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Nursing Theory Persuasive

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1. How does the Nursing Theory assist the practicing nurse in the delivery of care to patients? Explain your answer. Nursing theories are important to the lives of nurses because they help develop and understand further the nursing practice. These were formulated by the theorists because they believed that these will aid nurses in the holistic health care delivery and furthermore help in collaborating with other disciplines and practices. These guide the nurse on what nursing is and is used as a guide for other ideas and techniques for nursing. Fawcell (1992) stated the ways in which theories and conceptual models developed by nurses have influenced nursing practice. It said that theories identify specific standards for nursing practice. It also can identify individual nursing processes to be used and technologies to be used. They also serve as the basis for clinical information systems including the admission data base, nursing orders, care plan, progress notes, and discharge summary.

Theory helps to identify the focus, the means, and the goals of practice. It helps develop communication, augments accountability to care, and present independence to the profession. In the example of Florence Nightingale, her view on nursing is focused on physical environment. She believed that healthy surroundings were necessary for proper nursing care and restoration of health. Her essential components, (pure air, pure water, efficient drainage, cleanliness and light) is still very relevant in nursing practice nowadays as in her time. Although pure air is still not applicable in our setting, especially in government hospitals where there are no air conditioners, they still try to provide electric fans for our clients and windows are left open. Cleanliness is of course is very important, most especially in handling wastes and hand washing. This is essential to prevent contamination of the environment. Nurses need to control and are responsible for the patient’s environmental surroundings.

2. Describe the curriculum and the description of a nurse during Silent Knowledge Stage and Procedural Knowledge Stage. A nurse’s role in the Silent Knowledge Stage was to obey and completely rely to medical authority, that nurses were completely dependent on doctors without questions. There was no independent decision-making by a nurse and that technical skills were only to be performed by skilled nurses. They also believed that there was no need to be educated of theory. Schools of nursing were attached to hospitals, and the training of nurses and student nurses were hospital based. In the Procedural Knowledge Stage however, the National League for Nursing applied that nursing curricula be based on conceptual frameworks. Nursing theorists published their principles on what nursing should be. Common elements of nursing were enumerated such as: roles and actions, client, the environment and health. Books were also written to teach nurses how to describe, explain and apply nursing theories. Theories set apart nurse’s role from what they do in reality to what nursing really is.

3. Differentiate Metatheory from Macrotheory
Metatheory is the highest level of theory. It refers to the body of knowledge about a body of knowledge or a “theory of a theory”. According to Sell and Kalofissudis, it presents the most global perspective of the nursing discipline by identifying and evaluating critical phenomena in unique ways. It provides the meanings, sentences, and structures interconnecting situations and events observed by nurses on a global scale. The macrotheory on the other hand, refers to a set of rules, procedures and assumptions used to explain large scale phenomenon of society (things that have a public concern). [www.ask.com/question/what-is-a-macro-theory] It is general in nature and it attempts to explain very wide areas in a discipline and may include many theories.

4. Differentiate factor-isolating theories from factor-relating theories

Factor-isolating theories identify and describe the most important concepts of phenomena however they do not explain the connection of the concept. They are tested by descriptive research and describes ‘what is’. It may include models that illustrate an experience, culture or process. Factor-relating theories on the other hand are explanations or causes of the phenomenon. These explain the relationship of the theory; how or why concepts are related.

5. Differentiate situation-relating theories from situation-producing theories.

Situation-relating theories are achieved when the connections of concepts under a certain condition are able to describe future outcomes consistently. It is the kind of theory that is generated and tested using experimental research. Situation-producing theories deal with nursing actions and test the validity and certainty of specific nursing interventions. It is also used in testing new nursing interventions. To prevent occurrence of the phenomenon by controlling or eliminating possible causes.

Unit II – Concept Development

Unit III – Theory Development
1. Discuss all the topics in Unit III

A metaparadigm for nursing is a framework for the discipline that sets forth the phenomena of interest and the propositions, principles, and methods of the discipline. It is very general and is intended to reflect agreement among members of the discipline about the field of nursing. It is the most abstract level of nursing knowledge and closely mirrors beliefs held about nursing. It offers a context for developing conceptual models and theories. (Parker, 2001) It is the most global perspective of a discipline acting as an encapsulating unit or framework within which the more restricted structures develop. It identifies certain phenomena which are of interest to a discipline and explains how that discipline deals with those phenomena in a unique manner. (Fawcett, 1992) One of the functions of met paradigms is that it summarizes the intellectual and social missions of a discipline and place a boundary on the subject matter of the discipline. It also distinguishes a discipline from others.

