答辩白理之路:阶段与里程碑

就算在上一章中涉及的理论思考和理论化障碍存在障碍,医护人员在稳步和有团体地照顾人类方面一贯加入某种方式的反驳探讨。护理,舒适,交流,爱戴,康复和健康等概念被用来教导临床实践,然后才将它们标记为概念,并且在将它们连接在一块形成护理理论在此之前。然而,在一九四九年到一九八零年中间,产生了1个严肃的标签和更系统的概念和申辩调换的进度。这么些进程持续累加强护理艺术学科。

弗Loren斯·南丁格尔于19世纪末和20世纪初第三次尝试实行辩驳护理,描述了克里米亚战争中的护理重点和行进。南丁格尔被促使在多如牛毛出版物中论述他的观点,并建议分裂的目的。那几个目的之一是获得对国家对护士的须要的协理,为看护的启蒙布置的上进取得接受,并暴表露战争时期英帝国战士忍受的不正规的条件条件。

随之的理论化尝试由美利哥医护人员教育工笔者在20世纪50时期后期发布,必要表达区别的看护教育程度是在理的,并且供给为守护中的每一个教育级别制定学科。为了差异课程设置,并抓好每门课程的教诲品质,一些前任医护人员将其临床专业知识与前瞻性视野结合起来,回答诸如“什么是守护目的?”和“护理目的应该是何许?”等题材。那个中期理论家意识到,通过支付代表护理观点的安顿,他们将扶持护农学生(即现在的医治医师)专注于护理现象和难点,而不是临床现象和题材。在美利坚联邦合众国的不比地区(随后或同时在世界此外地点)创立了小组,并建立了委员会来研商护理的性质,护师工作的性质以及医生和护师的不一样平时方面。这几个早先时代工作的指标还集聚在将护理与别的常规不利学科区分开来。这一个对话进一步钻探了护理知识的品质。

莫不考虑护理理论历史和剖析护师当前对理论的兴趣的最好方法是在护理知识发展的两样阶段考虑主导核心(参见第4章的守护观点研讨)。那里蕴含的只倘诺,文献中商量的核心是提醒性的,并表示了该科目在其升高进程中分化时期对什么样成员感兴趣。除了讲述这个焦点外,对理杂文献的剖析为我们提供了说不定助长理论护理发展的切切实实里程碑。那三种方法都提供了护理如何演化成其眼下情状的见解。

在本章中,主旨被演讲为影响知识发展进度的级差。阶段是由里程碑来补充的,那个里程碑描述了从3个阶段转移到另3个等级的节骨眼。那一个等级和里程碑有助于达成本学科近来的提升程度。

On the Way to Theoretical Nursing:Stages and Milestones

看护进程中的阶段

自克里米亚战争以来,护理在检索工作身份和概念其世界方面经验了不少等级。值得注意的是,大家对医生和护师理论思维,大家所生存的夫权社会以及护师和护理人士的眼光和地位的辨析和评估大概会使得看起来各种阶段都距离了创建护教育学科。但是,这个等级中的各个阶段的确曾经确立和澄清了建立该学科科学方面所急需的维度,促进或促成了医生和护师学科的学问衍生和变化。每一个阶段都援救医护人员更类似鲜明护理领域,明确其任务,并规定其论理基础。

辩论护理之路:阶段与里程碑

Despite the barriers against theoretical thinking and theorizing
identified in the previous chapter, nurses, in caring for human beings
in an orderly and organized way, have always been involved in some form
of theorizing. Concepts of care, comfort, communication, protection,
healing, and health, among others, were used to guide clinical practice
before they were labeled as concepts and before they were linked
together to form nursing theories. However, between 1950 and 1980, a
process of serious labeling and a more systematic communication of
concepts and theories occurred. This process continues to enrich the
discipline of nursing.

尽管在上一章中涉嫌的理论思考和理论化障碍存在障碍,护师在一如既往和有组织地照顾人类方面平素参与某种格局的驳斥钻探。护理,舒适,交换,爱慕,康复和例行等概念被用来辅导临床实践,然后才将它们标记为概念,并且在将它们连接在联合形成护理理论从前。可是,在1948年到一九七七年时期,发生了三个简直的价签和更系统的定义和理论交换的长河。那些历程持续增进护经济学科。

First attempts in theoretical nursing were made by Florence Nightingale
in the late 19th and early 20th centuries to describe nursing focus and
action in the Crimean War.Nightingale was prompted to articulate her
ideas in numerous publications, with different goals. Among these goals
were gaining support for a national need for nurses, achieving
acceptance for the development of educational programs for nurses, and
exposing the unhealthy environmental conditions that were endured by
English soldiers during wars.

弗Loren斯·南丁格尔于19世纪末和20世纪初第一次尝试进行辩白护理,描述了克里米亚战争中的护理重点和走路。南丁格尔被促使在诸多出版物中演讲他的理念,并建议不一样的靶子。那个目的之一是取得对国家对医护人员的要求的援助,为看护的指导安顿的向上获得接受,并暴暴光战争时期英帝国新秀忍受的不不荒谬的条件标准。

Subsequent attempts in theorizing were published by American nurse
educators in the mid- 1950s, prompted by the need to justify different
educational levels for nurses and the need to develop curricula for each
of the educational levels in nursing. To differentiate curricula, and to
enhance the quality of education in each curriculum, a few pioneer
nurses combined their clinical expertise with forward vision to answer
such questions as “What are nursing goals?” and “What ought to be the
aims of nursing?” These early theorists were aware that by developing
programs that represented a nursing perspective, they would help nursing
students—that is, future clinicians—to focus on nursing phenomena and
problems rather than on medical phenomena and problems. Groups were
formed in different parts of the United States (and subsequently or
simultaneously in other parts of the world) and committees were formed
to discuss the nature of nursing, the nature of nurses’ work, and the
unique aspects of nursing. The goals of these early efforts were also
focused on differentiating nursing from other health science
disciplines. These dialogues went further to explore the nature of
nursing knowledge.

紧接着的理论化尝试由美利哥护师教育工作者在20世纪50年代中叶发布,供给表明不一致的护师教育水准是合情的,并且必要为守护中的种种教育级别制定学科。为了不同课程设置,并抓牢每门课程的启蒙品质,一些前任护师将其治疗专业知识与前瞻性视野结合起来,回答诸如“什么是看护指标?”和“护理目的应该是何许?”等题材。这个前期理论家意识到,通过开发代表护理观点的陈设,他们将辅助护经济学生(即今后的诊疗医务人士)专注于护理现象和题材,而不是医疗现象和题材。在U.S.的例各省段(随后或同时在世界别的地点)创制了小组,并建立了委员会来谈谈护理的习性,护师工作的个性以及护理的极度方面。这个早先时期工作的目的还汇聚在将护理与任何常常科学学科区分开来。那些对话进一步探索了医生和医护人员知识的性质。

Perhaps the best way to consider the history of nursing theory and to
analyze nurses’ current interest in theory in perspective is to consider
dominant themes in the different stages of the development of nursing
knowledge (see discussion on Nursing Perspective in Chapter 6). The
implicit assumption here is that the themes discussed in the literature
are indicative and representative of what members of the discipline were
interested in at different times during the process of its development.
In addition to delineating these themes, an analysis of the
theory-literature provides us with specific milestones that may have
helped in the development of theoretical nursing. Both approaches
provide insights into how nursing evolved into its current status.

或许考虑护理理论历史和剖析医护人员当前对理论的兴趣的最好办法是在护理知识发展的不比阶段考虑主导核心(参见第④章的守护观点研究)。那里包蕴的只假如,文献中研究的大旨是提醒性的,并表示了该学科在其进步进度中不相同时期对怎么成员感兴趣。除了讲述这么些大旨外,对理杂谈献的解析为我们提供了说不定推动理论护理发展的切切实实里程碑。那二种方法都提供了医生和医护人员怎样演化成其眼下景观的视角。

In this chapter, the themes are articulated as stages that have
influenced progress in knowledge development. Stages are complemented by
milestones, which characterize the turning points for moving from one
stage to the next. These stages and milestones helped achieve the
current level of progress in the discipline.

在本章中,主旨被演说为影响知识发展历程的等级。阶段是由里程碑来填补的,这几个里程碑描述了从二个品级转移到另八个阶段的转搭飞机。那么些等级和里程碑有助于实现本学科最近的开拓进取程度。

执行阶段

用作职业的西方护理版本的历史可追溯到19世纪末和20世纪初,是克里米亚战争的产物。由于须要照顾受伤地铁兵,弗Loren斯·南丁格尔集团了一群女士在他的督察下和烟尘口腔科医务卫生人士那里提供护理。南丁格尔以整洁为对象,以环境变化为手段达成这一对象。

开班护理的西边版本赋予Rufaida Bent Saad al-Aslamiya(也号称Koaiba Bent
Saad),他在伊斯兰洲大学战中陪伴先知穆罕默德。她也组织了一批妇女,专注于照顾伤员的净化和条件。她树立了卓殊的活动帐篷来照顾伤者,伤员和残疾人。她仿效了急救,火急护理和长时间医疗和医生和医护人员。她关心伤者并操练妇女开始展览救护和护理(Fangary,1977;
SH
Hussein,个人通信,1986)。像南丁格尔一样,al-Aslamiya在穆斯林世界建立了第叁所护理高校。其它,她还为护师和启发性年轻女性展开了伦理规范概念教育(1999年7月)。像南丁格尔一样,她在护理中的角色并没有趁机战事而终结。al-Asalmiya继续倡导保健,防保和正规教育。

Hussein(壹玖捌贰)描述了al-Aslamiya对护理的忠爱和她在建立新的规则和优质护理古板地点的成功,那么些规则和观念是中东现代护理的后驱。在医生和护师最先的东西方版本中,一名女士认为有须求协会其余女性照顾战争中的伤员;
在那两下面,他们都提供热切护理和深远护理。他们都留意于关怀,康复,促进健康环境,并培养其余医护人员。他们都受到道德承诺的驱使,以减轻难熬和提升医疗。

据此,在那一个等级,护理的重任被定义为提供护理和舒服,以进步康复和幸福感,并创办3个有助于削减痛心和恶化的例行条件。护师将其领域定义为包含伤者和提供护理的条件。Nightingale和al-Aslamiya都创立并监测了护理的环境。实践阶段赋予护理其设有的说辞,其难点和沉重。Nightingale(一九四八)的叙述护理目的和进度的反驳着作表明了护师从理论上演讲实践活动的潜力。那一个着作也建议护理作为叁个举行领域的恐怕在理论上得到演说。

STAGES IN NURSING PROGRESS

有教无类和行政阶段

从早先时期对执行的尊重以及陪伴的徒弟和劳动观念出发,转向了与作育安顿和看护课程有关的难题。实践的“怎么着”最后被转载为发展的科目,以支撑不相同层次的守护教育以及怎么样助教它。将近三十年的时间花在尝试不相同的教程,准备教授的法子,为护理和劳动学校引导管理人士的办法,以及准备执业护师的点子。在这么些等级,重点是护师职能角色的发展。那一个阶段的重中之重核心是从护师的教育和行政剧中人物演化而来的。

这一品级在该科目理论发展中的首要意义在于它提供了医护人员向医生和医护人员领域提议难点的动力。在制定面向不相同教育水准医护人员的学科时,医护人员问:什么是医生和护师?由文凭毕业生,副大学生毕业生,农学博士学位或硕士学位毕业生提供的守护服务有多分化?那几个题目促使医护人员用越来越多的驳斥术语来评释护理实践的骨干(Henderson,一九七零)。奇怪的是,便是在这一个阶段,美利哥看护先驱理论家的辩解观念诞生了。由此,保护教学和教诲大概为辩驳护理的特别提升铺平道路。

护理进度中的阶段

Since the time of the Crimean War, nursing has gone through many stages
in its search for a professional identity and in defining its domain. It
is interesting to note that our analysis and evaluation of nursing’s
theoretical thought, the patriarchal societies we live in, and the view
and status accorded nurses and nursing may make it appear as if each of
these stages was a deviation from the goal of establishing the
discipline of nursing. However, each of these stages has indeed
sharpened and clarified the dimensions needed for the establishment of
the scientific aspects of the discipline, promoting or leading to a
scholarly evolution of the nursing discipline. Each stage has helped
nurses come closer to identifying the domain of nursing, defining its
mission, and defining its theoretical base. Progress in the development
of theoretical nursing is definable in terms of six stages: practice,
education and administration, research, theory, philosophy, and
integration.

自克里米亚战争以来,护理在搜索工作身份和概念其世界方面经验了不少等级。值得注意的是,大家对医生和护师理论思维,我们所生存的夫权社会以及医护人员和护理人士的眼光和身价的剖析和评估可能会使得看起来每种阶段都距离了成立护医学科。然则,那一个等级中的每一种阶段的确曾经确立和清淤了建立该学科科学方面所急需的维度,促进或促成了医生和护师学科的学问衍生和变化。种种阶段都帮衬护师更接近明确护理领域,明显其义务,并规定其辩驳基础。

商讨阶段

切磋等级是经过一多重与执行和指导阶段重叠的风浪演变而来的。Gortner(两千)提议,在20世纪20年份,案例研究被制定为教学工具,但它们也被看作标准化的重力。对这么些案例的体系评估引发了U.S.民代表大会萧条后的博士教育需求。战争时代须求多少搜集和剖析,由此要求在1949年建立花旗国公卫服务机关,成立护理能源部门。二个研究公司的出世就此诞生。在20世纪70年间,医护人员探讨员委员会和理事会创制。医护人员更多地在其余课程获得博士学位,国家研究服务奖的基金已经济建设立。

看护在教育,课程开发,教学和学习策略以及管理方面包车型客车大势也招致教育工笔者开始展览钻探。护理课程专家认识到,即使没有色金属商讨所究和系统钻探不一致的教学/学习方式和教学/学习环境对成果的熏陶,护师教育就不可能获得纠正。因而,研商兴趣从教育和评估进程中出现并汇总于难点。教学奖学金主导着早期的商量型公司。

怎么样教,怎么样管理,怎么样领导以及怎么样政策在教学和管理方面更有效是导致护理商讨发展和增加的标题(Gortner
and
Nahm,一九八〇)。一九五四年,United States树立了第壹份名为“护理钻探”的医生和护师商量杂志,南美地区教委(SREB)和西方护理高等教委(WCHEN)创制于1951年中。
20世纪50年份和60年份先前时代。他们的对象须求创新护理教育,提升医生和医护人员切磋的生产率,进步研商品质。该杂志和SREB和WCHEN的会议帮衬护理职员发展其科学规范,即“一套文化价值观和管理科学活动的学识”(默顿,1971年,第②70页)。

科学随想的评定审查标准建立在科学探索必须由同行业评比议的功底上。因此,护师切磋人口最先遵从默顿的普遍主义规范,即通过合理标准对讨论产品进行客观评价(默顿,壹玖柒伍年,第③70页)。大学也对她们为任何教师担任的医生和医护人员教师抱有一样的想望;
具体而言,护理大学的先生成员必要发布本人的想法,并经过在学术期刊上登载的小说和在学术会议上的学问演说在科学领域拓展交换。由此,从科学的角度来看,“出版或消失”教条并非不具体,而是管理护理科学的另1个正规。

护理在介绍想法和分享钻探成果方面的始发尝试遭到了别样医护同事严重的,有时甚至是毁灭性的批评。(那多少个出席过早期研商会议的人大概会记得长日子和粗暴的钻研批评,这个斟酌批评让切磋人口和观者都蒙受了外伤。这么些批评的撰稿人大概没有考虑过护理探讨的前进阶段。)因而,除了普遍性和共同性,此外多少个专业衍生和变化:客观性和独立案审查查。研商评估的合理性标准通过了肯定和共享,为切磋细化和更为上扬提供了2个转折点(Leininger,一九六六)。

钻探提升阶段对当代的学术护理做出了重庆大学贡献。科学工具通过钻研学科和总计课程的新产品以及由此编写制定和重组要紧探究工具和工具的好多出版物在学科中留给主要标志的级差。

那几个等级是整个世界平行的。国际教育程度也影响着知识发展的拓展。一些国度,如澳国和德意志联邦共和国,分别在20世纪80年间和90年间将护理教育从医院培养转向大学培训。随后,理学和辩论对话以及学士产力的累积轨迹不断充实。

Stage of Practice

那正是说,这个正是看护调查和不利的初阶。在这一个阶段,与任何科学一样,研讨者强调科学语法

进度而不是商讨内容(Kuhn,一九七〇)。收集到的真实意况的束缚框架或存款和储蓄仍旧不够。就算如此,该课程的语法已经制定。

实施阶段

The Western version of nursing as an occupation dates from the late 19th
century and the early 20th century, a product of the Crimean War.
Because of the need to care for wounded soldiers, Florence Nightingale
organized a group of women to deliver care under her supervision and
that of the war surgeons. Nightingale focused on hygiene as her goal and
environmental changes as the means to achieve that goal.

