Theoretical Foundations of Nursing Practice

Theoretical Foundations of Nursing Practice

  • Nursing Foundation Theory:
    • Serves as the foundation for the art and science of nursing.
    • Theory, research, and practice are interlinked in an ongoing relationship.
  • Purpose of Theory:
    • Helps to explain events by:
    • Defining ideas or concepts.
    • Explaining relationships between concepts.
    • Predicting outcomes.
    • Nursing theory conceptualizes aspects of nursing and can describe, explain, predict, and/or prescribe nursing care.
  • Components of a Theory:
    • Phenomenon: The event or occurrence that is being studied.
    • Concepts: The building blocks of a theory.
    • Definitions: Clarifies the meaning of concepts.
    • Theoretical/Conceptual Definitions
    • Operational Definitions
    • Assumptions: Statements accepted without proof that form the foundation of the theory.
  • Domain of Nursing:
    • Encompasses the nursing metaparadigm:
    • Person: The recipient of care.
    • Health: The degree of wellness or illness experienced.
    • Environment/Situation: Influences that affect the patient.
    • Nursing: The actions taken by nurses to care for patients.
  • Evolution of Nursing Theory:
    • First nursing theorist: Florence Nightingale.
    • Key eras in nursing theory development:
    • Curriculum era (1900-1940s)
    • Research era (1950-1970s)
    • Graduate education era (1950-1970s)
    • Theory era (1980-1990s)
    • Theory utilization era (2000s-today)
    • Theories are dynamic and evolve according to changes in society and nursing practice.
  • Types of Theory:
    • Grand Theories: Broad, complex frameworks.
    • Middle-range Theories: Limited scope, less abstract.
    • Practice Theories: Focused and specific to practice.
    • Descriptive Theories: Describe phenomena and situations.
    • Prescriptive Theories: Guide practice change and predict outcomes.
  • Theory-Based Nursing Practice:
    • Theory generates nursing knowledge that supports Evidence-Based Practice (EBP).
    • Derived from basic and nursing sciences, experience, aesthetics, nurses’ attitudes, and standards of practice.
    • Aims to differentiate nursing from other healthcare disciplines.
  • Shared Theories:
    • Provide explanations for phenomena specific to the discipline developing them, also known as interdisciplinary or borrowed theories.
  • Systems Theories:
    • Focus on patient interaction with the environment through various domains:
    • Psychological
    • Physiological
    • Developmental
    • Sociocultural
    • Environmental
    • Spiritual
    • Structures include:
    • Input: Patient interaction data
    • System: Nursing process (assessment, diagnosis, planning, implementation, evaluation)
    • Output: Patient's health status returning to the environment
    • Feedback: Patient functioning outcomes.
  • Case Study Examples:
    • Susan tutoring Bill about theoretical foundations and navigating concepts like Maslow’s hierarchy of needs.
  • Select Nursing Theories:
    • Nightingale’s Environmental Theory: Focuses on the environment in nursing care. (Grand theory)
    • Peplau’s Interpersonal Theory: Focuses on the nurse-patient-family relationship phases: preorientation, orientation, working, resolution. (Middle-range theory)
    • Orem’s Self-Care Deficit Nursing Theory: Emphasizes patient self-care. (Grand theory)
    • Leininger’s Culture Care Theory: Integrates cultural beliefs into care. (Middle-range theory)
  • Link Between Theory and Knowledge Development:
    • Nursing knowledge is shaped by theoretical and experiential learning.
    • Objectives of theoretical knowledge include stimulating thought and understanding nursing science and practice.
    • Experiential knowledge involves practical care experiences.
  • Nursing Practice and Theory Relationship:
    • Nursing practice is centralized by a theory that generates knowledge and is adaptable across various patient needs.