CAROLYN C.

CALUPITAN May 22, 2011

MSN (OSMUN)

THEORETICAL FRAMEWORK

FINALS

1. Evaluate Leininger’s Cultural Theory. How relevant is it in Nursing?

Madeleine Leininger’s vision has guided nurses and other health personnel in the discovery of a new
body of nursing knowledge – to provide culturally congruent and competent care practices across the
world. Today, nurses with a deeper appreciation of human life and its uniqueness plus their
commitment to render quality nursing care and education to clients as well as the members of the
health team, develop cultural sensitivity for a more appropriate and individualized approach to their
clinical practice and even in nursing education.

Cultural competence, as they say, is a necessity in today’s diverse and globally-interrelated society and
is an essential component of clinical practice. We are aware of how the health care system failed to
provide adequate care to clients from a different background despite the providers’ good intentions. If
the client does not respond as the nurse expects, the nurse may interpret it as a resistance or
unconcern making the nurse feel anxious and frustrated.

In our country, we know that nurses are in demand worldwide for many years and practitioners have
many opportunities to work and serve diverse populations here and abroad. Nurses, especially in the
U.S., with its multi-cultural population, have the opportunity to deal with clients with a vast array of
backgrounds, beliefs and culture. This is one of the reasons why nurses need to train and learn about
trans-cultural experiences. For a nurse to successfully provide care for a client with a different cultural
background, effective trans-cultural communication should be emphasized and be included throughout
the nursing process, thereby effecting quality nursing care.

2. Discuss the challenges of Nursing Theory in the new millennium.

Theory is a body of knowledge relating to a particular practice. Because the practice of nursing is
central to nursing theory, nursing theory assembles this body of knowledge from several other fields --
or resources -- of knowledge. Nursing theory is evolving and draws on several bodies of knowledge.
Nursing theory is intended to explain both a patient's condition and his needs. Nursing theory teaches
students how to communicate effectively with their patients dependent upon their particular situation.

Since the nursing career is not something that can be measured, nursing theory supplies the analysis
of every nurse's profession. Also, having a standard theory boosts the professionalism of nurses, and
they understand what is expected of each other.

Nursing theory is logical and consistent. It relies on both daily observations and past precedence. To
assess a current patient, nurses apply the theories that were determined in the past under similar
circumstances. In addition to patient care, nursing theory also helps medical professionals determine
the future of nursing. Nursing theory guides the industry towards the future by displaying what new
information needs to be learned and applied. Nursing theory also exemplifies the importance of
continued education for nurses.

For a long time, nursing was considered non-professional and non-intellectual. With the
professionalization of nursing, this impression has been substantially overcome, and the best resource
for anyone who is interested in nursing theory is a nursing education, in which key elements of the most
accepted theories are taught. The provision and application of the revised Nursing Curriculum (CHED
CMO. 14) and Core Competencies of Nursing Practice can be regarded as an example in this aspect.

3. Expound the essence of theoretical framework in nursing subject in your advancement as a

professional nurse.

Theories that have been developed in nursing and related disciplines must be tested through research
for their applicability to hospital units and/or other nursing or health environments that relate with our
interest and experience. The theoretical framework outlines the research theory to be verified or
validate in the study. It focuses attention on issues essential to providing care. It implies criteria with
which to evaluate what nurses do. It presents concepts capable of supporting research most useful to
nurses. Thereby it helps create knowledge unique to nursing, thus augmenting the status of nursing as
a profession. In fostering research, nursing theory and the formulation of a theoretical framework, it
upholds nursing education, maintaining it on a par with other academic disciplines.

Theory improves care by enabling nurses to process vast amounts of information in so far as nursing
education aims primarily to train competent nurses, it depends on theory. Structuring education, nursing
theory draws attention to essential elements of nursing, including the patient, the patient's environment,
the care nurses can provide, which is the very concept of health.

4. Development of theoretical framework for nursing practice

Format:
1. Introduction
- May include your purpose/objectives and motivation
2. Significance of the study
- Who will benefit and what’s the implication
3. Related Literature
- Integration of concepts you have learned
4. Theoretical Framework
- Presentation of the formulated framework (own theory)
- With narrative explanation
5. Evaluation
 I. INTRODUCTION

To the extent that nursing strives to be a profession, it needs a body of knowledge unique to
itself. Developing nursing theory and supporting theory-based research contributes to building that body
of knowledge. Hence, schools that teach theory may not only impart mastery of the particular
techniques and methods characteristic of nursing but, through nursing research, augment nursing as a
profession, earning it the respect it fully deserves.

To earn equal respect among other colleges, nursing schools must meet the same standards of
research and publication applied to other academic disciplines. This is the main reason why research,
both in the academe and in the clinical setting, are encouraged further improving and developing
nursing as a profession.

The objective of doing this is to cultivate evidence-based practice as well as a research-based

teaching and learning strategies in education which will, in effect, enhance the competency and
knowledge of the nurse and uplift the nursing profession in general. It also aims to present that “caring
attitude” has always been central to nursing. The interpersonal interaction through meaningful and
respectful communication can affect positive response combined with competent care to health care
clients.

II. SIGNIFICANCE OF THE STUDY

Nursing is a profession, with professional standards. Standards are based on theoretical

development. Nursing derives its theoretical development from both empirical sciences and social
sciences. By developing new theories and concepts to nursing, in practice and in education, the nurses
can cope and deal with ever-changing and evolving practice of the profession without compromising or
undermining the quality of nurses produced and the care rendered to clients.

The Philippines is expected to produce nurses who are able to compete with local nurses of the
recruiting countries as well as with the nurses of other supplier countries. The competition is not only in
the aspects of nursing knowledge and skills but most particularly in the aspect of caring in this
increasingly impersonal technological world.

