Chapter 13

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Chapter 13

  1. 1. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 13Chapter 13 Theories From the SociologicTheories From the Sociologic SciencesSciences
  2. 2. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Theories From Sociology • Historically, nursing has been responsive to society’s needs. • Early nursing leaders (e.g., Nightingale, Barton, Wald, Sanger) were frequently social activists.
  3. 3. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Theories From Sociology—(cont.) • Nursing practice and research must consider the social factors and issues that constrain and shape health behaviors. • Examples of sociological theories that are used by nurses are – Systems Theory – Feminist Theory – Critical Social Theory – Chaos Theory
  4. 4. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins General Systems Theory • General Systems Theory was introduced in the 1930s by Ludwig von Bertalanffy. • Presumes that there are universal principles of organization which hold for all systems, whether they are physical, chemical, biological, mental, social, etc. • Considered to be a “grand” theory because of its universal relevancy and applicability
  5. 5. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins General Systems Theory—(cont.) • Systems are composed of structural and functional components. – These interact within a boundary that filters exchange with the environment. – Living systems are open, and there is an ongoing exchange of matter, energy, and information.
  6. 6. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins General Systems Theory—(cont.) • All systems contain the following elements – Input—matter, energy, and information received from the environment – Throughput—matter, energy, and information that is modified or transformed within the system – Output—matter, energy, and information that is released from the system into the environment – Feedback—information regarding environmental responses used by the system (may be + or − or neutral)
  7. 7. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Elements of a system.
  8. 8. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins General Systems Theory—(cont.) • Basic tenets of GST – A system is composed of subsystems, each with its own function. – Systems contain energy and matter. – A system may be open or closed. – Open and closed systems reach stationary status. • A system must achieve a balance internally and externally (equilibrium) – Equilibrium depends on the system’s ability to regulate input and output to achieve balance. – Adaptation helps maintain equilibrium.
  9. 9. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins General Systems Theory and Nursing • Several grand theorists (e.g., Neuman, Orem, King, Roy, Rogers) reported they used GST as one component from which their theory was derived. • GST was the basis of development of the nursing process. • Frequently used in nursing management and administration • Limited use in nursing research
  10. 10. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following is NOT a central concept in Systems Theory? A.Feedback B.Input C.Output D.Reciprocation
  11. 11. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D. Reciprocation Rationale: The central concepts or elements of Systems Theory are input, throughput, output, and feedback.
  12. 12. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Feminist Theory • Gender differences and subordination have been viewed as natural and inevitable. • Many believe that gender is socially constructed and justifies the subordination and exploitation of women. • A core assumption in feminist theories is that women are oppressed.
  13. 13. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Feminist Theory—(cont.) • Definition—an analysis of women’s subordination (within families and all other institutions) for the purpose of determining how to change it.
  14. 14. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Feminist Theory—(cont.) • Common themes in feminist theories – Gender is a basic organizing concept—There is a social construction and recognition of differences. – Gender differences are used to legitimize and perpetuate power relationships between men and women. – Women’s experiences are central, normal, and valuable. – Gender relations must be analyzed within specific sociocultural and historical contexts. – Social constraints and expectations contain class, cultural, and heterosexual biases and support the oppression of women.
  15. 15. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following is NOT a common theme in Feminist Theories? A. Gender is a socially constructed, organizing concept. B. Gender differences are used to influence power relationships between men and women. C. Gender relations should be analyzed without regard to sociocultural differences. D. Social constraints and expectations contain biases that support the oppression of women.
  16. 16. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer C. Gender relations should be analyzed without regard to sociocultural differences. Rationale: Gender role beliefs and expectations are highly determined by cultural norms and values and historical times. Therefore, understanding of feminism must consider the specific sociocultural and historical contexts.
  17. 17. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Feminist Theory and Nursing • Fairly common theme in nursing literature— focusing on: – Advancement of the profession and education – Practice implications in patient care – Research in several areas (both practice and professional) – Administration issues
  18. 18. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory • Jürgen Habermas is the best known of the Critical Social Theorists. • Habermas was part of a group of German scholars in Frankfurt writing in the 1960s. • He promoted critical social theory to describe “distortions and constraints that impede free, equal, and uncoerced participation in society.”
  19. 19. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Critical social theory began in Marx’s argument that oppression requires revolutionary action. • Critical social theory uses societal awareness to expose social inequalities that keep people from reaching their full potential.
  20. 20. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Critical social theory emphasizes recognition of oppressive behavior and emancipation for a group of people. • The purpose of critical social theory is to uncover an oppressive situation and motivate victims to free themselves from oppression.
  21. 21. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Critical social theory sponsors the belief that social meaning structures events through social domination. • The dominate group in a society has the ability to identify its norms and values as the “right” ones in society. • The dominate group has the power to enforce norms and values on other groups.
