Chapter 4: Theoretical Foundations of Nursing Practice

Question 1

Nursing metaparadigm:

Answer 1

person (or human beings)

health

environment/situation

nursing

Question 2

Grand theories:

Answer 2

abstract, broad in scope, complex

provides the structural framework for general, global ideas about nursing

Requires further clarification through research so they can be applied in nursing practice

Question 3

Middle-range theory:

Answer 3

limited in scope, less abstract

SPECIFIC PHENOMENON and REFLECT PRACTICE

Focuses on a concept found in specific field of nursing such as UNCERTAINTY, INCONTINENCE, SOCIAL SUPPORT, QUALITY OF LIFE and CARING rather than reflect on a wide variety of nursing care situations

Question 4

Practice theories:

Answer 4

situation-specific theories

BRING THEORY TO BEDSIDE

Narrow in scope and focus

specific population at a specific time

“pain management protocol for patients recovering from cardiac surgery”

Question 5

Descriptive theories:

Answer 5

describe phenomena and identify circumstances in which the phenomena occurs

example: theories of growth and development describe the maturation process

Question 6

Prescriptive theories:

Answer 6

nursing interventions for a phenomenon

guide practice change and predict consequences

used to anticipate the OUTCOMES of nursing interventions

Question 7

Shared theory:

Answer 7

explains a phenomenon specific to the discipline that developed the theory

Piaget’s theory of cognitive development helps to explain how children think, reason and see the world

Question 8

Hildegard Peplau:

Answer 8

Mother of psychiatric nursing

Middle-range theory includes INTERPERSONAL relations among a NURSE, PATIENT, PATIENT’S FAMILY and developing the NURSE-PATIENT relationship

4 phases characterize the nurse-patient interpersonal relationship

• preorientation(data gathering)
• orientation (defining issue)
• working phase (therapeutic activity)
• resolution (termination of relationship)

Question 9

Roy:

Answer 9

Grand theory-ADAPTATION

nurses help a patient cope with or adapt to changes in physiological, self-concept, role function and interdependence domains

Question 10

Erickson-Tomlin-Swain

Answer 10

Grand theory-MODELING/ROLE MODELING

Nurses understand a patient’s model of the world or world view and helps a patient use internal/external resources to make changes (role modeling) to attain optimal health

Question 11

Watson:

Answer 11

Grand theory-CARING

10 Carative factors
Purpose of nursing is to understand the interrelationship among health, illness and human behavior rather than focus on the disease-cure model

Question 12

Benner:

Answer 12

middle range theory- skill acquisition

nurses progress through 5 stages of skill acquisition

1) novice
2) advanced beginner
3) competent
4) proficient
5) expert

Question 13

Kolcaba:

Answer 13

Middle-range theory- COMFORT

Nurses facilitate health seeking behaviors in patients by striving to relieve physical, emotional, social, environmental and spiritual distress

Question 14

Mishel

Answer 14

Middle-range theory: UNCERTAINTY IN ILLNESS

Nurses facilitate patient COPING and ADAPTATION by performing interventions aimed at helping patients process and find meaning related to their illness

Question 15

Leininger

Answer 15

Middle-range-CULTURE CARE THEORY

cultural diversity and the goal of nursing care is to provide patient with CULTURALLY SPECIFIC NURSING CARE

recognizes importance of culture and its influence on everything that involves a patient, including health beliefs, role of family and community and dietary practice

Question 16

Orem’s theory:

Answer 16

Grand theory-self-care deficit nursing theory

patients who participate in self-care activities are more likely to improve health outcomes