用作职业的天堂护理版本的历史可追溯到19世纪末和20世纪初,是克里米亚战争的产物。由于须要照顾受伤的大兵,弗Loren斯·南丁格尔公司了一群女士在他的督察下和烟尘皮肤科医师那里提供护理。南丁格尔以整洁为对象,以环境变化为手段完毕这一指标。

The Eastern version of the beginning of nursing gives credit to Rufaida
Bent Saad al-Aslamiya (also referred to as Koaiba Bent Saad), who
accompanied the prophet Mohammed in his Islamic wars. She, too,
organized a group of women and focused on hygiene and environment in
caring for the wounded. She established special moving tents to attend
to the sick, the wounded, and the disabled. She modeled first aid,
emergency care, and long-term healing and caring. She cared for patients
and trained women in the arts of first aid and nursing (Fangary, 1980;
S.H. Hussein, personal communication, 1990). Like Nightingale,
al-Aslamiya established the first school of nursing in the Muslim world.
In addition, she conceptualized a code of ethics for nurses and inspired
young women to be educated (Jan, 1996). Like Nightingale, her role in
nursing did not end with the war. al-Asalmiya continued to advocate for
health care, preventive care, and health education.

千帆竞发护理的东头版本赋予Rufaida Bent Saad al-Aslamiya(也叫做Koaiba Bent
Saad),他在佛教战争中陪伴先知穆罕默德。她也集体了一批妇女,专注于照顾伤员的干净和环境。她树立了新鲜的位移帐篷来观照病者,伤员和残缺。她仿效了急诊,火急护理和长久治疗和看护。她关心伤者并磨炼妇女举办抢救和护理(Fangary,1977;
SH
Hussein,个人通信,一九九〇)。像南丁格尔一样,al-Aslamiya在穆斯林世界建立了第①所护理高校。别的,她还为护师和启发性年轻女性实行了伦理规范概念教育(一九九六年10月)。像南丁格尔一样,她在医生和护师中的剧中人物并从未随着战争而告终。al-Asalmiya继续发起保健,预防保健和常规教育。

Hussein (1981) described al-Aslamiya’s devotion to nursing and her
success in establishing new rules and traditions for quality nursing
care as precursors to modern nursing in the Middle East. In both Eastern
and Western versions of the beginnings of nursing, a woman saw the need
for organizing other women to care for the wounded in wars; in both,
they provided emergency care as well as long-term care. They both
focused on caring, healing, promoting healthy environments, and on
training other nurses. They both were driven by moral commitments to
alleviate suffering and enhance healing.

胡斯sein(壹玖捌肆)描述了al-Aslamiya对护理的热爱和她在确立新的规则和优质护理古板地点的打响,这么些规则和守旧是中东现代护理的先行者。在医生和医护人员开头的东西方版本中,一名妇人认为有供给协会其余女性照顾战争中的伤员;
在那两上面,他们都提供急切护理和长久护理。他们都放在心上于关切,康复,促进健康环境,并培养其余医护人员。他们都碰着道德承诺的驱使,以减轻痛心和增加医疗。

Therefore, during this stage, the mission of nursing was defined as
providing care and comfort to enhance healing and a sense of well-being,
and to create a healthy environment that helps decrease suffering and
deterioration. Nurses defined their domain to include the patient and
the environment in which the care is offered. Both Nightingale and
al-Aslamiya created and monitored the environment in which the care was
being given. The stage of practice gave nursing its raison d’être, its
focus, and its mission. Theoretical writings by Nightingale (1946)
describing the care goals and processes are testimony to the potential
for nurses to articulate practice activities theoretically. These
writings also point to the potential for nursing as a field of practice
to be articulated theoretically.

由此,在这么些阶段,护理的重任被定义为提供护理和清爽,以增进康复和幸福感,并创制三个拉动削减痛楚和恶化的符合规律环境。医护人员将其世界定义为统揽病人和提供护理的条件。Nightingale和al-Aslamiya都创制并监测了护理的环境。实践阶段赋予护理其设有的说辞,其要点和任务。Nightingale(1949)的讲述护理目的和经过的说理着作注解了护师从理论上论述实践活动的潜力。那几个着作也提议护理作为2个推行领域的或许在争鸣上获得解说。

力排众议阶段

说到底,关于护理本质的主旨难题 – 其义务和对象 –
起首以更有系统的点子表现。一群尖锐的管理者,医护人员认为理论应当教导医护实践,他写到理论的需求,护理理论的本来面目,国学家的驳斥观点以及哪些营造护理理论。即使护艺术学理论家在医生和医护人员学科的定义图式出现在学科的教诲和治本阶段,但直到理论阶段出现后才被重视(Nursing
Theory Think Tank,一九七八)。

在那几个等级,关于护理是还是不是唯有是军事学的2个章节,恐怕它是生物学,自然科学还是物理科学的一有的(类似于中期的笛卡儿的定义,生物学仅仅是物军事学的2个章节)的争辩就应运而生了。笛卡儿的定义被推翻了(生物学确实是一个特殊的自治科学),护农学继续对抗它是文学一部分的意思。对新一代医护人员领导者

  • 国学家和理论家(只怕概念主义者,就像是他们关系的这一人)而言 –
    变得很掌握 –
    护理无法大致地归咎为一种只涉及人的多少个地点的单一科学,就好像生物学一样不能简化为大体。护理是错落有致的,供给其内容和艺术的内在自主性。

对定义一致性的求偶从对语法的瞩目发展到对护理现实的谨慎和享有想象力的探究,以及引导其行为的意思和真理(表5-1)。从对科学情势的令人瞩目到估摸和架空的进步,令人回首18世纪和19世纪艺术学思想的向上。18世纪受Newton和Bacon的影响十分的大,而Bacon又蒙受笛卡尔的熏陶。19世纪由康德主宰,其只要的,演绎的和教条主义的法子鼓励科学的一见青睐本质。护理中的投机者开头营造他们看来的现实,他们有所想象力的结构从他们的法学背景和她俩的教导倾向升高而来。

Stage of Education and Administration

表5-1 理论发展起来阶段的性状
•  利用外部范式来指导理论
•  关于学科现象的不确定性
•  离散和独立的理论
•  研究,实践和理论之间的分离
•  寻求概念上的一致性
•  用于课程的理论
•  单一范例的目标占上风

力排众议发展面临任何课程的范式,医护人员理论家的教育背景以及立时的医学基础的熏陶是很自然的。由此,大家发现源于存在主义,分析经济学和实用主义的前提是指引那么些理论的上进,有时是明显而且日常隐含的。医护人员还动用了任何范式的概念和命题,如精神分析,发展,适应,互动以及人文主义,以教导其评估和行动。理论是为了酬答对商讨中单独的斟酌结果的缺憾。新面世的反驳阐释了人类在与医疗保健系统的互动和贸易中的本质。

即便有些理论概念是从分歧的范式综合而来,但只有从护理的角度来看,大多数护理理论(如行为子系统,剧中人物补充,治疗触觉和自助)都以能够限制和分析的。理论为周边的莘莘学子努力和医护的基本解释性职责提供了始于协议。那些阶段提供了有关情形的学问,但医生和护师学科及其智力目的仍存在不分明性。就如在核物管理学中

  • 当第1个实现不是着眼或数学总计之一,而是智力想象 –
    概念图式之一在对护理的阅历范围有任何显明认识在此之前就衍变了。在护经济学方面,理论援助该科目专注于其定义和难点。

罗吉尔斯(一九六六)提出了护理概念,重点关心人与环境的随地调换。Johnson(一九七六)发展了一种守旧,即人类

  • 海洋生物系统 –

    也是以原生态须求为基本的抽象系统。Levine(1966)和Orem(1973)提出了医生和医护人员疗法的引导方针,以保证人类的完整性,心思学和社区挂钩

    简单易行,就是全体人。Orem(一九八三)提示我们人类完全有能力自作者照顾,并应当朝着这几个目的前进。

是因为较早关切教育和职业认可,因为全国护理联盟规定了课程的概念框架,并且由于并未采纳经验实证主义者确证的专业鲜明理论的实际,所以没有使用新兴理论携带实践或钻研,而是用来辅导教学。由此,在制定与那些理论相呼应的课程时,科学能量消失了。

虽说理论只怕影响了学生的进行,但那种影响在文献中从不记载,这一个文献越多地集中在教育连串辩白上。作为一名教育工作者,他曾是一所接纳护理理论(也号称方式)作为课程框架的院所的积极分子,在1956年份中叶,作者切肉体验了安顿毕业生在他们想要的时候碰到的争辨使用护理框架,他们在实践中学习和感受过他们的教诲安排,并且由于其新颖性和奥秘的概念而不或者那样做。护理情势在教育中的使用是还是不是使护理尤其可行和有作用是三个留下来实行估测计算的题材,并且仅在孤立事件中以及经过经验性叙述分析表达,因为它们不够普遍性和泛化。应该鼓励60年份先前时代和60时期中叶护理理论课程的结业生用那个根据理论的课程写出他们经历的传说,并因而那些课程告知或不告诉他们的施行。

  唠叨问题仍在继续:

  • 哪些框架可以提高护理实践的安全性?
  • 护理的目标是什么?
  • 与护理有关的理想结果是什么?
  • 护理干预如何与预期结果相关联?
  • 什么是评判护理实践的质量护理标准?

那一个难题继续导致一种档次的答案:让我们找到2个辅导范式,或探寻多少个对持有医生和医护人员维度具有解释力的广阔理论,一旦大家发现那一个包蕴万象的反驳,大家将能够应对有关的标题到纪律。这种艺术提醒我们,伽利略和笛卡尔谈到化学家的职责是力所能及破译大自然的心腹并完成世界真相的“真正结构”。不过,那是Plato式的上佳,而不是对科研任务的举世瞩目描述。后来,科学家起初抛弃那种追求。物艺术学家和生农学家“今后相信那点。。。大家应当在那些世界做得更好,在日趋走向更相像的定义的同时,而不是从一发端就坚定不移完全的日常“(Toulmin,一九七六,p。387)。图尔明提议,“人类的作为总体而言代表了一个太普遍的天地,被含有在二个理论体内”(第②87页)。当地文学家接受三种驳斥的须要,并且当她们接受科学的历程本质时,它将改为该课程中“成熟而不是战败主义的标志”(第叁87页)。

因为医护人员物农学家在全部课程中摸索一种理论,所以这一个职务依旧是压倒性的,要么太肤浅(罗杰s,1966),只怕过于简单化和简化(Orem,一九七五)。从业职员的情怀是对全部理论的大概和有用性建议质询,正如20世纪60年份和70时代在护理实践中动用护理理论的微小文献所证实的那么。护理实践要求一个单纯的定义框架来指引医生和医护人员课程。医护人员从业者起先相信她们被要求在争鸣之间作出选用,然后坚持不渝这一一定的辩驳。因为这几个理论都并未提到护理的各类方面,所以医护人员从业者防止了医护理论,忽视了医生和医护人员理论,恐怕拒绝使用护理理论。神话正在形成,不过。

医生和医护人员的多个大旨是在这一个等级发展的,接受护理的繁杂和各种答辩的必然性;
接受在解散任何辩驳之前测试和表明区别理论的重中之重命题的需求;
以及通过积累效应留在现场的定义或辩论成为发显示实意见的底子。二元论和多元论是辩论阶段的科班。在这一等级,护理人士开发了不可或缺的边际,以便将重视播在查询和须要的灵活性上,以便通过创立性努力贯彻扩展。

教育和行政阶段

From that early focus on practice and the concomitant traditions of
apprenticeship and service, there was a shift to questions related to
training programs and nursing curricula. The “how to” of practice
eventually was translated into what curriculum to develop to support
different levels of nursing education and how to teach it. Almost three
decades were spent experimenting with different curricula, ways of
preparing teachers, modes of educating administrators for schools of
nursing and for service, and ways of preparing nurse practitioners.
During this stage, the focus was on the development of functional roles
for nurses. The dominant themes of this stage evolved from the
educational and administrative roles of nurses.

从最初对施行的讲究以及陪同的徒弟和劳务观念出发,转向了与培养和磨练布署和护理课程有关的题材。实践的“怎样”最终被转接为提升的课程,以支撑区别层次的医生和医护人员教育以及怎么样教师它。将近三十年的日子花在品尝分化的科目,准备教师的主意,为守护和劳务高校教育管理职员的法门,以及准备执业医护人员的章程。在这么些等级,重点是看护职能角色的上扬。这一个阶段的机要核心是从医护人员的引导和行政剧中人物演变而来的。

The significance of this stage in the theoretical development of the
discipline lies in the impetus it provided nurses to ask questions
related to the domain of nursing. In developing curricula geared toward
preparing nurses for different educational levels, nurses asked: What is
nursing? How different is nursing care as provided by a diploma
graduate, an associate-degree graduate, a bachelor of science graduate,
or a master’s-degree graduate? These questions prompted nurses to
articulate the core of nursing practice in more theoretical terms
(Henderson, 1966). In a curious way, it is during this stage that the
theoretical ideas of the pioneering American nurse theorists were born.
A focus on teaching and education, therefore, may have paved the way for
the further development of theoretical nursing.

这一阶段在该课程理论发展中的首要意义在于它提供了护师向医生和护师领域建议难题的引力。在制定面向不一致教育程度护师的课程时,护师问:什么是看护?由文凭毕业生,副硕士结业生,管理学大学生学位或博士学位结业生提供的护理服务有多分歧?那几个题材促使医护人员用越多的申辩术语来表明护理实践的主导(Henderson,一九六六)。奇怪的是,正是在那些阶段,花旗国看护先驱理论家的论战观念诞生了。由此,注重教学和携带或然为理论护理的一发升华铺平道路。

法学的阶段

乘机医护人员开始反省护理实践的定义方面,界定护理领域以及最适合知识发展的艺术,他们开始盘算农学难题。这一等级的机借使建议和回应关于护理知识本质的标题(Carper,一九八〇;
Silva,1979),斟酌的习性(艾利斯,一九八三)以及护理知识的本质与探讨措施之间的一致性(
Allen,Benner和Diekelman,1988)。在这些等级,文学被认为是打算驾驭护理理论和切磋的工学前提(Sarter,一九八六),并试图进步法学钻探作为医生和医护人员知识发展的官方格局(Fry,一九九零)。

这一等级深入影响了医生和护师文献中的知识分子话语。在那个阶段,认识论的各样性被接受,对道德,逻辑和认识论的斟酌的需求被合法化,正如接受宣布的不少依据艺术学的手稿所验证的(艾利斯,一九八三)。

其一等级的表征还在于该学科的学问成熟,因为它的分子认可限制适用的工具来调查探究大旨和实在难题。关于人类全部性,情境变量和全部护理的比方须求一律的调查工具,而护师学者承认使用现有工具捕捉护理现象的复杂(Newman,一九九三;
Stevenson和伍德s,一九八六)。在维持现象的背景性和错综复杂的还要接受局限性代表了显着的学问成熟度,并且有可能将主要放在开发适合的工具上。

在那几个等级早些时候,切磋涵盖了医生和医护人员中差别的“认知主意”,并建议超越经验的央求(Carper,1976)。这一个有关文化结构,理论性质,分析标准以及文化发展一定措施的说辞的认识论研商不小地力促了医护学科身份的觉察和建构。当理论家和变体论者研商创设护理知识的经济学基础时(Allen等,1987;
罗伊,1992),出现了一组新的标题。这一个标题更加多地反映了正在开发的知识的价值和意义以及这几个文化对医生和医护人员实践的熏陶,而更少关怀知识的组织和合理性(Bradshaw,一九九三;
Silva,Sorrell)

对文化的强调与对“存在”的另一强调相得益彰。存在并不仅限于医护人员,也不压制病人,而是各自与种种人以及两岸都进入关怀互动(Benner,1992;
Newman,1991)。那些带有认识论和本体论四个组成都部队分的文学阶段为看护提供了利用多重艺术学和理论功底来打探和应对与价值,意义和实际相关的题材的合法性。

本条法学阶段持续存在,与下一个结合阶段重叠。关于后殖民主义的对话提供了掌控权,权力和抵挡怎么着影响从个人到社会种种层次的医疗保健碰到的农学经验(Kirkham
and
Anderson,2000)。在种族,文化,种族,各个性和权限差别的课程中,后殖民地护艺术学奖学金获得了公告。它是指和构架生活在殖民统治压迫下的人们经历的辩白和实证工作。利用这一军事学立场,我们得以更好地领略色彩,宗教,性取向,种族和阶级性各个性对作育健康和疾病反应的熏陶。

后现代主义,史学家对实证主义的反馈,将护理翻译成Whall描述的“让大家摆脱全数医生和护师理论”(Whall,1991;
Whall和希克斯,二〇〇二)。固然背景对后现代工学至关心注重要,不过大规模的全部是不大概的。表征后现代主义的别的概念是相对主义,解构主义,语境,无理论叙事和布局影响。

