Theoretical Foundations of Research Emphasis Era

● Focused on the research process

Nursing (black = ppt; purple = notes) and the long-range goal of acquiring
substantive knowledge to guide
Introduction to Nursing Theory:
nursing practice
Its History and Significance
● Nurses sought degrees in higher
● The history of professional nursing
education
began with Florence Nightingale
● Began to participate in research and
● Development of nursing knowledge
research courses were included in
apart from medical knowledge to
nursing curricula
guide nursing practice
● Awareness of the need for concept
● Nursing was based on principles and
and theory development coincided
traditions that were handed down
with two other milestones in the
through an apprenticeship model of
evolution of nursing theory:
education and individual hospital
○ The standardization of
procedure manual
curricula for nursing master’s
● Nursing practice reflects its
education by the National
vocational heritage more than its
League for Nursing
professional vision
accreditation criteria for
● Develop a body of specialized
baccalaureate and
knowledge on which to base nursing
high-degree programs
practice
○ The decision that doctoral
● There is a strong emphasis on
education for nurses should
practice and nurses worked
be in nursing
throughout the century toward the
development of nursing as a
Graduate Education Era
profession
● Developed in tandem with the
research era
Curriculum Era
● Master’s degree programs in nursing
● Addressed the question of what
emerged to meet the public need for
content nurses should study to learn
specialized clinical nursing practice
how to be a nurse
● Included concepts in:
● Emphasis was on what courses
○ Concept development
nursing students should take, with
○ Nursing models
the goal of arriving at a standardized
○ Early nursing theorists
curriculum
○ Knowledge development
● The idea of moving nursing
process
education from hospital-based
● Baccalaureate degree began to gain
diploma programs into colleges and
wider acceptance as:
universities began to emerge during
○ Educational level for
this era
professional nursing
● Emphasized course selection and
○ Academic discipline in higher
content for nursing programs and
education
gave way to the research era
 ● Nurse researchers worked to
develop and clarify a specialized
body of nursing knowledge with the
following goals:
○ Improving the quality of
patient care
○ Providing a professional style
of practice
○ Achieving recognition as a
profession
● The transition from vocation to
profession
● Meleis (2007) noted, “ theory is not a
luxury in the discipline of
nursing...but an integral part of the
nursing lexicon in education,
administration and practice”
● An important precursor was the
acceptance of nursing as a
profession and an academic
discipline in its own right
Theory Era
● A natural outgrowth of the research
and graduate education eras
● Emphasis on theory development
and testing
● Accelerated as early works
developed as frameworks for
curricula and advanced practice
guides began to be recognized as a
theory
● The transition from the pre-paradigm
to paradigm period in nursing
● Fawcett’s seminal proposal of four
global nursing concepts as a nursing
metaparadigm served as an
organizing structure for existing
nursing frameworks
● Pre-paradigm
○ “before scientific consensus”
or before a general
statement of agreement was
made by specialists in a
certain field
● Paradigm
○ ideas and beliefs of a group
of specialists in a certain field
that are used to understand
theories; models
● Metaparadigm
○ a set of theories or ideas that
provide structure on how a
discipline should function
● Classification of nursing models as
paradigms within a metaparadigm:
○ Person
○ Environment
○ Health
○ Nursing
● The said classification united nursing
theoretical works for the discipline
● Emphasis shifted from learning
about the theorist to use of the
theoretical works to generate:
○ Research questions
○ Guide practice
○ Organize curricula
● Theory development emerged as a
process and product of professional
scholarship and growth and sought
higher education among:
○ Nurse leaders
○ Administrators
○ Educators
○ Practitioners
Theory Utilization Era
● Emphasis shifted to theory
application in nursing practice,
research, education, and
administration
● Restored the balance between
research and practice for knowledge
development in the discipline of
nursing
● Emphasis to produce evidence for ○ Middle Range Theory
quality professional practice.
● Types of nursing theoretical works:
○ Nursing philosophy
■ Sets forth the
meaning of nursing
phenomena through
analysis, reasoning,
and logical
presentation
■ Basis for subsequent
development
○ Nursing conceptual
models/frameworks
■ Comprises nursing
works by the theorists
who also are referred
to as pioneers in
nursing
■ Used to organize
curricula, structure
curriculum content,
and guide course
content in nursing
programs
○ Nursing Theory
■ Derived from nursing
philosophies,
conceptual models or
more abstract nursing
theories, or from
works of other
disciplines
■ Developed from some
conceptual
frameworks and is
more specific than the
framework
■ Theories may be
specific to a particular
aspect or setting of
nursing practice
■ More specific focus
and is more concrete
than nursing theory in
its level of abstraction
■ More precise, with a
focus on answering
specific nursing
practice questions
■ Address the specifics
of nursing situations
within the perspective
of the model or theory
from which they are
derived
■ They specify each
factor as:
● The age group
of the patient
● The family
situation
● The health
condition
● The location
of the patient
● The action of
the nurse
■ Types of nursing
theoretical works:
 ● inextricably linked and failure to
recognize and separate them from
each other anchors nursing in a
vocational view rather than a
professional view
● The discipline is dependent on
theory for its continued existence
○ Nursing can be just
vocational or nursing can be
a discipline with a
professional style of
theory-based practice
● Nurses moved from the functional
focus (emphasizing on what nurses
can do) to patient focus
(emphasizing what nurses know for
decision-making and action)
● Forms of basis in recognizing
nursing as a discipline:
○ Knowledge of person
○ Health
○ Environment
● Every discipline or field of
SIGNIFICANCE OF NURSING
knowledge includes theoretical
THEORY
knowledge
● DISCIPLINE
○ Nursing as an academic
○ specific to academia and
discipline depends on the
refers to a branch of
existence of nursing
education, a department of
knowledge
learning, or domain of
knowledge
Significance For The Profession
● PROFESSION
● Theory
○ refers to a specialized field of
○ is essential for the existence
practice, founded upon the
of nursing as an academic
theoretical structure of the
discipline
science or knowledge of the
○ is also vital to the practice of
discipline and accompanying
professional nursing
practice abilities
● Higher degree nursing is recognized
as a profession today
Significance For The Discipline
● Nursing was the subject of
● This emphasis led into the theory
numerous studies by sociologist who
era that moved nursing toward the
used the criteria for a profession
goal of developing nursing
knowledge to guide nursing practice
● The discipline and the profession are
● Criteria for the development of the ● nursing theoretical works and
professional status of nursing: achievement of status as a
○ Utilizes in its practice a profession
well-defined and ● The use of substantive knowledge
well-organized body of for the theory-based evidence for
specialized knowledge that is nursing is a quality that is
on the intellectual level of characteristic of their practice
higher learning ● The commitment to the theory-based
○ Constantly enlarges the body evidence for practice is beneficial to
of knowledge it uses and patients in that it guides systematic,
improves its techniques of knowledgeable care
education and service
through the use of the
scientific method
○ Entrust the education of its
practitioners to institutions of
higher education
○ Applies its body of
knowledge in practical
services vital to human and
social welfare
○ Functions autonomously in
the formulation of
professional policy and
thereby in the control of
professional activity
○ Attracts individuals with
intellectual and personal
qualities of exalting service
above personal gain who
recognize their chosen
occupation as a life-work
○ Strives to compensate its
practitioners by providing
freedom of action, an
opportunity for continuous
professional growth, and
economic security
● Nursing is recognized as a
profession and
● emphasis is placed on the
relationship between