Nursing Theory

Theresa Tarrant, PhD, RN

Terminology
Concepts
Propositions
Metaparadigm
Philosophy
Conceptual Models
Theories
Empirical Indicators
What separates nursing knowledge
from that of other healthcare
disciplines?
HOLARCHY
(hierarchy)
Components of nursing knowledge

Based on level of abstraction
Metaparadigm Most Abstract
Philosophy
Conceptual model
Theory
Empirical indicators Most Concrete
Concepts
Word or phrase that summarizes ideas, observations or
experiences.

A word that creates mental images

I.e. bicycle or
Graduation

Building blocks of theory


Propositions
Statement about a concept or the relationship
between one or more concepts.

Non relational proposition describes or defines
a concept
Vacations are fun!
Relational proposition asserts there is a
relationship.
Parents teach their children how to ride bicycles

Paradigm
Thomas Kuhn
set of practices that define a scientific discipline at any
particular time period of time. Thomas Kuhn (1962)
accepted model of or pattern. (1970)
what the members of a scientific community, and they alone
share. (1977)
Paradigm

The functions of a paradigm are to supply puzzles for scientists
to solve and to provide the tools for their solution.
A crisis in science arises when confidence is lost in the ability
of the paradigm to solve particularly worrying puzzles called
anomalies.
Crisis is followed by a scientific revolution if the existing
paradigm is superseded by a rival.

Metaparadigm
Statement or group of statements identifying its
relevant phenomena (Fawcett, 1984)
Most abstract
Concise
Global concepts that define the areas of central
issue of discipline

map that guides the discipline (Hardy, 1978)

Brings unity to a discipline
Encourages communication
Metaparadigm
Four functions
1. Identify a domain distinctive from domain of other
disciplines
2. Encompass all phenomena of interest to the discipline
3. Perspective Neutral
4. International in scope and substance
Metaparadigm of Nursing
Nursing
Human beings (Person, patient, man)
Environment
Health
Philosophy
Statement encompassing ontological claims
about the phenomena of central interest to a
discipline
Statements of beliefs and values

Directed at discovery of knowledge
Identify what is important and valuable to nurses
Communicate what the members of the
discipline know to be true in relation to the
phenomena of interest to that discipline.
Philosophy
What is believed about nursing, human beings, environment
and health
Conceptual Models
Set of relatively abstract and general concepts that address
the phenomena of central interest to a discipline , proposition
that broadly describe those concepts, and the propositions
that state relatively abstract and general relations between
two or more concepts.
Conceptual Models
A distinctive frame of reference
Alternative ways of how to observe and interpret phenomena
Certain aspects of phenomena are emphasized other maybe
ignored

Some models focus more on one or more of the
metaparadigm concepts.
Theory
One or more relatively concrete and specific concepts that
are derived from a conceptual model , the propositions that
narrowly describe these concepts and the propositions that
state relatively concrete, and specific relations between two
or more of the concepts
Levels of Theories
Grand - broad

Middle Range more concrete and narrower.
Addresses more concrete and specific phenomena
Describes, explains, or predicts

Prescriptive theory most narrow provides specific
direction

Unique vs. borrowed
Empirical Indicator
An actual instrument, experiential condition, or procedure
that is used to observe or measure a middle range theory
concept.

Used to generate or test a middle range theory

Approaches to Theory Building
Derivation shift or redefining a concept used in one field to
another field .

Synthesis: combining isolated bits of information gathered
through observation to construct a new concept.

Analysis : Clarify or redesign by dissecting a whole into its
component parts to enhance understanding .
Concept Analysis
Taking a concept normally used in nursing:
Analyze so it is clearly defined
Identifies what makes them unique from other concepts

What is true about the concept today.
Examine the basic element of the concept
Eliminating ambiguity
Developing standardized language and empirical indicators for
the concept
Steps of Concept Analysis
Select a concept
Determine the Aims or purposes
Identify all the use f the concept you can discover
Determine defining attributes
Identify a case model
Identify borderline, related, contrary , invented and
illegitimate cases
Identify ancedents and consequences
Define empirical referents.
Categories of Knowledge
From Other Disciplines:

Developmental
psychology

Systems
Biology and physics

Interaction
Sociology


Nursing Categories of
Knowledge

Nursing Categories of Knowledge
Needs and outcomes
Client focused
Person focused
Nursing therapeutics focused
Energy fields
Conservation
Substance support
Enhancement