarity (Alligood & Tomey 2007)
o Has little background and limited practical skills
o Relies on rules and expectations of others for directions (Chitty & Black, 2007)
stage 1 novice
178
o Applies to most newly passed or graduated nurses
o Feel highly responsible for managing patients care
o Still rely on the help of the more experienced nurse
o Has marginally competent skills
o Uses theory and principles much of the time
o Experiences difficulty establishing priorities (Chitty & Black, 2007)
Stage 2 advanced beginner
179
o Usually Applies to nurses with 2-3 years’ experience
o Coordinates several tasks simultaneously
o Consistent, predictable and able to manage time
o May display hyper responsibility for the patient
o Begins to recognize patterns
o Determines which elements of the situation warrant attention and which can be ignored (Alligood & Tomey, 2007)
stage 3 competent
180
o Perceives and understands situations as whole parts
o Views patients holistically (Nursing Theory, 2011)
o Focuses on long – term goals
o Can see changing relevance in a situation
o Demonstrates increased confidence in their knowledge and abilities
o No longer relies on present goals for organization (Alligood & Tomey, 2007)
STAGE 4: PROFICIENT
181
o No longer relies on principles, rules or guidelines to connect situations and determine actions
o Performances are fluid, flexible, and highly proficient
o Expertise comes naturally (Nursing Theory, 2011)
o Become more efficient and organized
o Reached only after extensive experience
o Grasps patients need automatically
o Demonstrates a clinical grasp and resource-based practice (Chitty & Black, 2007)
stage 5: the expert
182
NURSING APPLICATION OF BENNER’S THEORY
o Nursing school curriculum
o Building clinical ladders for nurses (Frisch, 2009)
o Developing mentorship programs
o Development of the Clinical Simulation Protocol (Larew et al., 2006)
183
KATIE ERIKSSON
(THE THEORY OF CARITATIVE CARING)
184
Assumption of Katie Erikson:
human being is fundamentally an entity of ___,___, and ___
body soul spirit
185
AKE:means accepting the human obligation of serving with love, of existing for the sake of others.
human dignity
186
AKE: human being is fundamentally
religious and holy
187
AKE:___ means a movement in becoming, being and doing, and striving for integrity and holiness which is compatible with bearable suffering.
health
188
AKE: The basic category of caring
suffering.
189
AKE: The basic motive of caring.
the caritas motive
190
AKE:___implies alleviating suffering in charity, love, faith, and hope.
o Caring
191
AKE:expressed through tending, playing, and teaching in a sustained caring relationship.
Natural basic caring
192
AKE:forms the meaningful context of caring and derives its origin from the ethos of love, responsibility, and sacrifice, that is, a caritative ethic.
Caring relationship
193
it is consists of love and charity (caritas), and respect and reverence for human holiness and dignity
Caritative caring
194
According to the theory of eriksson, suffering that occurs as a result of a lack of caritative care is a violation of
human dignity
195
deals with the basic relation between the patient and the nurse-the way in which the nurse meets the patient in an ethical sense. It is about the approach we have toward the patient.
itis the core of nursing ethics.
CARING ETHICS –
196
deals with the ethical principles and rules that guide the work or the decisions
NURSING ETHICS –
197
____constitutes one of the basic concepts of caritative caring ethics. ______ is partly absolute dignity, partly relative dignity. ____ is granted the human being through creation, while relative dignity is influenced and formed through culture and external contexts. A human being’s absolute dignity involves the right to be confirmed as a unique human being (Eriksson, 1988, 1995, 1997)
dignity
human dignity
absolute dignity
198
_____ constitutes the context of the meaning of caring and is the structure that determines caring reality. It is a form of intimate connection that characterizes caring. It requires meeting in time and space, an absolute, lasting presence. It is characterized by intensity and vitality, and by warmth, closeness, rest, respect, honesty, and tolerance. It cannot be taken for granted but pre-supposes a conscious effort to be with the other. it is seen as the source of strength and meaning in caring
Caring communion
199
refers to the act that occurs when the career welcomes the patient to the caring communion. The concept of this finds room for a place where the human being is allowed to rest, a place that breathes genuine hospitality, and where the patient’s appeal for charity meets with a response (Eriksson, 1995; Eriksson & Lindström, 2000)
Invitation
200
this refers to the drama of suffering. A human being who suffers wants to be confirmed in his or her suffering and be given time and space to suffer and reach reconciliation. this implies a change through which a new wholeness is formed of the life the human being has lost in suffering. In this, the importance of sacrifice emerges (Eriksson, 1994a). Having achieved this implies living with an imperfection with regard to oneself and others but seeing a way forward and a meaning in one’s suffering. this is a prerequisite of caritas (Eriksson, 1990)
Reconciliation (this)
201
_____ is the concept that Eriksson uses to describe the patient.
The patient refers to the concept of patients (Latin), which means “____.” The patient is a
____ and patiently endures (Eriksson, 1994a; Eriksson & Herberts, 1992)
The suffering human being
suffering
suffering human being
202
is the concept that Eriksson (1987) uses instead of environment. It characterizes the total caring reality and is based on cultural elements such as traditions, rituals, and basic values. It transmits an inner order of value preferences or ethos, and the different constructions of culture have their basis in the changes of value that ethos undergoes. If communion arises based on the ethos, the culture becomes inviting. Respect for the human being, his or her dignity and holiness, forms the goal of communion and participation in a caring culture.
