Introduction to Nursing Theory: Its History and Significance Flashcards
1
Q
the beginning of nursing theory development can be traced to
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Florence Nightingale
2
Q
is the backbone of clinical care
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nursing theory
3
Q
highlights of significant events in this history
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Florence Nightingale, The Columbia School (1950s), The Yale School (1960s), the 1970s, The 1980s, The 1990s
4
Q
presents the first nursing theory that focuses on the manipulation of the environment for the benefit of the patient
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Nightingale’s Notes on Nursing
5
Q
The Eras of Nursing Knowledge
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Curriculum Era, Research Era, Graduate Education Era, Theory Era, Theory Utilization era
6
Q
- is specific to academia
- refers to a branch of education
- department of learning
- domain of knowledge
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discipline
7
Q
- a specialized field of practice founded on the theoretical structure of the science of knowledge of the discipline and accompanying practice abilities.
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profession
8
Q
led to the recognition of nursing as an academic discipline and a profession
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nursing theories
9
Q
this era emphasizes on courses included in nursing programs
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Curriculum Era 1900-1940
10
Q
This era emphasizes role of nurses and what to research
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Research Era 1950-1970
11
Q
the goal is to develop specialized knowledge and higher education
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Curriculum Era
12
Q
(emerging goal) Isolated studies do not yield unified knowledge
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Research Era
13
Q
emphasis is caving out an advanced role and basis for nursing practice
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Graduate Education Era (1950 - 1970)
14
Q
(Emerging Goal) Focus graduate education on knowledge development.
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Graduate Education Era
15
Q
The emphasis is that there are many ways to think about nursing
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Theory Era: 1980-1990s
16
Q
emphasis is that nursing theory guides research, practice, education, and administration
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Theory Utilization Era (21st century)
17
Q
(Emerging Goal) Theories guide nursing research and practice.
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(Emerging Goal) Theories guide nursing research and practice.
18
Q
emerging goal for this era is that, nursing frameworks produce knowledge
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Theory Utilization Era
19
Q
the gratest significance of nursing theory is that
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nursing was recognized as an academic discipline and profession.
20
Q
the significance of theory for the discipline of nursing is tha
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the discipline is dependent on theory for its continued existence — that is, nursing can be vocation, or nursing can be a discipline with a professional style of theory-based practice
21
Q
regards reason as the chief source and test of knowledge
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Rationalism
22
Q
any view appealing to reason as a source of knowledge or justification
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Rationalism
23
Q
methodology or a theory “in which the criterion of truth is not sensory but intellectual and deductive”
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rationalism
24
Q
based on the central idea that scientific knowledge can be derived only from sensory experience (i.e seeing, feeling, hearing facts)
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Empiricism
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inductive inquiry (empiricism) uses
research-then-theory approach
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deductive inquiry (rationalism) uses
theory-then-research approach
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describes how we experience the objects of the external world and provides an explanation of how we construct objects of experience
Phenomenology
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focuses on discovering patterns that may describe, explain, and predict phenomena.
Postpositivism
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tends to promote understanding by addressing the meanings of the participant's social interaction that emphasize the situation, context, and multiple cognitive constructions individuals create from everyday experiences
interpretative paradigm
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views the biophysical, psychological, and sociological subsystems as related but separate; thus the whole is equal to the sum of the parts
Wholism nursing
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multiple subsystem are in continuous interaction and that mind-body relationships do exist
holistic nursing
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has a metaphysical component that implies that the natural world exists; there is no nonnatural supranatural realm.
Naturalism
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it is a methd for describing, explaining, and predicting causes or outcomes of interventions.
science is important because
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two competing philosophical perspectives used in science are
rationalism and empiricism
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a term or label that describes a phenomenon or group phenomena
concept
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highest level of abstraction
metaparadigm
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can be either observed or experienced through the senses
empirical concept
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abstract concept
one that is not observable, such as hope or caring
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the most global perspective of a discipline
metaparadigm
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the global concepts that identify the phenomenon of central interest to a discipline, the global propositions that describe he concepts, and the global propositions that state the relations between or among the concepts
metaparadigm
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he metaparadigm concepts for the discipline of nursing are as follows
person (human being), environment, health, nursing
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individuals, families, communities, and other groups who are participants in nursing
human being or person
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human being's significant others and physical surroundings as well as local, regional, national and worldwide, cultural, social, political, and economic conditions that are associated with human being's health.
