Chapter 2 : Nursing Theories and Research
Topics covered in this snack-sized chapter:
Theories are a set of interrelated concepts that give a systematic view of a phenomenon that is explanatory and predictive in nature
Nursing research is the term used to describe the evidence used to support nursing practice
Research is needed:
- To evaluate the effectiveness of nursing treatment modalities
- To determine the impact of nursing care on the health of the patients
Following are the purposes of theory in research:
- To identify meaningful and relevant areas for study
- To propose plausible approaches to health problems
- To develop or refine theories
- To define the concepts and proposed relationships between concepts
- To interpret research findings
- To develop clinical practice protocols
- To generate nursing diagnosis
Four common concepts common in nursing theory that influence and determine nursing practice are:
- Individual, family, or community
- All internal and external conditions, circumstances, and influences affecting the person
- Degree of wellness or illness experienced by the person
- Nursing: Actions, characteristics and attributes of person giving care
Nursing theory
is the term given to the body of knowledge that is used to support nursing practice
Following are the important nursing theories:
- Florence Nightingale’s Environmental Theory
- Hildegard Peplau’s Theory of Interpersonal Relations
- Dorothy E.Johnson’s Behavioral system model
The theory focuses on nursing and the patient environment relationship
It focuses on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act
Florence identified five environmental factors:
- Cleanliness and sanitation
Deficiency in these factors produce illness or lack of health, but with a nurturing environment, the body could repair itself
Hildegard Peplau’s Theory of Interpersonal Relations arrow_upward
Nursing is a maturing force and an educative instrument
The theory stressed the importance of nurses’ ability to understand own behavior to help others identify perceived difficulties
The four phases of nurse-patient relationships are:
This is a problem defining phase
Person seeks professional assistance from the nurse
Selection of appropriate professional assistance
Patient begins to have a feeling of belonging and a capability of dealing with the problem which decreases the feeling of helplessness and hopelessness
The nurse uses communication tools to offer the service to the patient
Nurse aids the patient in exploiting all avenues of help and progress is made
towards the final step
Termination of professional relationship
The patients’ needs have already been met by the collaborative effect of
patient and nurse
According to the theory, Individuals maintain stability and balance through adjustments and adaptation to the forces that impinges them
Johnson’s work focused on the person as well as nursing
She identified the person as a system with:
- Four structural characteristics (assumptions)
- Three functional requirements
When one or more of the subsystems is in disequilibrium, the person reacts in a patterned, purposeful, repetitive ways
Nursing research is defined as the application of scientific inquiry to the phenomena of concern to nursing
Scientific research is a systematic and objective attempt to provide answers to certain questions
Nursing research falls largely into two areas:
This type of research focuses upon outcomes for clients that are measurable, generally using statistics
The research examines the experience of those receiving or delivering the nursing care, focusing, in particular, on the meaning that it holds for the individual
Evidence Based Practice, is the use of the best clinical evidence in making patient care decisions and such evidence typically comes from research
Evidence based Practice helps in integrating individual clinical expertise with the best available external clinical evidence from systematic research
Evidence based Practice should give the clinician the tools to help her enhance clinical effectiveness and affect the delivery of healthcare
Following steps should be followed to perform EBP:
- Forming a clinical question
- Searching for the Evidence
- Critically appraise the evidence
- Implementing the Evidence