Ch. 5 Theories of Nursing Practice

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concept
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idea; general impression; basic ingredient of theory; develop theories; enhance practice; essential for research development
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nursing theory
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compilation of data that defines, describes, and logically relates information that will explain past nursing phenomena and predict future trends; provide a foundation for developing models or frameworks for nursing practice development
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schematic model
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a diagram or visual representation of concepts, conceptual models, or theory
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theory
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a group of related concepts that explain existing phenomena and predict future events
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hypothesis
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ask the question that is to be the main focus. It usually includes independent and dependent variables
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method
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decide what data will be collected to answer the question; decide on and identify the step-by-step procedure that will be used to collect these data; make sure this process can be easily replicated
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data collection
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implement the step-by-step procedure that has been determined to answer the question
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results
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on the conclusion of the data collection, statistically identify the outcomes. Establish parameters that will determine whether the data are relevant
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evaluation
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examine the results to determine the relevance of outcome data in answering the hypothesis; determine the significance and identify the potential for future research
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inclusiveness
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does the theory include all concepts related to the area of interest
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consistency
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can the theory address new entities without having its founding assumptions changed
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accuracy
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does the theory explain retrospective occurrences; does the theory maintain its capacity to predict future outcomes
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relevance
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does the theory relate to the scientific foundation from which it is derived; is it reflective of the scientific base
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fruitfulness
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does the theory generate new directions for future research
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simplicity
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does the theory provide a road map for replication; is it simple to follow; does it make sense
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Florence Nightingale
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grand range theory; Theory of Practice: An Environmental Adaptation Theory
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Hildegard E. Peplau
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middle range theory; Interpersonal Relations
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Interpersonal Relations
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identifies the client’s feelings as a predictor of positive outcomes related to health and wellness; interventions focus on reducing stressors through therapeutic interpersonal interaction; assist the client with mutual goal-setting
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Martha E. Rogers
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grand range theory; Science of Unitary Human Beings
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Dorothea Orem
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grand range theory; Self-Care Model
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Sister Callista Roy
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grand range theory; Adaptation Model
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Jean Watson
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middle range theory; Theory of Human Caring
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Theory of Human Caring
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10 carative factors; harmony in mind, body, and soul; altruism, sensitivity, trust, interpersonal skills
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Margaret Newman
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grand range theory; Health as Expanding Consciousness
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Merle Mishel
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middle range theory; Uncertainty of Illness
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what are the five steps to scientific inquiry?
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hypothesis; method; data collection; results; evaluation
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nursing science
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collection of data that guides nursing to better serve patients through healing, prevention, education, and health maintenance
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4 influences that directed Nightingale to theory development
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classic education; upper class background; religion; era of reform in England
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Nightingale’s definition of nursing
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nursing is an art that requires practical and scientific training; nursing is putting someone in the best place to cure disease; nursing is there to help a patient live
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canons of nursing
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ventilation and warming; noise; variety; light; diet; chattering hopes and advices; cleanliness
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nursing as an art
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caring; empathy; compassion; creation of helping, healing relationships; moral; values; perceptions of patient needs
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nursing as a science
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collection of data related to nursing that may be applied to the practice of nursing; healing; prevention; education; health maintenance
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paradigm
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a set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline
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basic concepts in nursing
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nursing; person; health; environment
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examples of nursing concepts
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pain; quality of life; health; stress; adaptation
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conceptual model of framework
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more loosely structured than theories; deals with concepts relevant to a common theme; linking of concepts
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example of conceptual model of framework
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nursing curriculum model
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how nursing theory is developed by nursing theorists
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nursing theorists put on paper “in words and images” their views of perspectives of how multiple concepts relate to one another and outcome(s) of the interrelationships; the outcomes are solely a result of the NURSE’S ACTIONS and SPECIALIZED KNOWLEDGE in a given situation
