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Basis for Professional Nursing
to show the relationship and importance of evidenced-based theoretical nursing in developing the curriculum and activities of nursing schools here in the Philippines. n To discussthe application of nursing theories in academic and clinical management .
JOURNEY TO NURSING THEORIES (Activity)
By Pairs: Interview Method Ask your partner these questions:
1.As an undergraduate student, can you easily recall 5 nursing theorists and their theories? 2.Choose 1, describe the concepts. 3.Were you able to use this theory either personally or professionally? 4.If yes, please describe the occasion.
NURSING THEORIES THAT CAN BE APPLIED IN THE ACADEME n n Background: First reaction to Theoretical Foundations in Nursing: UGH! .
Why? The Journey is Long and Winding n STAGES IN NURSING PROGRESS THEORY .
Stage 1: PRACTICE What DEVELOPMENT THEORIST ho? Aimed to define nursing and FLORENCE NIGHTINGALE identify (WESTERN WORLD) goals Organization of women to take care of wounded soldiers RUFAIDA SAAD ALASLAMIYA establishment of formal (EASTERN WORLD) education and training for nurses. advocated for alleviation of suffering and promotion of . code of ethics.
Stage 2: EDUCATION AND ADMINISTRATION What ? Aimed to IMPROVE definition of nursing and added HOW TO practice nursing Definition of the different levels of nursing education different from medical profession Who? VIRIGINIA HENDERSON (1966) 14 Nursing Needs .
and lead schools Gortner and Nahon. Improving nursing education b. administer. Embracing research productivity c.Stage 3: RESEARCH What ? Overlapped with the first two stages started as case studies (1920) Objectives of research were focused on: a. 1977) 1980: Focus on scientific syntax (influenced by Kuhn) . Raising quality of graduates Who? 1948: Division of Nursing Research 1952: First Nursing Research Journal 1970: Commission and Council of Nurse Researchers 1977: Research on how to teach.
nursing is complex that Being” requires body of knowledge Simplistic and reductionist (theories) 2. Concepts/ Theory” theories needed to support .Stage 4: THEORY What ? Who? Aimed at finding essence and Theory Think Tank mission of nursing in an Overwhelming and too abstract organized way Example: Martha Rogers Acceptance of the following: “Science of Unitary Human 1. Nursing is an Dorothea Orem (1971) autonomous “Nursing Care Deficit Nursing profession.
1980 1981 . Henderson. Wiedenbach Theory: A National Goal for Nursing Theory Development: A Tangible Goal for Academics Theory Syntax: Metaparadigm of Nursing A Time to Reflect Nursing Theories Revival : Emergence of Domain From meta theory to concept development Concepts Mid-Range and Situational Theories Evidence Based Research Diversity in thought: Linking Theory and Practice .1970 1971 .1965 1966 .1975 1976 .1985 1986 . Rogers.PERIOD BEFORE 1955 1955 – 1960 1961 . Hall.2000 2001 – 2005 Why? Milestones in Theory Development in Nursing DESCRIPTION From FN to Research Stages Birth of Nursing Theory Columbia University Teachers College Abdellah.1990 1991 – 1995 1996 . Peplau.
too theoretical . books were dated 2. the Journey is Complicated. n Survey of McEwen (2000) : 1.Furthermore. too focused on Grand Theories 3.
many questions remain unanswered. . Uncomfortable.In Practice.
How will they relate? . the noise competes with acquisition of knowledge.In the academe.
emphasis on Middle Range Theories and more modern ones. Grand Nursing Theories as knowledge foundation 2.McEwen (2006) Recommendations: n 1. complement nursing theories with borrowed theories used in Nursing . organize text according to Nursing language 4. teach and practice evidence –based nursing linked to research 3.
FOCUS ON MRT AND MODERN THEORIES n Use the classification as guide .1.
COMPARISON DIAGRAM THEORY Level of Abstraction MOST Meta theory Grand Theories Mid-range theories Practice theories LEAST .
Benner . and logical arguments Nightingale. Abdellah. Philosophies: based on analysis. Watson. Henderson. Hall. Wiedenbach. reasoning.CLASSIFICATION OF THEORIES IN NURSING n Tomey and Alligood (2002) Scope of THEORETICAL WORKS: 1.
