7. Ch. 9 Nursing Theory: The Basis of Professional Nursing
1. Environment 2. Person 3. Health 4. Nursing
what are the key aspects of nursing's metaparadigm? 1. ______: one that supports human caring 2. ______: both the patient and the nurse 3. _______: in terms of health promotion and illness prevention 4. _____: what nurses contribute to the encounter with the patient
1. evidence -Determining which data are important -Organizing, analyzing, and understanding connections in patient data 2. interventions 3. interventions
Nursing theory guides the professional nurse via: 1. Clinical judgments based on _____ -Determining which data are important -Organizing, analyzing, and understanding connections in patient data 2. Planning appropriate nursing ______ 3. Evaluating outcomes of ______
King's Interacting Systems Framework and Theory of Goal Attainment
This theory provides a view of people from the perspective of their interactions with other people at three levels of interacting systems
Watson's Philosophy
this philosophy of nursing is based on human values and interest in the welfare of others and is concerned with health promotion, health restoration, and illness prevention
Middle Range Theories of Nursing
-They incorporate a limited number of concepts and focus on a specific aspect of nursing. -They typically merge practice and research.
Leininger's Theory of Culture Care Diversity and Universality
-This nursing theory considers the impact of culture on all aspects of human life, with particular attention to health and caring practices. -Nursing care is focused on culture care preservation, accommodations, or re-patterning depending on the patient's need.
already done
Although a research topic may be new and innovative, much can be gained from choosing research problems that are connected to work ________, thereby building the body of knowledge of nursing.
philosophy
A _______ is a set of beliefs about the nature of how the world works
model or framework
A conceptual ______ or _______ is a more specific organization of nursing phenomena than philosophies
philosophy
A nursing ________ puts together some or all concepts of the metaparadigm.
metaparadigm
A nursing philosophy puts together some or all concepts of the ________
Watson's Philosophy
Believed that 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
B. Orem's Self-Care Model
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: A. King's interacting systems framework B. Orem's self-care model C. Roy's adaptation model D. Watson's philosophy
theories
Models are more abstract than ______ of nursing
clinical
Ideas for nursing research often arise from nurses' ______ observations
1. Diagnostic 2. Prescriptive 3. Regulatory
In Orem's Self-Care Model what is the series of three operations for appropriate care for the patient? 1. ______ -Establishment of the nurse-patient relationship -Assessment of patient's baseline ability to provide adequate self-care 2. ________ -occur when therapeutic self-care requisites (based on deficits) are determined and the nurse reviews various methods, actions, and priorities with the patient 3. _______ - the nurse designs, plans, and produces a system for care (Berbiglia, 2002).
Orlando's Nurisng Process Theory
It is specific to nurse-patient interactions. The goal of the nurse is to determine and meet patients' immediate needs and to improve their situation by relieving distress or discomfort. What theory of nursing are these qualities of?
patients to their surroundings
Nightingale's unique perspective on nursing practice focused on the relationship of ______
research
Nursing ______ tests and refines the knowledge base of nursing.
theory
Nursing as a profession is strengthened when nursing knowledge is built on sound _____.
Transcultural Nursing
Planning care based on knowledge that is culturally defined, classified, and tested and then used to provide culturally congruent care is an explanation of what type of nursing?
1. Clinical Practice 2. Literature 3. Theory
Research ideas are generated from what three sources?
optimal nursing care
Sigma Theta Tau International Honor Society of Nursing believes that _________ is provided when nurses and health care decision-makers have access to a synthesis of the latest research, a consensus of expert opinion, and are thus able to exercise their judgment as they plan and provide care that takes into account cultural and personal values and preferences.
Evidence Based Nursing (EBN)
Sigma Theta Tau International Honor Society of Nursing: The society defines ____ as an integration of the best evidence available, nursing expertise, and the values and preferences of the individuals, families, and communities who are served.
Nursing Research
Systematic investigation of phenomena related to improving patient care is called what?
