© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Framework for Professional 2 © JonesNursing & Bartlett Practice Learning, LLC © Jones & Bartlett Learning, LLC NOT KathleenFOR SALE Masters OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & BartlettAlthough Learning, the beginning LLC of nursing theory development© Jones & can Bartlett be traced Learning, to LLC NOT FOR SALE FlorenceOR DISTRIBUTION Nightingale, it was not until the secondNOT half FORof the SALE1900s that OR nurs DISTRIBUTION- ing theory caught the attention of nursing as a discipline. During the decades of the 1960s and 1970s, theory development was a major topic of discussion and publication. During the 1970s, much of the discussion was related to the development of one global theory for nursing. However, in the 1980s, atten- tion turned from© Jones the development & Bartlett of aLearning, global theory LLC for nursing as scholars © Jones & Bartlett Learning, LLC began to recognizeNOT FORmultiple SALE approaches OR DISTRIBUTION to theory development in nursing. NOT FOR SALE OR DISTRIBUTION Because of the plurality in nursing theory, this information must be orga- nized to be meaningful for practice, research, and further knowledge devel- Key Terms and Concepts opment. The goal of this chapter is to present an organized and practical » Concept overview of the major concepts, models, philosophies, and theories that are » Conceptual model © Jonesessential & in Bartlett professional Learning, nursing practice. LLC © Jones & Bartlett» Propositions Learning, LLC » Assumptions NOT FORIt can SALE be helpful OR to DISTRIBUTION define some terms that might be unfamiliar.NOT A concept FOR SALE» Theory OR DISTRIBUTION is a term or label that describes a phenomenon (Meleis, 2004). The phenom- » Metaparadigm enon described by a concept can be either empirical or abstract. An empirical » Person concept is one that can be either observed or experienced through the senses. » Environment An abstract concept is one that is not observable, such as hope or caring » Health » Nursing © Jones & Bartlett(Hickman, Learning, 2002). LLC © Jones & Bartlett Learning,» Philosophies LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC Learning© Jones Objectives & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION After completing this chapter, the student should be able to: 1. Identify the four metaparadigm concepts of 3. Begin the process of identifying theoretical nursing. frameworks of nursing that are consistent with © Jones2. Identify & Bartlett and describe Learning, several theoretical LLC works a personal© Jones belief & system. Bartlett Learning, LLC in nursing. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 47 © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 81982_CH02_Pass1.indd 47 22/09/12 1:12 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 48 ChaPTer 2 Framework for Professional Nursing Practice © Jones & BartlettA conceptual Learning, model is definedLLC as a set of concepts ©and Jones statements & Bartlett that Learning, LLC NOT FORintegrate SALE the OR concepts DISTRIBUTION into a meaningful configuration (Lippitt,NOT FOR1973; asSALE cited OR DISTRIBUTION in Fawcett, 1994). Propositions are statements that describe relationships among events, situations, or actions (Meleis, 2004). Assumptions also describe concepts or connect two concepts and represent values, beliefs, or goals. When assumptions are challenged, they become propositions (Meleis, 2004). © Jones & Bartlett Learning,Conceptual LLC models are composed of© abstract Jones and & Bartlettgeneral concepts Learning, and LLC NOT FOR SALE OR DISTRIBUTIONpropositions that provide a frame of referenceNOT FOR for members SALE ofOR a discipline.DISTRIBUTION This frame of reference determines how the world is viewed by members of a discipline and guides the members as they propose questions and make observations relevant to the discipline (Fawcett, 1994). A theory “is an organized, coherent, and systematic articulation of a set © Jones & Bartlett Learning, LLC of statements related to© significantJones & Bartlettquestions inLearning, a discipline LLC that are com- NOT FOR SALE OR DISTRIBUTIONmunicated in a meaningfulNOT whole,” FOR SALEaccording OR to DISTRIBUTIONMeleis (2007, p. 37). The primary distinction between a conceptual model and a theory is the level of abstraction and