The development of a theory

Shu-Fang Vivienne Wu Assistant professor NTUNHS

Objectives
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Define theory and list characteristics of a theory Describe the components of a theory and its use Trace the development of a nursing theory Theory Development in Nursing: Historical Overview Describe the different types of theories and examples of each.

Introduction to Theory

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Nursing as a profession There has been questions about whether nursing is a profession or an occupation. An occupation is a job a career. A profession is a learned vocation or occupation that has status of superiority and precedence within a division of work. It needs widely varying levels of training or education, skills and variable knowledge base. All professions are occupations but not all occupations are professions (Logan,Franzen, Butcher,2004;Schwiran , 1998)

Definitions of theory
Defining theory is the first step towards developing a set of criteria for the evaluation of theory.  Many of the early definitions of theory in the nursing literature were influenced by the Logical Positivistic Received View (Suppe, 1977), where the focus was on structure and process. Ex.1.McKay (1969) defines theory as “a logically interrelated set of confirmed hypotheses” (p. 394)and Jacox (1974) defines it as “a systematically related set of statements including law-like generalizations that are empirically testable” (p. 324).  These definitions are consistent with the Received View philosophy on theory at the time.

and/or controlling phenomenon” (p. in that it does not emphasize the structure of the theory. This definition begins a departure from the Logical Positivistic Received View.Definitions of theory   Chin and Jacobs (1983) define theory as “a set of concepts. definitions. 70). . explaining. and propositions that projects a systematic view of phenomena by designating specific interrelationships among concepts for purposes of describing. predicting.

and paradigm. 23). . Fawcett (1989) clearly states that “conceptual models and theories are clearly distinguished by their levels of abstraction and thus must be used in different ways” . conceptual model.Problem in nursing:lack of agreement on the definition of theory    Many authors have used the term theory as interchangeable with such terms as conceptual framework. She defines nursing theory as “a relatively specific and concrete set of concepts and propositions that purports to account for or characterize phenomena of interest to the discipline of nursing” (p. model.

.A conceptual model vs. A theory deals with one or more relatively specific and concrete concepts and propositions”(Dudley-Brown p.77) . A theory   A conceptual model is an abstract and general system of concepts and propositions.

Rogers. or predict specific phenomena. Neuman. the work is most likely a theory. If the purpose of the work is to articulate a body of distinct knowledge for the discipline of nursing.Distinguish a conceptual model from a theory   If the purpose is to describe.54) and Orlando. Ex. the work is most likely a conceptual model. and Roy. the works of Peplau (Alligood & Tomey Ch 5. Orem. King. Levine. p. . Ex. the works of Johnson. explain.

the use of different labels (theory. paradigm. according to Meleis (1985). not a conceptual model. However.Distinguish a conceptual model from a theory    Most of these theorists have been described by others as proposing a nursing theory. Failure to distinguish a conceptual model from a theory. Fawcett (1989) states. . leads to misunderstandings and inappropriate expectations of the work. model. and framework) corresponds to differences in emphasis rather than substance.

Definitions of theory • Pinnel and Menesis (1986) Systematic set of interrelated concepts. definitions and deductions that describe. explain or predict interrelationships .

definitions and propositions) that presents a systematic view of phenomenon and which is useful for description.Definitions of a theory  Walker and Avant (1983) Internally consistent group of relational statements (concepts. prediction and control . explanation.

purposeful and systematic view of phenomena .Definition of a theory  Chinn and Krammer creative and vigorous structuring of ideas that project a tentative.

.Definitions of a theory  Meleis.2005 Theory is an organized. coherent. and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole.

Some commonalities Purpose Concepts Definitions Propositions Structured ideas Tentative Describe a phenomenon or occurrence .

Components/Elements of theory 1.Purpose “Why is the theory formulated” 2. mental images of a phenomenon. an event or object that is derived from an individual’s experience and perception .Concepts are building blocks of theory – ideas.

Components/Elements of theory 3. person.Has a major concept like nursing. 4. health or environment. Definitions give meaning to concepts which can either be descriptive or procedural (stipulate-use of term within the theory) .

accepted “truths” that are basic and fundamental to the theory. . Or value assumptions where what is good or right or ought to be. paradigms or figures .Components/Elements of theory   Propositions are expressions of relational statements between and among the concepts. It can be expressed as statements. AKA as theoretical assertions Assumptions.

Characteristics of a Theory • • • Systematic. Tentative in nature ( change over time or evolving but some remain valid despite passage of time) .no contradictions) Creative structuring of ideas mental images of one’s experiences and create different ways of looking at a particular event or object. logical and coherent (orderly reasoning.

Theory Development .

How does a theory develop?  1. Practice – theory evolved from clinical practice . Four strategies of theory development Theory practice theory ( theory developed in other discipline and used in nursing situations) 2.

Original theory examined and given a new research findings. Research theory or inductive method Must evolve from research findings or empirical evidence. . 4. Theory research theory theories developed by other disciplines are utilized but given unique nursing perspective.How does a theory develop? 3.

Central concepts of person. In nursing this is main concepts that encompasses the subject matter and the scope of the discipline . health and nursing . environment.Most abstract level of knowledge.TERMINOLOGY METAPARADIGM .

TERMINOLOGY  - - - Philosophy Knowledge level which specifies the definitions of the metaparadigm concepts in each of the conceptual models of nursing. Nightingale is considered philosophical approach Out of these philosophies theory maybe formalized .

