Application of theories in nursing resea5 rch

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Application of theories in nursing resea5 rch

  1. 1. APPLICATION OF THEORIES INNURSING RESEA5RCHBYARUN.M
  2. 2. APPLICATION OF THEORIES INNURSING RESEARCHIntroduction:In any discipline science is result of relationshipbetween the process of enquiry (research) and theproduct of knowledge (theory)Frame work for researchTheory guides Research processResearch questionsResearch designAnalysis & interpretation of data
  3. 3. DESIGNS FOR NURSING RESEARCHA. Quantitative Research Design.B. Qualitative Research DesignQuantitative Research DesignThe study of phenomenon that tend themselves toprecise measurement and quantification ofteninvolving a rigorous and controlled design. Theinformation collected in numerical form. Statisticalprocedures used to assess the magnitude andreliability or relationship among phenomenon.In this design theories are tested
  4. 4. Qualitative Research DesignThe investigation of phenomenon typically in anin-depth and holistic fashion through thecollection of rich narrative materials using aflexible research design. Here the data iscollected in narrative (non numerical) formthrough an unstructured interview . Theorganization & interpretation of data is used todiscover the underlined dimensions & patternsof relationship.This design usually generates a theory.
  5. 5. QUANTITATIVE RESEARCH DESIGNPurposes & Dimension – PredictionExperimental Quasi Experimental Non Experimental1.Before& afterdesign.2.After only design.3.Factorial design.4.Repeated measuredesign.5.Clinical trials1.Non equivalent controlgroup before – afterdesign.2.Non equivalent controlgroup after only design.3.Time series design1. Ex post factoresearch design. -Retrospectivestudies- Prospective studies.(Case controlledstudies)2. Descriptive design– longitudinal,cross sectional, corelational andcomparative
  6. 6. SPECIFIC TYPES OF QUANTITATIVERESEARCH1. Surveys – Prevalence ,distribution, interrelationship,description.2. Evaluation – Process analysisOutcome analysisImpact analysis3. Outcome Research
  7. 7. QUALITATITIVE RESEARCHMETHODS1. Ethnography.2. Phenomenology.3. Grounded theory.4. Historical research.5. Action research.6. Triangulation.7. Case study method
  8. 8. Ethnography – It is branch human enquiryassociated with the field of anthropology. Thedesign focuses on culture of a group of people.E.g. The health practices & health seekingbehavior pattern of tribal women ofreproductive age group in a selectedgeographical area.Phenomenology – This design focuses of livedexperiences of human beingExampleThe lived experiences of panic disorder inmother during postpartum period.
  9. 9. Grounded theory –This designfocuses on symbolic interpretation orinteractions to address verbal or nonverbal expressionExampleThe reproductive & motheringexperience of HIV positive women.
  10. 10. Triangulation Method:The use of multiple methods to collect or interpretdata about a phenomenon.It could be• Data triangulation (Time, space, person).• Methodological triangulation (qualitative,quantitative).• Investigator triangulation (Doctors, Nurses,Investigator).• Theoretical triangulation (Application of morethan one theory in research)
  11. 11. Historical research – It is the study ofinterrelationship with people activity behaviouretc. in the past.Example: Nursing – A transition from occupationto professionAction research – A research method characterizedby the systematic study of the implementation ofplanned change to a system.Example : An outcome study on implementation ofRCA type of latrines in a rural communityCase study method- “Case” is a person with acondition under study
  12. 12. RESEARCH PURPOSES & RESEARCHQUESTIONSType oftheory&ResearchQuantitative research Qualitative ResearchDescriptiveTheoryDescriptiveResearchHow prevalent is thephenomenon?How often does it occurWhat the characteristics ofthe phenomenon?What are the dimensions ofthe phenomenon?What variations exists?What is important about thephenomenon?DescriptiveTheoryExploratoryResearchWhat factors are related to thephenomenon?What are the antecedents ofthe phenomenon?What is the full nature of thephenomenon?What is really going on here?What is the process by whichthe phenomenon isexperienced?
