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Midlevel theories, describing the interrelationships among a broad range of concepts within nursing, have been well tested through nursing research. Midrange theories focus on specific concepts or relationships that are more limited in scope than grand theories but broader than practice theories.

All schools of nursing in the United States are organized around one of the conceptual models described in this chapter. Some programs may integrate multiple theories or use evidence-based frameworks instead of a single traditional conceptual model.

Nursing theory guides the direction of research but not that of education or practice. Theories provide a foundational framework for curriculum development in nursing education, help in forming care models in clinical settings, and influence the direction and design of research studies.

Build a rationale for programs of research: While research benefits from having a theoretical framework, this is not the primary purpose of theory. Research programs often use theory as a foundation, but theory itself is developed to explain and interpret phenomena.

Explain why scientists do what they do: This option misrepresents the function of theory. Theory helps explain natural or social phenomena-not the personal or professional motivations behind scientists’ actions.

Distinguish science from art: Theory does not exist to draw a line between science and art. In fact, both domains may use theory to structure ideas and practices.

It takes time and experience to become a competent nurse. Time and experience are necessary for developing proficiency in any profession or career

Research and theory development is a central focus: Although research and theory are important in nursing, they are more strongly associated with academic or theoretical disciplines. In a practice discipline, the emphasis is on applying that research and theory in clinical settings.

Nurses function as members of a team who form a practice group: Teamwork is essential in nursing, but being part of a team is a characteristic of many professions and does not define a practice discipline.

Johnson: Dorothy Johnson developed the Behavioral System Model, which focuses on maintaining and restoring balance in a patient’s behavioral subsystems (e.g., achievement, dependency, aggression).

Roy: Sister Callista Roy’s Adaptation Model emphasizes helping individuals adapt to changes in physiological, self-concept, role, and interdependence domains.

Peplau: Hildegard Peplau’s Interpersonal Relations Theory focuses on the nurse-patient relationship and the phases of interaction (orientation, working, resolution). It emphasizes communication and therapeutic interaction.

Person, health, environment, and theory. Although theory is crucial in nursing, it is not one of the four components of the metaparadigm. The correct components are person, health, environment, and nursing.

Health, theory, concepts, and environment. This option replaces “nursing” and “person” with “theory” and “concepts,” which are tools used within the metaparadigm, not the core elements.

Nurses, physicians, health, and patient needs: This list includes physicians, who are not part of the nursing metaparadigm, and patient needs, which are considered within the “person” domain.

A concept is a basic building block of theory. It is a single idea or mental image that represents a phenomenon (e.g., pain, fatigue, stress). Concepts are not organized sets, and they do not explain relationships.

A proposition describes a statement about the relationship between two or more concepts. While propositions are part of theories, they do not independently explain a phenomenon. They are components within a theory, not the full explanatory system.

discipline refers to a field of study or branch of knowledge (e.g., nursing, biology). It encompasses theories, research, practice, and education but is not itself a conceptual or explanatory system.

King: Imogene King's Theory of Goal Attainment defines the person as a rational, social, and purposeful being who interacts with their environment to achieve goals.

Neuman: Betty Neuman's Systems Model views the person as a system of physiological, psychological, sociocultural, developmental, and spiritual variables.

Watson: Jean Watson’s Theory of Human Caring sees the person as a holistic, transpersonal being with a focus on human dignity and caring. While she emphasizes caring, she does not frame the person primarily as a cultural being.

Layer 0 represents the contextual factors that influence clinical judgment, such as environmental conditions, facility policies, and the health care system. It does not reflect the nurse’s internal cognitive processes.

Layer 1 consists of six cognitive steps (Recognize cues, Analyze cues, Prioritize hypotheses, Generate solutions, Take action, Evaluate outcomes). However, this layer defines the broad cognitive model.

Layer 3 represents observable behaviors that result from cognitive processes, such as actions taken during patient care. In this scenario, the nurse has not yet acted, but is still processing data to make a decision-so this layer does not apply yet.

Layer 4 includes measurement models used to assess clinical judgment, particularly in testing (e.g., NGN exam structure). It is not part of the clinical reasoning process, but rather a framework for evaluating it. It does not describe what the nurse is doing in this scenario.

Inductive reasoning is the opposite of what is described in the question. It begins with specific observations or data and moves toward general conclusions or theories.

Conceptual modeling refers to visual or diagrammatic representations of theories or systems, rather than a method of reasoning. It’s used to communicate or organize theory, but it does not describe the process of moving from general to specific ideas.

Concept development involves clarifying and refining ideas that form the foundation of theory, but it does not describe the method of reasoning.

Fact: A fact is a piece of information that is objectively verifiable and considered to be true. A concept, in contrast, is more abstract-it represents an idea that may vary in interpretation and is not always measurable or provable.

Science: While science uses concepts to build knowledge, the word “science” refers to a systematic method of inquiry rather than a definition for “concept.”

Truth: A truth is a belief or proposition that is accepted as universally valid, which may result from evidence or consensus. Concepts are not necessarily truths; they are starting points for theorizing and understanding phenomena, not proven realities.

Environment: While environment is an essential concept, as it influences health and well-being, it is not the central focus of nursing care. Instead, the nurse considers environmental factors in relation to how they affect the person.

Health: Health is a key component of nursing theory, representing the outcome or goal of nursing care. However, it is not the primary focus-rather, it is the desired state for the person, reinforcing that the person is central.

Nursing: Nursing defines the actions and role of the nurse, including assessments, interventions, and advocacy. It is crucial for theory and practice but exists to serve the needs of the person. Therefore, nursing is not the most important concept, but one that supports the care of the person.