Development Of Nursing Theory Research Articles

Exploring issues in theory development in nursing: Insights from literature

Theory development in nursing profession continues to raise more debates about critical issues. The present study aimed to explore the critical and contemporary issues and concerns about theory viewed from both the discipline- and professional-related perspectives. This narrative literature review was done in 2020. English articles in the electronic databases of Medline, Scopus, PubMed, CINAHL and Google Scholar were searched using the keywords: concerns, issues, nursing theory development, nursing theory construction, nursing discipline and nursing profession, and literature was retrieved and screened for eligibility. The date limit considered in the literature search was from 2010 to 2019. In the initial search, a total of 179 studies were retrieved and assessed for eligibility; 163 studies were eliminated due to not meeting the exact criteria set, leaving only 16 studies that were finally included in the content analysis. Content analysis method was used to extract our findings. Four themes (issues) emerged and were grouped into two overarching categories of discipline-related issues/concerns and profession-related issues/concerns. The four themes were (1) philosophical issues, (2) issues with validation of nursing theories, (3) multiplicity of nursing theories and divergent practice paradigms of nursing and (4) integration of theory into professional practice. This paper offers a promising premise to reconcile various concerns arising from nurses' attempts to develop, use and test theories. Identification and discussion of these issues should inform the nursing profession to plan activities to resolve or reduce them systematically.

Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing.

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person-centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions.

A scoping review of complexity science in nursing.

To describe how complexity science has been integrated into nursing. A scoping review. Academic Search Elite, Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, PubMed and Web of Science were searched November 2016, updated in October 2017 and January 2020. The working process included: problem identification, literature search, data evaluation, synthesizing and presentation. Four categories were found in the included 89 articles: (a) how complexity science is integrated into the nursing literature in relation to nursing education and teaching; (b) patients' symptoms, illness outcome and safety as characteristics of complexity science in nursing; (c) that leaders and managers should see organizations as complex and adaptive systems, rather than as linear machines; and (d) the need for a novel approach to studying complex phenomena such as healthcare organizations. Lastly, the literature explains how complexity science has been incorporated into the discourse in nursing and its development. The review provided strong support for use in complexity science in the contemporary nursing literature. Complexity science is also highly applicable and relevant to clinical nursing practice and nursing management from an organizational perspective. The application of complexity science as a tool in the analysis of complex nursing systems could improve our understanding of effective interactions among patients, families, physicians and hospital and skilled nursing facility staff as well as of education. Understanding complexity science in relation to the key role of nurses in the healthcare environment can improve nursing work and nursing theory development. The use of complexity science provides nurses with a language that liberates them from the reductionist view on nursing education, practice and management.

Patients' and Nurses' Perceptions of What Constitutes Good Nursing Care: An Integrative Review

Differences between patients' and nurses' perceptions of good nursing might be one of the barriers to optimal nursing care that matches the preferences of patients. A better understanding of the attributes of Good Nursing Care across different settings, circumstances, and patient populations will provide an integrated idea about Good Nursing Care, which can contribute to nursing theory development and future research. This study aimed to integrate the literature on patients' and nurses' perceptions of what constitutes Good Nursing Care and thereby identify the similarities and differences in patients' and nurses' perceptions of Good Nursing Care. A literature search of PubMed, CINAHL, and MEDLINE was conducted for article published between January 2000 and June 2017. A total of 18 studies were identified and assessed using the Mixed Method Appraisal Tool. The studies were analyzed and synthesized using Swanson's theory of caring as the theoretical framework. Some dissents and agreements were found between patients and nurses regarding the crucial attributes of Good Nursing Care. While "enabling," such as providing information, coaching, and guidance, was more emphasized by patients, "being with" (being present at the bedside) was more emphasized by nurses. "Doing for," especially expert performance and enhancing physical comfort, was the most frequently mentioned attribute of Good Nursing Care by both patients and nurses. Theoretical developments regarding Good Nursing Care-characterized by a balance between sufficient nursing knowledge and competent technical skills on one hand and patient empowerment based on trusting relationships on the other hand-would promote the provision of Good Nursing Care in clinical practice.

