Grand Nursing Theories Ch 6 – Flashcards

-They are broad formulations of philosophies based on attempts to include the whole of nursing realities as the the scholar understands it OR - it is a model made of the composition of concepts, which are used to help people know, understand, or simulate a subject the model represents (eg a toy model made to work as the object represents) -They are abstract and non-testable

-derived from conceptual models - most complex, widest scope - attempt to explain broad issues within the nsg discipline - abstract concepts (less abstract than conceptual models) - may or may not be testable - developed through thoughtful/insightful existing ideas - may lead to production of middle range theories - guide research (applied to education, practice, further research, administration) for EBP → enhance QOL/health/pt safety/ predictable pt outcomes= necessary for evaluating nursing interventions -theory requires constant renewal and re-evaluation due to ever changing health care field

-advantage→ applied to multiple patients and problems -abstract makes it more difficult to apply to all situations -can be controversial→ do we still need these theories?

-provides a different lenses of the same viewpoint/ different labels for the same view point

scope, nursing domains, paradigms

-based on the scope of the theory, eg the nursing conceptual models or the nursing theories

-schools of thought=nursing domains -ex. needs/ interaction/ outcomes theorists, as they developed in various eras, and caring/becoming theorists in current era

-paradigm: world view/overall way of viewing discipline and it's science

-paradigm shifts: empirical reality no longer fits the existing theories of science (change in approach or underlying assumptions) -ex. change in health leads to change in theory

Newman, parse, and fawcett

1.a) Totality paradigm: humans are biopsychosocial spiritual beings, adapting to environment, in whatever way theory define environment -orem, roy, johnson 2.a) Simultaneity paradigm: humans are id'd as unitary beings, which are energy systems in simultaneous, continuous, mutual process with the universal energy system -parse, rogers, newman -simultaneity paradigm (whole of the person)→ rogers, newman -human becoming paradigm→ parse (later in time)

1.b) Particulate-deterministic paradigm 2.b)Interactive- integrative paradigm 3.b) Unitary-transformative paradigm

- Particulate-deterministic paradigm: positivist view of the theory of sciences and stresses research methods that demand control in search for knowledge -humans are reducible, and change is linear and causal -nightingale, orem, orlando, peplau

-Interactive- integrative paradigm: postpositivist view that objectivity and control are important, but reality is multidimensional and contextual, and objectivity and subjectivity are desirable -roy, watson, erickson -integrative/interactive relationships=both directions (ex. stress causes pain and pain can cause stress however stress can cause hypertension but BP can not cause stress) -change happens simultaneously -context is part of the situation however humanism involves the energy of person just being there effecting their environment

-Unitary-transformative paradigm: view humans as unitary beings, which are self-evolving and self-regulating and are always interacting with self evolving energy system; not known as the sum of their parts, rather known by their patterns of energy and ways of being distinct from each other

-Simplified newman's categorization to represent worldview based on tx of change -Reaction worldview, Reciprocal interaction, Simultaneous action.

-Rxn worldview: beings are biopsychosocial spiritual beings who react to environment in a causal way; interaction changes predictably and controllably as humans survive and adapt, phenomena is observable and measurable

- reciprocal interaction: beings are holistic who interact reciprocally with environment; reality of multidimensional, contextual, and relative -reaction is more concrete (people react in a way you expect them too, is a casual way) -reciprocal rxn= the nature of the relationship

- Simultaneous action: beings are unitary who are constantly interacting, changing and evolving with the environment; change is unidirectional and unpredictable -linear= unidirectional -simultaneous is more broad and abstract

- reveals the foundations of theorist's ideas -experience and speciality also influenced theoretical perspective -placement of author in historical and conceptual perspective promotes understanding of the extant views of science during the time which the theory was written

- background of scholar contributes to philosophical basis and paradigmatic origins -the education reflects in theory -personal philosophies reflects in theory

- it is the substance of the formulation -direct practice, assist with selection of concepts to be studied, generate collateral theories -assumptions will be spelled out or inferred and indicate strength of the theory -concepts are defined and explained, along with derivation→ determining the essence of the theory -relationships between concepts, their strength and whether they are positive/negative/neutral indicate structure of the theory

- in reviewing usefulness, grand theories are not very useful due to scope and level of abstraction and can not be tested, but can lead to testable theories

-testability should be disprovable, questionable and tested through research= most reliable guides for scholarly work -grand theories that are testable lead to middle range theories

-parsimony is important because the more complex the theory, the less easier is to understand - tf the theorist should apply the simplest explanation as possible for understanding of the theory (ex. using well accepted and known theories instead of new hypothesis) -the more parsimonious the theory, the more in depth and complicated the theory is - it is important in assisting with the derivation of methods of problem solving

-look at how the grand theory directs holistic and comprehensive nursing interventions that improve health and well being -ask "does the theory generate new knowledge?"

-user must comprehend the theory, believe in the concepts and assumptions and be able to internalize the basic philosophy of the theorist -choice of theory should fit with the user's personal ideals and requires critique for it's value in extending the professional work

- guide research, practice, education, administration