Environment
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human process of living and dying
health
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the actions taken by the nurses in behalf of or in conjunction with human beings, and the goals or outcomes of nurisng actions; the process of which encompasses activities that are referred to as assessment, diagnosis (labeling), planning, ntervention, and evaluation
nursing
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the actions taken by the nurses in behalf of or in conjunction with human beings, and the goals or outcomes of nurisng actions; the process of which encompasses activities that are referred to as
assessment, diagnosis (labeling), planning, intervention, and evaluation
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set forth the general meaning of nursing and nursing phenomena through reasoning and the logical presentation of ideas
philosophies of nursing
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are broad and address general ideas about nursing
philosophies
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it contributes to the discipline by providing direction, clarifying values, and forming a foundation for theory development
philosophies
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Conceptual Models of Nursing can also be called
Paradigms or Frameworks
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are composed of abstract and general concepts and propositions that provide a frame of reference for members of the discipline
conceptual models
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a set of concepts and statements that integrate the concepts into a meaningful configuration
conceptual model
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are accepted as truth and represent the values and beliefs of the theory or concepts framework.
assumptions
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form the basis for defining concepts and framing propositions
assumptions
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is a statement about a concept or statement of the relation between two or more concepts
proposition
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using a conceptual model or framework also helps to provide consistency in nursing by
facilitating communication and provides a mechanism for engaging in a systematic approach to nursing research, education and practice
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a conceptualization of some aspect of reality (invented or discovered) that pertains to nursing
nusing theory
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the primary distinction between a conceptual model and a theory is
level of abstraction
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the theory that is broad in scope and highly abstract conceptually may be referred to as
grand theory
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difference between conceptual models and nursing theories
a conceptual model is highly abstract system of global concepts and linking statements while a theory, in contrast, deals with one or more specific, concrete concepts and propositions.
59
the theory that has a narrow scope and is more concrete or practical may be referred to as
middle range theory
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types of nursing theoretical works
nurisng philosophies, nursing conceptual models, nursing theories, grand theories, middle-range nursing theories
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examples of philosophies in nursing
Nightingale's Philosophy of Nursing (1946), Watson's Philosophy of Nursing (1979), Benner's Philosophy of Nursing (1984)
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Nightingale provides an answer to the question "What is nursing?" in her work
"Nursing: What It Is and What It Is Not"
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Nursing: What Is It and What It Is Not
distinguishes nursing from household servant of her day, draws a contrast between nursing and medicine, and specifies the concern of nursing to be healthy rather than illness
64
Watson provides a unique approach to nursing in her work
"Nursing: The Philosophy and Science of Caring"
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She called for a return to earlier values of nursing, which emphasize its caring aspects
Watson
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In this philosophical work, she sets forth theoretical proposotions for the human-to-human relationships of nursing and specifies ten carative factors to guide its application in nursing practice
"Nursing: The Philosophy and Science of Caring"
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provides a philosophical view of nursing practice that is focused on how the knowledge of practice is aqcquaired and how it develops overtime.
Benner's Philosophy of Nursing
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Examples of Nursing Models
Johnson's Behavioral System Model, King's Conceptual System, LEvine's Conservation Model, Neuman's System Model, Orem's Conceptual Model, etc.
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Examples of Nursing Theories
Orlando's Theory of Nursing Process, Modeling and Role-Modeling Nursing Theory, Mercer's Theory of Becoming a Mother
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are methods used to study nursing theoretical works critically
analysis, critique and evaluation
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is carried out to acquire knowledge of theoretical adequacy
analysis of theory
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it is an important process and the first step in applying nursing theoretical works to education, research, administration or practice
analysis of theory
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is an important process for learning, for developing research projects, and for expanding the science associated with theoretical works of nurisng in he future
analysis
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the criteria that are used for analysis of nursing conceptual models and theories are as follows:
1. Clarity
2. Simplicity
3. Generality
4. Accessibility
5. Importance
75
Refers to consistency in terms of terminology and structure
Clarity"
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"How clear is the theory?"