Grand Theory – comprehensive and include their perspectives. n .CLASSIFICATION OF THEORIES IN NURSING Tomey and Alligood (2002) Scope of THEORETICAL WORKS 2. usually developing from their own model Example: Person as An Adaptive System Theory from Adaptation Model by Roy 2.
unless the students’ will pursue studies .GRAND NURSING THEORIES n n n Historical Background Focus on greatest contribution to nursing Just enough knowledge to whet readers’ appetite.
Middle –Range Theories focus on specific phenomena in the middle of a continuum between GNT and SITUATION BASED THEORIES Example: Kolcaba .FOCUS: THEORIES IN NURSING n Tomey and Alligood (2002) Scope of THEORETICAL WORKS: 3.
Meta theory. situation-specific theory or practice theory* 5. Philosophy. Micro theory. Partial Theory or in the development stage .CLASSIFICATION OF THEORIES BASED ON RANGE. Grand Theory or Macro theory 3. SCOPE AND ABSTRACTNESS n n Peterson (2004) 1. or Worldview 2. Middle Range or Mid-range* 4.
RELATIONSHIP AMONG LEVELS OF THEORY SUPPORTS REFINES TESTS IN PRACTICE Walker and Avant (2005) Strategies for Theory Construction .
Logan. interactive process Levine. Artinian. Orem. Swain King. unitary process Rogers. Newman. Neuman 2. Abdellah. Watson 3. Erickson. Tierney. Parse . Johnson. Tomlin.CLASSIFICATION OF THEORIES IN NURSING n 3 Major Groups: 1. Roy. Roper. Henderson. human needs Nightingale.
prescriptive (situation producing) Note: level of development is progressive. descriptive (factor –isolating) 2. n . predictive (situation relating ) 4.CLASSIFICATION BASED ON PURPOSE Dickoff and James (1968) 1. explanatory (factor-relating) 3.
CLASSIFICATION BASED ON PURPOSE .
DESCRIPTIVE –Factor Isolating PURPOSE: OBSERVE. FLANDERSPURPOSE: TO PROVIDE STEPANS MEANING (2004) AND OBSERVATIONS Descriptive model of mothers whose pregnancies were GENERATED AND TESTED complicated with HELLP BY DESCRIPTIVE syndrome (hemolysis. AND DESCRIPTIONS DESCRIPTION AND EXAMPLES: EXPLAIN HOW IT DOES NOT OR WHY THE CONCEPTS ARE RELATED Examples: KIDNER. NAME CONCEPTS. elevated RESEARCH TECHNIQUES liver enzymes. PROPERTIES. low platelets) INCLUDING: . DESCRIBE.
Tesh.EXPLANATORY (FACTOR RELATING ) It does Relates concepts with one another Describe interrelationships Cause and Effect and correlations Developed by Correlational Research Fawcett(1999) DESCRIPTION AND EXAMPLES Examples: Mc Carley(1999) Chronic Dyspnea Haight. Courts (2002) Thriving Model (Failure to Thrive in elderly) These models need additional research and developments . Barba.
PREDICTIVE OR SITUATION RELATING It does: Description and examples Conditions under which Dirksen (2000) Prediction of concepts are related. educational preparenedness. nursing literatures interpersonal interactions between patient and caregiver. Social Support. consistently Self Esteem) Prediction of precise relationships between concepts Smith et al (2002) Caregiving Effectiveness Model Relatively difficult to find in (Characteristic of caregiver. and the Well being among Breast Cancer relational statements are able to Survivors describe future outcomes (Reosurcefulness. and adaptive factors such as economic .
the SURGICAL PAIN.PRESCRIPTIVE OR SITUATION PRODUCING It does: Description and Examples Precribe activities necessary THE MOST DIFFICULT TO to reach defined goals IDENTIFY INNURSING LITERATURES. Address nursing therapeutics and consequences of Novak (1997). Middle Range interventions Theory on CHRONOTHERAPEUTICINTE They describe the type of RVENTION FOR POST client. the conditions. . It used a prescription and the time dependent approach to pain consequences assessment and provides directed Meleis ( 2005) nursing interventions to address post op pain.
Human being-environment interactions Rogers 3. Roy.CATEGORIZATION BASED ON NURSING DOMAINS Meleis(2004) 1. Orem n . Travelbee 4. Orlando. Newman 2. Nursing clients: Johnson. Nursing therapeutics: Levin . Interactions : King.
