Nurse 340 Theory

What is nursing science?

the substantive, discipline-specific knowledge that focuses on the human-universe-health process articulated in the nursing frameworks and theories. In general, nursing science refers to the system of relationships of human responses in health and illness addressing biologic, behavioral, social, and cultural domains.

Metatheory refers to a theory about _____.

theory

Partial theories

those in the development stage. Theories derived from the social sciences, including nursing, are probably exclusively partial theories because there are few, if any, phenomena that have been totally and completely explained.

What is the goal of nursing science?

to represent the nature of nursing- to understand it, to explain it, an to use it for the benefit of humankind

Logical positivism maintained that science is ______ free, independent of the scientist, and obtained using _________ methods.

value; objective

Empirical indicator

very specific and concrete identifiers of concepts. They are actual instructions, experimental conditions, and procedures used to observe or measure the concept(s) of a theory

What is Logical positivism

was the dominant empirical philosophy of science between 1880s and 1950s. Logical positivists recognized only the logical and empirical bases of science and stressed that there is no room for metaphysics, understanding, or meaning within the realm of science.

Concept

The elements or components of a phenomenon necessary to understand the phenomenon. They are abstract and derived from impressions the human mind receives about phenomena through sensing the environment. A symbolic statement describing a phenomenon or a class of phenomena

Florence Nightingale

The first modern nursing theorist. The first to delineate what she considered nursing's goal and practice domain, and she postulated that "to nurse" meant having charge of the client "in the best condition for nature to act upon him"

What is ontology?

the study of being: what is or what exists

What is Epistemology?

the study of knowledge or ways of knowing

Phenomenology

the study of phenomena and emphasizes the appearance of things as opposed to the things themselves. Perceptions, feelings, values, and the meanings that have come to be attached to things and events are the focus.

T/F No single dominant philosophy has prevailed in the discipline of nursing.

True

T/F Nursing is an evolving profession, an academic discipline, and a science.

True

T/F Practice theories are more specific than middle range theories and produce specific directions for practice.

True

T/F Practice theories are usually limited to specific populations or fields of practice and often use knowledge from other disciplines.

True

Worldview

the philosophical frame of reference used by a social or cultural group to describe that group's outlook on and beliefs about reality

Empirics

the scientific form of knowing. Empirical knowledge comes from observation, testing, and replication

Phenomena

the designation of an aspect of reality; the phenomena of interest become the subject matter that are the primary concerns of a discipline

Nightingale established a school for nurses. According to Nightingale, why was training for nurses necessary? What did she teach?

"to teach not only what is to be done, but how to do it". She was the first to advocate the teaching of symptoms and what they indicate. She taught the importance of rationale for actions and stressed the significance of "trained powers of observation and reflection".

What is methodology?

the means of acquiring knowledge

What are the characteristics of a profession?

1. a defined knowledge base 2. power and authority over training and education 3. registration 4. altruistic service 5. a code of ethics 6. lengthy socialization 7. autonomy A profession must also have an institutionalized goal or social mission as well as a group of scholars, investigators, or researchers who work to continually advance the knowledge of the profession with the goal of improving practice.

Fawcett (2000) states that a middle range theory may be one of what three things?

1. a description of a particular phenomenon 2. an explanation of the relationship between phenomena 3. a prediction of the effects of one phenomenon or another

What are characteristics of disciplines?

1. a distinct perspective tand syntax 2. determination of what phenomena are of interest 3. determination of the context in which the phenomena are viewed 4. determination of what questions to ask 5. determination of what methods of study are used 6. determination of what evidence is proof

Two dominant forms of scientific inquiry have been identified in nursing:

1. empiricism, which objectifies experience and may test propositions or hypotheses in controlled experimentation 2. phenomenology and other forms of qualitative research

Carper (1978) identified four fundamental patterns for nursing knowledge. What are they?

1. empirics- the science of nursing 2. esthetics- the art of nursing 3. personal knowledge of nursing 4. ethics- moral knowledge of nursing

Why is nursing not easily called a profession?

1. extension of services provided by wives and mothers 2. nurses have delayed in identifying and organizing professional knowledge 3. education for nurses is not yet standardized 4. Autonomy in practice is incomplete because nursing is still dependent on medicine to direct much of its practice.

Kidd and Morrison (1988) described five stages in the development of nursing theory and philosophy:

1. silent knowledge 2. received knowledge 3. subjective knowledge 4. procedural knowledge 5. constructed knowledge

In epistemology, what are the basic types of knowledge?

Empirics Personal knowledge Intuitive knowledge Somatic knowledge metaphysical (spiritual) knowledge Esthetics Moral or ethical knowledge

Theory

A set of logically interrelated concepts, statements, propositions, and definitions, which have been derived from philosophical beliefs of scientific data and from which questions or hypotheses can be deduced, tested, and verified. A theory purports to account for or characterize some phenomenon.

Areas that identify nursing as a distinct discipline are as follows:

An identifiable philosophy At least one conceptual framework (perspective) for delineation of what can be defined as nursing. Acceptable methodologic approaches for the pursuit and development of knowledge.

