This is a very important question .. nursing theories are the skeleton of nursing practice and we have both comprehensive theories and very-specific and each theorist tried to explain nursing from a different perspective; so difference is for good and for better understanding. many centers are building their practice based on certain theories such as Jean Watson.

Congratulations Nader Aghakhani for posting significant question. I agree with your observation that there is  lack of agreement in the nursing theories and may create confusion. 

Theory is the most discrete form of nursing knowledge. The use of theory provides direction and guidance for structuring professional nursing practice, education and research. Theory allows organization and linking of data in building body of knowledge for nursing. Furthermore theory differentiates the focus of nursing from other profession. The four concepts in nursing metaparadigm, which are the most global philosophical conceptual framework of a profession: person, environment, health, and nursing.

Although nursing theories vary in terminologies and philosophical approaches concepts in nursing metaparadigm are common to almost all of them. Additionally, the concepts in nursing metaparadigm are defined variably by different theorists in accordance with philosophy, scientific orientation, experience, and views of nursing held by the nurse theorist. Thus, not all theorists embrace the four nursing metaparadigm concepts as distinct concepts. It is interpreted as lack of agreement  in the nursing theories and may create confusion. 

One of the nursing theories I used in my research study was Patricia Benner’s Novice to Expert Theory. From the research findings I developed Framework on Levels and Role Expectations and Education Trajectory for Nurse Practitioner in the Philippines. The development of this framework was guided by  Patricia Benner’s Novice to Expert Theory. Benner's Stages of Clinical Competence In the acquisition and development of a skill, a nurse passes through five levels of proficiency: novice, advanced beginner, competent, proficient, and expert. 

Dear Mario,

You are welcome!

Dear Mario,

You are welcome!

Thank you Mario Vincenzo Russo for your best wishes to us all. May the the holiday season bring us peace joy, and love and be blessed with what our heart desire. 

Some theories based on empirical research could be useful to the practice of nursing. The main issue is to conduct applied research which incorporates accurate, reliable and relevant data.

Val

I think the most important step is  apply these theories in a practical setting & working on researches serve this applying &  referee to it in the studies. So the researchers & community will confirm it when its reflected positively in the scientific environment.

Dear Howieda ,

How can we  apply these theories in a practical setting?

The nursing theories  can be applied in practical setting based on four concepts in nursing metaparadigm: person, environment, health, and nursing. Person is the recipient of care, including physical, spiritual, psychological, and sociocultural components. The person refers to the Individual, family, or community. Environment refers to all internal and external conditions, circumstances, and influences affecting the person. Health refers to the degree of wellness or illness experienced by the person. Nursing  refers to the actions, characteristics and attributes of person giving care. The application of the nursing theories depends on the focus of application based on the four concepts in nursing metaparadigm. As I have mentioned above the concept of person, environment, health, and nursing are defined variably by different theorists in accordance with philosophy, scientific orientation, experience, and views of nursing held by the nurse theorist. 

Personally, I will use Jean Watson’s Theory of Human Caring in Palliative Care. Betty Neuman’s System Model is very applicable in various settings involving the four major concepts, person, environment, health and nursing. Peplau's Interpersonal Theory defines the nurse/patient relationship. Madeleine Leininger’ Transcultural Nursing emphasizes nursing care that is congruent with cultural values, beliefs, and practices. Patricia Benner Novice to Expert Theory says experience is a prerequisite for becoming an expert.

HAPPY HOLIDAYS TO ALL!

Happy Christmas to each of you!! 

There are quite a few articles about application of nursing models to practice. As an educator teaching nursing theory, my students kept challenging me. In our area there were no nursing theory based units. So I implemented the Toy adaptation model at a hospital in the Bronx. I have a few articles and book chapters about the experience. One of the best ways to find them is to go onto www.researchgate.com.  The most recent article was in Nursinf Exonomic$ about how the use of the model saved the hospital $300,000 by decreasing turnover. 

From a personal note, it was a LOT of work implementing the RAM. Staff nurses do not accept change easily. Also, I needed a nurse expert in the area where we implemented it: neurosurgery. I knew the model but couldn't work side by side with the nurses as they were providing care to explain how the model would be applied during care. 

Hope this is helpful. 

