Concepts in Advanced Nursing Practice Chapters 6 & 10 – Flashcards

-Most Complex and widest in scope of the levels of theory. -Attempts to explain broad areas within the discipline -Composed of re;actively abstract concepts and propositions that are less abstract than conceptual models and may not be ameneable for testing. - Concept Mode = Theory= Hypothesis -Provide a background of philosophycal reasoning that allows nurse scientists to develop organizing principles for research or practice sometimes referred as middle range theories. -Help develop a discipline. -Helps updating the work base on changes on healthcare system and society. -May lead to confusion

-Composed of relatively abstract concepts. - Developed through thoughtful appraisal of existing ideas. -May incorporate other theories.

-Human Needs theory (particulate-deterministic). -Interactive theories (Integrative, reciprocal). -Unitary process theories ( unitary, simultaneity).

-Problems, nurse's function -Abdellah, Henderson, Johnson, Nightingale, Neuman and Orem. -Needs deficit -Illness and disease.

-Interaction, illness as experience -Helpless being, human experience/meaning. -Integrative reciprocal -Postpositive worldview: Recognizes that reality is multidimensional and contextual. Objectivity and subjectivity are desirable. -Artinian, Erickson, Tomlin and Sawin, King, Levine, Roper, Logan and Tierney., Roy and Watson.

-Humans as unitary beings, self evolving and self regulating. -Man-living-health. universe health process. -Human becoming: both patient and nurse. -Desicion making between both nurse and client. -Rogers,Parse and Newman.

-Is a worldview or an overall way of looking at a discipline and its science. -Seen as an universal view of life, rather than just a model or principle of a theory.

-Lie between grand theories and practice theories. -Fewer concepts and encompass a more limited aspect of reality. -Concepts are relatively concrete and often operationally defined. -Propositions are relatively concrete and can be empirically tested. -Nursing has recognized MRT development as the latest step in knowledge development. -Used by emerging disciplines bc they are readily operationalized. -Easier to apply in practice. Better basis for generating testable hypothesis. -Address particular client populations and situations. -Easier to apply as frameworks for research studies. -Consistent with the desire to legitimize nursing as a profession.

-Ideas are relatively simple and general. -Consider a limited number of variables or concepts. -Have a substantive focus -Consider a limited aspect of reality -Can be tested empirically -Focus on client problems and outcomes -May specify an area of practice, client age range, nursing actions or interventions and outcomes. -Are clearly stated and easy to understand. -Consistent and coherent -Deal with current nursing perspectives -Address relevant topics that solve persistent problems -Can easily be adopted to guide nursing practice.

-Middle range theories consist of two or more concepts and specified relationships between the concepts. -Concepts should be discrete, observable, and sufficiently abstract to be applied across multiple settings. Examples: health promotion Comfort coping resilience pain self-transcendence

-Emerge from combining research and practice, and building on the work of others. -literary reviews -qualitative research -filed studies -conceptual models -taxonomies of nursing diagnosis and interventions -clinical practice guidelines -theories from other disciplines -statistical analysis of empirical data.

-Includes the one from grounded theory: theory of chronic sorrow theory of transitions theorybof caring -Theories from practices are less common

-Many scholars suggest development of MRT from Grand Theories bc of their abstract nature. -Nurse expressed empathy -Theory of self care(Orem's self care) -Prevention as intervention (Neuman systems model).

-Most commonly used are theories from behavioral sciences, sociology and anthropology. -Health Belief Model -Theory of Reasoned Action -Social Learning/ Social Cognitive Theory -Theory of Comfort (Kolcaba, 1994). -Theory of skill acquisition (Benner, 2001)-Dreyfus model od skill acquisition. -Uncertainty in illness theory. (Mishel & Clayton 2003).-- Chaos theory.

-Combining concepts or elements of multiple theories is very common in middle range theory development. -Theory of exercise as self-care (Ulbrich 1999) Orem's + transtheorical model + concept of risk. -Theory of adaptation to chronic pain (Dunn, 2004)- Roy adaptation model + gate control theory, stress and coping (Lazarus) + relaxation theory.

-Least common source for MRT development in nursing -Public health Nursing Practice Model (Smith & Bazini-Bakarat, 2003) Healthy people 2010, Standards of PHN Practice and 10 Essential Services of PH. -Theory of peaceful End of Life (Ruland & Moore 1998)-- Standards of care for terminally ill.

-Articulate the theory name -Describe approach used to develop the theory. -Clarify the conceptual linkages in a diagram or model -Describe the research-practice links of the theory. -Explain the association between the theory and the discipline of nursing.

-High: include broad, fairly abstract concepts (caring, transcendence, adaptation, culture. Nearest to GNT. Pender, Leininger, transitions, synergy model. -Middle: Theoretically defines, fairly specific construct. (uncertainty in illness, unpleasant symptoms, chronic sorrow. -Low: more defined and specific (women's anger, acute pain management, intervention for post-surgical pain).

-Health promotion behaviors -1982 -Biopsychosocial process that motivates individuals to engage in behaviors that promote health. -Individual characteristics and experiences -Behavior specific cognitions and affect -Behavioral outcomes. -Used by nurses to develop and execute health-promoting interventions. -Used to develop research studies focusing on one aspect of health promotion. -used frequently as a framework for research studies. -148 CINAHL articles.

-Transcultural Health model 1970 -Caring for persons considering their cultural heritage and values. -Culturally competent/congruent nursing care to persons of diverse culture. -Understand the individual's view of illness. -Understanding cultural similarities and differences will allow the RN to positively influence health. -Most frequent cited theory.

-Alaf Meleis -Observations based on experiences faced as people deal with changes related to health, well being ab=nd the ability to care for themselves. -Central concept in nursing. transition: is the passage from one fairly stable state to another fairly stable sate. A process triggered by change. -Attempts to describe the interactions bw nurses and patients. -Concern as people undergo transitions. -Goal of nursing therapeutics is to recognize and address the potential problems encountered during transitional experiences. -Develop preventive and therapeutical interventions to support patients during these occasions. -Charaterized by stages, milestones, and turning points. -Can be assistaed and managed by RN. -Categories: developmental, situational, Health-illness and organizational. -RN are facilitators/inhibitors of transitions: readiness, preparartion for transition and role supplementation -Widely applicable and used in both practice and research.

-Framework for certified practice -Nurses contributions, activities and outcomes related to caring for critically ill patients. -Conceptual model framework for designing practices and competencies. -Used for research. -Three levels of outcomes: derived from patient, nurse and healthcare system. -Designed to optimized outcomes. When patient characteristics and nurse competencies match and synergies, the outcomes for the patient are optimal. -Indication to use in practice aside from critical care.