Module 1 Flashcards
How are practice, theory, and research related?
A nurse DEVELOPS and IDEA, then conducts RESEARCH, and if supported, formulates a THEORY
What is the significance of the framingham studies?
Launched multidisciplinary research conducted over 50 years in Birmingham, Massachusetts. The research conducted ended up changing the treatment for diabetes breast, cancer, heart disease, arthritis, and others. For example, mammography was once believed to be unreliable until after the research, where it was the number one thing they used.
Benner’s Novice to Expert Theory
proposed by Patricia Benner. She studied the progression of being a nurse beginner to an expert. Helped set performance expectations.
Benner = Better. Nursing getting ‘better’ at her job
Watson’s science of human caring significance
Developed by Gene Watson. Researched how caring about the patient impacts care. Before Watson research, nurses were mechanistic meaning they prioritize doing tasks over showing care. After the research it was the opposite.
‘watson’ = want sum care
did Lawrence Nightingale display mechanistic or caring nursing?
she emphasize mechanistic nursing despite compassion.
What does being an expert mean?
Have intuitive grasp, broader situation and able to analyze and think critically for creative solutions
What is being proficient mean?
Decision making and prioritizing come more easily. Practices with holistic protective rather than in steps or parts.
What does being competent mean?
intentional short term and longer-term planning for Care. Efficient and organized.
What is an advanced beginner?
Provides care drawing from some practical experience. Can perform task but has difficulty improvising and prioritizing.
What is being a novice mean?
beginners with no experience. Rigid adherence to rules. Minimal judgment.
What is the general understanding of a theory?
an organized set of ideas designed to help find meaning in our experiences with patients. It allows us to organize our thinking around a certain idea. Or it allows us to develop new ideas as well.
What are the characteristics of theories?
- they are derived from observations. The observation themselves can be a fact, but theory is not fact.
- subject to revision. Not static.
- offer way to link concepts and see reality in a structured way
What are the components of a theory?
they include assumptions, phenomena, concepts, definitions, and statements.
What are assumptions
ideas presumed to be true without any testing or proof. They are taken for granted.
For example, nursing theories implicitly assume that people are complex, even though they do not state it explicitly.
what are phenomena?
observable and experiential aspects of reality. They are the subject matter or domain often referred to phenomena of concern.
for example, pharmacists focus on medication. Nurses focus on the human beings.
Watson theory of caring allows us to describe nursing phenomena.
What is a concept?
A mental image or representation of phenomena option based on observations. It helps to organize and categorize the idea.
for example, if you have a fever, you may have the subjective experience a feeling warm. Theoretically, do you know that elevated body temperature and physiology of temperature regulation exist. You may think of a thermometer symbol or visual imagery of someone with fever. This is the concept.
Concepts can range from very simple to abstract. It may range from being concrete to being very complex.
‘con man’ concept. a con man does a puppet show. puppets are representatives
what is a simple and concrete concept example?
it means being directly observable. for example, height and weight.
what is a complex and abstract concept?
inferred through the indirect observations or direct observations. Like self-esteem. Or overall wellness.
What are the 10 items called in Watson’s Theory of caring?
Concepts.
what is Watson’s 10 caring processes?
forming an altruistic value system, instill hope in others, be sensitive, form trusting relationships, accept either positive/negative feelings, use scientific problem-solving, promote teaching/learning, create a nurturing environment. In many ways fulfill their needs, and understand their experience as a human being.
what is the definition? in components of a theory. what types of definitions are there
statement that specifies the meaning of a term or concept
- Theoretical definition is conceptual. For example, pain is an unpleasant sensory and emotional experience.
- operational definition serves to explain measurement of a concept. For example, Pain is defined as the patient verbal statement of being in pain.
Statements or propositions are what in theory?
The link among concepts. For example, in Maslow’s hierarchy of needs, concepts such as physiological needs and self-esteem are linked by the statement:
physiological needs must be met to an acceptable degree before a person can attempt to meet self-esteem needs.
Think of “S” in statement: a chain link is two S’s crossed on each other.
summarize the five aspects of theory. With their definitions.
assumptions are presumed truths without testing.
Phenomena are observable realities defining a discipline’s focus.
Concepts are mental representations, organizing phenomena.
