Elements found in each nursing theory
The four most common elements found in each nursing theory are person, nursing, environment, and health. The person is the patient who is seeking some form of medical need. Nursing is the profession in which the patient seeks some form of health care advice or need. The environment consists of areas where a person spends most of his/her time and with whom that time is spent. Health is determined individually as the highest level of wholeness and independence of activities of daily living. Each theorist defines and perceives each of these terms with slight variation within their theory.
“Knowing” is related to theory foundation in that knowledge is a byproduct of research, and knowing is the communication of that knowledge through theory, which is defined as empirical knowing (McKenna, 1997). Emancipatory knowing as defined in 2018 by Butts & Rich “is a central, critical, and necessary pattern of knowing that underpins the development of all nursing knowledge, and that shapes all nursing practices that flow from nursing’s disciplinary knowledge (p. 143). The end goal is to implement the knowledge developed through education, hands-on experience, intuition, research, and understanding of theory into everyday practice.
The four types of theories in nursing are: (briefly describe and state their purpose)
- Metatheory – A theory built upon an existing theory. A metatheorist is a person who analyzes and categorizes theories, assesses how they relate to nursing practice and research while, in turn, creating their theory based upon that existing theory. They hold the belief that models and theories are the same, and they create higher levels of existing theory for nursing to use in practice.
- Grand theory – is a theory that is considered abstract. They are formed from conceptual models and are broad-focused but often later turned into a narrower mid-range theory. Grand theories are used to develop theories that are much more focused on a particular topic.
- Mid-range theory – As the theory levels build upon each other, they become narrower in focus on practice. Mid-range theorists build on the concepts created in grand theories and narrow the focus with the intent of use in everyday nursing practice.
- Practice theory – practice theories are developed by narrowing down the focus of mid-range theories and concepts to develop specific nursing interventions of that issue to use in practice.
My theory of choice is Jean Watsons Theory of Human Caring, which I will apply to my CSP topic on the importance of immunizations and the attempt to counteract vaccine hesitancy. I interpret this theory about my topic as caring for the well-being of humans and the importance of building caring, trusting relationships with patients. It is the nurse’s responsibility to educate the importance of immunizations to patients and families in hopes they will adhere to those guidelines.
This theory links to the theory elements as follows:
Nursing – The NP in practice developing a caring/trusting relationship with the parents who are against vaccinating their child.
Person – The child in which the NP is advocating to have immunized through caring, empathetic talks with her parents on the importance of the child’s health and well-being.
Health – Using Watson’s theory to listen and provide facts regarding the importance of the patient’s health as well as the health of others to vaccinate.
Environment – Striving to help the parents understand that having their child out in the world unvaccinated is not only subjecting him/her to possible deadly illnesses but creating a possible outbreak of already eradicated diseases in the environment.
My goal is to build caring relationships while having difficult conversations with parents who are against vaccinations. A recent journal article on vaccine hesitancy states that “NPs who have prepared themselves by building their knowledge base and listening to concerns with empathy and understanding can positively affect the decision to vaccinate” (Koslap-Petraco, 2019, p. 625).
References
Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice (Third ed.). Jones & Bartlett Learning.
Koslap-Petraco, M. (2019). Vaccine hesitancy: Not a new phenomenon, but a new threat. Journal of the American Association of Nurse Practitioners, 31(11), 624–626. https://doi.org/10.1097/jxx.0000000000000342
McKenna, H. (1997). Nursing theories and models. Routledge.
Response
Nursing theories combined with evidence-based practice are the bases of the nursing profession. Nursing theories are frameworks designed to explain phenomena in nursing practice and organize knowledge (Silén & Johansson, 2016). Besides, Silén & Johansson (2016) argues that nursing theories are a set of definitions, concepts, assumptions, and relationships derived from other medical disciplines and nursing models. Nursing theory provides the basis of nursing practice by helping nursing professionals to generate further knowledge through research (Jensen, 2019). This is because they are the bases for hypotheses that can be tested. Every nursing theory has four elements, which include the person, nursing, the environment, and health, where each theory explains each concept. According to Carvajal Hermida & Sánchez-Herrera (2018), the person, often the patient, is the most crucial element in each nursing theory because the patient is affected by all other three components of nursing theories. There are four classes of nursing theories. A metatheory is considered a theory of theory, where a theorist analyzes specific issues in nursing theory and clarifies the roles and methodology of the theory. Thus, he/she comes up with another theory. Other theories include the grand theory, mid-range theory, and practice theories, and each theory can be suitably applied to different nursing situations based on the appropriateness.
References
Carvajal Hermida, E. Y., & Sánchez-Herrera, B. (2018). ” Nursing Care with a Human Approach”: A Model for Practice with Service Excellence. Aquichan, 18(2), 149-159.
Jensen, K. T. (2019). Nursing research: A marriage of theoretical influences. Nursing Open, 6(3), 1205-1217.
Silén, M., & Johansson, L. (2016). Aims and theoretical frameworks in nursing students’ Bachelor’s theses in Sweden: A descriptive study. Nurse education today, 37, 91-96.
5th Post
There are 4 common elements or aspects commonly found in every nursing theory. Authors Butts & Rich summarizes that there are four parts of nursing theory which include the person/patient, the environment, the health, and lastly, nursing (2018). Each one of these components play an important role in the nursing theory as follows: The person is who is receiving the care or intervention, the environment is everything that is an outside source that effects that patient internally and externally, the health is related to the person, described above, is experiencing in their own personal health, and the nursing are the interventions that will be used in patient care related to the person.