  13. 13. ExplanatoryTheoryCorrelationresearchWhat are the measurableassociations betweenphenomenon?What factor cause thephenomenon?Does the theory explain thephenomenonHow does thephenomenon work?Why does thephenomenon exists?What is the meaningof the phenomenon?How did thephenomenon occur?PredictiveTheoryExperimentalresearchWhat will happen if we alter aphenomenon or introduce anintervention?How can we make thephenomenon happen or alter itsnature or prevalence?Can the occurrence of thephenomenon be controlled?
  14. 14. In descriptive research data are gathered byparticipants/non participant observation, openended are structured interview schedule orquestionnaire.• Data may quantitative or qualitative or both.• Descriptive theories are used in• Concept analysis.• Psychomotor analysis.• Case studies.• Survey, evaluation outcome• Phenomenology.• Ethnography.• Grounded theory.• Historical enquiry
  15. 15. In correlation research data is collected through observationquestionnaire & interview schedule.• It is used both in qualitative & quantitative research.• Data is analyzed by inferential statistics – correlation &association.• Explanatory theories are used in comparative andcorrelation researchIn experimental research the data is generated or testedIt gives cause & effect between variable .• It involves manipulation of some phenomenon to determinethe effect on another phenomenon.• It require quantifiable data• Inferential statistics is used to measure the difference.• Predictive theories are used in theory testing (quantitative)and theory generating (qualitative)
  16. 16. EXAMPLES OF DESCRIPTIVE RESEARCH:A study to describe the problem of skin break down inextremely low birth weight infant (Quantitative)• A study to describe the psycho social and behavioralaspects of clients living with urinary incontinence ina nursing home (Qual)EXAMPLES OF EXPLORATORY RESEARCH:A study to explore the role that village health nursesplay in implementation of RCH programme toreduce maternal & infant morbidity & mortality(Quant.).• A study to explore women’s midlife experience &perception of their changing body duringmenopausal period (Qual.)
  17. 17. EXAMPLES FOR EXPLANATORY STUDIESA study to explain use of hormones duringmenopause based on quantitative indicators ofwomen’s habits believes and norms anddemographic characteristics (Quant.)A study to explain the experience oftransitioning technology- dependent fromhospital to home/ community – based care(Qual.)EXAMPLE FOR PREDICTION &CONTROLLED STUDYTo identify risk factor that could predict postoperative pulmonary complications after totalabdominal hysterectomy (Quant.).Intervention Studies (Quant.)
  18. 18. CATEGORIZATION OF THEORIES USED INRESEARCH1. A. Descriptive theories based on human needs• Florence Nightingale - environmental theory.• Faye G Abdellah – patients centered approach innursing.• Virginia Henderson – the principles & practices innursing.• Dorothea E Orem – The self care deficit nursingtheory.• Lydia E. Hall– core care & cure modelB. Descriptive theories based on interactive process.• Jean Watson – theory of human caring.• Sister Callista Roy – adaptation model .• Myra Estrin Levine – the conservation model• Martha E Rogers – unitary human being
  19. 19. 2. Explanatory theories in co relational research. Hildegard E Peplau – psycho dynamic nursing . Ida Jean Orlando – nursing process theory Joyce Travelbeee – human to human relationshipmodel. RT mercer – maternal role attainment theory. E. Barnard – parent child interaction model. Madeleine Leininger Culture care – Diversity &universality theory. Ernestine Wiedenbach - helping art of clinicalnursing theory. Nola J Pender – the health promotion model. Joyce J Fitzpatrick – life perspective model
  20. 20. 3. Predictive theory & experimentalresearch. Dorothy E Johnson - behavioral systemmodel. Betty Neuman systems model. Imogene King - interacting systemsframework & theory of goal attainment. Bertalanify - general system model
  21. 21. THEORIES APPLIED IN DESCRIPTIVERESEARCH (Quant. & Qual.)1. Nightingale’s Environmental Theory:A. Person: Person is referred to patient who is beingacted upon by a nurse & affected by theenvironment.B. Environment: All the external conditions & forcesthat affects one’s life and development.C. Health: is described as maintaining well being andcontrolling environmental factors to preventdiseases.D. Nursing: Facilitates persons reparative process byensuring the best possible environment.
