DEVELOPMENT AND CLASSIFICATIONOFNURSING THEORIESPresented byARUN.M
THEORIES ARE NOTDISCOVERED IN NATUREBUT ARE HUMAN INVENTIONS
THEORYA set of concepts, definitions andprepositions that projects a systematic viewof phenomena by designating specificinterrelationships among concepts forpurposes of describing, explaining,predicting and controlling phenomena.
NURSING THEORYConceptualization of some aspectof nursing communicated for thepurpose of describing phenomenaexplaining relationships betweenphenomena predicting consequences orprescribing nursing care.
PHILOSOPHYPHILOSOPHYConcerned with the values and beliefs of aConcerned with the values and beliefs of adiscipline and with the values and beliefsdiscipline and with the values and beliefsheldheld by members of the discipline.by members of the discipline.CONCEPTCONCEPTComplex mental formulation of anComplex mental formulation of anobject, property or event that is derivedobject, property or event that is derived fromfromindividual perceptual experience. It isindividual perceptual experience. It is ananidea, a mental image oridea, a mental image or generalization formedgeneralization formedand developed inand developed in the mind.the mind.
CONCEPTUAL MODELCONCEPTUAL MODELA set of relatively abstract andA set of relatively abstract andgeneral concepts and the propositionsgeneral concepts and the propositionsthat describe or link those concepts.that describe or link those concepts.
COMPONENTS OF A NURSING THEORYCOMPONENTS OF A NURSING THEORYConceptsConcepts DefinitionsDefinitionsAssumptionsAssumptionsororPropositionsPropositionsPhenomenon
CONCEPTSCONCEPTS Theory consists of inter related conceptsTheory consists of inter related concepts Concepts are ideas, mental imagesConcepts are ideas, mental images They help to describe or label phenomenaThey help to describe or label phenomena They are mental formulations of an object or eventThey are mental formulations of an object or eventthat come from individual perceptual experiencethat come from individual perceptual experienceDEFINITIONSDEFINITIONS Convey the general meaning of the concepts in aConvey the general meaning of the concepts in amanner that fits the theory.manner that fits the theory. Describe the activity necessary to measure theDescribe the activity necessary to measure theconstructs, relationships or variables within aconstructs, relationships or variables within atheory.theory.
ASSUMPTIONSASSUMPTIONS Statements that describe concepts or connect twoStatements that describe concepts or connect twoconceptsconcepts They are the “taken for granted” statements thatThey are the “taken for granted” statements thatdetermine the nature of the concepts, definitions,determine the nature of the concepts, definitions,purpose, relationships and structure of the theory.purpose, relationships and structure of the theory.PHENOMENONPHENOMENON An aspect of reality that can beAn aspect of reality that can be consciouslyconsciouslysensed orsensed or experiencedexperienced Nursing theories focus on the phenomena ofNursing theories focus on the phenomena ofnursingnursing In nursing, phenomena reflect the domain ofIn nursing, phenomena reflect the domain ofnursing practicenursing practice
CHARACTERISTICS OF A THEORYCHARACTERISTICS OF A THEORY1) Interrelate concepts in such a way as to create1) Interrelate concepts in such a way as to createa different way of looking at a particulara different way of looking at a particularphenomenon.phenomenon.2) Must be logical in nature2) Must be logical in nature3) Should be relatively simple yet generalizable3) Should be relatively simple yet generalizable4) The bases for hypothesis that can4) The bases for hypothesis that can be tested orbe tested orfor theory to be expandedfor theory to be expanded...continued.....continued..
6)6)Contribute to and assist in increasing theContribute to and assist in increasing thegeneral body of knowledge within thegeneral body of knowledge within thediscipline through the research implementeddiscipline through the research implementedto validate them.to validate them.7) Used by practitioners to guide and7) Used by practitioners to guide and improveimprovetheir practice.their practice.8)8) Consistent with other validated theories,Consistent with other validated theories,laws, and principles but will leave openlaws, and principles but will leave openunanswered questions that need to beunanswered questions that need to beinvestigated.investigated.
TYPES OF THEORYTYPES OF THEORY(I) LEVEL OF ABSTRACTION(I) LEVEL OF ABSTRACTIONGrand Theory Middle RangeTheorySituation specificTheory
II GOAL ORIENTATIONII GOAL ORIENTATIONDescriptive PrescriptiveFactor isolating Explanatory theory
GRAND THEORIES Systematic constructions of the nature ofnursing, the mission of nursing and thegoals of nursing care. Broad in scope and complex Require further specification throughresearch before they can be fully tested. Concepts are abstract Not easily empirically tested.