Stage of Research

构成阶段

本条等级有三个通用特征,各类特征在随着的文书中都有描述。应该用它们来鼓舞对本国学科发展情形的研商和议论,无论是在境内依旧在国际上。这些等级与中间和表面别的科目整合的下一阶段区别。这一阶段的第一本性状是应用实质性的对话和议论,侧重于规定整个护工学科及其特定专业领域的平等结构(Schlotfeldt,一九八六)。那个构造包罗在意于护理领域及其现象的正确性,理论,文学和诊治知识。那些对话爆发在议会,智囊团。

这一品级的首个性格是通过理论,商量和推行的咬合(例如环境与健康,症状管理或转型与正规)围绕实质性领域展开教育安插。这也反映在医生和护师管理人士,临床医务卫生职员和教诲工小编接纳理论护理的便利性以及学科成员与学识,发现和进步额利休戚相关事项之间更加多的对话,那么些文化,发现和前进都集聚在和浮泛护理。

这一阶段的第四个特色是由课程护理治疗医务职员,教师,管理职员,研讨人士和理论家对理论护理的差别地方开始展览评估。评估不限于理论测试;
它还包蕴描述,分析和批评。由于其各样农学基础,那么些进程中的每三个对我们学科的升华和升美利坚合众国的首都很主要。

这一阶段的第⑥个特征是,学科成员对知识发展战略给予的关注与该科指标一起假设一致,并设想到全体性,形式化,经验和意义的规范(Newman,一九九一)。

第⑥个特色是规范领域成员参预升高与特定领域现象有关的争鸣。这种参加并不解决对与护理领域现象有关的理论的接近关心;
例如,描述和干涉症状的争辨。

第肆特性状是对农学和辩论功底的批判性重新评估,那么些基础指引了护理领域基本概念的定义和浮泛,以及用于转移知识的方法论。那种话语的1个例子是重复评估护理文献中客户的概念以及那个概念与世界假设的一致性(Allen,1988)。另二个事例是有关融合不一样措施以发出更切合人类科学规律的学识的对话,如扎根理论,女权主义理论和批判理论(Kushner
and Morrow,贰零零贰)。

这一等级的第⑦本性状是透过学术单位运维诊所(护理医院)或培训临床教员职位,使护医学术部门参加病者看护的创设性格局。

研讨阶段

The stage of research evolved through a series of events overlapping
with the stages of practice and education. As Gortner (2000) indicated,
during the 1920s, case studies were formulated as teaching tools, but
they also were used as an impetus for standardization. Systematic
evaluation of these cases triggered the need for graduate education
during the post-Depression years in the United States. The war years
required data collection and analysis, necessitating the establishment
of the Division of Nursing Resources as part of the U.S. Public Health
Services in 1948. The beginnings of a research enterprise were born. In
the 1970s, commissions and councils of nurse researchers were
established. Nurses increasingly were receiving graduate degrees in
other disciplines, funds for National Research Service awards were
established, and nursing research journals were initiated.

研究等级是透过一类别与实践和教诲阶段重叠的事件演化而来的。Gortner(3000)提出,在20世纪20年间,案例研讨被制定为教学工具,但它们也被作为标准化的重力。对那一个案例的连串评估引发了美利坚合众国民代表大会萧条后的学士教育须要。战争时代供给多少搜集和剖析,由此必要在壹玖伍零年树立美国国有卫生服务单位,成立护理财富部门。贰个研究公司的降生就此诞生。在20世纪70年份,护师研究员委员会和理事会创建。医护人员更加多地在任何科目得到大学生学位,国家研讨服务奖的本金已经确立。

The momentum in nursing in education, curriculum development, teaching
and learning strategies, and in administration also led educators to
pursue research. Experts in nursing curricula recognized that without
research and a systematic inquiry into, for example, the different
teaching/learning modalities and the teaching/learning milieu on
outcomes, the education of nurses could not be improved. Therefore, the
research interest emerged from and focused on questions related to
educational and evaluative processes. The scholarship in teaching
dominated the early research enterprise.

医生和护师在教育,课程开发,教学和学习策略以及管理方面包车型客车自由化也造成人事教育育育工小编开始展览商量。护理课程专家认识到,如若没有色金属讨论所究和系统商讨差异的教学/学习格局和教学/学习条件对成果的影响,护师教育就无法获取改革。由此,商量兴趣从事教育工作育和评估进度中现身并集中于难题。教学奖学金主导着中期的斟酌型集团。

How to teach, how to administer, how to lead, and which strategies would
be more effective in teaching and administering were questions that led
to the development and expansion of nursing research (Gortner and Nahm,
1977). The first nursing research journal—entitled Nursing Research— in
the world was established in 1952, in the United States, and the
Southern Regional Educational Board (SREB) and the Western Council for
Higher Education in Nursing (WCHEN) were founded in the mid-1950s and
mid-1960s, respectively. Their objectives called for improving nursing
education, enhancing nursing research productivity, and raising the
quality of research. The journal and the meetings of the SREB and WCHEN
helped nursing develop its scientific norms—that “set of cultural values
and mores governing the activities termed scientific” (Merton, 1973, p.
270).

如何教,怎么着管理,怎么样领导以及哪些政策在教学和管理方面更实惠是促成护理商讨发展和扩充的标题(Gortner
and
Nahm,壹玖柒玖)。1951年,美利坚合众国起家了第壹份名为“护理切磋”的看护研究杂志,南美地区教委(SREB)和西方护理高教育委员会员会(WCHEN)创设于壹玖伍壹年中。
20世纪50年份和60年份中期。他们的靶子须要创新护理教育,提升医生和护师商量的生产率,进步商讨品质。该杂志和SREB和WCHEN的议会扶助护理人士发展其科学规范,即“一套文化观念和管理科学活动的知识”(默顿,1972年,第三70页)。

Criteria for reviewing scientific papers were established, on the basis
of the assumption that scientific inquiry must be judged by peers.
Therefore, nurse researchers began to abide by Merton’s norm of
universalism, the impersonal evaluation of a research product by some
objective criteria (Merton, 1973, p. 270). Universities also held the
same expectations for nursing faculty that they held for other faculty;
specifically, members of faculty in schools of nursing were required to
develop their ideas and communicate them in the scientific arena through
publications in refereed journals and scholarly presentations in
meetings. Therefore, when seen in the context of science, the “publish
or perish” dogma was not unrealistic but was rather another norm
governing nursing science. Nurses were now involved in that
communality—the sharing of ideas—and their research was subjected to the
scrutiny of their peers and anonymous critics (Gortner, 1980; Merton,
1973).

56net亚洲必赢手机,科学故事集的评定审查标准建立在不利探索必须由同行业评比议的底子上。由此,医护人员研究人口早先坚守默顿的普遍主义规范,即透过创制标准对商讨产品实行客观评价(默顿,一九七五年,第370页)。大学也对他们为别的老师担任的看护教授抱有雷同的期望;
具体而言,护理大学的教授成员要求揭橥自身的想法,并因而在学术期刊上刊载的篇章和在学术会议上的学问演说在不利领域进行沟通。因而,从天经地义的角度来看,“出版或消亡”教条并非不现实,而是管理护理科学的另二个正式。

Nursing’s initial attempts at introducing ideas and sharing research
results were met with severe and, at times, devastating criticisms from
other nursing colleagues. (Those who participated in early research
conferences may remember the lengthy and severe research critiques that
traumatized researchers and audience alike. These authors of these
critiques may not have considered the stage of nursing research
development.) As a result, and in addition to universality and
communality, two other norms evolved: objectivity and detached scrutiny.
Objective criteria for research evaluation, which were identified and
shared, provided a turning point—a scholarly medium for research
refinement and further development (Leininger, 1968).

看护在介绍想法和享受切磋成果方面包车型大巴上马尝试遭到了别的医生和医护人员同事严重的,有时依旧是毁灭性的批评。(那多少个参预过早期切磋会议的人或然会记得长日子和从严的钻研批评,那个商量批评让商量人士和观者都饱受了创伤。那几个批评的作者恐怕没有设想过护理研究的迈入阶段。)因而,除了普遍性和共同性,其它八个正规衍变:客观性和单身审查。研讨评估的合理标准通过了认可和共享,为钻探细化和特别进步提供了三个关口(Leininger,1966)。

The stage of research development made major contributions to
contemporary scholarly nursing. It was also the stage in which tools of
science left a major mark on curricula through the new offerings of
research classes and statistics courses and through the several
publications in which major research tools and instruments were compiled
and combined.

研商发展阶段对现代的学问护理做出了重庆大学进献。科学工具通过探究学科和总计课程的新产品以及因此编写制定和组合要紧研究工具和工具的几何出版物在科目中留下首要标志的阶段。

These stages have a global parallel. Progress in knowledge development
is also influenced by international levels of education. Some countries,
such as Australia and Germany, moved nursing education from hospital
training to university training in the 1980s and 1990s, respectively.
Subsequently, there has been a steady increase in philosophies and
theoretical dialogues, as well as a cumulative trajectory of research
productivity.

那么些等级是天底下平行的。国际教育程度也影响着文化发展的进行。一些国度,如澳洲和德意志,分别在20世纪80年间和90年间将护理教育从医院作育转向大学培养和磨练。随后,理学和辩论对话以及大学生产力的累积轨迹不断追加。

These, then, were the beginnings of nursing inquiry and science. During
this stage, as in other sciences, researchers emphasized scientific
syntax—the process rather than the content of research (Kuhn, 1970). The
binding frameworks or depositories of collected facts were still
lacking. Nevertheless, the syntax of the discipline had been formulated.

跨学科阶段

结缘阶段造成并抢先跨学科性阶段。花旗国国立卫生钻探院(NIH)在21世纪初的门路图为不一致档次的结缘提供了强大的拉重力,那种重组向差异学科的成员提议挑衅,以建立纳入分歧理论和证据的钻研安插领域。即使护理一贯凭借,借鉴并分享其余课程的探讨和辩论,但跨学科学和教育育和教学商讨的驱引力以后正值超级的钻研单位中拿走放大。这一阶段的宗旨主题是确立不一致科目成员的钻研人士和看病医师之间的涉及,发展同步研讨机构,推进研商陈设,或提供更健全的教诲。睡眠商量为主,疼痛管理,姑息治疗,补充性和替代性实践,安全实施和枪伤是索要不一样科目成员的专业知识的范例。NIH运行了一项反映不错性质和错综复杂的类似举动。驱动那一个部门的难点是它们是还是不是相应呈现纪律或不利领域。时间将告诉我们,摆脱纪律部门是还是不是会三番五次帮衬横向和纵向学科的升高。关于课程和跨学科的越来越多研商在第①4章中提供。枪支受伤是内需差别学科成员的专业知识的范例。NIH运行了一项反映不错性质和复杂性的近乎举动。驱动这几个单位的题材是它们是还是不是相应反映纪律或不易领域。时间将告诉大家,摆脱纪律部门是还是不是会一连辅助横向和纵向学科的升华。关于课程和跨学科的越来越多切磋在第二4章中提供。枪支受伤是索要不一致科目成员的专业知识的范例。NIH运营了一项反映不错性质和错综复杂的类似举动。驱动这个单位的问题是它们是否合宜显示纪律或不易领域。时间将报告我们,摆脱纪律部门是或不是会继续帮忙横向和纵向学科的向上。关于课程和跨学科的更加多商讨在第②4章中提供。时间将告诉大家,摆脱纪律部门是否会持续支持横向和纵向学科的前进。关于课程和跨学科的越来越多切磋在第二4章中提供。时间将报告大家,摆脱纪律部门是或不是会一而再援救横向和纵向学科的升华。关于课程和跨学科的更多探讨在第叁4章中提供。

那便是说,那个正是医生和护师调查和正确的伊始。在这些等级,与其余科学一样,钻探者强调科学语法

经过而不是斟酌内容(Kuhn,一九六六)。收集到的实际的束缚框架或存款和储蓄依旧缺少。就算如此,该课程的语法已经制订。

技巧和音讯体系阶段

守护记录,机器人药物分配器,远程家庭护理,远程监护,虚拟手术以及约定和药品的语音邮件提示是医生和医护人员学科发展史上这一等级的特色。包蕴与新闻学和技巧突破有关的变量和标准化的说理是此阶段的画龙点睛驱动机原因素。将化学家和临床医务职员通过互连网向群众传播的初阶进和新型消息纳入个人和家中时,自作者保健实践将全数不一致的意义。自作者保健的做法和目的还包蕴动用家用血压仪,葡萄糖试剂盒,自作者诊断协议和本身监测小工具等新型监测装置。

Stage of Theory

表5-2看护中的理论发展:里程碑
1955年之前 从弗洛伦斯南丁格尔到护理研究
1955-1960 护理理论的诞生
1961-1965 理论:护理的国家目标
1966-1970 理论发展:学术界的切实目标
1971-1975 理论语法
1976-1980 反思
1981-1985 年的时间护理理论的复兴:领域概念的出现
1986-1990 从元理论到概念发展
1991-1995 中期和情境理论
1996-2000 证据意味着研究而不是理论
2001- 2005 思想多样性:将理论与实践联系起来
2006-2010 护士授权:以证据和技术为资源

反驳阶段

Eventually, the fundamental questions about the essence of nursing—its
mission and its goals—began to surface in a more organized way. An
incisive group of leaders, nurses who believed that theory should guide
the practice of nursing, wrote about the need for theory, the nature of
nursing theory, philosophers’ views of theory, and how nursing theory
ought to be shaped. Although the conceptual schemata of nurse theorists
for the discipline of nursing appeared during the education and
administration stages of the discipline, it was not until the emergence
of the stage of theory that they were taken seriously (Nursing Theory
Think Tank, 1979).

最后,关于护理本质的为主难点 – 其任务和对象 –
起首以更有系统的章程展现。一群尖锐的领导职员,医护人员认为理论应当引导医生和医护人员实践,他写到理论的内需,护理理论的精神,翻译家的争持观点以及怎么样作育护理理论。尽管护教育学理论家在医生和护师学科的概念图式出现在课程的教育和保管阶段,但直至理论阶段出现后才被珍视(Nursing
Theory Think Tank,1978)。

During this stage, arguments arose about whether nursing was merely a
chapter of medicine or whether it was part of the biologic, natural, or
physical sciences (analogous to the earlier Cartesian concept that
biology is simply a chapter of physics). The Cartesian concept was
rejected (biology is indeed a distinct and autonomous science), and
nursing continued to resist the implication that it was a part of
medicine. It became clear to a new breed of nurse leaders—the
philosophers and the theorists (or conceptualists, as some referred to
them)—that nursing could not be reduced to a single science that
inquires into just one aspect of man, just as biology is not reducible
to physics. Nursing is complex, necessitating its intrinsic autonomy in
content and methods.

在那些等级,关于护理是不是仅仅是医术的三个章节,大概它是生物学,自然科学还是物理科学的一片段(类似于后期的笛卡儿的概念,生物学仅仅是物管理学的叁个章节)的争持就涌出了。笛卡儿的概念被否决了(生物学确实是二个非正规的自治科学),护工学继续对抗它是医术一部分的意义。对新一代医护人员领导者

  • 教育家和理论家(或许概念主义者,就如他们涉嫌的那多少人)而言 –
    变得很明亮 –
    护理不可能简单地归结为一种只涉及人的二个上面的十足科学,就像生物学一样不能够简化为大体。护理是复杂的,须要其剧情和措施的内在自主性。

The search for conceptual coherence evolved from a preoccupation with
syntax to the disciplined and imaginative study of the realities of
nursing and the meaning and truths that guide its actions (Table 5-1).
Its development from preoccupation with scientific method to speculation
and conceptualization is reminiscent of the development of philosophical
thought in the 18th and 19th centuries. The 18th century was greatly
influenced by Newton and by Bacon, who was in turn influenced by
Descartes. The 19th century was dominated by Kant, whose hypothetical,
deductive, and metaphysical approach encouraged the speculative nature
of science. The speculators in nursing began to construct realities as
they saw them, and their imaginative constructs evolved from their
philosophical backgrounds and from their educational inclinations.

