Midterm Flashcards
Week 1-5
A theory is
Theory is a set of concepts, definitions, and propositions that projects a systematic view of phenomena by designating specific interrelationships among concepts for purposes of describing, explaining, predicating, and/or controlling phenomena.
What’s the order of the Nursing Metaparadigm?
a) Grand theories, Practice-Level and Middle Range
b)Middle Range, Grand Theories, Practice-Level
c)Grand theories, Middle Range, Practice-Level
c)
What is Nursing?
A professional discipline
Disciplines Include…
Networks of philosophies, theories, concepts and community of scholar share that make commitments to value, knowledge and proceses
To develop a theory it involves…
Viewing is from a lens. Determining components of concepts, inter-relationships of various elements & aspects along with circumstances under which they are presented. Requires both deductive and inductive reasoning.Enables us to more accurately define & develop the focus of our professional thinking (for us, nursing’s thinking)
Paradigm is
a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated
Framework is based on
Your own thinking/lens. It provides different views
(Referred to asConceptual Models or Grand Theory
What’s the structure of Nursing Theories
Metaparadigm, Paradigm, Grand Theories, Middle Range&Practice-Level
Metaparadigm is
The framework for nursing that sets forth phenomena of interest.
Very general
Intended to reflect agreement
Most abstract level of nursing knowledge
Closely mirrors nursing beliefs
Provides a context for developing nursing knowledge
What are the four concepts of Metaparadigm?
Person or human being
Environment
Health
Nursing
The Environment(concepts) is
Human beings’ significant others and physical surroundings as well as local, regional, national and worldwide cultural social, political, and economic conditions that are associated with human beings’ health. does it also include relational elements or concepts associated with milieu
Conceptual Model/Grand Theories of Nursing is
Sets of concepts and propositions that provide perspectives on the major concepts of the metaparadigm of nursing
Extra stuff
Reflect values and beliefs of the discipline.
Reflect research and practice approaches.
Provide direction for research.
Less abstract than philosophy
More abstract than theory
Paradigm is
Worldview or Shared Perspective
Extra
Reflects the differences within the shared beliefs
More than one paradigm can be accepted within a community
Generally a consensus is usually reached within the community
Totality Paradigm is
Known as health even though you are missing something
Humans are seen as integrated human beings with distinguishable dimension
Humans are described as adapting to their environments
Health & illness viewed as states along a continuum
Simultaneity Paradigm is
Humans seen as unitary (indivisible, unable to be broken down into separate components)
Humans, as irreducible wholes, viewed as inherently connected to the universe
Humans seen as exiting in continuous mutual process with environment (rather than adapting to environment)
You don’t have everything to be whole, you aren’t considered as whole
Middle-Range Theory is
Represent least abstract level of theory development
Derived from specific grand theory in nursing
May reflect the application of theory from another discipline to nursing
May involve testing of specific relationships identified in a grand theory
May focus on exploration of a concept of particular relevance to nursing (e.g. resilience)
Practice Level is
Hands on work that the nurses do with their patients
Pertinent to a specific range of nursing situations
Provides framework for nursing practice
Predicts outcomes and impact of nursing practice
Interrelated with concepts from middle-range theories
Philosophy is
Set of ideas/knowledge. The love of wisdom
The 5 ways of knowing are
Ethical, Personal, Empirical, Esthetic, emancipatory
What equals praxis?
Nursing Theory & Nursing Practice
What is Nursing Praxis?
refers to the reciprocal relationship of theory & practice
What are the 3 dimensions of Nursing Praxis?
Being
Knowing
Doing
What’s the difference between knowing and knowledge?
Knowledge is expressed in a way that can be shared with others and may be discipline-specific having met standards of a critique across the discipline.
Knowing is internal to the knower. It’s a range of experiences that are unique to the individual. It acquires personal reflection.
Empirical knowing is
Most familiar
How nurses come to know science of nursing
Knowing actual theories, concepts, and principles
It can be verified and tested
Ethical Knowing is
Knowing what’s right or wrong
Knowing the moral practice
Duty, rights and obligations
Guides Nursing practice
Essential in day to day nursing actions
Aesthetic knowing is
Cannot be taught
Through personal practice
Your intuition with the way your care for patients
Action based
Creative and imaginative use of nursing knowledge in practice
Nurses express their art of practice through interpretation and guiding use of various theories
Personal knowing is
Understanding the knowledge ourselves
Clients based relationship
First encounter with your patient
Creating and building that therapeutic relationship
Emancipatory knowing is
Bringing it all together
Taking a stand for what is right
Advocating for your patient
integrating knowing, doing, and being
Florence Nightingale’s 5 components of environmental health are
Pure air(proper ventilation)
Pure water
Efficient drainage
Cleanliness(Including bathing & hand washing)
Light
Peplau’s Theory is based on
Nurse-Patient Relationship
What’s the orientation phase of Peplau’s theory?
An individual has a perceived need and seeks professional assistance.
The nurse helps the patient recognize and understand his or her problem and collaboratively they determine his or her need for help.
