Theoretical Foundations of Practice

Discussion Questions and Comments

Question 1:

Nightingale’s focus is on the environment, as she believed that nature in collaboration with nursing presented a perfect avenue through which a patient could get better. Johnson’s theory is based on the behavioral systems of people and how they affect balance in a person’s life. According to her, nursing only comes into play when there is imbalance in a person’s sub-systems. Orem bases her theory on self-care, which can be defined as a set of activities that a person performs to maintain health. Nursing helps a person perform these activities when they lose their ability to do so. In Roy’s theory, a person has the ability to adapt to whatever changes happen in their life. Additionally, a nurse must help them adapt adequately to these changes. Leininger’s theory is based on the transcultural model of nursing, which incorporates culture and beliefs into the different methods for provision of care. In Neuman’s theory, a person is like a system, which is made up of different parts. Therefore, in providing nursing care, a nurse must focus on all aspects of the system. Most importantly, she focuses on understanding how stress affects a person’s health. Rogers’ defines her theory based on the relationship that exists between man and the environment. This theory implies that there exists energy fields that create waves and defines a person’s stet of health.

Watson emphasizes the role of nursing in her model of caring. Just like Nightingale, she recognizes the environment as an important part of the healing process.

Reference:

McKenna, H. P. (1997). Nursing theories: Essentials for Nurses Series. New York, NY: Routledge.

Question 2:

            There are several factors, which influenced the theorists in their development of models to explain the components of the metaparadigms. First, the period in which a person lived in largely influenced their decisions and what kind of models they came up with. This is because there were different issues that affected people during different years. A theorist had to come up with a model that would fit the problems of the particular period effectively. The example of Florence Nightingale is most applicable in this case. Through her experiences in time of war, she realized that having a clean environment was the key driving factor in keeping people healthy. Additionally, the theorists were also influenced by knowledge and research that existed during their times. With the advent in easier ways to conduct research, theorists also advanced in whatever models they came up with.

Reference:

Blais, K. (2006). Professional nursing practice: Concepts and perspectives. Upper Saddle River, NJ: Pearson/Prentice Hall.

Comment #1:

First, I agree with the first comment that the theorists have slightly different views in defining their models. The emphasis that Nightingale put on the importance of the environment is also evident in this comment. Additionally, the basis of Johnson’s theory is on how imbalance relates to a patient’s health. The concept of self-care as defined by Orem is also evident as she emphasizes how a nurse should help patients in providing self-care. However, in Neuman’s theory, it is important for the writer to note the how she emphasizes the definition of the body as a system.

Reference:

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. The Journal of Nursing Scholarship, 16, 84-87.

Comment #2:

In the second comment, it is notable that the writer recognizes the role of the patient in all the theories. Each theorist comes up with their own way of incorporating the patient into their models. As noted in this response, the nurse also plays an important role in the models. However, I disagree with the response in saying that Johnson’s theory was based on the environment. It is important to note that Johnson did not define the environment and based her theory on human behavioral systems. I agree with the writer’s description of Roger and Watson’s theories.

Reference:

Kim, H. S. (1983). The nature of theoretical thinking in nursing. Norwalk, CT: Appleton-Century Crofts.

Comment #3:

First, it is important to acknowledge the arrangement of the work, which makes it easier to read. The division of the work into the four components of the metaparadigm is also an important part of this response as each theorist had something to say on these components. One of the most notable responses is that on Leininger who based her theory on the multicultural model. As seen in this response, Leininger insisted on the totality of the nursing process where the cultural aspect had to be included. Additionally, in Neuman’s theory, a human being is viewed as a system with different parts.

Reference:

Rodgers, S. (2000). The role of nursing theory in standards of practice: A Canadian perspective. Nursing Science Quarterly, 13, 177.  

Comment #4:

This response has also divided each model according to what the theorists had to say about each component. As seen in all other responses, Nightingale emphasized the role of the environment in the healing process. It is important to understand that the environment involves anything, which is external to the patient’s body. This sometimes even involves the spiritual and cultural beliefs of the patient. It is also evident that Johnson emphasized the physical outlook of a person more than the inward aspects. Additionally, Orem emphasized self-care and nurses only acted as facilitators of self-care provision.

Reference:

Meleis, A. I. (1997). Theoretical nursing: Development and progress. Philadelphia, PA: Lippincott.

Comment #5:

This response has analyzed the different components that each theorist focused on in their models. For example, the response analyzes Nightingale’s perspective on the environment, health and person. This means that Nightingale focused on analyzing the relationships that existed between these components. Additionally, the response notes that Nightingale viewed nursing as a calling whereby a person could not be successful in this career if they did no have this calling. The response also notes that Neuman’s focus was on the nurses’ role as health coordinators. It is also important to add that nurses were required to facilitate a patient’s well being in all aspects of life.

Reference:

Kim, H. S., & Kollak, I. (2006). Nursing theories: Conceptual & philosophical foundations. New York, NY: Springer Pub. Co

Comment #6:

As seen in the other responses, this one also explains how the different theorists perceived the components of the metaparadigm. I agree with the writer that Roy based her theory on the adaptation of stimuli. As seen in explanations given above, Roy explained that human beings have the ability to adapt to whatever changes that occur in their lives. Illness is a change that occurs in the health sector of a human being. Additionally, it is also important to note that Watson based her model on caring. Through caring, nurses would be able to enhance the healing process of their patients.

Reference:

Tiffany, C. R., & Lutjens, L. R. J. (1998). Planned change theories for nursing: Review, analysis, and implications. Thousand Oaks, CA: Sage.

Comment #7:

I agree with this response as it gives some of the most important factors that affected how theorists came up with models. As seen from the explanation of theories, theorists from different eras had differing approaches to the components of the metaparadigm. The historical period within which a person lived greatly influenced her views on the nursing practice. Additionally, the scientific knowledge that a person had, also influenced a theorist’s way of thinking as they searched for ways to improve patients’ lives. Other factors included past experiences, successes and availability of research material.

Reference:

George, J. B. (2002). Nursing theories: The base for professional nursing practice. Upper Saddle River, N.J: Prentice-Hall

Comment #8:

            Whatever a person experiences changes how she or he perceives life in different areas. The nursing theorists are no different as they were majorly affected by their experiences in life. I agree with this response in that whatever the theorists experienced in their nursing careers influenced the kind of models they came up with. Additionally, the educational background also influenced their views. As seen in the example given, Jean Watson had a rich educational back, which influenced the development of the caring theory. Additionally, Neuman’s teaching experiences also influenced the development of her theory.

Reference:

Peterson, S. J., & Bredow, T. S. (2009). Middle range theories: Application to nursing research. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins