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Theory Development Barrier and Stimulants
Theory Development Barrier and Stimulants
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Order Number |
5566789643 |
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Type of Project |
ESSAY |
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Writer Level |
PHD VERIFIED |
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Format |
APA |
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Academic Sources |
10 |
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Page Count |
3-12 PAGES |
Instructions/Descriptions
Theory Development Barrier and Stimulants
Week 2 – Course Resources
Theory Development – Barrier and Stimulants
Development of a theoretical body of knowledge, unique to the nursing domain, is directly proportional to equivalent strides taken in the area of research. Effective integration of theory and practice is essential for the survival and growth of the nursing profession. To continue the cycle of meaningful advancements, researchers need to identify barriers and overcome them. Along with this, they also need to take note of factors that stimulate the process of theory development. Let’s examine how knowledge has played a crucial role in setting obstacles in the path of theory development on the one hand and, on the other, how it has facilitated the development of nursing theories.
| How did knowledge act as a barrier to the process of theory development? | How did knowledge act as a stimulant in the process of theory development? |
| Use of the knowledge of other disciplines was long seen as superior to that developed by nurses. | Knowledge breeds knowledge; existing theory now provides impetus for further refinement and development. |
| Other disciplines, such as sociology, psychology, and physiology, prepared their students to do research in nursing and develop theories for nurses, rather than encouraging nursing to prepare its own students to do research and theory development. | Old paradigms are challenged by new ones as they are influenced by social factors, factors in healthcare, and practice changes. |
| The National League for Nursing (NLN) requirement for colleges and universities often resulted in the development of curricula with esoteric content. | The new worldview is less mechanistic, more congruent with women’s views of science and nurses’ views of health; it is more wholistic and ecological. |
| The knowledge base developed was unrelated to practice and was far removed from preparing students to be change agents in practice. | Nurses are trained to observe record, analyze, and solve problems, and this unique source of knowledge has provided research efforts that are, finally, far more based in the practice realm than ever before. |
| The academic focus was on conceptual models as a way to develop theories and theoretical thinking, and often lost sight of the reason to conceptualize in the first place, that is, the underpinnings of nursing practice and patient care. | Nurses spend long hours with patients and family, and are better able to identify and understand patterns of phenomena, rather than perceive health and nursing as a series of isolated incidents. |
| Development of conceptual models and theories was encouraged as a way to justify and define the status of nursing as a profession, and required the existence of theories. | The move toward the development of middle-range theories, rather than grand theories and conceptual models, has allowed nurses involved directly in the provision of care to ask practice-based questions, do research to answer those questions, and develop new information on a more manageable scale. |
Professional Barriers and Stimulants
In addition to knowledge, other factors have hindered or promoted the development of theories. These barriers and facilitators can be professional and social.
Before 1970, women entered nursing because of its service orientation rather than its professional potential. Women were not career oriented; nursing was seen as an in-and-out occupation, one that could be carried out on a part-time basis. It was seen as preparation for an eventual role as wife and mother; the self-identity of nursing students lay in their roles as women, rather than in a professional identity.
Let’s examine the impact of some professional factors on theory development. Sex role stereotyping, for instance, has been a major influence.
How did gender and social status act as a barrier to the process of theory development?
- Role stagnation discouraged the creativity necessary for theoretical thinking, and issues existed over the nature/nurture conflict and giver/scientist role.
- Recognition in nursing was based on the practitioner or educator roles and not based on the roles of researcher or developer of theory, as is the case in other disciplines.
- The self-perception of members of the profession for the discipline was that of low autonomy, poor advancement, and less availability of intellectual stimulation.
- Education has the role of training individuals in thinking, analysis, and conceptualization; nurses were provided training, not education.
- Former nursing training methods served to decrease curiosity and the questioning attitude. These methods thus succeeded in fostering the handmaiden image to doctors, in addition to emphasizing the role of executing orders and implementing hospital policies.
- The focus was on doing tasks, not on thinking. Hospitals played a paternalistic role in which rules and regulations were made by non-nurses, and this created an environment in which questioning was discouraged and rebelliousness punished.
