Concept Comparison and Analysis Across Theories - Term Paper Example

?Introduction Every discipline has a distinct focus for the development of knowledge and this unique characteristic distinguishes that particular field from another. Nursing is not an exception and the knowledge that constitutes the profession makes it unique and enhances its organization to facilitate transfer of knowledge to the learners. Nursing theories contribute an important part of the profession and according to Mary and Patricia (2008), nursing knowledge includes theories, philosophies, research and practice wisdom of the discipline. In the nursing profession, acquisition of this knowledge is essential for guiding practice (CN, 2011). Nursing theory is a group of concepts, relationships, definitions and assumptions or propositions resulting from nursing models or other disciplines. The theory illustrates an intended and systematic view of phenomena through formulating particular interrelationships among the concepts, with objectives of describing, explaining, predicting and prescribing (Cowling, 2007). In this respect, knowledge structure in the nursing profession is studied in different headings, including nursing philosophies, conceptual models and grand theories, metaparadigm, nursing theories in addition to middle range theories and nursing theories. This paper discusses the main concepts across Florence Nightingale’s environmental theory and Faye Abdella theory of 21 nursing problems. . Barrit (1973:49) defines a concept as the “mental idea that constitutes the basic elements of a theory”. Concepts and propositions constitute to conceptual models. According to Fawcett (2000), conceptual model is a representation of the way of judgment about a particular problem or a method of representing the complexity of functionality of a particular aspect. One main defining characteristic of conceptual models is that they are not usually based on a particular nursing theory. In this regard, the models are usually based on various theories, which enhance comprehension of a particular nursing problem in a different setting or context. Florence Nightingale’s environmental theory and Faye Abdellah’s theory of 21 nursing problems are examples of two nursing theories with common core concepts. Both theories acknowledge the concepts of nursing, person, environment and health. Florence Nightingale’s environmental theory emphasizes on the role of environment in promoting cure and health to a person. According to environmental theory, the role of nursing is to provide fresh air, cleanliness or hygiene, warmth, appropriate diet and a silent environment to facilitate curative process of patient (Barrit, 1973). In reference to the theory, Nightingale considers a person in the nursing context as a patient served by a nurse and affected by environment and as an individual possessing reparative abilities (Fawcett, 2000). To promote health, the environmental theory recommends provision of necessary physical, psychological and social support to the patients. In this respect, environment forms the basic component of the theory. The theory consists of all environmental aspects including social, psychological, physical and all other external conditions that influence a person’s health. To ensure the maintenance of health, the environmental theory holds that the healing powers within a person should be utilized to their maximum (Mary and Patricia 2008). This is achieved by deliberately controlling the physical, psychological, and social needs to prevent the occurrence of disease. In this respect, Florence Nightingale attributed the emergence of disease to nature, argued that ill health is reparative, preventable, and managed by controlling the relevant external and internal factors surrounding the patient (Florence Nightingale Museum). Therefore, according to the environmental theory, the focus of nursing professionals is management of the patient’s health and disease, whereby they should help the affected individuals regain health by providing a favorable environment. Faye Abdella’s topology of twenty-one nursing problems recognizes the role of implementing patient centered approaches to manage diseases and equally important, the role of nurses in identifying and solving particular health problems related to the patients’ health (Fawcett, 2000). To address these issues, Abdella (1973) classified the theory into three main categories. The first category includes the physical, emotional, and sociological needs of the patient; the second involves the type of the interpersonal relationships established between the patients. Finally, Abdella’s theory investigated the common elements practiced in the patient care. According to Cowling (2007), the typology of 21 problems was intended to provide the base of evaluating the competence of nurses from the outcomes of their services to the patients. Just like Nightingale’s environmental theory, Abdellah’s typology of 21 problems conceptual framework elaborates on nursing, health, person and the environment. In Abdellas’ view, nursing is a helping profession and it entails provision of a wide range of services in order to meet the needs of the patient. In this respect, the role of nursing is to enhance and restore the patients’ health back to normal to enable them undertake their individual roles in the society independently (Abdella, 1973). Therefore, Abdellah’s theory considers health to be a state characterized by absence of disease where all needs of a person are met and there is no actual or anticipated disability of the patient (Mary and Patricia, 2008). In this regard, the typology of the 21 problems defines a person in nursing context as an individual in need of physical, social and emotional necessities, and hence the recipient of the nursing services. Concerning the environment, Abdellah’s typology of 21 problems recognizes the critical role that the external factors such as the living premises and the society play in influencing the health people in the society (Current Nursing, 2011). Both of these theories have common concepts on health, person, nursing and environment. In particular, the theories highlight the importance of nursing care in restoring health of a patient by initiating the appropriate recovery process. Concerning nursing profession, both