  22. 22. Example:The factors influencing the recovery of patientsadmitted in post operative surgical unitExternalconditions& ForcesClientfactorsNurse &NursingcareRecoveryof clients
  23. 23. 2. Virginia Hendersons Definition of NursingMajor Concepts:A. Nursing :• The nurse has a unique function to help sick or wellindividual. She maintains good nurse physicianrelationship.The 14 components of nursing care encompass allpossible functions of nursing.A. Person (Patient):• The person must maintain physiological andemotional balance and requires help towardsindependence.A. Health:Health is basic to human functioning which requiresindependence & interdependence.
  24. 24. D. Environment:• Healthy individuals may be able to control their environment butillness may interfere with that ability.D. Needs: 14 basic needs identified by Henderson1. Breath normally.2. Eat & drink adequately.3. Eliminate body wastes.4. Move & maintain desirable positions5. Sleep & rest.6. Select suitable clothing.7. Maintain body temperature.8. Maintain body cleanliness & grooming.9. Avoid dangers in the environment.10. Communicate with others to express emotion, needs, fears, andopinions.11. Worship according to one’s faith.12. Work in a way that provides a sense of accomplishment.13. Participate in various form of recreation.14. Learn, discover or satisfy the curiosity that leads to normaldevelopment & health
  25. 25. Nurses role diminishes as rehabilitation progresses among amputated patientsBefore operation First day First weekFour month Fourth monthOne yearNurseSurg.Phys.SWFamilyAnaesthNursePhysSurg.FamPatientNursePhysSurgPhysiothOccutheFamPatientNurseSocialworkerPhysicianSurgeonFamilymembersPatients NurseNurseFamily membersPatientPhySurgFamilyPatient
  26. 26. 3. Hall’s Core, Care and Cure ModelHall’s model and the four concepts of nursing metaparadigmA. Person (patient)Composed of three parts- Person (core circle)- Body (care circle)- Pathology (cure circle)B. Environment must be conducive to self development.Any nursing action taken in relation to the environment shouldassist the patient in attaining a personal goal.C. Health- Illness as a behavior directed by persons feeling of selfawarenessD. Nursing- the goal of nursing care is to help the patient to develop selfawareness
  27. 27. CORE, CARE AND CURE MODELTHE CORE CIRCLETHE CURE CIRCLETHE CARE CIRCLE• The person• Social sciences• Therapeutic use of self• The body• Natural and biological sciences• Intimate body care• The disease pathological andtherapeutic sciences• Seeing the patient andfamily through medical careExample: A descriptive study to assess the nursing functions in reduction ofhospital stay and health care cost among patients admitted in selected hospitals.
  28. 28. 4. Nola Pender’s Health Promotion Model:Pender’s Health Promotion Model seeks to increase on individuals level of wellbeing. The model focuses of individuals cognitive and perceptual factors, modifyingfactors and participation in health promoting behavior.Example: A descriptive study to assess the knowledge and prevalence of bronchialasthma among floor workers working in oil refineries.Cognitive PerceptualFactorsModifyingFactorsParticipation in Health– Promoting BehaviorsKnowledge on s/s ofBARisk FactorsDiagnosisTreatmentPreventionEducationPast HistoryProvision of safetymeasurementIndustrial policiesEmerging measuresOn conclusion offactorsHealth PromotingBehavior+veUse of safetymeasurementMedical checkup-veAbsentismsicknessEpisode of BA Episode of BA
  29. 29. 5. Laffery & Kulbok’s Community Health Promotion ModelThis model focuses on two complimentary paradigms1. Health paradigm2. Service paradigmThis the component of the above paradigm is composed of two major dimension1. The focus of care that include primary, secondary and tertiary care focusingon promotive, preventive, curative and rehabilitative health services.2. The client system includes individual family and community at large.3. The health personal form the base of service paradigm their servicesinfluences the health care their by decides the outcome of health paradigmspecially the community.Example: A descriptive study to assess the knowledge attitude, and skill amongvillage health nurses on immunization coverage of under five children of aselected primary health centers.
