Marianne C.

Buendia, RM, RN, MAN

Definitions of theory
Defining theory is the first step towards developing a

set of criteria for the evaluation of theory. Many of the early definitions of theory in the nursing literature were influenced by the Logical Positivistic Received View (Suppe, 1977), where the focus was on structure and process. Ex.1.McKay (1969) defines theory as a logically interrelated set of confirmed hypotheses (p. 394)and Jacox (1974) defines it as a systematically related set of statements including law-like generalizations that are empirically testable (p. 324). These definitions are consistent with the Received View philosophy on theory at the time.

Definitions of theory
Chin and Jacobs (1983) define theory as a set of

concepts, definitions, and propositions that projects a systematic view of phenomena by designating specific interrelationships among concepts for purposes of describing, explaining, predicting, and/or controlling phenomenon (p. 70). This definition begins a departure from the Logical Positivistic Received View, in that it does not emphasize the structure of the theory.

Theory
Organized system of accepted knowledge that is

composed of concepts, propositions, definitions and assumptions intended to explain a set of fact, event, or phenomena.
Concept-idea formulated by the mind or an

experienced perceived and observed; building blocks of theories

Proposition- explains the relationship of different

concepts

 Definition-composed of various descriptions which

convey a general meaning

Assumption- statement that specifies the relationship

or connection of factual concepts or phenomena.

 Philosophy- sets forth the meaning of phenomena

through analysis, reasoning and logical argument

A conceptual model vs. A theory

A conceptual model is an abstract and general system

of concepts and propositions. A theory deals with one or more relatively specific and concrete concepts and propositions(Dudley-Brown p.77) .

Distinguish a conceptual model from a theory

If the purpose is to describe, explain, or predict specific phenomena, the work is most likely a theory. Ex. the works of Peplau (Alligood & Tomey Ch 5, p.54) and Orlando.
If the purpose of the work is to articulate a body of distinct knowledge for the discipline of nursing, the work is most likely a conceptual model. Ex. the works of Johnson, King, Levine, Neuman, Orem, Rogers, and Roy.

Distinguish a conceptual model from a theory

Most of these theorists have been described by others as proposing a nursing theory, not a conceptual model. Failure to distinguish a conceptual model from a theory, Fawcett (1989) states, leads to misunderstandings and inappropriate expectations of the work. However, according to Meleis (1985), the use of different labels (theory, paradigm, model, and framework) corresponds to differences in emphasis rather than substance.

Definitions of theory

Pinnel and Menesis (1986) Systematic set of interrelated concepts, definitions and deductions that describe, explain or predict interrelationships

Definitions of a theory
Walker and Avant (1983)

Internally consistent group of relational statements (concepts, definitions and propositions) that presents a systematic view of phenomenon and which is useful for description, explanation, prediction and control

Definition of a theory
Chinn and Krammer

creative and vigorous structuring of ideas that project a tentative, purposeful and systematic view of phenomena

Definitions of a theory
Meleis,2005

Theory is an organized, coherent, and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole.

Some commonalities
Purpose Concepts Definitions Propositions Structured ideas Tentative Describe a phenomenon or occurrence

Components/Elements of theory
1.Purpose Why is the theory formulated 2.Concepts are building blocks of theory ideas, mental images of a phenomenon, an event or object that is derived from an individuals experience and perception

Components/Elements of theory
3.Has a major concept like nursing, person, health or environment.
4. Definitions give meaning to concepts which can either be descriptive or procedural (stipulate-use of term within the theory)

Components/Elements of theory
Propositions are expressions of relational

statements between and among the concepts. It can be expressed as statements, paradigms or figures . AKA as theoretical assertions Assumptions- accepted truths that are basic and fundamental to the theory. Or value assumptions where what is good or right or ought to be.

Characteristics of a Theory

Systematic, logical and coherent (orderly reasoning,no contradictions) Creative structuring of ideas mental images of ones experiences and create different ways of looking at a particular event or object. Tentative in nature ( change over time or evolving but some remain valid despite passage of time)

How does a theory develop?

1.

Four strategies of theory development Theory practice theory ( theory developed in other discipline and used in nursing situations)

2. Practice theory evolved from clinical practice

How does a theory develop?

3. Research theory or inductive method Must evolve from research findings or empirical evidence. 4. Theory research theory theories developed by other disciplines are utilized but given unique nursing perspective. Original theory examined and given a new research findings.

TERMINOLOGY
METAPARADIGM - Most abstract level of knowledge. In nursing this is main concepts that encompasses the subject matter and the scope of the discipline - Central concepts of person, environment, health and nursing

TERMINOLOGY
Philosophy - Knowledge level which specifies the definitions of the

metaparadigm concepts in each of the conceptual models of nursing. - Nightingale is considered philosophical approach - Out of these philosophies theory maybe formalized

Conceptual models
Frameworks or paradigms that provide a broad frame

of reference for the systematic approaches to the phenomena with which the discipline is concerned. different views nursing like Roy focuses on adaptation, King on interaction and Abdellah on interventions

Theory
Group of related concepts that propose actions that

guide practice

Nursing theory
Group of related concepts that derive tfrom the nursing models. Some derive from other nursing discipline like LEininger which comes from anthropology 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,2005).