Development of trust in the therapeutic nurse-patient relationship is central and the parameters of the relationship are negotiated.
What’s the working phase of Peplau’s Theory?
The patient identifies with those who can help him or her and attempts to derive full value from the available resources.
The nurse supports exploration of feelings to aid the patient.
The nurse facilitates development toward well-being through enactment of the roles of the nurse
Support the patient from the orientation phase
Patient is working towards independence
What’s the resolution phase of Peplau’s Theory
The patient gradually puts aside old goals and adopts new goals
Concurrently moves from dependence to independence
Nursing Process includes
Assessment, Diagnosis, Planning, Implementation, Evaluation
The three layers include
Recognizing cues
Analyze Cues
Prioritize Hypothesis
Generates Solution
Take Action
Evaluate Outcomes
Recognizing cues is
Filtering information from different sources(Sign and symptoms)
Analyze Cues is
Linking and recognized cues to the client’s clinical presentation and establishing probable client needs, concerns or problems
Prioritize Hypothesis is
Evaluating and ranking hypothesis according to priority
Generate solutions is
Identifying expected outcomes and using hypotheses to define a set of interventions for the expected outcome
Take Actions is
Implementing the solution that addresses the highest prioritites
Evaluate Outcomes is
Comparing observed outcomes against expected outcomes
Trauma Informed Care is
Approach used for clients who have experienced trauma
Focus on client
Understanding behavioural response(s)
The traumatic experience is individualized and based on personal narrative
Realizing, Recognizing and responding, an intervention of approach focusing on how trauma can impact the behavioural response of a clients receiving treatment
Short term Trauma is
Event that happens
Event /experience resolves itself
No major impact to emotional, mental, physical well being
Long Term Trauma is
Major event occurring
Event /experience resolves itself
Can have minimal to major impact to emotional, mental, physical well being
Experience can cause triggers, eg. car accident, surgery
Generational Trauma is
Trauma that is passed down from generation to generation
Can be silent
Undefined
Covert
Historical Trauma is
Trauma based on a major event
ie residential schools, slavery, holocaust
Trauma Informed Care Approach is
Acknowledging the trauma
Recognize how the trauma is impacting the individual
Respond appropriately
Realizing the prevalance of the trauma.
Recognize how trauma affects all individuals within the system
Responding by putting knowledge to practice
Leininger’s Theory is based on
Cultural care diversity and universality
Transcultural nursing was found by
Leininger
What’s Leiningr’s Theory?
The Culture Care Diversity and Universality theory focuses on describing, explaining and predicting nursing similarities and differences focused primarily on human care and caring in human cultures
It does not focus on medical symptoms, disease entities or treatments
It focuses on methods of approach to care that means something to the people to whom the care is given
Ethnonursing is
a research method for describing, documenting, and explaining nursing care phenomena by the study of the beliefs, values, and practices concerning nursing care that belong to a specific culture, as reflected by the language, beliefs, and values of the members of that culture.
What’s the metaparadigm concept of person?
Humans are believed to be caring & capable of being concerned about the desires, welfare & continued existence of others. Human care is collective, meaning, seen in all cultures
Humans are universally caring beings who survive in a diversity of cultures through their ability to provide universality of care in a variety of ways according to differing cultures, needs and settings
Recipient of care, including physical, spiritual, psychological, and sociocultural components should refer to families, groups and communities
What’s the metaparadigm concept of the environment
Included events with meanings and interpretations given to them in particular physical, ecological, sociopolitical or cultural setting
Existing forces outside the organism and in the context of culture
What’s the metaparadigm concepts of Health?
A key concept in transcultural nursing due to weight on the need for nurses to have knowledge that is specific to the culture in which nursing is being practiced
It is acknowledged that health is seen as being universal across cultures but distinct within each culture in a way that represents the beliefs, values, and practices of the particular culture
Therefore, health is both universal and diverse
Not distinct to nursing as many disciplines use this term
What’s the metaparadigm concept of Nursing?
Care has the greatest meaning which explains nursing
Nurses must have sufficient preparation with a transcultural perspective in order to value & practice nursing
Developed 3 types of nursing actions that are culturally-based & consistent with the needs & values of the clients:
Cultural care preservation/maintenance
Cultural care accommodation/negotiation
Cultural care repatterning/restructuring
The sunrise enabler is
The conceptual guide to knowledge discovery
What is caring?
Sense of belonging
extra(Milton Mayeroff)
We can make order out of and bring meaning to life
What are the 8 ingredients?
knowledge, alternating rhythms, patience, honesty, trust, humility, hope & courage
Leininger describes caring as?
The central focus of nursing
Watson describes Nursing as?
The art science of caring
The metaparadigm(person) concept for watson is
: physical, psychological and spiritual; unique and free to make choices; cannot be seen without context or environment
The metaparadigm(Health) concept for watson is
as a subjective experience; harmony, or balance, within mind, body and spirit; related to the degree of congruence between the self as perceived and the self as experienced
The metaparadigm(Nursing) concept for watson is
a human science of person and human health-illness experiences that are mediated by professional, personal, scientific, Aesthetic, and ethical and ethical human care transactions.
