The theory era began with a strong emphasis on knowledge development. Although in the previous two
decades proponents of nursing theory and nursing theorists had begun to publish their works, it is
noteworthy that they denied being theorists when they were introduced as such at the 1978 Nurse
Ed...
, Nursing Theory
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Theory
The theory era began with a strong emphasis on knowledge development. Although in
the previous two decades proponents of nursing theory and nursing theorists had
begun to publish their works, it is noteworthy that they denied being theorists when
they were introduced as such at the 1978 Nurse Educator Conference in New York
with the Nursing Theory theme. There was understanding among those attending the
conference that the presenters were theorists, and by the second day, the audience
responded to their denials with laughter. This seems strange today, but this was the
first time most of the theorists even met each other. Their works had grown out of
content organization in nursing education courses, nursing practice administration in
large agencies, and structures for the thought and action of practice. It was clear that
their works were nursing theoretical structures even before they recognized them as
such. The theory era, coupled with the research and graduate education eras, led to
understanding of the scientific process beyond production of a scientific product
Theory forms the foundation of knowledge. Nursing theories form the foundation of
nursing practice, research, and education. Throughout your professional life, you will
be applying theory and the knowledge derived from theory in your practice
environment regardless of the setting. An understanding of the nature of nursing
knowledge from a historical perspective will help you relate better to where nursing
theory development is today.
The new millennium has witnessed a rapid change in the global healthcare arena.
This profession is continually evolving to face the monumental changes that have
emerged. In the past, nursing theories were taught strictly from an academic point of
view. Those in practice saw little connection or integration of theory and practice.
However, the contemporary move toward evidence-based practice has seen nursing
professionals applying theory to describe, predict, and prescribe nursing practice.
Relevance to Present and Future
Theories are a reflection of the past, present, and future of nursing.
Understanding the relevance of theories will enhance the relationship of concept
with practice. This will help you comprehend the complex phenomena and
interconnectedness between theory and practice and build a new way of
thinking, understanding, working, and living.
Relevance to Research
Research on theories help in the systematic investigation of the domain of
knowledge. Research acts as a source of knowledge development. Research studies
conducted on nursing theories help highlight the interlinking cyclical connection
between theory and practice. Learners get an idea about the interconnectedness
between real world clinical issues, theory, and actual research.
Early knowledge consisted of loosely connected clusters of concepts. Later
knowledge developed interrelatedstatements connecting the concepts.
Advanced theory provided a knowledge base for intervention strategies that
clusters of concepts could not.
Identification of theory is important to understand the characteristics of
theory structures. A complete theory of nursing identifies the three elements
of context, content, and process; some theorists articulate each element
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better than others.
Context is the environment in which nursing acts occur; the context of a
theory describes the nature of the world of nursing and may describe the
nature of the patient’s world.
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Content includes the subject matter of a theory; this comprises the stable
components that are acted on or that do the acting
Process implies the action part of the theory, the intervention elements.
In addition to these elements, all theories should be examined for certain
common factors: Theories should be based on concepts and propositions
Theories should be specific to the nursing context Theories can be applied
to many situations Theories should be relevant to potential users
Theories should be easy to define it in operational terms
Theories should correspond with empirical findings Theories should demonstrate
internal consistency. Florence Nightingale made the first attempts at theory-based
nursing during the late 19th and early 20th centuries. She organized a group of
women to deliver care under her supervision and that of war surgeons. She
established the need for hygiene, with environmental change as the means to
enhance healing. For her, the nursing domain was the patient and the environment in
which care was offered. Her goals were to expose the unhealthy conditions of soldiers,
to gain support for the need for nurses, and to achieve formal education for nurses.
She was the first to use data collection and analysis to prove efficacy of nursing
actions.
Theory is defined as "an organized, coherent, and systematic articulation of a set of
statements related to significant questions in a discipline that are communicated in a
meaningful whole; a symbolic depiction of aspects of reality that are discovered or
invented for describing, explaining, predicting, or prescribing responses, events,
situations, conditions, or relationships" (Meleis, 1997, pp. 8,12)1. Thus, a theory is a
coherent set of propositions and statements that describe (factor-isolating), explain
(factor-relating), and predict (situation- relating) phenomena as well as prescribe
(situation-producing) actions toward goals. (Dickoff et al., 1968)
Theory development requires perceiving phenomena that are peculiar to nursing and
proposing meaningful explanation for these perceptions. The nursing profession
identifies four levels of theory— metatheory, grand theory, middle range theory, and
practice theory. The theories are classified based on their levels of abstraction or
complexity.
A complete structure includes a conceptual model, derived theories, and
correlated empirical research methods. Each conceptual model and theory is
comprised of concepts and propositions. The complete structure forms a hierarchy
that is based on levels of abstraction.
Most abstract: the conceptual model that provides the context or frame of
reference for theory- generating and theory-testing research
Intermediate level: the theory that is generated or tested
Most concrete: the empirical research methods used to collect and analyze the
data
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