Enhancement of the skills, knowledge and attitude of the nurse will result in increased
satisfaction for the clients, encourages the nurse to improve the dignity and capability of her profession
and promote self-worth and fulfillment through the service it shares to others.
III. RELATED LITERATURE

Many nursing theory has emerged within the last two decades. That is because new information
technology has facilitated a knowledge explosion that has developed new ideas, terms and
concepts. This, in turn, has led to a superabundance of resources for nurses and nursing
educators, so many that it can be confusing, even overwhelming.
The development of standards in nursing is based on revision of theory, which is in turn based
on revisions of theory in hard sciences and social science. Research drives the evolution of these
sciences, so emerging research in medical science and social science is also an emerging
resource. (Clark 2010)
Nursing theory encapsulates statements and ideas that allow a nurse to present, formulate and
analyze the various concepts of medical practice. Many different components of nursing theory,
however, can be categorized and compared to one another. According to (Pesacreta, 2010) to
teach nursing theory, you must explain the different categories of theories, list the various types of
theories, describe the levels of theories and list the individuals who contributed to the development
of the nursing theory.
Nursing colleges need theory to compete with other, more established academic departments.
Indeed, nurse theorist Martha Rogers opined that if nurses required only knowledge from other
disciplines, there would be no need for higher education in nursing. Hence, to inspire and guide the
research necessary to justify their existence within the university, nursing schools must develop and
teach nursing theory (Miller, 2010). Using theory, nurses can better acquire and develop knowledge
unique to nursing. Schools that teach theory may not only impart mastery of the particular
techniques and methods characteristic of nursing but, through nursing research, augment nursing
as a profession, earning it the full respect it deserves.

Nursing research encapsulates statements and ideas that allow a nurse to present, formulate
and analyze the various concepts of clinical practice. Many different components of nursing theory
and research, however, can be categorized and compared to one another. The ability to determine
what is essential and interesting to the nurse is most likely the subject that will capture her desire to
conduct the study.

According to Betty Neuman (1924) Systems Model, the person is a complete system, the
subparts of which are interrelated physiological, psychological, socio-cultural, spiritual and
developmental factors. The model provides a unifying focus for approaching the client as a multi-
dimensional whole that is in constant dynamic interaction with the environment needing holistic care
to every aspect of his being to achieve desired health status or wellness.

Emerging social sensitivities also drive theoretical development in nursing. Social theories on
gender, ethnicity, culture and class that have grown out of social struggles have had a significant
effect on nursing theory. Researches on these topics are ongoing and vigorous and have greatly
contributed to the health care delivery system.
 IV. THEORETICAL FRAMEWORK

In the present health care scenario, prime value is placed on the efficiency and quality of
services rendered by health care providers. Nurses believe that the clinical expertise makes a critical
difference in the client’s outcome.

For the purpose of improving quality of nursing care, the process of role development among
nurses has been conceptualized by many theorists and writers. To better understand clinical practice,
Benner (1984) describe the performance of nurses as a continuum from novice, advanced beginner,
competent, proficient to expert.

Evidence-based nursing is one approach that may enable future health care providers to
manage the explosion of new information and technology and ultimately may result in improved client
outcomes.

While competence is a non-negotiable attribute of the advanced nurse practitioner in this age of
technology, one cannot underscore the value of holistic care. Combining competence with bio-
behavioral nursing measures will eventually lead and result to improved satisfaction of the client’s
wellness outcome.

Satisfaction of care includes nurses always being sensitive to the needs of the clients.
Comforting words, a squeeze of a hand, finding time to greet and smile, can be greatly appreciated by
the client and their relatives and may lead to meaningful outcome and recovery towards wellness.

The theoretical paradigm (Fig.1) illustrate the framework of this study showing the relationships
between the importance of research utilization and evidence-based practice and the significance of the
carative behaviors/attitude and core values of the nurse towards rendering holistic care thereby
attaining wellness and satisfaction for the client and their relatives as well.

RESEARCH UTILIZATION CARING BEHAVIORS

EVIDENCE-BASED CONNECTEDNESS
PRACTICE CORE VALUES

COMPETENT
QUALITY AND HOLISTIC CARE

CLIENT SATISFACTION
WELLNESS OUTCOME

Fig. 1. Theoretical Paradigm

 V. EVALUATION

The ever increasing population needing care worldwide has resulted in an increased demand
for health care providers including nurses. Many countries have joined the bandwagon in producing
manpower resources to address this need. The proliferation of nurses in the Philippines alone can
attest to this.

The major aim therefore is to produce nurses who are not only cognitively and technically
competent, which can be acquired through critical analyses, rigorous training, continuing education and
encouraging research utilization to support changes evolving in health care but to also inculcate the
genuine concern and care that is essentially the core of nursing practice in providing holistic care.
Indeed, this is a validation that the utilization of holistic care is a tangible expression of the nurse’s high
regard to the uniqueness and personhood of the individual and not only to their physical body. This
helps the client feel secure thereby trusting the nurse, which is an important element for a successful
nurse-patient relationship with the goal of improving the health status of the client.

References:

Books: Lee Anderson and Kathy Penningroth, (2010) Complete in All Its Parts.
Rider, J. and Harley, C. (2001) Nursing in Today’s World: Challenges, Issues and Trends.
Ruth Craven and Constance Hirnle, Fundamentals of Nursing, 1996
George, J. (1996) Nursing Theories: The Base for Professional Nursing Practice, 4th edition

Journals: Philippine Journal of Nursing Education, October 2007

Internet: Importance of Nursing Theory in Education | eHow.com