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this is a set of propositions or relational statements that describe, explain, or predict relationships among concepts that have been selected and organized as an abstract representation of some phenomenon.

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A theory

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If theory is more abstract, it is a

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grand theory

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example of grand theory (not kings)

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Theory of role concept (Roy)

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Theory of maternal role attainment in a first-time mother is an example of

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middle-range theory

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this is the Application of a theory at a more concrete level by specifying factors, such as site, specific condition, population characteristics (e.g., age, gender), and actions of the nurse

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middle-range theory

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this is when you take a theory or concept is taken and applied to a specific clinical situation --> give an example

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middle-range theory --> e.g. Theory of goal attainment in adolescent diabetic patients in the community

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Defines the scope of the discipline by identifying its central concepts --> how their theory interprets 4 concepts

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Nursing metaparadigm

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Nursing metaparadigm has Abstract set of 4 concepts:

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Person, Environment, Health, Nursing

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Person, Environment, Health, Nursing Concepts (Person, Environment, Health, Nursing) are defined more concretely by

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a selected philosophy or model. --> a researcher will define what terms mean

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how can a person/ or health be defined different with a selected philosophy or model.

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-a person could mean a single person, or a family, cultural group, community (does not always mean a single person) -health for hospice could mean comfort, different for OR -Ex. Orem's definition of nursing differs from Roy's definition of nursing

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these provide a unique perspective to philosophical questions, such as: What is nursing? (Nightingale) What is nursing expertise? (Benner) What is nature of human caring? (Watson)

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Philosophies

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theory that can only talk about one element of the nursing metaparadigm

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philosophies

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all terms: framework, model, theory, philosophy can all be used interchangeable but what word cannot

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middle-aged theory

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watson's philosophy on nature of human caring?

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if you don't do any skill (give medication) in a relational/caring way its not nursing --> any one can give an injection, its the relational experience/taking care/developing plan care/having the responsibility that makes you a nurse

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nightingale's philosophy

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cleaner environment (water, air, etc.) lead to better healing

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watson is all about

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theory of caring

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what is benner's philosophy

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the novelist expert model

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what is the benner's novelist expert model

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you start at a novice level (such as a nursing student) see everything concretely (black and white) such as formal procedures, text book for guidance, etc. until you become an expert where you can make judgments on your feet, more proficient, independent, abstract thinker

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facts on philosophies

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Set forth a general meaning of nursing or some specific nursing phenomena Are of a philosophical nature dealing with values, nature, knowledge development Are comprehensive (broad) in their view May address only one of concepts in metaparadigm

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these are broad, conceptual structures that offer a set of highly abstract, related constructs to explain phenomena of interest. They express assumptions and assume a philosophical stance

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Conceptual models

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t or f Conceptual models cannot be directly tested, and cannot be used alone as a framework for a study.

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true, they only Serve as an organizing framework for viewing all concepts in the metaparadigm

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A model combined with a _____ may provide a framework for research.

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theory

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these cover entire scope of what nursing is/ the nursing metaparadigm

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Conceptual models

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Conceptual models can be showed in some types of

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-figures and or -illustrations (will show how concepts are all interrelated)

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these -Provides a unique perspective of the person you are caring for and specifies the approach to be taken in delivery of nursing care -Provide a structure for critical thinking, reasoning, and decision-making

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Conceptual models

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examples of Conceptual models

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Johnson; King; Levine; Neuman; Orem; Roger; Roy

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-this is Derived from a philosophy or a conceptual model -Still abstract; often name is consistent with the model from which it is derived -proposes a specific outcome is expected in association with application of the theory

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grand theory

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grand theory aka

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kings model

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abstract vs concrete

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- broad -black and white

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examples of grand theories

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Theory of Goal Attainment (King's Model) Parse's Theory of Human Becoming (Derived from Roger's conceptual model - the Science of Unitary Human Beings)

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what is Theory of Goal Attainment (King's Model)

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idea tha nurses and patients work toward a goal such as discharge or understanding medication

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what is Parse's Theory of Human Becoming (Derived from Roger's conceptual model - the Science of Unitary Human Beings)

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experiences day in and out make you who are, you change who you are every day as a person d/t experiences, surroundings, internal/physiological resources

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Abstract, logical structure to guide a study- developing theory

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framework

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..utilizes a testable theory; may be from a conceptual model (frame work that *tests a theory*)

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Quantitative research

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...utilizes a philosophy or world view; theory generated from the study outcomes should be consistent with the philosophy (frame work that gets data first, then *develops a theory*)

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Qualitative research

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study where the Evidence of the framework is clearly noted throughout various steps of the study- researcher will literally stat what theory/and what concepts of theory is guiding your study/ they are using

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explicit

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study where No framework is identified; or if one is identified, it isn't actually utilized throughout the study (you have to make an inference of what theoretical foundation of study it is?)

