DEFINITION OF TERMS: - The focus of nursing practice

1. THEORY
 This term came from ancient Greek word
“THEORIA” , meaning looking at, 2. Health
viewing, beholding - Health is a state of complete physical,
 It is a creative and rigorous structuring of mental and social well-being and not
ideas that project a tentative, purposeful merely the absence of disease or
and systematic view of phenomena in infirmity (WHO)
which proposed explanation of a - Has different meanings for each client,
phenomena made in a way consistent with the clinical setting, and the health care
the scientific method profession
 Characteristics of Theory: - It is dynamic and continuously
1. CREATIVE- underscores the role of changing. Your challenge is to provide
human imagination and vision in the best possible care based on the
theory development client's level of health and health care
2. TENTATIVE-open to revision as new needs at the time of care delivery
evidence emerge 3. Environment
3. PURPOSEFUL-suggests a direction in - It represents the persons immediate
how to view facts and events physical surroundings, the community
4. SYSTEMATIC step by step process or the universe and all that it contains
- The internal and external surroundings
2. PHENOMENA of the client
 A phenomena is something that which - It refers to the surroundings of an
strikes one as strange, unusual, or object
unaccountable; an extraordinary or very 4. Nursing
remarkable person, thing, or occurrence - The profession concerned with the
 It is an aspect of reality that people provision of services essential to the
consciously sense or experience maintenance and restoration of health
- This may include diagnosing and
3. NURSING THEORY treatment of human responses to
 It is a body of knowledge that is used to actual or potential health problems
support nursing practice.
 This is derived from experiential learning,
from formal sources such as research or
from non-nursing sources meaning from
other theories
 Derived from nursing philosophies,
conceptual models or more abstract
nursing theories or from works of other
disciplines
 Conceptualization of some aspects of
nursing for the purpose of describing,
explaining, predicting, nursing care

4. NURSING METAPARADIGMS
 “meta” Greek Word àwith & “paradigm”à
pattern= (with pattern)
 These are patterns used to show 5. PHILOSOPHY
relationship among existing theoretical  It is from the Greek word philosophia,
works in nursing which literally means love of wisdom
 It is the core content of nursing discipline  It is an academic discipline that exercises
 It places a boundary on the subject matter reason and logic to understand reality and
of the discipline (focus of nursing theory) answer fundamental questions about
knowledge, life, morality and human
 The Four Nursing Metaparadigm nature
1. Person  It specifies the definition of paradigm
- It is the term used for HUMAN BEING concepts in each conceptual models of
- Considered the recipient/s of nursing nursing
care in the form of individual, family or  It provides a broad understanding and
community direction
 - those that are not observable, such as
6. CONCEPTUAL MODEL/FRAMEWORK caring, hope, and infinity
 It is the representations of an idea (a - all concepts become abstractions in the
model is anything used in any way to absence of the object
represent anything else) based on the own ex. social system, nurse
understanding of the person competency
 The representations of the interaction among and 3. Theoretical Definitions
between the concepts showing patterns - are the meaning of a word based on how a
 It allows the concepts in nursing theory to be certain theory or relevant literature
successfully applied to nursing practice perceives it to be.
 Concepts that specify their interrelationship to form 4. Operational Definitions
an organized perspective for viewing the - are meaning of a word based on the
phenomena method of how it was measured or how
[Link]’s Goal Attainment the person come up with the perception
5. Discrete
7. SCIENCE - identifies categories or classes of
 It came from Latin word: scientia, meaning phenomena
"knowledge" ex. Typologies of marital status:
 System of acquiring knowledge based on single, married, widowed or divorced
scientific method 6. Continuous
 Organized knowledge based on research - permits classifications of dimensions or
 Basic Types of Science: gradations of a phenomena
1. Natural Sciences- geology, ex. indicating degree of marital
meteorology conflict. (high or low)
2. Basic or Pure Sciences- mathematics, - it uses continuum
English ex. degree of temperature, level of
3. Human or Social Sciences- political anxiety, degree of pain
science, economics, sociology, - can be simple or complex and relate to an
psychology object or event that comes from individual
4. Practice or Applied Sciences- nursing, perceptual experiences
engineering, architecture
Let’s Begin!
8. KNOWLEDGE
 It is an expertise, and skills acquired by a A. CLINICAL PRACTICE
person through experience or education  Assists nurse to describe, explain,
& predict everyday experiences
9. CONCEPTS  Serves to guide assessment,
 These are considered to be the building intervention, and evaluation of nursing
blocks of theory care
 It can include words that describe objects ,  Provides a rationale for collecting
properties, or events and are basic reliable data about the health status of
components of theory clients à essential for decision-making &
 …or an idea, thought or notion conceived implementation
in the mind  Helps to establish criteria to
 These bring forth mental pictures & give measure the quality of nursing care
meanings of things  Helps build a common nursing
 Concepts can be categorized in terms of: terminology to use in communicating with
1. Types: a. Empirical/Concrete other HCPs
b. Abstract  Enhances autonomy of nursing
2. Defining: a. Theoretical Definition through defining its own independent
b. Operational Definition functions
3. Typologies: a. Discrete
a. Continuous Concepts B. EDUCATION
 Provides a general focus for
Categorization Of Concepts: curriculum design
1. Empirical/ Concrete  Guides curricular decision making
- they can be observed or experienced
through the senses C. RESEARCH
ex. stethoscope (can be seen and  Offers a framework for generating
touch) knowledge & new ideas
2. Abstract
  Assists in discovering knowledge  Personal maturity and freedom are
gaps in the specific field of study components of personal knowledge.
 Offers a systematic approach to  Expressed in personality
identify questions for study, select
variables, interpret findings & validate
nursing interventions