Philosophical and Contextual Issues in Nursing Theory Development Concerning Technological Competency as Caring in Nursing.

Theory development in nursing has been contentious so that issues about theory as knowledge base and counterpart of practice, and theory as the foundation of nursing as a discipline of knowledge and practice profession have facilitated the seeming ambiguity hindering theoretical contributions integral to human health and well-being. Nursing science continues to generate discussions about its development particularly grounding its practice as a legitimate component of human health care. The aims of this paper are (a) to describe three contemporary issues regarding theory construction and development in nursing, and (b) to advance a theory of nursing that can reconcile these issues. Content analysis following a review of literature revealed ontological,epistemological, and contextual issues on nursing theory development and theory-based practice perspective. The middle-range theory of Technological Competency as Caring in Nursing is advanced as integral to pursuing the reconciliation of theory development and practice engagements within the Universal Technological Domain in nursing and the health sciences. J. Med. Invest. 66 : 8-11, February, 2019.

Patients and caregivers experience on Nursing in Italy: scoping review

Comparison of the state of nursing in Italy with other countries has shown that theory development in Italian nursing remains quite undeveloped. Theory development in Italian nursing will need to consider local cultural and professional aspects, specific to the Italian practice context, by drawing on known health needs, experiences and nursing approa- ches. The aim of this investigation was to map current knowledge related to nursing in Italy, based on the experiences of patients, families and communities, to provide a basis on which nursing theories could be developed. Scoping Review was selected as the best method for this knowledge mapping. Fawcett's nursing metaparadigm was chosen as a broad guide and means by which the litera- ture analysis could be structured. Twenty-two studies were retained and examined in this analysis, including contexts relating to acute care, chronic conditions, as well as emergency and home care services. We defined themes in line with the nursing metaparadigm. Although these definitions are partial, referring only to certain contexts specific to some aspects of nursing care, the original contributions of this investigation provides an important starting point for theory development in Italian nursing, based on the Italian context. Strong and credible theory development, that can be readily adapted to practice, requires a rigorous analysis of the points of view of all actors involved in the nursing care process.

Mixed method sequential study on the barriers underpinning a new patient centred care model implementation: the nurses' perspectives

Comparison of the state of nursing in Italy with other countries has shown that theory development in Italian nursing remains quite undeveloped. Theory development in Italian nursing will need to consider local cultural and professional aspects, specific to the Italian practice context, by drawing on known health needs, experiences and nursing approa- ches. The aim of this investigation was to map current knowledge related to nursing in Italy, based on the experiences of patients, families and communities, to provide a basis on which nursing theories could be developed. Scoping Review was selected as the best method for this knowledge mapping. Fawcett's nursing metaparadigm was chosen as a broad guide and means by which the litera- ture analysis could be structured. Twenty-two studies were retained and examined in this analysis, including contexts relating to acute care, chronic conditions, as well as emergency and home care services. We defined themes in line with the nursing metaparadigm. Although these definitions are partial, referring only to certain contexts specific to some aspects of nursing care, the original contributions of this investigation provides an important starting point for theory development in Italian nursing, based on the Italian context. Strong and credible theory development, that can be readily adapted to practice, requires a rigorous analysis of the points of view of all actors involved in the nursing care process.

CONCEPT ANALYSIS STRATEGIES FOR THE DEVELOPMENT OF MIDDLE-RANGE NURSING THEORIES

ABSTRACT Objective: to reflect on strengths and limitations of the concept analysis strategies as resources for the development of middle-range nursing theories. Method: a reflection study of metatheoretical nature. Results: strategies for concept analysis for the development of middle-range nursing theories are presented. The philosophical foundations of concepts and their interface with the analytical procedures were presented. It has been found that Nursing uses three approaches for concept analysis: adapted Wilsonian, evolutionary and pragmatic utility. The concept analysis strategy was illustrated by the Interactive Theory of Breastfeeding. Conclusion: concept analysis strategies have been employed in nursing to develop theories and to refine the concepts and terminologies used in research and practice. Despite their widespread use, there is still great diversity of methods used and some uncertainties that hinder their implementation.

