After studying this chapter, the reader will be able to: 1. Differentiate between a science and a theory. 2. Identify the criteria necessary for science. 3. Identify the criteria necessary for theory. 4. Explain a nursing theory and a nursing model. 5. Discuss two early and two contemporary nursing theorists and their theories. 6. Explain the effect of nursing theory on the profession of nursing. Additional resources are available online at: http://evolve.elsevier.com/Cherry/ When I was a nursing student, it was hard for me to understand why I needed to know anything about nursing theory, but now that I am in practice I see that theories provide a way for me to organize, deliver, and evaluate the care I provide. On our labor and delivery unit, we use Roy’s adaptation model to guide our practice as we provide care to laboring moms. The use of this theory allows us to assess how well they are coping and provides guidance as we plan nursing interventions that promote their successful coping. Science is dynamic and static—dynamic in figuring out how a phenomenon happens, static in describing what happens. Scientific inquiry involves five steps: (1) hypothesis, (2) method, (3) data collection, (4) results, and (5) evaluation. These five steps are described in Box 5-1. “Nursing theory is defined as a conceptualization of some aspect of nursing reality communicated for the purpose of describing phenomena, explaining relationships between phenomena, predicting consequences, or prescribing nursing care” (Meleis, 2012). Theory development functions in a parallel manner to scientific process, although theory generally applies to a more specific area of the larger scientific process. Even though Freud and Jung each had their individual theories about the psychology of man, their theories were focused on specific ideas taken from the entire knowledge base surrounding psychology and psychotherapy and its scientific premise. Similarly, Albert Einstein’s theory of relativity was but a fraction of the existing scientific knowledge base of mathematics at the time. Nevertheless, it is an undisputed fact that these theorists changed the thinking of their time and were responsible for the evolution of their philosophic and scientific interests (Anastasi, 1958). For a proposed theory to be accepted as a theory, it must meet the following six criteria: inclusiveness, consistency, accuracy, relevance, fruitfulness, and simplicity. These six criteria are further explained in Box 5-2. As might be expected, there are several definitions of nursing science (Abdellah, 1969; Jacox, 1974). Although these definitions differ, they generally support the premise that nursing science is a collection of data related to nursing that may be applied to the practice of nursing. These data encompass a vast array of knowledge that spans all of nursing and its diversity. This knowledge guides the practice of nursing to better serve patients through healing, prevention, education, and health maintenance. Researchers use theories and conceptual models as their primary method to organize findings into a broader conceptual context (Meleis, 2012; Polit and Beck, 2011). Different terms are used in relation to conceptual contexts for research. These terms include theories, models, frameworks, schemes, and maps. Terms are often used differently by different writers, thus resulting in a blurring of distinct terms (Meleis, 2012). Theory and theoretic thinking guide research and practice. The basic ingredients of theory are concepts. Examples of nursing concepts include health, stress, and adaptation. Propositions are statements that propose the relationship between and among concepts (Meleis, 2012). Theories provide us with a frame of reference, the ability to choose concepts to study, or ideas that are within one’s practice. A theory helps guide research, and research helps validate theory. Just as in any other discipline, nursing theory has its own unique language. The words of this language identify linkages between the database of scientific nursing knowledge and the extracted information taken from this source for nursing theory. The interpretation of these words translates uniquely to the theory investigated. This application, or language of nursing theory, is the structure, or framework, from which one understands the theory. Table 5-1 presents the language of nursing theory, along with definitions and examples. TABLE 5-1 THE LANGUAGE OF NURSING THEORY A schematic model is something that demonstrates concepts, usually with a picture. It is a visual representation of ideas. The model depicts concepts and shows how the concepts are related with the use of images, such as arrows and dotted lines (Polit and Beck, 2011). For example, a blueprint is a pictorial demonstration of a particular type of house someone might build. A model airplane is a detailed miniature replication of the original full-sized version. Diagramming a sentence outlines the specific parts (adverb, adjective, verb, subject, object, phrases) that make that particular sentence complete. Similarly, a nursing model gives a visual diagram or picture of concepts. Whether that is a critical pathway, decision tree, medication protocol, or other nursing-related practice, the model allows one to view the interrelated parts of the whole in picture form. A model of a nursing theory does the same thing. From the earliest model, offered by Florence Nightingale, nursing theory has been described and explained using this medium. Schematic models are used for clarifying complex concepts. The language of theory is translated into picture form, offering a comprehensive view, or model, of the theory. The schematic model shows how the concepts are related. A model, like a blueprint of a building, allows one to see the layout, including outlines of all features specific to the theory. Although it is not the same as understanding every minute detail about the structure, its intent is to provide an overview, which at a glance is informative and descriptive.
Theories of Nursing Practice
Science and Theory
Nursing Science
Theories, Models, and Frameworks
Nursing Theory
TERM
DEFINITION
EXAMPLES
Concept
Labels given to ideas, objects, events; a summary of thoughts or a way to categorize thoughts or ideas
Comfort, fatigue, pain, depression, environment
Conceptual model
A structure to organize concepts (ideas)
Roy’s adaptation model
Philosophy
Values and beliefs of the discipline
Watson’s philosophy and science of caring
Theory
The organization of concepts or constructs that shows the relationship of the ideas with the intention of describing, explaining, or predicting; the purpose is to make scientific findings meaningful and generalizable; our goal in science has been to explain, predict, and control.
Self-care, adaptation, caring, behavioral system, unitary man, hierarchy of needs, interpersonal relationships, humanistic, nurse-client transactions
Schematic Models
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