Social Barriers
Social factors too have influenced nursing theory development considerably. The social barriers and stimulants to theory development are:
| How did gender and social status act as a barrier to the process of theory development? | How did gender and social status act as a stimulant in the process of theory development? |
| As women, nurses had distinctly dual roles resulting in role overload that resulted in a state not conducive to questioning, investigation, analysis, and theory development. | Women, as an oppressed minority, have had to deal creatively with situations in which others controlled the resources; as a result, women developed flexibility, innovation, and creativity in finding alternative resources to accomplish their goals. Nurses, as women, are using what they have, valuing their uniqueness. |
| Female characteristics have long been conceived of as antithetical to creativity and scientific productivity. | Women’s cognitive styles are learned in a lifetime of socializing, negotiating, and fostering team efforts. These have been highly valued in the increasingly team-driven, business world of healthcare. |
| Women were seen as less analytical and cognitive and were expected to apply, rather than create, knowledge. | Women are a minority in other fields, but are a majority in nursing, and are appreciating the full citizenship this gives them in their own field. |
| Women suffer from ambivalence when they break away from the mold and often experience achievement-related conflict. | The resulting different attitudes toward nursing and its professional status led to a different attitude toward its theoretical underpinnings. |
| Internal, intradisciplinary debates, territory/turf issues, and lack of professional cohesion have confused other disciplines and the public about the true nature of nursing as a scientifically-based profession, with its own theoretical foundations and research-tested methodologies. | Women are now recognized for their observational and abstract thinking abilities. Observation is central to nursing practice, and the ability to think abstractly is critical for theorizing. Also important for theorizing is the ability to record what is happening in a nursing care situation. Nurses are adept at describing and explaining, one of the basic elements of the nursing process. |
Context, Content, and Process
The impetus for theory development increased dramatically when the NLN required a conceptual framework for nursing curricula. Each nursing education program was required to develop a theoretical framework for the delivery of nursing education. This could be the adoption of a single theory or an amalgamation of several, and were not required to be nursing theories. This became the impetus for theory development primarily in the realm of nursing education. Thus, emerging theories were used to guide teaching, but not practice or research.
Nursing scientists searched for one theory for the entire discipline. Resulting theories were too abstract and complex, or too simplistic. Practitioners believed that the theory movement required them to choose a single theory and adhere to it throughout their practice efforts. None of the theoretical models addressed all aspects of nursing. Therefore, practitioners avoided, ignored, or refused to acknowledge the use of theory in practice. Eventually, two themes evolved at this stage:
- Acceptance of the complexity of nursing and the inevitability of multiple theories to address nursing phenomena
- Acceptance of the need to test elements of theory through research before discarding them.
Now the focus moved to formulating questions about the unique nature of nursing knowledge.
Social Barriers and Stimulants
Context, Content, and Process
The impetus for theory development increased dramatically when the NLN required a conceptual framework for nursing curricula. Each nursing education program was required to develop a theoretical framework for the delivery of nursing education. This could be the adoption of a single theory or an amalgamation of several, and were not required to be nursing theories. This became the impetus for theory development primarily in the realm of nursing education. Thus, emerging theories were used to guide teaching, but not practice or research.
Nursing scientists searched for one theory for the entire discipline. Resulting theories were too abstract and complex, or too simplistic. Practitioners believed that the theory movement required them to choose a single theory and adhere to it throughout their practice efforts. None of the theoretical models addressed all aspects of nursing. Therefore, practitioners avoided, ignored, or refused to acknowledge the use of theory in practice. Eventually, two themes evolved at this stage:
- Acceptance of the complexity of nursing and the inevitability of multiple theories to address nursing phenomena
- Acceptance of the need to test elements of theory through research before discarding them.
Now the focus moved to formulating questions about the unique nature of nursing knowledge.
Early Influences
Theories explain the world. Every profession and discipline has a foundation that explains how and why it works. Every branch of science works the same way. Early theories were extremely basic and simple. Newton sat under that tree and was hit by the apple, leading him to speculate about the existence of gravity.
Once a theoretical speculation is made, it is tested through research. Newton conducted many studies or experiments that would seem, well, silly to us today. They had to do with going to various heights and dropping things. Then he dropped things of different weights to see what difference that would make. These experiments served to prove his theory and allowed him to refine it.
