Nursing theories
open access articles on nursing theories and models
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Introduction to nursing theories
INTRODUCTION
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Nursing theory is the term given to the body of knowledge that is used to support nursing practice.
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Nursing theory is a framework designed to organize knowledge and explain phenomena in nursing, at a more concrete and specific level.
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A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing.
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Each discipline has a unique focus for knowledge development that directs its inquiry and distinguishes it from other fields of study.(Smith & Liehr, 2008).
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Theory-guided, evidence-based practice is the hallmark of any professional discipline.
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Nursing is a professional discipline (Donaldson & Crowley, 1978).
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Almost 90% of all Nursing theories are generated in the last 20 years.
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Nursing models are conceptual models, constructed of theories and concepts
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A paradigm is a model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline.
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A trend has emerged to build nursing theories and theoretical frameworks with the goal of bridging the knowledge gap between theory and professional practice by offering more tangible notions that can be utilized and applied in the field.1
- Middle-range theory has a lower level of abstraction than grand theories, which are also considered highly applicable in nursing practice.1
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Nursing knowledge is structured an holarchy by Fawcett (2005) as metaparadigm, philosophy, conceptual models, grand theories, middle-range theories, and empirical indicators.2
METAPARADIGMS IN NURSING
Person
- Recipient of care, including physical, spiritual, psychological, and sociocultural components.
- Individual, family, or community
Environment
- All internal and external conditions, circumstances, and influences affecting the person
Health
- Degree of wellness or illness experienced by the person
Nursing
- Actions, characteristics and attributes of person giving care.
DEFINITIONS
Theory
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a set of related statements that describes or explains phenomena in a systematic way.
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the doctrine or the principles underlying an art as distinguished from the practice of that particular art.
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a formulated hypothesis or, loosely speaking, any hypothesis or opinion not based upon actual knowledge.
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a provisional statement or set of explanatory propositions that purports to account for or characterize some phenomenon.
Concept
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a mental idea of a phenomenon
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Concepts are the building blocks (the primary elements) of a theory.
Construct
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a phenomena that cannot be observed and must be inferred
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Constructs are concepts developed or adopted for use in a particular theory. The key concepts of a given theory are its constructs.
Proposition
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a statement of relationship between concepts
Conceptual model
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made up of concepts and propositions
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They represent ways of thinking about a problem or ways of representing how complex things work the way that they do.
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Different Frameworks will emphasize different variables and outcomes and their interrelatedness.( Bordage, 2009)
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Models may draw on a number of theories to help understand a particular problem in a certain setting or context. They are not always as specified as theory.
Variables
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Variables are the operational forms of constructs. They define the way a construct is to be measured in a specific situation.
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Match variables to constructs when identifying what needs to be assessed during evaluation of a theory-driven program.
Middle range theory
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a testable theory that contains a limited number of variables, and is limited in scope as well, yet is of sufficient generality to be useful with a variety of clinical research questions.
Types of theories
Based on the level of abstraction
- Grand theories
- Middle range theories
- Situation specific theories
Based on goal orientation
- Descriptive theories
- Prescriptive theories
Based on types of Knowledge
- Clinical
- Conceptual
- Empirical knowledge
NURSING PHILOSOPHIES |
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Theory |
Key Points |
Florence Nightingale’s Legacy of caring |
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Ernestine Wiedenbach: The helping art of clinical nursing |
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Virginia Henderson’s Definition of Nursing |
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Faye G.Abedellah’s Typology of twenty one Nursing problems |
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Lydia E. Hall :Care, Cure, Core model |
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Jean Watson’s Philosophy and Science of caring |
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Patricia Benner’s Novice to Expert |
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CONCEPTUAL MODELS AND GRAND THEORIES |
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Dorothea E. Orem’s Self care deficit theory in nursing |
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Myra Estrin Levine’s: The conservation model |
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Martha E.Roger’s: Science of unitary human beings |
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Dorothy E.Johnson’s Behavioural system model |
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Sister Callista: Roy‘s Adaptation model |
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Betty Neuman’s : Health care systems model |
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Imogene King’s Goal attainment theory |
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Nancy Roper, WW.Logan and A.J.Tierney A model for nursing based on a model of living |
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Hildegard E. Peplau: Psychodynamic Nursing Theory |
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Ida Jean Orlando’s Nursing Process Theory |
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Joyce Travelbee’s Human To Human Relationship Model |
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Kathryn E. Barnard’s Parent Child Interaction Model |
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Ramona T.Mercer’s :Maternal Role Attainment |
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Katharine Kolcaba’s Theory of comfort |
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Madeleine Leininger’s Transcultural nursing, culture-care theory |
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Rosemarie Rizzo Parse’s :Theory of human becoming |
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Nola J.Pender’s :The Health promotion; model |
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Strategies for theory development
- Synthesis – information based on observation is used to construct a new concept, new statement or theory. Synthesis allows the theorist to construct a theory by connecting isolated pieces of information that are yet theoretically unconnected.
- Derivation – the theorist transposes and redefines a concept, statement or theory from one context or field to another.
- Analysis – theorist clarifies, redefines, or sharpens concepts, statements or theories.
Process of Theory Development
- Concept development: creation of conceptual meaning
- Statement development: Formulation and validation of relational statements
- Theory construction: systematic organization of the linkages
- Testing theoretical relationships
- Theory application
Strategies for Concept Development
- Concept exploration
- Concept clarification
- Concept analysis
Criticism of nursing theories
- Nursing theories are and without specific context, especially grand theories.
CONCLUSION
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The conceptual and theoretical nursing models help to provide knowledge to improve practice, guide research and curriculum and identify the goals of nursing practice.
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Nursing knowledge is the inclusive total of the philosophies, theories, research, and practice wisdom of the discipline.As a professional discipline this knowledge is important for guiding practice.(Smith & Liehr, 2008).
REFERENCES
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Dantas AMN, Santos-Rodrigues RCD, Silva Júnior JNB, Nascimento MNR, Brandão MAG, Nóbrega MMLD. Nursing theories developed to meet children's needs: a scoping review. Rev Esc Enferm USP. 2022 Sep 9;56:e20220151. doi: 10.1590/1980-220X-REEUSP-2022-0151en. PMID: 36102780; PMCID: PMC10111381.
- Fawcett J. Contemporary nursing knowledge: analysis and evaluation of nursing models and theories. 2th. Philadelphia: F. A. Davis Company; 2005.
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Donaldson, S. K., & Crowley, D. M. (1978). The discipline of nursing. Nursing Outlook, 26, 113–120.
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Smith, M. J., & Liehr, P. R. (2008). Middle range theory for nursing. New York: Springer Publishing.
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George B. Julia , Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange.
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Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins.
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Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott.
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Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott.
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Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.
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Tomey AM, Alligood. MR. Nursing theorists and their work. (5th ed.). Mosby, Philadelphia, 2002
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Alligood M.R, Tomey. A.M. Nursing theory utilization and application. 2nd Ed. Mosby, Philadelphia, 2002.