对定义一致性的追求从对语法的注意发展到对医生和医护人员现实的胆战心惊和具备想象力的研商,以及指引其行事的含义和真理(表5-1)。从对科学格局的注目到估算和架空的前进,令人回想18世纪和19世纪军事学思想的进化。18世纪受Newton和Bacon的影响非常的大,而培根又遭受笛Carl的熏陶。19世纪由康德主宰,其只要的,演绎的和教条主义的法子鼓励科学的一见照旧本质。护理中的投机者发轫创设他们见到的切切实实,他们有着想象力的协会从他们的文学背景和她俩的启蒙倾向进步而来。

56net亚洲必赢手机 1

CHARACTERISTICS OF THE BEGINNING STAGE OF THEORY DEVELOPMENT

辩白发展的里程碑

反驳护理的迈入和进化有所多少个里程碑意义,那些里程碑是因而分析壹玖伍零年至二零零一年以内选定的医护期刊中出现的理杂谈献而规定的。那些里程碑大大改观了辩护在医生和护师中的地位,深切地影响了护理进一步升华理论护理。各种里程碑都在此地举办了定义和归纳描述(表5-2)。识别和概念那几个里程碑会挑衅别人探索每一种里程碑大概对护理知识的进行和进步产生的熏陶。

表5-1 理论发展起来阶段的特色
•  利用外部范式来指导理论
•  关于学科现象的不确定性
•  离散和独立的理论
•  研究,实践和理论之间的分离
•  寻求概念上的一致性
•  用于课程的理论
•  单一范例的目标占上风

It was natural for theory development to be influenced by the paradigms
of other disciplines, by the educational background of nurse theorists,
and by the philosophical underpinnings of the time. Therefore, we find
premises stemming from existentialism, analytical philosophy, and
pragmatism guiding the development of those theories, sometimes
explicitly and often implicitly. Nurses also adopted concepts and
propositions from other paradigms, such as psychoanalysis, development,
adaptation, and interaction, as well as from humanism, to guide its
assessment and its action. Theories were developed in response to
dissatisfaction with isolated findings in research. The emerging
theories addressed the nature of the human being in interactions and
transactions with the health care system, as well as the processes of
problem solving and decision making for assessment and intervention.

反驳发展碰着别的学科的范式,护师理论家的启蒙背景以及及时的管理学基础的震慑是很当然的。由此,大家发现源于存在主义,分析文学和实用主义的前提是指点那么些理论的升华,有时是扎眼而且平日隐含的。护师还选拔了其余范式的定义和命题,如精神分析,发展,适应,互动以及人文主义,以指点其评估和行进。理论是为着回应对斟酌中独立的商讨结果的不满。新出现的争论阐释了人类在与医疗保健系统的相互和交易中的本质。

Although certain theoretical concepts were synthesized from diverse
paradigms, most nursing theories, such as subsystems of behavior, role
supplementation, therapeutic touch, and selfhelp, were definable and
analyzable only from the nursing perspective. Theories offered a
beginning agreement on the broad intellectual endeavors and the
fundamental explanatory tasks of nursing. This stage offered knowledge
of relevant phenomena, but uncertainty continued about the discipline of
nursing and its intellectual goals. Just as in nuclear physics—when the
first achievement was not one of observation or mathematical calculation
but one of intellectual imagination— conceptual schemata evolved before
there was any clear recognition of nursing’s empirical scope. In
nursing, theories helped the discipline to focus on its concepts and
problems.

纵然有个别理论概念是从分裂的范式综合而来,但唯有从护理的角度来看,超过五成守护理论(如行为子系统,角色补充,治疗触觉和自助)都是能够限制和分析的。理论为常见的文人努力和医护的为主解释性职分提供了开班协议。这么些等级提供了相关景况的文化,但医生和医护人员学科及其智力目的仍存在不鲜明性。就像是在原子核物法学学中

  • 当第三个到位不是着眼或数学计算之一,而是智力想象 –
    概念图式之一在对医护的经历范围有别的鲜明认识从前就演化了。在护管理学方面,理论支持该课程专注于其定义和题材。

Rogers (1970) offered a conception of nursing that focused on the
constant human interaction with the environment. Johnson (1980)
developed the notion that a human being—a biologic system—is also an
abstract system of behavior centered on innate needs. Levine (1967) and
Orem (1971) proposed guidelines for nursing therapeutics that preserve
the integrity of the human being, the psychology, the community
affiliation—in short—the entire person. Orem (1985) reminded us that the
human being is perfectly capable of self-care and should progress toward
that goal.

罗杰斯(一九七〇)提议了护理概念,重点关切人与环境的穿梭交换。Johnson(1976)发展了一种观念,即人类

  • 生物系统 –

    也是以纯天然须求为主导的架空系统。Levine(一九六六)和Orem(一九七一)建议了医生和护师疗法的引导方针,以保障人类的完整性,心绪学和社区维系

    差不离,就是整套人。Orem(1983)提醒大家人类完全有力量自笔者照顾,并应当朝着这几个目的提升。

Because of the earlier focus on education and professional identity,
because the National League for Nursing stipulated a conceptual
framework for curricula, and because the truth of a theory had not yet
been established using the empirical positivists’ criteria of
corroboration, emergent theories were not used to guide practice or
research but were instead used to guide teaching. Consequently,
scientific energies were dissipated in developing curricula that
corresponded to these theories.

由于较早关注教育和职业认可,因为全国护理缔盟规定了课程的定义框架,并且由于尚未利用经验实证主义者确证的正式鲜明理论的真正,所以没有使用新兴理论教导实践或切磋,而是用来指引教学。由此,在制订与这一个理论相呼应的课程时,科学能量消失了。

Although theories may have influenced practice through students, such
influence was not documented in the literature, which focused more on
theory in educational programs. As an educator who was a member of a
school that used nursing theory (also called a model) as a framework for
the curriculum, I experienced first-hand, in the mid-1960s, the
conflicts that graduates of the program encountered when they wanted to
use a nursing framework, one that they studied and experienced in their
educational program, in practice and were unable to do so because of its
novelty and its esoteric concepts. Whether the use of nursing models in
education rendered nursing care more effective and efficient is a matter
left to speculation and was evidenced only in isolated incidents and
through experiential narrative analyses that were discounted for their
lack of universality and generalization. The graduates of programs based
on nursing theories in the early and mid-1960s should be encouraged to
write the stories of their experiences with these theoretically based
programs and the ways by which their practice was informed or not
informed by these programs.

固然理论或然影响了学生的进行,但那种影响在文献中没有记载,这个文献更加多地集中在教育项目辩白上。作为一名教育工笔者,他曾是一所利用护理理论(也称之为格局)作为课程框架的学府的分子,在1956年份前期,作者切身感受了安排结业生在她们想要的时候蒙受的争执使用护理框架,他们在实践中学习和经验过她们的启蒙安插,并且鉴于其新颖性和深邃的定义而不能那样做。护理形式在教育中的使用是不是使护理尤其实用和有效能是1个留下来进行测算的难题,并且仅在孤立事件中以及通过经验性叙述分析表明,因为它们贫乏普遍性和泛化。应该鼓励60年份中叶和60年份中叶护理理论课程的结业生用那么些依据理论的教程写出她们经历的故事,并通过那几个课程告知或不报告他们的施行。

  The nagging questions continued:

  • What frameworks enhance safety in nursing practice?
  • What are the goals of nursing care?
  • What are the desired outcomes related to nursing care?
  • How do nursing interventions relate to desired outcomes?
  • What are the quality care criteria by which to judge nursing practice?

  唠叨问题仍在继续:

  • 哪些框架可以提高护理实践的安全性?
  • 护理的目标是什么?
  • 与护理有关的理想结果是什么?
  • 护理干预如何与预期结果相关联?
  • 什么是评判护理实践的质量护理标准?

These questions continued to lead to one type of answer: Let us find a
guiding paradigm or search for a universal theory with explanatory power
for all dimensions of nursing and, once we find this all-encompassing
theory, we will be able to answer questions related to the discipline.
This approach reminds us that Galileo and Descartes talked of the
scientist’s task as that of being able to decipher once and for all the
secrets of nature and to arrive at the “one true structure” of the
nature of the world. However, that was a Platonic ideal rather than a
plain description of the task of scientific research. Later, scientists
began to discard this line of pursuit. Physicists and physiologists “now
believe that . . . we shall do better in these fields by working our way
toward more general concepts progressively, as we go along, rather than
insisting on complete generality from the outset” (Toulmin, 1977, p.
387). Toulmin proposed that “human behavior in general represents too
broad a domain to be encompassed within a single body of theory” (p.
387). When scientists accept the need for multiple theories, and when
they accept the process nature of science, it will be a “sign of
maturity rather than defeatism” (p. 387) within the discipline.

那一个题材继续导致一种类型的答案:让我们找到一个辅导范式,或探寻三个对拥有医生和护师维度具有解释力的科学普及通理科论,一旦大家发现这几个包罗万象的说理,我们将能够回答相关的标题到纪律。那种办法提醒我们,伽利略和笛Carl谈到物军事学家的职务是能够破译大自然的地下并完毕世界真相的“真正结构”。不过,那是柏拉图式的好好,而不是对正确研讨职务的肯定描述。后来,物历史学家起先遗弃那种追求。物管理学家和生医学家“今后相信那或多或少。。。我们相应在那些领域做得更好,在日趋走向更相像的概念的还要,而不是从一初始就百折不挠完全的平日“(Toulmin,一九八零,p。387)。图尔明提议,“人类的一颦一笑总体而言代表了一个太普遍的世界,被含有在二个理论体内”(第壹87页)。当地管理学家接受种种争辨的要求,并且当她们承受科学的进度本质时,它将变成该课程中“成熟而不是失利主义的阐明”(第叁87页)。

Because nurse scientists searched for one theory for the entire
discipline, the task was either overwhelming and too highly abstract
(Rogers, 1970), or too simplistic and reductionist (Orem, 1971). The
sentiment of practitioners was to question the possibility and
usefulness of an allencompassing theory, as evidenced by the meager
literature throughout the 1960s and 1970s on nursing practice using
nursing theory. The desire for a single conceptual framework to guide
the nursing curriculum was carried to nursing practice. Nurse
practitioners came to believe that they were being asked to make a
choice between theories, and then adhere to that one particular theory.
Because none of the theories addressed all aspects of nursing, nurse
practitioners avoided nursing theory, ignored it, or refused to use it.
A myth was being formed. However, many nurses abandoned the notion of a
universal theory to describe and explain nursing phenomena and units of
analysis and to guide nursing practice, just as physicists did when they
abandoned the 17th-century hope that a universal science of nature could
be developed within the framework of fundamental ideas of classical
mechanics.

因为护士物医学家在方方面面课程中寻找一种理论,所以那个职务照旧是压倒性的,要么太肤浅(罗吉尔s,一九七〇),大概过于简单化和简化(Orem,1974)。从业人士的心理是对整体理论的恐怕性和有用性建议质问,正如20世纪60时代和70年间在护理实践中使用护理理论的细小文献所验证的那么。护理实践要求多个纯净的定义框架来辅导医生和医护人员课程。护师从业者初步相信她们被须求在辩论之间作出采用,然后坚韧不拔这一一定的反驳。因为那几个理论都不曾关系护理的种种方面,所以护师从业者制止了医生和医护人员理论,忽视了医生和医护人员理论,可能拒绝使用护理理论。神话正在形成,可是。

Three themes in nursing that evolved during this stage were acceptance
of the complexity of nursing and the inevitability of multiple theories;
acceptance of the need to test and corroborate major propositions of
differing theories before dismissing any of them; and the idea that
concepts or theories remaining in the field, through a cumulative
effect, become the basis for the development of a specific perspective.
Dualism and pluralism were the norms during the stage of theory. It was
also during this stage that nursing developed the boundaries necessary
to focus its inquiry and the flexibility necessary to allow expansion
through creative endeavor.

守护的八个宗旨是在那么些阶段发展的,接受护理的复杂性和各个争执的必然性;
接受在解散任何辩驳在此以前测试和验证分歧理论的首要性命题的内需;
以及因此积累效应留在现场的概念或辩论成为发展实际意见的底蕴。二元论和多元论是理论阶段的标准。在这一等级,护理人员开发了必不可少的分界,以便将第壹放在查询和必备的八面见光上,以便通过创建性努力达成扩张。

一九五三年事先 – 从弗Loren斯南丁格尔到护理切磋

1952年事先影响全部医生和医护人员科学后续发展的2个生死攸关里程碑是确立了医生和医护人员商讨期刊,指标是告诉医护人员和其余人对医护的不易调查商讨(图5-1
)。该杂志最重点的对象是鼓励科学生产力。该杂志的成立证实了医生和医护人员的确是一门科学学科,其开展将取决于护士是或不是通过可敬的教程所运用的不二法门追求真理,即钻探。固然南丁格尔可能为钻探和理论提供了伊始的重力,但早期,她的影响在护理教育中格外敏感。护师教育主要性爆发在文凭课程中。

除此之外,护理钻探出版物的树立提供了一种困惑态度的框架,大概为查询创制了舞台,在晚年促成更加多的辩白话语,这段时日对于护理理论来说是通常的。

56net亚洲必赢手机 2

Chronology of the development of theoretical nursing

Stage of Philosophy

一九五二-一九六零年 – 护理理论的落地:哥伦比亚(República de Colombia)高校师范高校方法

固然弗Loren斯·南丁格尔关于护理的理念着眼于健康与环境之间的涉及,不过在20世纪初发展起来的,直到20世纪50时代中叶,护师才开首证明护理的申辩观点。关于护理本质,其职分和目的以及护师剧中人物的题材促使医护人员教育工小编捕捉这一个题指标答案,并将其彰显在进一步贯通的完好中。那些题材根源对护师从文凭课程到大学生学位课程的指导准备的转移的兴味,出于对课程内容或化解内容的忧患,以及护师必要上学如何担任护师。

哥伦比亚(República de Colombia)高校交通大学的首任护文学教师M. AdelaideNutting被任命为博士课程,主要担负教育和治本,为毕业生做好大家教育和保管的准备。纵然那些老谋深算的布置的机要不在于护理科学或护理理论,但该布置的加入者一定已经感到到他们处于促进教育学和申辩难题的对话和申辩的环境中。值得注意的是,在1997年,护理教育安插庆祝了100年的影响力,那是一个很好的喜庆活动,因为在那十年中提供护理概念的一大半理论家都在农业学院接受教育;
包含Peplau,Henderson,哈尔l,Abdellah,King,Wiedenbach和罗吉尔s(表5-3)。

艺术学的等级

As nurses began reflecting on the conceptual aspects of nursing
practice, on defining the domain of nursing, and on the most appropriate
methods for knowledge development, they turned to philosophical
inquiries. The focus during this stage was on raising and answering
questions about the nature of nursing knowledge (Carper, 1978; Silva,
1977), the nature of inquiry (Ellis, 1983), and the congruency between
the essence of nursing knowledge and research methodologies (Allen,
Benner, and Diekelman, 1986). During this stage, philosophy was
considered an attempt to understand the philosophical premises
underlying nursing theory and research (Sarter, 1987) and an attempt to
develop philosophical inquiry as a legitimate approach to knowledge
development in nursing (Fry, 1989).

乘势护师开始反省护理实践的定义方面,界定护理领域以及最适合知识发展的方法,他们开始思索理学难点。这一等级的首倘使提议和答复关于护理知识本质的题目(Carper,一九七八;
Silva,1976),研究的质量(艾利斯,1985)以及护理知识的精神与斟酌措施之间的一致性(
Allen,Benner和Diekelman,壹玖捌捌)。在那么些阶段,艺术学被认为是意欲理解护理理论和商讨的理学前提(Sarter,一九九〇),并打算升高历史学研讨作为医护知识发展的官方格局(Fry,一九八六)。

This stage influenced profoundly the intellectual discourse in nursing
literature. During this stage, epistemological diversity was accepted
and the need for ethical, logical, and epistemological inquiries was
legitimized, as evidenced in the numerous philosophically based
manuscripts accepted for publication (Ellis, 1983).

这一阶段深远影响了护理文献中的知识分子话语。在这一个等级,认识论的多种性被接受,对道德,逻辑和认识论的探赜索隐的要求被合法化,正如接受发表的多多依照农学的手稿所验证的(艾利斯,一九八一)。

This stage was also marked by a scholarly maturity in the discipline, as
its members acknowledged the limitation of appropriate tools to
investigate fundamental and practical issues. Assumptions about
wholeness of human beings, contextual variables, and holism of care
called for congruent investigative tools, and nurse scholars
acknowledged the complexity of capturing nursing phenomenon using
existing tools (Newman, 1995; Stevenson and Woods, 1986). Accepting
limitations while maintaining the reality of the contextuality and
complexity of the phenomenon represents a marked scholarly maturity and
the potential to focus on the development of appropriate tools.

本条阶段的性状还在于该课程的学问成熟,因为它的成员认同限制适用的工具来考察中央和骨子里难题。关于人类全体性,情境变量和一体化护理的尽管要求一律的检察工具,而医护人员学者认同使用现有工具捕捉护理现象的纷纭(Newman,一九九四;
史蒂文斯on和伍德s,1987)。在保险现象的背景性和错综复杂的同时接受局限性代表了显着的学术成熟度,并且有也许将重庆大学放在开发适合的工具上。

Earlier during this stage, discussions encompassed the different “ways
of knowing” in nursing and espoused a call for going beyond the
empirical (Carper, 1978). These epistemological discussions focusing on
the structure of knowledge, nature of theory, criteria for analysis, and
justification of particular methodologies for knowledge development
significantly contributed to the discovery and construction of an
identity for the discipline of nursing. As theorists and metatheorists
discussed the philosophical bases that shaped nursing knowledge (Allen
et al., 1986; Roy, 1995), a new set of questions emerged. These
questions reflected more the values and meaning of the knowledge being
developed and the consequences of this knowledge on nursing practice,
and focused less on the structure and justification of knowledge
(Bradshaw, 1995; Silva, Sorrell, and Sorrell, 1995).

