RITIKA SONI ASS.PROF.

1. INTRODUCTION TO…

2. Introduction
 Nursing is a unique health care discipline,
has 2 essential aspects: a body of
knowledge & the application of that
knowledge through clinical nursing
practice.
 This body of knowledge called
KNOWLEDGE BASE or the science of
nursing provide the rationale for nursing
interventions.
 The nurse will also use the knowledge base
developed specifically for nursing thru’
theory development & research.

3. Theory
 THEORY is a set of
concepts, definitions
& assumptions or
propositions to
explain/ describe a
pattern of reality or a
phenomenon.
 COMPONENTS OF
THEORY:
1. Concepts
2. Propositions or
assumptions
3. Definitions

4. Concepts
 Something conceived in mind, a thought or a
notion (idea)
 Are mental formulations of a object or event
that come from individual perceptual
experience
 They are ideas, mental images
 They are words that represent reality &
enhance our ability to communicate about it.

5. Conceptual Framework or Model
 These are group of concepts that follows an
understandable pattern.
 Concepts can be thought of as individual
bricks and boards used to build a house, with
conceptual framework being the BLUEPRINT
that specifies where each brick & board
should go.

6. Propositions
 They explain relationships between the
concepts
 Example: Nightingale proposed a beneficial
relationship between fresh air & health
Assumptions
These are statements that describe the
concepts or connect two concepts that are
factual

7. Evolution of Nursing Theories &
Application
 The history of professional nursing begins with Florence nightingale.
 Later in last century nursing began with a strong emphasis on practice.
 Following that came the curriculum era which addressed the questions
about what the nursing students should study in order to achieve the
required standard of nursing.
 As more and more nurses began to pursue higher degrees in nursing, there
emerged the research era.
 Later graduate education and masters education was given much
importance.
 The development of the theory era was a natural outgrowth of the research
era.
 With an increased number of researches it became obvious that the
research without theory produced isolated information; however research
and theory produced the nursing sciences.
 Within the contemporary phase there is an emphasis on theory use and
theory based nursing practice and lead to the continued development of the
theories.

8. Nursing Theory
 Nursing theory is the term given to the body
of knowledge that is used to support nursing
practice.
 Nursing theory is a framework designed to
organize knowledge and explain phenomena
in nursing, at a more concrete and specific
level.
 Nursing Theory differentiates nursing from
other disciplines & activities in that it serves
the purposes of describing, explaining,
predicting & controlling desired outcomes of
nursing care practices.

9. Nursing Theory
 Theories provide a means of testing
knowledge thru’ research & for nursing,
expanding its knowledge base to meet
healthcare needs of patients in an ever-
changing society.
 Nursing theories focuses on the phenomena
of nursing & nursing care.

10. Four Major Concepts of Nursing
1. Person (patient/client)
2. Environment
3. Health
4. Nursing

11. Person
 Person may represent one individual, a
family, a community or all of mankind
 Also referred as the patient (suffer or bear)
 Also referred to as the client (may not be sick
but well)
Environment
May represent the immediate surroundings,
the community or the universe

12. Health
 Represents a state of well-being
Nursing
 Is the science and the art of the discipline
 Theory generates knowledge for use in the
practice.

13. What are the purposes of nursing
theory?
 It guides nursing
practice and generates
knowledge
 It helps to describe or
explain nursing
 Enables nurses to
know WHY they are
doing WHAT they are
doing

14. CONTD….
 In Practice:
 Assist nurses to describe, explain, and predict everyday experiences.
 Serve to guide assessment, interventions, and evaluation of nursing
care.
 Provide a rationale for collecting reliable and valid data about the
health status of clients, which are essential for effective decision
making and implementation.
 Help to describe criteria to measure the quality of nursing care.
 Help build a common nursing terminology to use in communicating
with other health professionals.
 Ideas are developed and words are defined.
 Enhance autonomy (independence and self-governance) of nursing
through defining its own independent functions.

15. CONTD..
 In Education:
 Provide a general focus for curriculum design
 Guide curricular decision making.
 In Research:
 Offer a framework for generating knowledge and new ideas.
 Assist in discovering knowledge gaps in the specific field of
study.
 Offer a systematic approach to identify questions for study;
select variables, interpret findings, and validate nursing
interventions.
 Approaches to developing nursing theory

16. 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.
 This can be seen as an attempt by the nursing profession
to maintain its professional boundaries.

17. CHARACTERISTICS OF THEORIES
Theories:
 interrelate concepts in such a way as to create a different way
of looking at a particular phenomenon.
 are logical in nature.
 are generalizable.
 are the bases for hypotheses that can be tested.
 increase the general body of knowledge within the discipline
through the research implemented to validate them.
 are used by the practitioners to guide and improve their
practice.
 are consistent with other validated theories, laws, and
principles but will leave open unanswered questions that need
to be investigated

18. Basic Processes in Development of nursing
theories
 Nursing theories are often based on and influenced
by broadly applicable processes and theories.
Following theories are basic to many nursing
concepts.
A. General System Theory:
 It describes how to break whole things into parts and
then to learn how the parts work together in "
systems".
 These concepts may be applied to different kinds of
systems, e.g.. Molecules in chemistry , cultures in
sociology, organs in Anatomy and health in Nursing.