  22. 22. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Contemporary ideas from critical social theory – Knowledge is historical and value-laden. – Social and economic relationships shape development and dissemination of research— therefore, research is a political activity.
  23. 23. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Contemporary ideas from critical social theory—(cont.) – Power relationships inform knowledge development. – Language is paramount to how people comprehend meaning and create knowledge. – Social oppression is not natural or static; historical and social conditions contribute to their production and maintenance.
  24. 24. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Critical social theory aims to provide an environment in which individuals can become empowered, enlightened, and emancipated. – Enlightenment—raising the consciousness of the oppressed – Empowerment encourages people to undertake activities to improve their situation. – Emancipation—is the goal of empowerment through which new arrangements replace oppressive ones
  25. 25. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false: In critical social theory, it is posited that enlightened people will be encouraged to engage in activities to improve their situation.
  26. 26. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Rationale: Enlightenment raises the consciousness of the oppressed, which empowers them to undertake activities to improve their situation and reduce or eliminate disparities.
  27. 27. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Critical Social Theory—(cont.) • Critical social theory is used fairly frequently in nursing literature. – Concepts from critical social theory have been used to describe rationale for enhancing care and eliminating disparities. – It has also been used as a research framework to explain health behaviors (e.g., nursing care of adolescents with diabetes). – Articles focusing on empowerment and enlightenment can be found.
  28. 28. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Chaos Theory • Chaos theory is the science concerning nonlinearity. • Nonlinearity is everywhere; the majority of all nature’s phenomena are nonlinear.
  29. 29. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Chaos Theory—(cont.) • Problem in scientific analysis of the theory—Large data sets with long time sequences are necessary for chaos to become evident. • Most science recognizes and focuses on linear relationships, homeostasis, order equilibrium, predictability, and control. • The postmodern science focusing on nonlinear dynamic systems—such as chaos theory—encourages researchers to “think outside the box.”
  30. 30. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Chaos Theory—(cont.) • Chaos theory is the study of unstable, aperiodic behavior in nonrandom, nonlinear, dynamical systems. – Dynamical refers to the time-varying behavior of the system. – Aperiodic refers to the nonrepetitive but continuous behavior resulting from the effects of any small disturbance.
  31. 31. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Chaos Theory—(cont.) • Chaos theory focuses on finding the underlying order in the apparent disorder of natural and social systems and to understand how change occurs in nonlinear, dynamical systems over time. • According to chaos theory, natural and social systems survive because of their nonlinear behavior. – Political unrest – Families in crisis
  32. 32. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Concepts of Chaos Theory • Sensitive dependence on initial conditions or the “butterfly effect” – Even small differences can cause dramatic changes or divergent paths. – Equilibrium is never reached in a dynamical system. – Trajectories that start from “arbitrarily close” points will diverge exponentially.
  33. 33. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Concepts of Chaos Theory—(cont.) • Butterfly effect illustration – For want of a nail, the shoe was lost; – For want of a shoe, the horse was lost; – For want of a horse, the rider was lost; – For want of a rider, the message was lost; – For want of a message, the battle was lost; – For want of a battle, the kingdom was lost. • The small change—no nail—resulted in huge consequences, reverberating outward indefinitely.
  34. 34. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Three-dimensional model of a strange attractor.
  35. 35. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Concepts of Chaos Theory—(cont.) • A strange attractor—(“strange” because it is unexpected) – Exerts pull on objects to return them to their original starting point. – The controlling action of the attractor provides a boundary. – The attractor may be identified by graphing the changing behavior of an attribute of a system.
  36. 36. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Concepts of Chaos Theory—(cont.) • Bifurcation—transition from a steady state to a state characterized by an abrupt, significant change in behavior – When a system is pushed so far from its steady state that it is not able to recover, chaos or a crisis state is reached. – The system then is at a “fork in the road” with a choice of two or more alternative steady states, different from the original. – At each crisis point, the system reaches a bifurcation with choices. – With each successive bifurcation, choices become increasingly limited.
  37. 37. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Concepts of Chaos Theory—(cont.) • Dissipative structures—the capacity of systems in non- equilibrium conditions to change to a higher or more complex level of order • Dissipative systems may arise spontaneously out of conditions that look chaotic but, in fact, have a hidden order.
  38. 38. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Concepts of Chaos Theory—(cont.) • Fractals—characteristics of self-similarity, a fractal shape will look almost exactly the same no matter its point of viewing • Koch’s Snowflake—begin with a single triangle; at the midpoint of each side, add a new triangle one third the side and repeat
  39. 39. Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins Chaos Theory—Application to Nursing • Used sparingly but with increasing frequency in nursing research and practice (see also “complex systems” or “complexity” and “nonlinear systems” or “nonlinear dynamics”) – Used to develop a model of Ecological Health Nursing – Investigation of patterns in births to adolescents in Texas – Describe and forecast patient census in an ICU – Modeling for comprehensive evaluation of coronary patients

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