Today, we readily acknowledge the existence of gravity and even do complicated experiments in space where it does not exist. Thus, theory is all around us and is not unique to nursing. We are evolving new nursing theory all the time as we speculate about a new response to a nursing phenomenon and try it out. You may even have done this sometime yourself! Thus theory development is a rigorous process that relies completely on research process. It evolves continuously from areas like nursing practice, nursing education, nursing theory, and existing theory.
Nursing Practice
Theory development began with Florence Nightingale who used data collection and analysis techniques to present information about nursing and its focus. In the early days of nursing practice, a domain for nursing was identified that included the patient, the environment, and nursing care. Each subsequent stage of practice enhancement helped nurses come closer to identifying the domain for nursing and defining its theoretical base.
Nursing Education
The development of different curricula for different levels of nursing education in the mid-1950s resulted in the need to articulate the different levels of nursing practice and the educational preparation required for each. Conversely, questions emerging about the differences in nursing care provided by diploma, AD, BSN, and MSN graduates forced an articulation of nursing theory to add distinctions to practice that resulted from different educational levels. This early focus on levels of nursing practice encouraged nursing students and educators to focus on nursing concerns and problems, rather than on medical concerns and problems.
Theory development during this early period attempted to answer the questions:
- What is nursing?
- What do nurses do?
- How is nursing different from other health science disciplines?
- What is nursing knowledge?
Research
The focus on advanced education for nurses led educators to develop increased interest in the research process through research courses offered at the graduate level and through their own required research. Faculty was required to develop ideas and communicate them in the scientific arena through presentations and publications. Their research triggered further theory development on the part of their graduate students. Initial interest was on systematic inquiry through research into teaching/learning modalities, the educational milieu, and appropriate content for nursing curricula. Data derived from this research prompted related theory development which, in turn, generated further research.
Existing Theory
Arguments within the profession in the early days of theory development focused on questions of whether nursing was a separate discipline or part of medicine and whether it was a biological, social, or physical science. The search for a conceptual foundation specific and unique to nursing led to the study of the realities of nursing practice and the truths that guided its actions. These are the phenomena of nursing. Emerging theories addressed the nature of human beings in interaction with the healthcare system, as well as the processes of problem solving and decision making for bases for intervention.
Milestones in Theory Development
Popular culture uses the media to represent the cultural elements that prevail in any given society at a particular point in time. People want to be part of a group and to understand their identity in the group; mass culture allows people to define themselves in relation to everyone else. We watch television, go to movies, listen to music, read newspapers and magazines, use the Internet, eat snacks, and dress in certain ways. We see advertisements for products and services daily, and these form part of our popular culture. It has been said that we can learn much about a culture from its advertising. Simply consider current television ads, especially those aimed at teenagers. It is easy to understand what teens want from these ads. They also give us an insight into their values. This is no less true for nursing. The ads in nursing journals of decades ago say a great deal about where we were and how far we have come. In the 1940s and 1950s, ads appeared for many products aimed at nurses themselves or for nurses to recommend those drugs or products to patients. Nurses’ uniform ads were popular and often depicted an attractively-clad nurse—being looked over with interest by handsome doctors. We must all have been focused on the importance of male attention, given the importance of tight white uniform dresses! Nursing ads touted hand cream, menstrual pain relievers, various brands of coffee—even cigarettes! Nurses were all Caucasian women, and diversity did not exist.
Changes began to occur in the late 1960s and 1970s as equipment ads began to appear. Nurses could buy pink and green and blue stethoscopes that matched the pens and penlights and scissors. Form superseded function and the message was that we cared more for color coordination than for quality of equipment. Today’s ads demonstrate a major shift in advertising attitudes toward nurses. Current ads are sophisticated and informative and assume that nurses now have significant decision-making ability in the workplace, as reflected in the ads for medication, hospital equipment, information resources, and so forth. Nursing images are multicultural and include men.
