Theories of Nursing Practice

Why on earth do we study nursing theory?

What is a theory?
 Everyday practice enriches theory
 A set of concepts, definitions, relationships, and
assumptions that project a systematic view of a  Both practice and theory are guided by values and
phenomena beliefs

 It may consist of one or more relatively specific and  Theory helps to reframe our thinking about nursing
concrete concepts and propositions that purport to
account for, or organize some phenomenon (Barnum,  Theory guides use of ideas and techniques
1988)
 Theory can close the gap between theory and research
What are the components of a theory?
 To envision potentialities (Gordon, Parker, & Jester,
 Concepts – ideas and mental images that help to 2001)
describe phenomena (Alligood and Marriner-Tomey,
2002)  “The study and use of nursing theory in nursing
practice must have roots in the everyday practice
 Definitions – convey the general meaning of the of nurses (Gordon, Parker, and Jester, 2001).
concepts
So how do nurses use theory in everyday practice?
 Assumptions – statements that describe concepts
 Organize patient data
 Phenomenon – aspect of reality that can be  Understand patient data
consciously sensed or experienced (Meleis, 1997).  Analyze patient data
 Make decisions about nursing interventions
What is a paradigm?  Plan patient care
 Predict outcomes of care
 A model that explains the linkages of science,
 Evaluate patient outcomes
philosophy, and theory accepted and applied by the
discipline
(Alligood, 2001)
(Alligood and Marriner – Tomey, 2002)
How do student nurses begin to use nursing theory?
What is a domain?
By asking yourself two very important questions…..
 The view or perspective of the discipline
Student nurse questions
 It contains the subject, central concepts, values and
beliefs, phenomena of interest, and the central  What is the nature of knowledge needed for the
problems of the discipline practice of nursing?
How does domain relate to nursing theory?  What does it mean to me to practice nursing?
Nursing has identified its domain in a paradigm that includes
Nursing also utilizes non-nursing theories
four linkages:
Commonly used non-nursing theories
1) person/client
2) health
1. Systems theory
3) environment
2. Basic Human Needs theory
4) nursing
3. Health and Wellness Models
4. Stress and Adaptation
What are the purposes of nursing theory? 5. Developmental Theories
6. Psychosocial Theories
 It guides nursing practice and generates knowledge
What is the link between nursing theory and the research
 It helps to describe or explain nursing process?

 Enables nurses to know WHY they are doing WHAT
they are doing
Types of nursing theories
 Grand theories – broad and complex
 Middle-range theories- address specific phenomena
and reflect practice
 Theory provides direction for nursing research
 Relationships of components in a theory help to drive
the research questions for understanding nursing
 Chinn and Kramer (2004), indicate a spiral
relationship between the two
Current trends that influence nursing theory

 Descriptive theories – first level of theory 1. Medical science

development 2. Nursing education
3. Professional nursing organizations
 Prescriptive theories – address nursing interventions 4. Evolving research approaches
and predict their consequences 5. Global concerns
 6. Consumer demands  Structured ideas
7. Technologies  Tentative
“ Practicing nurses who despise theory are condemned to  Describe a phenomenon or occurrence
performing a series of tasks - either at the command of a
physician or in response to routines and policies.” Components/Elements of theory
Leah Curtin, RN, MS, FAAN (1989)
Purpose “Why is the theory formulated”

Concepts are building blocks of theory – ideas, mental images

Introduction to Theory of a phenomenon, an event or object that is derived from
an individual’s experience and perception
Nursing as a profession
There has been questions about whether nursing is a Has a major concept like nursing, person, health or
profession or an occupation. environment.

A profession is a learned vocation or occupation that has status
of superiority and precedence within a division of work. It
needs widely varying levels of training or education, skills and
variable knowledge base. All professions are occupations but
not all occupations are professions
(Logan,Franzen,Butcher,2004;Schwiran , 1998)
Characteristics of a profession
1. Utilizes in its practice a well-defined and well
organized body of specialized knowledge on the
intellectual level of the higher learning.
2. Constantly enlarges the body of knowledge it uses and
improves its techniques of education and service by
the use of scientific method.
Definitions give meaning to concepts which can either be
descriptive or procedural (stipulate-use of term within
the 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.

3. Entrusts the education of its practitioners to

institutions of higher education.

4. Applies its body of knowledge in practical services

that are vital to human and social welfare.

5. Functions autonomously in the formulation of

professional policy and in the control of professional
activity.

6. Attracts individuals of intellectual and personal

qualities who exalt service above personal gain and
who recognize their chosen occupation as a life work.

7. Strives to compensate its practitioners by providing

freedom of action, opportunity for continuous
professional growth and economic security.

Definitions of theory

1. Pinnel and Menesis (1986)

- Systematic set of interrelated concepts, definitions
and deductions that describe, explain or predict
interrelationships

2. 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
3. Chinn and Krammer (2011)
- creative and vigorous structuring of ideas that
project a tentative, purposeful and systematic
view of phenomena

Some commonalities

 Purpose
 Concepts
 Definitions
 Propositions