development of nursing theory.pptx

NURSING THEORY

1. CONCEPT, STATEMENT & STRATEGIES FOR THEORIES DEVELOPMENT MR. SUDHIR SINGH Ph.D. Scholar NIMS University Jaipur Rajasthan

2. DEVELOPMENT OF NURSING THEORIES INTRODUCTION Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or event) that is explanatory & predictive in nature. Theories are composed of concepts, definitions, models, propositions & are based on assumptions. Theory gives planners tools for moving beyond intuition to design and evaluate health behavior and health promotion interventions based on understanding of behavior.[Robert T. Croyle (2005)]. They are derived through two principal methods; deductive reasoning and inductive reasoning. Nursing theorists use both of these methods.  Theory is “a creative and rigorous structuring of ideas that projects a tentative, purposeful, and systematic view of phenomena”. A theory makes it possible to “organize the relationship among the concepts to describe, explain, predict, and control practice ”

3. DEFINITION:- Nursing theories are organized, knowledge-based concepts that essentially define the scope of nursing practice. This scope would include what constitutes nursing, what nurses are typically tasked with, and the reasons why these tasks are in place. Theory is defined as “a belief, policy, or procedure proposed or followed as the basis of action”. Nursing theory is “an organized framework of concepts and purposes designed to guide the practice of nursing”

4. Concepts:-  

5. NURSING METAPARADIGM

6. CONTI… Person Person (also referred to as Client or Human Beings) is the recipient of nursing care and may include individuals, patients, groups, families, and communities. Environment Environment (or situation) is defined as the internal and external surroundings that affect the client. It includes all positive or negative conditions that affect the patient, the physical environment, such as families, friends, and significant others, and the setting for where they go for their healthcare. Health Health is defined as the degree of wellness or well-being that the client experiences. It may have different meanings for each patient, the clinical setting, and the health care provider. Nursing The nurse’s attributes, characteristics, and actions provide care on behalf of or in conjunction with the client. There are numerous definitions of nursing, though nursing scholars may have difficulty agreeing on its exact definition. The ultimate goal of nursing theories is to improve patient care .

7. Who Develops Nursing Theories? The majority of nursing theories are developed by nurses, but at times other healthcare professionals, such as physicians have provided input into the development of nursing theories. Nurses may develop a theory on their own or in collaboration with other nurses. Nurse theorists often have a desire to explain, predict and describe elements of nursing care and practice

8. THEORY DEVELOPMENT STRATEGIES:- There are four strategies in origin of nursing theories These are differentiated primarily by their origin of theory , practice, or research, and by weather, in addition to their original sources, other sources were used in development the theory. The major strategies are 1. theory to practice to theory 2. practice to theory 3. research to theory 4. theory to research to theory

9. THEORY DEVELOPMENT STRATEGIES

10. THEORY TO PRACTICE TO THEORY STRATEGIES The theorist who uses this strategy begins the process of theorizing by selecting a theory to use in practice and then uses practice to refine the theory further. This strategy is based on several premises: • An existing theory can help in describing and explaining nursing phenomena; however, the theory’s assumptions are not completely congruent with the assumptions that guide nursing. • The theory is not entirely useful in helping nurses meet their goals in nursing practice. The theory does not define phenomena in ways that are useful for the integrity of the nurse practice act definitions. • The theory does not directly help in defining actions for nurses. The focus of the theory is different from the focus needed for nursing practice. • The theory does not provide adequate definitions of the central concepts of nursing.

11. PRACTICE TO THEORY STRATEGIES Some theories are driven by clinical practice situations and are inductively developed. They reflect experiences that evolve from practice and are based on clinical situations and on the experiences of theorists in practice.

12. RESEARCH TO THEORY The research to theory strategy is the most acknowledged and accepted strategy for theory development, both by scientists in other fields as well as by many within the discipline of nursing. This strategy is used to develop theories that are based on research. In fact, for empiricists, postempiricists , and postpositivists , theory development is considered exclusively a product of research. Therefore, according to this perspective, the strategy par excellence is research to theory.

13. THEORY TO RESEARCH TO THEORY STARTERGIES In this strategy, theory drives the research questions and the results that answer these research questions inform and modify the theory. The difference between this strategy and the research to theory strategy lies in the use or nonuse of theory as a guiding framework for the research questions. Theorists who begin the research by defining a theory and determining propositions for testing, and then go further to modify and develop the original theories, are considered users of this strategy.