theories consider it as a source of holistic care to the patient needs, with an objective of promoting healing and recovery. In this respect, the theories hold that nurses have the obligation of not only providing favorable recovery environment but also in identifying the individual needs of the patients. The environmental and the typology of 21 problem theories acknowledge the crucial role that the environment plays in causing diseases and how these factors could be adjusted to initiate and promote healing process. Concerning health of a patient, the theories affirm that individuals are capable of regaining the optimal state of their physical, emotional and social functioning if only the appropriate care is provided. Florence Nightingale environmental theory could be best applied in prevention and management of infections transmitted in healthcare setting. According to WHO (2002), pathogenic organisms such as bacteria, fungi and viruses are the major causes of hospital-acquired infections. WHO (2002) defines hospital-acquired infection as “a disease acquired in hospital by a patient who was admitted for a reason other than that infection”. In this regard, the infections occur in a patient within a hospital or other health care premises, whereby the infection was not present at the time of admission. These infections affect patients in both developed and developing countries. Some of the most common infections include urinary tract infections, lower respiratory tract infections and infections of surgical wounds. Most of these infections occur in intensive care units and orthopedic and surgical wards (WHO, 2002). Some of the factors contributing to the transmissions of these infections include the type of the microbial organism, the immune vulnerability of the patient, environmental factors and resistance of the microbes to drugs (WHO, 2002). Hospital acquired infections contribute significantly to hospital mortality and morbidity. The increasing incident of these infections in the world is an indicator of poor delivery of services in health care institutions. The hospital environment facilitates transmission of the microbes because many patients and carriers of different diseases assemble in such premises. In this case, the environmental theory could be best applied in prevention of these infections. In context to preventing the transmission of infections in health care setting, Nightingale’s environmental theory relates with interconnections between a healthy environment and nursing practice. This is theory is founded on the philosophy that external factors could stop, contain, or cause diseases. In this case, nurses can assist patients regain their health by controlling the environment and adjusting it in addition to meeting particular needs of the patients. In hospital setting, the environmental theory focuses on controlling the environment for patients, families and the community where they live in. Regarding the environment, the theory is applicable in addressing the physical, psychological and social elements of the patient in hospital setting to control the transmission of hospital acquired infections. The physical environmental aspect entails addressing cleanliness issues, whereby a high level of hygiene is necessary. Cowling (2007) noted that the state of physical environment determines the psychological and social environment of the patient. The psychological environment of a patient is highly affected by unfavorable physical environment and this contributes to the development of stress. High levels of stress prevent quick recovery of patients. In this respect, it is important for nurses to provide them with positive and appealing environment in addition to cultivating good interpersonal relationships with the patients. Equally important, the theory focuses on social environment affecting the patient within the hospital setting and in the outside community (Mary and Patricia, 2008). In this case, Nightingale’s environmental theory comprises of all the environmental elements that are necessary to promote recovery. This includes but not limited to healthy houses that are well ventilated with good lighting and low level of disturbance in form of noise. In addition, the theory emphasizes on the importance of cleanliness in the rooms, personal hygiene of the patient and the surroundings (Barrit, 1973). Conclusion In relation to nursing metaparadigms, Nightingale environmental theory addresses issues of the person, health, environment and nursing profession. The theory regards the person as patient vulnerable to the effects of the environment, but with inherent reparative power of dealing with the ailment. For a patient to regain health, the theory emphasizes on the importance of maintaining a safe environment. In respect to the environment, the theory appreciates the effect of physical, social, and psychological elements on health of an individual. Concerning health, environmental theory addresses the need of maintaining and controlling environmental factors to promote vigor. Moreover, the theory indentifies disease and health as the main concerns of nurses, where they should help patients until recovery. Finally, the theory holds that nursing, as a profession should provide the ideal environment in order to facilitate recovery of the patient (Barrit, 1973). References Abdella, F.G.(1979). Better patient care through nursing research. 2nd ed. New York: Macmillan. Barrit, E.R.(1973). Florence Nightingale’s values and the modern nursing education. Nursing Forum, 12(1), pp 11-52. Cowling, W.R.(2007). A unitary participatory vision of nursing knowledge. Advances in the Nursing Science, 30(1), pp 69-81. CN(Current Nursing) (2011). Nursing theories. A companion to nursing theories and models. Accessed on 14 June 2011, from http://currentnursing.com/nursing_theory/ Fawcett, J.(2000). Analysis and evaluation of contemporary nursing knowledge: Nursing models and theories. Philadelphia: F.A. Davis. FNM(Florence Nightingale Museum). Accessed on 14 June, 2011 from http://www.florence-nightingale.co.uk/cms/ Mary, J., and Patricia, R. (2008). The middle range theory for nursing. 2nd ed. New York: Springer publishing company. WHO (2002). Prevention of hospital acquired infections: A practical guide. 2nd ed. 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