Understanding Patient Care: Cultural Sensitivity, Nursing Theories, & Healthcare Economics, Slides of Nursing

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Bonnie M. Wivell, MS, RN, CNS

Chapter 13: Nursing Theory: The

Basis for Professional Nursing

Nursing Theory

 Latin “a viewing”; Greek “contemplating”

 A body of knowledge shaped by how nurses see

the world

 A group of related concepts, definitions &

statements that propose a view of nursing

phenomena from which to describe, explain or

predict outcomes

 Abstract ideas

Theory Guides the Professional

Nurse in….

 Organizing and analyzing patient data

 Understanding connections between pieces of data

 Discriminating between important and less pertinent

data

 Making sound clinical judgments based on evidence

 Planning effective nursing interventions

 Predicting and evaluating outcomes of interventions

Definition of Terms

 Metaparadigm = the major concepts or abstract ideas of the discipline; most important to practice and research  Person  Environment  Health  Nursing

 Philosophy = a set of beliefs about the nature of how things work and how the world should be viewed; begins to put together some or all concepts of the metaparadigm

Florence Nightingale

 Notes on Nursing:What It Is andWhat It Is Not (1969, originally published in 1859)  Her philosophy of health, illness, and the nurse’s role in caring for patients

 Focused on the relationship of patients to their surroundings

 Importance of observing the patient and recording information

 Importance of cleanliness

 Health and recovery from illness is related to environment

Virginia Henderson

 The “Unique function of he nurse… is to assist the

individual, sick or well, in the performance of those

activities contributing to health or its recovery (or a

peaceful death) that he would perform unaided if he

had the necessary strength, will or knowledge.”

 Nurse’s role = substitute for the patient, a helper to

the patient or a partner with the patient

 14 basic needs of the patient (see Box 13-3 on pg.

Watson Continued

 Proposed that nursing be concerned with spiritual matters and the inner knowledge of nurse and patient as they participate together in the transpersonal caring process  Nurses share their genuine self  Patient’s spiritual strength is recognized, supported, encouraged  RN encourages openness to understanding of self and others  Leads to trusting, accepting relationships where feelings are shared and confidence is inspired

Dorothea Orem

 Concept of self-care

 “Ordinary people in contemporary society want to be in control of their lives.”

 Patient’s baseline ability to provide adequate self-care is assessed

 Systems of care  Wholly compensatory  Partially compensatory  Supportive-educative

Sister Callista Roy

 Introduction of Nursing: An Adaptation Model (second edition

 Individual as a biopsychosocial adaptive system

 Nursing is a humanistic discipline that emphasizes the person’s adaptive and coping abilities

 The environment can be manipulated by the RN to further patient’s adaptation

Hildegard Peplau

 Interpersonal Relations in Nursing (1952 & 1988)

 Relationship between patient and nurse is the focus of attention

 Therapeutic interpersonal relationship

 Survival of the patient  Patient’s understand his or her health problems and learn from them as they develop new behavior patterns

 6 roles of the nurse: counselor, resource, teacher, technical expert, surrogate, and leader

Madeleine Leininger

 Theory of cultural care

 Founder of Transcultural nursing

 Patients viewed in the context of their cultures

 Nursing care should be culturally congruent

 “Sunrise Model” (Figure 13-2, pg. 317) guides the

assessment of cultural data for an understanding of

its influence on the patient’s life

Theory-Based Education

 PhD: a research degree that generates new, discipline- specific knowledge

 Master’s: use theoretical perspectives focused on the patient for specific nursing outcomes; base practice on evidence from research & experience

 BSN: introduced to research process & the use of theory to guide it

 ADN: find middle range theories useful as they are specific to patient care

Benefits

 Explain practice to others

 Passes on knowledge to students

 Contributes to professional autonomy

 Develops analytical skills, challenges thinking,

and clarifies your values and assumptions

Theory-Based Research

 Great strides have been made in the last 25 years in nursing research

 Nursing research tests and refines the knowledge base of nursing

 Research findings enable nurses to improve the quality of care and understand how evidence-based nursing influences patient outcomes

 Research is vital to the future of nursing and theory is integral to research