Nursing Research & Nursing Theory

General Theories of Nursing

Florence Nightingale - Environmental Theory Virginia Henderson - Nursing Need Theory Martha Rogers - Science of Unitary Human Beings Theory Dorothea Orem - Self-Care Deficit Theory

Nursing Theory Types of Theories (6) *Adaptation theories*

*Adaptation theories* - Adjustment of living matter to other living things and to environmental conditions - Continuingly occurring process that effects change and involves interaction and response

Nursing Theory Types of Theories (6) *Descriptive*

*Descriptive* Identifies and describes specific characteristics of particular people, groups, situations, relationships or events Identify properties and components of each and circumstances in which it occurs

Nursing Theory Types of Theories (6) *Developmental theories*

*Developmental theories* - Emphasize the process of growth, development and maturation - Describes growth and development as orderly and predictable - Erikson; Maslow

Nursing Theory Types of Theories (6) *General systems theories*

*General systems theories* - Examines system parts and their relationships at a given time - Emphasizes relationships between the whole and the parts - Describes how parts function and behave

MCCC Philosophy of Nursing

*Health* Person is an individual in interaction with the environment Within the environment, bio-psycho-social-spiritual requirements are necessary for survival *Human Needs* Health is a homeostatic process that integrates these human needs across a wellness-illness continuum A health need occurs when the ability of the individual to balance internal and external factors to achieve health is disturbed (continued..)

Nursing Theory Types of Theories (6) *Interpersonal theories*

*Interpersonal theories* Emphasizes the belief that people's interaction with others, especially significant others, determines sense of security, self, dynamics that motivate behavior and control anxiety

General Theories of Nursing Virginia Henderson (1966)

*Nursing Need Theory* Nurses care for a patient until a patient can care for him or herself Nurses are willing to serve and "nurses will devote themselves to the patient day and night" Nurses should be educated at the college level in both sciences and arts The nurse is concerned with both healthy and ill individuals The nurse acknowledges that she interacts with clients when recovery might not be possible Teaching and advocacy roles of the nurse are important 14 fundamental needs of the client (basic bio-psycho-social needs)

MCCC Philosophy of Nursing (continued)

*Nursing* Dynamic process Both an art and a science Uses critical thinking to apply knowledge and skills in a professional, caring relationship Provides a comprehensive view of client health needs Collaboration with client and health care team Coordination of available resources Focuses on human responses to actual or potential health needs *Nursing process* Holistic, goal oriented, adaptive approach *Role of the Nurse* Provide comprehensive care grounded in evidence-based practice Three essential roles of the AD nurse

Nursing Theory Types of Theories (6) *Prescriptive*

*Prescriptive* Describe nursing interventions and their consequences Control, promote and change clinical nursing practice

General Theories of Nursing Martha Rogers (1970)

*Science of Unitary Human Beings* - Emphasis on nursing as both a science and an art - Complex conceptualizations related to multiple scientific disciplines - Person is an irreducible whole and the whole is greater than the sum of its parts - Humans are dynamic energy fields in constant contact with environmental fields; both fields are infinite

General Theories of Nursing Dorothea Orem (1971)

*Self-Care Deficit Theory of Nursing* Individuals can take responsibility for their health and the health of others Three parts: - Theory of Self-Care - focuses on the self, the I - Theory of Self-Care Deficit - focuses on you and me - Theory of Nursing Systems - focuses on we, persons in community

Nursing Theory What is a conceptual framework?

A conceptual framework or model is a group of concepts that follows an understandable pattern. Is a group of related ideas, statements or concepts. Per google = A conceptual framework is an analytical tool with several variations and contexts. It can be applied in different categories of work where an overall picture is needed. It is used to make conceptual distinctions and organize ideas

Nursing Theory What is a theory? What is a concept or idea?

A theory is a group of concepts that *describe a pattern* of reality. Can be tested, changed or used to guide research, practice or provide a base for evaluation. A concept or idea is an *abstract impression organized into symbols* of reality. Describes objects, properties and events and relationships among them.

General Theories of Nursing Self-Care Deficit Theory

Activities the individual performs independently through life to promote and maintain personal well-being Ability to perform self-care activities Conditioned by age, developmental stage, life experience, socio-cultural orientation, health, available resources Self-care agent: person Dependent-care agent: other Self-care requisites (self-care needs) Measures or actions taken to provide self care Self-care deficit results when self-care agency is not adequate to meet the known self-care demand Specifies when nursing is needed. When an adult is incapable or limited in the ability to provide continuous, effective self-care How clients can be assisted through the five methods of helping: Acting or doing, Guiding, Teaching, Supporting, Providing an environment that promotes the individual's abilities to meet current and future demand

Systems Theories Sister Callista Roy (1974)

Adaptation Model of Nursing Health is an inevitable dimension of a person's life and is represented by a health-illness continuum Adaptation occurs when people respond positively to environmental changes Is a process and outcome whereby a person uses conscious awareness and choice to create human and environmental integration

Quantitative Research

Basic and applied research Systematic and logical Consists of a specific plan to collect information, uses controls, analyzes data using statistical procedures *Deductive method* ▽ "Numbers"

Qualitative Research

Conducted to gain insight by discovering meanings Based on belief that reality is based on perceptions that differ for each person and change over time Explores subjective/complex experiences of humans Data collection and analysis occur concurrently *Inductive method* △ Identified themes and patterns help to develop theory or framework that explains process under consideration "Feelings"