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Implicit (quantitative research is more guilty in failing to identify their framework)

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A pictorial or diagrammatic representation of the interrelationships among the concepts of a study.

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conceptual mapping

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conceptual mapping does not have to be a model, is your interpretation of concepts of a theory/ making connections between:

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- theory concepts - study variables - empirical indicators

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t or f people usually don't study entire list of concepts in a study usually just one. for example with Roys people would only study self concept

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true

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when selecting a study framework..

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Think about your own philosophy related to the nursing metaparadigm Read existing theories/models. Think about which one(s) are consistent with your own philosophy and your problem area of interest READ studies related to your area of interest? What theories have been used? Develop relational statements/hypotheses. Develop a concept map.

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Is a philosophy; 10 carative factors or nurse-relationship with patients

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Watson Philosophy and Science of Caring

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Need to identify person's perceptions of benefits and barriers to health-promoting behaviors

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Pender's Health Promotion Model

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Health need of person is the self-care deficit; 3 nursing systems - wholly compensatory, partly compensatory, educative-supportive. Nurse's role is to care for person until person can resume self-care

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Orem Self-care Deficit Theory

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define wholly compensatory, partly compensatory, educative-supportive with Orem Self-care Deficit Theory

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wholly- just the nurse partly- nurse helps but pt is starting to help care for self educative- (discharge teaching/ USED MOST)

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theory all about *self care*

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Orem Self-care Deficit Theory --> see a lot with discharge teaching

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nurse's role in Orem Self-care Deficit Theory

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teach people how to care for themselves ( change their dressings, inject insulin,monitor their glucose etc.)

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this identifies the focal stimulus to be the event that requires adaptation. The person adapts using 4 adaptive modes

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Roy's Adaptation Model

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4 adaptive modes of Roy's adaptation model

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physiological, self-concept, role function, and interdependence.

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The role of the nurse in Roy's Adaptation Model is

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to assist the person to adapt in a way that promotes positive outcomes, adapt the best way they can

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part of Roy's Adaptation Model that requires you to make a change or adapt

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focal stimuli

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example of physiological adaptation (Say with preterm birth)

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post partum healing

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example of focal stimuli

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fire or an accident

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define self concept in RAM

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who you think about the situation/ how they feel (emotional/psychological response)

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given an example of how you would measure self concept with preterm birth

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maternal bonding scale (are they depressed, anxious)

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define role function in RAM

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can you continue that role... as a mother, their job, relationship with husband, etc.

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define interdependence in RAM

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not used often, more like how you fit in the world, if you accomplish what you wanted, etc.

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with RAM a person can either adapt positively leading to

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optimal outcomes

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with RAM a person can either adapt negatively leading to

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adverse reactions (happens if nurse doesn't help adapt)

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things that can influence adapting such as

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regulators and cognators?

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what are regulators

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any physical being (nutrition, immunizations, immune system etc.) --> can't do anything about it

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what are cognators

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what you have learned- knowledge, ex- knowledge about s/s on how to prevent sickness or injury

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Person is at the core; has flexible and inflexible lines of defense against stressors (can be illness, emotional trauma, etc). Systems theory influence evident in constant energy exchange between person and their internal and external environment.

