正确应用护理模式和护理理论指导护理实践(1)

护理学是一门应用性和实践性的学科,护理学作为一门发展中的专业,在实践中已经形成了一系列独特的知识体系,包括一系列的模式和理论。尽管尚在不断完善的过程中,但这些模式和理论对护理实践起到了重要的促进作用。然而正如众多其它学科一样,如何缩短理论与实践之间的距离,一直是各学科努力探索的问题,尤其是绝大部分现有的护理模式和理论均来源于西方社会,[第一段]     

正确应用护理模式和护理理论指导护理实践(2)

4理解西方护理模式/理论过程中存在的难点护理学科常用的模式/理论大多来自于西方社会,在进行护理理论的教学中发现,无论是阅读原文还是翻译为中文的理论,往往会感到文字上生涩,某些概念比较生僻,对照原版文字还会发现翻译上的不一致性,这些都成为我国护理人员理解西方护理理论的障碍。现举几个实例:①Roy在其适应模式中认为相关刺激(contextual stimuli)和固有刺激(residual stim-uli)是两类性质不同的刺激,必须在二级评估时加以区分。而这两类刺激的区分往往是理解该理论的难点之一,更容易理解与更容易应用的方式是根据刺激的来源评估患…     

A theory for pediatric oncology nursing practice and research

This article describes the development and application of a theoretical framework that can be used to guide pediatric oncology nursing practice and research. The framework's six dimensions provide the nurse with an approach to comprehensive assessment and intervention with families of children with cancer. These dimensions are: systems (individual, family, community, society); mediating variables (identifying characteristics, orientation to life); time; adaptation variables (stressors, coping strategies); level of functioning (tasks, capabilities, needs); and intervention.     

Facilitating resilience using a society-to-cells framework: a theory of nursing essentials applied to research and practice

The resilience potential of each human being is an essential focus of nursing care and research. An honored nursing tradition is viewing each patient in the context of family and culture and recognizing how these factors affect a patient's health and ability to be resilient. We present a society-to-cells nursing theory that formalizes and extends this holistic view of patients by delineating factors that contribute to resilience potential based on the society, community, and family environment in which people live, as well as individual variables that influence psychological, physiological, and cellular coping abilities. We also summarize how this perspective is essential to optimize patient care and to inform future nursing research.     

Enhancing cardiac rehabilitation nursing through aligning practice to theory: implications for nursing education

This article presents a case study that examined the work practice of nurses in a cardiac step-down unit (CSDU). The action research included interviews, participant observation, and a self-reporting questionnaire. Nurses in the unit used a conceptual framework that was inconsistent with the rehabilitation-oriented nursing necessary to enhance patient outcomes in a CSDU. The results of this study show that a need exists for greater alignment between the practice and the educational preparation of nurses who work in a CSDU. A framework such as Dorothea Orem's Self-Care Theory of Nursing (1995) offers a conduit for nurses to deliver care appropriate to CSDU patient needs. However, there is a need for continuing education for nursing staff to align the cardiac rehabilitation nursing philosophy and the theories that underpin it (such as the Self-Care Theory) with nursing practice. Practice development provides a mechanism through which to examine the congruence between patient needs and nurse perception of those needs.     

Personal data assistants: using new technology to enhance nursing practice

This article explains how the new technology of personal data assistants can be used to enhance and augment comprehensive nursing care. Nurses are constantly challenged in their need for current, reliable, and accurate information at the point of patient care. Professional books and journals, by the very nature of their print format, have been prepared long before they can be actually used in practice. More current information is available from the World Wide Web, but it is often impractical for a nurse to access a computer during a patient encounter. Personal data assistants [PDAs] allow clinicians to access and document absolutely current information at the moment the patient is being seen. There are many general applications for PDAs that nurses might use such as keeping electronic calendars, address books, and reminder lists. In addition, however, there are even more actual healthcare applications, including patient tracking systems, access to pharmacologic databases, and a variety of clinical decision-making support tools. This article describes the wide variety of PDAs, along with the factors a nurse should consider in the decision of whether to purchase a PDA, and which type of device is best suited for which application.     

Developing a theory of nursing: the relation of theory to practice, education and research

The relevant literature is reviewed and it is held that the relationships between nursing theory, practice, education and research are close and reciprocal relationships. Each is related to the other but it is argued that the hub of the relationships is nursing practice as nursing is a practice discipline.
This paper is based on an address delivered on 10 July 1976 at the annual conference of the Association of Integrated and Degree Courses in Nursing held at the University of Hull, England.     

Barriers to using research evidence in nursing practice

Barriers to using research evidence in nursing practice The nursing profession has long recognized the importance of research as an essential basis for its development. More recently, the movement supporting evidence-based practice has brought this point into focus. However, relatively little research has been conducted to identify factors that interfere with the ability of nurses to base their practice on research evidence. Using factor analysis procedures, barriers to the use of research evidence in practice which were perceived to be present by 400 registered nurses working in an Australian hospital, were grouped under four main factors. These were accessibility of research findings, anticipated outcomes of using research, organizational support to use research and support from others to use research. The most important factor was perceived to be organizational support, particularly in relation to providing time to use and conduct research.     

