Nursing Theory

Theresa Tarrant, PhD, RN

Terminology• Concepts• Propositions• Metaparadigm• Philosophy• Conceptual Models • Theories• Empirical Indicators

What separates nursing knowledge from that of other healthcare disciplines?

HOLARCHY(hierarchy)Components of nursing knowledge

Based on level of abstraction •Metaparadigm Most Abstract•Philosophy•Conceptual model•Theory•Empirical indicators Most Concrete

Concepts• Word or phrase that summarizes ideas, observations or

experiences.

• A word that creates mental images

• I.e. bicycle or • Graduation

• Building blocks of theory

Propositions

• Statement about a concept or the relationship between one or more concepts.

• Non relational proposition – describes or defines a concept • Vacations are fun!

• Relational proposition – asserts there is a relationship.• Parents teach their children how to ride bicycles

Paradigm

Thomas Kuhn• “set of practices that define a scientific discipline at any

particular time period of time.” Thomas Kuhn (1962)• “accepted model of or pattern.” (1970)• “what the members of a scientific community, and they alone

share.” (1977)

Paradigm

• The functions of a paradigm are to supply puzzles for scientists to solve and to provide the tools for their solution.

• A crisis in science arises when confidence is lost in the ability of the paradigm to solve particularly worrying puzzles called ‘anomalies’.

• Crisis is followed by a scientific revolution if the existing paradigm is superseded by a rival.

Metaparadigm

“Statement or group of statements identifying its relevant phenomena” (Fawcett, 1984) • Most abstract • Concise• Global concepts that define the areas of central issue of

discipline

•“map that guides the discipline” (Hardy, 1978)

• Brings unity to a discipline • Encourages communication

Metaparadigm

Four functions1. Identify a domain distinctive from domain of other

disciplines2. Encompass all phenomena of interest to the discipline3. Perspective Neutral4. International in scope and substance

Metaparadigm of Nursing• Nursing• Human beings (Person, patient, man)• Environment • Health

Philosophy

• Statement encompassing ontological claims about the phenomena of central interest to a discipline• Statements of beliefs and values

• Directed at discovery of knowledge • Identify what is important and valuable to nurses • Communicate what the members of the

discipline know to be true in relation to the phenomena of interest to that discipline.

Philosophy• What is believed about nursing, human beings, environment

and health

Conceptual Models• Set of relatively abstract and general concepts that address

the phenomena of central interest to a discipline , proposition that broadly describe those concepts, and the propositions that state relatively abstract and general relations between two or more concepts.

Conceptual Models• A distinctive frame of reference • Alternative ways of how to observe and interpret phenomena• Certain aspects of phenomena are emphasized – other maybe

ignored

• Some models focus more on one or more of the metaparadigm concepts.

Theory• One or more relatively concrete and specific concepts that

are derived from a conceptual model , the propositions that narrowly describe these concepts and the propositions that state relatively concrete, and specific relations between two or more of the concepts

Levels of Theories

• Grand - broad

• Middle Range – more concrete and narrower. • Addresses more concrete and specific phenomena• Describes, explains, or predicts

• Prescriptive theory –most narrow – provides specific direction

• Unique vs. borrowed

Empirical Indicator• An actual instrument, experiential condition, or procedure

that is used to observe or measure a middle range theory concept.

• Used to generate or test a middle range theory

Approaches to Theory Building• Derivation – shift or redefining a concept used in one field to

another field .

• Synthesis: combining isolated bits of information gathered through observation to construct a new concept.

• Analysis : Clarify or redesign by dissecting a whole into its component parts to enhance understanding .

Concept Analysis

Taking a concept normally used in nursing:• Analyze so it is clearly defined• Identifies what makes them unique from other concepts

• What is true about the concept today. • Examine the basic element of the concept• Eliminating ambiguity • Developing standardized language and empirical indicators for

the concept

Steps of Concept Analysis • Select a concept• Determine the Aims or purposes• Identify all the use f the concept you can discover • Determine defining attributes• Identify a case model • Identify borderline, related, contrary , invented and

illegitimate cases• Identify ancedents and consequences• Define empirical referents.

Categories of Knowledge

From Other Disciplines:

•Developmental• psychology

•Systems• Biology and physics

•Interaction• Sociology

Nursing Categories of Knowledge• Nursing Categories of Knowledge• Needs and outcomes• Client focused• Person focused• Nursing therapeutics focused• Energy fields• Conservation• Substance support• Enhancement