King on interaction and Abdellah on interventions .Conceptual models   Frameworks or paradigms that provide a broad frame of reference for the systematic approaches to the phenomena with which the discipline is concerned. different views nursing like Roy focuses on adaptation.

Theory  Group of related concepts that propose actions that guide practice .

Some derive from other nursing discipline like LEininger which comes from anthropology Nursing theory is defined as a conceptualization of some aspect of nursing reality communicated for the purpose of describing phenomena. . predicting consequences.Nursing theory   Group of related concepts that derive tfrom the nursing models. explaining relationships between phenomena. or prescribing nursing care(Meleis.2005).

making nurses more confident about the practice. . Theories help to focus the goals. Theory guides and improve nursing practice   Theory provides goal for nursing care and with goals.Uses of theory 1. nursing practice is rendered more effective and efficient.

Theory guides research according to Meleis. Theory enhances communication .Uses of theory 2. It validates and modifies the theory. 3. primary use of theory is to guide research. Theory contributes to the development of the disciplines body of knowledge 4.

Theory Development in Nursing: Historical Overview .

rationale for actions and trained powers of observation and reflection . “ placing the client in the best condition for nature to act upon him” Taught about symptoms and what they indicate.Where do I begin? Florence Nightingale Considered first modern nursing theorist First one to delineate what is considered the nursing goal and practice domain.

defined nursing practice. and created a substantive body of knowledge  . warm .Historical Development of Nursing Theories: Significant Events Nightingale until the 50’s  Florence Nightingale Notes on Nursing control of the environment to care for the individual (ventilation. noise absence or reduction. light. or develop nursing theory. cleanliness & diet )   1952 Nursing Research Journal publication 1960’s nature of nursing practice was debated.

body. Examples: Abdellah 21 nursing problems and Hall’s Core.disease)  1969 first conference on nursing theory  . care and cure (person. and philosophy of nursing.Historical development 1960-1970 proliferation of conceptual models and frameworks.

Historical Development   Role of nurses where questioned. process of theory development was discussed . for whom where and when were determined. what they do. purpose of nursing.

Less debates on whether or not to use theory.Historical Development   1980’s characterized by acceptance of the significance of theory in nursing. practice theory or borrowed ones. . More and more publication up to the present.

Types of theories     According to range Grand theory Middle range theory Micro theory .

explaining. They are the most complex and broadest in scope. Roy’s Adaptation Model. Levine’s The Four Conservation Principles of Nursing. predicting and looking at nursing phenomena. Henderson’s The Nature of Nursing .     . and Orem’s Self-Care (Marriner-Tomey) Ex.Types of theories: Grand Theory  Grand Theory consist of broad conceptual frameworks that reflect wide and expansive perspectives for practice and ways of describing.

Peplau’s Psychodynamic Nursing and Orlando’s Nursing Process Theory  .Types of Theories: Mid RangeMid Range.less complex and narrower in scope than grand theory and micro theory.more limited in scope and less variables.  grand theory on stress and adaptation might not yield any interpretable guidelines on practice but if the theory is focused on chronic lingering illness as the stressor on family. Ex. the stress theory becomes operational for both research and practice purposes.  A more workable level is the middle range. and testable.

generally a set of theoretical statements Deals with specific and narrow defined phenomena .are the least complex. They deal with a small aspect of reality. They contain the least complex concepts and are narrowest in scope.Types of theories: Micro theories   Micro theories.

2. 3. Henderson Client-nurse dynamics: Watson Client-nurse environment : Leininger .According to Orientation or focus of the theory 1. Client centered: Nightingale.

Categories of nursing theories client nurse ` environment .

Levine.Pend er. resolved or alleviated by nursing interventions This category includes theories developed by the following : Nightingale.Client centered theory   Focused on the needs and problems of clients which are met.Abdellah.Henderson. . Hall.Orem. Roy.

Watson. This category includes theories developed by the following: Peplau. King and Orlando .Nurse – client dynamics   Focus on interaction between the nurse and client.

cultural diversity. As well as culture. Theories of Neuman and Leininger are discussed under this category. and universality. .Client Nurse Environment Dynamics    Focus on the interaction between nurse and client in an environment that includes broader dimensions of time and space.

Framework to Analyze the Nursing theory 1. nursing. health and environment 2. nursing. nurse clientenvironment dynamics -How similar and how different are their concepts of persons. . health. environment 3. Based on Focus Client centered. nurse-client dynamics. Some theories have several key concepts and it may have sub-concepts. Key concepts unique to the theory.What are the major concepts? Person.

Analysis of theory      Clarity-How clear is this theory? Simplicity-How simple is this theory? Generality-How general is this theory? Empirical precision -How accessible is this theory? Derivable consequences -How important is this theory? .

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useful solutions to problems. Theory evaluation including description. agreements. concept analysis. theory critique. continuous. testing and support.Conclusion     Theory development and evaluation are cyclical. it is the responsibility of each clinician. and dynamic process. academician. One can not exist without the other. . These process are based on the view that science is a human process that includes not only valid findings but also observation. Theory evaluation is central to the development of theory.

Describe the components of a theory and its use 3.Trace the development of a nursing theory 4.Theory Development in Nursing: Historical Overview .Define theory and list characteristics of a theory 2.Exercise Please see the attachment: Adaptation model of nursing 1.

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