I fully agree with you Keville Frederickson. There is always resistance to change. This resistance is a hindrance to innovation. The nursing theories or models are all beneficial and very much applicable in various settings: clinical, education, nursing leadership and management, and research. I applied Betty Neuman’s Systems Model and King’s Conceptual System and Theory of Goal Attainment and Transactional integrated with interdisciplinary models on change and systems in the study of Intra-family Violence.  I used Patricia Benner’s novice to expert theory in developing career trajectory framework. I believe that some nurses are using various nursing theories without knowing that they are applying nursing theories and what theories they applied. Nurses are using Peplau's Interpersonal Theory in the workplace in their everyday nursing practice but they may not be aware that their practice is guided by Peplau’s Interpersonal Theory. Personally nurses needs a drive to understand and embrace how nursing theories or models are applied in various work setting. 

personally, I no longer use the theories of care (the most common and traditional) neither in teaching nor in practice as I have not tested their applicability in counterstand Italian. I developed a proposal of mine, which I send in files (they slide for a conference). if you are interested, these are in Italian, but I can translate. Also we can talk in more detail.

Hello

Dear all, First of all Happy New Year, and all the best in 2016, let the Nursing be more developed and improved. 

I have read all the posts and I can see this is very interesting topic. For me this was a question for a long period especially in enviorement where I came from, how to implement Nursing theoris in practices!!!.

My personal opinion Nursing theories are very important for Nursing practice and they need to be used as a generator of new Nursin knowledge in Nursing job. All theories should applied in accordance with the conditions specific area (e.g. low developed countries and high develop countires). 

I still have opinion that Nursing Theories are very important for development of Nursing practice in accordance with evidence based nursing. 

Kind regards

Happy New Year To All,

Very important question. Thank you for posting it in this forum. Responses are very informative and insightful. I would like to add that nursing theory can promote nursing practice by providing the lens through which we can understand the phenomenon being studied and provide evidence-based rationales for interventions being employed.  

My experience in teaching both undergraduates and graduates students didactically and clinically has been that they can explain protocols for patients' clinical presentations using the medical model theory with ease. However, if the patients do not present with classic signs and symptoms, the nursing students appear to have a more challenging time explaining the 'why' for the interventions chosen. I believe nursing theory (ies)  answers the 'why' and  'how' of such interventions. 

With this said, I don't agree there is a lack of agreement in nursing theories, rather, there are several theories from which to choose from. This is important because one theory is not a proper fit for all studies; for various reasons: geographical, culturally, and technology to name a few. I have used  Roy's Theory of Adaptation (RAM), principles of Humanism and Veritvity to explain the lived experience of Dominican women living with Late Stage Breast Cancer. However, to  to address cancer worry of Urban Dominican, I chose the  Conceptual Model of Nursing and Population Health which centered on Upstream Factors, Population Factors, and Health Care Systems Factors, Nursing Activities, and Population Health Outcomes to address informatics strategies, by Fawcett & Ellenbecker.

The key to promoting evidence-based nursing practice is to expose nursing students  to various nursing theories and their applications throughout the curriculum. This would help them gain a greater understanding and transfer this knowledge to facilitated understanding of the data collected (whether clinical assessments and/or other types of research) and in turn create evidence-based interventions that will promote patients' well being. I found de Chesnay & Anderson book entitled : "Caring for the Vulnerable..." to be very helpful engaging and helping  students understand why and how nursing theories help promote evidence-based nursing practice.

Best wishes

Thanks Alsacia! You make very good points. I'm especially interested in your use of Fawcett and Ellenbecker's model on Population Health. We really need to test this model much more as it is derived from nurisng. I'm also interested in your work with the vulnerable and using deChesnay and Anderson. Keep up the good work, nursing scholar.

A very good understanding of the various nursing theories and their appropriate application to nursing practice, will salvage the falling standards in nursing care.  An understanding of these theories help nurses focus their nursing care, set goals for nursing care and the teaching of nursing students.

I have been very impressed particularly with the few articles i have read from Keville on Roy's adaptation model. I do not get tired reading them and wish i could do same in my country

Florence, We WILL! Keville

I have developed the theory of  narrative  nursing to supplement the traditional model for the Italian context. I leave the slides, but they are in Italian. If you are interested, to translate and insert them as soon as possible.

Hello

Giovanna

I would also be very interested in details of our proposal with those interested. And above all I started experimenting, but I would need  cooperation.

best regards

Giovanna

Please can the information be translated into English Language for those of us with no knowledge at all in Italian to be able to understand and make contribution?

ok, I translate your provider and then forwarding.

Bye

Giovanna

I change my question to:

How much nursing theories help to promotion of nursing practice?

The middle-range, transdisciplinary, and actionable theories are demanded to meet the 4th industrial revolution, which can support desirable decision-making:

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I have a few articles on how nursing theories (specifically Roy) can influence improved practice, increased nurse and patient satisfaction and improve hospital quality scores. Sadly, few nursing units use a nursing model for practice.