Nursing Theories – An Overview

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Theory
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A group of related concepts that propose action that guide practice. Composed of concepts, definitions, models , propositions and are based on assumptions. Derived through two principal methods: 1) Deductive reasoning 2) Inductive reasoning. Is “a creative and rigorous structuring of ideas that projects a tentative, purposeful, and systematic view of phenomena” Makes it possible to “organize the relationship among the concepts to describe, explain, predict, and control practice”
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Nursing Theory
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A set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing. Barnum(1998)—- “attempts to describe or explain the phenomenon (process, occurrence and event) called nursing”
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Kerlinger
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Views theories as a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or event) that is explanatory and predictive in nature.
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Concepts
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Basically vehicles of thought that involve images Words that describe objects , properties, or events and are basic components of theory.
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Types of Concepts
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Empirical concepts Inferential concepts Abstract concepts.
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Models
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Representations of the interaction among and between the concepts showing patterns.
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Propositions
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Statements that explain the relationship between the concepts
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Process
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A series of actions , changes or functions intended to bring about a desired result . During a process one takes systemic and continuous steps to meet a goal and uses both assessments and feedback to direct actions to the goal.
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Importance of Nursing Theories
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Nursing theory aims to describe, predict and explain the phenomenon of nursing. It should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future (Brown 1964). Theory is important because it helps us to decide what we know and what we need to know (Parsons1949). It helps to distinguish what should form the basis of practice by explicitly describing nursing. The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education (Nolan 1996). In addition, because the main exponent of nursing – caring – cannot be measured, it is vital to have the theory to analyze and explain what nurses do. As medicine tries to make a move towards adopting a more multidisciplinary approach to health care, nursing continues to strive to establish a unique body of knowledge. This can be seen as an attempt by the nursing profession to maintain its professional boundaries.
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THE CHARACTERISTICS OF THEORIES
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interrelate concepts in such a way as to create a different way of looking at a particular phenomenon. are logical in nature. are generalizable. are the bases for hypotheses that can be tested. increase the general body of knowledge within the discipline through the research implemented to validate them. are used by the practitioners to guide and improve their practice. are consistent with other validated theories, laws, and principles but will leave open unanswered questions that need to be investigated
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General System Theory
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It describes how to break whole things into parts and then to learn how the parts work together in ” systems”. These concepts may be applied to different kinds of systems, e.g.. Molecules in chemistry , cultures in sociology, organs in Anatomy and health in Nursing.
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Adaptation Theory
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It defines adaptation as the adjustment of living matter to other living things and to environmental conditions. Adaptation is a continuously occurring process that effects change and involves interaction and response. Human adaptation occurs on three levels: — the internal ( self ) — the social (others) — and the physical ( biochemical reactions )
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Developmental Theory
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It outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. The progress and behaviors of an individual within each stage are unique. The growth and development of an individual are influenced by heredity , temperament, emotional, and physical environment, life experiences and health status.
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COMMON CONCEPTS IN NURSING THEORIES
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The person( patient) The environment Health Nursing (goals, roles, functions) Of the four concepts, the most important is that of the person. The focus of nursing, regardless of definition or theory, is the person.
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Nightingale
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To facilitate “the body’s reparative processes” by manipulating client’s environment
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Paplau
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Nursing is; therapeutic interpersonal process.
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Henderson
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The needs often called Henderson’s 14 basic needs
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Abdellah
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Emphasizes delivering nursing care for the whole person to meet the physical, emotional, intellectual, social, and spiritual needs of the client and family.
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Orlando
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The client is an individual; with a need; that, when met, diminishes distress, increases adequacy, or enhances well-being.
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Johnson’s Theory
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How the client adapts to illness and how actual or potential stress can affect the ability to adapt. The goal of nursing to reduce stress so that; the client can move more easily through recovery.
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Rogers
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To maintain and promote health, prevent illness, and care for and rehabilitate ill and disabled client through “humanistic science of nursing”
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Orem
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This is self-care deficit theory. Nursing care becomes necessary when client is unable to fulfill biological, psychological, developmental, or social needs.
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King
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To use communication to help client reestablish positive adaptation to environment.
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Neuman
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Stress reduction is goal of system model of nursing practice.
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Roy
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This adaptation model is based on the physiological, psychological, sociological and dependence-independence adaptive modes.
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Watson’s Theory
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Watson’s philosophy of caring 1979 attempts to define the outcome of nursing activity in regard to the; humanistic aspects of life.
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CLASSIFICATION OF NURSING THEORIES
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Metatheory: the theory of theory. Identifies specific phenomena through abstract concepts. Grand theory: provides a conceptual framework under which the key concepts and principles of the discipline can be identified. Middle range theory: is more precise and only analyses a particular situation with a limited number of variables. Practice theory: explores one particular situation found in nursing. It identifies explicit goals and details how these goals will be achieved. Theories can also be categorised as: “Needs “theories. “Interaction” theories. “Outcome “theories. “Humanistic theories”
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“Needs” theories
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These theories are based around helping individuals to fulfill their physical and mental needs. The basis of these theories is well-illustrated in Roper, Logan and Tierney’s Model of Nursing (1980). Needs theories have been criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position.
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“Interaction” theories
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These theories revolve around the relationships nurses form with patients. Such theories have been criticized for largely ignoring the medical model of health and not attending to basic physical needs.
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“Outcome” theories
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These portray the nurse as the changing force, who enables individuals to adapt to or cope with ill health (Roy 1980). Outcome theories have been criticized as too abstract and difficult to implement in practice (Aggleton and Chalmers 1988).
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“Humanistic” Theories
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Humanistic theories developed in response to the psychoanalytic thought that a person’s destiny was determined early in life. Humanistic theories emphasize a person’s capacity for self actualization. Humanists believes that the person contains within himself the potential for healthy and creative growth. Carl Rogers developed a person -centered model of psychotherapy that emphasizes the uniqueness of the individual. The major contribution that Rogers added to nursing practice is the understanding that each client is a unique individual, so person-centered approach now practice in Nursing.
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CATEGORIES OF CONCEPTUAL MODELS
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Ten conceptual models of nursing have been classified according to two criteria: 1. The world view of change reflected by the model (growth or stability); and 2. The major theoretical conceptual classification with which the model seems most consistent (systems, stress/adaptation, caring, or growth/development).

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