FOUR WAYS OF KNOWING

1. EMPIRICAL
 denotes information gained by means of
observation, experience, or experiment
thus it is objective, abstract, generally
quantifiable, exemplary and verifiable
 when verified through repeated testing
overtime, it is formulated into scientific
generalizations, laws, theories and
principles that explain and predict.
 Most emphasized way of knowing in
nursing because there is a need to know Let’s Begin!
how knowledge can be organized into laws
and theories for the purpose of describing, I. EMPIRICISM
explaining and predicting phenomena of
concern to nurses  Knowledge can be derived only
from sensory experience (seeing,
2. ETHICS feeling and hearing facts)
 Being in accordance with the accepted  Empiricist view believes that
principles of right and wrong that govern scientific truth was discovered
the conduct of a profession through generalizing observed
 In nursing, it refers to the moral code in facts in natural world
nursing and is based on obligation to  Also called the inductive method-
service and respect to human life. to formulate generalizations
 Ethical knowledge occurs as moral  Research- then- theory method
dilemnas arise in situations of ambiguity  perceived by the senses to observe
and uncertainty and when consequences & collect data
are difficult to predict.
 Requires rational and deliberate II. RATIONALISM
examination and evaluation of what is
good, valuable, desirable as goals motives  Making use of reason as the
or characteristics. appropriate method for advancing
knowledge
3. AESTHETICS/ ESTHETICS  Uses from the cause to an effect or
 Is a branch of philosophy dealing with the from a generalization to a
nature of beauty, art, and taste, and with particular instance
the creation and appreciation of beauty.  Uses deductive logic
 Relies on perception  Theory –then –research method
 It is expressive, subjective, unique and
experiential rather than formal or III. EARLY 20TH CENTURY VIEWS OF
descriptive. SCIENCE AND THEORY
 It involves sensing the meaning of the
moment  Philosophersà focused on the analysis
 It is evident through actions, attitudes and of theory structure
interactions of the nurse in response to  Scientists à focused on empirical
another. It is not usually expressed in researchà knowledge should not only
language. be based on existing understanding
but what is still to be observed
4. PERSONAL  MAJOR DEVELOPMENTS:
 Knowledge of the self, individual’s, - Experimentation
private, owned - Positivismà believes that
 Incorporates experience, knowing, empirical research and logical
encountering and actualizing the self analysis (deductive and
within the practice. inductive were two approaches
 that would produce scientific MIDDLE RANGE THEORY
knowledge
- EMPIRICAL & OBJECTIVE DATAà  Deals with portion of nursing’s total
co-exist concern but not with the totality of the
discipline
IV. EMERGENT VIEWS OF SCIENCE  They are moderately abstract and
AND THEORY IN THE LATE 20TH inclusive but are composed of concepts
CENTURY and propositions that are measurable
 Middle Range Theories are considered to
 Emphasized that science was a be more helpful to nursing practice
process of continuously building  They have narrower focus than grand
research rather than a product of theory, more precise than grand theories
findingsà emphasis shifted to & focus on developing theoretical
understanding scientific discovery and statements to answer questions about
process as theories change over time nursing
 A new epistemology challenging the  Middle range theories covers such
empiricist view proposing that theories concepts as pain, symptoms management,
play an important role in determining cultural issues and health promotion
what the scientists observe and how it  Examples: Theory of adaptation to chronic
is interpretedà an observation is pain (Dunn, 2004), Theory of caregiver
influenced by the values and ideas in stress( Tsai,2003)
the mind of the observer
 Three different views of the
relationship between theories and
observation: GRAND THEORY
1. Scientists are merely passive
observers of occurrences in the  Any theory which attempts an overall
empirical world. Observable data explanation of human experiences
are objective truth waiting to be  Abstract and do not easily lend
discovered. themselves to application or testing
2. Theories structure what the  Tend to include views on person, health
scientist perceives in the empirical and environment to create a perspective
world of nursing
3. Presupposed theories and  Several well-known nursing theorists
observable data interact in the whose grand theories have served as a
process of scientific investigation. basis for practice and research
 Science is ongoing process à as the  Grand Theories does not prescribe actions
best approach to patient care based but rather provide structural framework
upon current science may change with  Examples: Madeleine Leininger’s
time. (When hew problems or a new CULTURAL CARE, DIVERSITY &
way to interpret observation emerges, UNIVERSALITY; Betty Neuman’s HEALTH
a change in the way we think and do CARE SYSTEMS MODEL; Imogene King’s
things occurs.) GOAL ATTAINMENT THEORY; Florence
Nightingale’s ENVIRONMENTAL THEORY
Let’s Begin!

