INTRODUCTIONINTRODUCTIONAccording to Mercer (1984) andAccording to Mercer (1984) andSilva (1986) states that research isSilva (1986) states that research isthe process through which thethe process through which theknowledge base for nursingknowledge base for nursingpractice grows. Theorypractice grows. Theoryconceptualizes the abstract natureconceptualizes the abstract natureof the relationship amongof the relationship amongconcepts. Research, however, isconcepts. Research, however, isthe systematic inquiry into thethe systematic inquiry into thepossible relationships amongpossible relationships amongparticular Phenomena.particular Phenomena.
Theoretical formulations supported byTheoretical formulations supported byresearch findings may potentiallyresearch findings may potentiallybecome the foundations of theory-become the foundations of theory-based practice in nursing. Theoreticalbased practice in nursing. Theoreticalknowledge derived from either aknowledge derived from either aqualitative or a qualitative source mustqualitative or a qualitative source musthave clinical relevance to be useful tohave clinical relevance to be useful toprofessionals in clinical practice and toprofessionals in clinical practice and tosociety in general.society in general.
DEFINITION OF THEORYDEFINITION OF THEORY““A theory is a statement thatA theory is a statement thatpurports to account for or characterizepurports to account for or characterizesome Phenomenon” and that it “pullssome Phenomenon” and that it “pullsout the salient parts of a Phenomenonout the salient parts of a Phenomenonso that one can separate the Criticalso that one can separate the Criticaland necessary factors (or relationships)and necessary factors (or relationships)from the accidental and unessentialfrom the accidental and unessentialfactors (or relationships)factors (or relationships)
PURPOSE OF THEORY IN RESEARCHPURPOSE OF THEORY IN RESEARCH It serves to make research findingsIt serves to make research findingsmeaningful and interpretable.meaningful and interpretable. It allows researchers to knit togetherIt allows researchers to knit togetherobservations into an orderly systems.observations into an orderly systems. It also serve to explain research findingsIt also serve to explain research findings It guides the researcher’s understanding notIt guides the researcher’s understanding notonly of the ‘what’ of natural phenomena butonly of the ‘what’ of natural phenomena butalso of the ‘why’ of their occurrence.also of the ‘why’ of their occurrence. It help to stimulate research and theIt help to stimulate research and theextension of knowledge by providing bothextension of knowledge by providing bothdirection and impetus.direction and impetus.
DEFINITION OF THEORETICALDEFINITION OF THEORETICALFRAMEWORFRAMEWORA theoretical framework isA theoretical framework isanalogous to the frame of a house.analogous to the frame of a house.A theoretical framework provides aA theoretical framework provides acontext for examining a problem,context for examining a problem,that is, the theoretical rationale forthat is, the theoretical rationale fordeveloping hypotheses, just as adeveloping hypotheses, just as adirection indicator provides adirection indicator provides acontext for using a road map.context for using a road map.
It is also a frame a reference that is aIt is also a frame a reference that is abase for observations, definitions ofbase for observations, definitions ofconcepts, research designs,concepts, research designs,interpretations, and generalizations, muchinterpretations, and generalizations, muchas the frame that rests on a foundationas the frame that rests on a foundationdefines the overall design of a house.defines the overall design of a house. Finally, a theoretical framework servesFinally, a theoretical framework servesas a guide to systematically identifyingas a guide to systematically identifyinglogical, precisely defined relationshipslogical, precisely defined relationshipsamong variables.among variables.
USES OF THEORITICAL FRAMEWORKUSES OF THEORITICAL FRAMEWORKAS A GUIDE IN A RESEARCH STUDYAS A GUIDE IN A RESEARCH STUDY It bringing meaning to the problem and studyIt bringing meaning to the problem and studyfindings.findings. It summarizes the existing knowledge in the fieldIt summarizes the existing knowledge in the fieldof inquiry and identifies the linkages amongof inquiry and identifies the linkages amongdefined concepts, thereby establishing a basis fordefined concepts, thereby establishing a basis forpredicting specific outcomes or generatingpredicting specific outcomes or generatinghypotheses.hypotheses. These linkages or propositions spell out howThese linkages or propositions spell out howconcepts are interrelated and lay a foundation forconcepts are interrelated and lay a foundation forthe development of methods that test the validitythe development of methods that test the validityand strength of predicted relationship orand strength of predicted relationship orhypotheses.hypotheses.
