discussion nr 3 (3119)

The relevance of theory and theoretical framework in practice

Nursing Theory in Practice

¤  Theory (defined) - Creative and systematic way of looking at the world or an aspect of it to describe, explain, predict, or control it.

¤  Nursing theories are a creative and systematic way of looking at nursing (or an aspect of it), to describe, explain, predict, or control it.

¤  Theories control nursing actions.

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¤  How do theories control nursing actions (processes & interventions)?

¤  The building blocks of a theory are concepts. When similar concepts are grouped together, they create relationships (propositions). The concepts with their propositions serve as the underpinning of a theory.

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¤  Research and EBP are based on a theory. In research, the theory may be identified through the research problems or the hypothesis. In EBP, the theory may be identified through the PICOT question.

¤  Since the concepts and propositions are what underpin the theory and “sets the stage” for the research/EBP, during the research process, tools (research instruments) are used to “measure” the concepts that underpin the theory.

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¤  Tools that measure the concepts may include: ¤  Questionnaires ¤  Likert Scales ¤  Q Sort ¤  Delphi

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¤  After the data is collected, it is evaluated for statistical significance.

¤  If the data reflects a statistical significance, there is usually a clinical significance.

¤  When the results of the research/EBP is disseminated, it will validate or invalidate current nursing practice.

Nursing Theory in Practice

¤  For that reason it is necessary to understand the three components of theoretical framework (the underpinnings of a theory).

¤  Concept Identification ¤  Concept Analysis ¤  Concept Measurement

Nursing Theory in Practice

¤  For that reason it is necessary to understand the three components of theoretical framework (the underpinnings of a theory).

¤  Concept Identification ¤  Concept Analysis ¤  Concept Measurement

Nursing Theory in Practice

¤  Concept Identification –

¤  Concept (defined) - a word or phrase that summarizes ideas, observations, and experiences.

¤  Though everyone may have a “theoretical” understanding of an idea, observation, or experience does not mean that the understanding is the same.

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¤  Concept Identification –

¤  The term “hypertension”… ¤  Some may theorize “hypertension” means anything over

120/80

¤  Some may theorize “hypertension” is 20% above a person’s baseline

¤  Some may theorize “hypertension” should be focused on the diastolic pressure

¤  Some may theorize “hypertension” could be situational.

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¤  Concept Identification & Analysis–

¤  Based on varying definitions and perceptions of the concept, it is necessary to identify and analyze the concept for the purpose of research.

¤  Since the concepts are used as the building blocks of the theory (that drives the research), it is necessary to have a clear and concise concept identification and analysis prior to research.

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¤ A Concept Analysis includes:

¤  The “isolating questions” of the concept – what would someone ask about the concept

¤  The “right answers” - the accepted definitions of the concept ¤  A “model case” – a case scenario that would be an example of

what the concept is ¤  A “contrary case” – a case scenario that would exemplify what the

concept is not

¤  A “related cases”- a case scenario that exemplifies what the concept might be

¤  A “borderline case” - a case scenario that exemplifies what the concept is close to

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¤ A Concept Analysis includes: (continued)

¤  An “invented case” – a case scenario of what the concept might be if it could be

¤  The “social context” – How is the concept viewed differently by different people

¤  The “underlying anxiety” – anxiety produced by the concept that may cause misperceptions

¤  The “practical results” – how the concept is applied in practice (operationalized)

¤  The “results in language” – a clear and concise definition that is used for research/EBP purposes.

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¤  Concept Measurement

¤  Since the research instrument is used to measure the concepts under investigation, it is necessary to analyze the instrument to ensure there is concept fidelity and the tool is appropriate to measure the concepts in question.

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¤  Concept Measurement Analysis -

¤  The concept measurement analysis is done by:

¤  Creating an instrument that reflects the concepts that gives rise to the theoretical underpinnings of the research

¤  If a preexisting instrument is used, comparing the theoretical underpinnings of the research/EBP with the theoretical underpinnings of the research instrument

Nursing Theory in Practice