Experiences 3.. KNOWLEDGE is existing and needs to be discovered. Teach and practice according to evidence –based research PRINCIPLES: 1.Conceptualization about KNOWLEDGE patients’ responses and experiences 4. II.Clinical experience 2. .
HUMAN BARRIERS “Nurses as Nurses” n Service orientation vs professionalization n Today.THE EVIDENCE BASED JOURNEY IS DAUNTING… BUT WORTHWHILE 1. financial potential and career growth overshadows the goals of nurses to make a difference in nursing profession n .
THE EVIDENCE BASED JOURNEY IS DAUNTING… BUT WORTHWHILE Cont. HUMAN BARRIERS “Nurses are Nurses” n Attitudes of students are changing as changes occur in the spheres of life n More nurses seeking Graduate Degrees n More male joining nursing . 1.
.THEORIES AND NURSING EDUCATION n n Before: Nurses are trained to be passive handmaidens of physicians. to question situations. to generalize and conceptualize. to link events. executors of Doctor’s orders. implementers of hospital policy Today: Nurses plays a major role in training the mind to think beyond immediate action.
uses own problem and medical system solving. base of setting.THEORIES AND NURSING EDUCATION Before Present Nurses are dependent on hospital Autonomous. uses own theory. debate on nursing issues Nurses do procedures and train as “socialized intellectual Nurses are trained in universities subordinates” in the hospital using its own standards. but not in may be due to lack of . HOWEVER: However: REWARDS are given in clinical No standards of rewards which practice and teaching. competencies and patient care and increase skills savings. Hospitals improve knowledge. critical thinking.
KNOWLEDGE BARRIER Our discipline status is based on scientific foundations.THE EVIDENCE BASED JOURNEY IS DAUNTING… BUT WORTHWHILE 2. 1999) Theories must be developed through asking and answering significant questions of profession and discipline (Tomey and Alligood. 2006) . 2005) However. THE THEORIES! (Meleis. discipline cannot be installed only academically with the use of theories in curricula (Fawcett.
2. KNOWLEDGE BARRIER n What is the central goal of nursing related to the use of the theories? .
sleeping. activities. relating etc. . mobility.KNOWLEDGE BARRIERS n CONCLUSION: There is a need for nursing theories to drive development of knowledge in daily responses. lives of patients such as eating. This can be supplemented by borrowed theories.
there seems to be a close gate that prevent nurses from developing and perceiving nursing phenomena.THE EVIDENCE BASED JOURNEY IS DAUNTING… BUT WORTHWHILE 3.CONCEPTUAL BARRIERS In the past. This is referred to as PERCEPTUAL BLOCKS (Adams 1974) .
Lack of experience.Use of comfortable boundaries on a phenomenon a. Focus on tangential issues 2.FORMS OF CONCEPTUAL BARRIERS 1. Seeing the world in medical models.Difficulty delineating a phenomenon that is worthy of pursuance theoretically a. Non-compliance/ Lack of diagnostics 3. Unable to perceive meaningful clues b. Societal expectations b. .
III. Organize text according to Nursing language .
CATEGORIZATION BASED ON PARADIGMS n n n PARADIGM is a worldview or an over all way of looking at a discipline and its science PARADIGM is a view of life and not just a principle or theory .
Sources of Knowledge n n n Traditional — passed down from generation to generation Authoritative — comes from an expert Scientific — arrived at through the scientific method .
Types of Knowledge n n n n n Science — knowledge in and of nursing Philosophy — the study of wisdom Process — conceptual frameworks and theories Historical influences — Florence Nightingale. societal changes Societal influences — schools of nursing .
Framework of Nursing Theory n Theory — group of concepts that describe a pattern of reality n Can be tested. or used to guide research n Concepts — abstract impressions organized into symbols of reality n Conceptual framework or model . changed.
Types of Reasoning n n n Deductive reasoning — examines general ideas and considers specific actions or ideas Inductive reasoning — builds from specific ideas or action to conclusions about general ideas Retroductive reasoning .
Interdisciplinary Base for Nursing Theories n n n General systems theory — theory for universal application Adaptation theory — adjustment of living matter to other living things and environment Developmental theory — orderly and predictable growth and development .
Benefits of Nursing Theory n n n Directs nurses toward common goal Leads to improved patient care Provides rational and knowledgeable reasons for nursing actions .
education.Benefits of Nursing Theory n n n n Gives nurses knowledge base necessary for appropriate actions Helps resolve current nursing issues Prepares nurses to question assumptions and values Serves research. and practice .