PURPOSE OF THEORETICALPURPOSE OF THEORETICALFRAMEWORK IN A RESEARCHFRAMEWORK IN A RESEARCHSTUDYSTUDYA theoretical rationale serves as aA theoretical rationale serves as aguide or map to systematicallyguide or map to systematicallyidentifying a logical, precisely definedidentifying a logical, precisely definedrelationship between variables.relationship between variables.Provides clear descriptions ofProvides clear descriptions ofvariables, suggesting ways or methodsvariables, suggesting ways or methodsto conduct the study.to conduct the study.Guiding the interpretation, evaluationGuiding the interpretation, evaluationand integration of study findings.and integration of study findings.
MAJOR THEORIES AND CONCEPTUALMAJOR THEORIES AND CONCEPTUALMODELS USED BY NURSEMODELS USED BY NURSERESEARCHERSRESEARCHERSNurse researchers have used bothNurse researchers have used bothnursing and non-nursing framework whichnursing and non-nursing framework whichprovide a conceptual context for theirprovide a conceptual context for theirqualitative and quantitative studies.qualitative and quantitative studies. Sister Callista Roy’s Adaptation ModelSister Callista Roy’s Adaptation Model Martha Rogers Unitary human beingMartha Rogers Unitary human being King’s Open Systems ModelKing’s Open Systems Model Neuman’s Health Care Systems ModelNeuman’s Health Care Systems Model Orem’s Model of Self-CareOrem’s Model of Self-Care Parse’s Theory of Human Becoming.Parse’s Theory of Human Becoming.
Other than these nurses have developedOther than these nurses have developedother models and theories that focus onother models and theories that focus onspecific phenomena of interest to nurses.specific phenomena of interest to nurses. Nola Pender’s Health Promotion ModelNola Pender’s Health Promotion Model Mishel’s Uncertainty in illness Theory – whichMishel’s Uncertainty in illness Theory – whichfocuses on the concept of uncertainty – the infocuses on the concept of uncertainty – the inability of a person to determine the meaningability of a person to determine the meaningof illnesss – related events.of illnesss – related events. Becker’s Health Belief ModelBecker’s Health Belief Model Lazarus and Folkmans theory of stress andLazarus and Folkmans theory of stress andcopingcoping Azjen and Fishbein’s theory of ReasonedAzjen and Fishbein’s theory of ReasonedAction.Action.
MAJOR THEORIES USED INMAJOR THEORIES USED INEXPERIMENTAL RESEARCHEXPERIMENTAL RESEARCHOrem’s Self-Care Deficit ModelOrem’s Self-Care Deficit ModelBertanlanffy General Systems TheoryBertanlanffy General Systems TheoryStuffle Beam’s Programme EvaluationStuffle Beam’s Programme EvaluationModelModelKenny’s Open Systems ModelKenny’s Open Systems ModelRosenstock’s Health Belief ModelRosenstock’s Health Belief ModelImogene King’s system’s Theory ofImogene King’s system’s Theory ofGoal AttainmentGoal Attainment
APPLICATION OF OREM’S SELFAPPLICATION OF OREM’S SELFCARE DEFICIT THEORYCARE DEFICIT THEORYThe central idea in Orem’s theoryThe central idea in Orem’s theoryis that the individuals areis that the individuals areaffected by limitations from timeaffected by limitations from timeto time that do not allow them toto time that do not allow them tomeet their self –care needs.meet their self –care needs.
Self-care as theSelf-care as thepractice of activities thatpractice of activities thatindividual initiate andindividual initiate andperform on their ownperform on their ownbehalf in marinating life,behalf in marinating life,health and well-being.health and well-being.
Dependent care is theDependent care is theaction performed by responsibleaction performed by responsibleadults to meet the components ofadults to meet the components oftheir dependent therapeutic self-their dependent therapeutic self-care demand.care demand. Dependent care agency is theDependent care agency is theability of responsible adults toability of responsible adults tomeet the continuing demands formeet the continuing demands forself – care of their dependents.self – care of their dependents.
Dependent care deficit is an unequalDependent care deficit is an unequalrelationship between capabilities ofrelationship between capabilities ofresponsible adults and the dependentresponsible adults and the dependentpersons who require therapeutic self-carepersons who require therapeutic self-caredemand.demand.Nursing agency is defined as theNursing agency is defined as thecomplex property or attributes of personscomplex property or attributes of personseducated and trained as nurses that iseducated and trained as nurses that isenabling others to know their therapeuticenabling others to know their therapeuticself-care demand, for helping others to meetself-care demand, for helping others to meetor in meeting their therapeutic self-careor in meeting their therapeutic self-caredemand and in helping others to regulatedemand and in helping others to regulatethe exercise or development of their self-the exercise or development of their self-care agency or their dependent carecare agency or their dependent careagency.agency.