在那一个阶段早些时候,研商涵盖了医生和护师中分裂的“认知主意”,并提议抢先经验的央求(Carper,一九八〇)。那么些有关知识结构,理论性质,分析标准以及文化发展一定措施的说辞的认识论研商一点都不小地力促了护经济学科身份的意识和建构。当理论家和变体论者研商创设护理知识的理学基础时(Allen等,1990;
罗伊,壹玖玖肆),出现了一组新的题目。那些标题越多地体现了正在开发的文化的市场股票总值和含义以及这几个文化对医生和护士实践的熏陶,而更少关切知识的结构和客观(Bradshaw,1991;
Silva,Sorrell)

The emphasis on knowing was complemented by another emphasis on “being.”
The being was not limited to the nurse, or to the patient, but to each
separately and to both joined in caring interactions (Benner, 1994;
Newman, 1995). This philosophical stage, encompassing both components of
epistemology and ontology, provided nurses with the legitimacy to ask
and answer questions related to values, meanings, and realities using
multiple philosophical and theoretical bases.

对文化的强调与对“存在”的另一强调相反相成。存在并不仅限于医护人员,也不压制病人,而是各自与种种人以及两岸都加入关切互动(Benner,一九九三;
Newman,壹玖玖伍)。那一个带有认识论和本体论四个组成都部队分的医学阶段为看护提供了动用多重管理学和驳斥基础来打听和回复与价值,意义和求实相关的题材的合法性。

This philosophical stage persists, overlapping with the following stage
of integration. Dialogues about postcolonialism provide the
philosophical canons for understanding how domination, power, and
resistance influence health care encounters at all different levels,
from the individual to society (Kirkham and Anderson, 2002). The
postcolonial scholarship in nursing was informed by the discourse in the
discipline on race, culture, ethnicity, diversity, and power
differential. It refers to and frames the theoretical and empirical work
of people’s experiences living under the oppression of colonial control.
Using this philosophical stand, we can better understand the effects of
diversity in color, religion, sexual preference, ethnicity, and class in
shaping responses to health and illness. It allows health care
professionals to access the meaning of marginalization.

以此文学阶段持续存在,与下二个组成阶段重叠。关于后殖民主义的对话提供了知道控制权,权力和抗击怎么样影响从个体到社会种种层次的医疗保健遭受的农学经验(Kirkham
and
Anderson,2000)。在种族,文化,种族,三种性和权力差别的学科中,后殖民地护工学奖学金获得了通报。它是指和构架生活在殖民统治压迫下的稠人广众经历的反驳和实证工作。利用这一教育学立场,大家能够更好地驾驭色彩,宗教,性取向,种族和阶级性四种性对培养健康和疾病反应的影响。

Postmodernism, a reaction by philosophers to positivism, translated in
nursing into a prevailing sentiment described by Whall as “Let’s get rid
of all nursing theory” (Whall, 1993; Whall and Hicks, 2002). Although
the context is vital to postmodernism philosophy, universal totality is
not possible. Other concepts that characterize postmodernism are
relativism, deconstruction, context, atheoretical narratives, and
structural influences.

后现代主义,思想家对实证主义的影响,将护理翻译成Whall描述的“让我们摆脱全体医生和医护人员理论”(Whall,1994;
Whall和希克斯,二〇〇一)。即使背景对后现代工学至关心珍视要,可是大规模的总体是不只怕的。表征后现代主义的别的概念是相对主义,解构主义,语境,无理论叙事和组织影响。

表5-3守护理论:一九四八-1979
1952年 Hildegarde Peplau。护理人际关系。也于1962年,1963年,1969年出版。
1955年 弗吉尼亚亨德森。护理原理和实践教科书(与B.哈默)。也是1966年,1972年,1978年。
1959年 多萝西约翰逊。“护理哲学”。也是1961年,1966年,1974年。
1959年 丽迪雅大厅。护理哲学。也是1963年(和其他人,1975年)。
1960年 Faye Abdellah。“以病人为中心的护理方法”也是1965年,1973年。
1961年 艾达让·奥兰多。动态的护患关系。
1963年 D. Howland和E. McDowell。“医院系统模型”。
1964年 D. Howland和E. McDowell。“病人护理的测量:概念框架。”
1964年 Joyce Travelbee。人际关系方面的护理。也是1969年,1971年,1979年。
1964年 E. Wiedenbach。临床护理:帮助艺术。也是1967年,1969年,1970年,1977年。
1966年 Myra Levine。“适应和评估。”
1966年 M. Harms和F. McDonald。“一个新的课程设计。”
1967年 Myra Levine。临床护理简介。也是1969年,1971年,1973年。
1968年 Imogene国王。“护理参考的概念框架”。也是1971年,1975年。
1969年 Joyce Travelbee。干预精神病护理。也是1971年(1979年)。
1970年 玛莎罗杰斯。护理理论基础介绍。1980年。
1970年 Callista Roy姐妹。“适应:护理概念框架”。也是1974年,1976年,1980年,1984年。
1971年 Imogene国王。走向护理理论:人类行为的一般概念。
1971年 Dorothea Orem。护理:实践的概念。也是1981年,1982年,1985年,1991年。
1972年 贝蒂纽曼。“贝蒂纽曼医疗保健系统模型。”也是1989年。
1976年 约瑟芬帕特森和L. Zderad。“人文护理”,也是1988年。

为准备功用角色和体会准备教学大纲的力量,设置人士配备方式等恐怕早就释放了那一个大家对学术历程的别样地点(如理论或概念模型开发)的创造能力。就算其余经验和陈设或然平素影响到那一个大家的辩论追求(例如,罗杰斯在John霍普金斯大学的大学生诗歌准备),但仿佛师范高校的农学直接地不仅影响了精神病学理论和钻研,而且还涉嫌全部医生和护师的理论思考(Sills,1978)。询问和回复有关学术环境对准备有收获的专家的熏陶的标题大概会促使人们寻求奖学金的属性。

Peplau(一九五一)利用哈利 Stack
Sullivan的申辩标题和概念来开发自个儿的答辩,爆发了护理作为人际关系的率先个掌握的概念,当中人际进程的组成都部队分须要被发明和分析。精神病护理领域随后利用Peplau的想法小幅提升。别的在20世纪60年份发展兴起的驳斥是依照那么些早期的看护概念。例如,维吉妮亚Henderson与Bell森哈默一起研究开发了护理理论的早期种子,该理论于20世纪50年份中叶公布在护理原理和实施教科书上。

国际护理理事会(ICN)提议的限量护理及其义务的渴求致使一九六〇年的ICN证明出现在广大分发的出版物中,并在国际上展开了调整(亨德森,一九六七年,第25页)。Peplau和Henderson给出的音信是,护理有2个一定的和区别经常的职务,而且以此沉重有局地足以传达的秩序和集团。那几个显著的一体化代表护理理论的起始。

从他在哥大的做事中发展而来的Abdellah的守护理论是该高查对理论护理影响的另3个事例(Abdellah,Beland,Martin和Matheney,1965)。一九五四年Abdellah硕士故事集在希尔德gard
Peplau领导下的师范高校专注于规定隐性方面包车型大巴看护难题。她的商量成果随后公布在护理商量中,标志着她尝试理论化护理进度的开端。她的医生和医护人员概念化是从她的博士杂文研商和从1951年达成的另一项探讨中,根据伤者对医生和护师的供给而升高而来的。后者是依据从伤者,医护人员和先生收集的多寡。

别的理论家的想法是围绕要求1个有约束力的框架来指引课程设计的,但她俩的著述和出版物并从未像Peplau,Henderson和Abdellah那样对理论护理产生即时影响。他们的观念对医生和护师发生潜移默化缓慢。Orem的想法第3次刊出于一九六零年制定实用护理课程的指南开中学。伤者要求也是至关心珍贵要。霍尔于1958年花费并于一九六五年在勒布护理和康复大旨推行了一种基于需要和人际关系的守护概念。人们能够看到Peplau和Henderson在他的著述(哈尔l,1962)中的影响。

独自于电子科技大学的理论家小组,Johnson开端在抽象护理中发布核心作用。Johnson(一九五七)对护工学科学性质的解析无疑是在专注看护作为一门科学学科的潜力以及提倡发展其特殊的学问底子方面包车型地铁一个里程碑。当时,Johnson一时建议护理知识是依照与文学诊断截然分歧的医生和护师诊断理论。那种诊断的实质性难点是Johnson理论的起来,以往始于制定。(请参阅第贰0章,理解每位理论家的十三分引文。)

护理进展的另贰个里程碑是确立专门的看护商讨奖学金陈设,以推进,帮忙和鼓励护师的钻研生涯教育。该安插为看护在生物学,生历史学,社会学和人类学等相关领域接二连三开展大学生教育提供了财政激励和支撑。

Stage of Integration

1964-一九六四-理论:全国护理目的

从收缩人的定义为“疾病”或“手术”出现体征和症状,20世纪50年份末期的守护理论将护理注意力重新集中在民用作为一组供给和当作一组特殊成效的护理上。就算如此,还设有一种还原手段。20世纪60时代,在兵连祸结的社会中,Camelot的协调与现有的指标以及Peplau的熏陶也许促使护理从其满意患儿要求的沉重转向医护人员与病者之间建立关系的指标。若是经过人际交往有效建立关联(如一九五二年Peplau以及一组新的理论家所倡导的那样),那么护理护理能够满足患儿的要求

  • 不像护师所定义的那么,而是由病者。

在此时期,加州洛杉矶分校大学护理大学的地方受到了哥伦比亚共和国师范高校结业生的震慑,该高校结业生成为浦项工业学院的名师,正在开端制定。对于这一个专家的话,护理被认为是一个进程而不是实现,一个互动而不是内容,以及多个人里面包车型客车关系,而不是井水不犯河水的看护和患者之间的并行。多种社会能力扶助香港理教院将其理念发展为守护概念。联邦拨款用于准备从精神病护理到教学岗位,用于鲜明护理中的精神病学概念以及支出综合科目。因而,时间和财富的可用性在提供供给的拉动。

虽说新加坡国立大学护理高校的办事大概在20世纪60年间对美利坚同车笠之盟的守护切磋爆发了源源而来的震慑,但其对理论的影响在霎时并没有那么显着。那种影响的复苏发生在20世纪80年间,因为护师认可香港理工科的申辩发展战略;
那反映了奥兰多工作(Schmieding,1983,一九八七,1988)以及护理商讨向现象学的范式转变(Oiler,1981;
Omery,1981; Silva and
Rothbart,壹玖捌伍)的重新考虑。由此,那么些作者的守护概念化并不是有助于下一阶段理论发展的里程碑。相反,它是United States护师组织(ANA)的立场文件

  • 看护被定义为看护,治疗和协调。

在此时期发生了其余两项重庆大学情状发展。首先,向希望在其间一门基础科学领域接受硕士教育的护师提供联邦帮助。这个科目标结业生是这么些在20世纪70年份中叶进一步上扬了复合理论的人。第四个进步是看护科学杂志的揭幕。就算时间短暂,但它是医生和护师理论和科学观点调换的介绍人,也证实护理是一门具有理论基础和基础的频频前进的不利。

重组阶段

This stage has seven universal characteristics, each described in the
subsequent text. They should be used to stimulate thinking and
discussions about the state of development of our discipline, both
nationally and internationally. This stage differs from the next stage
in its internal versus external integration with other disciplines. A
first characteristic of this stage is the use of substantive dialogues
and discussions focused on identifying coherent structures of the
discipline of nursing at large and of its specific areas of
specialization (Schlotfeldt, 1988). The structures include scientific,
theoretical, philosophical, and clinical knowledge that is focused on
the nursing domain and its phenomena. These dialogues take place in
conferences, think tanks, and themed journal editions devoted to the
development of middle-range and situation-specific theories focused on
an aspect of nursing.

本条阶段有四个通用特征,各种特征在跟着的文件中都有描述。应该用它们来刺激对小编国学科发呈现象的思维和议论,无论是在国内照旧在列国上。这一个阶段与中间和外部别的课程整合的下一阶段不一样。这一阶段的首先个特点是行使实质性的对话和斟酌,侧重于规定整个护文学科及其特定专业领域的均等结构(Schlotfeldt,一九九〇)。这几个构造包涵在意于护理领域及其现象的科学,理论,法学和医疗知识。那几个对话爆发在议会,智囊团。

A second characteristic of this stage is the development of educational
programs that are organized around substantive areas through the
integration of theory, research, and practice— such as environment and
health, symptom management, or transitions and health. It is also
manifested in the ease by which nursing administrators, clinicians, and
educators use theoretical nursing, and in the increasing dialogue among
members of the discipline regarding matters related to knowledge,
discovery, and development that is focused on and emanates from the
domain of nursing.

这一品级的第二天性状是透过理论,商讨和实施的三结合(例如环境与常规,症状管理或转型与符合规律)围绕实质性领域开始展览教育安顿。那也反映在医生和护师管理人士,临床医务职员和教化学工业小编辑采访用理论护理的便利性以及学科成员与学识,发现和进化相关事项之间越是多的对话,那一个文化,发现和提升都集中在和浮泛护理。

A third characteristic of this stage is the evaluation of different
aspects of theoretical nursing by members of the discipline—nursing
clinicians, teachers, administrators, researchers, and theoreticians.
Evaluation is not limited to theory testing; it includes description,
analysis, and critiques as well. Each of these processes is important in
the development and progress of our discipline because of its diverse
philosophical bases.

这一品级的第二本性况是由科目护理治疗医务卫生职员,教授,管理职员,研商人口和理论家对理论护理的两样方面实行业评比估。评估不压制理论测试;
它还包含描述,分析和批评。由于其各个历史学基础,那么些经过中的每3个对大家学科的上进和发展都很要紧。

A fourth characteristic of this stage is the attention that members of
the discipline give to the strategies of knowledge development that are
congruent with the discipline’s shared assumptions and that consider the
conditions of holism, patterning, experience, and meaning (Newman,
1995).

这一品级的第伍个特点是,学科成员对文化发展战略给予的酷爱与该学科的一块假设一致,并考虑到全部性,方式化,经验和意义的规格(Newman,一九九四)。

A fifth characteristic is the involvement of members of specialty fields
in developing theories that are pertinent to the phenomena of that
particular field. This involvement does not preclude similar attention
to theories related to phenomena of the domain of nursing at large; for
example, theories to describe and intervene in symptoms.

第伍天性状是专业领域成员参与进步与特定领域现象有关的说理。那种参加并不免除对与医生和医护人员领域现象有关的论战的接近关切;
例如,描述和干涉症状的论争。

A sixth characteristic is the critical reappraisal of philosophical and
theoretical underpinnings that have guided the definitions and
conceptualizations of the central concepts of the nursing domain, as
well as the methodologies used to generate knowledge. An example of such
discourse is the reappraisal of the definition of client in the nursing
literature and the congruency of these definitions with domain
assumptions (Allen, 1987). Another example is the dialogue about melding
different methods to generate knowledge that is more congruent to the
tenets of a human science, such as grounded theory, feminist theory, and
critical theory (Kushner and Morrow, 2003).

第5天性状是对理学和驳斥基础的革命性重新评估,这一个基础指引了医生和医护人员领域基本概念的定义和虚幻,以及用于转移知识的方法论。那种话语的七个例证是双重评估护理文献中型地铁户的定义以及那几个概念与世界假如的一致性(Allen,一九九〇)。另三个例证是关于融合分化格局以发出更切合人类科学原理的知识的对话,如扎根理论,女权主义理论和批判理论(Kushner
and Morrow,2001)。

A seventh characteristic of this stage is the creative ways by which
academic institutions in nursing become involved with patient care,
either through academically run clinics (nursing clinics), or by
developing clinically based faculty positions.