Subjective knowledge Source of knowledge Impact on theory and research

Authority was internalized and a new sense of self emerged A negative attitude toward borrowed theories and science emerged Nurse scholars focused on defining nursing and on developing theories about and for nursing. Nursing research focused on the nurse rather than on clients and clinical situations.

Silent knowledge: Source of knowledge Impact on theory and research

Blind obedience to medical authority Little attempt to develop theory. Research was limited to collection of epidemiological data

Criticizing Carper's work, Schultz and Meleis (1988) observed that Carpers's work did not incorporate practical knowledge into the ways of knowing in nursing. Because of this and other concerns, they described three patterns of knowledge in nursing:

Clinical, conceptual, and empirical

Empiricism has its roots in the writings of ________, ____________, and __________, who valued, _________, ________, and ___________ as sources of knowledge.

Francis Bacon, John Locke, and David Hume; observation, perception by senses, and experience

________ theories are nonspecific and comprised of relatively abstract concepts that lack operational definitions.

Grand

_________ theories are the most complex and the broadest in scope.

Grand

Procedural knowledge Source of knowledge Impact on theory and research

Includes both separate and connected knowledge Proliferation of approaches to theory development. Application of theory in practice was frequently underemphasized. Emphasis was placed on the procedures used to acquire knowledge, with over-attention to the appropriateness of methodology, the criteria for evolution, and statistical procedures for data analysis.

List the theories from most abstract to least abstract: Grand theories Practice theories Metatheory Middle range theories

Methatheory Grand theories Middle range theories Practice theories

________ theory lies between the nursing models and more circumscribed, concrete ideas (practice theories). They are substantively specific and encompass a limited number of concepts and al limited aspect of the real world.

Middle range

What is the difference between an occupation and a profession?

Occupation is a job or a career, whereas a profession is a learned vocation or occupation that has a status of superiority and precedence within a division of work.

________ is open, variable, and relativistic and based on human experience and personal interpretations. As such, it is a guiding paradigm for nursing practice theory and education.

Phenomenology

_______ is often equated with empiricism.

Positivism

_______ theories are also called microtheories, prescriptive theories, or situation-specific theories and are the least complex.

Practice

T/F All professions are occupations but not all occupations are professions.

TRUE

_________ are made to describe, explain, and predict phenomena in nature and to provide understanding of relationships between phenomena.

Theories

T/F In recent years, scholars have determined that the positivist view of science is outdated and misleading in that it contributes to over fragmentation in knowledge and theory development.

True

What is a discipline?

a branch of knowledge ordered through the theories and methods evolving from more than one worldview of the phenomenon of concern. a branch of educational instruction or a department of learning or knowledge.

Taxonomy

a classification scheme for defining or gathering together various phenomena. Range in complexity from simple dichotomies to complicate hierarchical structures.

Personal knowledge

a priori knowledge. Personal knowledge pertains to knowledge gained from thought alone.

Laws

a proposition about the relationship between concepts in a theory that has been repeatedly validated. Highly generalizable. Found primarily in disciplines that deal with observable and measurable phenomena.

Conceptual model/conceptual framework

a set of interrelated concepts that symbolically represents and conveys a mental image of a phenomenon.

Philosophy

a statement of beliefs and values about human beings and their world

What is nursing philosophy?

a statement of foundational and universal assumptions, beliefs and principles about the nature of knowledge and thought (epistemology) and about the nature of the entities represented in the metaparadigm.

definitions of theory

a systematic explanation of an event in which constructs and concepts are identified and relationships are proposed and predictions made a creative and rigorous structuring of ideas that project a tentative, purposeful and systematic view of phenomena a set of interpretative assumptions, principles, or propositions that help explain or guide action.

Borrowed or shared theory

a theory developed in another discipline that is not adapted to the worldview and practice of nursing

Conceptual knowledge

abstracted and generalized beyond personal experience. It explicates patterns revealed in multiple client experiences, which occur in multiple situations, and articulates them as models or theories.

Paradigm

an organizing framework that contains concepts, theories, assumptions, beliefs, values, and principles that form the way a discipline interprets the subject matter with which it is concerned. It describes the work to be done and frames an orientation within which the work will be accomplished.

Grand theories

attempt to explain broad areas within a discipline and may incorporate numerous other theories. (macro theories)

Assumptions

beliefs about phenomena one must accept as true to accept a theory about the phenomena as true. May be based on accepted knowledge or personal beliefs and values. Although they may not be susceptible to testing, they can be argued philosophically.

Science is concerned with __________ (cause and effect).

causality

Ontology

concerned with the study of existence and the nature of reality

Middle range theories are comprised of relatively _____ concepts and are operationally defined and relatively concrete propositions that may be ______ tested.

concrete; empirically

Practice or microtheory

deals with a limited range of discrete phenomena that are specifically defined and are not expanded to include their link with the broad concerns of a discipline

What kind of knowledge tends to be the most emphasized way of knowing in nursing? Why?

empirical knowledge because there is a need to know how knowledge can be organized into laws and theories for the purpose of describing, explain, and predicting phenomena of concern to nurses.

