USING NURSING
THEORIES AS
FRAMEWORKS FOR
PRACTICE,
EDUCATION, &
RESEARCH
Susan S. Gunby, RN, PhD
Fall Semester 2003
“Practicing nurses who despise
theory are condemned to
performing a series of tasks –
either at the command of a
physician or in response to
routines and policies.”
-- Leah Curtin, RN, MS, FAAN (1989)
Former Editor, Nursing Management
“Theory internalizes
principles which increase
adaptability and
flexibility and enables
one to transfer
experience from one
situation to the next.”
-- Leah Curtin
“ . . . the truth thus
ascertained would enable us
to save life and suffering,
and to improve the
treatment and management
of the sick . . . .”
-- Florence Nightingale
Proposal presented to the
International Statistical Congress in
London, 1860
“All must go at the end of 2
months, except those who
are dying.”
- Florence Nightingale (1854)
Informed action (simultaneously
the action and the knowledge
that inform it). (Carr & Kemmis, 1986)
Reflection upon practice toward
the refinement of theory and
therefore the enhancement of
practice. (Thorne & Hayes, 1997)
Discipline of Nursing Must
Examine:
• What it means to practice nursing.
• What knowledge is held as “private”
vs. “public.”
• What ideals are embedded in
nursing practice as well as in the
generation of nursing knowledge.
(Kim, 2000)
Barbara A. Carper (1978):
• “It is the general conception
of any field of inquiry that
ultimately determines the
kind of knowledge that field
aims to develop as well as
the manner in which that
knowledge is to be organized,
tested, and applied . . . .”
Barbara A. Carper (1978):
• “Such an understanding . .
. involves critical attention
to the question of what it
means to know and what
kinds of knowledge are
held to be of most value in
the discipline of nursing.”
WAYS OF KNOWING
or
FORMS OF KNOWLEDGE
Empirical
Ethical
Personal
Esthetic
COMPONENTS & LEVEL OF
ABSTRACTIONS
Metaparadigm
Most Abstract
Philosophies
Conceptual Models
Theories
Empirical Indicators
Most Concrete
METAPARADIGM
Global concepts that identify
the phenomena of interest
METAPARADIGM
Global propositions that
state the relationships among
those phenomena
METAPARADIGM
. . . an encapsulating unit, or
framework, within which the more
restricted. . .structures develop.”
(Eckberg & Hill, 1979, p. 927)
METAPARADIGM
The functions of a metaparadigm
are to summarize the intellectual
and social missions of a discipline
and place a
boundary on the subject matter
of
that discipline.
(Kim, 1989)
PHENOMENA OF INTEREST TO
NURSING REPRESENTED BY
FOUR CENTRAL CONCEPTS
1. Person
2. Environment
3. Health
4. Nursing
PHILOSOPHIES
Are Statements About:
*** What people assume to be true in relation
to the phenomena of interest to a discipline.
(Christensen & Kenney, 1990)
*** What people believe regarding the
development of knowledge about those
phenomena.
EXAMPLE OF
PHILOSOPHICAL
STATEMENT
“The individual . . . behaves
purposefully, not in a sequence of
cause and effect.”
(Roy, 1988, p. 32)
CONCEPT
• An abstract
idea or
mental image
of
phenomena
or reality.
CONCEPTS
• Abstract ideas that give
meaning to our perceptions
• Permit generalizations
• Stored in memory for
recall & use at later time
in a new & different
situation.
CONCEPTS
• May be linked
together to
explain
approaches to
nursing care and
to predict the
outcome of care.
Concepts
• When operationalized,
become variables used
in hypotheses to be
tested in research.
• Explicate subject
matter of theories of
a discipline.
CONCEPTUAL MODELS
A set of abstract and general
concepts and propositions that
integrate those concepts into a
meaningful configuration.
(Lippitt, 1973; Nye & Berardo, 1981)
CONCEPTUAL MODELS
Provide a distinctive frame of
reference.
EXAMPLES OF
CONCEPTUAL MODELS
*** King’s General Systems Framework
*** Roy’s Adaptation Model
THEORIES
Consist of relatively specific
and concrete concepts and
propositions that purport to
account for or organize some
phenomenon.
(Barnum, 1994)
THEORIES
Vary in the relative level
of concreteness and
specificity of their
concepts and
propositions.
THEORIES
Primary Purpose:
To generate knowledge.
THEORIES
Provide a communication
system in terms of a
set of concepts that
are interrelated and
understandable to
others.
THEORIES
Enable nurses to know
WHY they are doing
WHAT they are doing.
THEORIES
Provide knowledge to
improve practice &
education by
describing, explaining,
predicting, controlling,
and understanding
phenomena.
THEORIES
Help develop analytical skills,
challenge thinking, clarify values
and assumptions, and determine
purposes for nursing practice,
education, and research.
THEORIES
Enhance professional autonomy by
guiding the practice, education,
and research functions of the
profession.
EMPIRICAL INDICATORS
The actual instruments,
experimental conditions,
and research methodologies
used to observe or
measure the concepts of a
middle-range theory.