Fundamentals of Nursing Models, Theories and Practice - Hugh McKenna - E-Book

Fundamentals of Nursing Models, Theories and Practice E-Book

Hugh McKenna

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A concise, accessible introduction to the development, application and evaluation of nursing theories, this new edition of Fundamentals of Nursing Models, Theories & Practice provides a thorough overview of the body of knowledge on the topic, and a clear outline of their relevance to everyday nursing practice. Linking the development of theory to practice, this full-updated text features learning outcomes, key concept summaries and reflective exercises to aid the study of this key element of all modern nursing courses. Special Features * Clearly examines the relationship between nursing theory, clinical practice and nursing roles * Accessible and user-friendly with a range of features to help study, including key concepts, learning objectives and reflective exercises * Useful for all pre-registration nursing students, as well as newly qualified nurses * Accompanied by an online resource centre featuring case studies, multiple choice questions, exercises and activities

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CONTENTS

Cover

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Series page

Title page

Copyright page

About the series

Dedication

Preface

How to use your textbook

Features contained within your textbook

The anytime, anywhere textbook

1 The case for nursing theory

Introduction

The necessity and meaning of theory

Theory defined

Construction of theory

Theory and science of nursing

Other interpretations of theory

Main paradigms and philosophies and their influence on the development of nursing science

Theory and practice of nursing

Do we really need theory?

Nursing theories today

Conclusion

2 Knowing in nursing and nursing knowledge

Introduction

Defining knowing and knowledge

Philosophies of knowledge

How do nurses know?

Developing nursing knowledge

Conclusion

3 Theory from practice and practice from theory

Introduction

First steps – reflecting on theory

The questions begged

Developing nursing theory

Levels of theory

The relationship between theory and practice

The questions begged – some answers

Conclusion

4 Nursing theories and new nursing roles

Introduction

Defining role

Background to the development of new roles in nursing

Some implications of the new nursing roles

Using theory to understand new roles in nursing

Conclusion

Useful web links

5 Nursing theories or nursing models

Introduction

Reasons for historical nursing theory evolution

Model

Theory

Theory or model?

The classification of theories

Current trends in nursing theories

The nursing metaparadigm

Limitations of nursing theories

Benefits of nursing theories

Conclusions

Additional reading

6 Interpersonal relationships

Introduction

Types of interpersonal relationships

Interpersonal theories of nursing

Implications for nurse education

Social capital

Threats to the development of interpersonal relationships in nursing and the use of interpersonal theories

Conclusion

Additional reading

Useful web links

7 How to select a suitable model or theory

Introduction

Selecting an appropriate nursing theory

Potential problems when selecting a nursing theory

Choosing a suitable nursing theory

Nurses’ own philosophy as a basis for selecting a theory

A strategy for choice

Who should select the theory?

Nursing theories or theories developed by another discipline?

Conclusion

Additional reading

Useful web links

8 Research and theory

Introduction

Building theory through research: an inductive approach

Is the link between theory and research strong?

Research in nursing

Theory-generating research (TGR)

Theory-testing research (TTR)

Theory-framed research (TFR)

Theory-evaluating research (TER)

Strategies for theory development through research

Conclusions

Additional reading

Useful web links

9 Criteria for theory description, analysis and evaluation

Introduction

The evaluator of a nursing theory

Significance of the theory

Step 1: Theory description

Origins and logical development of a theory

Step 2: Theory analysis

Concept analysis

Internal and external criteria

Step 3: Theory evaluation

Simplicity and complexity

Importance and significance

Adequacy

Testability

Conclusion

Additional reading

References

Index

Access the companion website

Eula

List of Tables

Chapter 02

Table 2.1 Philosophies of knowledge.

Table 2.2 Types of knowledge.

Table 2.3 Human science: the received view versus the perceived view.

Chapter 05

Table 5.1 Perceived benefits of theories for practice.

Table 5.2 Perceived limitations of theories for practice.

Chapter 06

Table 6.1 How interpersonal theories define nursing and denote the focus, goals and interventions of nursing.

Table 6.2 Phases and roles within Peplau’s theory.

Chapter 08

Table 8.1 Types of propositional statements developed through theory-generating research.

Table 8.2 The relationship between levels of theory and levels of research.

Table 8.3 Relationships between types of theory and research methods.

Table 8.4 Carper’s ways of knowing as related to research approach.

Table 8.5 Developing concepts.

Chapter 09

Table 9.1 Concept analysis.

Table 9.2 Analysis and evaluation of theories by various authors.

Table 9.3 Theory evaluation.

List of Illustrations

Chapter 01

Figure 1.1 The links between theory and practice.