Effectiveness of a structuredEffectiveness of a structuredteaching programme amongteaching programme amongmothers of asthmatic children onmothers of asthmatic children onhome management of childernhome management of childernwith asthma in a selectedwith asthma in a selectedhospitals of Udupi district,hospitals of Udupi district,Nishe,2000.Nishe,2000.
Application of General SystemsApplication of General SystemsTheory by Bertanlanffy (1968)Theory by Bertanlanffy (1968)Effectiveness of instruction cumEffectiveness of instruction cumtreatment on haemoglobin, serumtreatment on haemoglobin, serumferritin and intelligence level amongferritin and intelligence level amonganaemic adolescent girls in selectedanaemic adolescent girls in selectedschools, Mangalore district,schools, Mangalore district,Karnataka.Karnataka.
Theoretical framework selected for this study isTheoretical framework selected for this study isbased on General Systems Theory bybased on General Systems Theory byBertanlanffy (1968). In this theory main focus isBertanlanffy (1968). In this theory main focus ison the discrete parts and their interrelationship,on the discrete parts and their interrelationship,which makes up and describes the whole. Hewhich makes up and describes the whole. Hedefines system as a complex interaction whichdefines system as a complex interaction whichmeans that system consists of two or moremeans that system consists of two or moreconverted elements which form an organizedconverted elements which form an organizedwhole and which interest with each other. Thewhole and which interest with each other. Theelements in this study which are organized toelements in this study which are organized toget the effect of treatment I & II in relation toget the effect of treatment I & II in relation tohaemoglobin and serum ferritin.haemoglobin and serum ferritin.
According to him ‘input’ refers toAccording to him ‘input’ refers toenergy, matter and information. Allenergy, matter and information. Allsystems must receive varying typesystems must receive varying typeand amount of information from theand amount of information from theenvironment. This system uses theenvironment. This system uses theinput to maintain its homeostasis.input to maintain its homeostasis.
According to him ‘throughput’According to him ‘throughput’refers to the process by whichrefers to the process by whichthe system process input andthe system process input andrelease an output.release an output.
According to him ‘output’ refers toAccording to him ‘output’ refers tomatter, energy and information thatmatter, energy and information thatleave a system.leave a system.According to him the feed back refersAccording to him the feed back refersto the output that is returned to theto the output that is returned to thesystem that allows it to monitor itselfsystem that allows it to monitor itselfovertime in an attempt to move closerovertime in an attempt to move closerto a steady state known as equilibriumto a steady state known as equilibriumor homeostasis. Feedback may beor homeostasis. Feedback may bepositive, negative or neutral.positive, negative or neutral.
According to him system as a whole; aAccording to him system as a whole; adysfunction of a part causes a symptomdysfunction of a part causes a symptomdisturbance rather than loss of a singledisturbance rather than loss of a singlefunction. In all system activity can befunction. In all system activity can beresolved in to an aggregation ofresolved in to an aggregation offeedback circuits such as the input,feedback circuits such as the input,through put and output. The feedbackthrough put and output. The feedbackcircuits helps in the maintenance of intactcircuits helps in the maintenance of intactsystem.system.
Application of Context- Input-Application of Context- Input-Process-Product [CIPP] modelProcess-Product [CIPP] model A study to determine theA study to determine theeffectiveness of need basedeffectiveness of need basedteaching protocol on nursesteaching protocol on nursesresponsibility in ABG Analysis forresponsibility in ABG Analysis forthe, nursing personal working inthe, nursing personal working incritical care units in a selectedcritical care units in a selectedhospital in Karnataka – Sonali,hospital in Karnataka – Sonali,2003 used this model.2003 used this model.
The present study has aimed at developing andThe present study has aimed at developing andevaluating a teaching protocol on “Nurses’evaluating a teaching protocol on “Nurses’Responsibility in ABG Analysis” for the nursingResponsibility in ABG Analysis” for the nursingpersonnel working in the critical! care units.personnel working in the critical! care units.The conceptual framework of this study wasThe conceptual framework of this study wasbased on Stufflebeam’s, (1973)based on Stufflebeam’s, (1973) Context-Context-Input-Process-Product (CIPP)Input-Process-Product (CIPP) model. It’smodel. It’sa four-step model of programme evaluationa four-step model of programme evaluationdeveloped for obtaining useful information fordeveloped for obtaining useful information fortaking decisions. It provides a comprehensive,taking decisions. It provides a comprehensive,systematic, continuous, ongoing framework forsystematic, continuous, ongoing framework forprogramme-evaluation.programme-evaluation.
