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This document provides an overview of philosophy, science, and theory as it relates to nursing. It discusses nursing as both a profession and academic discipline. Key aspects covered include:
- Nursing's metaparadigm concepts of person, environment, health, and nursing.
- Types of nursing theories from practice to grand theories and their scopes.
- Stages of nursing theory development from silent to constructed knowledge.
- Ways of knowing in nursing including empirics, esthetics, ethics, and personal knowledge.
- The relationship between nursing philosophy, science, and philosophy of science.
This document provides an overview of philosophy, science, and theory as it relates to nursing. It discusses nursing as both a profession and academic discipline. Key aspects covered include:
- Nursing's metaparadigm concepts of person, environment, health, and nursing.
- Types of nursing theories from practice to grand theories and their scopes.
- Stages of nursing theory development from silent to constructed knowledge.
- Ways of knowing in nursing including empirics, esthetics, ethics, and personal knowledge.
- The relationship between nursing philosophy, science, and philosophy of science.
This document provides an overview of philosophy, science, and theory as it relates to nursing. It discusses nursing as both a profession and academic discipline. Key aspects covered include:
- Nursing's metaparadigm concepts of person, environment, health, and nursing.
- Types of nursing theories from practice to grand theories and their scopes.
- Stages of nursing theory development from silent to constructed knowledge.
- Ways of knowing in nursing including empirics, esthetics, ethics, and personal knowledge.
- The relationship between nursing philosophy, science, and philosophy of science.
Dr. Helen Hodges Sometimes all that is possible is to embrace the mystery, the unknown, of a situation and allow it to be beyond reach or understanding for a while (Porter-OGrady & Malloch, 2007, p.425).
Philosophy? Nursing Theory? ARGGHHHH. Right? Nursing as profession & academic discipline What differentiates a profession from an occupation?
Defined knowledge base Power & authority over training & education Registration Altruistic service Code of ethics Lengthy socialization Autonomy, and accountable to public
Nursing as a profession & academic discipline What distinguishes one academic discipline from another?
Structure and tradition, ie delineation Language Worldview, ie philosophy Professional disciplines practical; research is prescriptive and descriptive Methods of knowledge development Is nursing a science? Science is logical, systematic, & coherent way to solve problems and answer questions Pure or basic (aka bench science) Natural, human, or social Applied or practical What are the concerns of Philosophy Philosophy studies concepts that structure thought processes, foundations, and presumptions Nature of existence Morality Knowledge and reason Human purpose From what philosophers is nursing generally drawn? Upon what philosophers is nursing based? Descartes & Spinoza (1600s) rationalists: reason is superior to experience as a source for knowledge through deduction and mathematics Bacon (1600) empiricist: experimentation and scientific method Kant (1700) knowledge is relative; mind is active in knowing What is philosophy of science and predominant schools of thought? Received View: rationalism positivism empiricism: Observation, testing, verification, explain, predict, mathematical, deduction, parts of the whole. Logical Positivism dominant philosophy of science until 1950s Perceived View: (aka interpretive view) phenomenology, human science, experience, context, holism, understanding meaning, patterns; feminism, critical theory (influence of gender, culture, society, & power) How are nursing philosophy, science, and philosophy of science related? Nursing philosophy: foundational and universal assumptions, belief system & principles of the profession; Epistemology (nature of knowledge); Ontology (nature of existence)
Nursing science: discipline-specific knowledge of relationships of human responses in health and illness How are nursing philosophy, science, and philosophy of science related? Philosophy of Science of Nursing establishes the meaning of science
Scientific knowledge is transformed into nursing knowledge though contexts of nursing practice (Reed, 2000/2009, p.100) Ways of knowing Carpers patterns of knowing (1978) Empirics Esthetics Personal knowledge Ethics
Schultz and Meleis (1988): Clinical, conceptual, empirical Human science knowledge understood in context Wilhelm Dilthey (1833-1911) concepts, methods, theories fundamentally different from natural sciences Interpretation of phenomena Embrace subjectivity Understand the nature of experience Holistic approach
Early Views on Nursing Theory Confusing, of no practical value, too theoretical
Confusion over terms: conceptual framework, conceptual model, and theory
Levels, testing, analysis, one theory or many?