这一品级的第五个特征是因此学术部门运维诊所(护理医院)或培育临床教员职位,使护文学术单位参加病者看护的成立性格局。

1970-一九七零年 – 理论发展:学术界的现实目的

乘势全日本航空公司建议理论发展成为该行业的参天优先事项,并且在得到联邦补助的动静下,凯斯西储大学赞助的研讨会作为医生和医护人员科学安排的一有些实行。这一次研究讨论会分为三有的。理论部分于一九六六年八月十11日举行,在此时期被视为3个里程碑(表5-4)。这几个杂文一年后宣布在护理商量中。那几个出版物帮助从前被认为是根源孤立数量的理论家对理论护理的简要明了和概念。不仅有一群首要的护理职员聚在一块谈论护理理论,而且该领域的官方科学杂志通过公布那个随想来认识这几个程序的最重要。

看护还拿走了两位国学家和1位守护理论家的承认(他曾在加州圣地亚哥分校大学护理教学工作5年),理论对于守护实践有至关心重视要意义,护理实践符合理论发展,而医护人员是力所能及进步理论(狄克off,James和Wiedenbach,1967)。Dickoff和詹姆斯(一九七零)和Dickoff等人的公布以及随后的一层层出版物。(壹玖陆玖a,一九六七b)深切地影响了医生和护师学科,这几个出版物的经典性质以及与辩论相关的出版物的持续加速表明了这或多或少。定义了医生和医护人员理论,制定了辩护发展对象,外界职员(护理领域以外的人,非理性文学家)的肯定是有功力的。

Stage of Interdisciplinarity

表5-4护理中的理论发展:历史透视
1860 弗洛伦斯·南丁格尔满足了对研究和护士教育准备的需求。
1900-1950 文凭学校担任护士的主要来源 – Flexner医学报告。
1952年 护理研究首次出版。
1955年 在国立卫生研究院护理部建立特别护士研究奖学金计划。
1959年 德约翰逊。护理科学的本质。护理展望,7,292-294。
1960年 RN Schlotfeldt。对护理研究的几点思考。美国护理学杂志。60(4),492-494。(护理研究的主要任务是开发理论,作为实践的指导。)
1961年 外科医生总顾问护理顾问组任命向外科医生咨询护理需求并确定联邦政府在确保国内适当护理服务方面的适当角色。该团队大力支持护理研究,并建议大幅增加资金。
1961年 德约翰逊。专业护理教育模式。护理展望,9,608(护理科学可能通过识别与护理直接相关的患者的常见但主要问题更容易地发展。)
1962年 护士科学家研究生培训资助计划
1963年 护理科学首次出版
1963年 ME罗杰斯。关于护理实习理论基础的几点意见。护理科学,1,11-13。(护理实践的理论基础是护理科学……以描述性,解释性和预测性原则为特征的科学知识体……通过合成和重新合成来自人文学科以及生物学,物理学和社会科学的选定知识……它通过选择和模式化这些知识来承担自己的“独特的科学”组合)。
1963年 ME罗杰斯。建立强大的教育基础。美国护理学杂志,63(6),941.(护理的解释和预测原理使可能的护理诊断和对可预测目标的知识性干预……护理科学不是可叠加的,而是具有创造性的。)
1964年 德约翰逊。护理和健康教育。国际护理研究期刊,1,299。(护士必须作为学者社会化,必须发展对科学知识使用的探究和技能的承诺。)JS Berthold。概念的理论和经验澄清。护理科学,406-422。MI布朗。(弹簧)。护理理论发展研究。护理研究,13,109-112。(评估护理理论发展的进展,强调需要明确的理论研究关系。)FS Wald和RC Leonard。(1964年)。走向护理实践理论的发展。护理研究,13(4),309-313。
1965年 美国护士协会。护士从业人员和助理护士的教育准备:立场文件.P。普特南。护理理论的概念方法。护理科学,430-442。
1967年 VS克莱兰。现有理论的运用。护理研究,16(2),118-121。
1967年 LH Conant。(弹簧)。寻求解决护理中存在的问题。护理研究,16,115。护理学理论发展研讨会。(护理研究报告,1968,17(3))。)
1967- 1970年 国家护理和护理教育研究委员会主任Jerome F. Lysaught。
1968年 第一届护理科学性质护士科学家会议。由科罗拉多大学护理学院主持,Madeleine Leininger博士主持。(报告在护理研究,1969年,18 [5]。)第一届年度WCHEN通信研究会议
1968年 J. Dickoff和P. James。理论理论:立场文件。护理研究,17(3),197-206。(专业学科有义务比理论构造的解释和预测更进一步,对规定性理论的发展)。迪科夫,P.詹姆斯和E.维登巴赫。实践学科理论:第一部分。实践导向理论。护理研究,17(5),415-435。同上。理论在实践学科:第二部分。实践导向的理论。护理研究,17(6),545-554.R。埃利斯。(1968年)。重要理论的特点。护理研究,17(3),217-222.DE约翰逊。护理理论:借鉴与独特。护理研究,17(3),206-209.M。穆尔。护理:一门科学学科。论坛,7(4),340-347.JL Sasmor。走向理论发展的护理。护理论坛,7(2),191-200。
1969年 G. Mathwig。护理科学:护理知识的理论核心。Image,3,9-14,20-23.R。麦凯。护理理论,模型和系统。护理研究,18(5),393-399.CM Norris(编辑)。会议记录:第一,第二和第三届护理理论会议。堪萨斯大学,1969年和1970年。
1971年 F. Cleary。理论模型:其适应护理的潜力。图片,4(1),14-20.IM哈里斯。护理学理论建构:文献综述。图片,4(1),6-10.M。雅各布森。定性数据作为护理理论的潜在来源。图像,4(1),10-14.JF墨菲(编辑)。专业护理的理论问题。纽约:Appleton-Century-Crofts.I。沃克。更清晰地理解护理理论的概念。护理研究,20(5),428-435。
1972年 M.纽曼。护理的理论演变。护理展望,20(7),449-453.NLN学士学位和高等学位课程理事会批准了“评估护理学士学位和高等学位课程的标准”,其中包括标准,指出课程应基于概念框架。
1973年 我哈代。理论的本质。在M.哈代(编辑),护理理论基础。纽约:MSS信息公司。护理发展会议组。(1973年)。护理概念的制定:过程和产品。波士顿:Little,Brown&Co.
1974年 我哈代。理论:组件,开发,评估。护理研究,18,100-107.A。Jacox。护理理论建设:概述。护理研究,23,4-13.DE Johnson。理论的发展:作为一个初级卫生专业的护理的必要条件。护理研究,18,372-377。
1975年 护理理论会议组。(由于需要材料来帮助护理学生理解和使用护理理论在护理实践中形成。)
1978年 护理科学进展。SK唐纳森和D.克劳利。护理学科。护理展望,26(2),113-120。
1979年 马纽曼。护理理论的发展。费城:FA戴维斯。
1982年 MJ Kim和DA Moritz。护理诊断的分类。纽约:麦格劳 – 希尔。
1983年 LO Walker和KC Avant。护理学理论构建策略。纽约:AppletonCentury-Crofts.J。菲茨帕特里克和A.沃尔。护理概念模型:分析与应用。Bowie博士:RJBrady Co.PL Chinn和MK Jacobs。理论与护理:一种系统的方法。圣路易斯:CV Mosby.HS Kim。护理理论思维的本质。纽约:Appleton-Century-Crofts.IW Clements和FB Roberts。家庭健康:护理的理论方法。纽约:John Wiley&Sons.PL Chinn。护理理论发展进展。Rockville,MD:Aspen Systems。
1984年 J. Fawcett。概念模型的分析和评估。费城:FA戴维斯。

尽管在那之中人员(护师理论家)大概制定了辩驳发展的行动路线,但停止那时截止主导护理的争辩(从批评者认为理论是天经地义的和从经验的,实证主义形式演变而来的)的困惑和嫌疑是在狄克off和James(1969,一九七三)和Dickoff,詹姆斯和Weidenbach(一九六七a,1966b)体现他们的医生和护师成分的第3集会时期进行的演讲和座谈中微微压抑。困惑主义的证据来源于遗漏而非佣金。在这么些时代使用理论时,它们与教育结合使用,而不是在实践中(除了London和浦项政法大学的师生)或切磋。

在这段时日内,护理中的变体者早先咨询。那一个时代的题目与医护人员应该升高怎样品种的驳斥有关,而不是那个理论的实质内容的性质。第三个元变理论家是Ellis(一九六八)和Wiedenbach(Dickoff等人,一九六七a,1967b)。Dickoff和詹姆士(1966)通过培养学习国学家,化解了关切理论类型和辩护内容的辩论难题。关于这个理论是基础性的要么借用性的,纯粹的要么应用性的,描述性的或规定性的,都发生过争议。

眼下的完毕能够总结为:

• 护理是适合理论化的天地。
• 护师能够付出理论。
• 实践是辩论的增进领域。
• 实践理论应当成为护理理论发展的对象。

医护人员的万丈理论指标应该是规定性理论,不过制定描述性和解释性理论是还不错的。

跨学科阶段

The stage of integration leads and overlaps the stage of
interdisciplinarity. The road map for the National Institutes of Heath
(NIH) at the beginning of the 21st century provided a strong impetus for
a different type of integration, one that challenged members of
different disciplines to build programs of research that incorporate the
theories and evidence from different fields. Although nursing has
consistently depended upon, borrowed from, and shared the research and
theories of other disciplines, the drive for interdisciplinary education
and teaching research was now being promoted at leading research
institutions. A central tenet of this stage is the forging of
relationships between researchers and clinicians who are members of
different disciplines, to develop joint institutes, advance research
programs, or to provide more comprehensive education. Centers for sleep
research, pain management, palliative care, complementary and
alternative practices, safe practice, and gun-shot injuries are examples
of areas that require the expertise of members of different disciplines.
A similar move to reflect the nature and complexity of science was
initiated at the NIH. The question that drove these institutes was
whether they should reflect discipline or an area of science. Time will
tell whether a move away from disciplinary institutes will continue to
support the development of disciplines horizontally as well as
vertically. More discussion of disciplines and interdisciplines is
provided in Chapter 14.

组合阶段造成并抢先跨学科性阶段。美利坚联邦合众国国立卫生研商院(NIH)在21世纪初的路线图为不相同类型的结缘提供了有力的牵引力,那种重组向不一致学科的成员建议挑衅,以建立纳入分裂理论和证据的钻研安顿领域。固然护理向来凭借,借鉴并分享别的课程的探讨和辩论,但跨学科学和教育育和教研的驱重力以后正值超级的钻研机关中赢得放大。这一阶段的宗旨大旨是确立不一致科目成员的钻研人士和诊治医务卫生人士之间的涉嫌,发展同步切磋部门,推进商量安排,或提供更周详的教育。睡眠钻探为主,疼痛管理,姑息治疗,补充性和替代性实践,安全实施和枪伤是亟需分歧科目成员的专业知识的范例。NIH运维了一项反映不错性质和错综复杂的好像举动。驱动那几个机构的难题是它们是不是应当体现纪律或不利领域。时间将告诉大家,摆脱纪律部门是或不是会持续支持横向和纵向学科的开拓进取。关于课程和跨学科的越来越多研商在第壹4章中提供。枪支受伤是要求分化学科成员的专业知识的范例。NIH运转了一项反映不错性质和复杂的接近举动。驱动这么些机构的标题是它们是还是不是应当反映纪律或不利领域。时间将告诉大家,摆脱纪律部门是或不是会持续辅助横向和纵向学科的腾飞。关于课程和跨学科的更加多商讨在第34章中提供。枪支受伤是急需分化学科成员的专业知识的范例。NIH运行了一项反映不错性质和错综复杂的切近举动。驱动那些机关的难题是它们是不是应当反映纪律或不易领域。时间将告诉大家,摆脱纪律部门是不是会持续协助横向和纵向学科的上进。关于课程和跨学科的更加多探究在第壹4章中提供。时间将报告大家,摆脱纪律部门是不是会一连帮衬横向和纵向学科的前进。关于课程和跨学科的越来越多研商在第24章中提供。时间将告诉大家,摆脱纪律部门是还是不是会三番五次接济横向和纵向学科的升华。关于课程和跨学科的更加多探讨在第贰4章中提供。

1971-一九七一-理论句法

有一段时间,就在护理钻探公司专注于回复该领域的首要性难点之前,护师商讨人士小心于斟酌和作品研商方法论。理论领域存在并行。1966年至一九六八年里边早先关情感论发展,随后尝试明确理论的构造组成都部队分(见表5-4)。Metatheorists统治了这几个时代。重点在于表达,定义和阐发理论部分以及理论分析和批判中本来的进度。护理理论家们不再怀疑护理是还是不是要求一种理论,恐怕理论是不是能够在医生和医护人员中前进;
那几个时代的难题集中在辩论的意义上(Ellis,一九六六,1972;
沃克,1974),关于理论的重大组成部分(哈帝,1971;

Stage of Technology and Information Systems

Jacox,一九七五)以及分析和批判理论的法门(Duffey和Muhlenkamp,一九七三)。通过联邦援助的医护人员

地艺术学家布置对基础,自然和社科护师举办教育,发生了3个装有三头目的的看护阵容:建立格外规的看护知识库。研究哪边构成理论和辩论语法的规定就像是促成这一指标的手腕。

在那段时日停止此前,那是二个里程碑。正如全日本航空公司在前一之间确认理论发展的关键意义一样,全国护理联盟(NLN)不仅认可理论,而且还将理论课程作为验证须求。估摸护理高校将为他们的课程选取,开发和实施二个概念框架。这种认证要求既是引力,也是理论发展的基本点障碍。利用理论举办学科开发,进一步升高了学术护理对理论意义和水土保持护理理论的认识。然则,这一渴求将履行理论(那几个将回应与履行有关的显要难题的辩白)的指标转向了将舌战用于教育的靶子。可是,那个里程碑增添了对理论的争鸣和议论的选择,并驱使越多关于理论语法的文字,以帮助大家和学习者精通和应用理论课程和教学。承认和推动理论护理的期刊数量少于,推动实证切磋成果发布的关键以及部分刊物财困的增多是辩论和辩白方面包车型客车封皮调换的障碍。这一里程碑增添了对理论的论战和座谈的采纳,并敦促越多的有关理论语法的写作帮忙大家和学生领会和应用理论课程和教学。承认和促进理论护理的刊物数量有限,拉动实证钻探成果公布的要紧以及一些杂志财困的增多是论战和辩驳方面包车型客车封面调换的阻力。这一里程碑扩大了对理论的辩论和议论的行使,并促使更多的有关理论语法的著述协理大家和学员精晓和使用理论课程和教学。认可和拉动理论护理的杂志数量有限,拉动实证切磋成果宣布的重庆大学以及一些刊物财困的充实是理论和理论方面包车型客车封面调换的障碍。

技巧和新闻连串阶段

Health care records, robotic medication dispensers, tele-home care,
long-distance monitoring, virtual surgeries, and voice mail reminders of
appointments and medications are characteristic of this stage in the
history of the development of the nursing discipline. Theories that
incorporate variables and conditions related to informatics and
technological breakthroughs are necessary drivers for this stage.
Self-care practices take on different meanings for individuals and
families when they incorporate the most advanced and up-to-date
information disseminated by scientists and clinicians to the public via
the internet. Self-care practices and goals also incorporate the use of
such new monitoring devices as home blood pressure apparatus, glucose
kits, self-diagnosis protocols, and self-monitoring gadgets. The ability
to sort among accurate and inaccurate information, and the alternative
“if-then” scenarios that result, will need to be guided by
situation-specific theories that incorporate guidelines for clinicians
and consumers (An, Hayman, Panniers, and Carty, 2007).

医生和护师记录,机器人药物分配器,远程家庭护理,远程监护,虚拟手术以及约定和药物的话音邮件提醒是看护学科发展史上这一品级的风味。包括与信息学和技艺突破有关的变量和标准的辩论是此阶段的不可或缺驱动机原因素。将地农学家和临床医务人士经过互连网向公众传播的初步进和新颖音信纳入个人和家庭时,自作者保健实践将富有不一致的意义。自小编保健的做法和目的还包含运用家用血压仪,果糖试剂盒,自小编诊断协议和自作者监测小工具等风靡监测设施。

56net亚洲必赢手机 3

THEORY DEVELOPMENT IN NURSING: MILESTONES

一九八零-一九七八年 – 反映时间

护师理论家被邀约加入由医护人员教育工小编主办的会议上的演说,探讨和辩白,那标志着守护理论举行中的2个重大里程碑。一九七七年召开的全国护理理论会议和护理理论智囊团的多变更为援助了正规方向,即选拔现有理论和越发理论的上扬来叙述和分解护理现象,预测关系,以及指引医生和医护人员(预览,1977)。那是看护院士们将护理理论作为课程的点拨框架,考虑将答辩应用于别的用途的时候,尤其是在实践中。

该杂志“护理科学实行”的开幕式侧重于“涉及科学发展的总体活动”,包蕴“理论创设,概念和分析”以及理论应用,是中间另二个最首要的里程碑那一个时代(Chinn,一九七六)(见表5-4)。该杂志在争鸣和辩护发展地点的第②为理论护理的意思扩张了越来越多的帮忙,同时让理论上呼吸道感染兴趣的看护有必不可少介绍并商讨他们的想法。它同意在任何学科中前进理论基础所需的质询和驳斥。

本条时代的个性是质问护理的升华是还是不是会从利用单一范式和单纯真理理论中受益(Carper,一九七六;
Silva,1979)。护理文献中冒出了越来越多关于理论护理必要项目(Beckstrand,1980a,一九七八b,壹玖柒玖)和申辩难点(Crawford,Dufault和Rudy,1976)的冲突。对理论发展的更坚毅的允诺出现了,并且与护师在辩论发展位置的全力的切实方向相结合(唐Naderson
and Crowley,1979;
哈代,1976)。理论与商量时期的联络被考虑和座谈(Batey,1976;
Fawcett和Downs,一九八八),该路线被用来修复理论与执行之间的辩驳讨论差别(Barnum,壹玖捌陆)
,一九七九),并强烈了独家在护理知识发展中的效用(见图5-1)。领域概念开首被辨认出来,并在下二个时代被接受。

表5-2护理中的理论发展:里程碑
1955年之前 从弗洛伦斯南丁格尔到护理研究
1955-1960 护理理论的诞生
1961-1965 理论:护理的国家目标
1966-1970 理论发展:学术界的切实目标
1971-1975 理论语法
1976-1980 反思
1981-1985 年的时间护理理论的复兴:领域概念的出现
1986-1990 从元理论到概念发展
1991-1995 中期和情境理论
1996-2000 证据意味着研究而不是理论
2001- 2005 思想多样性:将理论与实践联系起来
2006-2010 护士授权:以证据和技术为资源

一九八四年至一九八五年 – 护理理论的再生:域概念的现身

在那些年代,理论先导被质问得越来越少,多元论辩论也越来越少。那暂且代的风味是接受护理理论的重庆大学,并且还有要求开支护理理论。护历史学学士课程将理论纳入其课程并将其便是主旨内容领域,将其列为全数其余主旨内容(Beare,Gray和Ptak,一九八五)的顶部。这一时代的特性还体未来列国上对理论护理的趣味,那反映在瑞典王国的集会上,并供给在泰国,南韩和埃及(The Arab Republic of Egypt)等国家开始展览辩解教学磋商。

在此时期对理随想献的追忆揭发了对于是或不是利用理论实践与基础理论或借用与护理理论的争论。相反,就像是有更加多的有关差别研讨和履行难题以及不相同定义之间比较的看护理论商讨的行文(Jacobson,1983;
Spangler和Spangler,1985)。那么些时代的标题归纳:
• 大家从理论中学到了何等?
• 大家怎么运用理论?