Stufflebeam has identified four types ofStufflebeam has identified four types ofdecision.decision. Planning decision will determine thePlanning decision will determine theobjectives of the programme.objectives of the programme. Structuring the decision in which theStructuring the decision in which theprocedure strategies need to achieve theprocedure strategies need to achieve theobjectives is made.objectives is made. The model involves implementing theThe model involves implementing thedecision and lastly, recycling decision todecision and lastly, recycling decision tomake changes in response to the outcomemake changes in response to the outcomeof the programme.of the programme. With each step comes a specific type ofWith each step comes a specific type ofevaluation, which Stufflebeam labeled asevaluation, which Stufflebeam labeled ascontext, input, process and output.context, input, process and output.
Context evaluation defines theContext evaluation defines theenvironment in which theenvironment in which theprogramme will operate in bothprogramme will operate in boththe actual and desiredthe actual and desiredconditions, observation,conditions, observation,interview and archival datainterview and archival dataprovide the basis for contextprovide the basis for contextevaluation.evaluation.
Input evaluation is necessary toInput evaluation is necessary tomake structural decisions. Itmake structural decisions. Itincludes assessing relevantincludes assessing relevantcapabilities of those involved incapabilities of those involved inthe programme, strategies forthe programme, strategies forachieving objectives and waysachieving objectives and waysof implementing the strategies.of implementing the strategies.
Both context and input evaluationBoth context and input evaluationbegin before the programmebegin before the programmestarts but the process evaluationstarts but the process evaluationis a formative evaluation and asis a formative evaluation and assuch provides feedback data tosuch provides feedback data toguide programme modificationguide programme modificationbefore implementation.before implementation.
After implementation of theAfter implementation of theprogramme product evaluation isprogramme product evaluation isdone which measures programmedone which measures programmeachievements, leading to recyclingachievements, leading to recyclingdecisions by determining if theydecisions by determining if theyhave met the objectiveshave met the objectives..
Schematic Representation of the CoSchematicRepresentation of the Conceptual Frameworknceptual FrameworkContext Evaluation Input Evaluation Process Evaluation Product Evaluation•· Critical care nursingunits.• Nursing personalwith diploma, workingin the critical care unitshaving workingexperience less than 2years, 2-4 years andabove 4 years.• Assessed learningneed by a StructuredKnowledgeQuestionnaire in allaspects of “Nurses’Responsibility in ABGAnalysis”.• Quality nursing care• Existing knowledgeand practice of nursiExisting knowledge andpractice of nursingpersonnel assessed bya KnowledgeQuestionnaire andpractice level byObservation Checklist.• Developing ateaching protocolon“Nurses’ Responsibilityin ABG Analysis”.• Teaching strategyLecture cumdiscussions anddemonstration.• Need Assessment• Establishing NeedAssessment• Establishing validityof the research tools.• Establishing reliabilityof the tools.• Pilot study.• Modification of toolsand teaching protocol.• Conducting pre-test,teaching and post-test.• Analysis of the effectivenessof the teaching protocol interms of effectiveness of theteaching protocol in terms ofgain in knowledge andpractice of the nursingpersonnel• gain in knowledge andpractice of the nursingpersonnelConceptual framework for development and evaluating of a teaching Protocol on “Nurses’ Responsibility in ABG Analusis” modifiedfrom Stufflebeam’s (1973. CIPFig .1 Conceptual framework for development and evaluating of a teaching Protocol on “Nurses’
APPLICATION OF KENNY’S OPENSYSTEM MODELASSESS THE EFFECTIVENESS OFPLANNED NURSING CARE FOR THEPATIENTS WITH LOWER SEGMENTCESAREAN SECTION IN K.N RAOHOSPITAL, SALEM, 2006.
It was developed based on system theory ofLudwing Von Bertalanffy (1968). Accordingto Kenny, all living systems are open; theyare in continuous exchange of matter,energy, and information which results invarying degree of interaction with theenvironment from which the systemreceived input and gives back output in theform of matter, energy and information.
INPUTThe input can be matter, energy andinformation from the environment.THROUHPUTThe matter, energy and informationare continuously processed throughthe system which is also calledcomplex transformation known asthroughput.
FEEDBACKFor feedback information andenvironmental responses by thesystem needs adjustment, correctionand accommodation to the interactionwith the environment.
