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EVOLUTION OF NURSING THEORIES

Terminology
Metaparadigm is the most abstract level of knowledge. It specifies the main concepts that encompass the subject matter and the scope of a discipline. Powers and Knapp have noted, There is general agreement that nursing metaparadigm consists of the central concepts of person, environment, health and nursing.

Philosophy is the next knowledge level; it specifies the definitions of the metaparadigm concepts in each of the conceptual models of nursing.

Conceptual models are frameworks or paradigms that provide a broad frame of reference for systematic approaches to the phenomena with which the discipline is concerned. Conceptual models provide different views of nursing according to the characteristics of the model.

Theory is a groups of related concepts that propose actions that guide practice
Nursing Theory is a group of related concepts that derived from the nursing models. Some nursing theories also derive from other disciplines such as Leiningers work, which comes from anthropology, or Peplaus work, which draws from psychiatric sources.

Science is performing the processes of observation, idenitification, description, experimental investigation, and theoretical explanation of natural phenomena. It is also a body of knowledge; both unified body of knowledge concerned with specific subject matter and as the processes and methodologies. Concept is an idea or complex mental image of a phenomenon (object, property, or event). Concepts are the major components of theory. Abstract concepts are independent of time or place and they are indirectly observable. Hope is an example of an abstract concept.

Concrete concepts are specific to time and place and are observable. A persons features such as eye color, height or weight. Paradigm is another term for conceptual framework or conceptual model. Term used to denote the prevailing schema or approaches within a discipline.

Evolution of Nursing Theory within Types of Works PHILOSOPHIES Nightingale Wiedenbach Henderson Abdellah Hall Watson Benner

Evolution of Nursing Theory within Types of Works


CONCEPTUAL MODELS AND GRAND THEORIES Orem Levine Rogers Johnson Roy Neuman King Roper, Logan, and Tierney

Evolution of Nursing Theory within Types of Works THEORIES AND MIDDLE-RANGE NURSNG THEORIES Peplau Baranard Orlando Leininger Travelbee Parse Kolcaba Mishel Erickson, Tomlin, and Swain Newman Mercer Adam Pender

Significance of Theory for Nursing As a Discipline and Profession


Discipline-specific to academia and refers to a branch of education, a department of learning, or a domain of knowledge.
Profession-refers to a specialized field of practice, which is founded upon the theoretical structure of the science or knowledge of that discipline and the accompanying practice abilities.

SIGNIFICANCE OF THEORY FOR NURSING AS A DISCIPLINE


To develop knowledge as a basis for nursing practice. Baccalaureate programs proliferated, master programs in nursing were developed and the curricula began to be standardized through the accreditation process. Advocated nursing as an applied science and others proclaimed nursing as a basic science.

SIGNIFICANCE OF THEORY FOR NURSING AS A PROFESSION


1. Utilizes in its practice a well-defined and wellorganized body of specialized knowledge [that] is in the intellectual level of the higher learning. 2. Constantly enlarges the body of knowledge it uses and improves its techniques of education and service by the use of the scientific method. 3. Entrusts the education of its practitioners to institutions of higher education. 4. Applies its body of knowledge in practical services [that] are vital to human and social welfare.

5. Functions autonomously in the formulation of professional policy and in the control of the professional policy thereby.
6. Attracts individuals or intellectual and personal qualities who exalt service above personal gain and who recognize their chosen occupation as a life work. 7. Strives to compensate its practitioners by protinuous professional growth, and economic security.

Nursing Theory and the Practicing Nurse Theory assists the practicing nurse to: Organize patient data Understand patient data Analyze patient data Make decisions about nursing interventions Plan patient care Predict outcomes of care Evaluate patient outcomes.

PHILOSOPHIES
Florence Nightingale
Florence Nightingales work is closely related to her philosophical orientation of the patient environment interaction and the principles and rules on which nursing practice was founded. Nightingale believed that disease was a reparative process. Patients surroundings-ventilation, warmth, light, diet, cleanliness and noise-would contribute to the reparative process and the health of the patient. Notes on Nursing: What it is and what it is not.

Ernestine Wiedenbach concentrated on the art of nursing and focused on the needs of the patient. It guides the nurses action in the art of nursing. Four Elements: 1. Philosophy 2. Purpose 3. Practice 4. Art

Postulated that clinical nursing is directed toward meeting the patients perceived need-for-help. Clinical Nursing: A Helping Art.

Virginia Henderson viewed the patient as an individual requiring help toward achieving independence. She envisioned the practice of nursing as independent from the practice of the physicians and acknowledges her interpretation of the nurses function as a synthesis of many influences. Henderson emphasized the art of nursing and identified the 14 basic human needs on which nursing care is based. Her definition of nursing first appeared in 1995 in the fifth edition of Textbook of the Principles and Practice of Nursing by Harmer and Henderson.

Henderson stated, The unique function of the nurse is to assist the individual sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength. She identified the following 14 basic needs of patients that comprise the components of nursing care:

1.

2.
3. 4. 5. 6. 7.

Breathing Eating and drinking Elimination Movement Rest and sleep Suitable clothing Body temperature

1.

2. 3. 4. 5. 6. 7.

Clean body and protected integument Safe environment Communication Worship Work Play Learning

She identified three levels of nurse-patient relationships in which the nurse is a: 1. Substitute for the patient 2. Helper to the patient

3. Partner with the patient.


She supports empathetic understanding and states that the nurse must get inside the skin of each of her patients in order to know what he needs.

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