Definitions are clarifications of concept meanings.
Statements are propositions linking concepts.
What is a paradigm?
The worldview or ideology of a discipline. Represents the broadest most global conceptual framework. It is not a theory, but a perspective or lens through which phenomenon are understood.
For example, A medical paradigm might focus on just treating the disease and emphasize cells organ and body parts. A nursing paradigm might view the person holistically, focusing on responses to changes and health.
Paradigms are not theories. They simply represent how we see things.
paramore wearing glasses
what is conceptual framework?
It’s a set of related concepts forming a pattern. The pattern is called the theoretical framework.
Conceptual framework is generally more broad than a theory. It’s typically not developed using research and not tested in practice. As often just used organize ideas and guide research.
sometimes it could be challenging, trying to differentiate between a theory and a conceptual framework. Sometimes early nursing theories are classified as a conceptual framework while later theories are classified as theories.
What is a model?
A symbolic representation of a framework or concept. It can take many forms.
A diagram, graph, picture, drawing, physical model. It can be very simple or very complex.
What is a conceptual model?
A model expressed with words. The words serve as symbols. Sometimes conceptual model is used interchangeably with a conceptual framework.
how do theories, models, paradigms, and frameworks relate to each other?
They differ depending on the level of detail and testing done.
- A theory has the highest level of research, detail, and organization. Like Watson’s theory of caring.
- A conceptual model organizes ideas with words. For example, full spectrum model. Interchangeable with conceptual framework.
-conceptual framework links to concepts together to form a pattern. Broad level of detail. Not always tested. For example, early nursing theories. - a model is a symbolic representation that is visual or physical. It can be detailed or simple. For example, diagrams.
- a paradigm is a very broad perspective. It’s abstract with no testing done. An example is nursing versus medical paradigm.
How are theories developed?
- First an idea is formed that they want to explore. Second, they use either inductive or deductive reasoning.
- Neither inductive or deductive approach guarantees fact.
What is inductive reasoning?
move from specific observations to general conclusions.
for example, a patient’s temperature is 101 and their pulses 104 and the respiration rate is 20 breast for a minute. Your conclusion is at the patient is ill.
IN- duction is bringing specific data INto the equation to form a general conclusion.
what is deductive reasoning?
moves from a general premise to a specific conclusion.
- based on knowing that pylenephritis causes fever and back pain, you deduce a patient with pylenephritis will likely exhibit the symptoms.
Every nursing theory should address what 4 foundational concepts?
- Person: an individuals health reactions. Learning needs, fears, family concerns, and discharge arrangements. The absence of this concept leads to a mechanistic view of care.
- Environment: the physical surroundings, social context, and any external factors. For example, keep a patient environment, clean, colorful, quiet
- Health: the individual state of well-being or illness. Nursing theories aim to improve or maintain health through interventions.
- Nursing: the role of the nurse and the actions of a nurse.
PEN H
what does a meaningful nursing theory do?
it defines the four concepts and explains interrelationships, providing a framework for holistic and patient centered care.
how does Watson theory work inside of the four concepts for all nursing theories?
- person focuses on the individual and caring relationship between the nurse and the patient.
- environment creates a healing environment, like clean, quiet, colorful surroundings.
- health focuses on all caring behaviors to improve the health and well-being of the person
- nursing focuses on the caring moments between the nurse and the person
what is the puzzle of nursing theory?
Four concepts form a ‘puzzle’ of nursing theory, with proper integration reflect full spectrum nursing care
H PEN. health patient environment nursing
What’s the definition of of a clinical practice theory?
they do not attempt to explain all aspects of nursing, they simply guide nursing actions involved with specific areas and decision-making.
What are some examples of clinical practice theories?
nightingale’s environmental theory, Dr. Imogene Rigdon’s theory on bereavement, Nola Penders health promotion model, Dr. Katherine Kolcaba’s theory of holistic comfort.
Explain nightingale’s environmental theory
Emphasized the environment in patient care. Influenced designs of hospitals and construction for decades.
Explain Dr. Imogene Rigdon’s Theory on Bereavement
- studied grief in older women and how their grief compares to men in young women.
- it is now used in hospice care to support older women experiencing loss.