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Neuman's System Model

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Role of the nurse is in Neuman's System Model

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strengthen the lines of defense so person returns to wellness through intervention that include levels of primary, secondary, and tertiary prevention

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primary, secondary, and tertiary prevention in r/t to Neuman's System Model

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people need information for types of prevention levels in order to fight illness/ defense against it or injury

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theory that people have the ability to resist a disease/ genetic factors that are prone or not prone to develop conditions

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Neuman's System Model

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Role of nurse is to place the person in the best environment so that natural healing can occur

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Nightingale's Environmental Theory

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Nurse provides information to assist with attaining goals and *making decisions*

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King's Theory of Goal Attainment

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this is when the nurse interacts with the patient and the nurse believes what she is telling the patient, patient receives it in a certain way, reacts, processes, comes to a decision such as (for example have procedure/ test done)

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King's Theory of Goal Attainment

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what is the nurse's role in Pender's Health Promotion Model

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you can teach people all you want on healthy behaviors, preventing illness/injury, etc. but a nurse must focus on making the benefit of performing healthy behaviors greater than the rationalization of the barrier ( benefit of smoking is relaxing is better than the feeling they are going to feel when trying to quit/ work too much to exercise)

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Focus is on understanding how a person's culture influences beliefs and practices related to health and health care; nurse needs to provide culturally competent care

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Leininger's Theory of Culture Care/ Sunrise model

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what should a nurse keep in mind about culture with Leininger's Theory of Culture Care

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provide culturally competent care/ keep in mind relationships, language, communication, decision processes, economics, education (only men receive it in some cultures)

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theory where the nurses role is to help people physically and psychologically during times of uncertainty

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Mishel's Uncertainty in Illness

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what are times of uncertainty in the theory Mishel's Uncertainty in Illness that a nurse can help with

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cancer remission or MS (with exacerbations) - can happen even when in a healthy phase

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theory where the role of the nurse is to provide comfort whether it is psychological or physical

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kolcaba theory

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theory where you enter a relationship when you meet patient in a psych setting but get to a point where it is no longer needed (resolution)

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peplau (under watson)

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Emotional response is a construct, in r/t this what would be a concept

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Grief is a concept (it is less abstract than an emotional response which could mean anything)

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The study variable would be grief responses to sudden loss of spouse (very concrete and specific)

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hoerst

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the abstract or theoretical meaning of a concept under study for example: stress

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conceptual definition

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the definition of a concept or variable in terms of the procedures by which it is to be measured for example: Blood pressure

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operational definitions

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Theories and models represent an explanation of the relationship of concepts identified by the theorist to be part of some phenomenon

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hoerst

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this abstractly describes and names a phenomenon; providing it with a separate identity or meaning.

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A concept --> construct and variable are types of concepts

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If term has a general, abstract meaning...it is a

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construct ex: emotional response

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If term is more concrete, I.e., can be defined so as to be measurable, it is a

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variable

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if the construct is emotional response a concept would be : a variable would be:

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- anxiety - visual analog scale (measures anxiety)

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an approach to correcting and analyzing qualitative data that aims to develop theories about social psychological processes grounded in real-world observations

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grounded theory

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more comprehensive than a dictionary definition; researcher defines the concept including selected associated meanings

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Conceptual definition

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Processes of defining a concept include:

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Concept synthesis Concept derivation Concept analysis

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Process of defining a concept: Describing and naming a previously unrecognized concept

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Concept synthesis

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Process of defining a concept: Modifying a concept from another discipline for suitability in nursing

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Concept derivation

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Process of defining a concept: Identifying a set of characteristics that are essential to the connotative meaning of the concept

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Concept analysis

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melies theory of transition

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certain points in people's life that requires them to get through transitional period (could be developmental)

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example of melies theory of transition

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child has sickle cells turns 16- go to real doctor no longer pediatrician, now is making decisions for self or turns 18 and is now getting all the health info

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nurse's role in melies theory of transition

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take into account resources they have for transitional period such as transitional programs (these can help jump from one care to the other)

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theories nursing uses that aren't nursing studies but are appropriate to use

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borrowed theory

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examples of borrowed theory

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-developmental theory (psychological theory not nursing) -gate theory of pain - change theory? -social cognitive theory -trans-theorectical mode -epidemiological triad/model on infection control are all psych, sociology, or medicine theories not nursing

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when a borrow theory is used so much in nursing such as the Lazarus and folk man stress and coping theory it is called

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a shared theory

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theory of pain asserts that non-painful input (such as massage or breathing exercises, guided imagery) closes the "gates" to painful input, which prevents pain sensation from traveling to the central nervous system.

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gate theory of pain

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objective theories

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- make new finding meaningful - integrate knowledge into coherent systems - to stimulate new research - explain relationships among phenomenons

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