The four requirements for a metaparadigm according to Fawcett are the following: First, a metaparadigm must identify a domain that is distinctive from the domain of other disciplines. It is fulfilled only when the concepts and propositions represent a unique perspective for inquiry and practice. Second, it must encompass all phenomena of interest to the discipline in a parsimonious manner. It is fulfilled only if the concepts and propositions are global and if there are no redundancies in concepts or propositions. Third, it must be perspective-neutral. It is only fulfilled only if the concepts and propositions do not reflect a specific paradigm or conceptual model, or is a combination of perspectives. Lastly, it must be international in scope and substance. This requirement is corollary of the third requirement, is fulfilled only if the concepts and propositions do not reflect particular national, cultural or ethnic beliefs and values.

The following are the category of theory based on scope or level of abstraction: 1. Metatheory/Philosophy/Worldview
These are philosophical or methodological questions related to developing a theoretical base for nursing – Hickman (2002). This also deals with processes of generating knowledge and debating broad issues related to the nature of theory – Avant and Walker (2005) 2. Grand theories

Are composed of relatively abstract concepts that are not operationally defined and they attempt to reveal all aspects of human experience and response. These are conceptual frameworks defining broad perspectives for practice and ways of looking at nursing phenomena based on these perspectives. 3. Middle Range Theories

Are limited in number and scope and are more precise and only analyzes a particular situation with a limited number of variables. It covers concepts such as pain, symptom management, cultural issues and health promotion. 4. Practice/Prescriptive/Microtheory

These explain prescriptions or modalities for practice. It explores one particular situation found in nursing. Its essence is a defined or identified goal and prescriptions for interventions or activities to achieve the goal.

The following are theories based on purpose:
1. Descriptive Theories
This is the first and most important level of theory development – Barnum (1998) They describe, observe and name concepts, properties and dimensions but they do not explain the interrelationships among the concepts or propositions and they do not indicate how changes in one concept affect other concepts. 2. Explanatory Theories

It is the second level of theory development. This can be viewed in relation to other phenomena. They attempt to tell how or why the concepts are related and may deal with causality, correlations and rules that regulate interactions. 3. Predictive

The third level of theory development. They describe precise relationships between concepts. They presuppose prior existence of the more elementary types of theories and they describe future outcomes consistently. 4. Prescriptive

This is the highest level of theory development. They prescribe activities necessary to reach definite goals.

The following are theories based on Philosophical Underpinnings of the Theories 1. Needs theories
They are based around helping individuals to fulfil their physical and mental needs. They are criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position. 2. Interaction Theories

They revolve around the relationships nurses form with patients – Peplau (1988) They are criticized for ignoring the model of health and not attending to basic physical needs. 3. Outcome Theories

They portray the nurse as the changing force who enables individuals to adapt to or cope with ill health. They are criticized as too abstract and difficult to implement. 4. Humanistic Theories
They are developed in response to the psychoanalytic thought that a person’s destiny was determined early in life. They emphasize a person’s capacity for self-actualization. Humanists believe that the person contains within himself the potential for healthy and creative growth.

Components of a theory
1. Purpose
It explains why the theory was formulated and specifies the context and situation in which it should be applied. (Chin and Kramer, 2004)

2. Concepts and Conceptual Definitions
Concepts are linguistic labels that are assigned to objects or events and are considered to be the building blocks of theories. These are ideas, mental images, generalizations formed in the mind. These are also abstract impressions from environment. (Taylor, 1996) Theoretical definition defines the concept in relation to other concepts and permits the description and classification of phenomena. Operationally defined concepts link the concept to the real world and identify empirical referents of the concept that will permit observation and measurement.

3. Theoretical Statements
These are also called prepositions. This is a statement about the relationship between two or more concepts and is used to connect concepts to devise the theory. It has two types namely the existence statement and the relational statement. The existence statement relates to specific concepts and makes existence claims about that concept. It also serves as adjuncts to relational statements and clarifies meaning to the theory. It is termed nonrelational statements and may be right or wrong depending on the circumstance. Relational statements on the other hand only names and classifies objects and may also be classified as associational or causal relationship.

4. Structure and Linkages
It is the determination of the order of appearance of relationships, identification of central relationships and delineation of direction, strength and quality of relationships. By logical arrangement and specifying linkages of the theoretical concepts and statements.

5. Assumptions
They are notations that are taken to be true without proof. They are also beliefs about a phenomenon that one must accept as true to accept a theory and although they may not be empirically testable, they can be argued philosophically.

6. Models
They are schematic representations of some aspect of reality. They help illustrate the processes through which outcomes occur by specifying the relationships among the variables in graphic form where they can be examined for inconsistency or errors. They provide an overview of the thinking behind the theory and may demonstrate how theory can be introduced into practice, for example, through specific methods of assessment. Models are useful as they allow the concepts in nursing theory to be successfully applied to nursing practice (Lancaster and Lancaster 1981). Their main limitation is that they are only as accurate or useful as the underlying theory.


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