These changes are profound and have been reflected in the development of our theory and our knowledge base. The earliest theorists wrote when nurses were being sold custom-made uniforms and capes, white garter belts and stockings, cigarettes, and the notion that nursing was a job, not a career, one that would serve them until marriage, preferably to a doctor. The theorists today write and study at a time when all things are possible for nurses who can practice in advanced roles with prescriptive authority and who can sit in the office of the hospital CEO.
Nursing Theory Critique
Why Analyze Theories?
Theories are analyzed and reviewed to describe the theoretical basis for advanced nursing in professional nursing environments. In addition, a critique also helps to apply the knowledge gained during the critique to identify factors that aid in improving the healthcare delivery system. One of the reasons of the evaluation exercise is to ascertain how user friendly the theory is and how its weaknesses can be overcome to improve its applicability in the real environment. Further, selecting and analyzing theories develop your analytical skills and help you choose appropriate theories for future research.
Critique Evaluation Criteria
In the past few decades, healthcare professionals have been trying to further develop, test, and use proposed nursing theories. The ultimate aim of evaluation is to utilize theory in various domains like practice, research, and education.
Evaluation lays emphasis on the depth and breadth of content.
Depth: The content should encompass the four metaparadigm concepts in a relatively unambiguous manner. The theory should include a description of the person or other focus of the nursing actions, identification of the person’s environment, discussion of the author’s meaning of health, a definition of nursing, a statement of nursing goals or outcomes, and an outline of the nursing process. The relational propositions of the model should link all four metaparadigm concepts.
Breadth: This requires that the theory is sufficiently broad in scope to provide guidance in clinical situations and serve as the basis for research, education, and administration. Although the expectation is that the theory or model is a useful frame of reference for many nursing activities, no one theory or model is appropriate for all clinical situations.
The four elements of theory critique are: background, theory description, evaluation, and application. Background refers to origin of the theory and theorist. Theory description focuses on the major concepts of the theory. Evaluation of theory is basically an analysis of clarity, congruence, assumptions, and metaparadigms. Application refers to the level and usefulness of the theory and its weaknesses. Although most theorists start with the same view of the general purpose of nursing, in the final form, most present distinctively different views of the basic metaparadigm concepts. Different models are concerned with different problems in nurse-patient situations or different problems in person-environment interactions.
Nursing Theory and Practice
The Theory-Practice Gap
We know that the development of nursing theory is critical to the establishment of a theoretical body of knowledge that is peculiar to nursing as a science. However, theory development should not take place in isolation. It should be integrated with nursing practice if the profession is to have sustained growth and development. There has always been serious concern on the theory-practice gap.
This gap is based on the observation that what happens in clinical situations rarely, if ever, matches what the textbooks say ought to happen. The problem of the theory-practice gap is one of the most important and fundamental issues in nursing today, as the gap calls into question the very foundation upon which nursing is based.
Nursing theory maintains that nursing is a science and that nursing knowledge is advanced through the application of the scientific method. Scientific research is seen as the predominant method of generating new knowledge.
If nursing theory cannot and does not predict what actually happens in clinical practice, with any degree of certainty, then the entire body of nursing knowledge is seen by some as redundant, and nursing is reduced to nothing more than trial and error.
Theorists claim the theory-practice gap is between what research and theory say ought to be happening, and what actually happens in the imperfect clinical world. They see practice-based nurses as failing to use research findings in practice. Their goal and rationale is that practice should move closer to the ideals of nursing theory, as nurses read research and implement results in practice.
Direct care practitioners say that the gap is between what actually works in real life and unrealistic textbooks’ ideals. They feel that the gap will be bridged by nursing theory more closely reflecting the realities of clinical life. The gap is seen by some as a consequence of the way in which theory has failed to keep pace with changes in the practice of nursing. Practitioners feel that although concepts of nursing practice have undergone significant changes over the past 30 years, nursing theory has not grown in the same way.
Prevailing models of education and research result from and sustain nursing theory, often unintentionally strengthening its separation from actual nursing practice. The result is a level of mistrust by practitioners that academic knowledge can offer anything of relevance to practice situations, and a frustration on the part of academic-based researchers that practitioners will relate theory to the provision of care.
Theory, research, and education are viewed as mutually supportive, but practice is not seen as being included in the equation.
Theory Development Barrier and Stimulants