Feminist theory and nursing: an empowerment model for research

This article describes the use of the feminist process to empower nurses in conducting research. The criteria for feminist research, defined by Duffy, are applied to a research study that identifies the effects of physical abuse during pregnancy on maternal-infant outcomes. The authors describe the process of empowerment of the investigators through the use of a consortium model of research, the staff nurses who are conducting the interviews, and the research participants (pregnant women). The integration of feminist principles and nursing research is a process that merges similar beliefs and ideologies.     

Understanding barriers to basing nursing practice upon research: a communication model approach

It is suggested in this paper that the potential barriers to facilitating research-based practice can be comprehensively understood using a communication model approach Barriers can thus be explored related to the research findings' message, to the ways in which this message is encoded and transmitted by nurse researchers and to the ways in which the message is received, interpreted and accepted by nurse practitioners The role of research-based practice as a communication feedback mechanism is also described The paper concludes by proposing that strategies for increasing the research base of our profession are more likely to be successful if all of these potential barriers are taken into account     

Careful nursing: a model for contemporary nursing practice

BACKGROUND: Careful nursing, a system of nursing developed in Ireland by Catherine McAuley in the early years of the 19th century and used by Irish nurses at the Crimean war, has been described as Ireland's legacy to nursing. Although records of careful nursing have been preserved, it has received little attention in the nursing literature. AIM: The purpose of this study was to conduct a preliminary content analysis of the mainly primary source historical documentation of the careful nursing system and present it within the structure of a contemporary conceptual model of nursing. METHODS: The documents describing the careful nursing system were studied and re-studied to gain understanding of the philosophical assumptions underlying careful nursing and of the thinking, attitudes, actions and practice of the nurses. Content relating to the four central nursing concepts was identified and summarized. RESULTS: Careful nursing definitions of person, environment, health and nursing are presented. Ten key concepts of careful nursing practice are identified as disinterested love, contagious calmness, creation of a restorative environment, 'perfect' skill in fostering safety and comfort, nursing interventions, health education, participatory-authoritative management, trustworthy collaboration, power derived from service and nurses' care for themselves. The spiritual dimension of human life and the spiritual in nursing emerge as important characteristics of the model. CONCLUSIONS: The results of this preliminary analysis require further verification and critical examination. However, the careful nursing model illuminates important aspects of professional nursing and could be further developed to conceptualize and guide nursing practice.     

Utilization of nursing research in practice and application strategies to raise research awareness amongst nurse practitioners: a model for success

This paper describes the views of nurse practitioners regarding the utilization of nursing research in practice and puts forward four major strategies to raise research awareness amongst students and qualified nursing staff. The aims of the study were to describe the extent to which nursing research was being used in practice and secondly the degree of nurses' awareness of current research findings relevant to their daily work. Attention also focused on strategies needed to improve research awareness amongst nurse practitioners. The study was centred on two large district general hospitals, chosen to provide contrasts. Data were collected at two points in time, over a 2½-year period, using in-depth individual and group interviews. The results of the study showed that research awareness amongst many nurses and research utilization in several practice areas were poor despite availability of a number of relevant and well-established nursing research findings. It also showed that resistance to applying nursing research to practice was often high, particularly amongst more senior nursing staff. However, it could be changed if researchers, nursing lecturers and nurse practitioners work jointly together towards promoting nursing research in practice and using: facilitation, support and encouragement; role modelling; consistency; and application in clinical practice.     

基于PBL教学法的护理学理论实践一体化教学模式的介绍

改革传统的护理教学中理论、技能和实践之间脱节的教学方法,将PBL学习法和理论实践一体化教学法相结合,融入护理综合能力训练的教学中,通过PBL病案再现临床情景,以护理问题为线索,以护理程序为方法,按时间推进,模拟临床护理工作。激发学生的学习兴趣,锻炼学生的临床思维能力及自主学习、信息管理、团队协作、评判性思维、人际沟通、法律意识等能力。     

Bourdieu's theory of practice and its potential in nursing research

AIMS: This paper seeks to consider the utility of Bourdieu's "Theory of Practice" in nursing, and considers specifically its use as a framework for research exploring nurses' conceptualizations of illness and the patients in their care. Bourdieu's work uses the concepts of field, capital and habitus to explain interactions within the social world. This paper describes these concepts and their relationship with nursing is discussed using dementia care as an example. BACKGROUND: The work of French scholar Pierre Bourdieu has contributed to debates throughout the social sciences, but has had relatively little attention in the nursing literature. Pierre Bourdieu's work developed against a backdrop of change in the academic world. The emergence of the social sciences and the debate around objective and subjective styles of research were influential in the development of his "Theory of Practice". DISCUSSION: The importance of the conceptualization process is discussed, and the considerable potential influence of conceptualization on patient care is highlighted. Reflexivity is a cornerstone of Bourdieu's work, and is an important feature of nursing research. Examples of health care research using his work as a framework are discussed, and some of the challenges of the approach are outlined. CONCLUSIONS: The use of Bourdieu's "Theory of Practice" as a research framework could allow nurse researchers to explore the interactions of nurses with the structures, agents and symbols of illness within the field of care. This work could enhance understanding of how nurses view and react to patients in their care, and promote the development of practice innovations and policy change. The theory may, therefore, have much to offer future nursing research.