MICRO RANGE THEORY NON NURSING THEORIES

 Also known as practice theory 1. HUMAN NEEDS THEORY

 is a linking of concrete concepts into a
statement that can be examined in
practice and research
 Concepts used are narrowly defined, list
specific goal and action
 Least complex in nature and more specific
than middle range
 Provide specific directions and limited to
specific populations
 Examples: Social Learning theory, Stress
and Coping
 identification of the obstacles to the
accomplishment of change
 Teaches patience in the achievement of
change as well as the importance of
flexibility on the part of management in
achieving change objectives.
 Concept that changes is constant but
resistance to change is normal

FLORENCE NIGHTINGALE
• Florence Nightingale was born on May 12,
1820, in Florence, Italy and died on August
13-1910.

 The physiological needs. oxygen, water, • Nightingale’s affluent British family

protein, salt, sugar, calcium, and other belonged to elite social circles.
minerals & vitamins. the need to maintain
a pH balance (getting too acidic or base • Florence was raised on the family estate
will kill you) and temperature. there’s the at Lea Hurst, where her father provided
needs to be active, to rest, to sleep, to get her with a classical education, including
rid of wastes (CO2, sweat, urine, and studies in German, French and Italian.
feces), to avoid pain, and to have sex. • By the time she was 16 years old, it was
clear to her that nursing was her calling.
 The safety and security needs. When She believed it to be her divine purpose.
physiological needs are largely taken care
of. You will become increasingly THE CRIMEAN WAR
interested in finding safe circumstances,
stability, protection.  It was during this war where Florence
Nightingale volunteered her services and
 The love and belonging needs. When was eventually given permission to take a
physiological needs and safety needs are, group of 38 nurses to Turkey.
a third layer starts to show up. You begin  She recognized that overcrowding, filth,
to feel the need for friends, a sweetheart, and poor ventilation all contributed to the
children, affectionate relationships in illness of the soldiers.
general, even a sense of community.  At night, she carried a lamp through the
corridors, stopping to help the suffering of
 The esteem needs. Next, we begin to look
the wounded soldiers, for this she was
for a little self-esteem. (FAME,GLORY SELF-
nicknamed, “The Lady with the Lamp”
RESPECT)
 Based on her observations in Crimea,
 Self-actualization - continuous desire to Nightingale wrote Notes on Matters
fulfill potentials, to “be all that you can Affecting the Health, Efficiency and
be.” They are a matter of becoming the Hospital Administration of the British Army
most complete, the fullest, “you” -- hence
the term, self-actualization. ENVIRONMENTAL THEORY

1. LIGHT
2. SYSTEMS THEORY
2. VENTILATION
3. WATER
 Considers a system as a set of
independent and interacting parts. 4. NOISE
 The main goal is to study general 5. NUTRITION
principles of system functioning to be
applied to all types of system in all fields
of research

3. CHANGE THEORY

 Provides the ability to identify strategic

communication needs and allows