Imogene Rigdon = Imagine rigid dead bodies
Explain Nola Pender’s Health Promotion Model
Focused on preventative care and health promotion. Now it serves as the basis for most health promotion delivered by nurses.
pender=pander to someone’s ideas. pander means to cater or promote to someone
Explain Dr. Katharine Kolcaba’s Theory of Holistic Comfort
holistic perspective on discomfort. It’s surpassed earlier theories of pain and anxiety. is now used to help nurses focus on the bigger picture in supporting their patients physically emotionally and environmentally.
Kolcaba= cold cab is discomforting
What are grand, middle range, and practice theories?
- Grand theories are broad. Address large areas of concern. For example, Watson theory of caring. However, it is limited because it does not specify nursing interventions.
- Middle range theories are narrow scope and more specific than grand theories. It is used to develop nursing protocols and procedures.
- a practice theory is focused on situational, specific situations with clerical goals, and interventions. For example, a practice theory, addressing end of lifecare might specify how nurses should communicate with grieving families.
how does theories in nursing research serve a purpose? Whats an example
they provide a structured framework for research questions, what to measure (variables), and how to interpret the results.
-Kolcaba’s Holistic Comfort Theory: tested the hypothesis that comfort interventions improve the health of the whole person. This gives research a direction to go in.
Who was Florence Nightingale?
A nurse theorist. Transformed nursing during the Crimean war. The founder of modern nursing.
- She believed soldiers would have better survival rates if they have a clean, healthy environment and nutritious food. It supported the germ theory.
-she conducted meticulous research by recording hospital conditions before+ after implementing the changes. She then found statistical evidence that a clean environment improves patient health. This greatly impacted soldier mortality rates. It revolutionized the British army Hospital system.
Who was Virginia Henderson?
- A US Army nurse in 1918. Questioned mechanistic nursing and a subordinate role of nurses.
- developed a 14 basic needs (of patients) framework for nursing care so that nurses could understand what it means to be a nurse.
-Redefined nursing with her definition in 1966.
-Address both of physical AND emotional aspects of patient care.
Virginia= Verging on.both emotional and physical
Who was Hildegard Peplau?
- psychiatric nurse. proposed that health could be improved for psychiatric patients if there was a better way to communicate with them. this was a problem back in the early 1900s before there was a personal relationship with psychiatric patients and psychotropic drugs. Patients were often agitated and extremely difficult to communicate with.
- she did research that showed developing a relationship makes treatment more effective.
- Advocated for advanced nursing education.
- Played a critical role and establishing nursing as a regulated, standardized, and professional discipline.
- advocated for expansion of advanced nursing rules.
Peplau= pep ‘talk’, talking to psychiatric patients more effectively
Who is Patricia Benner?
- Focused on what makes an expert nurse. For example, an ICU nurse that intuitively knows when to intubate.
- interviewed ICU nurses to determine the five stages of nursing knowledge and skill development (novice, advanced beginner, competent, proficient, expert in NUR211 module 1 flashcards)
- Formed the primary caring model.
what is the primary caring model?
-Caring helps clients cope with stress and offers nurses an interpersonal relationship with the patient. it sees every person as unique. Since every person is unique, caring should be tailored to every person.
how does Patricia Benner primary caring model fit into the four components of nursing theory?
- Person: focuses on nurse skill level and the patient needs
- nurse: matches skill level to the patient acuity
- health: nurse contributes to health based on their skill level
- environment: the ICU serves as the defined setting
Who is Madeleine Leininger?
- founder of transcultural nursing. Emphasized caring through cultural competence.
- developed theory while working with diverse children in a psychiatric hospital. Explored if treatment was more effective when framed around their cultural context.
Madeleine = ‘Mad land’, meaning a world with many cultures is potentially chaotic without understanding and respect.
How does transcultural nursing fit into the four components of nursing theory?
- person: an individual with unique, cultural beliefs.
- nurse: the professional who values cultural diversity and accommodates, cultural beliefs.
- environment: the nurse and person interact within the healthcare system.
- health: Health is defined by the individual and may vary by the individuals culture.
what is an example of accommodating someone who has cultural beliefs?
A monk who refuses pain medication believing his pain was a spiritual offering to God.
administer medication every eight hours instead of every 3 to 4 hours and provide extra support during the medication‘s active period.