  30. 30. ASSESSMENT•Age•Sex•Qualification•Experience•Training&ISE•CaringexperienceClientsystem/FocusesofcareHEALTHPERSONNELHEALTHPERSONNELHEALTHPERSONNELIndividualFamilyAggregateCommunityCARE COMPONENTPRIMARY CARECARE COMPONENT - SECONDARY CARECARE COMPONENT – TERTIARY CAREHEALTHYCOMMUNITYHEALTHYPROMOTIONINTERVENTIONIMMUNIZATIONOFUNDERFIVECHILDRENSCLIENTSYSTEMATTITUDE OF HEALTH PERSONNEL & PRACTICESKNOWLEDGE OF HEALTH PERSONNELSERVICE PARADIGM HEALTH PARADIGM
  31. 31. 6. Leininger’s Culture care diversity & Universality theory (sunrisemodel)A. Person1. Is refereed to by Leninger as “human being”2. Is caring and capable of being concerned about others and care of humanbeing is universal in all cultures.B. Environment1. It is closely related to the concept of cultureC. Health1. reflects the ability of the individual to perform their daily roles2. it is universal across all cultures define differently by each culture toreflect its specific values and beliefs.D. Nursing1. Uses three modes of action (culture care preservation, culture careaccommodation, culture care repatterning) suited to client’s culture.Example: A study to assess the knowledge attitude and practices of child bearingand child rearing among tribal mothers residing in selected hilly areas.
  32. 32. TechnologicalFactorsReligiousandPhilosophical FactorsCulturalvaluesandlifewaysSocialFactorsGenericof locksystemsNursingcareProfessionalsystemPolitical andlegal factorsEconomicfactorsEducationalFactorsCulture care world viewCultural and social structure dimensionIndividuals, Families, Communities, and institutions, in divers health systemInfluences careexpression, patternsand practicesHealth (well-being)Nursing care decision and actionsCultural care preservation and maintenanceCultural care accommodation and negationCultural care repatterning and restructuringCulture-congruent careSUNRISEMODEL
  33. 33. THEORIES APPLIED TO RESEARCHES WITH THE PURPOSE OFEXPLANATION AND EXPLORATION7. Paplau’s Interpersonal Relations ModelA. PersonAs an individual that strives to reduce anxiety cost by needs.B. EnvironmentIt implied that nurse must consider culture and values when caring thepatient at the hospital environment.C. HealthHealth consists of interacting physiological and interpersonal conditionspromoted through the INTERPERSONAL PROCESS (it is derived frombehavioral sciences and this model evolves psychodynamic nursing.D. NursingIs a significant therapeutic interpersonal process.Example: Interpersonal influence in relationships between psychiatricpatients and nursing staff on changing behavior in selected hospital.