1. perceptions 2. stresses 3. decision
The King nurse is guided by what concepts at the system levels? 1. Personal system leads the nurse to pay close attention to the patient's ______. 2. Interpersonal system guides the nurse to explore the patient's roles and the _____ in each role. 3. Social system cues the nurse to consider influences on the patient's ______ making.
Roy
The _____ nurse focuses on adaptation of the patient and on the environment
Watson
The ______ nurse has responsibility for creating and maintaining an environment supporting human caring while recognizing and providing for patients' primary human requirements.
Nightingale
The ______ nurse is sensitive to the effect of the environment on the patient's health or recovery from illness
Henderson
The _______ nurse adopts an orientation to care from the perspective of the 14 basic needs.
Orlando
The _______ nurse individualize care for each patient by -Attending to behavior -Confirming with patient ideas and inferences the nurse draws from interactions -Identifying pressing needs
Peplau
The _______ nurse uses a four-pronged approach to assist the patient to achieve personal growth
metaparadigm
The ________ of nursing consists of the major concepts of the discipline—person, environment, health, and nursing.
Orem's Self-Care Model
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
Roy's Adaptation Model
The model provides a comprehensive understanding of nursing from the perspective of adaptation
culturally congruent
The outcome of _______________ nursing care is health and well-being for the patient
Optimal Nursing Care (Sigma Theta Tau Honor Society)
This approach to nursing care bridges the gap between the best evidence available and the most appropriate nursing care of individuals, groups, and populations with varied needs.
King's Interacting Systems Framework and Theory of Goal Attainment
This theory emphasized the importance of goal setting by the nurse and the patient (mutuality). The goal of nursing is gaining or regaining health.
King's Interacting Systems Framework and Theory of Goal Attainment
This theory focused on people, their interpersonal relationships, and social contexts with three interacting systems: personal, interpersonal, and social
Orlando's Nurisng Process Theory -Study tip: fast pass in disney world in Orlando
This 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.
Orlando's Nurisng Process Theory
This theory is about how nurses process their observations of patient behavior and about how they react to patients based on inferences from patients' behavior
Peplau's Theory of Interpersonal Relations in Nursing
This 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
1. Dorothea Orem 2. Imogene King 3. Callista Roy
What Conceptual Models of Nursing do these questions represent? 1. What deficits does this patient have in providing his or her own self-care? 2. What goals can we set together to restore the patient to health? 3. How can I modify this patient's environment to facilitate his or her adaptation?
1. theoretical 2. transmission 3. autonomy 4. analytical
What are the Benefits of Theory-Based Practice? 1. It shapes _____ orientation to practice. 2. It facilitates the ______ of nursing knowledge. 3. It contributes to professional _____. It is a nursing-based guide for practice, education, and research. 4. It helps develop ______ skills, challenges thinking, and clarifies values and assumptions.
1. Personal system 2. Interpersonal system 3. Social system presents
What are the three levels of interacting systems implemented by King's Interacting Systems Framework and Theory of Goal Attainment? 1. _______ system identifies concepts that provide an understanding of individuals, personally, and intrapersonally (within the person) 2. _______ system deals with interactions and transactions between two or more people 3. _______ system concepts that consider social contacts, such as those at school, at work, or in social settings.
1. Peplau's 2. Orlando's 3. Leininger's
What are the three main examples of grand-to-middle range theories? 1. _______ Theory of Interpersonal Relations in Nursing 2. ______ Nursing Process Theory 3. _______ Theory of Culture Care Diversity and Universality
Watson's 10 Caritas Processes
What are these called collectively? 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.
Sigma Theta Tau International Honor Society of Nursing
What are these characteristic of? -Leader in the development and dissemination of knowledge to improve nursing practice -Supports the development and implementation of evidence-based nursing (EBN)
evidence-based practice
What are these characteristics of? -Awareness of research that supports specific interventions -Basing one's practice on published work or reliable texts is an element of critical thinking and a good means of improving clinical judgment. -Focuses on patients' responses amenable to nursing care.
