Paradigm & Theory

Levels

Presented by:
Rini Rachmawaty, S.Kep., Ns., MN, PhD
 What is a paradigm?

• A model that explains the linkages of science,

philosophy, and theory accepted and applied
by the discipline (Alligood and Marriner –
Tomey, 2002)
• One function of a paradigm is to identify the
boundary or limits of the subject matter of
concern to a discipline ( Kim, 1989 ).
• A paradigm also provides a summary of the
intellectual and social purposes of the discipline.
What is a domain?

• The view or perspective of the

discipline
• It contains the subject, central
concepts, values and beliefs,
phenomena of interest, and the
central problems of the discipline
How does domain relate
to nursing theory?

Nursing has identified its domain in

a paradigm that includes four
linkages:
1) Person/Client
2) Health
3) Environment
4) Nursing
Conceptual Models

• Conceptual models are a “set of interrelated concepts that symbolically

represent and convey a mental image of a phenomen[on]” (Fawcett &
Alligood, 2005, p. 228).
• Adam (1992) claims that they are the cornerstone of nursing’s
development (p. 61).
• Conceptual models are considered less abstract and more explicit and
specific than philosophies but more abstract and less explicit and specific
than theories (Adam, 1992; Alligood & Tomey, 2006; Caper, 1986;
Fawcett, 2005).
 What is a theory?
• A set of concepts, definitions, relationships,
and assumptions that project a systematic view
of a phenomena
• It may consist of one or more relatively specific
and concrete concepts and propositions that
purport to account for, or organize some
phenomenon (Barnum, 1988)
 What are the components
of a theory?

• Concepts – ideas and mental images that

help to describe phenomena (Alligood
and Marriner-Tomey, 2002)
• Definitions – convey the general meaning
of the concepts
• Assumptions – statements that describe
concepts
• Phenomenon – aspect of reality that can
be consciously sensed or experienced
(Meleis, 1997).
 What are the purposes
of nursing theory?

• It guides nursing practice and generates

knowledge
• It helps to describe or explain nursing
• Enables nurses to know WHY they are
doing WHAT they are doing
 Types of nursing
theories
• Grand theories – broad and complex
• Middle-range theories- address
specific phenomena and reflect practice
• Descriptive theories – first level of
theory development
• Prescriptive theories – address
nursing interventions and predict their
consequences
Benefits of Grand Theories
(McKenna, 1997)
• A guide for practice as an alternative to
practicing solely by tradition or intuition,
• A framework for education by suggesting a focus
and a structure for curricula, and
• An aid to the professionalization of nursing by
providing a basis of practice.
Examples of Grand Theories
 Middle Range Theories In Comparison To
Grand Theories As Follows:

• Narrower in scope (Fawcett, 2005; Liehr & Smith, 1999; McKenna, 1997; Meleis, 1997;
Parker, 2001; Walker & Avant, 1995)
• Concerned with less abstract, more specific phenomena (Fawcett, 2005; Meleis, 1997)
• Comprised of fewer concepts and propositions (Fawcett, 2005; McKenna, 1997; Walker &
Avant, 1995)
• Representative of a limited or partial view of nursing reality (Jacox, 1974; Liehr & Smith,
1999; Young, et al., 2001)
• More appropriate for empirical testing (Liehr & Smith, 1999 ; McKenna, 1997; Meleis,
1997; Parker, 2006; Walker & Avant, 1995)
• More applicable directly to practice for explanation and implementation ( McKenna, 1997;
Walker & Avant, 1995; Young et al., 2001)
 Descriptive and Prescriptive Theories

1) Factor-isolating theories (descriptive)

2) Factor-relating theories (descriptive/explanatory)
3) Situation-relating theories (explanatory/predictive)
4) Situation-producing theories (prescriptive) (Dickhoff & James, 1968, pp. 200–
201)
 Everyday practice enriches theory

Both practice and theory are guided by values

and beliefs

Why on earth Theory

nursing
helps to reframe our thinking about

do we study
nursing theory? Theory guides use of ideas and techniques
Theory can close the gap between theory and
research

To envision potentialities (Gordon, Parker, &

Jester, 2001)
 “The study and use of nursing
theory in nursing practice must
have roots in the everyday
practice of nurses ”

(Gordon, Parker, and Jester,

2001).
 So how do nurses
use theory in
everyday practice?
• Organize patient data
• Understand patient data
• Analyze patient data
• Make decisions about nursing
interventions
• Plan patient care
• Predict outcomes of care
• Evaluate patient outcomes
(Alligood, 2001)
Commonly used non-
nursing theories

• Systems theory
• Basic Human Needs theory
• Health and Wellness Models
• Stress and Adaptation
• Developmental Theories
• Psychosocial Theories
What is the link between
nursing theory and the
research process?

• Theory provides direction for

nursing research
• Relationships of components in a
theory help to drive the research
questions for understanding
nursing
• Chinn and Kramer (2004), indicate
a spiral relationship between the
two
 Current trends that influence nursing
theory

• Medical science
• Nursing education
• Professional nursing organizations
• Evolving research approaches
• Global concerns
• Consumer demands
• Technologies
Thank You!