The world of health care changes on a daily basis. Client needs and problems often change on a minute-by-minute ba- sis. Knowledge, information, and technology in both health care and nursing are growing at unprecedented rates. In the face of these advances, nursing strives to preservethe notion of caringin health care. Theories are needed to organize knowl- edge and to guide nursing practice and nursing research.
Nurses encounter a variety of clinical situations in which application of nursing theory is needed. The nursing process has been integrated into many nursing frameworks and theories. In these occurrences, nurses may discover that specific theories will be more appropriate for certain clinical situations than others. Knowledge of specific theories should expand as nurses gain experience in nursing practice. In all cases, theories that are selected for application in practice should be congruent with the nurse’s own beliefs and val- ues. Parse (1998, p. 74) defines research as ‘‘the formal process of seeking knowledge and understanding through use of rigorous methodologies.’’ Nursing frameworks and theories have provided numerous research instruments to measures constructs operationally defined to provide consis- tency with the particular framework or theory; such instru- mentation is essential to advanced nursing knowledge (Barrett, 2002). Advances have been made in the develop- ment of unique research methodologies such as Carboni’s Rogerian process of inquiry; Leininger’s ethnonursing
research method; Newman’s praxis method; and Parse’s method of basic research.
Current emphasis has shifted from developing new theo- ries to applying existing theories to practice and expanding existing nursing theories by including such concepts as cultural diversity, spirituality, family, and social change. For example,
Mendyka and Bloom have expanded King’s model by adding a cultural perspective. According to Catalano (2006), the theo- ries that are flexible and adaptable to new discoveries while being realistic and usable in practice will continue to thrive and remain the cornerstones of professional nursing; those theo- ries that are too theoretical or rigid will gradually disappear.
KEY CONCEPTS
• Concepts are abstract vehicles of thought and are the building blocks of theory.
• Propositions are relational statements that link con- cepts together.
• Theories help to show how things fit together. The function of theory is to provide a framework for explain- ing, predicting, and sometimes controlling situations.
• Nursing uses theories from other disciplines in con- junction with nursing theory.
• The development, use, and testing of nursing theory are necessary for the professionalization of the disci- pline of nursing.
• The relationship between nursing theory, practice, and research is an interdependent one. As a practice-oriented discipline, nursing theory and research inform and transform nursing practice.
• Theories range in scope from grand theories to middle-range theories to micro-range theories.
• The metaparadigm names the phenomena of con- cern to a discipline and distinguishes one discipline from another.
• The currently accepted metaparadigm concepts in nursing are person, environment, health, and nursing.
• The metaparadigm may be composed of more than one paradigm. Parse purports that there are two paradigms in nursing: the totality paradigm and the simultaneity paradigm.
• Early nursing theorists were attempting to answer questions related to the ‘‘what’’ and ‘‘how’’ of nursing.
• The theories developed by Levine, Orem, and Roy are useful in guiding nursing practice.
• A new worldview of nursing is emerging in the work of such theorists as Watson, Rogers, and Parse.
REVIEW QUESTIONS
1. Nursing’s metaparadigm includes:
a. Concepts, theory, health, and environment b. Health, person, environment, and nursing c. Providers, standards, models, and clients d. The person, environment, health, and nursing 2. ‘‘An organized, coherent set of concepts and their
relationship to each other that is proposed to explain a given phenomenon’’ best defines which of the following?
a. A concept b. A proposition c. A theory d. A discipline
3. Which theories are examples of the totality para- digm? Select all that apply.
a. Martha Rogers b. Rosemarie Parse
c. Sr. Callista Roy d. Dorothea Orem e. Jean Watson f. Madeleine Leininger
4. A caring, cultural being best defines ‘‘person’’ by which theorist?
a. King b. Leininger c. Neuman d. Watson
5. Why are nursing theories needed? Select all that apply.
a. To organize knowledge b. To guide nursing practice c. To promote nursing diagnosis d. To guide nursing research e. To develop a language for nurses f. To define professional nursing practice
online companion
Visit the DeLaune and Ladner online companion resource atwww.delmar.cengage.comfor additional content and study aids. Click on Online Companions, then select the Nursing discipline.
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—JOHNLECARRE
CHAPTER 3
Research and Evidence-Based Practice
COMPETENCIES
1. Explain the basis for research and knowledge development in nursing.
2. Describe the steps in the research process.
3. Explain the responsibilities of the researcher in guarding the rights of research participants and others who assist in the research study.
4. Identify the various applications of nursing research in nursing practice.
5. Describe how evidence-based practice is used to guide clinical decision making.
6. Describe the key elements of evidence reports.
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