Conceptual Models of Nursing
What are these examples of collectively? -Orem's Self-care Model -King's Interacting Systems Framework Theory and Theory of Goal Attainment -Roy's Adaptation Model
1. Hildegard Peplau 2. Ida Orlando 3. Madeleine Leininger
What grand-to-middle range theories are these questions representative of? 1. Within the relationship with my patient, how can I best help him or her understand his or her health problems and develop new, healthier behaviors? 2. How can I best figure out what my patient needs through my interaction with him or her? 3. What are the best ways to provide care to my patient that are culturally congruent?
supporting excellence in practice
What is the ultimate goal of nursing theory?
Roy's Adaptation Model study tip: RAMs modify environment
What model does a nurse work from when the nurse modifies the environment to facilitate patient adaptation?
1. Nightingale 2. Henderson 3. Watson
What nursing philosophies do each of these questions relate to? 1. What needs to be adjusted in this environment to protect the patient? 2. What can I help this patient do that he would do for himself if he could? 3. How can I create an environment of trust, understanding, and openness so that the patient and I can work together in meeting his or her needs?
American Nurses Association, 2015
What states that "..All nurses working alone or in collaboration with others can participate in the advancement of the profession through the development, evaluation, dissemination, and application of knowledge in practice."
The American Nurses Association's Code of Ethics, Provision 7.3
What states that "The nursing profession should engage in scholarly inquiry to identify, evaluate, refine, and expand the body of knowledge that forms the foundation of its discipline and practice. ..."
Peplau's Theory of Interpersonal Relations in Nursing
What theory are these apart of? Goals of therapeutic interpersonal relationship -Survival of the patient -Patient's understanding of health problems and learning from these problems as s/he develops new behavior patterns
-Theory of self-care -Theory of self-care deficit -Theory of nursing system
What three theories did Orem formalize?
The Peplau Nurse
What type of nurse assumes these roles: counselor, resource, teacher, technical expert, surrogate, and leader?
Evidenced-Based Practice
What type of practice is a approach to the delivery of health care that "integrates the best evidence from [research] studies and patient care data with clinician expertise and patient preferences and values"
Roy's Adaptation Model
Which model believes that when demands of environmental stimuli are too high or the person's adaptive mechanisms are too low, the person's behavioral responses are ineffective for coping
Orem's Self-Care Model
Which model has the nurse prescribe and regulate 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
Henderson's Philosophy
Which philosophy believed that 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"
Watson's Philosophy
Which philosophy focused on the relationship of the nurse and the patient? -An approach that emphasized how the nurse and patient change together through transpersonal caring.
King's Interacting Systems Framework and Theory of Goal Attainment
Within these three systems, she identified concepts that provide a conceptual structure describing the processes in each system.
Theory-based
________ practice occurs 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.
Research
_________ findings enable nurses to improve the quality of care and understand how evidence-based practice influences improved patient outcomes.
Models
are less abstract and more formalized than the philosophies
Theories
are less abstract than models and usually propose specific outcomes
Theories
are more concrete descriptions of concepts that are embedded in propositions
middle-range theories
are neither overly broad nor narrow in scope
Propositions
are statements that describe linkages between concepts and are more prescriptive; that is, they propose an outcome that is testable in practice and research.
associate degree
at the _______ level they use nursing theory to teach the unique perspectives of nursing
grand theory
is a broad conceptualization of nursing phenomena
philosophy
is a set of beliefs about the nature of how the world works
PHD
is going to use all of this because it is a research degree that generates new discipline specific knowledge
middle-range theory
is narrower in focus and makes connections between grand theories and nursing practice
DNP or MSN
may use theoretical perspectives focused on the patient for specific nursing outcomes
"Model" or "framework"
provides an organizational structure that makes clearer connections between concepts.
Conceptual models
provides organizational structures for critical thinking about the processes of nursing
Metaparadigm
refers to the most abstract aspect of the structure of nursing knowledge
BSN nurse
the _______ gets an introduction to the research process, evidence-based practice, and the use of theory as a guide
effective adaptive responses
the ___________________ are important because they promote the patients integrity by conserving energy and they promote the survival, growth, reproduction, and mastery of the human system