Goal of Theoretical Frameworks
n n n n
Holistic patient care Individualized care to meet needs of patients Promotion of health Prevention or treatment of illness
METAPARADIGM OF Nursing Theories
n n n n
Person (patient) Environment Health Nursing
IV. Complement nursing theories with borrowed theories used in Nursing
Kuhn (1970) Science of Scientific revolution a. Paradigm b. Paradigm shift Nursing developed its own paradigm and meta paradigm
Four Principles of Learning n n n n n Prior Knowledge : What we know affects what we learn Social Interaction: Learning is enhanced when learners talk to each other Use of Strategies: Successful learning involves use of numerous strategies Particular Situations: Learning is situational and not readily transferred to other situations .
Learner-centered teaching in Education Piaget : Knowledge constructed through assimilation/accommodation Dewey : Active learning Bruner : Developing thinking Ausubel : Rote and discovery learning .
Learner-centered teaching in Education Vygotsky : Proximal Metacognition/Zone of Development Sternberg : Learning styles Gardener : Multiple Intelligences Wiggins : Performance based Assessment .
Learning and Psychology n n n Affective Cognitive Psycho-motor .
PSYCHOMOTOR (Dave 1975) Juxtaposition with Benner’s “From Novice to Expert” will be useful development of Nursing Curriculum .
It is concerned with values.AFFECTIVE LEARNING (Kratwohl. . and ranges from mere awareness (Receiving). through to analyzing values. Bloom and M Affective domain has received less attention. or perception of value issues. and is less intuitive than the Cognitive.
It can be viewed as a sequence of progressive contextualisation of the material.Bloom’s Taxonomy (1956) Knowledge Cognitive: the most-used of the domains. . refers to knowledge structures (although sheer “knowing the facts” is its bottom level).
Anderson and Krathwohl (2001) Later version .
Synthesis moved from second on top to the top as Creating.htm .edu/educ/llschult/blooms_taxonomy.g. Note the change from Nouns to Verbs [e. 2005) (Evaluation moved from the top to Evaluating in the second from the top." (Schultz. Application to Applying] to describe the different levels of the taxonomy..) Source: http://www. Note that the top two levels are essentially exchanged from the Old to the New version.odu.Side by Side: Bloom’s and Schultz Caption: Terminology changes "The graphic is a representation of the NEW verbage associated with the long familiar Bloom's Taxonomy.
Observations have to be organized as prioritized by the mind to develop into knowledge (Kant. n n . but observation by themselves do not form experience. 1800). experience on observation.Journey :Year 2010 onwards! n Nurses are now on the land of the “CAN “ and not anymore in the land of the “CAN’T” Knowledge depends on experience.
ASSIGNMENT Week 4: Thursday Reporting by Pair: MANAGEMENT THEORIES Scientific Management (Frederick Taylor) Management Functions (Henri Fayol) Participative Management ( Follet) Weber (Bureaucratic Organizations) Hawthorne Effect (Mayo) Theory Y and X (McGregor Employee Participation (Argyris) Activities of Management (Gulick) n .
ASSIGNMENT Week 5: Thursday n Reporting by Pair: LEADERSHIP THEORIES The Great Man/ Trait Theory Leadership Styles Organizational Structure Integrated Leader –Manager Behavioral Theories Situational and Contingency Leadership Interactional Leadership Transactional and Transformational Leadership Quantum Leadership and Thought Leadership Servant Leadership Emotional Intelligence Cultural Bridging n .
3rd ed. Alligood. Theoretical Basis for Nursing. A. M.. Philippine Edition. Lippincott Williams and Wilkins. Philadelphia. A. E. Bredow. williams. 6th ed.References: Meleis. Fawcett. Theoretical Nursing Development and Progress. J. Lippincott. El Sevier Singapore Pte Ltd. Singpaore. 2nd ed.. Tomey. Wills. (2008). (1995). M.I. S. Middle Range Theory. Application to Research . Philadelphia. 4th ed. F. Philadelphia. PA.. and Wilkins. (2009). Davis Company. Nursing Theories and their Works. (2007). T. (2007). Analysis and Evaluation of Conceptual Models of Nursing. 2nd ed.A. PA. . Peterson . McEwen. Lippincott Williams and Wilkins.
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