APPLICATION OFAPPLICATION OFROSENSTOCK’S HEALTHROSENSTOCK’S HEALTHBELIEF MODELBELIEF MODEL A study to determine theA study to determine theeffectiveness of planned patienteffectiveness of planned patientteaching programme on diabeticteaching programme on diabeticdiet, prescribed medication anddiet, prescribed medication andfoot care for diabetic clients in afoot care for diabetic clients in aselected hospital of Udupi District,selected hospital of Udupi District,Usha OV, 2001.Usha OV, 2001.
The present study aims atThe present study aims atdeveloping and evaluating adeveloping and evaluating aplanned patient teaching programplanned patient teaching programon diabetic diet, prescribedon diabetic diet, prescribedmedications and foot care inmedications and foot care interms of their gain in knowledgeterms of their gain in knowledgeand compliance. The conceptualand compliance. The conceptualframework of the study was basedframework of the study was basedon modified Health Belief Modelon modified Health Belief Modelof Rosenstock.of Rosenstock.
In this model human behaviour is seen asIn this model human behaviour is seen asbeing dependent upon two primary variables.being dependent upon two primary variables.(1). the values placed by a person upon a(1). the values placed by a person upon aparticular outcome and (2) the persons beliefparticular outcome and (2) the persons beliefthat a given action will result in that outcome.that a given action will result in that outcome.The individual perception about the susceptibilityThe individual perception about the susceptibilityand occurrence of the disease will make theand occurrence of the disease will make theperson take preventive action to avoid theperson take preventive action to avoid thedisease. The assumption in this model is that thedisease. The assumption in this model is that theperception will always have a personalperception will always have a personalimplication, that by taking a particular action theimplication, that by taking a particular action thesusceptibility of developing diabeticsusceptibility of developing diabeticcomplications would be reduced or diabetes cancomplications would be reduced or diabetes canbe controlled.be controlled.
The perceptions in the present study areThe perceptions in the present study areperceived susceptibility to complications.perceived susceptibility to complications.The attitude of the diabetic clients whichThe attitude of the diabetic clients whichcan be influenced by the teaching programcan be influenced by the teaching programand which will determine their healthand which will determine their healthbehaviour i.e. prevention of complicationsbehaviour i.e. prevention of complicationsand reduce the cost of care. It is alsoand reduce the cost of care. It is alsoassumed that a particular teachingassumed that a particular teachingprogram will improve the diabetic client’sprogram will improve the diabetic client’sknowledge towards their care, which willknowledge towards their care, which willresult in improvement in compliance.result in improvement in compliance.
APPLICATION OF IMOGENEAPPLICATION OF IMOGENEKING’S SYSTEMS THEORY OFKING’S SYSTEMS THEORY OFGOAL ATTAINMENTGOAL ATTAINMENT A study to find the side effects ofA study to find the side effects ofchemotherapy as experienced by thechemotherapy as experienced by thecancer patients and the effectiveness ofcancer patients and the effectiveness ofinformation guide on the knowledge andinformation guide on the knowledge andpractice of cancer patients regarding itspractice of cancer patients regarding itsrelieving measures in a selected hospitalrelieving measures in a selected hospitalof Udupi Disk,Jacob JA, 2002of Udupi Disk,Jacob JA, 2002
The framework is adopted from ImogeneThe framework is adopted from ImogeneKing’s System’s Theory of GoalKing’s System’s Theory of GoalAttainment. King (1989) states that “theAttainment. King (1989) states that “thestructure of a system interacting withstructure of a system interacting withan environment”.an environment”.
According to King “nursing function includeAccording to King “nursing function includeviewing, recognizing, observing, synthesizing,viewing, recognizing, observing, synthesizing,interpreting and analyzing which are within theinterpreting and analyzing which are within thecontext of nursing process. It includes thecontext of nursing process. It includes theinterpretation of specific information to plan,interpretation of specific information to plan,implement and evaluate the nursing care. Sheimplement and evaluate the nursing care. Shefurther states that “…the major focus of thefurther states that “…the major focus of thetheory is the interpersonal system, becausetheory is the interpersonal system, becausewhat nurses do with and for individual is whatwhat nurses do with and for individual is whatmakes the difference between nursing and anymakes the difference between nursing and anyother health profession.other health profession.
Action is based on the perceptionsAction is based on the perceptionsand judgement of the nurse and the clientand judgement of the nurse and the clientengaged in interactions and leads toengaged in interactions and leads totransaction. Goal attainment is thetransaction. Goal attainment is thetransaction phase of the nursing processtransaction phase of the nursing processwhich takes place through mutual goalwhich takes place through mutual goalsetting, exploration and agreement tosetting, exploration and agreement tomeans to achieve goal and the evidencemeans to achieve goal and the evidenceof behaviour that moves toward goalof behaviour that moves toward goalattainmentattainment