Regenerating Nursing's Disciplinary Perspective

As we approach the 50th anniversary of the first national symposium on nursing theory development, the need to clarify nursing's disciplinary perspective is just as relevant as it was 50 years ago. The purpose of this article is to regenerate the disciplinary perspective by analyzing the literature on the focus of the discipline of nursing, synthesizing the themes and suggesting areas of knowledge development for the discipline, and imagining ways to move forward in claiming, clarifying, and strengthening the discipline. The 4 themes identified were human wholeness, health/healing/well-being, human-environment-health relationship, and caring. Nine areas of inquiry generated from the disciplinary perspective were suggested.

Theory and Theorizing in Nursing Science: Commentary from the Nursing Research Special Issue Editorial Team.

Articles from three landmark symposia on theory for nursing-published in Nursing Research in 1968-1969-served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory. The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue. The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory, big data, and doctoral education. Using a dialogue format, the editors discussed these core questions. The classic nursing metaparadigm (health, person, environment, nursing) was viewed as a continuing unifying element for the discipline but is in need of revision in today's scientific and practice climates. Practice theory and precision healthcare jointly arise from an emphasis on individualization. Big data and the methods of e-science are challenging the assumptions on which nursing theory development was originally based. Doctoral education for nursing scholarship requires changes to ensure that tomorrow's scholars are prepared to steward the discipline by advancing (not reifying) past approaches to nursing theory. Ongoing reexamination of theory is needed to clarify the domain of nursing, guide nursing science and practice, and direct and communicate the unique and essential contributions of nursing science to the broader health research effort and of nursing to healthcare.

Nursing's Boundary Work: Theory Development and the Making of Nursing Science, ca. 1950-1980.

Beginning in the late 1950s and intensifying through the 1960s and 1970s, nurse educators, researchers, and scholars worked to establish nursing as an academic discipline. These nursing leaders argued that the development of nursing theory was not only critical to nursing's academic project but also to improving nursing practice and patient care. The purpose of the article is to examine the context for the development of nursing theory and the characteristics of early theory development from the 1950s through the early 1980s. The methods used were historical research and analysis of the social, cultural, and political context of nursing theory development from the 1950s through the early 1980s. How this context influenced the work of nurse theorists and researchers in these decades was addressed. The development of nursing theory was influenced by a context that included the increasing complexity of patient care, the relocation of nursing education from hospital-based diploma schools to colleges and universities, and the ongoing efforts of nurses to secure more professional autonomy and authority in the decades after World War II. In particular, from the 1960s through the early 1980s, nurse theorists, researchers, and educators viewed the establishment of nursing science, underpinned by nursing theory, as critical to establishing nursing as an academic discipline. To define nursing science, nurse theorists and researchers engaged in critical boundary work in order to draw epistemic boundaries between nursing science and the existing biomedical and behavioral sciences. By the early 1980s, the boundary work of nurse theorists and researchers was incomplete. Their efforts to define nursing science and establish nursing as an academic discipline were constrained by generational and intraprofessional politics, limited resources, the gendered and hierarchical politics, and the complexity of drawing disciplinary boundaries for a discipline that is inherently interdisciplinary.

Moral Distress Model Reconstructed Using Grounded Theory.

The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. The aim of this study was to reconstruct the model of moral distress using the grounded theory. Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan. Data were collected using intensive, 2- to 3-hour interviews with each participant. Audio recordings of the interviews were made and then converted into transcripts. The data were analyzed using the grounded theory. In the clinical setting, the perspective that nurses take toward clinical moral events reflects their moral values, which trigger moral cognition, provocation, and appraisal. The moral barriers that form when moral events that occur in clinical settings contradict personal moral values may later develop into moral distress. In handling moral barriers in the clinical environment, nurses make moral judgments and determine what is morally correct. Influenced by moral efficacy, the consequence may either be a moral action or an expression of personal emotion. Wasting National Health Insurance resources and Chinese culture are key sources of moral distress for nurses in Taiwan. The role of self-confidence in promoting moral efficacy and the role of heterodox skills in promoting moral actions represent findings that are unique to this study. The moral distress model was used in this study to facilitate the development of future nursing theories. On the basis of our findings, we suggested that nursing students be encouraged to use case studies to establish proper moral values, improve moral cognition and judgment capabilities, and promote moral actions to better handle the regular pressures of moral distress in future clinical or workplace settings. Moreover, a better understanding of moral distress may help retain staff nurses.