MIDDLE RANGE THEORIES Limited scope Less abstract concepts Address specific phenomena or concepts Reflect practice (Administration, clinicalor teaching) Increased theory-based research andnursing practice strategies
SITUATION SPECIFIC THEORIES Focus on specific nursing phenomena that reflectclinical practice. Limited to specific populations or to a particularfield of practice. Limited scope More direct impact on nursing practice Predict outcomes and the impact of nursing practice Called as prescriptive theory Day-to-day experience of nurses is a major source tosituation specific theory
DESCRIPTIVE THEORIES Describe a phenomenon, an event, a situation ora relationship Needed when very little isknown about a phenomena Describe phenomena, speculate on whyphenomena occur and the consequences of aphenomena. Have explanatory, relating and predicting utility They are complete and have the potential forguiding research.
PRESCRIPTIVE THEORIES Prescriptive theory designates the prescription(intervention), the conditions under which theprescription should occur, and theconsequences. They are action oriented which tests thevalidity and predictability of a nursingintervention. Guide nursing research to develop and testspecific nursing interventions.
TYPES OF THEORY AND LEVEL OFTYPES OF THEORY AND LEVEL OFABSTRACTIONABSTRACTIONTypes of TheoryTypes of Theory Level of abstractionLevel of abstractionConceptual modelConceptual model Most AbstractMost AbstractGrand theoryGrand theoryMiddle -Range theoryMiddle -Range theorySituation specific theorySituation specific theory Most concreteMost concrete
THEORISTTHEORIST PHILOSOPHIESFlorence NightingaleFlorence Nightingale An Environmental Adaptation TheoryAn Environmental Adaptation TheoryErnestine WidenbachErnestine Widenbach The helping Art of Clinical NursingThe helping Art of Clinical NursingVirginia HendersonVirginia Henderson Basic Needs of the PatientBasic Needs of the PatientFaye AbdellahFaye Abdellah Need TheoryNeed TheoryLydia E. HallLydia E. Hall Care, Core, Cure ConceptCare, Core, Cure ConceptJean WatsonJean Watson Philosophy and Science of CaringPhilosophy and Science of CaringPatricia BennerPatricia Benner Excellence and power in clinicalExcellence and power in clinicalNursing PracticeNursing PracticeKari MartinsenKari Martinsen Philosophy of caringPhilosophy of caringPHILOSOPHIES
CONCEPTUAL MODELSTHEORISTTHEORIST MODELMODELDorothy JohnsonDorothy Johnson Behaviour System ModelBehaviour System ModelMyra LevinMyra Levin Conservation ModelConservation ModelMartha RogersMartha Rogers Science of Human beingsScience of Human beingsBetty NeumanBetty Neuman Systems ModelSystems ModelSister Callista RoySister Callista Roy Adaptation ModelAdaptation Model
GRAND THEORIESTHEORISTTHEORIST THEORYTHEORYImogene KingImogene King Theory of Goal AttainmentTheory of Goal AttainmentLeningerLeninger Theory of Culture Care andTheory of Culture Care andUniversalityUniversalityMargaret A. NewmanMargaret A. Newman Health as ExpandingHealth as ExpandingConsciousnessConsciousnessDorothea OremDorothea Orem Self-Care Deficit TheorySelf-Care Deficit TheoryParseParse Theory of Human BecomingTheory of Human BecomingIda Jean OrlandoIda Jean Orlando Nursing Process TheoryNursing Process TheoryHildegard E.PeplauHildegard E.Peplau Inter personal relationship TheoryInter personal relationship Theory
MIDDLE RANGE THEORIESTHEORISTTHEORIST THEORYTHEORYRamona T. MercerRamona T. Mercer Maternal role attainmentMaternal role attainmentMerle H. MishelMerle H. Mishel Uncertainty in Illness TheoryUncertainty in Illness TheoryPamela G. ReedPamela G. Reed Self – Transcendence TheorySelf – Transcendence TheoryPhil BarkerPhil Barker Tidal Model of Mental HealthTidal Model of Mental HealthRecoveryRecoveryKatharine KolkabaKatharine Kolkaba Theory of ComfortTheory of ComfortCheryl Tatano BeckCheryl Tatano Beck Post partum Depression TheoryPost partum Depression TheoryKristen M. SwansonKristen M. Swanson Theory of CaringTheory of Caring
THEORY DEVELOPMENTTHEORY DEVELOPMENTPURPOSES OF THEORY DEVELOPMENTPURPOSES OF THEORY DEVELOPMENT♦♦ To distinguish fact from pseudo fact.To distinguish fact from pseudo fact.♦♦ Nursing requires the attempt to structureNursing requires the attempt to structureconverging facts from a number of fields.converging facts from a number of fields.♦♦ Theoretical knowledge is used to give directionTheoretical knowledge is used to give directionof practice.of practice.♦♦ Theory is also useful as a framework for theTheory is also useful as a framework for theretrieval and use of generated and storedretrieval and use of generated and storedknowledge which lies in libraries.knowledge which lies in libraries.