Caring culture
203
The origin of the concept of ____is to be found in such dimensions as reverence, tending, cultivating, and caring; these dimensions are central to the basic motive of preserving and developing a caring culture
(Eriksson, 1987a; Eriksson & Lindström, 2003)
culture
204
o IMOGENE KING
(GENERAL SYSTEMS FRAMEWORK & GOAL ATTAINMENT THEORY)
205
King proposed that the nurse interacts in the system simultaneously at three different levels namely:
PERSONAL, INTERPERSONAL & SOCIAL frameworks
206
These levels are independent and at the same time co-exist to influence over-all nursing practice
* PERSONAL SYSTEM
* INTERPERSONAL SYSTEM
* SOCIAL SYSTEM
* In order to identify problems and establish goals, the nurse and patient has to perceive one another, act and react, interact, and transact
* PERSONAL SYSTEM
* INTERPERSONAL SYSTEM
* SOCIAL SYSTEM
207
* In order to identify problems and establish goals, the nurse and patient has to perceive one another, act and react, interact, and transact. t or f
t
208
how the nurse views and integrates self-based from personal goals and beliefs;
* PERSONAL SYSTEM
209
how the nurse interrelates with a co-worker or patient, particularly in a nurse-patient relationship;
* INTERPERSONAL SYSTEM
210
how the nurse interacts with co-workers, superiors, subordinates and the client environment in general;
* SOCIAL SYSTEM
211
fundamentals in understanding human being because this refers to how the nurse views and integrates self-based from personal goals and beliefs.
personal system
212
individuals, who are regarded as rational, sentient, social beings.
perosnal systems
213
concepts for the personal system
o PERCEPTION
o SELF
o GROWTH AND DEVELOPMENT
o BODY IMAGE
o SPACE
o TIME
214
a process of organizing, interpreting, and transforming information from sense data and memory that gives meaning to one's experience, represents one's image of reality, and influences one's behavior
perception
215
a composite of thoughts and feelings that constitute a person's awareness of individual existence, of who and what he or she is
self
216
cellular, molecular, and behavioral changes in human beings that are a function of genetic endowment, meaningful and satisfying experiences, and an environment conducive to helping individuals move toward maturity
growth and development
217
a person's perceptions of his or her body
body image
218
the physical area called territory that exists in all directions
space
219
the duration between the occurrence of one event and the occurrence of another event
time
220
King refers to two individuals as ___, three as ____and four or more individuals as _____ or _____ (King, 1981)
dyads
triads
small group
larger group
221
____between the nurse and the client can be verbal or nonverbal.
Communication
222
___between the Dyads (nurse-patient) is very important for the attainment of the goal.
Collaboration
223
CONCEPTS ASSOCIATED FOR THE INTERPERSONAL SYSTEM:
o INTERACTIONS
o COMMUNICATION
o TRANSACTION
o ROLE
o STRESS
o COPING
224
the acts of two or more persons in mutual presence; a sequence of verbal and nonverbal behaviors that are goal directed.
o INTERACTIONS
225
the vehicle by which human relations are developed and maintained; encompasses intrapersonal, interpersonal, verbal, and nonverbal communication.
o COMMUNICATION
226
a process of interaction in which human beings communicate with the environment to achieve goals that are valued; goal-directed human behaviors.
o TRANSACTION
227
— a set of behaviors expected of a person occupying a position in a social system.
o ROLE
228
a dynamic state whereby a human being interacts with the environment to maintain balance for growth, development, and performance, involving an exchange of energy and information between the person and the environment for regulation and control of stressors.
stress
229
a way of dealing with stress
coping
230
CONCEPTS ASSOCIATED WITH THE SOCIAL SYSTEM:
o AUTHORITY
o POWER
o STATUS
o DECISION MAKING
o Control
231
being in charge
control
232
a dynamic and systematic process by which goal-directed choice of perceived alternatives is made and acted upon by individuals or groups to answer a question and attain a goal
decision amking
233
the position of an individual in a group or a group in relation to other groups in an organization
status
234
the process whereby one or more persons influence other persons in a situation
power
235
a transactional process characterized by active, reciprocal relations in which members' values, backgrounds, and perceptions play a role in defining, validating, and accepting the ____of individuals within an organization
authority
236
Describes the importance of the participation of all individuals in decision making as well as choices, alternatives, and outcomes of nursing care.
