Chapter 5 components and levels of abstraction in nursing knowledge
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Transcript of Chapter 5 components and levels of abstraction in nursing knowledge
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Chapter 5Components and
Levels of Abstraction in Nursing Knowledge
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Introduction
• Graduate students and advanced practice nurses must be familiar with the components and levels of abstraction in nursing knowledge.
• One way to conceptualize this information is by using the structural holarchy developed by Jacqueline Fawcett.
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Components of Nursing Knowledge
• Nursing knowledge is the cumulative, ever-evolving result of prior learning, experience, theory, and research.
• Fawcett (2005) places nursing knowledge into a structural holarchy with five components: – Metaparadigm– Philosophy– Conceptual model
– Theory– Empirical indicator
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Knowledge Holarchies• A holarchy is a hierarchy in which each level is a
whole but is also part of a larger whole.• Each holon or node functions independently but
also interacts with other holons or nodes.• Within a holarchy, holons coordinate and include
holons on subordinate levels.• Some holons also interact with other holons of the
same level.• Can be viewed through either testing theory or
generating theory.
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Metaparadigms• A metaparadigm is the most abstract view of a
discipline, and it consists of the concepts that define that discipline.
• In nursing, the most common metaparadigm concepts are human beings, environment, health, and nursing.
• Because it has a metaparadigm, nursing is accurately classified as a discipline, or “a distinct way of viewing all phenomena.”
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Philosophies (1 of 3)
• Broadly speaking, a philosophy is the search for and communication of a viewpoint.
• According to Fawcett (2005), the function of a philosophy is “to communicate what the members of a discipline believe to be true in relation to the phenomena of interest to that discipline.”
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Philosophies (2 of 3)
• There are four areas of philosophical inquiry:– Ontological area: Involves the study of reality and what
the members of a discipline believe to exist.– Epistemology area: Involves the study of knowledge,
including how it can be created, disseminated, and categorized.
– Ethics area: Involves inquiry about what is valued by a discipline in terms of actions and practices.
– Logic area: Is a method of inquiry through which arguments are presented and evaluated.
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Philosophies (3 of 3)
• Nursing scholars use three main philosophies:– Reaction world view: States that humans react to stimuli in a
linear, causal manner and change only when necessary for survival.
– Reciprocal interaction world view: States that humans are active, have reciprocal reactions with the environment, and may or may not change under certain circumstances.
– Simultaneous action world view: States that humans change continuously and are in mutual rhythmical interchange with the environment.
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Conceptual Models (1 of 3)
• Also called conceptual framework, conceptual system, paradigm, and disciplinary matrix.
• Fawcett (2005) defines a conceptual model as a “set of relatively abstract and general concepts that address the phenomena of central interest to a discipline, the propositions that broadly describe those concepts, and the propositions that state relatively abstract and general relations between two or more of the concepts.”
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Conceptual Models (2 of 3)
• Conceptual models characterize relationships among phenomena to shape a distinctive frame of reference.
• Individuals can interpret and characterize the same reality in different ways using different conceptual models.
• These models have practical value because they guide research and practice.
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Conceptual Models (3 of 3)
• Fawcett recognizes seven conceptual models of nursing.
• According to Fawcett, these models are the foundation of nursing as a discipline.
• Conceptual models are more abstract than theories, and they can be distinguished from theories using a series of if-then determinations.
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Theories (1 of 2)
• According to Fawcett (2005), a theory is “one or more relatively concrete and specific concepts that are derived from a conceptual model, the propositions that narrowly describe those concepts, and the propositions that state relatively concrete and specific relations between two or more concepts.”
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Theories (2 of 2)
• Theories can be defined in different ways:– Based on structure– Based on practice goals– Based on tentativeness– Based on research– Based on creativity in developing and connecting
concepts– Based on progression from conceptual models to
theory
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Functions of Theory: Theory to Practice
• The usefulness of a theory is closely connected to “how good” the theory is.
• Theory development serves two functions:– Testing and generating theories drives research– Finding research-based evidence for theories drives
changes in practice
• The relationship of theory development to practice is called the conceptual-theoretical-empirical (C-T-E) formalization.
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Theory by Levels of Abstractions (1 of 2)
• Theories can be categorized as follows based on their levels of abstraction and scope:– Metatheory: A philosophical stance about theory
and its methods for generating knowledge– Grand theory: A set of concepts that is less broad
than a conceptual model but too abstract to state relationships or hypotheses in empirical terms
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Theory by Levels of Abstractions (2 of 2)
– Middle-range theory: A set of concepts that is not as broad as a grand theory and is strongly supported by empirical data.
– Practice theory: A narrow theory that results from empirical testing; sometimes called situation-specific theory or micro theory.
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Middle-Range Theory and Nursing
• Middle-range theories are important because they have specificity for nursing practice.
• A middle-range theory may be categorized as:– Descriptive: “Information presenting”– Explanatory: “Knowledge building”– Predictive: “Knowledge confirming”– Prescriptive: “Knowledge utilizing”
• Good middle-range theories are closely linked to specific conceptual models.
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Empirical Indicators
• Defined by Fawcett (2005) as “an actual instrument, experimental condition, or procedure that is used to observe or measure a middle-range theory concept.”
• Information derived from these indicators is commonly known as data.
• Empirical indicators provide a way to test or generate middle-range theories.
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Using the Components in Practice (1 of 2)
• As mentioned, the C-T-E system can be used to connect theory and practice.
• When applying the system, three elements must be considered:– Translation of the metaparadigm of nursing into practice
(e.g., via hospital mission statements)– Translation of philosophies into practice (e.g., via codes
of ethics , patient bills of rights, and statements of nursing philosophy)
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Using the Components in Practice (2 of 2)
– Translation of conceptual models, theories, and empirical indictors into a “formal nursing knowledge system” (e.g., via practice standards, assessment designs, intervention protocols, and evaluation programs).
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Summary• Fawcett’s holography connects five main
components of nursing knowledge: metaparadigm, philosophy, conceptual model, theory, and empirical indicator.
• Middle-range theories must be closely linked to conceptual models if nursing is to retain its status as a discipline.
• The C-T-E system is necessary for translating nursing models and theories into practice.