Theoretical Foundations in Nursing – Study Notes (Bullet-Point Summary)

What is a theory?

  • A theory is a creative and rigorous structuring of ideas that projects a tentative, purposeful and systemic view of phenomena (Chinn and Kramer, 1991).
  • A theory is a system of ideas proposed to explain a given phenomenon (Kozier, 2008).
  • An organized system of knowledge composed of concepts, propositions, definitions and assumptions intended to explain a set of facts, events or phenomena (Octavio & Balita, 2008).
  • Phenomena – sets of experiences that can be observed:
    • Clinical or environmental setting
    • Disease process
    • Client’s behavior
    • Interventions

Elements of a theory

  • Concepts – building blocks of theory; abstract cannot be observed vs empirical can be observed; concrete.
  • Definitions – descriptions of the concepts.
  • Assumptions – statements the theorists holds as factual.
  • Propositions – statements that imply relationships between concepts.
  • Theory – a systematically organized view of phenomena.
  • Phenomena – the observable events or facts the theory aims to explain.

Nursing Theory

  • A nursing theory is a group of interrelated concepts developed from various disciplines and experiences, aiming to view the essence of nursing care.
  • Meleis (1991) defines nursing theory as an articulated and communicated conceptualization of invented or discovered reality pertaining to nursing for describing, explaining, predicting or prescribing nursing care. (Classification according to function)
  • Functions of a theory in nursing: Describes, Explains, Predicts, Prescribes NURSING CARE

Types of Theories by Function (Dickoff and James, 1968)

1) Descriptive – Factor-isolating theories

  • Example: a descriptive study on teenage pregnancy
    2) Explanatory – Factor-relating theories
  • Example: study on factors affecting substance abuse in adolescents
    3) Predictive – Situation-relating theories
  • Example: effect of advertisements on cigarette smoking in college students
    4) Prescriptive – Situation-producing theories
  • Example: Laurente’s theory validating different nursing management in ER in relieving anxiety of clients

Characteristics of Theory

  • Logical
  • Simple but generally broad in nature
  • Can be a source of hypotheses that can be tested
  • Can enrich the general body of knowledge through studies validating them
  • Can be used by practitioners to direct and enhance their knowledge
  • Must be consistent with other validated theories, laws and principles

Concepts (concepts and propositions)

  • Concepts – building blocks; abstract vs empirical
  • Definitions – descriptions of concepts
  • Assumptions – statements taken as factual by the theorist
  • Propositions – statements that imply relationships between concepts
  • Conceptual vs Operational: meaning based on literature vs measured/perceived in practice
  • Example: Ambulation
    • Concept: Ambulation is to walk from one place to another or to move about
    • Operational meaning: Taking 6 steps without assistance

What is science?

  • Science refers to knowledge or practices in a discipline of study; an organized body of knowledge based on research.
  • Scientific Method:
    1) Observation – integration of knowledge and/or phenomenon
    2) Gathering Data – recognition and collection of data
    3) Forming Hypothesis – propose a nature of the phenomenon
    4) Experimental Investigation – examinations to solve a query
    5) Conclusion – statement explaining the phenomena or query

What is knowledge?

  • Knowledge comprises information, expertise and skills acquired through life experiences or formal/informal learning.
  • It can be abstract or workable understanding of an idea; facts and information or awareness gained by experience.
  • Knowledge components (from the cognitive map): Perception, Association, Learning, Reasoning, Communication

Types of Cognitive Processes

  • Perception – achieving understanding of sensory data
  • Association – combining two or more concepts or ideas to form a new concept
  • Learning – acquiring experience, skills, information and values
  • Reasoning – mental process of seeking conclusions through reason
  • Communication – transferring data from sender to receiver using different mediums/tools

Sources of Knowledge

1) Traditional – Passed down from generation to generation
2) Authoritative – Idea of a person of authority perceived as true due to expertise
3) Scientific – From the scientific method or research; systematic and accurate

Nursing is…

  • American Nursing Association (ANA): the diagnosis and treatment of human responses to actual or potential health problems.
  • International Council of Nurses (ICN): autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness and the care of the ill, disabled and dying people.

Nursing is… (ADPCN definition)

  • Association of Deans of the Philippine Colleges of Nursing (ADPCN): Nursing is a dynamic discipline; it is the art and science of caring for individuals, families, groups and communities geared toward promotion and restoration of health, prevention of illness, alleviation of suffering and assisting clients to face death with dignity and peace.
  • It focuses on assisting the client as he or she responds to health-illness situations, using the nursing process and guided by ethico-legal and moral principles.

Nursing Metaparadigms

  • Metaparadigms are patterns/models used to show clear relationships among existing theoretical works in nursing.
  • Current theories focus on the relationship of four major concepts: Person, Environment, Health, Nursing

Metaparadigm of Nursing

  • Four concepts:
    1) Person – the recipient of care: individuals, families and communities
    2) Environment – external and internal aspects of life that influence the person
    3) Health – the holistic level of wellness the person experiences
    4) Nursing – the interventions of the nurse rendering care in support of or in cooperation with the client

Importance of Theory

  • Education: program objectives, course objectives, course description and clinical performance criteria
  • Research: provides answers to questions encountered during clinical practice
  • Clinical Practice: guides critical thinking and decision making in practice; strengthens professional independence

Interdependence of Theory and Research

  • Nursing practice ↔ Nursing theory ↔ Nursing research (interconnected cycle) – theory informs practice, practice informs theory, research tests theory

Theoretical vs Practical Knowledge

  • Theoretical knowledge: stimulates thinking and broadens understanding of the science and practice of nursing; theoretical underpinnings
  • Practical knowledge: learned during practice; nursing knowledge applied in real care

Theory-generating vs Theory-testing Research

  • Theory-generating research: designed to discover and describe relationships and phenomena without imposing predetermined notions on the phenomena
  • Theory-testing research: used to determine how accurately the theory describes a phenomenon

Categories of Theory According to Scope

  • Scope refers to the qualified level of precision of a theory and the accuracy of its concepts and propositions
  • Types by scope:
    • Grand Theories
    • Middle-range Theories
    • Micro-range Theories

4 Ways of Knowing

  • Empirical Knowing: scientific, research-based, theoretical and factual information used in nursing
  • Aesthetic Knowing: focuses on feelings, attitudes, points of view and the uniqueness of each individual
  • Ethical Knowing: judgments of right and wrong in relation to intentions, reasons and attributes
  • Personal Knowing: self-awareness and understanding of one’s own biases and experiences

Reference

  • Alligood, M. (2014). Nursing Theories and Their Works (8th ed.). St. Louis, Missouri: Elsevier Mosby.

Thank you!