III.

Theories and Theoretical Models in Nursing Informatics

Nursing informatics relies on various theories and models to guide practice, including:
- General Systems Theory
- Change Theory
- Cybernetics Theory
- Cognitive Learning Theory
- Novice to Expert Theory
- DIKW Theory

IV. General Systems Theory

Developed by Ludwig von Bertalanffy in 1936, the General Systems Theory provides a
framework for understanding complex systems across disciplines. Key concepts
include:
- Systems consist of interconnected components with a common purpose.
- Input, throughput, output, and feedback are essential elements of a system.
- Systems exhibit characteristics such as wholeness, differentiation, and order.
- Assumptions include goal-directedness, holistic nature, and dynamic interactions
within systems.

V. Change Theory
Kurt Lewin's Change Theory outlines a three-stage model—unfreezing, change, and
refreezing—to explain the process of organizational change. Key concepts include:
- Behavior as a dynamic balance of driving and restraining forces.
- Driving forces push for change, while restraining forces resist it.
- Equilibrium represents a state of balance between driving and restraining forces.
- Successful change requires prior learning to be challenged and replaced.

VI. Application in Nursing Practice

Understanding these theoretical foundations is crucial for nurses in various practice
areas, including research, education, clinical practice, and administration. By
integrating theoretical knowledge with practical experience, nurses can enhance their
performance and contribute effectively to healthcare delivery.

*Kurt Lewin's Change Theory*

*Overview:*
Change Theory, developed by Kurt Lewin, provides a structured approach to
understanding and implementing organizational change. Lewin's model consists of
three key stages: unfreezing, change, and refreezing. Each stage is essential for
successfully transitioning from old habits to new behaviors within an organization.

*Stages of Change:*

1. *Unfreezing:*
- Recognition of the need for change and the dissolution of previously held patterns
of behavior.
 - Involves overcoming resistance to change by increasing driving forces or
decreasing restraining forces.
- Methods for achieving unfreezing include boosting motivation for change and
reducing barriers to change.
- Example: Intensive training programs to embrace nursing informatics in healthcare
settings.

2. *Change:*
- Movement towards a new and more productive pattern of behavior.
- Involves a shift in thoughts, feelings, or behaviors towards the desired change.
- Example: Transitioning from traditional paper-based documentation to electronic
health records.

3. *Refreezing:*
- Long-term solidification of the new pattern of behavior as the standard operating
procedure.
- Establishing the change as a new habit to prevent reverting to old behaviors.
- Example: Institutionalizing electronic documentation practices as the norm in
healthcare settings.

*Major Assumptions:*
- People undergo continuous growth and change throughout their lives, driven by
basic human needs.
- Change is a constant process, occurring both subtly and disruptively in everyday life.
- Reactions to change are influenced by fundamental human needs for self-esteem,
safety, and security.
- Change involves modification or alteration, whether planned or unplanned.

*Components of Change:*
1. Recognition of the need for change.
2. Analysis of existing forces maintaining the status quo and those driving change.
3. Identification of methods for change implementation.
4. Consideration of group norms and customs influencing change.
5. Understanding the methods utilized by reference groups to facilitate change.
6. The actual process of change implementation.

*Cybernetics Theory*

*Overview:*
Cybernetics theory explores the study of control and communication within various
systems, including biological, mechanical, and social systems. It originated as an
interdisciplinary field in the mid-20th century and has since evolved to encompass
concepts such as circular causality, feedback mechanisms, and goal-directed behavior.

*Key Concepts:*

1. *Circularity and Circular Causal Systems:*

 - Cybernetics introduces the concept of circular causality, where actions within a
system result in feedback that influences subsequent actions.

2. *Boundaries and Goals:*

- Systems are defined by boundaries, and each system has a goal or purpose
towards which it aims its actions.

3. *Feedback Mechanisms:*
- Information returns to the system through feedback, allowing it to measure the
difference between its current state and its goal.

4. *Error Detection and Correction:*

- Systems detect errors between their current state and the desired goal and adjust
their actions accordingly to move towards the goal.

5. *Applications:*
- Basis for modern communication systems and cognitive science models of learning.
- Applied in management science for organizational learning and efficiency.

*Scope and Application:*

Cybernetics theory has broad applications across disciplines, including health sciences,
sociology, and psychology. It provides a framework for understanding feedback
processes and communication dynamics within complex systems, making it valuable
for optimizing system design and function.

*Conclusion:*
Cybernetics theory offers insights into the functioning of diverse systems,
emphasizing the importance of feedback loops and goal-directed behavior. Its
interdisciplinary nature and focus on communication processes make it applicable
across various fields, contributing to advancements in understanding and improving
complex systems.

*Cognitive Learning Theory*

*Overview:*
The Cognitive Learning Theory explores how individuals process and interpret
information to learn. It encompasses two main theories: Social Cognitive Theory (SCT)
and Cognitive Behavioral Theory (CBT), focusing on intrinsic and extrinsic factors
influencing learning.

