Evidence-based practice is an issue that has brought forth debates on whether or not nurses should provide patient care based on research and theory. While some clinical nurses believe that nursing research should be based on nursing theories, others believe that research can use an interdisciplinary theoretical approach rather than theories. In fact, evidence shows that a majority of nurses do not appreciate the connection between nursing theory and nursing practice. In my view, the best practice in the nursing profession includes the nursing practices based on research-based knowledge. Therefore, I submit that research done by clinical nurses should be based on the nursing theoretical framework.
Nursing theoretical framework
The theoretical framework for the nursing practice is built in a process arising from clinical practice and is replicated through research and development of various concepts relating to the clinical practice. Therefore, when examining a certain phenomenon, a nurse should first begin with understanding the phenomenon and then define the concepts of interest to build knowledge in a particular area. Having done so, the nurse is in a better position to develop theories that are directly connected or linked to clinical practice.
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Analyzing concepts is important in developing theories and enhancing knowledge about a certain area or phenomenon. Studying concepts also enhances practice in the sense that professionals can understand the meaning of various terms used in the nursing profession. Take, for instance, a nurse who conducts research with the aim of understanding the meaning of the concept of respect. Doing so would help the nurse become more aware of the importance of respect and how it relates to the provision of health care to patients.
There are various nursing-related patterns of knowing which can be considered as types of nursing theories and whose mode of inquiry help in developing nursing theories necessary for evidence-based practice. The four patterns include personal, aesthetics, empirics and ethics (Fawcett et al. 2001). While empirical knowing includes explanations, predictions and factual descriptions that are based on subjective data, ethical knowing includes descriptions of moral values and moral obligations. The mode of inquiry for ethical knowing is justification for the moral values, beliefs and ethics in the nursing practice (Fawcett et al. 2001)
Personal knowing is a pattern which focuses on expressing the quality of the relationship between patients and nurses as well as interpersonal relationships of nursing. More specifically, it focuses on how nurses learn how to be trustworthy and reliable by listening to other people’s responses and reflecting on those responses in their practice. Aesthetic knowing is a pattern that includes the perception of the nurse of what is and what is not significant in the behavior of the patient (Fawcett et al. 2001). The above patterns of knowing are fundamental for professional nursing practice and, therefore, they should be used together and not in isolation (Chinn & Kramer, 2015).
Validating nursing theory
In this section, I will use the article, Nursing theory and clinical practice: How three nursing models can be incorporated into the care of patients with end-stage kidney disease by Janet Graham (2005) to demonstrate how the researchers validated the theory in their research. Evaluating the quality of a study is important because it promotes the reliability, credibility, and validity of the results presented by the researchers involved in the study. Reliability and validity are important aspects of nursing research as they demonstrate a study’s ability to reveal a certain phenomenon.
In the chosen article, the researcher endeavored to demonstrate how nurses can use Peplau’s, Orem’s and Neuman’s theories to enhance their practice (Graham, 2005).The researcher validated Orem’s theory of self-care by explaining how nurses can use it teach patients on how they can adopt behaviors that control the impacts of the diseases on their lives. The researcher also validated Neuman’s System model by examining its use by nurses in making clinical decisions concerning treatment procedures of the disease. The researcher also validated Peplau’s theory of interpersonal relationships by examining its relevance in helping nurses to remain accountable, professional as they interact with their patients (Graham, 2005). Indeed, the researcher’s validation of the three nursing theories verifies that her interpretations were real and not just mere imagination.
References
Chinn, P.L. & Kramer, M.K. (2015). Integrated theory and knowledge development in nursing (9th ed.). St. Louis, MO: Mosby Elsevier. ISBN ISBN-13: 978-0323077187. Chapter 9.
Fawcett, J., Watson, J., Neuman, B., Walker, P.H., Fitzpatrick, J.J. (2001). On nursing theories and evidence. Journal of Nursing Scholarship 33 (2): 115-119.
Graham, J. (2005). Nursing theory and clinical practice: how three nursing models can be incorporated into the care of patients with end stage kidney disease. CANNT journal= Journal ACITN, 16 (4), 28-31.
