Nursing Theories


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Nursing Theories

  1. 1. Nursing Theories Ma. Tosca Cybil A. Torres, RN, MAN
  2. 2. Theory- Defined • Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or event) that is explanatory & predictive in nature. Theories are composed of concepts, definitions, models, propositions & are based on assumptions. Nursing theorists use both of these methods. Theory is “a creative and rigorous structuring of ideas that projects a tentative, purposeful, and systematic view of phenomena”. A theory makes it possible to “organize the relationship among the concepts to describe, explain, predict, and control practice”
  3. 3. Definition of terms • Concepts- are vehicles of thought that involve images. Concepts are words that describe objects, properties, or events & are basic components of theory. – Types: Empirical concepts , Inferential concepts, Abstract concepts • Models - representations of the interaction among and between the concepts showing patterns. • Propositions -statements that explain the relationship between the concepts. • Process - a series of actions, changes or functions intended to bring about a desired result. During a process one takes systemic & continuous steps to meet a goal & uses both assessments & feedback to direct actions to the goal.
  4. 4. Importance of nursing theories • Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs1978). • It should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future (Brown 1964). • Theory is important because it helps us to decide what we know and what we need to know (Parsons1949). • It helps to distinguish what should form the basis of practice by explicitly describing nursing. • The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education (Nolan 1996). In addition, because • The main exponent of nursing – caring – cannot be measured, it is vital to have the theory to analyze and explain what nurses do. • As medicine tries to make a move towards adopting a more multidisciplinary approach to health care, nursing continues to strive to establish a unique body of knowledge. • This can be seen as an attempt by the nursing profession to maintain its professional boundaries.
  5. 5. The characteristics of theories Theories are: • interrelating concepts in such a way as to create a different way of looking at a particular phenomenon. • logical in nature. • generalizable. • bases for hypotheses that can be tested. • increasing the general body of knowledge within the discipline through the research implemented to validate them. • used by the practitioners to guide and improve their practice. • consistent with other validated theories, laws, and principles but will leave open unanswered questions that need to be investigated.
  6. 6. Common concepts in nursing theories Four concepts common in nursing theory that influence & determine nursing practice are: – The person (patient). – The environment – Health – Nursing (goals, roles, functions) • Each of these concepts is usually defined & described by a nursing theorist, often uniquely; although these concepts are common to all nursing theories. Of the four concepts, the most important is that of the person. The focus of nursing, regardless of definition or theory, is the person.
  7. 7. Nursing Theorists
  8. 8. Florence Nightingales’s Environmental Theory • Defined Nursing: “The act of utilizing the environment of the patient to assist him in his recovery.” • Focuses on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act. • Identified 5 environmental factors: fresh air, pure water, efficient drainage, cleanliness/sanitation and light/direct sunlight. • Considered a clean, well-ventilated, quiet environment essential for recovery. • Deficiencies in these 5 factors produce illness or lack of health, but with a nurturing environment, the body could repair itself.
  9. 9. Hildegard Peplau’s Interpersonal Relations • Theory Defined Nursing: “An interpersonal process of therapeutic interactions between an Individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help. • Nursing is a “maturing force and an educative instrument” Identified 4 phases of the Nurse - Patient relationship: Orientation - individual/family has a “felt need” and seeks professional assistance from a nurse (who is a stranger). This is the problem identification phase. Identification - where the patient begins to have feelings of belongingness and a capacity for dealing with the problem, creating an optimistic attitude from which inner strength ensues. Here happens the selection of appropriate professional assistance. Exploitation - the nurse uses communication tools to offer services to the patient, who is expected to take advantage of all services. Resolution - where patient’s needs have already been met by the collaborative efforts between the patient and the nurse. Therapeutic relationship is terminated and the links are dissolved, as patient drifts away from identifying with the nurse as the helping person.
  10. 10. Faye Glenn Abdellah’s Concept of Twenty One Nursing Problems • Nursing is broadly grouped into 21 problem areas to guide care and promote the use of nursing judgement. • Nursing is a comprehensive service that is based on the art and science and aims to help people, sick or well, cope with their health needs.
  11. 11. 21 Nursing Problems 1. To maintain good hygiene. 2. To promote optimal activity; exercise, rest and sleep. 3. To promote safety. 4. To maintain good body mechanics 5. To facilitate the maintenance of a supply of oxygen 6. To facilitate maintenance of nutrition 7. To facilitate maintenance of elimination 8. To facilitate the maintenance of fluid and electrolyte balance 9. To recognize the physiologic response of the body to disease conditions 10. To facilitate the maintenance of regulatory mechanisms and functions 11. To facilitate the maintenance of sensory functions 12. To identify and accept positive and negative expressions, feelings and reactions
  12. 12. 13. To identify and accept the interrelatedness of emotions and illness. 14. To facilitate the maintenance of effective verbal and non-verbal communication 15. To promote the development of productive interpersonal relationship 16. To facilitate progress toward achievement of personal spiritual goals 17. To create and maintain a therapeutic environment 18. To facilitate awareness of self as an individual with varying needs. 19. To accept the optimum possible goals 20. To use community resources as an aid in resolving problems arising from illness. 21. To understand the role of social problems as influencing factors
  13. 13. Dorothy Johnson’s Key Concepts of Behavioral System • Each individual has patterned, purposeful, repetitive ways of acting that comprises a behavioral system specific to that individual. The four major concepts Johnson views “human being” as having two major systems, the biological system and the behavioral system. It is role of the medicine to focus on biological system where as Nursling's focus is the behavioral system. “Society” relates to the environment on which the individual exists. According to Johnson an individual’s behavior is influenced by the events in the environment “Health” is a purposeful adaptive response, physically mentally, emotionally, and socially to internal and external stimuli in order to maintain stability and comfort. “Nursing” has a primary goal that is to foster equilibrium within the individual .she stated that nursing is concerned with the organized and integrated whole, but that the major focus is on maintaining a balance in the Behavior system when illness occurs in an individual.