其次个难题是诊疗医师开端询问的标题,并且有为数不少一蹴而就的对话。

新现身的语法被用来分析现有的论战(Fawcett,一九八二;
Fitzpatrick和Whall,一九八一)。别的,现有理论被认为是付出独特级护理理知识的手腕。分明了护理的为主概念,并且现有理论(已规定的概念的来源于)反过来在一发的前行和改进方面举办了双重新审查视(Crawford,1984;
Reeder,1983)。

这一时半刻代的表征是看护理论倡导者主张选取一般护理观点或具体接纳护理理论(Adam,1981;
Dickson和Lee-比利亚senor,一九八二)。(参见护理科学开始展览,护理管理杂志和美国护医学杂志关于U.S.协助者的例子和国际帮忙者例子中的高级护理杂志)。在这一个时期还出现了另一组:理论合成器。提倡者与合成者之间的异样处于分析范围的档次。倡导者提倡护理理论,并将其用于切磋项目或少数的进行领域。这么些合成器超出了不难的施用限制来讲述和剖析护理理论怎么着影响护理实践,教育,商量和管制。合成器的事例包括但不限于Fitzpatrick和Whall(一九八一,一九九六)和Fawcett(一九八二,一九九五)。罗吉尔斯第一回全国会议(一九八二年)及其后的理论家,实践者和商量人口从区别的角度谈谈了罗吉尔斯理论的效用,那是有效综合理论不相同用法的另三个例证。此次会议的监制属于理论合成器组。是辩论差别用途的管用综合的另一个例子。此次会议的导演属于理论合成器组。是理论差异用途的管事综合的另2个事例。此次会议的出品人属于理论合成器组。

一些抵触合成器在20世纪70年间中叶从纽约大学结束学业。有一件不容忽视的作业是London大学护理类型对促进理论护理的影响。通过对一九四一年至1982年London大学护经济学大学生随想题指标想起能够领略地看出那一点,这清楚地表明了一个利用连贯的争持框架的护理高校怎么样拉动连贯的钻研究商议程。当先一半舆论标题都标明了护理观点,如同是积累知识发展的尝尝。可是,那种方式如何以及以何种措施影响和大概延续影响理论发展是1个值得进一步查明和分析的天地,大家每隔一段时间就会看出2次罗杰瑞议会,会让许多看护学者一起讲同样的争鸣语言并出示他们的切磋成果。这几个有关护理知识的觉察,整合和翻新的大团圆的结果没有形成文件。

本条时代的表征是承受理论作为五个工具,从注重的实行难题,可用于教导实践和钻研工具。这一个时期的性子是辩论和商量时期的关系比理论和施行之间的涉嫌更是清晰。

在那段时间里剩余的多个歪曲与语义有关。概念模型被号称概念框架,理论,元数据,范式和元类,并且当区分时,界限并不完全明了,属性也不完全分歧。(见第壹3章有关罗吉尔斯理论的商讨。)

MILESTONES IN THEORY DEVELOPMENT

1987-一九九零-从理论到概念发展

其一里程碑的五个特色是认识论辩论,本体论分析以及概念发展和分析的增多。这一时半刻期的另多个特点是认识到理论与实施之间的差异。认识论辩论包蕴与叙述知识发展的任何方法有关的题材,如气象学的利用,批判理论,女性主义或经验主义方法论,以及哪些将方言方法与理论和履行联系起来(如阿伦,1983;
Allen et al。 一九八六; Hagell,一九八九;
伦Nader,一九九〇)。即便辩论的首要集中在学识发展上而不是学科的辩驳发展上,但这么些理论与辩论护理的上扬也有关系。

一蹴而就的辨析重点集中在与中心护理概念有关的本体论信念,例如环境(Chopoorian,壹玖捌捌;
史蒂文斯,1988)和正规(Allen,一九八四,1989;
Benner,1982)。那些分析大大增添了知情各样概念的更加多田地方法。那些分析还升高了护师对利用框架的须求性的认识和意识,那个框架允许对护理现象开始展览总结,全体和田地描述,那些情况超出了私家客户的限定。那些作者申明,这样的框架保持了历史上教导医生和护师实践的基本本体论信念的完整性,例如全部论,综合反应和与环境的涉及。

这一个里程碑的第九个属性是与概念开发有关的着作扩大。这么些发展与最初的争论发展分裂,这几个提高包含对“什么是守护”这样的貌似难题的应对。这几个分析特别以实施为导向,是完整的,并且表示了单领域理论发展的早期尝试。那也是对物质实行抗辩的时日(Chinn,一九八七;
Downs,一九八七; Meleis,一九八九;
伍德s,1990)。那几个作者答疑了别的课程成员的眼光,并促使更关怀医疗对象面临的实质性难题的说话。

在实质性纪律内容的基础上,进度辩论成为辩论发展的潜在力量。由此,与其论理批判理论或女权主义理论是不是更切合当作该学科的文学基础,人们唯恐会争执从那二种观点或三种看法来看环境依旧舒适都特别实惠。那样的实质性辩论会增多或修改该文化领域的参数和维度。

辩解发展的里程碑

The progress and development of theoretical nursing is marked by several
milestones, which are identified through an analysis of theoretical
literature that appeared in selected nursing journals between 1950 and

  1. These milestones substantially changed the position of theory in
    nursing and profoundly influenced the further development of theoretical
    nursing. Each milestone is defined and briefly described here (Table
    5-2). Identifying and defining these milestones challenges others to
    explore the impact each milestone may have had on the progress and
    development of nursing knowledge.

理论护理的向上和升华具有多少个里程碑意义,那么些里程碑是透过分析一九五零年至二〇〇二年中间接选举定的护理期刊中出现的反驳文献而规定的。这么些里程碑大大改变了辩驳在护理中的地位,深远地震慑了医生和医护人员进一步上扬理论护理。每一种里程碑都在此地进行了概念和归纳描述(表5-2)。识别和概念这一个里程碑会挑衅外人探索每一个里程碑可能对护理知识的实行和前进发生的影响。

一九九四-一九九一-中间范围和特定情境理论化的初始

标志着守护知识发展得到长足升高的1个重庆大学里程碑呈今后这一时代发展兴起的众多中级范围理论中。当中有的被标记为理论(例如,Younger的主宰理论[1991]或Mishel的不显明性理论[1990])。别的人被认为正在变成辩论。(请参阅芬克,Tornquist,Champage,Copp和Wiese
[1990]关于复苏和Hagerty,Lynch-Sauer,Patusky和Bouwsema
[1993]至于她们关于人类相关性的新生理论的要紧方面包车型客车切磋。)中等范围理论重点对反映并从护理实践中涌现出来并爱戴治病进程的现实性护理现象(Meleis,一九八八)。它们提供了浮现学科价值的定义主题和心思图像。

具体情形的驳斥恐怕正在成为另三个里程碑,即使它们在晚些时候有更好的概念。它们是更具临床意义的争鸣,反映特定背景的争鸣,并且可能包罗行动蓝图。他们与其说中层理论抽象,但比单个护师针对具体情况设计的施行框架更抽象(Meleis,1996;
Im and Meleis,1996;
Im,二零零五)。那些针对具体情形的申辩只怕出现于综合和重组有关特定情景或人群的商讨结果和看病样本,以期提供框架或蓝图来领会一组客户的一定情景。它们是为着回应关于限制有限且首要有限的气象的一层层连贯难题而制定的驳斥。例如,能够从钻探结果,临床样本以及护师对那一个人群的守护经验中提升出中东移民健康疾病转变反应形式的概念(Meleis,Isenberg,Koerner,莱西和斯特恩,1992年)。一个例证是注重于中东移民(阿富汗人,伊朗人,埃及(Egypt)人和阿拉伯人)的劳作,那么些工作获得那么些人在作者国的切近工作的支撑,那有助于注解移民前的行为和反应形式,并推进提供历史以及移民在新江山的影响的社会文化背景。能够从切磋结果,临床样本以及护师在这一人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中前进出中东移民对正规疾病转变反应格局的概念。斯特恩,一九九一年)。二个事例是器重于中东移民(阿富汗人,伊朗人,埃及(Egypt)人和阿拉伯人)的做事,这几个工作取得这个人在本国的好像工作的支撑,那有助于声明移民前的表现和影响形式,并促进提供历史以及移民在新江山的反馈的社会文化背景。能够从商量结果,临床样本以及护师在那么些人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中前行出中东移民对正规疾病转变反应方式的概念。斯特恩,一九九五年)。二个事例是注重于中东移民(阿富汗人,伊朗人,埃及(The Arab Republic of Egypt)人和阿拉伯人)的干活,那个干活儿获得这么些人在本国的好像工作的支持,这促进注脚移民前的作为和影响形式,并推动提供历史以及移民在新国家的反响的社会文化背景。以及护理职员照顾那个人群的经历(Meleis,Isenberg,Koerner,Lacey和Stern,一九九二)。1个例证是注重于中东移民(阿富汗人,伊朗人,阿拉伯埃及共和国(The Arab Republic of Egypt)人和阿拉伯人)的工作,这么些工作取得那一个人在小编国的近乎工作的支撑,这促进申明移民前的行事和反馈形式,并有助于提供历史以及移民在新江山的感应的社会文化背景。以及护理人士照顾这个人群的阅历(Meleis,Isenberg,Koerner,Lacey和Stern,一九九二)。一个事例是重视于中东移民(阿富汗人,伊朗人,埃及(Egypt)(The Arab Republic of Egypt)人和阿拉伯人)的做事,那一个干活儿赢得那些人在本国的类似工作的帮衬,那有助于评释移民前的表现和反应情势,并促进提供历史以及移民在新江山的反馈的社会文化背景。

Prior to 1955—From Florence Nightingale to Nursing Research

一九九七年至两千年 – 证据意味着探讨,而不是论战

据他们说证据的实践在文献中从循证实践到循证护理的累累话语中国对外演出集团变而来。在那几个里程碑时期,关于该课程的文献珍视于分明利用保健模型与一流证据,将研商转化为执行以及选择应用研讨(斯洛伐克语,壹玖玖陆年)之间的相似之处和差别之处。为了鲜明证据,研讨了概念个体研讨品质的主意,整合斟酌结果的主意,判断综合发现的标准以及能够用于文献的证据(Goode,三千;
McKee,Britton,Black,
McPherson,Sanderson,Bain,一九九九)。多少个属性区分了这些里程碑。首先,大多数会话最初都以根据历史学领域的争论,那将“证据”下落到生物艺术学,经验和实证主义的变量和专业(Lohr
and
Carey,1998)。第一个属性是有关证据的折衷观点的开拓性对话,这么些看法或者带有与医生和护士科学更平等的组成都部队分,并且来自于怎么样定义护理知识和知识。那么些关键的对话包涵钻探扩充证据的意思以使其进一步多元化,将人文经验和私家经验作为待用格局的证据(Clarke,一九九九)。但是,从这一个框架内判断证据的正儿八经还未曾被追究,也绝非汲取鲜明的想法。这一里程碑的第①项属性是关怀在卫生保健机构实施最佳证据的最佳策略。

Cochrane系统评价数据库在为严俊查处数据证据提供框架,整合评定审查以分明最佳援救证据,开发和推行最佳团队基础设备以实践和加大最佳实践方面揭橥着相当重要功效(Foxcroft,Cole,
Fullbrook,Johnston,史蒂文斯,2000)。

这一里程碑的第陆项属性是其在天下各市的吸重力和选取基于证据的概念。区别地点的护师,研商人员和医治医生参加了有关医疗医生依据钻探的学识的综合评估和可访问性的对话。(见汤普森,McCaughan,Cullum,Shelton,Mullhall和汤普森二〇〇三)

这一里程碑的末段二个风味是贫乏关于理论或农学在推进证据性质方面包车型地铁强劲的争鸣对话,辅助艺术多元化的前提,解释框架和结果选取偷偷的标准。从以推行为根基的循证论述转变为以探索为根基的对话恐怕会引起对医生和护师实践的探索性理论研究。(Doane和Varcoe,二〇〇八;
霍姆斯,Murray,Perron和Rail,2006; 霍姆斯,罗伊和Perron,2009)

1952年事先 – 从弗洛伦斯南丁格尔到护理商讨

The significant milestone of the period before 1955, which has
influenced the subsequent development of all nursing science, was the
establishment of the journal, Nursing Research, with the goal of
reporting on scientific investigations for nursing by nurses and others
(Fig. 5-1). The journal’s most significant goal was to encourage
scientific productivity. The establishment of the journal confirmed that
nursing is indeed a scientific discipline and that its progress will
depend on whether nurses pursue truth through an avenue that respectable
disciplines take, namely, research. Although Nightingale may have
provided the beginning impetus for research and theory, initially, her
impact was most keenly felt in nursing education. Education of nurses
had predominantly occurred in diploma programs, but this period marked a
beginning interest in providing different routes for nurses’ education.

1954年事先影响全数医生和医护人员科学后续发展的三个最首要里程碑是树立了护理探讨期刊,目标是告诉护师和别的人对医生和护师的没错调查(图5-1
)。该杂志最重要的指标是鞭策科学生产力。该杂志的创造证实了护理的确是一门科学学科,其展开将在于医护人员是不是经过可敬的教程所运用的门道追求真理,即探究。就算南丁格尔只怕为商量和辩驳提供了启幕的引力,但早期,她的熏陶在护理教育中相当敏感。医护人员教育任重(英文名:rèn zhòng)而道远发生在文凭课程中。

This period was otherwise uneventful for nursing theory, except that the
establishment of nursing research publications provided the framework
for a questioning attitude that may have set the stage for inquiries
that led to more theoretical discourses in later years.

