Chapter 4 Theoretical Foundations of Nursing Practice Copyright

Chapter 4 Theoretical Foundations of Nursing Practice Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.

The Domain of Nursing Domain Ø Ø Is the perspective of a profession Provides the subject, central concepts, values and beliefs, phenomena of interest, and central problems of a discipline Domain of nursing provides both practical and theoretical aspects of the discipline. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 2

Paradigm Ø Links science, philosophy, and theories accepted and applied by a discipline Nursing paradigm Ø Links person, health, environment/situation, and nursing Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 3

Terminology Person Health Environment/situation Nursing process: Method of applying theory or knowledge Integration of theory and nursing process is the basis for professional nursing. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 4

Theory A theory contains a set of concepts, definitions, and assumptions or propositions that explain a phenomenon. Theories guide the design of nursing interventions. Nursing theory Ø Ø Is a conceptualization of some aspect of nursing Describes, explains, predicts, and/or prescribes nursing care Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 5

Components of a Theory Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 6

Types of Theory Grand Ø Middle-range Ø More limited in scope and less abstract Descriptive Ø Broad in scope, complex, require specification Describe phenomena, speculate on why phenomena occur, and describe the consequences of phenomena. Prescriptive Ø Address nursing interventions for a phenomenon, and predict the consequence of a specific nursing intervention. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 7

Theory-Based Nursing Practice Theories Ø Ø Ø Generate nursing knowledge for use in practice Can direct how to use nursing process Are adaptable to different patients and all care settings The goal of nursing knowledge is to explain the practice of nursing as different and distinct from the practice of medicine, psychology, and other health care disciplines. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 8

Interdisciplinary Theories Explain systematic views of phenomena specific to the discipline of inquiry: Ø Ø Basic human needs Developmental Psychosocial Systems Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 9

Systems Theories Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 10

Selected Nursing Theories Nightingale Peplau Henderson Orem Leininger Neuman Roy Watson Benner and Wrubel Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 11

Selected Nursing Theories (cont’d) Nightingale (mid-1800 s) Ø Ø Environment as the focus of nursing care Descriptive theory Peplau (1952) Focus on interpersonal relations between nurse, patient, and patient’s family Ø Development of nurse-patient relationship Ø Henderson (1955, 1966) Ø Ø 14 basic needs of the whole person Framing nursing care the needs of the individual. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 12

Selected Nursing Theories (cont’d) Orem (2001) Ø Ø Leininger (2010) Ø Ø Focuses on patient’s self-care needs Goal is for patient to manage his or health problems. Theory of cultural care diversity and universality Considers social structure factors Neuman (2010) Based on stress and the patient’s reaction to the stressor Ø Role of nursing is to stabilize the patient or situation. Ø Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 13

Selected Nursing Theories (cont’d) Roy (1989) Ø Ø Views the patient as an adaptive system When patient cannot adapt to stressors, nursing is needed. Watson (1996) Defines the outcome of nursing activity with regard to the humanistic aspects of life Ø Purpose is to understand the interrelationships among health, illness, and human behavior. Ø Benner and Wrubel (1989) Ø Caring is central. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 14

The Link Between Theory and Knowledge Development Nursing knowledge is theoretical and practical. The goals of theoretical knowledge are to stimulate thinking and create a broad understanding of the “science” and practices of the nursing discipline. Experiential knowledge, or the “art” of nursing, is based on nurses’ experiences in providing care to patients. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 15

The Link Between Theory and Knowledge Development Theories provide direction for nursing research. Nursing theory and nursing research build the knowledge base for nursing, which is then applied to practice. Theory-generating or theory-testing research refines the knowledge base of nursing. Nurses incorporate research-based interventions into theory-based practice. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 16