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Theories, frameworks, and concepts in nursing

  1. Theories, Frameworks, and Concepts in Nursing Donna Hinson Brown Winston-Salem State University NUR 2312 Spring 2012
  2. What is nursing? • Science? • Art? • What makes nursing different? • How do we know? • What is a theory? • “Theory helps us bear our ignorance of the facts.” George Santayana
  3. What theory should be… “Enthusiastic discourse that that fits the description…a place where people work at the very edges of their abilities, constantly pushing each other’s thinking into new territory, giving names to things that have gone unnamed, dreaming of better ways, describing common ground and finding ways to realize shared dreams” Belenky, Clinchy, Goldberg, & Tarule (1996).
  4. Person trauma Nurse-patient relationship health CARE Health- HOPE Wellness wellness continuum CONCEPTS Story of Hope FRAMEWORK THEORY
  5. Theories • Represent abstract ideas rather than concrete facts • Can be broad or limited • Grand theories • Middle-range or midrange theories • Practice theories (situation-specific theories)
  6. Grand Theories • Florence Nightingale’s Environmental Theory • Martha Rogers’ Science of Unitary Human Beings • Dorothea Orem’s Self-Care Deficit Theory • Roy’s Adaptation Model • Neuman’s Systems Model • Watson’s Science of Philosophy and Caring • Peplau’s Interpersonal Process • King’s Theory of Goal Attainment • Leininger’s Cultural Care Theory
  7. Middle Range Theories • Uncertainty in Illness (Mishel & Clayton) • Theory of Self-Transcendence (Pam Reed) • Theory of Community Empowerment (Persily & Hildebrandt) • Theory of Self-Efficacy (Resnick) • Theory of Unpleasant Symptoms (Lenz & Pugh) • Story Theory (Smith & Liehr)
  8. Practice Theories • Less abstract • Limited scope and focus (single phenomenon) • Situational (does not transcend time, place) • Answers a specific question • Sociopolitical, cultural, historical in perspective; easily recognizable in clinical practice setting • Examples
  9. Where to begin??? • What are my interests? • How do I think about my nursing process and practice? • What do I want to know? • Sources (original) • Sources (secondary/ application)
  10. Story Theory: Theoretical Model Developing story-plot Intentional Dialogue NURSE PERSON Complicating health challenge Creating Ease Movement toward resolving Smith, M.J., & Liehr, P.R. (2008). Middle Range Theory for Nursing, 2nd ed. New York: Springer
  11. Purpose • Stories as a part of human experience • Stories bind people and time • Stories as expressions of who we are, where we have been and where we are going • Story theory = context for nurse-person health promoting process • Structure to guide nursing in practice and research by collecting stories about health situations that are important to the person
  12. Story Theory • The major concepts: 1. Person 2. Environment NURSING 3. Health PRACTICE 4. Nursing • Clinical practice use for story theory
  13. Questions and Comments