What is the role of theory in nursing ?
·Required for quality nursing practice.
·Guides practice, so nurses can provide systematic and knowledgeable care.
·Guides education and research in nursing.
·Clarifies values, assumptions, and beliefs.
·A tool for reasoning.
·Challenges thinking, develops analytical skills, e.g., critical thinking and problem-solving skills.
·Facilitates and enhances decision-making.
·Contributes to defining what makes nursing a discipline.
·Contributes to defining what makes nursing a profession.
What the types of knowing i Nursing ?
What are the seven professional standards according to the college of nurses of Ontario ?
- accountability
- continuing competence
- ethics
- knowledge
- knowledge applicattion
- Leaderhship
- Relationships
Why study theory ?
- Guides practice, education, research
- Clarifies values, assumptions
- Develops analytical skills
- Challenges thinking
- Defines purpose
- Ultimately advances nursing as a profession by developing our own body of knowledge
What is Theory + practice ?
PRAXIS
Being, Doing, Knowing
What is the theory development process ?
- Conceptual model or framework to define the phenomena of interest is the first step ( concepts and definitions)
- Building relationships with linkages between concepts is the second step (linkages and ordering)
- Relationship statements /propositions are developed
What are concepts ?
- terms that refer to phenomena that occur in nature
- building blocks of a theory or phenomena
- formulated in words that enable people to communicate their meanings about realties in the world
- More than terms,
- Constructing conceptual meaning is a vital approach to theory building
- Study of concepts enhances knowledge development for nursing through naming, creating and confirming the topic or phenomenon of interest
- Theoretical statements
- Operational statements
What is the importance of concept developement or analysis to nursing ?
- Clarifying recognizing, and defining concepts that describe phenomena is the purpose of concept development or concept analysis
- These processes serve as the basis for the development of conceptual frameworks, theories and research studies
Considerable portion of conceptual basis of nursing theory, research, and practice has been constructed using concepts adapted from other disciplines
Basic human needs adapted from Abraham Maslow
Needs to examine pre existing concepts and provide relevance to the nursing theory
Process of applying borrows or shared concepts from other disciplines may have altered their meaning, and it is important to review them for appropriateness of application
What are the philosphical underpinnings of nursing ?
Ontology and epistemology are two different branches of philosophy.
Ontology is about the reality portrayed in a paradigm (worldview).
Epistemology has to do with knowledge and how to develop knowledge in light of a particular reality.
Depending on the paradigm theorists are coming from, the aim of their theory development and the way in which they carry out research to support their theory can be quite different.
What are the aspects of rationalism & empricism ?
Both are philosophical perspectives on how to develop knowledge; epistemology.
Though they take different approaches, they both tend to fit under the broader umbrella of ‘quantitative’ approaches to research that nurses might use.
Do not confuse them with the ‘qualitative’ research approaches that nurses might use to systematically develop nursing knowledge.
Despite the statement in ch. 3 that rationalism uses deductive reasoning and empiricism uses inductive reasoning, nurses generally use the term ‘inductive’ in reference to interpretive and qualitative forms of research.
What are the aspects of rationalism ?
Based on the main idea that reasoning is the way to develop knowledge.
Importance of a priori reasoning for advancing knowledge; hypothesis.
Reasoning from the cause to an effect or from a generalization to a particular instance.
Causal reasoning then needs to be tested before being supported, modified, or discarded.
‘Theory-then-research strategy’.
What are the aspects of Empricism ?
- Based on the main idea that scientific knowledge can be derived only from sensory experience (scientific observation, but does not mean just ‘sight’).
- Generalization of observed facts in the natural world.
- Collection of facts precedes attempts to formulate generalizations.
- No hypothesis; develop research question, use appropriate research method to collect data, use study results (data) to generalize from sample to population.
- ‘Research-then-theory strategy’.
What are the two branching philosphies of knowledge in nursing science ?
Post positivism
- Generally deductive: Start with a general picture and move to a specific direction; deductive reasoning uses two or more concepts and it is their relationship that is of interest.
- Empiricist.
- Mechanistic.
- Quantitative.
Constructivism & Critical Social Theory:
- Generally inductive: Start with details of an experience and move to a general picture. [CST may use both inductive and deductive, and qualitative method of grounded theory uses both.]
- Interpretive.
- Holistic.
- Qualitative.
What are the differences between the quanatative and qualitative approaches to research ?
What is the worldview of a metaparadigm ?
- Worldview
- Paradigms (worldviews) are human constructions, so can develop new ones, discard old ones, and change existing worldviews.
- Different nurses can have different paradigms.
- All paradigms have strengths and weaknesses.
- Theory development & inquiry in nursing can be constrained by strict adherence to a single paradigm.
