Criteria for Evaluating Nursing Theories

1. Criteria for Evaluating Nursing Theories prepared by prof.Dr Nefissa Abdel Kader Prof. of Mental Heath Nursing Vice Dean of Education & Student Affairs Cairo University

2. Objectives • To be a Critical Consumers of theories. • To decide which theory is more appropriate to use as a framework for research, teaching, administration, or consultation. • To identify effective theories in exploring some aspect of practice or in guiding a research project.

3. Objectives • To enhance the potential of constructive change and further theory development. • To affect changes in clinical practice , to define research priorities, and to identify content of teaching, and guidelines for nursing administration.

4. Outlines • Introduction • The nature of judgment. • Definition of theory critique. • Definition of internal & external criticism. • Internal criticism Clarity Consistency Adequacy Logical development Level of theory development

5. Outlines Cont. • Definition of External Criticism Reality Convergence Utility Significance Discrimination Scope of Theory Complexity Other Evaluating Criteria

6. The Nature of judgment People often view the task of judgment from one of two positions: • Judgment is matter of personal taste, the merits of a given theory ultimately are matters of personal preference and taste. • There are certain clear criteria for judging nursing theory. Any reasonably intelligent and informed person when applying these criteria will arrive at similar judgment.

7. Definition of Theory Critique • Critique is defined as: Critical examination or estimation of a thing or situation to determine its nature and limitations or its conformity to standers.

8. Internal Criticism • Internal criticism deals with the how theory components/ structure fit with each other. • This accomplish by making a critical assessment and judgment of the relationship between the different component such as a assumptions, concepts, propositions, and domain concepts.

9. Clarity • The criteria of clarity requires that a theory be presented in a way that can be easily understood by the reader. • In judging clarity, two sorts of meaning are given to terms. Denotative and Connotative. • Denotative meaning: Is referential ; it enables one to point out all the objects meaning, to which a term refers. • Connotative meaning : Describes the characteristics of an object.

10. Questions ??? • How many sentences are meaningful? • Are the basic terms themselves clear? • Are the terms clear as to both denotation and connotation? • Are concepts the oretically and operationally defined? • Are there obvious gaps in the theory that prevent the reader from linking parts of the theory with subsequent aspects?

11. Consistancy • In the criterion of consistency we should examine inconsistency in terms, interpretation, principle and method. • The simplest case involves definition of terms. Once the theorist has defined a term in a certain way, consistency requires the term always be used in that way. • Common errors occurs when theorist defines: Nursing- as care of individuals or group, but goes on to discuss it only as it applies to care of the individuals. Adaptation – as stimulus response patterning, and later to mean psychological adjustment to a complex environmental change…….the fault includes a shift in meaning.

12. Consistancy Cont • The adaptation example represents more than a simple shift in meaning of a term. However, the fault includes a shift in the world being described. This shift in interpretation is frequent fault in nursing theories. • As regards inconsistencies in principle, a theory has reciprocal principles one in the patient and one in the nursing act.(e.g the principle explaining the patient is comprehensive- a holistic benign). On the other hand, that the principle of nursing action is relying on a stimulus- response explanation of behavior (two – diverse principles in a single theory). • Similarly, inconsistencies in relation to method often occurs when trends in nursing dictate one method, whereas the author’s own inclination follows a different path.

13. Adequacy • A nursing theory is adequate if it accounts for the subject matter with which it deals. • A nursing theory is adequate If its prescriptions are extensive enough to cover the scope claimed by the author. • Rubin(1968). For example, presents a theory of clinical nursing in which nursing is a helping technique. Nursing is differentiated from other helping professions by its operation within the immediate present in relation to the patient’s dependency needs. • Some critics argue that this theory is appropriate for obstetrics but not for clinical nursing in general. The focus is on immediacy is built on the image of the patient in labor in the midst of a major immediate life change. The model fails to consider such element as forward- looking health education or care of patient with a chronic disease.

14. Simplicity/Complexity • The more phenomena the theory considers, the more potential relationships it could generate, and the more complex theory is. • Simplicity of a theory is more desirable if it focuses on fewer concepts and few relationships that may enhance its utility. • Complexity of a theory may be desirable criterion if the complexity enhances the number of explanations and predictions over the theory.

15. Tautology/ Teleology • A general assessment of tautology is done by considering the needless repetition of an idea in different part of theory. Tautology decreases the clarity of the theory. • Teleology occurs when the definition of concepts, conditions, and events uses consequences rather than properties and dimensions. • When defining a concept by consequences only, the theorist introduces new concepts to define existing ones. This practice leaves the original concept undefined.

16. Logical development • The criterion of logical development require that every conclusion in a theory Logically follow from the reasoning that have been preceded it. • Logical development demands that a conclusion be warranted, based on its premises. • Modes of logical reasoning. • Deduction • Induction

17. Logical development Example of a deductive argument. Premises: All Nursing (s) is a form of interaction (m) All communication (P) is a form of interaction . Conclusion: All Nursing is a form of communication. Syllogistic Form : All s is M.,All P is M

18. Logical development • Example of deductive argument. • Premises: All protective body responses (M) work toward establishment of homeostasis (p) • Some pain (S) is a protective body response (M):. • Conclusion : Some pain (S) works toward establishment of homeostasis (p). • Syllogistic: is valid, premises are true and conclusion is true All (M) is (p) Some S is M SomeS is P

19. Example of inductive argument • In contrast, inductive argument is based on probability and cases known as: • Morphine is a narcotic & relieves pain • Codeine is a narcotic & relieves pain • Heroin is a narcotic & relieves pain Therefore, all narcotics relieve pain • Logical development of theory refers to the validity of it argument, not to the sequence in the presentation. Furthermore, logical development requires that a reader not have to supply missing links in an argument reach (agree with ) a conclusion.

20. Level of theory development • The ultimate aim of any theory is to reach the stage in which purposeful nursing interventions can be derived, leading to predictable patient outcome. • It is possible that one theory, in a descriptive phase, may hold more promise than another theory already in an explanatory phase of development. • Therefore, relatively low (early) level of theory development is not necessarily a drawback.