Evolution of Nursing Theories: "History, terminologies and Analysis"

HISTORY

>Curriculum Era addressed the question of what perspective nurses must study and learn to become a nurse. Here occurs the movement of nursing education from hospital based diploma programs into colleges and universities emerged, but mid-century before this goal achieved.

>Research Era more nurses sought degrees in higher education began to emerge. Nurses began to participate in research and research courses began to be included in the nursing curricula. “The research was the path to new knowledge.

>Graduate Education Era- Masters programs in nursing to meet the need for nurses with specialized nursing education in nursing. Many of these programs included a course in nursing research in the curricula and at the end of this era a course in nursing theory or nursing conceptual models that introduced students to the nearly nursing theorist and the theory development process.

>Theory Era was the natural outgrowth of the research era with an increased understanding of research and knowledge development, it became obvious that research without theory produced isolated information. Research and theory produced nursing science.

>Contemporary phase, there is an emphasis on theory use in theory-based nursing practice and continued theory development.
>1950, Nursing as a science, nursing practice was based on principles and traditions passed on through apprenticeship education and common-sense wisdom that came with years of experience.
>1960, New awareness of nursing as a profession and academic discipline in its own right emerged from debates and discussions regarding the direction and appropriate discipline for nursing knowledge development.  This new awareness was evidenced by an explosive proliferation of nursing doctoral programs and nursing theory literature.
>1970, The transitions from vocation to profession was a major turning point fro nursing. According to Meleis, this progress in nursing theory is a most significant aspect of scholarly evolution and the cornerstone of the nursing discipline.
>1980, Nursing theory development. Transition from the preparadigm period to the paradigms period. The prevailing paradigms (models) provided various perspectives for nursing practice, aministration, education, research, and further theory development.

THEORIST HISTORY

1. Nightingale (1860): To facilitate “the body’s reparative processes” by manipulating client’s environment. It is Nightingale who envisioned nurses as a body of educated women when women were neither educated nor employed in public service.

2. Peplau 1952: Nursing is; therapeutic interpersonal process.
3. Henderson 1955: The needs often called Henderson’s 14 basic needs
4. Abdellah 1960: The nursing theory developed by Faye Abdellah et al (1960) emphasizes delivering nursing care for the whole person to meet the physical, emotional, intellectual, social, and spiritual needs of the client and family.

5. Orlando 1962: To Ida Orlando (1960), the client is an individual; with a need; that, when met, diminishes distress, increases adequacy, or enhances well-being.
6. Johnson’s Theory 1968: Dorothy Johnson’s theory of nursing 1968 focuses on how the client adapts to illness and how actual or potential stress can affect the ability to adapt. The goal of nursing to reduce stress so that; the client can move more easily through recovery.
7. Rogers 1970: to maintain and promote health, prevent illness, and care for and rehabilitate ill and disabled client through “humanistic science of nursing”

8. Orem1971: This is self-care deficit theory. Nursing care becomes necessary when client is unable to fulfill biological, psychological, developmental, or social needs.
9. King 1971: To use communication to help client reestablish positive adaptation to environment.
10. Neuman 1972: Stress reduction is goal of system model of nursing practice.
11. Roy 1979: This adaptation model is based on the physiological, psychological, sociological and dependence-independence adaptive modes.
12. Watson’s Theory 1979: Watson’s philosophy of caring 1979 attempts to define the outcome of nursing activity in regard to the; humanistic aspects of life.

TERMINOLOGIES

Phenomena- the subject matter in which unstudied, unexplained and unaware events.

Concept- an idea regarding phenomena or reality. A building block of a theory.

Abstract Concept- indirectly observable ideas. It is covert.

Concrete Concept- observable and specific to time and place. Ideas that can be directly observe. It’s overt.

Conceptual framework- a group of concepts that focuses on the discipline of a phenomenon or reality.

Construct- an idea created/invented by the help of studied concepts to present how phenomena or reality occurs.

Theory- a set of interrelated concepts, definitions, and propositions that present a systematic way of viewing phenomenon by specifying relations among the variables with the purpose of explaining, describing, and predicting the phenomenon. (Kerlinger) Theory’s Four Major Concept:

1.       Person/Client- recipient of nursing care.

2.       Environment- internal and external surrounding of a client.

3.       Health/Illness- person’s state of wellbeing.

4.       Nursing- Client’s care interventions.

Nursing Theory- a set of interrelated concepts originated from the nursing conceptual frameworks.

Metaparadigm- encompasses the main concepts of a subject matter and the range of boundaries. The nursing metaparadigm consists of the central concepts: Person, Environment, Health and Nursing.

Philosophy- the next knowledge level; it specifies the definitions of the metaparadigm concepts in each of the conceptual models of nursing.

Middle Range Theories- the least abstract level of theoretical knowledge because they include details specific to nursing practice.

Grand Theories- nearly as broad as the nursing model they are derived from, but they are different from nursing models.

Theories- may be broad but limited to the aspects of nursing they address.

Knowledge Structure Level with Examples

Knowledge Structure                      Example

Metaparadigm                                  Person, environment, health and nursing

Philosophy                                        Nightingale

Conceptual Model                            King’s System Framework

Grand Theory                                   King’s Theory of Goal Attainment

Theory                                              Goal Attainment in the Hospital Setting

Middle Range Theory                       Goal attainment in adolescent diabetic patients in the community

Theoretical Definitions- giving meaning to a concept in related to a particular theory by specifying realistic indicator.

Operational Definitions- specifying measurement of a variable in a particular research.

Assumptions- are statement that the theorist holds as truth and excludes from measurement and testing.

Theoretical Statements- is also called “principles” or “propositions.” It describes the relationships between two or more ideas.

Propositions- are the relationship of two or more ideas with theoretical basis from a theory.

Hypothesis

Inductive- is making logical reason from specific to general. Examples are phenomenology and grounded theory. It is combining concepts to make a set of things.

Deductive- is making logical reason from general to specific. It is combining concepts to form a particular idea.

Retroductive- it is the combination of inductive and deductive by the use of analogy and devising theory as method. 

CRITERIA IN ANALYZING A THEORY

1.       Clarity                                                   How clear is this theory?

2.       Simplicity                                              How simple is this theory?

3.       Generality                                            How general is this theory?

4.       Empirical Precision                              How accessible is this theory?

5.       Derivable Consequences                    How important is this theory?

    Reference:

             Nursing Theorists and Their Work by Ann Marriner Tomey and Martha Raile Alligood, 5th Edition.
             http://currentnursing.com/nursing_theory/development_of_nursing_theories.html