TF - M1 - CU2- History and Philosophy of 2.
Metaparadigm -The broad conceptual
Science boundaries of the discipline of nursing, human
beings, environment, and health (Person, Health,
Rationalism-Rationalist epistemology (scope of Environment, Nursing)
knowledge) emphasizes the importance of a priori
reasoning as the appropriate method for Purposes of Nursing Theories
advancing knowledge.
The primary purpose of theory in the profession
-Priori reasoning uses deductive logic by of nursing is to improve practice by positively
reasoning from the cause to an effect or from influence the health and quality of life of patients.
generalization to a particular instance. Nursing theories are also developed to define and
describe nursing care, guide nursing practice, and
History of nursing theory provide a basis for clinical decision making. The
-The history of professional nursing began with accomplishments of nursing in the past led to the
Florence Nightingale. Nightingale envisioned recognition of nursing in academic discipline,
nurses as a body of educated women at a time research, and profession.
when women were neither educated nor The Nursing Metaparadigm
employed in public service.
There are four major concepts that are frequently
Curriculum Era interrelated and fundamental to nursing theory:
-Addressed the question of what content nurses person, environment, health, and nursing. These
should study to learn how to be a nurse. four are collectively referred to as metaparadigm
for nursing.
-The idea of moving nursing education from
hospital-based diploma programs into colleges Person
and universities began to emerge during this era Person (also referred to as Client or Human
(Erwin,2015; Judd &Sitzman, 2013). Beings) is the recipient of nursing care and may
Theory Era include individuals, patients, groups, families,
and communities.
-It was a natural outgrowth of the research and
graduate education eras (Alligood,2014; Im& Environment
Chang,2012). Environment (or situation) is defined as the
Significance for the Discipline internal and external surrounds that affect the
client. It includes all positive or negative
-The significance of theory for the discipline of conditions that affect the patient, the physical
nursing is that the discipline is dependent on environment, such as families, friends, and
theory for its continued existence. significant others, and the setting for where they
-Nursing can be a vocation, or nursing can be a go for their healthcare.
discipline with a professional style of theory- Health
based practice.
Health is defined as the degree of wellness or
-Commitment to theory-based evidence for well-being that the client experiences. It may have
practice is beneficial to patients in that it guides different meanings for each patient, the clinical
systematic, knowledgeable car setting, and the health care provider.
TF - M1 - CU3 - Structure of nursing Nursing
knowledge
The attributes, characteristics, and actions of the
nurse providing care on behalf of or in
TERMINOLOGIES conjunction with, the client. There are numerous
1.Structure Level-Structure level presents the definitions of nursing, though nursing scholars
structure and analysis of specialized nursing may have difficulty agreeing on its exact
knowledge. (Analysis of theory, clarity, simplicity, definition, the ultimate goal of nursing theories is
generality, accessibility, importance). to improve patient care. You’ll find that these four
concepts are used frequently and defined
differently throughout different nursing theories. •Address the nursing metaparadigm components
Each nurse theorist’s definition varies in of person, nursing, health, and environment
accordance with their orientation, nursing
experience, and different factors that affect the Middle-Range Nursing Theories
theorist’s view of nursing. The person is the main •More limited in scope (as compared to grand
focus but how each theorist defines the nursing theories) and present concepts and propositions
metaparadigm gives a unique take specific to a at a lower level of abstraction. They address a
particular theory. To give you an example, below specific phenomenon in nursing.
are the different definitions of various theorists on
the nursing metaparadigm: •Due to the difficulty of testing grand theories,
nursing scholars proposed using this level of
Components of Nursing Theories theory.
For a theory to be a theory it has to contain a set •Most middle-range theories are based on the
of concepts, definitions, relational statements, works of a grand theorist but they can be
and assumptions that explain a phenomenon. It conceived from research, nursing practice, or the
should also explain how these components relate theories of other disciplines.
to each other.
Phenomenon
TF - M1 - CU4 - Philosophy, Conceptual
A term given to describe an idea or responses Models and Middle Range Theory
about an event, a situation, a process, a group of
events, or a group of situations. Phenomena may Philosophy-Sets forth the meaning of
be temporary or permanent. Nursing theories nursing phenomena through analysis,
focus on the phenomena of nursing. reasoning and logical presentation of concepts
and ideas.
Concepts
Conceptual models-Are sets of concepts
Interrelated concepts define a theory. Concepts that address phenomena central to nursing in
are used to help describe or label a phenomenon. propositions that explain the relationship
They are words or phrases that identify, define, among them.
and establish structure and boundaries for ideas Theory-a system of ideas intended to explain
generated about a particular phenomenon. something, especially one based on general
Concepts may be abstract or concrete. principles independent of the thing to be
explained.