Clarity
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a word should be defined specifically according to the frameowrk within which it is used
clarity
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are facilitated with diagrams and examples
clarity
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the logical developmet and type of structure used should be clear, and assumptions should be stated clearly and be consistent with the goal of theory
clarity
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A theory should be sufficiently comprehensive presented at a level f abstraction to provide guidance, and have as few concepts as possible with as simplistic elation as possible to aid clarity
Simplicity
81
"How simple is the theory?"
Simplicity
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Refers to the scopes of the concepts and the purpose of the theory
Generality
83
"How general is this theory?"
Generality
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Addresses the extent to which empiric indicators for the concepts can be indentified and to what extent the purpose of the theory can be attained
Accessibility (Empirical Precision)
85
is vital to developing nursing research to test a theory
accessibility
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facilitates testing because the empirical indicators provide linkage to practice for testability and ultimate use of a theory to describe and test aspects of practice
Accessibility
87
"How accessible is this theory?"
Accessibility
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"Does this theory create understanding that is important to nursing?"
Importance (Derivable Consequences)
89
"How important is this theory?"
Importance
90
steps on Evaluation of Theory
1. an explanation of the origins of the model and examination of statements
2. exploration of the comprehensiveness of the content of the model
3. consider whether the structure of the model is logical
4. consider whether the modell will lead to further theory generation
5. focus on the credibility of the model for use in practice
6. a determination is made as to the contributions of the model to the discipline pf nursing
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considerss whether special education is required to use the model in practice
social utility
92
considers whether the model will lead to nursing activities that meet the expectations of the public
social congruence
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considers whether the model makes differences in the health conditons of the public
social significance
94
an organized, coherent, and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole.... discovered or invented for describing, prediciting or prescribing events or relationships
theory
95
the vital role of ______________ in professional nursing is greatly recognized in this theory utilization era
critical thinking
96
is the intellectually discipline process of acticely and skillfully conceptualizing, applying, anbalyzing, synthesizing, and evaluating information gathered from, or generated by observation, experience, reflection, reasoning, and communication as a guide to belief and action
Critical thinking
97
is the most recognized name in the field of nursing
Florence Nightingale
98
changed the face of nursing to create sanitary conditions for patients to get care
Environmental Theory
99
when and where was Forence Nightingale born?
May 12, 1820 in Florence, Italy
100
where did Florence Nightingale study nursing?
Kaisersworth, Germany in the Institution of Deaconesses
101
Florence Nightingale served the wounded soldiers during the
Crimean War
102
Florence Nightingale's writing, which included philosophy and directions were inspired from
a need to define nursing and reform hospital environments
103
Because of Forlence Nightingale's works in reforming nursing, she was given the title
Founder of Modern Nursing
104
Florence Nightingale established
a school of nursing at St. Thomas Hospital in England
105
Nightingale strongly advocated that
nursing knowledge is distinct from medical knowdledge
106
Nightingale's philosophy in nursing is
environement-oriented
107
Nightingale believed that the person is a ________________ and thus had a spiritual dimension
holistic individual
108
Nightingale recognized
nursing of the sick (nursing proper) and nursing of the well (nursing general)
109
In using Nightingale's theory, the nurse must consider
Nightingale's 13 Canons, health promotion and spiritual distress
110
Nightingale viewed the ________________________________________________ as a major component of nursing care
manipulation of the physical environment
111
She defined the following aspects as amjor areas of the physical, social, and psychological environment that the nurse could control:
health of houses, ventilation and warming, light, noise, variety, bed and bedding, cleanliness of rooms and walls, personal cleanliness, nutrition and taking food, chattering hopes and advices, observation of the sick, petty management
112
the social and psychological environment that affect the physical environemnt are
variety, chattering hopes and advices, and petty management
113
is closely related to the presence of pure air, pure water, efficient drainage, cleanliness and light
Health of Houses
114
Nightingale believed that it was essential to "keep the air he breathes as pure as the external air, without chilling him"
Ventilation and Warming
115
Nightingale also belived that "noxious air" or "effluvia" or foul odor affects the client's health
Ventilation and warming
116
other words for foul odor
noxious air or effluvia
117
Nightingale also emphazised the ______________. The patient should not be too warm or too cold.
