Chapter 4: Theoretical Foundations (Week 1) Flashcards
What is Domain?
Perspective of a profession. Provides practical and theoretical orientations for a discipline
Paradigm
A paradigm is useful in describing the domain of a discipline. A paradigm links science, philosophy, and theories accepted and applied by a discipline. Nursing’s paradigm links: person, health, environment/situation, and nursing.
Nursing’s paradigm links what
Person, health, environment/situation and nursing
Describe what physicians in medicine do vs. what nurses do
M.Ds = Diagnose and treat disease
Nursing = Diagnose and treat human responses to actual or potential health problems — looks for ways to prevent disease
Theory
Set of concepts, definitions and assumptions/propositions that explains a phenomenon. Constitutes much of the knowledge of a discipline
Guides the design of nursing interventions
What does theory link with
Inquiry
Nursing theory
Conceptualization of some aspect of nursing. Communicates the purpose of describing, explaining, predicting and/pr prescribing nursing care
How/Why does nursing theory help nurses
It does the following:
1) a perspective to view patient situations, 2) a way to organize data and 3) a method to analyze and interpret information.
Theories guide the design of nursing interventions 
What are the components of a theory
- Phenomenon
- Concepts
- Definitions
- Assumptions
Explain what the phenomenon component of a theory is
An aspect of reality that people consciously sense or experience - it includes caring, self-care, patient response to stress
Explain what the concepts component of a theory is
Concepts may bee simple or complex. May relate to an object or event with individual experiences are ideals mental images
It helps describe/label phenomena
Explain the definitions component of a theory
Communicate the general meaning of a concept and describe
Explain the assumptions component of a theory
Are taken for granted statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory 
What are the different types of theories?
Grand theories
Middle range theories
Descriptive theories
Prescriptive theories 
Grand theories
Broad in scope, complex, and requires specifications through research
A grand theory does not provide guidelines for specific nursing interventions, but provides the structural framework for broad and abstract ideas related to nursing 
Requires further clarification through research
Middle range theories
They are more limited in scope and less abstract
The address of specific phenomenon, and reflect practices of administration, clinical interventions, or teaching
These types of theories cross different nursing fields and reflect a wide variety of nursing care situation such as uncertainty, incontinence, social support, quality of life, and caring 
Descriptive theories
The first level of theory development
They describe phenomena, speculate, on why phenomena occur, and describe the consequences of phenomena
These theories do not direct specific nursing activities, but help to explain patient assumptions 
Prescriptive theories
Address nursing interventions for a phenomenon, and predict the consequence of a specific nursing intervention
In nursing this type of theory, designates the nursing intervention, the condition, under which the nursing intervention occurs, and the consequences of the intervention
These theories guide, nursing research to develop and test specific nursing interventions 
What is the relationship of theory to nursing practice? 
The nursing process is the basis of nursing practice. However, the nursing process is not a theory. It is a systematic set of steps for the delivery of nursing care, not the knowledge component of our discipline.
Remember that a theory can direct how a nurse uses the nursing process
Theories generate nursing knowledge for use in practice and are adaptable to different patients and all care settings
Interdisciplinary theories 
These theories explain, systematic views of phenomenon, specific to the discipline of inquiry
It includes systems theory, basic human needs which is Maslows theory, developmental theories, and psychosocial theories 
Systems theory
This is an interdisciplinary theory
Is comprised of different components Marx/ Darwin The systems theory can be open or closed.
Open theory interacts with the environment, exchanging information between the system and the environment. Examples of an open system include: human organism, nursing process..
A closed system does not interact with the environment.
What are the three components of a systems theory in relationship to the nursing process
Systems have three components: input, output, and feedback
Input for the nursing process is the data or information obtained from assessment.
Output is the end product, which indicates whether the patient’s health status improves or remains stable as a result of nursing care rendered.
Feedback is reflected by outcomes, which are the patient’s response to nursing interventions.
Maslow’s hierarchy of needs
Interdisciplinary theory
The five needs in order are: 1) physiological, 2) safety and security, 3) love and belonging, 4) esteem and self-esteem and 5) self-actualization.
What do developmental theories help us determine
if clients are adapting during their specific developmental stage in life
Psychosocial theories
Predict client responses to their physiological, psychological, sociocultural, developmental and spiritual needs
What was Nightingales Theory
Came up with the first nursing theory
Grand theory Focused on patient environment
Peplau’s theory
Mother of psychiatric nursing
Middle range theory
focused on interpersonal relations - pre-orientation (data gathering), orientation (defining issue), working phase (therapeutic activity) and resolution (termination of relationship)
Orem theory
Grand theory that assesses patient’s ability to self care
Leininger theory
Middle range theory focused on cultural care diversity and universality
Goal is to provide culturally specific nursing care
Henderson
Grand theory
Principles and practice of nursing
Nurses assist patients with 14 activities until patients can meet these needs for themselves or they help patients have a peaceful death
Rogers
Grand theory
Unitary beings/human becoming/expanding consciousness
Nurses view a patient as a unique, dynamic energy field in constant energy exchange with the environment
Nurses role is to be present with the patient and accept their view of reality while providing guidance
Roy
Grand theory
focused on adaptation
Watson
Grand theory
Focused on caring. Purpose of nursing is to understand the interrelationships among health, illness, and human behavior rather than focus on the disease
Benner
Middle range theory
Focused on skill acquisition
Nurses progress through 5 stages
What is the link between theory and knowledge development
Nursing knowledge is theoretical and practical.
Theories provide direction to nursing research.
Nursing theory and nursing research build nursing’s knowledge base.
The goals of theoretical knowledge are to stimulate thinking and create a broad understanding of the science and practice within the nursing discipline. The practical knowledge, or art, of nursing is based on the nurse’s experience in providing care to patients.
The relationship between nursing theory and nursing research helps to build nursing’s knowledge base.
What is the nursing process
- The cornerstone of the Nursing Process is assessment. The nurse cannot determine a nursing diagnosis if he/she does not have a place to start.
- Determine the patient’s problems from the assessment and determine a nursing diagnosis, i.e. impaired tissue integrity (pressure ulcer, stage 2).
- What do we want to happen? Outcome, pressure ulcer will not progress to a stage 3 while hospitalized.
- Planning, how will we prevent the ulcer from progressing?
- Implement: Make sure the plan is passed on from shift to shift and nurse to nurse
- Evaluate: Did we meet our goal? Did the ulcer progress, stay the same, or shrink?