Effectiveness of Psychological Adaptation Model of Mental Health Nursing for nurse survivors experiencing post-earthquake disaster post-traumatic stress syndrome

The study to assess the effectiveness of psychological adaptation model of mental health nursing for nurse survivors experiencing post-earthquake post-traumatic stress syndrome (PTSS). This study used a quasi-experimental pre- post-test without control group method. Respondents amounted to 42 people who have been screened for PTSS. Research took place in a district in West Java. Research instrument consisted of: 1) questionnaire for respondent's characteristics and the skills of nurses, and 2) psychological adaptation model of mental health nursing intervention in the form of modules. Data collected was analyzed using bivariate analysis namely the t test dependent. Nurse survivors experienced increased ability in areas including analysis of self-awareness, communication or interaction, coping mechanisms, and intrinsic motivation after undertaking the PTSS intervention. Women were more likely to experience PTSS than men. The model can be used for nursing theory development, and as disaster management algorithms. The model is useful for training programs, in the form of certification of nurse expertise, and improve the ability of nurses to help themselves and others.

Transfiguring Light and Symphonic Blooming: A Wabi Sabi Story of Humanbecoming and Human Caring.

Transfiguring Light and Symphonic Blooming is word-art to describe the flowering of the humanbecoming and human caring schools of thought over time. A Wabi Sabi story journey was created to turn the tide in a world where the building of a unique body of knowledge for nursing has fallen into disfavor with nursing itself. Using nature-aligned paintings and a Japanese story-art aesthetic with poetry, the beauty of falling away to unitary essentials and holding the value of "both-and" in unitary consciousness was illuminated. Co-creating art-knowledge may transfigure nursing theory development and its acceptance with cosmic tree-rooted arches.

Ancient Ethical Practices of Dualism and Ethical Implications for Future Paradigms in Nursing.

Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing.

A statement synthesis of emotional eating and body size recognition: advancing nursing science related to obesity research.

A discussion of a statement synthesis of the relationship between the concepts of emotional eating and body size recognition. The interrelatedness of the concepts of emotional eating and body size recognition is poorly understood; however, both factors significantly impact weight management. Nurses can be instrumental in developing more effective weight management interventions as a critical step in helping to ameliorate the public health burden of obesity. This discussion article reports a literary statement synthesis. Five quantitative research studies from 1996 - 2014 were identified, which examined the relationship between the concepts. A relational statement delineating the direct association between the amount of self-reported emotional eating and an adult individual's recognition of their body size was constructed. Construction of a relational statement about emotional eating and recognition of body size is a step in the nursing theory-building process. The constructed relational statement will guide future research and nursing theory development and may ultimately help to construct more effective weight management interventions.

Analysis of Nurse’s Occupational Health in Managing Patients in Benyamin Guluh Hospital Kolaka Regency

Introduction: Occupational health and safety are a system designed to ensure a good safety and health in the workplace. Nurses have a higher risk of accidents and occupational diseases due to managing patients The goal of analyze the relationship or the influence of predisposing, enabling and reinforcing factors, and the concept of core and care in nurses’ safety and occupational health issue nurs in managing patient. Methods: Type of study is explanatory research using cross sectional design. Proportional random was chosen by consecutive sampling technique amounted to 100 respondents based on criteria. The variables measured were predisposing factors (knowledge, attitudes, beliefs and values), reinforcing factor (officers who became a role model), enabling factors (facilities, rules/regulation), core-care (interpersonal, concern), as well as safety and occupational health. Data were analyzed using Partial Least Square (PLS). Result and Analysis: Predisposing factors affecting safety and occupational health, value by t-count of 2.82 > t-table of 1.96. Reinforcing factors do not significantly affect occupational health and safety by t-count of 1.098 < t-table of 1.96. Enabling factors affecting occupational health and safety by t-count of 2.39 > t-table of 1. Factors of core and care factors affecting nurses’ safety and occupational health in managing patients in Benyamin Guluh Hospital, Kolaka Regency have t-count of 1.963 > t-table of 1.96. Discussion and Conclusion: Development of behavioral and nursing theories to nurses’ occupational health and safety showed R-square value of 39.5%. The new model structure are: predisposing factors (knowledge, attitudes, beliefs and values), enabling factors (facilities, rules / regulation), core (interpersonal relationships) and care (concern).Keywords: occupational health, behavior, nursing