Figure 1.2 Theory as construction.

Figure 1.3 Nightingale theory of nursing.

Figure 1.4 Correlation: education, science and practice.

Figure 1.5 Basic structure of nursing. Reproduced from Pajnkihar M (2003) Theory development for nursing in Slovenia.

PhD thesis

. Manchester: University of Manchester, Faculty of Medicine, Dentistry, Nursing and Pharmacy.

Chapter 02

Figure 2.1 ‘Know that', 'know how' and 'know why' knowledge.

Figure 2.2 Patterns of knowing in nursing (Carper 1978).

Figure 2.3 Ways of knowing (Kerlinger 1986).

Figure 2.4 Hierarchy of evidence (Muir Gray 1997).

Figure 2.5 A proposed new hierarchy of evidence.

Figure 2.6 Developing nursing knowledge.

Chapter 03

Figure 3.1 Categorisations of theory.

Figure 3.2 Levels of theory (Dickoff & James 1968).

Figure 3.3 The utility of theory in nursing.

Figure 3.4 Levels of theory.

Figure 3.5 Levels of theory-abstraction.

Figure 3.6 Classification and examples of ‘grand’ theories (Meleis 2012).

Figure 3.7 Examples of mid-range theories.

Figure 3.8 Propositional theory: from conception to application.

Figure 3.9 The theory–practice relationship.

Figure 3.10 The thing observed.

Chapter 04

Figure 4.1 The ‘practice cross’.

Figure 4.2 Development of advanced nursing roles (Pulcini et al. 2010).

Figure 4.3 Role sets.

Figure 4.4 Classification and examples of nursing ‘grand’ theories (Meleis 2012).

Chapter 05

Figure 5.1 The theory–model controversy: position A.

Figure 5.2 The theory–model controversy: position B.

Chapter 08

Figure 8.1 Examples of propositional diagramming.

Figure 8.2 A typical theory testing process.

Chapter 09

Figure 9.1 Theory description, analysis and evaluation.

Figure 9.2 Difference between inductive and deductive development of theory.

Figure 9.3 Testing theory.

Guide

Cover

Table of Contents

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This title is also available as an e-book. For more details, please seewww.wiley.com/buy/9780470657768or scan this QR code:

SECOND EDITION

Fundamentals ofNursing Models, Theories and Practice

Hugh P. McKenna

CBE, PhD, BSc(Hons), RMN, RGN, RNT, DipN(Lond), AdvDipEd, FFN FRCSI FEANS, FRCN, FAANProfessor and Pro Vice Chancellor, Research and InnovationUniversity of Ulster, UK

Majda Pajnkihar

PhD, RNAssociate Professor, Dean, Senior Research Fellow, Head of Institute of Nursing CareFaculty of Health SciencesUniversity of Maribor, Slovenia

Fiona A. Murphy

PhD, MSc, BN, RGN, NDN, RCNT, PGCE(FE)Associate ProfessorCollege of Human and Health SciencesSwansea University, UK

This edition first published 2014 © John Wiley & Sons, Ltd

Registered OfficeJohn Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Offices350 Main Street, Malden, MA 02148-5020, USA9600 Garsington Road, Oxford, OX4 2DQ, UKThe Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

For details of our global editorial offices, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of Hugh McKenna, Majda Pajnkihar and Fiona Murphy to be identified as the authors of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.

Limit of Liability/Disclaimer of Warranty: While the publisher and authors have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. It is sold on the understanding that the publisher is not engaged in rendering professional services and neither the publisher nor the author shall be liable for damages arising herefrom. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data

McKenna, Hugh P., 1954– author.Fundamentals of nursing models, theories and practice / Hugh P. McKenna, Majda Pajnkihar, Fiona A. Murphy.  p. ; cm. Includes bibliographical references and index.

 ISBN 978-0-470-65776-8 (paperback)I. Pankhihar, Majda, author. II. Murphy, Fiona, author. III. Title. [DNLM: 1. Nursing Theory. 2. Models, Nursing. 3. Nursing Process. WY 86] RT84.5 610.7301–dc23

2014002678

A catalogue record for this book is available from the British Library.

Cover image: Reproduced from iStock © kertlisCover design by Visual Philosophy

About the series

Wiley’s Fundamentals series are a wide-ranging selection of textbooks written to support preregistration nursing and other healthcare students throughout their course. Packed full of useful features such as learning objectives, activities to test knowledge and understanding, and clinical scenarios, the titles are also highly illustrated and fully supported by interactive MCQs, and each one includes access to a Wiley E-Text: powered by VitalSource – an interactive digital version of the book including downloadable text and images and highlighting and note-taking facilities. Accessible on your laptop, mobile phone or tablet device, the Fundamentals series is the most flexible, supportive textbook series available for nursing and healthcare students today.

