Module 3: Foundational Theories

What is a concept?

An idea that we conceive in our minds to represent the world around us.

3 features of a concept

1) Can change over time

2) A building block of theory

3) A vehicle of thought

What is a nursing concept?

An idea or principle that guides nursing practice; part of nursing theory to guide nursing care.

A concept is a building block of what?

Theory.

4 characteristics of a good theory

1) be logical

2) integrate previous research

3) be testable

4) contain no contradictory statements

Phenomenon

An aspect of reality that can be sensed or experienced

What is a nursing theory?

Theory that organizes knowledge about nursing so nurses can use it in a professional and accountable manner

What is a nursing PRACTICE theory?

A theory based on specific nursing situations, with the focus on interventions.

Nursing theory vs nursing practice theory

Nursing theory: organizes nursing knowledge for professional, accountable use

Nursing practice theory: tied to specific nursing situations and interventions.

Conceptual Framework.

A broad idea of using nursing knowledge to understand specific patient care.

What is a paradigm?

A logical explanation among concepts within an actual world view.

What is a metaparadigm?

The way a professional discipline looks at the world; its primary concepts are described by the metaparadigm.

What does the nursing metaparadigm include?

A set of concepts or ideas important to the discipline of nursing - those central or core to nursing.

Name the 4 core concepts

Person, health, nursing, environment.

Person

The recipient of nursing care: individuals, patients, groups, families and communities.

Health

The degree of wellness or well-being the client experiences.

Nursing

Attributes, characteristics and actions of the nurse providing care on behalf of or in conjunction with the client.

Environment

The internal and external surrounds that affect the client.

Which concept is 'subjective'?

Health.

Which concept involves 'dynamic changes'?

Person.

Which concept is 'all things that impact a person'?

Environment.

Which concept is 'actions of the nurse in a nurse/pt relationship'?

Nursing.

Name the 4 types of foundational theories in nursing

Grand, mid-range, descriptive, prescriptive.

Grand theory

Global.

Mid-range theory

More specific.

Descriptive theory

Describes aspects of care.

Prescriptive theory

Addresses interventions.

Grand vs mid-range

Grand = global (broad). Mid-range = more specific.

Descriptive vs prescriptive

Descriptive = describes aspects of care.

Prescriptive = addresses interventions.

[Peplau] Her theory

Interpersonal Relations Theory.

[Peplau] Her title

"Mother of Psychiatric Nursing."

[Peplau] What did she challenge nurses to do?

Form a relationship (within 4 phases).

[Peplau] What did she want for the patient?

For the patient to achieve independence.

[Peplau] Applied today

Forming a relationship leads to improved patient outcomes.

[Neuman] Her theory

Systems model.

[Neuman] Philosophy behind her model

Each human being is a total person as a client system and is a layered, multidimensional being.

[Neuman] What did she identify?

Environmental stressors.

[Neuman] Applied today

Treating the patient holistically, ensuring interventions address unique needs and stressors.

[Henderson] Her theory

Need Theory.

[Henderson] What does her theory focus on?

The basic needs of patients.

[Henderson] What did she believe nurses should do?

Assist patients in meeting their essential needs.

[Henderson] Examples of essential needs

Nutrition, hygiene and comfort.

[Henderson] Applied today

Her ideas about meeting basic needs apply to today's nursing.

[Watson] Her theory

Theory of Human Caring.

[Watson] What are her '10 ___ Factors'?

Carative

[Watson] How does she see a person?

As made up of mind, body and spirit.

[Watson] What is the transpersonal self?

your deepest inner core (your spirit or soul) rather than just your physical body or daily mind

[Watson] Her 'oneness' idea

Person > nature > universe = oneness.

[Watson] Applied today

"Caring is central to nursing practice and promotes health better than a simple medical cure."

[Allen] Her model

The McGill Model.

[Allen] Her education

Earned a doctoral degree.

[Allen] Contributions to nursing education (2)

Criteria for accreditation of nursing school; developed an evaluation tool for nursing schools.

[Allen] Contribution to nurses' rights

Collective bargaining rights for nurses.

[Allen] Her focus

Health promotion.

[Allen] Applied today

In health promotion.

[Benner] Her theory

Novice to Expert Theory (Benner's Stages of Clinical Competence).

[Benner] How many levels of proficiency?

Five.

[Benner] Name the 5 levels in order

1) Novice

2) Advanced beginner

3) Competent

4) Proficient

5) Expert

[Benner] When do nurses pass through the levels?

When developing a skill.

[Benner] Applied today

Nurses use previous knowledge and critical thinking through all levels.

[Who Am I?] Mother of Psychiatric Nursing

Hildegard Peplau.

[Who Am I?] Interpersonal Relations Theory

Hildegard Peplau.

[Who Am I?] Systems model; layered, multidimensional client system

Betty Neuman.

[Who Am I?] Identified environmental stressors

Betty Neuman.

[Who Am I?] Need Theory; nutrition, hygiene, comfort

Virginia Henderson.

[Who Am I?] Theory of Human Caring; 10 Carative Factors

Jean Watson.

[Who Am I?] McGill Model; Canadian; collective bargaining rights

Moyra Allen.

[Who Am I?] Novice to Expert

Patricia Benner.

[Who Am I?] Which theorist is linked to holistic patient treatment today?

Betty Neuman: treating the patient holistically.

[Who Am I?] Which theorist is linked to health promotion today?

Moyra Allen.

[Who Am I?] Which theorist's idea: relationship leads to better outcomes?

Hildegard Peplau.

What does theoretical knowledge lead us to reflect on?

The basic values, guiding principles, elements and phases of a conception of nursing

How do theories relate to practice?

Theories can influence or shape nursing practice.

What should happen to theories over time?

They are to be created, built upon, and used to grow the profession of nursing.