MIGUEL D.

SOLEDAD
President and CEO
 
DR. LUCILA T. LUPO
DEAN,AHSE
 
BLAISE B. NIEVE,RN,MAN
Program Chair
 
KENNETH M. SABIDO,RN,MN
Level 1-2 RLE Supervisor
 
DOMINGO T. SO JR,RN,MN
Level 3-4 RLE Supervisor
 
Davao doctors college philosophy statement – AESTIMAMUS VITAM “We Value Life”
 

VISION
The school of choice of future healthcare proffesionals.
 

MISSION
To provide our clients with health care education of the highiest order, our employees
with rewarding and fruitful working environment; our partners with mutually benificial
relationships, and our stockholders with a viable and sustainable enterprise.
 
  
CORE VALUES
 
L-iberty to learn
The exercise of academic freedom. The liberty to explore, to innovate, to advance the
search for knowledge.

I-ntegrity
Adherence to rules on acceptable conduct.
Standing upright to uphold what is right

F-ortitude
Strength of character. Courage in the face of adversity

E-xcellence
Performing to attain results of the highest order in everything we do.
 

COURSE DESCRIPTION

▪ Meta concepts of a person, health, environment, and nursing as viewed by the different
theorists also includes non-nursing theories

▪ How these concepts and theories serve as guide to nursing practice

▪ Deals with health as a multi-factorial phenomenon and the necessary core competencies that
the nurse need to develop

 
 NURSING
 
 autonomous and collaborative care of individuals of all ages, families, groups &
communities, sick or well and in all settings

 includes the promotion of health, the prevention of illness, and the care of ill, disabled
and dying people.
 
 
IS NURSING AN OCCUPATION OR A PROFESSION?
 
OCCUPATION
require widely varying levels of training or education, varying levels of skill, & widely variable
defined knowledge bases.
 
PROFESSION
a learned vocation or occupation that has a status of superiority & precedence within a division
of work.
 
ALL PROFESSIONS ARE OCCUPATIONS, BUT NOT ALL OCUPATIONS ARE PROFESSIONS
Finkelman & kenner, 2013
 

CHARACTERISTICS OF A PROFESSION
 
1. Defined & specialized knowledge base
 
2. Control & authority over training & education
 
3. Credentialing system or registration to ensure competence
 
4. Altruistic service to society
 
5. A code of ethics
 
6. Formal training within institutions of higher education
 
7. Lengthy socialization to the profession
 
8. Autonomy
 
 NURSING
 
 dramatic changes in response to societal needs and influences
 reveals its continuing struggle for autonomy and professionalization
 unique place in the healthcare system
 largest health care profession
 work in diverse settings and fields
 frontline providers of health care services
 
 NURSES’ ROLE
 
 responsible for the ongoing care of sick individuals
 
 assess their health status and help them throughout the process to recovery
 
 promote health and prevent illness
 
 care for the disabled and physically or mentally ill people
 
 engage in healthcare teaching
 
 participate in the provision of healthcare alongside other team members
 
 supervise training and education of nurses 
 assist in healthcare research
 
  
ROLES AND FUNCTIONS OF THE NURSE
 
 CARE GIVER – assist the client physically and psychologically while preserving
the client’s dignity
 
 COMMUNICATOR – integral to all nursing roles with the client, support persons,
other health professionals, and people in the community
 
 TEACHER – helps clients learn about their health and the health care procedures
they need to perform to restore or maintain their health
 
 CLIENT ADVOCATE – acts to protect the client. Nurse may represent the client’s
needs and wishes to other health professionals
 
 COUNSELOR – process of helping a client to recognize and cope with stressful
psychological or social problems. Involves providing emotional, intellectual, and
psychological support
 
 CHANGE AGENT – assisting clients to make modifications in their behavior and
dealing with change in the health care system
 
 LEADER – influences others to work together to accomplish a specific goal
 
 MANAGER – manages the nursing care of individuals, families, and communities.
Delegates nursing activities to ancillary workers and other nurses
 