  34. 34. The nurse and the patient are the strangers to each other and many haveentirely separate goals and interestsThe roles of each in the problematic situation may differ, partly because ofTheir individual preconceptions about the meaning of the medical problemTogether, the nurse and the patient can work toward a partially mutual andPartially individual understanding of the nature of the medical problemCommon, shared health goals can result from a mutual understanding ofThe nature of the problem and of the roles and requirements of the nurseAnd the patient in solving the problem.Their collaborative efforts can direct the nurse and the patient towardsolving he problem together, productively.CHANGING ASPECTS OF THE NURSE-PATIENT RELATIONSHIP
  35. 35. 8. Ernestine Wiedenbach: The Helping Art of Clinical Nursing TheoryA. Person (client)A human being who strives towards self direction and independencedesires to make the best use of personal abilities to fulfill responsibilities.B. EnvironmentEnvironment are factors in realities constitute a dynamic sense of ideasevents experiences and objectives in contact with a patient.C. HealthIs addressed as nurse patient relationship and need for help.D. NursingNursing is a clinical practice disciplineHelps a patient overcome difficulties and meet the need for help.Example: A study to assess the effectiveness of structured teaching program forTraditional Birth Attendants (TBAs) on identification of risk factors ofpregnant women at selected Health Unit District, Tamilnadu.
  36. 36. NURSING ACTION• Pressessment of knowledge ofTBAs on early identification ofhigh risk factors.• Inadequate knowledge• Need for improvingSTEP1: IDENTIFYING THE NEEDFOR HELPSTEP2: MINISTERING THENEEDED HELP1.Realities 2.PrescriptionAgentNurse HealthEducatorHealth TeachingOn earlyIdentification ofhigh risk factorsin•Antenatal•Intranatal•Postnatal•NewbornRecipientTBAs withdifferentvariablesSHORT TERM GOALTBAs gain knowledgeTBAs identify high riskmothersLONG TERM GOALImproved safe motherhoodpracticePrevention of complicationduring pregnancy andchild birthSTEP3: VALIDATING THATTHE NEEDED HELP WAS MET• Post assessment of knowledge ofTBAs on early identification ofhigh risk factors after plannedhealth teaching.• Analysis of findingsCENTRAL PURPOSEWiedenbach: The Helping Art of Clinical Nursing Theory
  37. 37. 9. Sister Callista Roy’s Adaptation TheoryA. PersonPerson is a recipient of care is a BIO PSYCHOSOCIAL being who constantly interactwith the changing environment.– is an adaptive system who uses innate and acquired coping mechanism to dealwith STREESS- Can be individual, group, family or society.B. EnvironmentAll conditions, circumstances and influences affect the development and behaviorof individual and group it is constantly changing and interacting.Consist of external and internal environment which provide input in the form ofstimuli.C. HealthIt is defined as a process of being and becoming an integrated and whole person.The goal of the persons behavior and persons ability to be an adaptive organism.D. NursingIncludes assessment , diagnosis, goal setting, intervention and evaluation.Example:A comparison of level of depression between elderly residing at old age home andwith families of selected community.
  38. 38. THE PERSON AS ADAPTIVE SYSTEMPERSONPhysiologicalSelf - conceptInterde-pendenceRolefunctionADAPTATIONCOPINGMECHANISMSSTIMULIBEHAVIORBEHAVIOR
  39. 39. CALLISTA ROY’S ADAPTATION MODELINPUT OUTPUTTHROUGHPUTPerson has an Adaptive SystemElderly personliving in theelderly homeAge, sex, education,occupation, income, religion,type of family, marital status,no. of children, recreationalactivities, religious activities,type of illnessElderly personliving in thefamiliesAge, sex, education,occupation, income, religion,type of family, marital status,no. of children, recreationalactivities, religious activities,type of illnessSTIMULIPsychologicalProblemAnxiety, depression,loneliness, emotionalproblems related to poorphysical health,worthlessness,hopelessness,suspiciousnessPhysiologicalProblem•Diseases•DisabilitiesSocialProblemPoverty, dependency, elderabuse, social isolation, lossof role and status, wanderlytendency, drug abuseLevel of physiologicalwell-being•Neural regulation•Chemical & endocrineregulationLevel ofEsteem•Body imageand sensation.•Selfconsistency andself ideal•Selfobservation andself evaluationLevel of interpersonalrelatedness withothers•Relationship withothers•Help seeking, attentionand affection.•Taking initiativessatisfaction in lifeRole Personnel•Position in society•Interaction•Role performanceAdaptiveResponseMaladaptiveResponseHealthEducationHealthEducation•Referral•Counseling•Mild level of depression•Moderate level of depression•Severe level of depressionEnhancementReinforcementImprovedqualityoflifeEuthymic
