Theoretical Foundations of Nursing Essay
Theoretical Foundations of Nursing
The selected middle range theory is the theory of comfort. Katharine Kolcaba came up with the theory in 1991 and it is applied in education, research, and clinical research. According to the theory, comfort is the most important aspect of care provision (Krinsky et al., 2014). Holistic care provision promotes comfort for the patient. The basic concepts of the theory of comfort include healthcare needs; intervening variables; nursing interventions; health seeking behaviors; patient comfort and integrity. According to this theory, holistic nursing care should bring patient comfort in the form of relief from a health condition. For instance, meeting the needs of patients comforts the patient by bringing them a sense of relief. For example, when a patient experiencing pain is given a pain reliever, the patient gets comfort by having the pain relieved (Khan, 2017).
The assumptions in the theory of comfort include that all four metaparadigms (person, nursing, health, and environment) affect the patient; the nurse provides care to ensure patient comfort; the environment influences the patient’s comfort or discomfort; nursing interventions aim to promote comfort and ensure that the patients’ comfort needs are met; intervening variables include anything affecting patient outcomes; while patient comfort is defined as the condition of having all the patient needs met physically, socially, emotionally, and in terms of the environment (Khan, 2017).
The theory of comfort emphasizes that individuals have holistic responses to stimuli and comfort is the essential holistic outcome during care provision. Individuals strive to have their needs met and thus meeting the comfort needs of patients strengthens and provides the necessary support to the patients. Theoretical Foundations of Nursing Essay
References
Krinsky, R., Murillo, I., & Johnson, J. (2014). A practical application of Katharine Kolcaba’s comfort theory to cardiac patients. Applied Nursing Research, 27(2), 147-150.
Khan, A. A. (2017). Application of Katharine Kolkaba’s comfort theory to nursing care of patients. Int. J. Sci. Res. Publ, 7, 104-107.
Introduction
Theory description is the initial step in the evaluation process. In theory description, the works of a theorist are reviewed, with a focus on the historical context of the theory. In addition, related works by others are examined to gain a clear understanding of the structural and functional components of the theory. The structural components include assumptions, concepts, and propositions. The functional components consist of the concepts of the theory and how they are used to describe, explain, predict, or control.
The purpose of this module is to explore the components of theory description: purpose, concepts, definitions, relationships, assumptions, and structure. In addition, the components for constructing the description of theory will be investigated.
These topics are designed to direct your readings, assist you in the development of assignments, and prepare you for module discussions.
Outcomes
Upon completion of the module, students will be able to:
- discuss the process for describing theory.
- identify criteria for evaluating theories for their scientific value and potential utilization in nursing practice, education, and research.
- critique theories to evaluate paradigmatic origins applied to nursing as a discipline.
- apply selected criteria in the evaluation of a nursing theoretical formulation.
Topics Index
The following topics are covered in this module:
- Theory Description
- What is the Purpose?
- What are the Concepts?
- What are the Relationships?
- What is the Structure?
- What are Assumptions?
These topics are designed to direct your readings, assist you in the development of assignments, and prepare you for module discussions.
- Theory Description
Theory evaluation has been defined as the process of systematically examining a theory. Criteria for this process are variable, but they generally include examination of the theory’s origins, meaning, logical adequacy, usefulness, generalizability, and testability. Theory evaluation does not generate new information outside the confines of the theory, but it often leads to new insights about the theory being examined.
Theory evaluation identifies a theory’s degree of usefulness to guide practice, research, education, and administration. Such evaluation gives insight into relationships among concepts and their linkages to each other, and allows the reviewer to determine the strengths and weaknesses of a theory. It also assists in identifying the need for additional theory development or refinement. Finally, theory evaluation provides a systematic, objective way of examining a theory that may lead to new insights and new formulations that will add to the body of practice or research. The ultimate goal of theory evaluation is to determine the potential contribution of the theory to scientific knowledge.
In nursing practice, theory evaluation may provide a clinician with additional knowledge about the soundness of the theory. It also helps identify which theoretical relationships are supported by research, provides guidelines for the choice of appropriate interventions, and gives some indication of their efficacy. In research, theory evaluation helps clarify the form and structure of a theory for use as a conceptual framework. Evaluation will also identify inconsistencies and gaps in theory used in practice or research. Theoretical Foundations of Nursing Essay
Various methods have been utilized to assist with the process of theory evaluation. These methods use several overlapping terms, or terms that are used in different ways by different authors. For example,theory analysis, theory description, theory evaluation, and theory critique all describe the process of critically reviewing a theory to assess its relevance and applicability to nursing practice, research, education, and administration. In this module, theory description is used as a global term to discuss the process of reviewing theory.
Chinn and Kramer use the terms theory description and critical reflection to describe a two-phase process. Theory description has six components: purpose, concepts, definitions, relationships, structure, and assumptions. Describing theory involves a process of posing questions about these components and responding to the questions with one’s own interpretation of the theory. Exemplars for each topic are based on Eakes, Burke, and Hainsworth’s Middle-range Theory of Chronic Sorrow.