Uses of theory
1. Theory guides and improve nursing practice

Theory provides goal for nursing care and with goals, nursing practice is rendered more effective and efficient. Theories help to focus the goals, making nurses more confident about the practice.

Uses of theory
2. Theory guides research according to Meleis, primary use of theory is to guide research. It validates and modifies the theory. 3. Theory contributes to the development of the disciplines body of knowledge 4. Theory enhances communication

Where do I begin?
Florence Nightingale - Considered first modern nursing theorist - First one to delineate what is considered the nursing goal and practice domain. - placing the client in the best condition for nature to act upon him - Taught about symptoms and what they indicate, rationale for actions and trained powers of observation and reflection

Historical Development of Nursing Theories: Significant Events

Nightingale until the 50s Florence Nightingale Notes on Nursing

control of the environment to care for the individual (ventilation, light, warm , noise absence or reduction, cleanliness & diet )
1952 Nursing Research Journal publication

1960s nature of nursing practice was debated, defined

nursing practice, or develop nursing theory, and created a substantive body of knowledge

Historical development
1960-1970 proliferation of conceptual models and

frameworks, and philosophy of nursing. Examples: Abdellah 21 nursing problems and Halls Core, care and cure (person,body,disease) 1969 first conference on nursing theory

Historical Development
Role of nurses where questioned; what they do, for whom where and when were determined.
purpose of nursing, process of theory development was discussed

Historical Development
1980s characterized by acceptance of the significance

of theory in nursing. Less debates on whether or not to use theory, practice theory or borrowed ones. More and more publication up to the present.

Types of theories
According to range
Grand theory Middle range theory

Micro theory

Types of theories: Grand Theory

Grand Theory consist of broad conceptual frameworks that

reflect wide and expansive perspectives for practice and ways of describing, explaining, predicting and looking at nursing phenomena. They are the most complex and broadest in scope. Ex. Hendersons The Nature of Nursing ; Levines The Four Conservation Principles of Nursing, Roys Adaptation Model, and Orems Self-Care (Marriner-Tomey)

Types of Theories: Mid Range Mid Range- less complex and narrower in scope than grand theory and micro theory. A more workable level is the middle range.more limited in scope and less variables, and testable. grand theory on stress and adaptation might not yield any interpretable guidelines on practice but if the theory is focused on chronic lingering illness as the stressor on family, the stress theory becomes operational for both research and practice purposes. Ex. Peplaus Psychodynamic Nursing and Orlandos Nursing Process Theory

Types of theories: Micro theories

Micro theories- are the least complex. They contain

the least complex concepts and are narrowest in scope. They deal with a small aspect of reality, generally a set of theoretical statements Deals with specific and narrow defined phenomena

According to Orientation or focus of the theory

1. 2. 3.

Client centered: Nightingale, Henderson Client-nurse dynamics: Watson Client-nurse environment : Leininger

Categories of nursing theories

client nurse

` environment

Client centered theory

Focused on the needs and problems of clients which are met, resolved or alleviated by nursing interventions This category includes theories developed by the following : Nightingale,Abdellah,Henderson,Orem,Pender, Roy, Levine, Hall.

Nurse client dynamics

Focus on interaction between the nurse and client.
This category includes theories developed by the

following: Peplau, Watson, King and Orlando

Client Nurse Environment Dynamics

Focus on the interaction between nurse and client in

an environment that includes broader dimensions of time and space. As well as culture, cultural diversity, and universality. Theories of Neuman and Leininger are discussed under this category.

Framework to Analyze the Nursing theory

1.What are the major concepts? Person, nursing, health and environment 2. Based on Focus Client centered, nurse-client dynamics, nurse client-environment dynamics -How similar and how different are their concepts of persons, nursing, health, environment 3. Key concepts unique to the theory. Some theories have several key concepts and it may have subconcepts.

Analysis of theory
ClarityHow clear is this theory? SimplicityHow simple is this theory? GeneralityHow general is this theory? Empirical precision How accessible is this theory? Derivable consequences How important is this theory?

Conclusion
Theory development and evaluation are cyclical, continuous, and dynamic process. One can not exist without the other. Theory evaluation including description, concept analysis, theory critique, testing and support. These process are based on the view that science is a human process that includes not only valid findings

but also observation, agreements, useful solutions to problems. Theory evaluation is central to the development of theory; it is the responsibility of each clinician, academician.

Exercise
Please see the attachment: Adaptation model of nursing 1.Define theory and list characteristics of a theory 2.Describe the components of a theory and its use 3.Trace the development of a nursing theory 4.Theory Development in Nursing: Historical Overview