*Key Concepts:*

1. *Learning as Mental Processes:*

- Learning is viewed as a cognitive process influenced by both intrinsic (cognitive)
and extrinsic (environmental) factors.

2. *Effective Cognitive Processes:*

 - Effective cognitive processes facilitate learning and retention of new information,
while ineffective processes lead to learning difficulties.

3. *Social Cognitive Theory:*

- Considers the interaction between behavioral, environmental, and personal factors
in shaping learning outcomes.

4. *Person-Environment Interaction:*
- Personal beliefs, behaviors, and cognitive competencies are influenced by
environmental factors, which, in turn, impact learning.

*Applications:*
Social Cognitive Theory emphasizes the importance of positive personal
characteristics, appropriate behavior, and supportive environments for effective
learning outcomes. It also highlights the role of past experiences in shaping present
learning experiences.

*Social Cognitive Theory: Basic Concepts*

1. *Observational Learning:*
- Learning from others by observing their behaviors and actions, which can influence
one's own knowledge and behavior.

2. *Reproduction:*
- The process of increasing the repetition of a behavior by creating a conducive
environment with accessible materials to encourage practice and retention of new
knowledge and behaviors.

3. *Self-efficacy:*
- The learner's ability to improve newly learned knowledge or behavior by applying
it in practice.

4. *Emotional Coping:*
- Effective coping mechanisms against stress and negative personal characteristics
that facilitate learning, particularly in adults.

5. *Self-regulatory Capability:*
- The ability to control behavior even in unfavorable environments, contributing to
effective learning.

*Cognitive Behavioral Theory*

*Overview:*
Cognitive Behavioral Theory, developed by Aaron Beck, explores how cognition
influences behavior. It emphasizes the role of self-concepts and environmental
factors in shaping individual behavior.
*Key Concepts:*

1. *Self-Concepts:*
- Individuals form self-concepts that influence their behavior, which can be
influenced by both positive and negative environmental factors.

*The Novice to Expert Theory*

*Overview:*
The Novice to Expert Theory, originally proposed by Hubert and Stuart Dreyfus and
later applied to nursing by Patricia Benner, outlines stages of skill acquisition from
novice to expert. It has significant relevance in nursing informatics.

*Key Concepts:*

1. *Stages of Development:*
- The theory describes five levels of development: Novice, Advanced Beginner,
Competent, Proficient, and Expert, each building upon the previous one.

2. *Characteristics of Expertise:*
- Successful progression to the expert level requires deliberate practice and a
willingness to take risks beyond the norm.

3. *Deliberate Practice:*
- Individuals engage in goal-oriented practice to continually improve their skills and
performance, striving for excellence within their field.

4. *Taking Risks:*
- Moving beyond the comfort zone and taking risks are essential for progressing
through the levels of expertise, often demonstrated by super users and champions in
nursing informatics.

*Novice to Expert Levels:*

1. *Novice:*
- Relies on memorization of context-free features and follows explicit rules for
actions. Requires monitoring and feedback for improvement. Example: Learning to
use a new hospital information system with explicit instructions.

2. *Advanced Beginner:*
- Still dependent on rules but starts noticing additional aspects from real-life
situations. Begins to apply learned knowledge to related conditions.

3. *Competent:*
- Grasps all relevant rules and facts, able to use own judgment in each case. Enters
the problem-solving stage, capable of using the system with ease and solving
technical difficulties.
4. *Proficient:*
- Progresses to fluency, where holistic perception of situations replaces step-by-step
analysis. Can interpret data from various sources and provide guidance to others as
needed.

5. *Expert:*
- Possesses a vast repertoire of experienced situations, leading to intuitive and
appropriate actions. Situations elicit immediate and suitable responses without
conscious rule application. Demonstrates situational discrimination and knows how to
achieve goals effectively.

*The DIKW Theory:*

*Overview:*
The DIKW Model, proposed by Russell Ackoff and expanded by Fricke, describes the
transformation of data into wisdom through the stages of data, information,
knowledge, and wisdom.

*Key Concepts:*

1. *Data (D):*
- Raw collected information that appears jumbled and disorganized.

2. *Information (I):*
- Connections formed between raw data parts, creating meaningful content.

3. *Knowledge (K):*
- Formation of whole meaningful contents from information, allowing for
conceptualization and understanding.

4. *Wisdom (W):*
- Represents the highest level of the hierarchy, where conceptualized knowledge is
applied in decision-making and future planning.

*Transformation Process:*

1. *Contextual Concept:*
- Involves gathering data, connecting raw data parts to form information, creating
meaningful content (knowledge), and conceptualizing and applying this knowledge
(wisdom).