THEORY GENERATION AND DEVELOPMENTTHEORY GENERATION AND DEVELOPMENTDeductionDeduction InductionInductionTheoryTheory TheoryTheoryPropositional statement Propositional statementPropositional statement Propositional statementHypothesisHypothesis Empirical GenerationEmpirical GenerationEmpirical dataEmpirical data Empirical dataEmpirical data
1. Theory – Practice – Theory strategy1. Theory – Practice – Theory strategyThe clinical theorist selects an established theory fromThe clinical theorist selects an established theory fromanother discipline, uses it in practice, and refines andanother discipline, uses it in practice, and refines andadapts the theory to the nursing situation.adapts the theory to the nursing situation.Eg:Eg: TheoryTheory PracticePractice TheoryTheoryPsychoanalytic theory Psychiatry PeplauPsychoanalytic theory Psychiatry PeplauAdaptation theory Pediatrics RoyAdaptation theory Pediatrics RoySystems theory PediatricsSystems theory Pediatrics JohnsonJohnson
2. Practice – Theory strategy2. Practice – Theory strategy♦♦ Impetus for this strategy comes from question inImpetus for this strategy comes from question inthe practice situation for which no theory isthe practice situation for which no theory isavailable to explain the phenomenon.available to explain the phenomenon.♦♦ Observation of phenomena, description andObservation of phenomena, description andlabeling of concepts and linking of concepts tolabeling of concepts and linking of concepts to formformrational statement are the major activities.rational statement are the major activities.Eg:Eg: Theories of Orlando, Travel bee and Widen bachTheories of Orlando, Travel bee and Widen bachdeveloped their ideas by being totally immersed indeveloped their ideas by being totally immersed inclinical work.clinical work.
3. Research – Theory strategy3. Research – Theory strategyCharacteristics of a selected phenomena areCharacteristics of a selected phenomena aremeasured in a variety of situations and thenmeasured in a variety of situations and thenanalyzed for existence of significant patterns thatanalyzed for existence of significant patterns thatare formalized into theoretical proposition.are formalized into theoretical proposition.Eg: Johnson’s behavior system model, Barnard’sEg: Johnson’s behavior system model, Barnard’sparent- child interaction theory.parent- child interaction theory.
4. Theory – Research – Theory strategy4. Theory – Research – Theory strategy In this strategy, theory derives the researchIn this strategy, theory derives the researchquestions and the results that answer thesequestions and the results that answer theseresearch questions inform and modify theresearch questions inform and modify thetheory.theory. Theorists begin the research by defining a theoryTheorists begin the research by defining a theoryand determining propositions for testing and thenand determining propositions for testing and thenfurther modify and develop the original theories.further modify and develop the original theories.
STAGES OF THEORY DEVELOPMENTTaking inDescribing the phenomenonLabelingConcept developmentStatement developmentExplicating assumptionsSharing and Communicating
STAGES OF THEORY DEVELOPMENT1. Taking inA process of sizing up a situation that hasattracted our attention for whatever reason. Aphenomenon may attract and hold the attention ofthe observer making her pause to think about it orreflect on its nature.2. Describing the phenomenonCognitive, intuitive or inferentialinterpretation of the phenomenon is made todescribe and delineate the phenomena.
3. LabelingLabeling is defining the concept rangingfrom dictionary definition to a more complexdefinition that takes the perspective of the theoristin consideration Defining Differentiating Delineating antecedents Delineating consequences Modeling Analyzing Synthesizing4. Concept development
5. Statement developmentExplanations related to the phenomenonthat link the concepts, antecedents,consequences and assumptions are provided.6. Explicating assumptionsAnalysis of one’s views, beliefs andtheoretical underpinnings will help delineateassumptions of the developing theory.
7. Sharing and CommunicatingSharing and communicating goes beyondwriting and publication. Clinical conferencesmay be redefined to include a theoreticaljournal sharing hour. Faculty meeting timemust be re-organized to permit discussion forevolving concepts or statement.
BARRIERS TO THEORY DEVELOPMENT1. Human barriers(i) Nurses as Nurses:• Nurses looked nursing as an occupation ratherthan profession with theoretical foundations.• Nursing is service oriented rather thanprofession orientation• Theory creation is an active process but earlyresearch characterized nurses as passive• Nurses were taught intellectual subordination.• Critical thinking skills were not taught to
(ii) Nurses as women:• Theory development is a laborious processwhereas nurses as women were hardworking person whose energies shouldbe for rearing children and caring for a family• Nurses as women are considered to be moreaffective, more subordinate,more emotional,less achievement oriented and generallyexpected to apply rather than to create.• Women are conditioned to considerprofessional career as secondary tofamily and home.
(iii) Nurses as Theorists:Nurses have been harsh in critiquing nursingtheories because•Theories did not appear to evolve from anempirical base.•Theories were developed by women.•Theories in itself were not able to describeand predict all nursing phenomena.
2. Knowledge barriers:• Theories used knowledge developed by otherdisciplines.• Reluctance of the members of the discipline touse nursing theory developed within thediscipline.• Knowledge of nursing theory is not useful inpractice.3. Conceptual barriers:Conceptual blocks are those closed gatesthat prevent nurses from previewing ofdeveloping nursing phenomena beyond theimmediate problem solving need.