Theoretical Foundations of Nursing – Prelim Week 1

Vocabulary flashcards covering key terms from the lecture on the history, eras, and core concepts of nursing theory.

FLORENCE NIGHTINGALE

• Founder of modern nursing—“The Lady with the Lamp”

• Envisioned nursing as a respected, educated profession for women

• Emphasized education and sanitation

• Her works became the foundation for nursing theories and schools

SUCCESSIVE ERA

• Transition from vocation to profession

  - calling or job (caring for the sick) formal eduction or professional status

FIVE HISTORICAL ERAS OF NURSING

1. Curriculum Era

2. Research Era

3. Graduate Education Era

4. Theory Era

5. Theory Utilization Era

CURRICULUM ERA

• Emphasis on curricular content and movement toward the goal of standardized curricula

• Emphasis on “what nurses needed to know to practice nursing”

• Fundamentals/Basic essentials

• Taught in a ward-like classrooms (Nursing Arts Laboratory to Skill Labs)

RESEARCH ERA

• Emhasized nursing scholarship and need to disseminate research findings in scholarly publications

• To improve patient care

RESEARCH ERA

• Focus: Doing scientific studies in nursing

• Goal: Build nursing knowledge through evidence

GRADUATE EDUCATION ERA

• Nurses started going to graduate school

GRADUATE EDUCATION ERA

• Focus: Higher education for nurses

• Goal: Prepare nurse leaders, educators and researchers

THEORY ERA

• Nurses started writing theories to guide practice

THEORY ERA

• Focus: Developing nursing theories

• Goal: Establish nurse as science, not just a practice

FAWCETT (1984, 1989)

• Proposed metaparadigm

• Person, Health, Environment, Nursing

THEORY UTILIZATION ERA

• Concentrating on applying nursing theories in practice, education, research, and administration.

THEORY

• An organized system of accepted knowledge that is composed of concepts, propositions, definitions and assumptions

• A creative and rigorous structuring of ides that projects a tentative, purposeful and systematic view of phenomena

• A supposition or system of ideas that is proposed to explain a given phenomenon

CONCEPTS

• An idea formulated by the mind and an experience perceived and observed

TYPES OF CONCEPTS

1. Abstract Concepts

2. Concrete Concepts

3. Discrete Concepts/Non-Variable Concepts

4. Continuous Concepts/Variable Concepts

ABSTRACT CONCEPTS

• Are mentally constructed

• Independent of a specific time and place

• Can’t see or touch

• Examples: Pain, Love, Stress, Comfort, Anxiety, Caring

CONCRETE CONCEPTS

• Are directly experienced, observable, or measurable idea

• Related to time and place

• Can see, touch, or measure

• Example: Fever, Blood Pressure, Wound, Heart Rate

DISCRETE CONCEPTS (NON-VARIABLE)

• Identifies categories or classes of phenomena

• Example: Gender, Marital Status, Year Level

CONTINUOUS CONCEPTS

• Permits classification of dimensions or gradations of a phenomenon

• Expressed in degrees on a continuum

• Example: Score on a Pain Scale

VARIABLE CONCEPTS

• Composed of various descriptions which convey a general meaning and reduce vagueness in understanding a set of comcepts

TWO TYPES OF VARIABLE CONCEPTS (DEFINITION)

1. Conceptual Definition

2. Operational Definition

CONCEPTUAL DEFINITION

• Establish meaning

OPERATIONAL DEFINITION

• Provide measurement

PROPOSITIONS

• Explains the relationships of different concepts

• Shows how one concept affects or relates to another

Example:

1. Concept: Children and fear of injections

   Children who do not want to stay in the hospital because of their fear of injections

2. Concept: Stress and Health

   Increased stress negatively affects a person’s health

ASSUMPTIONS

• Statements that specifies the relationship or connection of factual concepts or phenomena

• “Believed to be true, even if it hasn’t been proven yet”

• Example:

  Florence Nightingale’s Environmental Theory

  “A clean well-ventilated environment promotes healing”

  Assumption: The environment directly affects patient recovery

PHENOMENON

• Sets of empirical data or experiences that can be physically observed or tangible

SCOPE OF THEORY

• Based on the complexity and degree of abstraction

• Includes:

  1. 1. Level of specificity

  2. 2. Concreteness

1. SCOPE THEORY

1. Metatheory

2. Grand Theory

3. Middle Range Theory

4. Practice Theory

METATHEORY

• A.k.a Philosophy of Worldview

• Theory about a theory

• Focuses on broad issues like the process of generating knowledge and theory development

GRAND THEORY

• The most complex and broadest attempts to explain broad areas

• Broadly conceptualized and usually applied to a general area of a specific discipline

MIDDLE RANGE THEORY

• Specific, limited number of concepts and limited aspect of the real world

• Composed of:

1. 1. Concrete concepts

2. 2. Concrete propositions

• May be:

  1. 1. Description of a phenomenon

  2. 2. Explanation of the relationship between the phenomenon

  3. 3. Prediction of effects of one phenomenon on another

PRACTICE THEORY

• Also called Situation-Specific Theory or Prescriptive Theory

• Lease complex and narrowest in scope

TYPES OF THEORY

1. Descriptive

2. Explanatory

3. Predictive

4. Prescriptive

DESCRIPTIVE THEORY

• Observes, describes, and names concepts, properties and dimensions

• Does not explain interrelationships

• What is happening but doesn’t say what to o about it

• Example:

  To provide observation and meaning

  "At the adolescent stage (age 12-18), individuals face the conflict of identity vs. role confusion."

  Nursing use: Helps nurses understand the psychosocial needs of patients at different ages

EXPLANATORY

• Tells WHY concepts are related; WHY the phenomenon happened

• Example:

  A research study about factors affecting newborns failing to thrive

PREDICTIVE

• Describes the precise relationship between concepts, specifies the kind of relationship between A and B

• Foresees or forecasts outcomes

• Example:

  If a patient believes exercise is beneficial and they have family support, they are more likely to start exercising

PRESCRIPTIVE

• Order activities; the highest level of theory development

• Tell nurses WHAT to do, HOW to do it and WHEN to do it to achieve a desired outcome

• It goes beyond describing or predicting; gives specific directions for nursing actions

• Example:

  If a patient cannot give themselves insulin, the nurse should administer it and teach them how to do it safely in the future

DISCIPLINE

• Specific to academia

• Branch of education ; department of learning

• Domain of knowledge or body of knowledge

• Learning = knowledge, theory, science

• SIGNIFICANCE:

  Nursing programs are being recognized and nursing leaders are offering their perspectives on the development of nursing science

PROFESSION

RATIONALISM

• Thinking and logic first

• Knowledge comes from reasoning and thinking deeply

• Example:

  Nursing Theorists used reason and logic to build nursing models and concepts, even before

EMPIRICISM

• Experience and observation first

• Knowledge comes from what we can see, touch, and measure - SENSES

• Example:

  Scientists collect data and evidence before accepting something as true.

EARLY 20th CENTURY VIEW

• Science is exact

• People believed science was the only true way to know something

POSITIVISM

• Dominant view of modern science, termed by Auguste Comte, believing in the natural rather than supernatural

EMERGENT VIEW

• Multiple ways of knowing

• Science is important, but NOT the only way to understand something

• Human experience, feelings, culture, and meaning also matter - NOT just data

• Example:

  Combining science (labs, meds) with art and compassion (listening, comforting)