  40. 40. 10. Dorothea E.Oren: Self-Care Deficit Theory of NursingA. PersonPatient to functions biologically, symbolically and socially and who has the potential forlearning and development.Is an individual subject to the forces of nature, with a capacity for self-knowledge, who canengage in deliberate action, interpret experiences, and perform beneficial actions.Is an individual who can learn to meet self-care requisites; if, for some reason, the personcannot learn self-care measures, other must provide the care.B. EnvironmentCan positively or negatively affect the person ability to provide self care.C. HealthConsist of physical, psychological interpersonal, social aspect of care and they are inseparableIt includes promotion and maintenance of health treatment of illness and prevention ofcomplicationD. NursingIs caring the sick and wellpromotes patient as a self-care agent which include self-care agency, self-care requisites andtherapeutic self-care demands.It consists of three steps determination of needs for care designing a nursing system deliveringcare.Example: A comparative study to assess the activity of daily living between the residential and nonresidential mentally challenged children in selected institutions.
  41. 41. Self-careSelf-carecapabilities(self-care agency)TherapeuticSelf-caredemandNursingcapabilities(nursing agency)<R RR RPATIENT
  42. 42. MentalHealthNurseHigh familysupport andformal trainingby healthprofessionalsEnhancedcompetencyin activitiesof dailylivingSupportiveEducativeSupportiveGuidance•Counseling•Rehabilitative•Education•Training of parentsSustained selfcare activitiesCompromisedself care abilityPartiallycompensated systemHealth careprofessionals/Mentally challengedchildrenActivities of dailylivingWholly compensatedsystemHealth careprofessionalsActivities of dailylivingLack of familysupport andtraining byhealthprofessionalsInsufficientcompetencyin activitiesof dailylivingPartiallysustained selfcare abilityNegativeoutcomePositiveoutcomeAssessmentDV ADLDV ADLHealthInterventionDorothea E.Oren: Self-Care Deficit Theory of Nursing
  43. 43. 11. Joyce J. Fitzpatrick Life perspective modelA. PersonPerson is open system a unified whole characterized by a basic human rhythmB. EnvironmentMan and environment are open system continually changing matter and energywith each other.C. NursingThe meaning of nursing is attached to life the basic understanding of humanexistence is a central concern of nursing as a science and profession.D. HealthIs viewed as a continuously developing characteristic of humans with thefull life potential that may characterized the process of living and dying.ExampleA study to access the impact of child birth process on psychological wellbeing of mothers during post natal periods at selected hospitals.
  44. 44. RELATIONSHIP WITHIN THE LIFE PERSPECTIVE MODELNormaldeliveryCaesareandeliveryPostnatalMother(Person)Impact of childbirth(health) processAssesses and comparedpsychological well-being ofpostnatal mothers(Nursing action)Temporal patternsMotion PatternConscious patternPerceptual patternSubjectivewell beingMoodStatusSleepPatternInteractionPatternMaternalInfantRelationPsychological well-being of mothers Joyce J. Fitzpatrick Lifeperspective model
  45. 45. THEORIES APPLIED TO RESEARCHES WITH THE PURPOSE OFPREDICTION12. Dorothy E. Johnson behavioral systems modelA. PersonIs an open interrelated system identified by actions and behaviors thatare regulated and controlled by biological, psychological and sociologicalfactors.B. EnvironmentConstantly interact with the individual.C. HealthIt is a balance and stability of a persons behavioral system todemonstrated by orderly purposeful predictable behavior thateffectively manages the relationship to the environmentD. Nursingis an eternal regulatory force that acts to preserve optimal organizationand integration of a patents behavior.