Who is Faye Abdullah?
theory of nursing 21 problems. Deliver care to the whole person. problem-solving.
ab-dull-ah’; longest problem list out of all theorys, and the list is incredibly dull
Who is Dorothy Orem?
The self-care deficit nursing theory explains what cares required when people can’t care for themselves.
‘door’ thee opens the ‘door’ for patients who cannot help themselves
think the O in orem is like an open mouth waiting to be fed
Who is Carl Rogers?
person centered model theorist of psychotherapy that recognizes each client as a unique individual.
link to mr. rogers kid show, where fred rogers spoke directly to children, affirming their unique qualities
Who came up with theory of attainment?
Imogene King. mutual goalsetting. These interactions can promote growth.
think of a ‘king’ who is ‘kind’, builds alliances for ‘mutual’
Who came up with interpersonal process of nursing?
Jean Watson. caring promotes health and growth. The person as they are and what they will become.
‘gene’ which connects to the DNA/ foundation of a person. ‘watson like watts on’, symbolizing energy, growth, and potential being activated.
Who is Betty Neuman?
general system theory. A person is an open system with sub systems. The sub systems are physiological, psychological, sociocultural, spiritual, and developmental subsystems. Internal and external environment influences the system.
people are systems. my friends little brother started saying ‘bet’ when it became cool. an isolated system until it comes into contact with the sociocultural influence. now he is a cool new man ‘neuman’
theory of health and interacting with the environment- who came up with that?
Margaret Newman. Nurses help patient recognize their own pattern of interacting with the environment and enable patients to use the power from within/expanding consciousness. Opposed mechanistic thinking.
‘margaret’ = ‘magnet’ symbolizing attraction and spiritual energy aka expanding consciousness
Who is Emestine Wiedenbach?
The purpose of nursing is to meet patients needs for help.
‘emestine’ = earnest in wanting to help
What is the behavioral system model and who came up with it?
Dorothy Johnson. Incorporates five principles of the BEHAVIORAL system. The principles can reach a balance. Nurse helps them reach it.
attach, depend, ingestive, eliminative, sexual, aggressive, achievement
‘johnson’ = join son, symbolizeses interconnectedness of subsystems
Who is Myra Levine?
came up with a conservation model, which was designed to promote adaptation of the person while maintaining holiness or health.
Conservation of energy refers to balancing energy input and output to avoid excessive fatigue. It includes adequate rest, nutrition, and exercise.
‘levine’ = ‘Le-vine” symbolizes vitality like a vine that conserves energy to growth and survive.
Who is Ida Jean Orlando?
Nurses are in tune with a verbal and nonverbal expressions to meet patients needs. And improve patient outcomes.
disney is located in orlando florida. its where I learned a song or ‘tune’.
Jean is ‘tuned’ into verbal and nonverbal cues, much like tuning into a frequency.
Who is Rosemary Rizzo Parrse?
invented theory of human becoming, which focuses on the quality of life and reaching the patients potential.
’ rosemary rizzo’ =’rose-mary rise’ like the process of growth
Who is Nola Pender?
The health belief model focuses on promoting optimum health through disease prevention, Identify risk, and remove obstacles for patients to comply.
nola pender acts as the preventer, saying no to risks and removing obstacles
Who is Martha Rogers?
theory of science of unitary human beings. Focuses on the betterment of humankind through innovation. Keep environment clear of negative energy.
humans are indivisible, dynamic energy fields completely integrated with their environment, meaning they cannot be understood by examining separate parts, but rather as a whole, evolving system in constant interaction with their surroundings; essentially viewing people as “unitary beings
martha stewart on tv as a kid made her seem bigger than just a person; she became my envirinment on tv
Who is sir Calista Roy?
Formed adaptation model. inspired by strength and resilience of children. It examines the choices people make as they adapt to illness.
Sir Calista Roy can be imagined as a child’s toy knight fighting a dragon
which theories are based on needs; theories helps individuals fulfill their physical and psychosocial needs?
nursing problems, basic needs, self-care, deficit, nursing theory
My theories are caring, humanistic theories? centered on the person in capacity for achieving growth and health.