19. Contd..
 B. Adaptation Theory
 It defines adaptation as the adjustment of living
matter to other living things and to environmental
conditions.
 Adaptation is a continuously occurring process that
effects change and involves interaction and response.
 Human adaptation occurs on three levels:
 --- the internal ( self )
 --- the social (others)
 --- and the physical ( biochemical reactions )

20. Contd..
 C. Developmental Theory
 It outlines the process of growth and development of
humans as orderly and predictable, beginning with
conception and ending with death.
 The progress and behaviors of an individual within
each stage are unique.
 The growth and development of an individual are
influenced by heredity , temperament, emotional,
and physical environment, life experiences and
health status.

21. CLASSIFICATION OF NURSING
THEORIES
A. Depending On Function (Polit et al 2001)
 Descriptive :To identify the properties and
workings of a discipline
 Explanatory: To examine how properties relate and
thus affect the discipline
 Predictive :To calculate relationships between
properties and how they occur
 Prescriptive :To identify under which conditions
relationships occur

22. B. Depending on the generalisability of their
principles
 Metatheory: the theory of theory. Identifies specific
phenomena through abstract concepts.
 Grand theory: provides a conceptual framework under
which the key concepts and principles of the discipline
can be identified.
 Middle range theory: is more precise and only
analyses a particular situation with a limited number of
variables.
 Practice theory: explores one particular situation
found in nursing. It identifies explicit goals and details
how these goals will be achieved.

23. C. Based on the philosophical
underpinnings of the theories
A. Needs" theories
 These theories are based around helping individuals to
fulfill their physical and mental needs.
 Needs theories have been criticized for relying too much
on the medical model of health and placing the patient in
an overtly dependent position.
B. Interaction" theories
 These theories revolve around the relationships nurses
form with patients.
 Such theories have been criticized for largely ignoring the
medical model of health and not attending to basic
physical needs.

24. C. Outcome" theories
 These portray the nurse as the changing force, who
enables individuals to adapt to or cope with ill health
(Roy 1980).
 Outcome theories have been criticized as too abstract
and difficult to implement in practice (Aggleton and
Chalmers 1988).

25. D. Humanistic" Theories:
 Humanistic theories developed in response to the
psychoanalytic thought that a person’s destiny was
determined early in life.
 Humanistic theories emphasize a person’s capacity for self
actualization .
 Humanists believes that the person contains within himself
the potential for healthy and creative growth.
 Carl Rogers developed a person –centered model of
psychotherapy that emphasizes the uniqueness of the
individual.
 The major contribution that Rogers added to nursing practice
is the understanding that each client is a unique individual, so
person-centered approach now practice in Nursing

26.  Criticisms of nursing theories
 To understand why nursing theory is generally neglected
on the wards.
 A nrsing theory should have the characteristics of
accessibility and clarity.
 It is important that the language used in the
development of nursing theory be used consistently.
 Many nurses have not had the training or experience to
deal with the abstract concepts presented by nursing
theory.
 Majority of nurses fail to understand and apply theory to
practice (Miller 1985).

27. So how do nurses use theory in
everyday practice?
 Organize patient data
 Understand patient data
 Analyze patient data
 Make decisions about
nursing interventions
 Plan patient care
 Predict outcomes of care
 Evaluate patient outcomes
(Alligood, 2001)

28. How do student nurses begin to
use nursing theory?
 By asking yourself two
very important
questions…..

29. Student nurse questions
 What is the nature of
knowledge needed for the
practice of nursing?
 What does it mean to me
to practice nursing?

30. Nursing Research and Theories
 Introduction
 RESEARCH – Process of inquiry
 THEORY – Product of knowledge
 SCIENCE – Result of the relationship between
research & theory
 To effectively build knowledge to research process
should be developed within some theoretical
structure that facilities analysis and interpretation of
findings.

31. Relationship Between Theory and
Research
 Research without theory results in discreet
information or data which does not add to the
accumulated knowledge of the discipline.
 Theory guides the research process, forms the
research questions, aids in design, analysis and
interpretation.
 Theory and its associated research design may be
 Descriptive
 Correlational
 Experimental

32. Purpose of Theory in Research
 To identify meaningful and relevant areas for study.
 To propose plausible approaches to health problems.
 To develop or refine theories
 Define the concepts and proposed relationships
between concepts.
 To interpret research findings
 To develop clinical practice protocols.
 To generate nursing diagnosis.