•Abstract Concepts. Defined as mentally
Middle Range theory -Concepts most
constructed independent of a specific time or
specific to practice that propose precise
place.
testable nursing practice questions and
•Concrete Concepts. Are directly experienced include details such as patient age group,
and related to a particular time or place. family situation, health condition, location of
the patient, and action of the nurse.
Grand Nursing Theories
Components of Nursing Theories
•Grand theories are abstract, broad in scope, and
complex, therefore requiring further research for For a theory to be a theory it has to contain a set
clarification of concepts, definitions, relational statements,
and assumptions that explain a phenomenon. It
•Grand nursing theories do not provide guidance should also explain how these components relate
for specific nursing interventions but rather to each other.
provide a general framework and ideas about
nursing Phenomenon
•Grand nursing theorists develop their works A term given to describe an idea or responses
based on their own experiences and the time they about an event, a situation, a process, a group of
were living explaining why there is so much events, or a group of situations. Phenomena may
variation among theories be temporary or permanent. Nursing theories
focus on the phenomena of nursing.
Concepts was typically introduced into program objectives,
course objectives, course descriptions, and clinical
Interrelated concepts define a theory. Concepts performance criteria. The purpose was to explain
are used to help describe or label a phenomenon. the fundamental implications of the profession
They are words or phrases that identify, define, and to enhance the status of the profession.
and establish structure and boundaries for ideas
generated about a particular phenomenon. In Research
Concepts may be abstract or concrete. Development of theory is fundamental to the
research process where it is necessary to use
•Abstract Concepts. Defined as mentally theory as a framework to provide perspective and
constructed independent of a specific time or guidance to the research study. Theory can also be
place. used to guide the research process by creating and
•Concrete Concepts. Are directly experienced testing phenomena of interest. To improve the
and related to a particular time or place. nursing profession’s ability to meet the societal
duties and responsibilities, there need to be a
Definitions continuous reciprocal and cyclical connection
Definitions are used to convey the general with theory, practice, and research. This will help
meaning of the concepts of the theory. Definitions connect the perceived “gap” between theory and
can be theoretical or operational. practice and promote the theory-guided practice.
•Theoretical Definitions. Define a particular In Profession
concept based on the theorist’s perspective. Clinical practice generates research questions and
•Operational Definitions. States how concepts knowledge for theory. In a clinical setting, its
are measured. primary contribution has been the facilitation of
reflecting, questioning, and thinking about what
Relational Statements
nurses do. Because nurses and nursing practice
Relational statements define the relationships are often subordinate to powerful institutional
between two or more concepts. They are the forces and traditions, the introduction of any
chains that link concepts to one another. framework that encourages nurses to reflect on,
question, and think about what they do provide
Assumptions
an invaluable service.
Assumptions are accepted as truths and are based
Classification of Nursing Theories
on values and beliefs. These are statements that
explain the nature of concepts, definitions, There are different ways to categorize nursing
purpose, relationships, and structure of a theory. theories. They are classified depending on their
function, levels of abstraction, or goal orientation.
Purposes of Nursing Theories
By Abstraction
The primary purpose of theory in the profession
of nursing is to improve practice by positively There are three major categories when classifying
influence the health and quality of life of patients. nursing theories based on their level of
Nursing theories are also developed to define and abstraction: grand theory, middle-range theory,
describe nursing care, guide nursing practice, and and practice-level theory.
provide abasis for clinical decision making. The
accomplishments of nursing in the past led to the
recognition of nursing in academic discipline, Grand Nursing Theories
research, and profession.
•Grand theories are abstract, broad in scope, and
In Academic Discipline complex, therefore requiring further research for
Much of the earlier nursing programs identified clarification
the major concepts in one or two nursing models, .•Grand nursing theories do not provide guidance
organized the concepts and build an entire for specific nursing interventions but rather
nursing curriculum around the created provide a general framework and ideas about
framework. The unique language in these models nursing.
•Grand nursing theorists develop their works
based on their own experiences and the time they
were living explaining why there is so much
variation among theories.
•Address the nursing metaparadigm components
of person, nursing, health, and environment.
Middle-Range Nursing Theories
•More limited in scope (as compared to grand
theories) and present concepts and propositions
at a lower level of abstraction. They address a
specific phenomenon in nursing.
•Due to the difficulty of testing grand theories,
nursing scholars proposed using this level of
theory.
•Most middle-range theories are based on the
works of a grand theorist but they can be
conceived from research, nursing practice, or the
theories of other disciplines.
Practice-Level Nursing Theories
•Practice nursing theories are situation specific
theories that are narrow in scope and focuses on a
specific patient population at a specific time.
•Practice-level nursing theories provide
frameworks for nursing interventions and suggest
outcomes or the effect of nursing practice.
•Theories developed at this level have a more
direct effect on nursing practice as compared to
more abstract theories.
•These theories are interrelated with concepts
from middle-range theories or grand theories.
By Goal Orientation
Theories can also be classified based on their
goals, they can be descriptive or prescriptive