Nursing practices, caring, art, transcultural, nursing, person centered model, nursing as a interpersonal process.
what theories are based on interaction and interpersonal theories?
theory of goal attainment, general system theory, interacting with the environment, interpersonal communication, needs for help.
What theories are based on the outcome? Nurse as a change agent for promoting health and coping with the illness.
Behavioral system model, conservation model, verbal and nonverbal expressions, theory of human becoming, health belief model, science on unitary human beings, adaptation model.
Maslows Hierarchy overview
lower level needs must be sufficiently met before higher level needs can be pursued. The dominant need is the most urgent unmet need which takes priority and varies among individuals.
what are Maslow’s physiological needs?
Level one. Basic requirements for maintaining life like food, air, water, temperature, elimination, rest, sex, and physical activity. Many aspects of nursing applied to this level.
what are Maslow’s safety and security needs level?
Level two. Includes both physical and emotional safety.
Physical safety includes protection from harm, such as falls, infections, or unsafe environments. Adequate shelter with sanitation temperature control.
Emotional safety includes freedom from fear and anxiety. For example, feeling secure in a relationship and the environment.
What is Maslows love and belonging needs level?
level three. The need to give and receive love and feel sense of belonging in a group. friendship, intimacy, trust and acceptance. Without it, someone feels isolated, lonely, or critical and demanding. Nurses must help patients establish meaningful relationships and connections during care.
What is Maslow’s self-esteem needs level?
level four. The need for accomplishment, confidence, and recognition for others to put it into context, a patient’s change in body image may affect their self-esteem. Another example, if someone can’t do their job because of an illness, they may feel a loss of confidence.
what is Maslow’s self actualization level?
They need to reach ones for potential and act unselfishly. Level five.
it’s characterized by someone, exhibiting wisdom, creativity, and responding appropriately. In order for someone to grow, they have to have the desire to know, understand and explore. they must have an appreciation for symmetry order and beauty. This is what someone needs in order to grow.
What is Maslow’s transcendence of self level?
level six, added later on. it is the drive to connect with something beyond oneself and to help others realize their potential too. Spiritual, and self sacrificial.
What is validation theory?
develop developed by feel and Klerk-Rubin from social work. Provides a new method for interacting with dementia geriatric patients. The approaches to join the person in their current reality instead of trying to correct them.
‘rubin’ = ‘ribbon’. santa, presents & ribbons. santa is imaginary. parents join kids in an imaginary world on christmas day.
what is stress and adaptation theory?
developed by hans Selye. Stress can be either be beneficial or harmful. however, when the stress levels exceed the bodies capacity to adapt, it leads to physiological symptoms and eventual illness.
what are the three developmental theories that focus on stages of progression for individuals, groups, families, and communities overtime?
- Erikson’s psychosocial developmental theory that explains psychosocial stages across the lifespan.
- Theories of family development that outline family changes and dynamics overtime.
- Kohlberg’s and Gilligan’s moral developmental theories that address, moral and ethical growth in individuals.
- the idea is to identify developmental norms and milestones to tailor nursing actions to the patient stage of development.
What is system theory?
- it was originated by Ludwig von Bertalanffy in the 1940s.
- developed system theory that contains subsystems and its interactions.
-Sub systems are components of a system that interact like the cardiovascular and renal systems in the body.
-Interactions are when sub systems constantly exchange information with one another and the environment. - Open and closed systems. Systems have input, thorough, output, and feedback.
‘ludwig’ = ‘hedwig’ the owl from harry potter. owls were part of a mailing system
What is input, thorough, output, feedback inside of a system?
- input: energy, information or materials entering the system.
- Throughput: converting input into output, like planning or thinking.
- Output: result
- Feedback: information used to monitor
What is an open system?
Exchange his information and energy freely with the environment.
For example, people, hospitals, body systems. They all display growth development and adaption.
What is it closed system?
fixed automatic relationships with little external interaction.
For example, rocks, isolated families, resisting external influences.
what are three examples of nursing theories that are based on system theory?
Johnson’s behavioral system model. Kings interacting systems framework. Neuman systems model.
- Key to system theory = the premises of systems theory is that all complex phenomenon, regardless of their type, have some principles, laws, and organization in common
How can you apply Watson caring theory to holistic nursing care?