 CASE MANAGER – works with staff nurses to oversee the care of a specific
caseload and help ensure that care is oriented to the client, while controlling costs
 
 RESEARCH CONSUMER – use research to improve client care and discriminating
consumer of research findings
 EVOLUTION OF NURSING
 
TIMELINE:
 
o NURSING at its BEGINNING
 
o NURSING IN THE EARLY 20th CENTURY
 
o Nursing Leaders of the 20th century
 
o NURSING SCIENCE AND THEORY IN THE LATE 20TH CENTURY
 
o NURSING IN THE PHILIPPINES
 
Where it began... THE EVOLUTION
 
o As intuitive way of caring for the sick family members
o In the Old Testament : Women provide care of children & infants and in delivery
o In Greece and Rome: Rely on Mythology
 
 WHERE IT BEGAN..
 
TRADITIONAL FEMALE ROLES
A wife, mother, daughter, and sister have always included the care and nurturing of other
family members.
 
RELIGION
PLAYED A SIGNIFICANT ROLE IN THE DEVELOPMENT OF NURSING
The Knights of Saint Lazarus (established circa 1200) dedicated themselves to the
care of people with leprosy, syphilis, and chronic skin conditions
 
WAR
NURSES EMERGED WITH NOTABLE CONTRIBUTION TO COUTRY AND HUMANITY
Sojourner Truth (1797–1883) and Harriet Tubman (1820–1913) provided care and safety to
slaves fleeing to the North on the Underground Railroad Mother Biekerdyke and Clara Barton
searched the battlefields and gave care to injured and dying soldiers
 
THE EARLY 20TH CENTURY: Major Developments
 
• Positivism
– Logical reasoning & empiricism
– Development of science

• Nursing evolved toward a scientific, research-based defined body of nursing knowledge and
practice

• The arrival of nursing as a profession and a "calling“

  
THE EARLY 20TH CENTURY
 
 
Florence Nightingale
Development of nursing education, practice & administration
 
Linda Richards
America’s first trained Nurse
 
JEAN HENRI DUNANT
Organized the international conference that founded Redcross
 
CLARA BARTON
Organized and established the American Red Cross
 
Lilian Wald
Founder of Public HealthNursing
 
Margaret HigginsSanger
Founder of Planned Parenthood
 
M. Lucille Kinlein
First Independent Nurse Practitioner
 
   
PHILIPPINE NURSING LEADERS
 
Cesaria Tan
1ST Filipino Nurse to have Masters Degree in Nursing
 
Magdalena Valenzuela
1st Filipino Industrial Nurse
 
Col. Elvegla Mendoza
1st Female Military Nurse
 
Dr. Julita Sotejo
Florence Nightingale of the Philippines
Author of the Code of Ethics
Founder of the UP-CN
 
Anastacia Tupaz
Founder of the FNA
 
Rosario Montemayor Delgado
1st President of the FNA
 THEORY
 a supposition or a system of ideas intended to explain something, especially one
based on general principles independent of the thing to be explained
 a plausible or scientifically acceptable general principle or body of principles
offered to explain phenomena
 
COMPONENTS IN A THEORY
 
CONCEPTS
 
 Ideas and mental images that help to describe phenomena (Alligood and
Marriner-Tomey, 2002)
 Ideas formulated by the mind or an experience perceived and observed such as
justice, love, war…
Concepts can be:
 Empirical – can be observed or experienced thru the senses (ex. Thru
stethoscope)
 Abstract – those are not observable (caring, hope..)
 
DEFINITIONS
 Convey the general meaning of the concepts
 Various descriptions which convey the general meaning & reduces the vagueness
in understanding a set of concepts
 
PROPOSITIONS
 Explains the relationship of different concepts

ASSUMPTIONS
 Statements that describe concepts and specifies the relationship or connection
of factual concepts or phenomena

PHENOMENON
 Aspect of reality that can be consciously sensed or experienced (Meleis, 1997).
 