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criteria for theory acceptance
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inclusiveness; consistency; accuracy; relevance; fruitfulness; simplicity
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levels of theory
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grand theory; middle range/practice theory
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grand theory
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broad and in scope; explains large segments of human experience; may incorporate numerous other theories; relatively abstract global concepts
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examples of grand theory
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the entire nursing process; Sister Callista Roy’s adaptation mode; Dorothea Orem’s self-care deficit model
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middle range/practice theory
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smaller in scope; guide daily practice for nurses; may refer to a specific population/situation
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example of schematic model
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Virginia Henderson’s need theory
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current policy issues
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nursing shortage; scarce resources; patient safety; medical errors; managed care; medicare; welfare-to work plans; confidentiality issues; scope of practice for advance practice nurses; whistle-blower protection; prescriptive authority; licensure; telemedicine
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environmental changes
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genetics; computers; noninvasive surgery; robotics; decreasing energy sources; increasing air population; environmental hazards; new diseases; antibiotic-resistant illness
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Faye Abdellah
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grand theory; Twenty-one Nursing Problems
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Twenty-one Nursing Problems
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related to human needs; nurse as a problem solver who provides care for the whole individual; client-centered interventions
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Virginia Henderson
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middle range theory; Need Theory
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Need Theory
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14 essential functions towards independence; focuses on the importance of increasing the patient’s independence to hasten their progress; emphasizes basic human needs and how nurse can assist in meeting those needs
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Ida Jean Orlando
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middle range theory; Theory of Nursing Process
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Theory of Nursing Process
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stresses the action of the individual client in determining the action of the nurse; focus is on the present or short-term outcome
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Myra Estrie Levine
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grand range theory; Conservation Model
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Conservation Model
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four conservation principles of inpatient client resources – energy, structural integrity, personal integrity, and social integrity
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Betty Neuman
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grand range theory; Systems Model
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Systems Model
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wellness-illness continuum; nurses provide care through primary, secondary, and tertiary prevention modes; the concern of nursing is to prevent stress invasion; protect the client’s basic structure and obtain or maintain a maximum level of wellness if stress not prevented
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Rosemarie Rizzo Parse
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grand range theory; Theory of Human Becoming
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Madeline Leninger
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middle range theory; Theory of Cultural Care Diversity and Universality
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Theory of Human Becoming
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quality of life from each person’s individual perspective should be the goal of nursing practice; individual actively participates in creating health according to environmental influences; individual is an open system; health is a process
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Theory of Cultural Care Diversity and Universality
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transcultural & caring nursing: diversity, universality, worldview, ethnohistory
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Dorothy E. Johnson
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grand range theory; Behavioral System Model for Nursing
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Behavioral System Model for Nursing
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separates the psychologic and the physiologic aspects of illness; nurse provides support and comfort to attain regulation of the client’s behavior
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Science of Unitary Human Beings
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nurse promotes synchronicity between human beings and their universe or environment; energy fields, openness, pattern, organization
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Self-Care Model
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nursing facilitates client self-care by measuring the client’s deficit relative to self-care needs; the nurse implements appropriate measures to assist the client in meeting these needs by matching them with an appropriate supportive intervention
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Adaptation Model
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client’s adaptation to condition using environmental stimuli to adjust perception
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Theory of Practice: An Environmental Adaptation Theory
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ventilation, noise, variety, diet, light, chattering hopes & advices, cleanliness
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Health as Expanding Consciousness
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movement, time, space; becoming more of oneself; finding greater meaning in life; reaching new dimensions of connectedness with other people and the world
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Uncertainty of Illness
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used in chronic illness; stimuli frame, appraisal stage, initiation of coping mechanisms, adaptation
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Imogene King
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grand range theory; Goal Attainment Theory
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Goal Attainment Theory
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using nurse-client transactions; addresses client systems and includes: society, groups, the individual
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Patricia Benner
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middle range theory; Theory of Novice to Expert
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Theory of Novice to Expert
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Novice – minimal to no experience Advanced Beginner – marginally acceptable performance Competent – demonstrates consistency, predictability, and time management Proficient – perception of a situation as a whole rather than separate pieces Expert – intuitive grasp from deep experiential background

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