Go beyond just administering meds, treating wounds. consider their fears, cultural beliefs, and the involvement of loved ones. Validate their emotional concerns while providing physical care.
How can you apply Watson caring theory to honoring personhood?
respect each individuals uniqueness by using patient’s names instead of referring to them by room number. Truly connect with them.
How can you apply Watson’s caring theory to transpersonal caring moments?
commit to being genuine and present during your interactions rather than task, oriented behaviors.
How can you apply Watson’s caring theory to personal presence?
To be emotionally and physically present with the patient and fully tuned to their needs, avoid distractions and focus on the patient.
how can you apply Watson’s caring theory to comfort?
Go be on pain relief to include comfort in four different ways.
- Physical: manage pain.
- Psychospiritual spiritual: address emotional and spiritual needs.
- Social: create a trust between nurse and patient.
- environmental: I just stimulate, room, temperature, or respect modesty.
respect cultural values
How to apply Watson’s caring theory to listening?
Actually listening without judgment
How to apply Watson’s caring theory to spiritual care?
Respect their wishes and offer support such as arranging clergy visits or praying with a patient if they desire
What is Watson caring theory when caring for the family?
Show respect and inclusive video, regardless of their structure, culture, or other factors. Communicate openly with the family members.
How to apply Watson’s caring theory to cultural competence
include cultural practices into care plans
Define nursing research
The systematic, objective process of analyzing phenomena important to nursing. It’s used to develop knowledge to address issues in clinical practice, nursing education, and administration.
what was the historical shift from Heparin to saline?
due to evidence based practice, there was a meta-analysis that demonstrated saline was equally effective and safer than heparin to flush IVs. Therefore saline replaced Heparin. And it became the standard of care.
Why should nurses do research and how do they participate in research?
applying research findings can improve the quality of nursing practice.
Ways nurses participate in research:
1. identify ideas to research in clinical setting.
2. Design the study as qualitative or quantitative.
3. Collect data.
4. After analyzing the data, apply the research findings to Clinical practice.
What is the American nurses association standards?
set the standard for nursing research by committing to ethical and advanced research. They are also responsible for sharing peer-reviewed research findings with colleagues.
ANA = ‘nay’; when research crosses ethical lines, the ANA say NAY
What is quality and safety education for nurses QSEN?
involves nursing research and it defines evidence-based practice.
Evidence based practice is defined as :
- Having the best current evidence.
- Clinical expertise.
- patient/family preferences for care.
‘QSEN’ sounds like question. think of it as “q (question) + “sen” (Send for evidence)
What is Institute of medicine core competencies (IOM)?
employ evidence based practice
what is the safe and effective nursing care competencies SENC?
Validate and incorporate evidence based research into practice. Evaluate client outcomes using research tools.
‘SENC’ sounds like ‘sense’; sensing if something is wrong to check the outcome
Nightingales nursing research- positives and negatives
- beginning of formalized nursing research
-nursing students conducted clinical research - however her authoritarian educational tradition discouraged critical thinking which slowed development
Modern day nursing research - how does it compare to nightingale’s?
- There’s federal funding and private grants to promote nursing research.
- Research is disseminated all over: nationally, internationally, and in interdisciplinary journals
- higher education offered to increase the quality and diversity of nursing research
what does the American nurses association ANA do?
Establish research priorities
What does the national Institute of nursing research do NNR?
Federal agency under the national Institute of health. Identifies research themes and funding priorities.
What is the current nursing research priorities at the moment?
promoting health, preventing illness, manage, chronic conditions, palliative care, end of life, developing technological advancements.
what kind of things can Baccalaureate degree in nursing do
critique research for application to clinical practice, identify research problems, and participate in the planning and implementation of research studies, apply research findings to establish sound, evidence based clinical practice.
What are the four types of nursing knowledge and define each.
- Theoretical knowledge: concepts theories, and principles guiding practice.
- Practical knowledge: skills and procedures for patient care.
- Ethical knowledge: understanding right and wrong in practice.
- Self knowledge: awareness of one’s own values, beliefs, and biases.
What are the ways to acquire knowledge?
trial and error, authority and tradition, intuition and inspiration, logical reasoning, scientific method
What is authority and tradition?
Relying on expert advice