  46. 46. SubsystemAchievementTensionHealth or illnessInvestigate/eliminativeAggressiveDependencyStress toleranceFlexibilityBehavioral system (patient)Attachment / affiliationStructureDrive Set, ChoiceBehavior DynamicEquilibrium (Goal)Active dynamic behavioral system(person, group, family)Internal stressors(+) or (-)Learning, Experience, Maturation, Otherchanging factors (biological,psychological, sociological)External stressors(+) or (-)Nursing actionNurtureProtectStimulateDynamic EnvironmentCUESexual
  47. 47. 13. Betty Neumans System modelA. Personis viewed as a whole, multidimensional, dynamic systemIs composed of basic core structures as well as physiologic, psychological, sociocultural,developmental and spiritual variables; these core structures and variables constantly interact withthe environment.Can be an individual, family, group, or community.Forces on the persons relationship and response to stress.B. EnvironmentIn described as those internal and external forces surrounding the person at any given time. Itincludes interpersonal, intrapersonal and extra personal stress that can interfere with the personsnormal line of defense and can affect the systems stability’s.C. Healthis defined as a state of wellness or system stability and is reflected by the level of wellness.D. NursingIs a unique profession that deals with all the variables affecting the persons, uses primary,secondary and tertiary interventions to reduce a client stress. Neuman’s nursing process consist ofthree steps Nursing diagnosis, Nursing goals and nursing outcomes.Example:A study to assess the effectiveness of educational intervention regarding self caremanagement of gestational diabetes among primigravida mothers attending outpatientdepartment
  48. 48. Client factor•Age•Religion•Education•Work pattern•Family income•Community•Type of family•Family historyof patientSTRESSOR•Pregnancy•Need for life-stylemodification in GDMconditionCLIENTPrimi gravidamothers withGDMPRETESTAssessment ofknowledge on SCM ofGDM, 1stdayinteraction with theinvestigatorNURSING INTERVENTIONStructured teaching onSCM of GDMPOST TESTAssessment ofknowledge on SCM ofGDM after one weekSecondaryPreventionTERTIARYPREVENTIONEarly detection andPrompt treatmenthelps in preventingthe complication ofGDMRehabilitativeNegative outcome Positive outcomeInadequateknowledge on SCMof GDMAdequate knowledgeon SCM of GDMDEGREEOFREACTIONBetty Neumans System modelSecondary prevention
  49. 49. 14. Imogene King Theory of Goal attainmentA. PersonIs a social rational, perceiving controlling, purposeful, action oriented, time-oriented being.has a right to self-knowledge, participation in decisions that affect life and healthB. EnvironmentInternal and external environmentC. HealthHealth is a dynamic state of life cycle and illness is view as an interference in thecontinuum of the life cycle.D. NursingRefers to observable nurse client interaction the focuses of which is to help theindividuals to maintain health.It is viewed as an interpersonal process of action, reaction, interaction andtransaction.Nurse perceives those the client and influence the interaction.Example:Effectiveness of structured teaching on knowledge on prevention of anemiaamong primigravida mothers attending outpatient department of selectedhospitals.
