Theories and models of nursing and nursing process

Recent advances in nursing 02/1989; 24:32-46.
Source: PubMed


In summary, nursing models can be evaluated by carefully considering how human beings are conceptualised within a model, how adequately the model guides nurses in the decision-making associated with all stages of the nursing process and how appropriate is the expected role of the nurse. Reference to the criteria for evaluating nursing theory (Fig. 1) demonstrates that not only can nursing models be regarded as the precursors of nursing theory but some evaluative criteria for nursing theory develop from ways of evaluating nursing models (Fig. 2). The essence of this paper has been to consider nursing theory and its place in the current climate of concern both about nursing's professional status and about standards of patient care. The difficulty in defining theory has been briefly explored and suggestions have been made of possible ways of evaluating nursing theory. A distinction has been drawn between nursing models and nursing theory with a rationale for considering nursing models as precursors of nursing theory especially as there are similarities in the criteria used to evaluate them both. The nursing process has been described as a systematic, problem-solving approach to care. It is neither a nursing model nor a theory but rather one way of organising nursing activities. A major dilemma has been omitted from this paper, however, which nonetheless deserves mention here. This dilemma is identified and summarised by Jacox (1974) among others. The question posed is: Can and should we develop nursing theories?' (Jacox's emphasis). The main competing arguments put forward by Jacox are on the one hand that there are no phenomena or activities peculiar to nursing around which nursing theory can develop, and on the other hand that there is a need for a specified body of knowledge to inform nursing practice. Efforts to establish a firmer body of knowledge on which to base nursing practice may help to identify the unique function of the nurse. This will only be achieved if practising nurses take a keen interest in developing rigorous approaches to the evaluation of nursing models and theories. Craig (1980) has linked theory development and its integration with nursing practice to professional survival. If nurses cannot identify phenomena and activities that are peculiar to nursing and if they are not prepared to safeguard these areas of practice, then the future of nursing looks bleak. Project 2000 (UKCC 1986) offers an opportunity for nurses to be more willing and able to critically consider nursing's unique contribution to health care.

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    • "In the literature, use of the Roper, Logan and Tierney model is useful in providing guidance in nursing practice, helping to articulate the nature of nursing (Chalmers 1989, Holder & Chitty 1997, Van der Merwe & Muller 1997, Meleis 1985) and enhance the quality of care (McKenna 1990). The Roper, Logan and Tierney Model focuses on the client as an individual engaged in living though his or her lifespan and moving from dependence to independence, according to age, circumstances and environment (see Fig. 1). "
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    ABSTRACT: To determine whether the Roper, Logan and Tierney Model of nursing care affects the outcomes of patients with chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease is a leading chronic health problem throughout the world. Although there are numerous studies on patients with chronic obstructive pulmonary disease, no studies have been found regarding patient care with chronic obstructive pulmonary disease investigated from the Roper, Logan and Tierney Model perspective. The study design was an experimental style. The sample consisted of 60 subjects with a diagnosis of chronic obstructive pulmonary disease who were hospitalized in a university hospital in Erzurum, Turkey, in 2001 and randomly selected into control and experimental groups. On admission, the researcher completed a nursing diagnosis form for chronic obstructive pulmonary disease for each patient, consisting of demographic characteristics and an assessment nursing diagnosis for each of the patients. Control group patients were treated by routine nursing care while the experimental group patients were treated by nursing care according to the Roper, Logan and Tierney Model. Upon discharge, nursing diagnoses were assessed again in both control and experimental groups. Results. Although there was no statistically significant decrease in most nursing diagnoses in the control group, there was a statistically significant decrease in nursing diagnoses in favour of the experimental group. This study demonstrated that there were improvements in patient's outcomes in the concept of holistic and individualized nursing care of patients with chronic obstructive pulmonary disease according to the Roper, Logan and Tierney model. The findings of this study have practical importance for nursing practise. Using the Roper, Logan and Tierney Model in care of patients with chronic obstructive pulmonary disease may serve as a guide for nurses working with chronic obstructive pulmonary disease patients to participate patient and her/his family to patient care and to facilitate the effectiveness of patient care.
    Full-text · Article · Aug 2007 · Journal of Clinical Nursing
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    ABSTRACT: Ever since organized nursing began, nurses have been theorizing about nursing. At any time when ideas (concepts) are delineated, hunches developed by linking concepts together to help describe, explain, predict or prescribe nursing, and those hunches are then communicated and used in a number of situations, the beginnings of nursing theory are formulated (Meleis, 1985).
    No preview · Chapter · Jan 1989
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    ABSTRACT: The Northern Ireland National Board of Nursing, Midwifery and Health Visiting has stipulated that models of nursing must be utilized on psychiatric nurse training wards. However, since there are approximately 40 such frameworks available to the practicing nurse a problem of choosing an appropriate one arises. The philosophical basis for this research centres around the assumption that all nurses regardless of specialty possess values and beliefs concerning four essential elements. These are: nursing, health, the person, and the environment. In addition the literature reveals that each of the recognized nursing models are also constructed around these four concepts, forming in many cases the very foundations of the model. Within this study it was possible to ask 95 ward managers from 49 long-stay psychiatric wards to view how different models deal with the four elements and to choose a model which best reflects not only their personal beliefs about nursing, health, person, and environment, but also the needs of their patients.
    No preview · Article · Oct 1989 · Journal of Advanced Nursing
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