2. *Understanding Concept:*
- Begins with researching and absorbing information, followed by action, interaction,
and reflection, leading to the development of wisdom.

*Representation in Time:*
 - Data, information, and knowledge levels represent the past, while wisdom
symbolizes the future, indicating the culmination of learning and experience over
time.

*DIKW Pyramid:*

1. *Data:*
- Raw, unprocessed information collected in bulk, including measurements, records,
and statistics. Does not provide meaningful results or answers.

2. *Information:*
- Processed data with defined relational connections, creating meaningful and
understandable content. Involves analysis to answer questions like Who, What, When,
and Where.

3. *Knowledge:*
- Appropriate collection of information that becomes useful. Represents stored
knowledge that is accumulated through memorization and usefulness. Does not
generate further knowledge on its own but provides specific measures to answer the
question "How".

4. *Wisdom:*
- Final stage of the DIKW Hierarchy where knowledge is extrapolated and processed
through human programming, including moral and ethical considerations. Involves
decision-making between right and wrong, good and bad, or improvement decisions.
Addresses the "Why" questions.

*Transformation Process:*

1. *Data to Information:*
- Raw data, such as "300 users visit a website daily", is transformed into meaningful
information, like "150 users visit Nursing Pharmacology section, 145 users visit
Nursing Research section, 5 users only visit the website". Answers questions of Who,
What, When, and Where.

2. *Information to Knowledge:*
- Processed information becomes stored knowledge, providing specific measures to
answer the question "How". For example, understanding how student nurses
between the age group of 18-22 years use a modular approach.

3. *Knowledge to Wisdom:*
- Knowledge gained from previous stages is applied and implemented in practical
life, addressing questions related to "Why". For instance, understanding that 70% of
student nurses visit the website for help with their lessons and technology needs can
inform decision-making and improvements.

*Computer System:*
1. *Computer Hardware:*
- Refers to the physical components of a computer, including the central processing
unit (CPU), input and output devices, disk drives, chips, and connections. Components
vary in size, shape, and type depending on the computer's purpose.

2. *Computer Hardware Systems:*

- The CPU processes and stores data, with essential components such as processor
cores, clock speed, random-access memory (RAM), and disk drive speed determining
performance. Multi-core processors enable computers to handle multiple tasks
simultaneously.

3. *Open Source and Free Software:*

- Software instructions given to hardware to perform tasks. Classifications include
free and open-source software (FOSS) and proprietary or closed software. FOSS
allows users to edit, modify, or reuse source code, fostering collaboration and
development without copyright constraints.

4. *Data Assessment:*
- Data quality assessment (DQA) scientifically evaluates data to ensure they meet
quality requirements for projects or business processes. It involves assessing technical
and business data issues, maintaining integrity, and addressing subjective issues
related to business processes.

5. *Personal, Professional, and Educational Informatics:*

- *Personal Informatics:* Information services filter data for individuals based on
preferences, transaction logs, social networks, etc., often accessible via mobile
devices.
- *Professional Informatics:* Health informatics professionals manage data
generated in patient care, using knowledge of healthcare and information technology
to improve patient health.
- *Educational Informatics:* Sub-discipline incorporating new technologies and
learning strategies to enhance the capture, organization, and utilization of
information in education, covering K-12, higher education, and enterprise-level
education. make this more shorter

HARDWARE AND SOFTWARE

The provided overview covers various aspects of computer systems, software, and
informatics, incorporating relevant information and examples. Here's a review of each
section:

1. *Computer Hardware:*
- The section provides a basic understanding of computer hardware, emphasizing its
physical components and functions. It mentions the essential components such as
CPUs and input/output devices and highlights their variability based on the
computer's purpose.

2. *Computer Hardware Systems:*

- This section delves deeper into CPU components and their performance
determinants, including processor cores, clock speed, RAM, and disk drive speed. It
explains the significance of multi-core processors and faster clock speeds for
enhanced performance.

3. *Open Source and Free Software:*

- The overview distinguishes between free and open-source software, outlining their
characteristics and benefits. It explains how FOSS enables collaboration and software
improvement by allowing users to modify source code.

4. *Data Assessment:*
- The section discusses data quality assessment (DQA) processes, highlighting their
importance in ensuring data integrity and supporting business processes. It covers
technical and subjective issues related to data quality and emphasizes adherence to
best practices and data quality dimensions.

5. *Personal, Professional, and Educational Informatics:*

- This section explores different informatics domains, including personal, professional,
and educational informatics. It defines each domain and explains its relevance,
applications, and impact, providing a comprehensive overview of informatics in
various contexts.

Overall, the overview effectively covers essential aspects of computer systems,

software classifications, data assessment processes, and informatics domains, making
it informative and insightful for readers seeking a basic understanding of these topics.
However, minor improvements could enhance clarity and organization, such as
breaking down longer paragraphs into smaller sections for easier readability.