THEORY
 a set of logically interrelated concepts, statements, propositions, and definitions,
which have been derived from philosophical beliefs of scientific data and from which
questions or hypotheses can be deduced, tested, and verified.
 
CHARACTERISTICS OF A THEORY
 Logical
 Consistent with everyday observations
 Similar to those used in previous successful programs 
 Supported by past research in the same area or related ideas
 SCOPE OF THEORIES & ANALYSIS
RANGE/SCOPE or ABSTRACTNESS
 
 Refers to the complexity & degree of abstractness of its concepts & propositions
Uses the terms:
 Metatheory, Philosophy or Worldview
 Grand Theory or Macrotheory
 Middle range or Midrange theory
 Practice theory, Situation-specific theory, or Microtheory
 
METATHEORY
 Describe the philosophical basis of the discipline
 Theory about a theory
 Focuses on broad issues (like process of knowledge generation & theory
development)
 
GRAND THEORY
 Describe the comprehensive conceptual frameworks
 Most complex & broadest in scope
 Non-specific, lack operational definitions
 Attempts to explain broad areas within a discipline & may incorporate numerous
other theories
 Not amenable for testing

MIDDLE RANGE
 To describe frameworks that are relatively more focused than the grand theories
 Lies between the Grand nursing models & Practice theories
 Composed of relatively concrete concept that can be operationally defined
 With concrete propositions, maybe empirically tested
 
PRACTICE THEORY
 Describe those smallest in scope
 more specific than Midrange theories
 Produce specific directions for practice
 Limited to specific populations or fields of practice & often use knowledge from
other disciplines
 
TYPE OR PURPOSE:
 
Factor-isolating theories (Descriptive theories)
a. Those that describe, observe, & name concepts, properties & dimensions
b. Identifies & describes major concepts of phenomena but does not explain how
or why they are related
 
Factor-relating theories (explanatory theories)
 Relate one concepts to one another
 Describe the interrelationships among concepts or propositions
 Attempt to tell how and why concepts are related
 
Situation-relating Theories (predictive or promoting or inhibiting theories)
 Related concepts are stated & the relational statements are able to describe
future outcomes
 Prediction of precise relationships between concepts
  These theories are relatively hard to find
 
Situation-producing theories (prescriptive theories)
 Those that prescribe activities necessary to reach defined goals
 Include propositions that call for change & predict consequences of nursing
interventions
 
ANALYSIS AND EVALUATION OF A THEORY
 
THEORY ANALYSIS
 The systematic process of objectively examining the content, structure and
function of a theory
 Conducted if the theory has potential for being useful in practice, research,
administration and education
 
THEORY EVALUATION
 The process of systematically examining a theory
 Identifies a theory’s degree of usefulness to guide practice, research, education
& administration
 Provide nurse clinician with additional knowledge about the soundness of a
theory
 Provides guidelines for the choice of appropriate interventions & gives indication
of their efficacy.
 Helps clarify the form & structure of a theory being tested
 May allow researcher to determine the relevance of the content of theory for
use as a conceptual framework
 
THEORY EVALUATION CRITERIA (Barbara Barnum)
 
INTERNAL CRITICISM
 Examines how the components of the theory fit with each other
 Clarity
 Consistency
 Adequacy
 Logical Development
 Level of Theory Development
 
EXTERNAL CRITICISM
 Examines how a theory relates to the world
 Reality Convergence
 Utility
 Significance
 Discrimination
 Scope
 Complexity

THEORY EVALUATION CRITERIA (Chinn & Kramer)

 
Clarity
  reviewed in terms of semantic clarity and consistency and structural clarity and
consistency.
o Words have multiple meanings within and across disciplines; therefore, a word
should be defined carefully and specifically according to the framework
 facilitated with diagrams and examples
 
Simplicity
 should be sufficiently comprehensive, presented at a level of abstraction to
provide guidance, and have as few concepts as possible with simplistic relations to aid
clarity. Reynolds (1971)
 Brief but complete. Walker and Avant (2011)
 
Generality
 speaks to the scope of application and the purpose within the theory (Chinn &
Kramer, 2011)
 The broader the scope, the greater the significance of the theory (Ellis, 1968)
 
Empirical Precision
 Utilizes empiricism, wherein the theory is testable by mere use of observation, &
usability
 Logical, scientific
 Derivable Consequences
 
HOW IMPORTANT IS THE THEORY?
 Provides guidelines for professional nurses.

