THEORETICAL

FOUNDATIONS IN
NURSING
 LEARNING OUTCOMES
• Define related terms
• Explain the various types of
knowledge
• Explain how theories from other
disciplines have influenced
nursing theory
• Identify the four concepts
common to all nursing theories
• Discuss the four ways of knowing
 THEORY
• Composed of a group of
concepts that describe a
pattern of reality.
• A statement that explains
or characterizes a process,
an occurrence, or an event
and is based on observed
facts.
 THEORY
• Can be tested, changed, or
used to guide research or
to provide a base for
evaluation
• Arrange a group of
related statements or
concepts so that they give
meaning to a series of
events
TWO PRINCIPAL METHODS
Deductive Reasoning
– one examines a general idea
and then considers specific
actions or ideas.
Inductive Reasoning
– reverse process is used; one
builds from specific ideas or
actions to conclusions about
general ideas.
Concept
– An idea of what something is
or how it works
Philosophy
– a particular set of ideas about
knowledge, truth, the nature
and meaning of life
• CONCEPT
– An idea of what something is or how it
works
• PHILOSOPHY
– a particular set of ideas about knowledge,
truth, the nature and meaning of life
• PHENOMENON
– an exceptional, unusual or abnormal
occurrence
• PARADIGM
– a model or pattern for someting that may
be copied
 NURSING
• A UNIQUE HEALTHCARE DISCIPLINE IN
WHICH NURSES PROVIDE A SERVICE
BASED ON KNOWLEDGE AND SKILL
• HAS TWO ESSENTIAL ASPECTS: A BODY
OF KNOWLEDGE AND THE APPLICATION
OF THAT KNOWLEDGE THROUGH
CLINICAL NURSING PRACTICE.
• KNOWLEDGE IS AN AWARENESS OF
THE REALITY ONE ACQUIRES THROUGH
LEARNING OR INVESTIGATION.
 SOURCES OF KNOWLEDGE
• TRADITIONAL KNOWLEDGE – PART OF
NURSING PRACTICE PASSED DOWN FROM
GENERATION TO GENERATION
• AUTHORITATIVE KNOWLEDGE – COMES
FROM AN EXPERT AND IS ACCEPTED AS
TRUTH BASED ON THE PERSON’S
PERCEIVED EXPERTISE
• SCIENTIFIC KNOWLEDGE – KNOWLEDGE
ARRIVED AT THROUGH THE SCIENTIFIC
METHOD.
 NURSING THEORY
• ATTEMPTS TO DESCRIBE OR EXPLAIN THE
PHENOMENON(PROCESS,OCCURRENCE OR
EVENT) CALLED NURSING ( BARNUM, 1998)
• DIFFERENTIATES NURSING FROM OTHER
DISCIPLINES AND ACTIVITIES IN THAT IT
SERVES THE PURPOSES OF DESCRIBING,
EXPLAINING, PREDICTING, AND
CONTROLLING DESIRED OUTCOMES OF
NURSING CARE PRACTICES.
TYPES OF NURSING THEORY
• GRAND THEORY
• MIDDLE RANGE THEORY
• CRITICAL/NURSING PRACTICE
THEORY
• GRAND NURSING THEORY
– Have the broadest scope and present general concepts and
propositions.
– Theories at this level may both reflect and provide insights useful
for practice but are not designed for empirical testing
• MIDDLE-RANGE NURSING THEORY
– Proposed by Robert Merton in the field of sociology to provide
theories that are both broad enough to be useful in complex
situations and appropriate for empirical testing.
• CRITICAL NURSING PRACTICE THEORY
– most limited scope and level of abstraction and is
developed for use within a specific range of nursing
situations.
– have more direct impact on nursing practice than do
theories that are more abstract.
FOUR COMMON CONCEPTS IN
NURSING THEORIES
• Person
• Environment
• Health
• Nursing
 WAYS OF KNOWING
• EMPERICAL KNOWING
• ETHICAL KNOWING
• PERSONAL KNOWING
• ESTHETIC KNOWING
• EMPERICAL KNOWING
– Concerns the science of
nursing; The nurse uses
empirical knowing to access
data from nursing, from related
disciples, and from the client.
– is factual descriptive and
ultimately aimed at developing
abstract and theoretical
explanations.