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- What is the Purpose?
This question helps identify why this theory was formulated and the overall purpose of the theory. The purpose of the theory should be stated explicitly or at least be identifiable in the text of the theory. In addition to identifying the purpose of the theory, one needs to ask if the purpose reflects understanding and creation of meaning. Does the purpose describe, explain, and predict a phenomenon? When would the theory no longer be applicable?
For example, the purpose of Eakes et al. theory of chronic sorrow is “to explain the experiences of people across the life span who encounter ongoing disparity because of significant loss” (Eakes et al., 1998, p. 179). In addition, the theorists provide the origins of the theory to facilitate understanding of the purpose and create meaning. According to Eakes et al., Chronic sorrow appeared in the literature in 1962 to describe recurrent grief experienced by parents of children with disabilities. A number of research projects were conducted in the 1980s and 1990s describing chronic sorrow among various groups with loss situations. The resulting Theory of Chronic Sorrow, therefore, was inductively developed using concept analysis, extensive review of the literature, critical review of research, and validation in 10 qualitative studies of various loss situations.
- What are the Concepts?
This question assists in the identification of the ideas that are structured and related within the theory. The qualitative and quantitative dimensions of concepts are questioned. The concepts of the theory should be linguistically expressed. Begin by listing key ideas and identify how they are related. As important theoretic concepts are identified, ask questions about the characteristics of the concepts and their associations. Is there one major concept with subconcepts? How many concepts are there, how many are major concepts, and how many are minor concepts? Are the concepts related and/or arranged into any configuration? Are the concepts broad or narrow in scope? Do the concepts represent objects, properties, or events?
As an exemplar, Eakes et al. have six major concepts:
- Chronic sorrow
- Loss experience
- Disparity
- Trigger events or milestones
- External management methods
- Internal management methods
By examining how the concepts are defined, the meanings for the concepts within the theory are clarified. Determining how concepts are defined also questions how empiric experiences are represented by ideas within the theory. Meanings of concepts are conveyed in theoretical definitions which give character to the theory.
Which concepts are defined and which are not? Are they explicitly defined or implied? Are there competing definitions for some concepts? Are there similar definitions for different concepts?
In the exemplar, Eakes et al. provide theoretical definitions for the major concepts. The definitions are:
Chronic sorrow: the periodic recurrence of permanent, pervasive sadness or other grief-related feelings associated with ongoing disparity resulting from a loss experience.
Loss experience: a significant loss, either actual or symbolic, that may be ongoing, with no predictable end, or a more circumscribed single-loss event.
Disparity: a gap between the current and desired reality as a result of a loss experience.
Trigger events or milestones: a situation, circumstance, or condition that brings the negative disparity resulting from the loss into focus, or exacerbates the disparity.
External management methods: interventions provided by professionals to assist individuals in coping with chronic sorrow.
Internal management methods: positive personal coping strategies used to deal with the periodic episodes of chronic sorrow.
Operational definitions for the major concepts are not provided by the authors.
- What are the Relationships?
Concepts are structured into a systematic form that links each concept with others. Examining the nature of relationships helps to focus on the various forms relationship statements can take, and how they provide structure to the theory. Once the relationship in the theory has been identified, questions need to be asked. Do relationships include all concepts, and if not, which are not included? Are there concepts that are included in multiple relationships? Is there a hierarchy of relationships? Do the relationships create meaning and understanding? If so, do they do this by describing, explaining, or predicting? Are the relationships directional, and if so, what are their directions? Are relationships illustrated?
In the exemplar, Eakes et al., linkages of the major concepts are described in the text and explicated in the following model.
Fig. 16: Middle-range Theory of Chronic Sorrow
- What is the Structure?
Addressing the overall form of the conceptual interrelationships helps discern whether the theory contains partial structures or has one basic form. The relationships are linked to form a whole when the ideas of the theory interconnect. The structure emerges from the relationships of the theory and makes it possible to follow its reasoning.
After identifying the structure of the relationships, other aspects of the structure can be described. “How are other structures united with central or core relationships? Can all relationships be structured? Do the structures take multiple forms? Are competing or partial structures suggested? Does the theorist provide diagrams that illustrate aspects of structure?” (Chinn & Kramer, 2018, p. 199)
In the exemplar, Eakes et al. provides a diagram Fig. 16 that assists in explaining the linkages of the concepts.
- What are the Assumptions?
Chinn and Kramer define assumption as “one of the structural components of theory that is taken for granted or thought to be true without systematically generated empiric evidence. Theoretical assumptions may be value statements or have potential for empiric testing, but are assumed true within the theory because they are reasonable. Therefore, assumptions refer to underlying truths that determine the nature of concepts, definitions, purpose, relationship, and structure. Assumptions may or may not be explicitly stated.
Once the assumptions are determined, the values of the theorist can be explored. Do the assumptions have an obvious value orientation, and if so, what is it? Can the assumptions be factually verified? Do the assumptions have any identifiable relationship to theoretic relationships or structure?
In this exemplar, Eakes et al., diagram Fig. 16 assumptions are not explicitly addressed.