Dedication

This book is dedicated to all the patients, families and communities with whom we have worked over the years. It is also dedicated to those scholars and students who have shaped our thinking on nursing theories.

In addition, we wish to acknowledge the patience and fortitude of our friends and families, specifically Tricia, Gowain and Saoirse McKenna, Grega and Jasna Pajnkihar, Boris Kac and Phil, Katie and Kieran Murphy. M.P. would also like to thank Dr Verena Tcshudin and Dominika Jakl for their help.

Hugh P. McKennaMajda PajnkiharFiona A. Murphy

Preface

The stimulus for this second edition was the very positive feedback we received for the first edition from nursing students, nurse lecturers and clinical nurses. It helped that the publishers were extremely keen on an updated version being produced. Initially, there was some reluctance on our part because we felt that the first book had dealt with the subject matter very thoroughly. However, on reflection we realised that in the intervening years there had been a growth in discussion and debate about nursing theory. A preface to a later edition of a book should set out to explain in what respects that edition differs from the previous one. There are a number of differences. Fiona Murphy and Majda Pajnkihar have joined the team and they bring with them new insights into how theory can inform nursing practice and research and how this, in turn, improves the quality and safety of patient care. The literature has been updated considerably and we have taken account of developments outside the USA and the UK. In particular, Majda provides information on how nursing theories are being taught and used in Slovenia, Croatia, Russia and Poland. Readers will also find that we have included more exercises. These include key concept boxes, reflective exercises, multiple choice questions, true/false questions, additional reading sources and a number of case studies.

Therefore, for these reasons and many others, we believe that this new edition is a considerable improvement on the previous book. It still takes the reader on a journey, from presenting the case for the use of theory in nursing practice through to considering the extent to which practice influences the development of theory, the definitions of theory and the different types of theory. We illustrate for readers the fact that theory is linked to science and why this is important for the profession of nursing. We spend a considerable amount of time outlining the different ways in which nurses know and the role of research and reasoning in building nursing knowledge.

One of the main movements for the profession worldwide is the emergence of new nursing roles. We show how such roles are linked to theories and we highlight the importance of ‘role theory’. We describe how grand nursing theories have evolved and the importance of mid-range and practice theories for guiding patient care. We unravel the often controversial relationship between nursing theories and nursing models, and examine these terms in detail and compare and contrast them, taking into account their advantages and disadvantages. We show how the biomedical model has influenced nurse education, practice and research over the years, and not always for the benefit of nursing.

We make a case for nursing being mainly about building and sustaining interpersonal relationships with patients, their families and communities. Several nursing theories have their roots in such relationships. We share a number of these with the readers, explaining Hildegard Peplau’s theory in considerable detail. We consider the differences between a normal interpersonal relationship and a therapeutic interpersonal relationship, stressing that practising nurses use both. We also outline the actual and potential barriers to the development of therapeutic interpersonal relationships.

Selecting an unsuitable theory can have a detrimental effect on patient care, and when this happens nurses are often reluctant to admit it and they try to mould the patient’s needs to fit the theory rather than moulding the theory to fit the patient’s needs! Conversely, we believe that a theory that is appropriate for practice will benefit patients and improve the working practices and morale of nurses. Therefore, choosing an appropriate theory to underpin nursing practice or nurse education needs a great deal of thought. We discuss 12 different criteria that can be used to help readers select a nursing theory for practice.

Since the first edition of this book, there has been a great deal written about evidence-based practice. We believe that no reasonable nurse would argue that an important part of every clinical nurse’s role is to ensure their practice is informed by the best available evidence. We show the link between theory and research and best evidence. We discuss how theory is generated by research, tested by research and evaluated by research. We also highlight how theory can help to shape a research study.

Every day in clinical practice, nurses are exposed to phenomena that influence patient care. Sometimes such phenomena are ignored because they seem commonplace or unimportant. We guide the readers through the process of identifying these phenomena, naming them and finding relationships between them. This provides an insight into how readers can construct a nursing theory.

Finally, we highlight how the worth of a theory is ascertained. The characteristics of a good theory are reviewed and these are presented as the basis for evaluating and analysing nursing theory. The particular place of testing a theory is considered, and the relationship between theory evaluation and theory testing is clarified.

We hope you enjoy reading this textbook as much as we have enjoyed writing it. We anticipate that it will open up new and interesting perspectives in your thinking about nursing theories and how they can be used to increase the knowledge base for the profession and enhance clinical practice.

Hugh P. McKennaMajda PajnkiharFiona A. Murphy

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