• ETHICAL KNOWING
– Ethics in nursing is the moral
component guiding choices within
the complexity of health care.
– Focuses on the primary principle of
obligation and what ought to be
done in the concept of service and
respect for human life.
• PERSONAL KNOWING
– The pattern most fundamental to
understanding the meaning of
health in terms of individual well-
being. (Carper, 1975)
– can be broadly described as
subjective, concrete, direct, and
existential and is relational to
another human being
• AESTHETIC KNOWING
– Perception of unity and resists
expression into the discursive.
– creative , such as when it is combined
with empirical knowing in the discovery
and appreciation of theory
– controlled by perception of the balance,
rhythm, proportion and unity of what is
done in relation to the dynamic
integration and articulation of the whole.
Evolution
of
Nursing
 Brief History of Nursing
INTUITIVE NURSING (Primitive Times – 16th Century)
 A function that belonged to women
 Disease were embedded in superstition and magic.
APPRENTICE NURSING (16th-18th Century)
 Western societies changed from having a religious orientation to
emphasizing warfare, exploration and expansion of knowledge
 Women who had committed crimes were recruited into nursing in lieu
of serving jail sentences.
EDUCATION NURSING (18th – 19th Century)
 Social reforms changed the roles of nurses and of women in general
 June, 1860 – Florence Nightingale School of Nursing
 The outbreak of the Crimean war and a request by the British to
organize nursing care for a Military Hospital gave an opportunity for
achievement
 Last two decades of the 19th century is also called “awakening of
nursing”
CONTEMPORARY NURSING (18th – 21st Century)
World War II had an enormous effect on nursing.
 Associated with scientific and technological
developments and social changes. (1945)
Professionalization of Nursing
 Schools of nursing were based on educational objectives
and were increasingly developed in university and college
settings, leading to degrees in nursing for both men and
women
 Increased emphasis on nursing knowledge as the base
for nursing practice has led to the growth of nursing as a
professional discipline
 ANALYSIS AND EVALUATION OF
NURSING THEORY
CRITERIA:
•CLARITY - Is the theory clearly stated?
•SIMPLICITY - Is it stated simply?
•GENERALITY - Can the theory be
generalized?
•EMPERICAL PRECISION - Is the theory
accessible?
•DERIVABLE CONSEQUENCES - How
important is the theory?
 Theory Analysis
Considerations:
•Scope of the theory
•Metaparadigm concepts and propositions
included in the theory
•Values and beliefs reflected in the theory
•Relation of the theory to a conceptual
model and to related disciplines
•Concepts and propositions of the theory
 Theory Evaluation
Considerations:
•Significance of the theory and relations with
structure of knowledge
•Consistency and clarity of concepts,
expressed in congruent, concise language
•Adequacy for use in research, education
and practice
•Feasibility to apply the theory in practical
contexts
 NON-NURSING THEORIES
1. HUMAN NEED THEORY
•LEVELS OF PRIORITY:
– Physiologic Need
– Safety and Security
– Love and Belongingness
– Self Esteem
– Self Actualization
2. SYSTEMS THEORY
•Components:
– Input - data/info that comes from a
client's assessment
– Output - end product of a system
– Feedback - serves to inform a system
about how it functions
– Content - product and info obtained from
the system
• Input - client interaction with the environment (
physiological, psychological, developmental,
etc.)
• Content - Nursing Process ( assessment, nursing
diagnosis planning, implementation, evaluation)
• Output - Client's health status for returning to
the environment
• Feedback - client successfully or unsuccessfully
functions in the environment
 SIGNIFICANCE OF
THEORY TO NURSING
AS A PROFESSION
 CRITERIA OF A PROFESSION
• Well defined body of specific and unique
knowledge ( Education )
• Strong service orientation ( Service )
• Code of ethics
• Professional organization that sets
standards ( Autonomy )
• Ongoing research
• Autonomy
• Caring
 QUALITIES OF A
PROFESSIONAL NURSE
• has faith in the fundamental values that
underlie the democratic way of life
• has a sense of responsibility for
understanding those with whom he/she
works or associates with through the use
of skills
• has the basic knowledge, skills and
attitude necessary to address present day
social problems through the use of critical
thinking
• has skills in using written and spoken
language
• has emotional balance
• appreciates high standards of
workmanship
• accepts and tries to understand
people of all sorts regardless of race,
religion and color