The metaparadigm(environment) concept for watson is
family, culture, community, society, etc.; interconnectedness between the person and the environment
Watson viewed caring science as
Humanitarian
Human science focus on caring
The arts, humanities, and science
Relationship & connectedness
Acknowledges unity of all life
Reflective, subjective, and empirical
Grounded in nursing but includes other disciplines
Has relevance to all health, education, and human service fields and professions
Caring moment/occasion is
Caring moment happens with the nurse and the person to be nursed (patient) come together in their wholeness
Each brings his/her past, his/her present, and his/her possible future
Both nurse & patient bring consciousness & freedom to choose how they will be & what they will do within that moment, while connected at the spirit level
Caring consciousness is
The whole caring – healing- loving consciousness is contained within a single moment
One caring & one being cared for are interconnected; caring-healing process is connected with the other human(s) & with the higher energy of the universe
Caring-healing-loving consciousness of nurse is communicated to the one being cared for
Caring-healing-loving consciousness exists through & transcends time & space; can be dominant over physical dimensions
What’s the transpersonal meaning from Watson on Nightgale?
Said that Nightingale’s blueprint for transpersonal meanings and models of caring transcend history.
Caring “called forth the full use of self, connecting the divine within and without as a source of inspiration as well as the foundation for a professional code”.
Watson also said that Nightingale “made explicit the connections between and among all aspects of self, other, humanity, the environment, nature, and the cosmos as a means of learning, understanding, and connecting health, caring, and healing”.
What are Intersectionality on Nursing care?
Attributes that are Seen and Unseen.
Intersectionality framework and praxis are
Gender, Age, Sexuality, status, race
What did Sister Callista Roy create?
RAM and The Conceptual Model
Totatality Paradigm is an exemplar of who’s theory?
Sister Callista Roy
What is the metaparadigm
(Nursing) for Callista?
a healthcare profession that focuses on human life processes and patterns and emphasizes promotion of health for individuals, families, groups, and society as a whole.
What is the metaparadigm
(Environment) for Callista?
Serves as the input that any one person has as an adaptive system. Negative or positive stimuli all stem from the environment, whether those stimuli be blatant (focal), subconscious (contextual), or even unknown (residual)
What is the metaparadigm
(Person) for Callista?
holistic, adaptive systems made of many parts with internal processes acting to maintain adaptation in the four adaptive modes
What is the metaparadigm
(Health) for Callista?
supported by adaptive responses; defined as a state and a process of being and becoming integrated and whole
What are the care concepts?
Coping and Adaptation
Adaptation is
Process and outcome by which thinking and feeling are used in conscious awareness and choice to create human and environmental integration
Coping is
Coping processes act to maintain adaptation and promote person and environment transformations
Implicit Assumptions are***
People that are a bio-psycho-social beings.
A person uses innate and acquired mechanisms(biological, psychological, and social) to cope with a changing world
Person must adapt in order to respond positively to environment
What are the 4 modes of adaptation?
Physiologic needs, self-concept, role function and interdependence
Explicit assumptions are
Person that can be reduced to parts for study and care.
Nursing is based on causality
Values and opinions should be considered and respected
Adaptation frees energy that can be used to respond to other stimuli
What are the three concepts include in RAM’s model
Environmental stimuli, coping processes and Models of Adaptation
What’s the definition of the environment according to Roy?
All the conditions, circumstances, and influences surrounding and affecting the development and behavior or individuals and groups
What are the three factors of environmental stimuli?
Focal, Contextual and Residual
What is focal?
Factors immediately affecting the person
What is Contextual?
All other stimuli affecting situation
What is the residual?
Factors whose effect are unclear
the three levels of adaptation are
Integrated adaptation, compensatory adaptation and compromised adaptation
Integrated adaptation is
Structures and functions of the adaptive modes are working together and meets human needs
Compensatory adaptation is
When the cognator and regular or stabilizer and innovator are activated by a challenge
Compromised adaptation is
When integrated and compensatory processes are inadequate, creating an adaptation problem.
What are the subsystems of coping
Regulator-cognator (A person)
Stabilizer-Innovator (A group)
What’s a regulator subsystem?
Uses physiologic process such a chemical, neurologic, and endocrine response to cope with the changing environment
what’s a cognator subsystem?
It involves the cognitive and emotional process that interacts with the environment
What’s the stabilizer subsystem?
Structures, values and daily activities work together to accomplish the primary purpose of the group
What’s the innovator subsystem?
Response to environmental change
What’s physiologic-physical mode of adaptation?
People as individuals interact as physical beings with environment
sense: fluid, electrolyte, acid-base balance: neurologic function: endocrine function
What’s Self-concept mode of adaptation?
A composite of beliefs and feelings that a person holds about him or herself at a given time: sense of purpose
Involves developing self, perceiving self, and focusing self
What’s role function mode of adaptation?
Role on people in society filing their needs for social integrity, relating self to others
Individual needs to know who one is in relation to others to act
What’s Interdependence mode of adaptation?
Close relationships of people and their purposes, structure and development
