Making the Link: TheoryPracticeResearch

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Making the Link Theory-Practice-Research

• NRSG 809
• MODULE 11

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6 Principles in Evidence ReviewOMathuna (2000)
Jnl of Nsg Scholarship, 32

• Avoid inappropriate associations
• Accurately present original research findings
• Conduct comprehensive lit. searches
• Report replications of studies
• Describe relevant research methods
• Include peer review any controversy

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Online Resources

• The NTPR (Nursing Theory, Practice Research)
  Project
• http//www.linksmanager.com/ntpr/
• Online Journal of Issues in Nursing
• http//www.nursingworld.org/ojin
• e.g., topic15/tpc15_4.htm
• Standards for holistic nursing practice A way
  to think about our care that includes
  complementary and alternative modalities Frisch
  (2001) Online Jnl of Issues in Nsg, 6(2)

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Amer. Holistic Nurses Assoc. http//www.ahna.org/h
ome/home.html
Core Values of Holistic Nursing

• Holistic philosophy education
• H. ethics, theories, research
• H. nurse self-care
• H. communication, therapeutic environment
  cultural competence
• H. caring process
• Recognition of body-mind-spirit connection

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Examples of AHNA Standards

• Holistic nurses
• interpret, use document information relevant to
  a persons care according to a theoretical
  framework.
• use available research evidence from different
  explanatory models to mutually create a plan of
  care with a person.
• disseminate research findings at meetings
  through publications to further develop the
  foundation practice of holistic nursing.

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Using Nursing Theory in PracticeDossey et al
(2000) Holistic Nsg Handbook for Practice

• Environment Nightingale
• create environment for healing to occur
• Adaptation Roy
• adaptation to stress requisite for balance
• Modeling Role-modeling Erickson
• build trust, promote strengths, set goals
• Caring - Watson
• establish caring relationship, give quality care
• Energy Field Rogers
• Interaction of human environmental energy
  fields

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Quantitative research

• How does each approach guide an understanding of
  the whole?... or the parts?
• How can CAM therapies be integrated with
  traditional therapies for optimal outcomes?

Qualitative research
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Why patients use alternative medicineAstin
(1998) JAMA, 279

• 3 competing theoretical perspectives
• Dissatisfaction vs need for personal control vs
  philosophical congruence
• Predictors of CAM use
• more education, poorer health
• holistic orientation to health
• health problems (e.g., anxiety, back pain)
• environmentalist, feminist, spiritual
• Not due to dissatisfaction with conv. med. or
  desire for personal control

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Making Links, Astin study
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Healthy Heart HP MaintenanceSerembus (1998)
Holist Nsg Pract, 12(2)

• CHD is major health problem in US
• 190 billion/yr little spent on health promo
• Model needs to include environment client
• Input
• Assessment internal external factors
• HP plan diet, activity, stress mgmt, smoking,
  HRT
• Support systems social professional
• Setting health clinic, work, school, church,
  commun.
• Client
• Outcome healthy CV life style

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Model for Health Promotion (HPM, TRA)
Risk factor assessment Practice
What study could test model?
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Urban HP IssuesLeviton et al. (2000), Amer Jnl
of Pub Health, 90

• Urbanization r/t behavior of city residents
• Weakened community family ties
• Lower trust r/t less use of health services
• More leisure time, but fear cost limit access
• NEED connectedness role models, barriers
• Inner-city environment
• Neg. ecological forces (violence, guns, drugs)
• Lack of control
• NEED enhance strengths, establish coalitions
  common goals

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Self-esteem Health behaviorSeigley (1999) Nsg
Outlook, 47

• Self-concept is cognitive view of self
• Self-esteem is affective part of self
• Research shows self-esteem health, but
  unclear how SE health
• Research shows how we think sig. others see us,
  influences our SE
• ?? SE as a part of SC, or self schemata, to
  explain link to health behavior (intentions
  actions)

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Appraisal of others opinions SE SE
health behavior
How could these ideas affect practice interventio
ns?
Person Health Nursing Environment Self competence
SE
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Theory, Practice ResearchMcEwen Wills (2002)
Theoretical Basis for Nsg

• Theory (T) is grounded in practice (P), modified
  in research (R), applied in practice
• T influences P by identifying clinical problems
  guiding actions
• Evidence-based P based on application of R
  findings, not tradition belief
• How are you using T and R in your P?