Analysis of Nurse’s Occupational Health in Managing Patients in Benyamin Guluh Hospital Kolaka Regency

Introduction: Occupational health and safety are a system designed to ensure a good safety and health in the workplace. Nurses have a higher risk of accidents and occupational diseases due to managing patients The goal of analyze the relationship or the influence of predisposing, enabling and reinforcing factors, and the concept of core and care in nurses’ safety and occupational health issue nurs in managing patient. Methods: Type of study is explanatory research using cross sectional design. Proportional random was chosen by consecutive sampling technique amounted to 100 respondents based on criteria. The variables measured were predisposing factors (knowledge, attitudes, beliefs and values), reinforcing factor (officers who became a role model), enabling factors (facilities, rules/regulation), core-care (interpersonal, concern), as well as safety and occupational health. Data were analyzed using Partial Least Square (PLS). Result and Analysis: Predisposing factors affecting safety and occupational health, value by t-count of 2.82 > t-table of 1.96. Reinforcing factors do not significantly affect occupational health and safety by t-count of 1.098 < t-table of 1.96. Enabling factors affecting occupational health and safety by t-count of 2.39 > t-table of 1. Factors of core and care factors affecting nurses’ safety and occupational health in managing patients in Benyamin Guluh Hospital, Kolaka Regency have t-count of 1.963 > t-table of 1.96. Discussion and Conclusion: Development of behavioral and nursing theories to nurses’ occupational health and safety showed R-square value of 39.5%. The new model structure are: predisposing factors (knowledge, attitudes, beliefs and values), enabling factors (facilities, rules / regulation), core (interpersonal relationships) and care (concern).

Defining and Measuring Spirituality in South African Specialist Psychiatry.

To define the meaning of "spirituality" in a South African phenomenological, theory-generating qualitative inquiry, theory construction methodology was used. This refers to the tradition of nursing theory development, where a central core concept identified from the integrated data-in this case, interviews and the literature content-had to be defined. A major focus of the study was to distinguish spirituality from religion. The denotative and connotative meanings of "spirituality" were explored to establish the components for a definition. The attributes of this definition included that spirituality constitutes a "quality", a "journey", a "relationship" as well as a "capacity". While these items derived from this local definition of spirituality can be proposed for inclusion in a questionnaire for measuring spirituality in a South African context, the limits of the scope of the explorative qualitative inquiry from which it was derived must be considered.

Older Rural Women Moving Up and Moving On in Cardiac Rehabilitation

Purpose: Cardiac disease often strikes without warning. Its sudden nature interrupts the lives of individuals and families. Recovery from cardiac events may take months or even years. Cardiac rehabilitation (CR) is an essential step in the recovery process. CR improves physical fitness and provides education for the reduction of risk factors for future cardiac events. Women are known to be under-referred to cardiac rehabilitation. Women are also under-represented in CR research, are less likely to attend CR than men, and may have worse outcomes than men. Little is known about the experiences of older rural women in CR. The purpose of this study was to describe and interpret the experiences of older women who lived in rural communities and attended CR. Sample: A purposive sample of 10 women (ages 60-83) was recruited from three CR centers in Pennsylvania and New York. All women were residents of rural communities and had been discharged from CR. Method: Participants were enrolled in a phenomenological study to identify the meaning of CR for older rural women. Interviews were audio-recorded, transcribed, and analyzed using van Manen’s methodology. Findings: Three themes emerged from the study: (a) companionship, (b) hospitality, and (c) accomplishment. Conclusions: The women described CR as a program offering companionship in an atmosphere of hospitality to assist women in accomplishing their personal goals. The study has implications for nursing practice, education, policy, and theory development in rural nursing. Key Words: older rural women, cardiac rehabilitation, phenomenology, companionship, hospitality, accomplishment