In the early days, theory was expected to be obscure. If it was clearly understandable, it wasnt considered a very good theory (Levine, 1995, p11).
So Why Theory? Why Now? In the 20 th century the focus of work was on performing the right processes. In the 21 st
century the focus is on obtaining the right outcomes (Porter-OGrady & Malloch, 2007, p. 4).
Benefits of theory based practice Structure & organization
Systematic, purposeful approach
Focused practice coordinated and less fragmented care,
Goals & outcomes identifiable and traceable.
Define and Differentiate Conceptual models or conceptual frameworks Propositions Theory Assumptions Purpose Indications for use
Stages of Nursing Theory Development Silent Knowledge Received Knowledge Subjective Knowledge Procedural Knowledge Constructed Knowledge
(Note: From Kidd & Morrison, 1988 who adapted language from seminal work of Belenky, Clinchy, Goldberger, & Tarules Womens Ways of Knowing from the early 80s. The 80s were an active period of womens studies and research about differences between men and womens ways of being in the world)
Scope* of Nursing Metatheory Most abstract Philosophical world views Philosophy of nursing Critical theory Feminist theory *Refers to complexity and degree of abstraction Scope* of Nursing Grand Theories
Complex and broad, as well as abstract Non specific Not immediately applicable or testable without further definitions Eg. Orem, Roy, Rogers
Scope* of Middle Range Nursing Theories
Middle Range theories
Less abstract Focus on a particular phenomenon Eg social support, quality of life, hope, anxiety; death and dying Scope* of Practice Nursing Theories
Specific directions for practice Specific phenomenon with specific population or field of practice Eg theory of departure in college students; Eg Death and Bereavement in Teens Fewest concepts Prescribe or guide practice Factor-isolating theories Descriptive, names concepts and dimensions Tested by descriptive research Describes what is May include models that illustrate an experience, culture, or process Factor-relating theories Attempts to explain how or why concepts related Eg smoking and fetal size Helping and lifespan in a nursing home Statistical correlation research
How do factor-relating theories differ from factor isolating theories? Situation-relating theories Predictive of future outcomes. If this, then that Eg smoking and fetal size Helping and lifespan in a nursing home Cause and effect, empirical testing
Situation-producing theories Prescriptive for future outcomes and defined goals. Smoking cessation and improved birth weight Cocaine abuse and fetal addiction
Prescribe directed interventions and consequences of interventions
Propositions call for change among specific patient groups and conditions
Nursings Metaparadigm Paradigm: A boundary structure which consists of items or phenomena for investigation for a given disciplinary perspective (Kim, 2009/1989, p.43).
A Metaparadigm is a gestalt or total world view within a discipline the broadest consensus within the discipline of the general parameters (Hardy, 2009/1978, (cited in Reed & Shearer, p.531) What are the main concepts in Nursing's metaparadigm? Thomas Kuhn (1970) The Structure of Scientific Revolutions
Paradigm 1 Normal ScienceAnomaliesCrisisRevolutionParadigm 2
Stages of Nursing Theory Development Silent Knowledge growth of hospital training programs w/ apprenticeship model of learning Received Knowledge focus on nursing education in universities; RN shortage, graduate nursing education; social, biologic, medical theory Subjective Knowledge Peplau (1952); philosophers Dickoff, James, Wiedenback; Nsg on nursing; functional nursing; Abdellah, Orlando, Henderson reflections on experience Procedural Knowledge (separate; connected) focus on separate eg. theory development approaches, methodology, statistical analysis; less on application Constructed Knowledge integration & building on previous studies, pt. experience, literature, etc
Hubungan Antara Tingkat Pengetahuan Dan Sikap Ibu Dalam Pencegahan Ispa Dengan Kejadian Ispa Pada Anak Balita Di Desa Pucangan Wilayah Kerja Puskesmas Kartasura I