specificity. A conceptual model is a highly abstract system of global concepts and linking statements. A theory, in contrast, deals with one or more specific, concrete concepts and propositions (Fawcett, 1994). © Jones & BartlettA metaparadigm Learning, is the mostLLC global perspective of a discipline© Jones and & “actsBartlett Learning, LLC NOT FORas SALEan encapsulating OR DISTRIBUTION unit, or framework, within which theNOT more FORrestricted SALE … OR DISTRIBUTION structures develop” (Eckberg & Hill, 1979, p. 927). Each discipline singles out phenomena of interest that it will deal with in a unique manner. The concepts and propositions that identify and interrelate these phenomena are even more abstract than those in the conceptual models. These are the concepts that © Jones & Bartlett Learning,comprise the LLC metaparadigm of the discipline© Jones (Fawcett, & Bartlett 1994). Learning, LLC NOT FOR SALE OR DISTRIBUTIONThe conceptual models and theoriesNOT of nursing FOR representSALE OR various DISTRIBUTION para- digms derived from the metaparadigm of the discipline of nursing. Therefore, although each of the conceptual models might link and define the four metaparadigm concepts differently, the four metaparadigm concepts are present in each of the models. © Jones & BartlettThe Learning, conceptual LLC models and © Jones & Bartlett Learning, LLC theories of nursing represent The central concepts of the discipline of nursing are NOT FOR SALE ORvarious DISTRIBUTION paradigms derived personNOT, environment FOR SALE, health OR, and DISTRIBUTION nursing. These four con- from the metaparadigm of the cepts of the metaparadigm of nursing are more specifically “The person receiving the nursing, the environment within discipline of nursing. which the person exits, the health–illness continuum within which the person falls at the time of the interaction with the © Jones & Bartlett Learning,nurse, and, LLC finally, nursing actions themselves”© Jones (Flaskerud & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION& Holloran, 1980, cited in Fawcett, 1994,NOT p. FOR5). SALE OR DISTRIBUTION Because concepts are so abstract at the metaparadigm level, many concep- tual models have developed from the metaparadigm of nursing. Subsequently, multiple theories have been derived from each conceptual model in an effort to describe, explain, and predict the phenomena within the model. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 81982_CH02_Pass1.indd 48 22/09/12 1:12 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Overview of Selected Nursing Theories 49 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC OverviewNOT FORof Selected SALE OR DISTRIBUTION Nursing NOT FOR SALE OR DISTRIBUTION Theories To apply nursing theory in practice, the nurse must have some knowledge of the theoretical works of the nursing profession. This chapter is not intended © Jonesto provide & Bartlett an in-depth Learning, analysis of each LLC of the theoretical works in© nursing Jones but & Bartlett Learning, LLC NOTrather FOR provides SALE an OR introductory DISTRIBUTION overview of selected theoretical worksNOT toFOR give SALE OR DISTRIBUTION you a launching point for further reflection and study as you begin your journey into professional nursing practice. CriTiCal ThiNKiNg QuesTioN v Theoretical works in nursing are generally categorized What are the specific competencies for nurses either as philosophies, conceptual models, theories, or in relation to theoretical knowledge? v © Jones & Bartlettmiddle-range Learning, theories LLC depending on the level© of Jones abstrac -& Bartlett Learning, LLC NOT FOR SALE tion.OR WeDISTRIBUTION begin with the most abstract of theseNOT theoretical FOR SALE OR DISTRIBUTION works, the philosophies of nursing. ■■ Selected Philosophies of Nursing Philosophies set forth the general meaning of nursing and nursing phenom- ena through ©reasoning Jones and & Bartlettthe logical Learning,presentation ofLLC ideas. Philosophies are © Jones & Bartlett Learning, LLC broad and addressNOT generalFOR SALEideas about OR nursing. DISTRIBUTION Because of their breadth, nurs- NOT FOR SALE OR DISTRIBUTION ing philosophy contributes to the discipline by providing direction, clarifying values, and forming a foundation for theory development (Alligood, 2006). Nightingale’s Environmental Theory © JonesNightingale’s & Bartlett philosophy