What are the aspects of metaparadigm ?
Meta = prefix added to name of a subject, designating another subject at a more abstract, higher level.
Metaparadigm = more than any single paradigm (worldview).
At top of structural hierarchy of discipline’s contemporary knowledge; most abstract component.
A metaparadigm is comprised of global concepts that identify all phenomena of interest to a discipline, as well as global propositions to show how the phenomena are related.
Puts a boundary around the domain of interest to a discipline.
Provides general parameters for a discipline, so allows for multiple approaches by scientists within that metaparadigm.
Nursing has a single nursing metaparadigm.
What is the nursing metaparadigm ?
Contemporary nursing knowledge = in 1995 when Fawcett wrote about this revised metaparadigm.
There is a single nursing metaparadigm; but it is comprised of four concepts: Nursing theorists focus in these four major concepts
Nursing: Actions taken by nurses on behalf of or in conjunction with the person; goals or outcomes of nursing actions; systemic process of assessment, labeling, planning, intervention, and evaluation.
Person (later Human being): Recipient of nursing, includes individuals, families, communities, and other groups.
Health: Person’s state of well-being, ranging from high-level wellness to terminal illness. Human processes of living and dying.
Environment: Person’s significant others and physical surroundings; setting in which nursing occurs, ranging from person’s home to clinical agencies to society as a whole. local, regional, national and worldwide cultural social, political, and economic conditions that are associated with human beings’ health
What is the four propositions of the nursing Metaparadigm ?
The discipline of nursing is concerned with:
- The principles and laws that govern the life process, well-being, and optimal functioning of human beings, sick or well. [links person/health]
- The patterning of human behavior in interaction with the environment in normal life events and critical life situations. [links person/environment]
- The nursing actions or processes by which positive changes in health status are effected. [links health/nursing]
- The wholeness or health of human beings, recognizing that they are in continuous interaction with their environments. [links person/environment/health]
What is the structure of nursing knowledge ?
Define Nursing Philosphies ?
- meaning of nursing phenomena through analysis, reasoning, and logical argument
- basis for professional scholarship that leads to new theoretical understandings
- early works predating the theory era and contemporary
- Philosophies are works that provide broad understandings
What are the nursing theories ?
Theories and Grand Theories
- describe, explain, or predict outcomes based on relationships among the concepts of nursing phenomena.
- propose relationships by framing a nursing issue and defining relevant terms.
- may be developed at various levels of abstraction.
- Grand nursing theories propose a testable outcome that tests the major premise of the grand theory.
Middle Range Theories
- least abstract theory level for concrete practice applications.
- characteristics of nursing practice or situations.
- theoretical evidence of applicability and outcome.
- develop evidence for nursing practice outcomes.
- recognizable as such because they contain characteristics of nursing practice.
Characteristics of middle-range theories include:
– The situation or health condition of the client/patient
– Client/patient population or age group
– Location or area of practice (e.g., community)
– Action of the nurse or intervention
– The client/patient outcome anticipated
What are Nursing conceptual models ?
- concepts and their relationships that specify a perspective and produce evidence among phenomenon specific to the discipline.
- broad metaparadigm concepts (human beings, health, nursing, and environment) perspectives with different foci for critical thinking about persons, families, and communities and for making knowledgeable nursing decisions.
- Nursing conceptual models provide a nursing perspective for theory development at various levels of abstraction.
Define the aspects of the Ontario Nursing Association ?
Ontario Nurses Association (ONA)
- Union; front-line nurses, especially in hospitals; provincial collective agreement.
- 68000 Registered Nurses
- Voice of Ontario Nurses
- Established 1973
- The Ontario Nurses’ Association (ONA) is a proactive union committed to improving the economic welfare and quality of work-life for our members, to enable them to provide high-quality health care.
ONA has worked collectively with members to ensure our front-line nurses and health-care professionals working in hospitals, public health, community health centres, home care, family health teams, long-term care and private clinics can provide the quality care our patients expect and deserve.
every nurse is required by the CNO’s professional standards to report professional practice and patient/client/resident care concerns to the employer and attempt to resolve them.
What are the beliefs of the ONA ?
Staffing and Quality of Care
- Appropriate staffing requires adequate baseline staffing and replacement resources to ensure positive patient outcomes, safety, and quality of care.
- Quality of care is measured by many dimensions. High quality care is evidence-based, focused on the patient, safe and timely.
- It is very difficult to provide safe, ethical and quality nursing care when faced with issues related to professional practice
Environment
- that it is the right of all of its members to work in a healthy and safe work environment. Unless members inform the employer of care concerns by filling out the PRWRF, the employer will assume patient care is satisfactory and/or that members are willing to accept the high-risk work environment.