importance of room temperature
118
Nightingale advocated that the sick needs both fresha ir and light --- direct sunlight was what clients wanted
Light
119
has quite real and tangible effects upon the human body
light
120
NICU
Neonatal Intensive Care Unit
121
ICCU
Intensive Coronary Care Unit
122
PACU
Post Anesthesia Care Unit
123
Nightingale belived that patients should never be waked intentionally or accidentally during the first part of sleep
Noise
124
In these modern times, noises that may irritate patients are
jewelries worn by nurses, keys that jingle, snapping of rubber gloves, the clank of the stethoscope against metal bed rails, radios, TV's, telephones ringing, machines that beep or alarm, etc.
125
Nightingale stressed that variety in the environment was a critical aspect affecting the patient's recovery
Variety
126
Nightingale agreed that the __________ greatly affects the ___________
mind, body
127
She believed that the bed should be placed in the lighte part of the room and placed so the patien could see out of the window
Bed and Bedding
128
Nightingale emphasized that "the greater part of nursing consists in preserving cleanliness
Cleanliness of Rooms and Walls
129
She believed that unwashed skin poisoned the patient and noted that bathing and rying the skin provided great relief to the patient
Personal Cleanliness
130
She has proven that attention given to the patient affected how the patient ate
Nutrition and Taking Food
131
Nightingale Percieved that falsely cheer the sick by making light of their illness and its danger is not helpful
Chattering Hopes and Advices
132
She felt strongly about the importance of obtaining complete and accurate information about patients
Observation of the Sick
133
"what you do when you are there, shall be done when you are not there"
Petty Management
134
She believed that the house and the hospital needed to be ell-managed----- that is organized, clean, and with appropriate supplies
Petty Management
135
Nightingale's report of her experiences and data was submitted to the
British Royal Sanitary Commission in "Notes on Matters Affecting the Health, Efficiency, and Hospital Adminitration of the British Army Founded Chiefly on the Experience of the Late War"
136
Nightingale's concept of environment (surroundings) is
anything that can be manipulated to place a patient in the best possible condition for nature to act
137
In most of Nightingale's writings, she referred to the peron as
patient
138
Nightingale defined _____________ as being well and using every power (resource) to the fullest extend in living life
Health
139
is being responsible for someone's health
Nursing
140
when was Notes on Nursing published originally?
in 1859
141
provide women with guidelines for caring for their loved ones at home and t gice advice on how to "think like a nurse"
Notes on Nursing
142
Nightingale recommended two essential behaviors by the nurse in the area of assessment
1. Ask the client what is needed or wanted
2. Observation
143
Nightingale belived that data should be used as the basis for forming any conclusion
Nursing Diagnoses
144
is the patient's responses to the environment and not the environmental problem
nursing diagnosis
145
is focused on modifying the environment to enhance the client's ability to repsond the disease process
Planning
146
Takes place in the environment that affects the client and involves taking action to modify that environment
Implementation
147
is based on the effect of the changes in the environment on the client's ability to regain his/her health at the least expense of energy
Evaluation
148
is the primary method of data collection used to evaluate the client's response to the intervention
Observation
149
Nightingale's work addresses 3 major relationships:
1. environment to patient
2. nurse to environment
3. nurse to patient
150
Nightingale used ________________________ in the conceptualization of her philosophy based on her description of health and sanitary conditions in Crimea and England
empirical evidence
151
__________________ is often a trait required of nurses
Compassion
152
addresses how nurses care for their patients, and how that caring translates into better health plans to help patients get healthy
Jean Watson's Philosophy and Science of Caring
153
Maragaret Jean Watson was born and grew up in
Welch, West Virginia
154
Jean Watson is the founder of the original
Center for Human Caring
155
The foundation of Jean Watson's theory of nursing was published in
1979: "Nursing: The Philosophy and Science of Caring"
156
Watson believes that the main focus in nursing is on
carative factors
157
Watson views nursing as
both as human science and an art
158
According to Watson, the major elements of Watson's Philosophy of her theory are