  50. 50. Schematic Diagram of Goal Attainment TheoryPerceptionNurseCommunicationPerceptionClientCommunicationAgree inmeansExploremeansTransactionMutual goalsettingActionReactionDisturbance
  51. 51. Nurse educatorin Antenatal O.P.DPerceptionPerception:: Lack of Knowledge on preventionof anemia for mothers may cause maternaland foetal hazardsJudgment:Judgment: Mobilize the resources forcreating awareness among mothers onpreventive measures of anemiaAction:Action: Implements health educationprogramme in order to create awarenessand improve their knowledge onprevention of anemiaAntenatalmothersin O.P.DAction:Action: Readiness to gain KnowledgeJudgment:Judgment: Identifying the sources togain knowledge on prevention ofanemiaReactionNurseeducatorpreparesflashcards andselfinstructionalbookletonprevention ofanemiaforeducatingantenatalmothersMutualgoal settingAntenatalmothersTo gainknowledgeInteraction•Presentknowledgeof antenatalmothers onpreventionof anemia.•Flashcards forgivingstructuredteaching.•Post testknowledgeof antenatalmothers onpreventionof anemiaTransaction•Level ofknowledge ofthe antenatalmothers afterthe structuredteachingprogrammingGains knowledge on preventionof anemia during pregnancyand adapt preventive measuresPerception:Perception: Need to gain knowledge on preventionof anemiaTeaching and trainingprogramme in preventionof anemiaLack of knowledge onprevention of anemiaduring pregnancyImogene King Theory of Goal attainment
  52. 52. Bertalaniffy General System TheoryThis model consist of four components, Structure input, processthroughput , Outcome output.Structure refers to the arrangement of parts and expressed as input.Process refers to design strategies role, functions, activities or task thatmaintain the equilibrium of the system. Is also expressed as throughput.Outcome is the end result of the interaction of the structure and processand is depend on the ability of the system to regulate the tool. Whenthere is a harmonious balance of the structure and process relationship ,then the desired outcome emerges.Feedback is the response of the structured process and outcome leadingto a recycling decision and context to modify the system.Example:Effectiveness of maternity nursing services rendered by villagehealth nurses working in subcentres of selected Health Unit Districts.
  53. 53. STRUCTURE PROCESS OUTCOMEANC INTRANATAL CARE PNC NEWBORN CAREHome Visits, Clinic, HealthEducation, Demonstration,CounselingAssessment, Diagnosis,Planning Intervention,Evaluation,Health awareness of the community,Degree of positive safe motherhood1. Registration2. Immunization3. Anemia prophylaxis4. Deworming5. Detection of high riskpregnancy6. Referral7. Morbidity pattern8. Mortality pattern9. Infant birth weight10. Infant immunization11. Breast feeding12. Birth spacing1. Health centre building2. Population3. Manpower quality andquantity4. Super vision5. CNE6. Equipment andsupplies7. Nutrition andsupplements8. Drugs9. Standing orders10. Policies11. Health educationmartial12. Transport13. Referral systemGeneral System Theory
  54. 54. Areas of future research nursingCritical health needs of communities and vulnerable population1. Family health and transition2. Health promotion and risk reduction3. Bio-behavioral manifestations of health and illness4. Women’s health5. Geriatric care6. Environments for optimizing7. Event outcome8. Genetic research9. End – of - life research
  55. 55. ConclusionThe relationship between research and theory isundeniable and it is important to recognize the impact of theirrelationship on the development of Nursing knowledge. Thesource of theory for research study is unique to nursing orborrowed from another discipline but the theoreticalframework should be explicit and appropriate.Let us work togetherShare our experiences in using theories and modelsLet it reflect in publications, Seminar, and ConferencesSo as to strengthen nursing as a professionHope Indian nurses may generate more theoriesAnd avoid borrowing theories from foreign theorists and fromother discipline
  56. 56. References:1. M.Ewen. & Wills.E.M, Theoretical Base forNursing, Philadelphia; Lippincott Williams 20022. Polit F.Denise & Hungler.B.P, Essentials of NursingResearch, Philadelphia; Lippincott Williams, 2004.3. Streubert & Carpenter . Qualitative ResearchNursing, Philadelphia; Lippincott Williams, 2007.4. Tommey A.M & Alligood M.R, Nursing Theoristsand their work, Philadelphia; Mosby Publication,2002.5. Wesley.L.R, Nursing Theories and models,Pennsylvania., Springhouse Corporation, 1995.

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