Informatics (DTHC)

HEALTH INFORMATICS

  • By Genesis A. Ysibido, RN, RM, MAN

CONCEPTS, PRINCIPLES AND THEORIES IN NURSING INFORMATICS

THE MAJOR THEORIES AND MODELS SUPPORTING NURSING INFORMATICS

  • General Systems Theory

  • Change Theory

  • Cybernetics Theory

  • Cognitive Learning Theory

  • Novice to Expert Theory

  • DIKW Theory

GENERAL SYSTEMS THEORY

Key Aspects

  • Analyzes the relationship of parts within a whole system.

  • Examines how components work together for a common purpose.

Components of General Systems

  • System: Composed of interrelated components.

  • Input: Information entering the system.

  • Output: End product of the system's processing.

  • Feedback: Process where output returns, influencing future performance.

VON BERTALANFFY'S ASSUMPTIONS (1969, 1976)

  1. Systems are goal-directed.

  2. A system is more than the sum of its parts.

  3. Changes in one part affect the whole.

  4. Systems are open and dynamic with implicit boundaries.

TERMINOLOGY OF GENERAL SYSTEMS THEORY

Term

Definition

Examples

Input

Energy/raw materials transformed by a system.

Information, money, time, individual effort.

Throughput

Process to convert raw materials.

Decision-making, information sharing, constructing, etc.

Output

Products/services resulting from throughput.

Software, laws, cars, clothing, financial assistance.

Feedback

Information to evaluate and guide system performance.

HealthCare Report Card, accreditation reports, patient satisfaction surveys.

Subsystem

A part of a larger system, can work in parallel or series.

Finance department, information system, workflow systems.

Dynamic System

Changes in response to the environment.

A young adult developing independence.

Closed System

Fixed relationships, no exchange with environment.

A rock.

Open Systems

Interacts with the environment, trading energy/resources.

Hospitals, families, businesses.

BASIC PRINCIPLES OF A SYSTEM APPROACH

  1. A system is greater than the sum of its parts, requiring holistic investigation.

  2. Predictability exists within the studied system.

  3. Each subsystem is self-contained but part of a larger whole.

  4. Central objectives supersede other objectives.

  5. Every system is an information system.

  6. Open systems interrelate with their environment.

  7. Complex systems may need subdivision for analysis.

  8. Systems consist of objectives and their relationships.

  9. Systems arranged in series necessitate alterations.

  10. Systems tend toward equilibrium.

  11. System boundaries can be redrawn by analysts.

  12. Viable systems are goal-directed, adaptive, and feedback-governed.

CHANGE THEORY (Kurt Lewin)

  • Overview: Most influential theory of social psychology.

  • Three-stage model: Unfreezing - Change - Refreezing.

  • Concepts: Driving forces, restraining forces, equilibrium.

Driving and Restraining Forces

  • Driving Forces: Push towards change.

  • Restraining Forces: Counteract driving forces and resist change.

Unfreezing, Change, Refreezing Process

  • Unfreezing: Letting go of old patterns.

  • Change: Moving to new behavior patterns.

  • Refreezing: Solidifying changes as new habits.

Major Assumptions of Change Theory

  1. Individuals undergo continuous growth and change.

  2. Daily change is subtle and disruptive.

  3. Reactions to change relate to self-esteem, safety, and security.

  4. Change can be planned or unplanned.

KURT LEWIN'S SIX COMPONENTS OF CHANGE

  1. Recognizing areas needing change.

  2. Analyzing existing forces maintaining the status quo.

  3. Identifying methods for change.

  4. Understanding group influences on change.

  5. Identifying methods used by the reference group.

  6. Executing the change process.

CYBERNETICS THEORY

  • Definition: Study of regulatory systems.

  • Goal: Understand functions/processes of systems with goals.

  • Loop Concept: Action ➔ Sensing ➔ Comparison ➔ Action.

Major Concepts in Cybernetics

  • Systems defined by their boundaries.

  • Importance of feedback in correcting actions.

  • Environments influence system operations.

COGNITIVE LEARNING THEORY

  • Explains the brain's information processing network.

  • Encompasses Social Cognitive Theory and Cognitive Behavioral Theory.

Social Cognitive Theory Variables

  • Behavioral factors, Environmental factors, Personal factors.

Key Concepts

  • Observational Learning: Learning through observation.

  • Self-efficacy: Improving knowledge through practice.

  • Self-regulatory Capability: Controlling behavior in unfavorable environments.

NOVICE TO EXPERT THEORY

  • Originated by Dreyfus, modified by Benner.

  • Application: Development of competencies, skills, and knowledge in nursing informatics.

Levels of Development

  1. Novice

  2. Advanced Beginner

  3. Competent

  4. Proficient

  5. Expert

Progression Features

  • Move from rule reliance to intuition.

  • Improved cognitive filtering of problems.

  • Greater involvement and responsibility in systems.

DIKW THEORY

  • Describes processing from data to wisdom.

  • Hierarchy: Data → Information → Knowledge → Wisdom.

COMPUTER SYSTEMS

  • Computer Hardware: Physical components and performance determinants.

  • Open Source Software: Software available for modification.

  • Data Quality Assessment (DQA): Evaluating data quality for effectiveness.

Personal, Professional, and Educational Informatics

  • Personal Informatics: Information services for individuals.

  • Educational Informatics: Enhancing information capture and organization.

MODELS IN NURSING INFORMATICS

  • Graves and Corcoran Model: Linear progression from data to knowledge.

  • Schiwirian's Model: Identification of information needs.

  • Turley's Model: Intersection of nursing, cognitive, information, and computer science.

CONCLUSION

  • Cybernetics and related theories are applicable to various disciplines requiring feedback and communication processes.