Chapter 4: Theoretical Foundations (Week 1)

Question 1

What is Domain?

Answer 1

Perspective of a profession. Provides practical and theoretical orientations for a discipline

Question 2

Paradigm

Answer 2

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.

Question 3

Nursing’s paradigm links what

Answer 3

Person, health, environment/situation and nursing

Question 4

Describe what physicians in medicine do vs. what nurses do

Answer 4

M.Ds = Diagnose and treat disease
Nursing = Diagnose and treat human responses to actual or potential health problems — looks for ways to prevent disease

Question 5

Theory

Answer 5

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

Question 6

What does theory link with

Answer 6

Inquiry

Question 7

Nursing theory

Answer 7

Conceptualization of some aspect of nursing. Communicates the purpose of describing, explaining, predicting and/pr prescribing nursing care

Question 8

How/Why does nursing theory help nurses

Answer 8

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 

Question 9

What are the components of a theory

Answer 9

1. Phenomenon
2. Concepts
3. Definitions
4. Assumptions

Question 10

Explain what the phenomenon component of a theory is

Answer 10

An aspect of reality that people consciously sense or experience - it includes caring, self-care, patient response to stress

Question 11

Explain what the concepts component of a theory is

Answer 11

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

Question 12

Explain the definitions component of a theory

Answer 12

Communicate the general meaning of a concept and describe

Question 13

Explain the assumptions component of a theory

Answer 13

Are taken for granted statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory 

Question 14

What are the different types of theories?

Answer 14

Grand theories
Middle range theories
Descriptive theories
Prescriptive theories 

Question 15

Grand theories

Answer 15

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

Question 16

Middle range theories

Answer 16

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 

Question 17

Descriptive theories

Answer 17

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 

Question 18

Prescriptive theories

Answer 18

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 

Question 19

What is the relationship of theory to nursing practice? 

Answer 19

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

Question 20

Interdisciplinary theories 

Answer 20

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 

Question 21

Systems theory

Answer 21

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.

Question 22

What are the three components of a systems theory in relationship to the nursing process

Answer 22

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.

Question 23

Maslow’s hierarchy of needs

Answer 23

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.

Question 24

What do developmental theories help us determine

Answer 24

if clients are adapting during their specific developmental stage in life

Question 24

Psychosocial theories

Answer 24

Predict client responses to their physiological, psychological, sociocultural, developmental and spiritual needs

Question 25

What was Nightingales Theory

Answer 25

Came up with the first nursing theory
Grand theory Focused on patient environment

Question 26

Peplau’s theory

Answer 26

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)

Question 27

Orem theory

Answer 27

Grand theory that assesses patient’s ability to self care

Question 28

Leininger theory

Answer 28

Middle range theory focused on cultural care diversity and universality
Goal is to provide culturally specific nursing care

Question 29

Henderson

Answer 29

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

Question 30

Rogers

Answer 30

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

Question 31

Roy

Answer 31

Grand theory
focused on adaptation

Question 32

Watson

Answer 32

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

Question 33

Benner

Answer 33

Middle range theory
Focused on skill acquisition
Nurses progress through 5 stages

Question 34

What is the link between theory and knowledge development

Answer 34

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.

Question 35

What is the nursing process

Answer 35

1. 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.
2. Determine the patient’s problems from the assessment and determine a nursing diagnosis, i.e. impaired tissue integrity (pressure ulcer, stage 2).
3. What do we want to happen? Outcome, pressure ulcer will not progress to a stage 3 while hospitalized.
4. Planning, how will we prevent the ulcer from progressing?
5. Implement: Make sure the plan is passed on from shift to shift and nurse to nurse
6. Evaluate: Did we meet our goal? Did the ulcer progress, stay the same, or shrink?