carative factors, the transpersonal caring relationship, the caring occasion/caring moment
159
guide for the core of nursing
carative factors
160
carative factors means
caring with love
161
carative originated from the term __________ which means _________________________________
caritas; to cherish, appreciate and give special attention
162
special kind of human care relationship -- a union with another person - high regard for the whole person and their being-in-the-world
transpersonal caring relationship
163
Watson's 10 Carative Factors
1. The formation of a humanistic-altruistic system of values
2. The instillation of faith-hope
3. The cultivation of sensitivity to one's self and to others
4. The development of a helping-trust relationship
5. The promotion and acceptance of the expression of positive and negative feelings
6. The systematic use of the scientific problem solving method for decision making
7. The promotion of interpersonal teaching-learning
8. The provision for a supportive, protective, and corrective mental, physical, sociocultural , and spiritual environment
9. Assistance with the gratification of human needs
10. The allowance of existencial-phenomenological forces; became "allowance for existential-phenomenological-spiritual forces"
164
what forms the "philosophical foundation" for the science of caring
1. The formation of a humanistic-altruistic system of values
2. The instillition of faith-hope
3. The cultivation of sensitivity to one's self and to others
165
defined as "an awareness and intentionality"
Caritas Consciousness
166
practice of loving kindness and equanimity toward self and other within context of caritas consciousness
The formation of a humanistic-altruistic system of values
167
Being authentically present, enabling, sustaining, and honoring faith, hope and deep belief system and the inner-subjective world of self/other
The instillation of faith-hope
168
is essential to both the carative and the curative process
faith-hope
169
Cultivation of one's own spiritual practices and transpersonal self, going beyond ego self, opening to others with sensitivity and compassion
The cultivation of sensitivity to one's self and to others
170
the nurses promote health and higher level functioning only when they form
person-to-person relationship
171
Developing and sustaining a helping-trusting, authentic caring relationship
establishing a helping-trust relationship
172
Being present to, and supportive of, the expression of positive and negative feelings as a connection with deeper spirit of self and the one-being-cared for
the expression of feelings, both positive and negative
173
Creative use of self and all ways of knowing as part of the caring process to engage in artistry of caring-healing practices/caritas
The systematic use of the scientific problem solving method for decision making
174
Engaging in genuine teaching-learning experience that attends to unity of being and meaning, attempting to stay within others' frames of reference
promotion of interpersonal teaching-learning
175
Creating healing environment at all levels, subtle environement of energy and consciousness, whereby wholeness, beauty, comfort, dignity and peace are potentiated
provision for a supportive, protective, and corrective mental, physical, sociocultural , and spiritual environment
176
Assisting with basic needs, with an intentional caring consciousness, administering "human care essentials" which potentiate alighnment of mind body spirit, wholeness, and unity of being in all aspects of care; tending to both the embodied spirit and evolving spiritual emergence
Assistance with the gratification of human needs
177
Watson's Ordering of Needs
- lower order needs (biophysical needs)
- lower order needs (psychophysical needs)
- higher order needs (psychosocial needs)
- higher order needs (intrapersonal-interpersonal need)
178
Lower order needs (biophysical needs)
- the need for food and fluid
- the need for elimination
- the need for ventilation
179
Lower order needs (psychophysical needs)
- the need for activity-inactivity
- the need for sexuality
180
higher order needs (psychosococial needs)
- the need for achievement
- the need for affiliation
181
Higher order need (intrapersonal-interpersonal need)
the need for self-actualization
182
Opening and attenting to spiritual ---mysterious and existential dimensions of one's own life-death; soul care for self and the one-being-cared-for
allowance of existencial-phenomenological forces; became "allowance for existential-phenomenological-spiritual forces"
183
is the study of human existence using phenomenological analysis
allowance for existential-phenomenological-spiritual forces
184
means to go beyond one's own ego and patient's comfort
transpersonal
