Chapter 5 components and levels of abstraction in nursing knowledge
- 1. Chapter 5 Components and Levels of Abstraction in Nursing Knowledge
- 2. 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.
- 3. 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
- 4. 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.
- 5. 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.”
- 6. 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.”
- 7. 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.
- 8. 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.
- 9. 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.”
- 10. 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.
- 11. 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.
- 12. 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.”
- 13. 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
- 14. 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.
- 15. 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
- 16. 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.
- 17. 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.
- 18. 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.
- 19. 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)
- 20. 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).
- 21. 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.