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USING NURSING THEORIES AS FRAMEWORKS FOR PRACTICE, EDUCATION, &
RESEARCH
Susan S. Gunby, RN, PhD
Fall Semester 2003
“Practicing nurses who despise theory are
condemned to performing a series of tasks – either at
the command of a physician or in response to routines
and policies.”
-- Leah Curtin, RN, MS, FAAN (1989)
Former Editor, Nursing Management
“Theory internalizes principles which increase adaptability and flexibility and enables one to transfer experience from one situation to the next.” -- Leah Curtin
“ . . . the truth thus ascertained would enable us to save life and suffering, and to improve the treatment and management of the sick . . . .”
-- Florence NightingaleProposal presented to the International Statistical Congress in London, 1860
“All must go at the end of 2 months, except
those who are dying.” - Florence Nightingale (1854)
Informed action (simultaneously the action and the knowledge that inform it). (Carr & Kemmis, 1986)
Reflection upon practice toward the refinement of theory and therefore the enhancement of practice. (Thorne & Hayes, 1997)
Discipline of Nursing Must Examine:
• What it means to practice nursing.
• What knowledge is held as “private” vs. “public.”
• What ideals are embedded in nursing practice as well as in the generation of nursing knowledge. (Kim, 2000)
Barbara A. Carper (1978):
•“It is the general conception of any field of inquiry that ultimately determines the kind of knowledge that field aims to develop as well as the manner in which that knowledge is to be organized, tested, and applied . . . .”
Barbara A. Carper (1978):
•“Such an understanding . . . involves critical attention to the question of what it means to know and what kinds of knowledge are held to be of most value in the discipline of nursing.”
WAYS OF KNOWINGor
FORMS OF KNOWLEDGE EmpiricalEthical
PersonalEsthetic
COMPONENTS & LEVEL OF ABSTRACTIONS
Metaparadigm
Philosophies
Conceptual Models
Theories
Empirical Indicators
Most Abstract
Most Concrete
METAPARADIGM
Global concepts that identify the phenomena of
interest
METAPARADIGM
Global propositions that state the relationships
among those phenomena
METAPARADIGM
. . . an encapsulating unit, or framework, within which the morerestricted. . .structures develop.”
(Eckberg & Hill, 1979, p. 927)
METAPARADIGM
The functions of a metaparadigm are to
summarize the intellectual and social missions of a
discipline and place a
boundary on the subject matter of
that discipline. (Kim, 1989)
PHENOMENA OF INTEREST TO NURSING REPRESENTED
BY FOUR CENTRAL CONCEPTS1. Person
2. Environment
3. Health
4. Nursing
PHILOSOPHIESAre Statements About:
*** What people assume to be true in relation to the phenomena of interest to a discipline.
(Christensen & Kenney, 1990)
*** What people believe regarding the development of knowledge about those phenomena.
EXAMPLE OF PHILOSOPHICAL
STATEMENT
“The individual . . . behaves purposefully, not in a sequence
of cause and effect.”(Roy, 1988, p. 32)
CONCEPT
•An abstract idea or mental image of phenomena or reality.
CONCEPTS
• Abstract ideas that give meaning to our perceptions
• Permit generalizations• Stored in memory for
recall & use at later time in a new & different situation.
CONCEPTS
•May be linked together to explain approaches to nursing care and to predict the outcome of care.
Concepts
•When operationalized, become variables used in hypotheses to be tested in research.
•Explicate subject matter of theories of a discipline.
CONCEPTUAL MODELS
A set of abstract and general concepts and propositions
that integrate those concepts into a meaningful
configuration. (Lippitt, 1973; Nye & Berardo, 1981)
CONCEPTUAL MODELS
Provide a distinctive frame of reference.
EXAMPLES OF CONCEPTUAL MODELS
*** King’s General Systems Framework
*** Roy’s Adaptation Model
THEORIES
Consist of relatively specific and concrete concepts
and propositions that purport to account for or organize some phenomenon. (Barnum, 1994)
THEORIES
Vary in the relative level of concreteness
and specificity of their concepts and
propositions.
THEORIES
Primary Purpose:
To generate knowledge.
THEORIES
Provide a communication system in terms of a set of concepts that are interrelated and understandable to others.
THEORIES
Enable nurses to know WHY they are doing WHAT they
are doing.
THEORIES
Provide knowledge to improve practice & education by describing, explaining, predicting, controlling, and understanding phenomena.
THEORIES
Help develop analytical skills, challenge thinking, clarify values and assumptions, and determine purposes for nursing practice, education, and research.
THEORIES
Enhance professional autonomy by guiding the practice, education, and research functions of the profession.
EMPIRICAL INDICATORS
The actual instruments, experimental conditions,and research methodologies used to observe ormeasure the concepts of a middle-range theory.