The practice of nursing is differentiated from other healthcare professions by what nurses do with and what they do for individuals. The nurse and patient/client communicate information in order to set goals mutually and then acts to attain those goals
THEORY OF GOAL ATTAINMENT
237
a means of behavior or activities that are towards the accomplishment of certain act; both physical and mental. The accomplishment of a task begins with mental action whereby a person seeks or formulates plan of activities & proceeded by physical action.
action
238
these are aimed towards setting goals through communication between the nurse and the client then exploring & agreeing means to perform them thereby achieving the set goal
action
239
– this is not specified but somehow relates reaction as part of action. It is a form of reacting or a response to a certain stimulus.
reaction
240
any situation wherein the nurse relates and deals with a client or patient
interaction
241
7 hypo in goal attainment:
________in nurse-patient interactions increases mutual goal settings
perceptual congruence
242
7 hypo in goal attainment:
_____increases mutual goal setting between nurses and patients which leads to satisfaction
Communication
243
7 hypo in goal attainment:
in nurses as well as patients increases goal attainment
satisfaction
244
7 hypo in goal attainment:
_____decreases stress and anxiety in nursing situations
and increases patient learning and coping in nursing situations
goal attainment
245
7 hypo in goal attainment:
_____experienced by nurses, patients, or both decreases transactions in nurse-patient interactions
Role conflict
246
7 hypo in goal attainment:
in role expectations and role performance increases transactions in nurse-patient interactions.
Congruence
247
t or f
King believed that if nursing students are taught the theory of goal attainment and it is used in nursing practice, then goal attainment can be measured and the effectiveness of nursing care can be demonstrated.
248
This theory focuses on all aspects of nursing process:
o Assessment
o Planning
o Implementation
o evaluation
249
King believed that a ____must assess in order to set mutual goals, plan to provide alternative means to achieve goals, and evaluate to determine if the goal was reached
nurse
250
Caritas Process: “Practice of loving-kindness and equanimity within the context of caring consciousness”
caritative factors: “The formation of a humanistic-altruistic system of values”
(EMBRACE)
251
Caritas Process: "Being authentically present and enabling and sustaining the deep belief system and subjective life-world of self and one being cared for”
caritas factor: “The instillation of faith-hope”
(INSPIRE)
252
Caritas Process: Cultivation of one’s own spiritual practices and transpersonal self-going beyond the ego self”
“caritas factor: “The cultivation of sensitivity to one’s self and to others”
(TRUST)
253
Caritas Process: “Developing and sustaining a helping trusting authentic caring relationship”
caritas factor: “Development of a helping-trust relationship” became “development of a helping-trusting, human caring relation”
(in 2004 Watson website)
(NURTURE)
254
Caritas Process: “Being present to, and supportive of, the expression of positive and negative feelings as a connection with deeper spirit and self and the one-being-cared for”
caritas factor “The promotion and acceptance of the expression of positive and negative feelings”
(FORGIVE)
255
CAritas Process:“Creative use of self and all ways of knowing as part of the caring process; to engage in the artistry of caring-healing practices”
caritas factor: “The systematic use of the scientific problem-solving method for decision making” became “systematic use of a creative problem solving caring process”
(in 2004 Watson website)
(DEEPEN)
256
CAritas Process: “Being present to, and supportive of, the expression of positive and negative feelings as a connection with deeper spirit and self and the one-being-cared for”
caritas factor:“The promotion of transpersonal teaching-learning”
(BALANCE)
257
CAritas Process: “Creating healing environment at all levels (physical as well as nonphysical, subtle environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated)”
caritas factor: “The provision of supportive, protective, and (or) corrective mental, physical, societal, and spiritual environment”
(CO-CREATE)
258
caritas process: “Assisting with basic needs, with an intentional caring consciousness, administering ‘human care essentials,’ which potentiate alignment of mind body spirit, wholeness, and unity of being in all aspects of care”
Caritas Factor:“The assistance with gratification of human needs”
(MINISTER)
259
caritas process: “Opening and attending to spiritual-mysterious and existential dimensions of one’s own life-death; soul care for self and the one-being-cared for”
open
Caritas factor: “The allowance for existential-phenomenological forces” became “allowance for existential-phenomenological spiritual forces” (in 2004 Watson website)
260
10 caritative factors: (dentifombc)
-embrace.
-inspire.
-trust.
-nurture.
-forgive.
-deepen.
-balance.
-co-create.
-minister.
-open.
261
Resembles the enviroment
Contect
262
The way nurse act using theory
Process
263
Subject of theory
Content
264
Provides the perspective of the patient
Nursing theoretical works
