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Nursing Theories and Frameworks

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Title: Nursing Theories and Frameworks


1
Nursing Theories and Frameworks
2
Learning Objectives
  • Compare inductive and deductive reasoning
  • Differentiate between conceptual and theoretical
    frameworks
  • Describe how a framework guides research
  • Differentiate between conceptual and operational
    definitions
  • Describe the relationship between research and
    theory and practice

3
Learning Objectives
  • Differentiate between grand and midrange nursing
    theories
  • Describe the criteria for critique of theoretical
    or conceptual frameworks in the nursing literature

4
Approaches to Science
  • Inductive Reasoning
  • Deductive Reasoning

5
Ladder of Abstraction
  • Worldview
  • Frameworks
  • Theories
  • Concepts
  • Variables

6
Concept
  • Definition
  • an abstraction
  • creates an image of an idea we want to share
  • representations of particular aspects of human
    behavior and characteristics
  • Pain
  • Coping
  • Grief
  • Resilience

7
Identify the Concepts
  • A theoretical model was developed and tested to
    explain the effects of learned helplessness,
    self-esteem, and depression on the health
    practices of homeless women. (Flynn, 1997)
  • prevalence and consequences of verbal abuse of
    staff nurses by physicians were examined in the
    context of Lazarus stress-coping model.
    (Manderino Berkey, 1997)

8
Construct
  • Similar to a concept in that it refers to an
    abstraction
  • Different from a concept in that it is
    deliberately invented (constructed) by
    researchers for a scientific purpose
  • Health locus of control
  • Self-care in Orems model
  • Concept and construct are sometimes used
    interchangeably although a construct often refers
    to a more complex abstraction than a concept

9
Terminology
  • Conceptual framework
  • Structure of concepts and theories pulled
    together like a map for the study
  • Theoretical framework
  • A structure of concepts that exists in the
    literature, a ready-made map for the study
  • Provide a theoretical rationale for the
    development of hypotheses

10
Conceptual Framework
  • Explains how the variables in your study are
    expected to relate to each other
  • A conceptual framework is used when the
    literature does not contain a specific theory
    that explains the relationship between study
    variables.

11
Theoretical Framework
  • Used when the variables have been studied before
    and have been found to be related to one another
  • At Level I there may be no framework based on
    existing literature. This establishes a rationale
    for the need to conduct such a study.
  • At Level II you can provide a conceptual
    framework from literature on the variables of
    your study.
  • Level III studies always have theoretical
    frameworks.

12
What does a framework do?
  • Provides direction for the study by providing an
    organized set of ideas/variables and their
    relationships
  • Reveals conceptual and operational definitions
  • Guides what data is to be collected and analyzed

13
Terminology
  • Conceptual definition like a dictionary
    definition conveys the general meaning of a
    concept
  • Operational definition specifies how the
    concept will be measured (i.e., what instruments
    will be used)

14
Appendix B Van Cleve et al., 2004
15
Terminology
  • Theory set of interrelated concepts that
    provides a systematic view of a phenomenon
  • OR Theory is an abstract generalization that
    presents a systematic explanation about the
    relationships among phenomena
  • Theory guides practice and research practice
    enables testing of theory and generates questions
    for research research contributes to
    theory-building and establishing practice
    guidelines. LB-W H p. 113

16
Nursing Theory
  • Many theory/concepts Borrowed from other
    disciplines
  • Nursing Theories
  • Grand
  • Mid-range
  • Microrange

17
Nursing Theories
  • Conceptual structure that organizes practice and
    research into ideas central to the discipline
  • Nursing theories are reservoirs in which
    findings related to nursing concepts, such as
    comfort, healing, recovering, mobility, rest,
    caring, enabling, fatigue, and family care, are
    stored. Meleis (1997)

18
Grand Theories
  • Conceptual structures that include views on
    person, health, and environment to create a
    perspective of nursing
  • Historically important
  • Guides discipline of nursing today
  • Abstract level
  • Address a phenomena of concern to nursing from a
    different perspective

19
Grand Theories
  • Imogene King, 1981 Open Systems Model
  • Madeleine Leininger, 1991 Theory of culture
    care diversity and universality
  • Dorothea Orem, 1985 Self-care Model
  • Sr. Callista Roy, 1984, 1991 Adaptation Model
  • Jean Watson, 1999 Theory of Caring
  • These models are broad, formal explanations of
    what nursing discipline is according to the
    developers point of view

20
Midrange Theories
  • Are moderately abstract but composed of concepts
    that are measurable
  • More focused than grand theories
  • Have a stronger relationship with research and
    practice
  • Lie between everyday working hypotheses and
    grand theoriesMerton (1968)

21
Midrange Theories
  • Tend to focus on concepts of interest to nurses
  • Pain, empathy, grief, self esteem, hope, comfort,
    dignity, quality of life
  • Some midrange theories have their basis in grand
    theories
  • Midrange theory of self-care deficit grew out of
    Orems (1980) grand theory of self care

22
Midrange Theories
  • Categorized by level of abstraction
  • High, middle and low
  • K. Kolcaba Theory of Comfort
  • R. Mercer Maternal Role Attainment
  • AACN The Synergy Model for Patient Care

23
Microrange Theory
  • Closely related to midrange theories
  • More narrow in scope
  • Described at the level of hypothesis
  • Questions/ hypotheses derived from practice

24
Critique Criteria
  • Is the theoretical or conceptual framework
    clearly identified?
  • Is the framework consistent with a nursing
    perspective?
  • Is the framework appropriate to guide research on
    the topic?
  • Is there logical connection between the
    framework, concepts and the measurement?

25
Critique Criteria
  • Are the concepts clearly and operationally
    defined?
  • Was sufficient literature reviewed to support the
    proposed relationships?
  • Is there a logical link between the framework,
    the study concepts, and the methods of
    measurement?
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