Empiricism is founded on the belief that what is _______ is what exists, and its knowledge base requires that these experiences by verified through _____________.

experienced, scientific methodology

Constructivist approaches

focus on understanding the actions and meaning of individuals. What exists depends on what individuals perceive to exist.

Model

graphic or symbolic representations of phenomena that objectify and present certain perspectives or pints of view about nature or function or both.

What is "philosophy of science in nursing"?

helps to establish the meaning of science through an understanding and examination of nursing concepts, theories, laws, and aims as they relate to nursing practice

Intuitive knowledge

includes feelings and hunches. Intuitive knowledge is not guessing, but relies on non-conscious pattern recognition and experience

What is science and philosophy's shared common goal?

increasing knowledge

Relationship statements

indicate specific relationships between two or more concepts. They may be classified as propositions, hypotheses, laws, axioms, or theorems.

Constructed knowledge Source of knowledge Impact on theory and research

integration of different types of knowledge (intuition, reason, and self-knowledge) Nursing theory should be based on prior empirical studies, theoretical literature, client reports of clinical experiences and feelings, and the nurse scholar's intuition or related knowledge about the phenomenon of concern.

Moral or ethical knowledge

knowledge of what is right and wrong. Values and social and cultural norms of behavior are components of ethical knowledge.

Esthetics

knowledge related to beauty, harmony, and expression. Esthetic knowledge incorporates art, creativity, and values.

Somatic knowledge

konwing of the body in relation to physical movement. Includes experiential use of muscles and balance to perform a physical task.

Received knowledge Source of knowledge Impact on theory and research

learning through listening to others theories were borrowed from other disciplines. As nurses acquired non-nursing doctoral degrees, they relied on the authority of educators, sociologists, psychologists, physiologists, and anthropologists to provide answers to nursing problems.

Positivism supports __________, ____________ principles, where the complex can be best understood in terms of its basic components.

mechanistic; reductionist

Construct

the most complex type of concept. They are comprised of more than once concept and typically built or constructed by the theorist or philosopher to fit a purpose.

It is ________ that gives direction to the future generation of substantive nursing knowledge, and provides the knowledge fora all aspects of nursing.

nursing science

The scientific approach to understanding reality is characterized by what?

observation, verifiability, and experience

Approaches to knowledge development have what three facets?

ontology, epistemology, and methodology

Empiricism focuses on understanding the ______ in attempt to understand the _______.

parts of the whole; the whole

Classification of theories in nursing typically uses the terms metatheory, philosophy, or worldview to describe the __________ basis of the discipline, grand theory or macrotheory to describe the _________ conceptual frameworks.

philosophical; comprehensive

Which kind of theories contain the fewest concepts and refer to specific, easily defined phenomena.

practice theories

Philosophy is concerned with the ________ of human life, the ________ of being and reality, and the _________ and limits of knowledge.

purpose; nature; theory

Middle range theory

refers to a part of a discipline's concerns related to particular topics. The scope is narrower than that of broad-range or grand theories.

Clinical knowledge

refers to the individual nurse's personal knowledge. Results from using multiple ways of knowing while solving problems during client care provision. Manifested in the acts of practicing nurses and results from combining personal knowledge and empirical knowledge.

Epistemology

refers to theories of knowledge or how people come to have knowledge; in nursing it is the study of the origins of nursing knowledge.

Metaparadigm

represents the worldview of a discipline- the global perspective that subsumes more specific views and approaches to the central concepts with which the discipline is concerned.

Empirical knowledge

results from experimental, historical, or phenomenological research and is used to justify actions and procedures in practice. The credibility of empirical knowledge rests on the degree to which the researcher has followed procedures accepted by the community of researchers .

When verified through repeated testing over time, empirical knowledge can be formulated into what?

scientific generalizations, laws, theories, and principles that explain and predict.

Metaphysical (spiritual) knowledge

seeking the presence of a higher pwoer. Aspects of spiritual knowing include magic, miracles, psychokinesis, extrasensory perception, and near-death experiences

What are the five stages in the development of nursing theory?

silent knowledge received knowledge subjective knowledge procedural knowledge constructed knowledge

The scope of a theory includes its level of _______ and the concreteness of its ____ and ______.

specificity; concepts; propositions.

Human science

study human life by valuing the lived experience of persons and seek to understand life in its matrix of patterns of meaning and values. increasingly, nursing is being referred to as a human science

Hypotheses

tentative suggestions that a specific relationship exists between two concepts or propositions. As the hypothesis is repeated confirmed, it progresses to an empirical generalization an ultimately to a law.

The term received view or received knowledge denotes what?

that individuals learn by being told or receiving knowledge

Praxis

the application of a theory to cases encountered in experience

Knowledge

the awareness or perception of reality acquired through insight, learning, or investigation. In a discipline, knowledge is what is collectively seen to be a reasonably accurate understanding of the world as seen by members of the discipline.