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EVOLUTION OF NURSING THEORIES
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Terminology
Metaparadigmis the most abstract level of knowledge. It
specifies the main concepts that encompass the subject
matter and the scope of a discipline.
Powers and Knapp have noted, There is generalagreement that nursing metaparadigm consists of the
central concepts of person, environment, health and
nursing.
Philosophy is the next knowledge level; it specifies the
definitions of the metaparadigm concepts in each of the
conceptual models of nursing.
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Conceptual models are frameworks or paradigms that
provide a broad frame of reference for systematic
approaches to the phenomena with which the discipline is
concerned. Conceptual models provide different views of
nursing according to the characteristics of the model.
Theoryis a groups of related concepts that propose
actions that guide practice
Nursing Theory is a group of related concepts thatderived from the nursing models. Some nursing theories
also derive from other disciplines such as Leiningers work,
which comes from anthropology, or Peplaus work, which
draws from psychiatric sources.
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Science is performing the processes of observation,
idenitification, description, experimental investigation, and
theoretical explanation of natural phenomena. It is also a
body of knowledge; both unified body of knowledge
concerned with specific subject matter and as the processesand methodologies.
Conceptis an idea or complex mental image of a
phenomenon (object, property, or event). Concepts are the
major components of theory.
Abstract concepts are independent of time or place and
they are indirectly observable. Hope is an example of an
abstract concept.
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Evolution of Nursing Theory within Types of Works
PHILOSOPHIES
NightingaleWiedenbach
Henderson
Abdellah
Hall
Watson
Benner
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Evolution of Nursing Theory within Types ofWorks
CONCEPTUAL MODELS AND GRAND THEORIES
OremLevine
Rogers
Johnson
Roy
Neuman
King
Roper, Logan, and Tierney
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Evolution of Nursing Theory within Types of Works
THEORIES AND MIDDLE-RANGE NURSNG THEORIES
Peplau BaranardOrlando Leininger
Travelbee Parse
Kolcaba Mishel
Erickson, Tomlin, and Swain NewmanMercer Adam
Pender
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Significance of Theory for Nursing As a
Discipline and Profession
Discipline-specific to academia and refers to a branch of
education, a department of learning, or a domain of
knowledge.
Profession-refers to a specialized field of practice, which
is founded upon the theoretical structure of the science or
knowledge of that discipline and the accompanying
practice abilities.
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SIGNIFICANCE OF THEORY FOR NURSING AS A
DISCIPLINE
To develop knowledge as a basis for nursing practice.
Baccalaureate programs proliferated, master programs in
nursing were developed and the curricula began to be
standardized through the accreditation process. Advocatednursing as an applied science and others proclaimed nursing
as a basic science.
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SIGNIFICANCE OF THEORY FOR NURSING AS A
PROFESSION
1. Utilizes in its practice a well-defined and well-
organized body of specialized knowledge [that] is in the
intellectual level of the higher learning.
2. Constantly enlarges the body of knowledge it uses andimproves its techniques of education and service by the
use of the scientific method.
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.
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5. Functions autonomously in the formulation of
professional policy and in the control of the professional
policy thereby.
6. Attracts individuals or intellectual and personal qualitieswho exalt service above personal gain and who
recognize their chosen occupation as a life work.
7. Strives to compensate its practitioners by protinuous
professional growth, and economic security.
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Nursing Theory and the Practicing Nurse
Theory assists the practicing nurse to:
Organize patient data
Understand patient data
Analyze patient data
Make decisions about nursing interventions
Plan patient carePredict outcomes of care
Evaluate patient outcomes.
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PHILOSOPHIES
Florence Nightingale
Florence Nightingales work is closely related to her
philosophical orientation of the patient environment
interaction and the principles and rules on which nursingpractice was founded. Nightingale believed that disease was
a reparative process. Patients surroundings-ventilation,
warmth, light, diet, cleanliness and noise-would contribute
to the reparative process and the health of the patient.Notes on Nursing: What it is and what it is not.
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Ernestine Wiedenbach concentrated on the art of nursing
and focused on the needs of the patient. It guides the
nurses action in the art of nursing.
Four Elements:
1. Philosophy 3. Practice
2. Purpose 4. Art
Postulated that clinical nursing is directed toward meetingthe patients perceived need-for-help. Clinical Nursing:
A Helping Art.
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Virginia Henderson viewed the patient as an individual
requiring help toward achieving independence. She
envisioned the practice of nursing as independent from the
practice of the physicians and acknowledges herinterpretation of the nurses function as a synthesis of many
influences. Henderson emphasized the art of nursing and
identified the 14 basic human needs on which nursing care is
based. Her definition of nursing first appeared in 1995 in the
fifth edition ofTextbook of the Principles and Practice of
Nursing by Harmer and Henderson.
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Henderson stated, The unique function of the nurse is to
assist the individual sick or well, in the performance of
those activities contributing to health or its recovery (or
to peaceful death) that he would perform unaided if hehad the necessary strength. She identified the following
14 basic needs of patients that comprise the components
of nursing care:
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1. Breathing2. Eating and drinking3. Elimination4. Movement5. Rest and sleep6. Suitable clothing
7. Body temperature
1. Clean body and
protected integument2. Safe environment3. Communication4. Worship5. Work6. Play
7. Learning
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She identified three levels of nurse-patient relationships in
which the nurse is a:
1. Substitute for the patient
2. Helper to the patient
3. Partner with the patient.
She supports empathetic understanding and states that the
nurse must get inside the skin of each of her patientsin order to know what he needs.
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THE END