General Theories of Nursing Science of Unitary Human Beings

Consists of eight concepts: - Energy field - Openness - Pattern - Pan-dimensionality - Homeodynamic principles - Resonance - Helicy - Integrality Directs nursing interventions toward patterning human environment fields or assisting in mobilizing inner resources Focuses on a person's wholeness Seeks to promote symphonic interaction between the two energy fields (human/environment) Coordinates human field with rhythmicities of environmental field Directs and redirects patterns of energy between the two fields to promote maximum health potential

Interpersonal Theories Madeline Leininger (1978)

Cultural Care Diversity and Universality Theory Care is the essence of nursing and its dominant, distinctive and unifying feature Caring is universal but varies among cultures in expression, process and pattern

Nursing Theory

Describes nursing Describes, explains, predicts and controls desired outcomes of nursing care practices Allows for testing of knowledge through research Allows for expansion of nursing knowledge base in order to meet healthcare needs of patients Identifies nursing's unique knowledge base Provides a common goal - ultimately improved patient care Provides rational and knowledge for nursing interventions Helps nurses develop problem-solving skills Prepares nurses to question assumptions and values in the profession Use of theories to guide practice provides autonomy, independence, allows nurses to be viewed as experts

General Theories of Nursing Florence Nightingale (1860)

First nursing theorist *Environmental Theory* - Utilizing the patient's environment to assist him in recovery - Meeting the personal needs of the patient within the environment - Links health to 5 environmental factors: pure/fresh air, pure water, efficient drainage, cleanliness, light - Deficiencies in these cause lack of health or illness

Interpersonal Theories

Hildegard Peplau - Interpersonal Relations Model Madeline Leininger - Cultural Care Diversity and Universality Theory Jean Watson - Human Caring Theory Rosemarie Parse - Human Becoming Theory

Rosemarie Parse (1981)

Human Becoming Theory Emphasizes how individuals choose and bear responsibility for patterns of personal health Nurses should focus on quality of life as it is described and lived Quality of life from client's own perspective is the goal of nursing practice

Interpersonal Theories Jean Watson (1979)

Human Caring Theory Caring is central to nursing Caring is the unifying focus for nursing practice

Systems Theories

Imogene King - Goal Attainment Theory Betty Neuman - Systems Model Sister Callista Roy - Adaptation Model

Interpersonal Theories Hildegard Peplau (1952)

Interpersonal Relations Model Describes the therapeutic relationship between the nurse and client Nurse enters into a therapeutic relationship with the client when the need is present Important in psychiatric nursing

Nursing Research

It is a Standard of Professional Practice (ANA) Expands current body of knowledge, promotes autonomy of the profession Improve care of people in clinical setting Study people and the nursing process - Education - Policy development - Ethics - Nursing history Develop greater autonomy and strength as a profession Provide evidence-based nursing practice

Common Concepts Nursing Metaparadigm

Most major nursing theories focus on understanding the relationships among 4 major concepts: Person (client) Environment Health Nursing

Systems Theories Betty Neuman (1972)

Neuman Systems Model Describes patient's relationship to stress, reaction to it and dynamic reconstitution factors Universal in nature, can be adapted to a variety of situations and be interpreted in many different ways

Florence Nightingale

Our first nurse researcher! - Systematically collected, organized and reported data - Used this data to advocate for and institute *sanitary reforms* that significantly *reduced mortality rates from contagious diseases*

Steps to Implementing Evidence-Based Practice

Step 1: Ask a question about a clinical area of interest or an intervention Step 2: Collect the most relevant and best evidence Step 3: Critically appraise the evidence Step 4: Integrate the evidence with clinical expertise, patient preferences and values in making a decision to change Step 5: Evaluate the practice decision or change

Systems Theories Imogene King (1971)

Theory of Goal Attainment Nurse and patient communicate information, set goals together, take actions to achieve those goals Describes an interpersonal relationship that allows a person to grow and develop in order to attain certain life goals Factors that affect the attainment of goals are roles, stress, space, time Goal of the nurse is to help patient maintain health so that they can function in their individual roles

Evidence-Based Practice

Using substantiation (evidence) to make clinical practice decisions.Collected from published research, national standards and guidelines, reviews of pertinent literature. Blends both the science and the art of nursing so that the best patient outcomes are achieved.

Systems Theories Neuman Systems Model

Views the client as an open system consisting of a basic structure or *central core* of energy resources (physiologic, psychological, socio-cultural, developmental, spiritual) Core is surrounded by *lines of resistance* or internal factors that help the client defend against a stressor (e.g. increase in WBC production during an infection) There are two lines of defense *Normal line*: person's state of equilibrium or state of adaptation developed and maintained over time, considered normal for that person *Flexible line*: dynamic and can be rapidly altered over time Protective against preventing stressors from penetrating normal line of defense Stressors can be: Intrapersonal, Interpersonal, Etrapersonal Reaction to stressors depends on the strength of the line of defense Reaction to stressor is known as reconstitution Nursing interventions focus on retaining and maintaining system stability

Caring and four nursing theories (Watson, Swanson, Leininger, and Boykin and Schoenhofer)

Watson's theory is based on a holistic paradigm in which both the nurse and the patient transcend time and the physical and material world. Swanson's theory focuses on practical ways that the nurse can help the patient through the use of the five caring processes. Leininger's theory focuses on maintaining and preserving the patient's cultural practices and ways of living. Boykin and Schoenhofer's theory stresses living in caring and growing in caring.

Henderson's theory

is based on the individual needs of a person. According to this theory, each person has 14 basic needs which are divided into five domains: physiological, psychological, sociocultural, spiritual, and developmental. This theory defines nursing as assisting an individual—well or sick—in performing activities that would contribute to health, recovery, or peaceful death.