As far as “knowing”, it is described as the in nursing, that we obtain knowledge through experience and the written word ( McKenna, 1997, p 24). This is the way a nurse gains experience is through performing what they have been shown and applying it. The “knowing” can also be related to mental reasoning and formulating hypothesis and propositions through ‘armchair theorising’ and then setting up and experiment to see if the theory can be corroborated in the real world ( Mc Kenna, 1997). This is an approach a lot of researchers use, because they don’t know how well their hypothesis will end up.
There are four general types of theories in nursing: Metatheory, Midrange Theory, Grand Theory, and Practice Theory. The Metatheory is an idea about a theories (psychologydictionary.org, 2013). A meta theory can be a researcher that researches theories, because they don’t have their own theory they introduced, and bases their research on the known theory. Per the University of Wisconsin-Milwakee:
The Grand Theory nursing theories have the broadest scope for addressing a variety of concepts and propositions that nurses may encounter in the practice of care…they tend to be oriented around models and conceptual frameworks for defining practice in a variety of situations and care environments and ways of examining phenomena based on these perspectives (2020).
It appears that this theory has a lot of moving parts and examines the outcome based on the different experiences and see what the outcome may be.
The Midrange Theory is a transition between The Grand Theory and The Practice Theory. As authors Liehr and Smith note the middle range level is below the more philosophical or grand theory and above empirical generalizations framed as hypothesis (2017). So this theory can be explained as more in-depth than a basic idea but not as evolved as the grand theory.
The Practice Theory describes, explains, and prescribes nursing practice in general. It serves as the basis for specific items in the curriculum of nursing education and for the development of theories in the administration of nursing and nursing education (medicaldictionary.com, 2020). This is the real life, bringing the research to the patient, and putting that research into play related to interventions. One example would be using evidence based research in regards to infection control: Hospitals use the research that has been performed by researchers and take their finding to the clinical setting, for example, the clinician washing their hands prior to every patient reduces the rate of spreading infection to the next patient.
Science is based on theory and nursing science, as well, is based on different theories and how we relate these theories into interventions that work in patient related care. Medical and research professionals have this idea that they think will prove their point or disprove their point, to put the definition of a theory into easy terms. Management level employees, researchers, psychologists, and nurses all work off of a theory. Personally, a theory I utilize a lot is the Stages of Change theory aka The Transtheoretical Model (Prochaska & DiClemente, 1983) is quite popular in the healthcare profession because the patient comes to the point where they are not forced to make that change, they gradually prepare and accept they want to change.
My DNP CSP project is focused on the Hispanic-Latino community, in Santa Ana, California. I am using a lower socio economic based community to engage in conversation and a survey of helping parents get the medical care/psychiatric care for their child. In this particular culture, mental health is often looked down upon and not spoken about or addressed. My focus is to create a movement of change in thinking for parents to come to the realization, on their own, of asking, being offered, or try to find the help they need for their children. If I need to focus on a nursing theory, I will use Ernestine Wiedenbachs theory of The Helping Art of Clinical Nursing because it focuses on individualized care in the patient that has discomfort (Current Nursing.com, 2012). I believe for the population I am aiming to serve, I need a theory that is not so caring based, but change based.
References:
Butts, J.B, and Rich, K.L (2018). Philosophies and Theories for Advanced Nursing Practice.
3rdedition. Jones & Bartlett. MA.
Current Nursing (2012). Nursing theories. Retrieved from www.currentnursing.com
Liehr, P., & Smith, M. J. (2017) Middle Range Theory: A Perspective on Development and
Use. Advances in Nursing Science, 40(1), 51–63. https://doi-
org.libproxy.chapman.edu/10.1097/ANS.0000000000000162
McKenna, H.P (1997). Nursing Theories and Models. Routledge, London.
Medical Dictionary (2020). Retrieved from www.medicaldictionary.the freedictionary.com
Pam, N. (2013). Metatheory. Retrieved from psychologydictionary.org
Prochaska & DiClemente, 1983. The Transtheoretical Model.
University of Wisconsin-Milwakee (2020). Retrieved from guides.library.uwm.edu .
Response
A nursing theory is a framework designed to explain specific phenomena in nursing explicitly. According to Hoeck & Delmar (2018), a nursing theory enables nurses to decide what is already known and what should further be investigated to be known. Nursing theories facilitate the provision of better patient care, enhances professional status for its professionals, improves communication between nurses, and acts as guidance for nursing education and research. Besides, nursing is more concerned about caring for patients. Caring cannot be measured; therefore, nursing theories analyze and explain the role that nurses should play in caring. Each nursing theory has four components, including the person, environment, health, and nursing. All these four components are related to nursing care (Indra, 2018). As mentioned, there are four types of nursing theories, and each theory can be applied to different nursing situations. For instance, the stages of change theory recognize the importance of knowing where a person comes from before we, as nurses, change their lifestyle to promote health (Drevenhorn, 2018). In this theory, there are phases of change, that is, pre-contemplation, contemplation, preparation, and action, maintenance, and relapse phases.
References
Drevenhorn, E. (2018). A Proposed Middle-Range Theory of Nursing in Hypertension Care. International journal of hypertension, 2018.
Hoeck, B., & Delmar, C. (2018). Theoretical development in the context of nursing—The hidden epistemology of nursing theory. Nursing Philosophy, 19(1), e12196.
Indra, V. (2018). Nursing Theories: A Review. International Journal of Advances in Nursing Management, 6(3), 271-274.