14. Types of Nursing Theories

15. Conti….. Grand Nursing Theories Grand theories are abstract, broad in scope, and complex, therefore requiring further research for clarification. Grand nursing theories do not guide specific nursing interventions but rather provide a general framework and nursing ideas. Grand nursing theorists develop their works based on their own experiences and their time, explaining why there is so much variation among theories. Address the nursing metaparadigm components of person, nursing, health, and environment .

16. Conti….. Middle-Range Nursing Theories More limited in scope (compared to grand theories) and present concepts and propositions at a lower level of abstraction. They address a specific phenomenon in nursing. Due to the difficulty of testing grand theories, nursing scholars proposed using this level of theory. Most middle-range theories are based on a grand theorist’s works, but they can be conceived from research, nursing practice, or the theories of other disciplines .

17. Conti….. Practice-Level Nursing Theories Practice nursing theories are situation-specific theories that are narrow in scope and focuses on a specific patient population at a specific time. Practice-level nursing theories provide frameworks for nursing interventions and suggest outcomes or the effect of nursing practice. Theories developed at this level have a more direct effect on nursing practice than more abstract theories. These theories are interrelated with concepts from middle-range theories or grand theories .

18. By Goal Orientation Theories can also be classified based on their goals. They can be  descriptive  or  prescriptive . Descriptive Theories Descriptive theories are the first level of theory development. They describe the phenomena and identify its properties and components in which it occurs. Descriptive theories are not action-oriented or attempt to produce or change a situation. There are two types of descriptive theories:  factor-isolating theory  and  explanatory theory . Factor-Isolating Theory Also known as category-formulating or labeling theory. Theories under this category describe the properties and dimensions of phenomena. Explanatory Theory Explanatory theories describe and explain the nature of relationships of certain phenomena to other phenomena.

19. Other Ways of Classifying Nursing Theories Classification According to Meleis Afaf Ibrahim Meleis (2011), in her book  Theoretical Nursing: Development and Progress , organizes the major nurse theories and models using the following headings: needs theories, interaction theories, and outcome theories. These categories indicate the basic philosophical underpinnings of the theories. Needs-Based Theories.  The needs theorists were the first group of nurses who thought of giving nursing care a conceptual order. Theories under this group are based on helping individuals to fulfill their physical and mental needs. Theories of Orem, Henderson, and Abdella are categorized under this group. Need theories are criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position. Interaction Theories.  These theories emphasized nursing on the establishment and maintenance of relationships. They highlighted the impact of nursing on patients and how they interact with the environment, people, and situations. Theories of King, Orlando, and Travelbee are grouped under this category. Outcome Theories . These theories describe the nurse as controlling and directing patient care using their knowledge of the human physiological and behavioral systems. The nursing theories of  Johnson ,  Levine ,  Rogers , and  Roy  belong to this group.

20. Classification According to Alligood Classification According to Alligood In her book,  Nursing Theorists and Their Work,  Raile Alligood (2017) categorized nursing theories into four headings: nursing philosophy, nursing conceptual models, nursing theories and grand theories, and middle-range nursing theories. Nursing Philosophy . It is the most abstract type and sets forth the meaning of nursing phenomena through analysis, reasoning, and logical presentation. Works of Nightingale, Watson, Ray, and Benner are categorized under this group. Nursing Conceptual Models . These are comprehensive nursing theories that are regarded by some as pioneers in nursing. These theories address the nursing metaparadigm and explain the relationship between them. Conceptual models of Levine, Rogers, Roy, King, and Orem are under this group. Grand Nursing Theories.  Are works derived from nursing philosophies, conceptual models, and other grand theories that are generally not as specific as middle-range theories. Works of Levine, Rogers, Orem, and King are some of the theories under this category. Middle-Range Theories.  Are precise and answer specific nursing practice questions. They address the specifics of nursing situations within the model’s perspective or theory from which they are derived. Examples of Middle-Range theories are that of Mercer, Reed, Mishel, and Barker.

21. LEVELS OF NURSING THEORY

22. IMPORTANCE OF NURSING THEORIES Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs1978). It should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future (Brown 1964). Theory is important because it helps us to decide what we know and what we need to know (Parsons1949). It helps to distinguish what should form the basis of practice by explicitly describing nursing. The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education (Nolan 1996). The main exponent of nursing – caring – cannot be measured, it is vital to have the theory to analyze and explain what nurses do. As medicine tries to make a move towards adopting a more multidisciplinary approach to health care, nursing continues to strive to establish a unique body of knowledge. This can be seen as an attempt by the nursing profession to maintain its professional boundaries .