SIGNIFICANCE OF THEORY IN NURSING

 
 Nursing practice was generally established by others and highlighted by
traditional, ritualistic tasks with little regard to rationale.
 
 nursing theories initially aimed at clarifying the complex intellectual and
interactional domains that distinguish expert nursing practice from the mere doing of
tasks (Omrey, Kasper, & Page, 1995).
 
 The use of theory offers structure and organization to nursing knowledge and
provides a systematic means of collecting data to describe, explain, and predict nursing
practice
 
EPISTEMOLOGY 
Epistemology - the study of the theory of knowledge.
 
Schultz & Meleis, 1988
Epistemologic questions include:
 What do we know?
 What is the extent of our knowledge?
 How do we decide whether we know?
 What are the criteria of knowledge?
 
Streubert and Carpenter (2011)
It is important to understand the way in which nursing knowledge develops to judge the
appropriateness of nursing knowledge and methods that nurses use to develop that
knowledge.
 
NURSING EPISTEMOLOGY
 The study of the origins of nursing knowledge, its structure and methods, the
patterns of knowing of its members, and the criteria for validating its knowledge claims
CARPER’S FOUR FUNDAMENTAL PATTERNS FOR NURSING KNOWLEDGE
(4 ways of knowing)
  
Empirical knowledge (Science of nursing)
 objective, abstract, generally quantifiable, exemplary, discursively
formulated, and verifiable
 formulated into scientific generalizations, laws, theories, and principles
that explain and predict
 
Esthetic knowledge (Art of Nursing)
 is expressive, subjective, unique, and experiential rather than formal or
descriptive
 includes sensing the meaning of a moment
 evident through actions, conduct, attitudes, and interactions of the nurse
in response to another
 focus on empathy, Adaptability/flexibility to patient’s needs
 
Personal knowledge
 refers to the way in which nurses view themselves and the client
 promotes wholeness and integrity in personal encounters
 incorporates experience, knowing, encountering, and actualizing the self
within the practice
 Therapeutic use of self – through self-understanding
 
Ethics (moral knowledge in nursing)
 refers to the moral code for nursing and is based on obligation to service
and respect for human life
 Ethical knowledge occurs as moral dilemmas arise in situations of
ambiguity and uncertainty

METAPARADIGM
 Generally accepted perspective of a particular discipline at a given time
 is the ideology within which the theories, knowledge, and processes for knowing
find meaning and coherence
 Nursing’s metaparadigm is generally thought to consist of the concepts of
person, environment, health, and nursing
 The phenomena of Person, Health, and Environment all relate to the
recipient(s) of nursing care or nursing actions. The phenomenon of Nursing is
only focused on the nurse
 
PERSON
 refers to a being composed of physical, intellectual, biochemical, and
psychosocial needs
 Person is defined according to the recipient of nursing care (the patient or client)
and may include the patient’s family and friends and the community
 
ENVIRONMENT
 consists of internal, external, and social factors that impact a patient’s health
 including genetics, immune function, culture, interpersonal relationships,
economics, mental state, geographic location, education level, politics, ecology, social
status, job or career level

HEALTH
 the ability to function independently
 Concept of health is relative to the person and is defined according to the
patient’s perspective
 Refers to the patient’s level of wellness (i.e., the health/wellness-illness
continuum) in all its many aspects: physical, psychological, mental, intellectual, emotional,
and spiritual
 
NURSING
 concept is related to the art and science of nursing
 consists of nursing actions or nursing interventions
 includes the nurse applying professional knowledge, procedural and technical
skills, and indirect and direct (hands-on) patient care