除了,护理商讨出版物的树立提供了一种质疑态度的框架,大概为查询成立了舞台,在晚年造成越多的理论话语,那段时日对于护理理论来说是通常的。

56net亚洲必赢手机 4

Chronology of the development of theoretical nursing

二〇〇〇-二〇〇七 – 思想的二种性:联系理论与实施

关心多元化是本学科理论发展进程中这一里程碑的表明。随着专家的身价,种族和古板多样化,并且随着他们对出入尤当中意,他们的静脉曲张开端出现在文献中,反映了她们不等的价值观,信仰和目的。思想和驳斥各类化的例证是出自区别国度的看护的事例。理论是由芬兰共和国和瑞典王国的医护人员开发的,并且有关更诚实的论争表明的对话反映了区别国家的实际越来越受欢迎(Salas,二〇〇七)。

如出一辙,在这些里程碑时期,从一些扎根理论商讨项目进步理论以及通过结合不相同理论出发的多样意见出现了比原先更狠抓硬的对话。例如,Olshansky(二〇〇一)进行了多个扎根理论项目并升高了一种“身份不孕”的辩解,并将这一理论与Miller(1993)的“关系文化”理论相结合,以分解女性干扰的秘密脆弱性,被鲜明为“不孕女生”。三种理论都被整合,并为这一个女性在怀孕后爆发的身份转变提供了更有力的诠释。该辩驳解释说,纵然被显著为“不孕女人”的妇人能够怀孕,但他俩很难认为本身是怀孕的。

作为这一里程碑的注明,种种性表以往各个正规疾病的情事下,须要密切分析造成多样性的要素。个中囊括年龄,种族,民族,遗产,性别和性方向。那种认识导致理论家和商讨人口对当今的法门和假诺举行批判,并建议替代性和更具内容的辩护思想。例如伯曼(Berman,二〇〇〇)关于围绕小孩子权力的好玩的事,Im和Meleis(2000)在她们关于开发关切健康与疾病的性别敏感理论的建议中,以及Andersonet
al。(2002)重写了后殖民主义和后民族主义女权主义理论中的文化安全概念。

格奥尔格e(格奥尔格es,二〇〇〇)定义了反映这一里程碑的最首要话语。她的散文是医生和护师中有二种话语正在作育当代医生和护师中的认知两种性。那么些是有关科学的话语更宽泛和开始展览,以及关于边缘化的后现代主义话语。那四个话语都提供了对有关允许私下代表不一致文化发展意见的主流通晓和协议的评说。在三个重视最普遍意义上的三种性的时日中,认识的各个性恐怕使该学科的成员免于包容,并也许转变学科,使其真正面与反面映医护人员须要劳务的人。那种各类性还会允许对权力不平等的批判以及协理这种不均等的幸存网络以及变更倾向于将主流理论方法制度化的社会实践(Gustafson,二〇〇五)。霍尔(二零零二)再度提示大家,在她的病关节炎历中,有一段强有力的自传体记录,关于疾病经历的历史学化以及生物艺术学模型的堡垒怎样不符合病者及其亲戚的特等利益。格奥尔格e(二〇〇六)使用批判女权主义的视角来公布她改写本人看成医疗医务职员

  • 理论家 –
    院士研讨员身份的旅程。她为在21世纪头十年的政治和社会背景下将舌战与履行联系起来提供了三个强大的经济学论证。那种关系可以透过教学说理应用政策来促成,这几个策略能够扶持学员进步他们的执行真实的声音。那些里程碑的风味是对现状的批判,所处地方和观点的重新概念化,以及对文化,种族背景,遗产,语言能力,性别和性取向的多样性予以器重的分析。

1955–1960—The Birth of Nursing Theory: The Columbia University Teachers College Approach

二〇〇六-二零一零年 – 医护人员授权:证据和技能作为能源

后实证主义时代,跨学科时代和后殖民女权主义时期的特色是守护的二个最主要里程碑,医护人员和医生和护师标准职员在影响护理方面包车型大巴权位。称笔者为乐观主义者,但让笔者付出一些缘故,为何自个儿认为那种转折点正在发生。许多探究从生物历史学情势,夫权制等级和非器重制度管理机制(Holmesand Gastaldo,二零零四; 霍姆斯,罗伊 and
Perron,二零零六)对医护的非殖民化举行了座谈。将护理与那些范式分开自个儿就是解放的;
但是,更相信的翻身指标是行使分歧的范式来教导理论发展和钻研,那点在20世纪初期十年的医生和护师文献中很明显(见护理科学,护理调查和护医学奖学金的以身作则)。黄金时段TV中护师的隆起地位以及他们当作强大的独立临床医务卫生职员的描述是护师变化的印象和知名度的其余例子。媒体发现,护理故事值得印刷,那申明记者正在认识到公众对那个高贵经验感兴趣。改正补偿,多样化就业选取的可用性,以及为职工独立的袖珍诊所选用医护人员都以医疗保健系统权力结构变化的迹象。黄金时段TV中护师的卓越地位以及他们当作强大的单独临床医务职员的描述是卫生员变化的形象和有名度的其余例子。媒体发现,护理逸事值得印刷,那表明记者正在认识到公众对这个难得经验感兴趣。革新补偿,种种化就业选拔的可用性,以及为职工独立的微型诊所采纳护师都以医疗保健系统权力结构变迁的一望可知。黄金时段电视机中护师的特出地位以及他们当作有力的独门临床医务卫生人士的描述是看护变化的形象和盛名度的别的例子。媒体发现,护理有趣的事值得印刷,那注解记者正在认识到公众对那一个宝贵经验感兴趣。更始补偿,三种化就业选用的可用性,以及为职工独立的小型诊所选取医护人员都以医疗保健系统中权力结构转变的征象。

关于政党为洋人口提供安全,优质和公平医疗保健的德性职务的治病改正话语包含认同护师的剧中人物是治病改善的主导。在解说中提到须要追加工作人士的医护人员人数,并确定保证丰盛利用其力量,那本人就予以了护师权力。由此,关于初级卫生保健,以病者为基本的医生和护师以及医务卫生职员和看护之间的通力合营伙伴关系(无论是在会议上只怕在医研院出版物中),对医护知识和看护的价值予以强调和认可(Frenk等,
二零零六; IOM,二零一一)。那么些在笔者眼里,是一个里程碑的目标:护师有权力。

还有其余迹象申明医护人员有能力有所作为。进入医院并洞察处理病人追踪系统,医疗保健记录,自动药物车和长途监护系统的护士建议了好多标题。尤其是,医护人员怎样将理论框架与技术提高相结合,以及特别注重通过电脑举办调换?医护人员怎么着将注意力集中在护理和伤者为着力的正规促进,关爱,安慰,减轻痛心,促进本人照顾和幸福感的目的上,同时注意护理职员施加的新需要21世纪医院和家庭护理的新闻和监测技术特点?

在新闻和技巧的立异和错综复杂环境中关怀个体和家园的并置要求开发新的框架和医生和护师格局。学科发展的这么些阶段通过在工程学,药学和音讯科学等科目之间创建差异和新的通力合营关系而取得丰盛。

人口老龄化,以及家庭老龄化人口和家庭生活和照顾长时间患有个体的人头越来越多,必要支出和平运动用更切实的答辩,以满意越来越明显的一定必要人数。有限支撑公司的补偿和报废须求以及在此阶段推进文化的广阔医疗革新框架情势的结果。研讨证据对于信誉,提供护理的安全性以及对服务的填补根本。护师正在充裕利用证据和技巧。

1954-一九六〇年 – 护理理论的降生:哥大师范高校方法

Although Florence Nightingale’s ideas about nursing, focusing on the
relationship between health and environment, were developed in the early
1900s, it was not until the mid-1950s that nurses began to articulate a
theoretical view of nursing. Questions about the nature of nursing, its
mission and goals, and about nurses’ roles drove nurse educators to
capture the answers to these questions and present them in a more
coherent whole. These questions grew out of an interest in changes in
the educational preparation of nurses from diploma to baccalaureate
programs, out of concerns about what to include or exclude in curricula,
and about what nurses needed to learn to function as nurses.

虽说弗Loren斯·南丁格尔关于护理的意见着眼王宛平规与环境之间的关系,可是在20世纪初发展起来的,直到20世纪50年间先前时代,医护人员才开端注明护理的争鸣观点。关于护理本质,其职责和对象以及医护人员剧中人物的题材促使医护人员教育工作者捕捉那个题指标答案,并将其呈以后一发贯通的欧洲经济共同体中。那一个题材根源对护师从文凭课程到博士学位课程的启蒙准备的浮动的趣味,出于对课程内容或解决内容的忧虑,以及护师要求上学怎么担任医护人员。

Columbia University’s Teachers College, where the first professor of
nursing, M. Adelaide Nutting, was appointed, offered graduate programs
that focused on education and administration, to prepare graduates as
expert educators and administrators. Although the focus of that
visionary program was not on nursing science or nursing theory,
participants in this program must have felt that they were in an
environment that promoted dialogue and debate of philosophical and
theoretical questions. Of note, in 1999, the nursing education program
celebrated 100 years of influence, a well-placed celebration given that
most theorists who offered a conception of nursing during that decade
were educated at Teachers College; these included Peplau, Henderson,
Hall, Abdellah, King, Wiedenbach, and Rogers (Table 5-3).

哥大医科大学的首任护法学教师M. AdelaideNutting被任命为博士教程,重要担负教育和保管,为结束学业生做好我们教育和管理的预备。即使那些深思熟虑的陈设的显要不在于护理科学或护理理论,但该布置的参加者一定已经感觉到到她们处于促进文学和辩白难题的对话和理论的条件中。值得注意的是,在一九九六年,护理教育安顿庆祝了100年的影响力,那是一个很好的热闹活动,因为在那十年中提供护理概念的多数理论家都在师范高校接受教育;
包蕴Peplau,Henderson,哈尔l,Abdellah,King,Wiedenbach和罗吉尔s(表5-3)。

56net亚洲必赢手机 5

TABLE 5-3 NURSING THEORISTS: 1950–1980

结论

本章介绍了与理论护理相关的要紧历史宗旨。理论护理的进行和升高是依照等级和里程碑来定义的。历史发展观提供了二个关于当前和前途的理论思考能够创设的第壹意见。没有追溯这个历史核心,分析当前的进步是欠缺​​的。

表5-3看护理论:一九五零-一九七八
1952年 Hildegarde Peplau。护理人际关系。也于1962年,1963年,1969年出版。
1955年 弗吉尼亚亨德森。护理原理和实践教科书(与B.哈默)。也是1966年,1972年,1978年。
1959年 多萝西约翰逊。“护理哲学”。也是1961年,1966年,1974年。
1959年 丽迪雅大厅。护理哲学。也是1963年(和其他人,1975年)。
1960年 Faye Abdellah。“以病人为中心的护理方法”也是1965年,1973年。
1961年 艾达让·奥兰多。动态的护患关系。
1963年 D. Howland和E. McDowell。“医院系统模型”。
1964年 D. Howland和E. McDowell。“病人护理的测量:概念框架。”
1964年 Joyce Travelbee。人际关系方面的护理。也是1969年,1971年,1979年。
1964年 E. Wiedenbach。临床护理:帮助艺术。也是1967年,1969年,1970年,1977年。
1966年 Myra Levine。“适应和评估。”
1966年 M. Harms和F. McDonald。“一个新的课程设计。”
1967年 Myra Levine。临床护理简介。也是1969年,1971年,1973年。
1968年 Imogene国王。“护理参考的概念框架”。也是1971年,1975年。
1969年 Joyce Travelbee。干预精神病护理。也是1971年(1979年)。
1970年 玛莎罗杰斯。护理理论基础介绍。1980年。
1970年 Callista Roy姐妹。“适应:护理概念框架”。也是1974年,1976年,1980年,1984年。
1971年 Imogene国王。走向护理理论:人类行为的一般概念。
1971年 Dorothea Orem。护理:实践的概念。也是1981年,1982年,1985年,1991年。
1972年 贝蒂纽曼。“贝蒂纽曼医疗保健系统模型。”也是1989年。
1976年 约瑟芬帕特森和L. Zderad。“人文护理”,也是1988年。

Being prepared for functional roles and experiencing a sense of
competency in preparing syllabi, setting staffing patterns, and so on
may have freed the creative abilities of these scholars for other
aspects of the scholarly process, such as theory or conceptual model
development. And, although other experiences and programs may have
directly influenced these scholars in their theoretical pursuits (e.g.,
Rogers’ doctoral preparation at Johns Hopkins), it appears that the
philosophy of Teachers College indirectly left an impact, not only on
psychiatric theory and research, but also on theoretical thinking in all
of nursing (Sills, 1977). Asking and answering questions about the
influence of scholarly environments on preparing productive scholars may
have stimulated the search for the nature of scholarship, which may have
led to questions related to the nature of the nursing identity.

为准备成效剧中人物和经验准备教学大纲的力量,设置职员配备形式等大概早已放出了这么些大家对学术历程的任何地方(如理论或概念模型开发)的成立能力。就算别的经验和安排也许一向影响到这个我们的答辩追求(例如,罗吉尔斯在John霍普金斯大学的博士随想准备),但就好像师范高校的农学直接地不仅影响了精神病学理论和钻研,而且还提到全部医生和医护人员的理论思考(Sills,壹玖柒玖)。询问和应对关于学术环境对准备有收获的咱们的熏陶的题目大概会促使人们寻求奖学金的习性。

Peplau (1952), using Harry Stack Sullivan’s theory title and concepts to
develop her own, produced the first articulated concept of nursing as an
interpersonal relationship, with components of interpersonal processes
central to nursing needing to be elucidated and analyzed. The field of
psychiatric nursing subsequently was substantially developed using
Peplau’s ideas. Other theories that evolved in the 1960s were based on
those early conceptions of nursing. For example, Virginia Henderson,
with Bershan Harmer, developed the early seeds of a nursing theory that
was published in the mid-1950s in a textbook on the principles and
practice of nursing.

Peplau(1951)利用哈利 Stack
Sullivan的论战标题和概念来开发协调的论争,发生了护理作为人际关系的率先个肯定的概念,当中人际进程的组成都部队分须要被发明和分析。精神病护理领域随后使用Peplau的想法大幅度提高。别的在20世纪60年间发展起来的争鸣是基于那一个早期的医生和护师概念。例如,VirginiaHenderson与Bell森哈默一起研究开发了医生和护师理论的早先时代种子,该理论于20世纪50年份先前时代发布在护理原理和举行教科书上。

The request from the International Council of Nursing (ICN) to define
nursing and its mission led to the subsequent ICN statement in 1958 that
appeared in a publication with wide distribution and that was adapted
internationally (Henderson, 1966, p. 15). The message given by both
Peplau and Henderson was that nursing has a specific and unique mission
and that this mission has some order and organization that can be
communicated. These articulated wholes represented the beginnings of
theories in nursing.

国际护理理事会(ICN)提议的限定护理及其职分的渴求致使1956年的ICN证明出现在普遍分发的出版物中,并在列国上拓展了调整(亨德森,1970年,第35页)。Peplau和Henderson给出的音讯是,护理有三个特定的和格外的重任,而且以此重任有一部分方可传达的秩序和团组织。那几个强烈的一体化代表护理理论的始发。

Abdellah’s nursing theory, evolving from her work at Columbia
University, is another example of the influence of that school on
theoretical nursing (Abdellah, Beland, Martin, and Matheney, 1961).
Abdellah’s doctoral dissertation in 1953 at Teachers College, under the
leadership of Hildegard Peplau, focused on determining covert aspects of
nursing problems. The results of her research were subsequently
published in Nursing Research, marking the beginning of her attempts at
theorizing the nursing care process. Her conceptualization of nursing
care evolved from her dissertation research and from another study
completed in 1955, on the needs of patients for nursing care. The latter
was based on data collected from patients, nurses, and doctors. Abdellah
developed her conception of what nursing is by focusing attention on
patients rather than on techniques.

从他在哥伦比亚(República de Colombia)高校的做事中提升而来的Abdellah的守护理论是该高查对理论护理影响的另四个事例(Abdellah,Beland,马丁和Matheney,1964)。一九五五年Abdellah大学生诗歌在希尔德gard
Peplau领导下的师范高校专注于规定隐性方面包车型大巴看护难点。她的研商成果随后发表在护理研讨中,标志着他尝试理论化护理进度的起来。她的护理概念化是从她的大学生随想商讨和从1953年完结的另一项钻探中,遵照病者对护理的急需而发展而来的。后者是基于从伤者,护师和医师收集的多寡。

Ideas of other theorists were formulated around the need for a binding
framework to guide curricula, but their writing and publications did not
have the instant impact as that of Peplau, Henderson, and Abdellah on
theoretical nursing. Their conceptions were slow to have an impact on
nursing. Orem’s ideas were first published in a guide for developing a
curriculum for practical nursing in 1959. Patient needs were also the
focus. Hall developed, in 1959, and implemented, in 1963, a concept of
nursing based on needs and interpersonal relations at the Loeb Center
for Nursing and Rehabilitation. One can see the influence of both Peplau
and Henderson in her writing (Hall, 1963).

别的理论家的想法是环绕须求3个有约束力的框架来教导课程设计的,但她俩的著述和出版物并没有像Peplau,亨德森和Abdellah那样对理论护理发生即时影响。他们的观念对医生和医护人员发生震慑缓慢。Orem的想法第一回刊出于一九五八年制定实用护理课程的指南开中学。病人须要也是重庆大学。霍尔于一九六零年成本并于一九六三年在勒布护理和康复大旨推行了一种基于要求和人际关系的守护概念。人们可以看到Peplau和Henderson在他的著述(哈尔l,一九六二)中的影响。

Independent of the Teachers College group of theorists, Johnson was
beginning to play a central role in conceptualizing nursing. Johnson’s
(1959) analysis of the nature of science in nursing was undoubtedly a
milestone in drawing attention to the potential of nursing as a
scientific discipline and in advocating the development of its unique
knowledge base. At that time, Johnson tentatively suggested that nursing
knowledge is based on a theory of nursing diagnosis that is distinct and
different from medical diagnosis. The substantive matter for such
diagnosis, the beginning of Johnson’s theory, was starting to be
formulated at this time. (See Chapter 20 for appropriate citations for
each theorist.)

单身于师范高校的理论家小组,Johnson发轫在虚幻护理中发布大旨作用。Johnson(1959)对医生和护师学科学性质的剖析无疑是在注意看护作为一门科学学科的潜力以及倡导发展其特殊的知识基础方面包车型客车贰个里程碑。当时,Johnson一时半刻提议护理知识是依据与军事学诊断截然差异的医生和护师诊断理论。那种诊断的实质性难题是Johnson理论的起来,今后始于制定。(请参阅第二0章,理解每位理论家的熨帖引文。)

Another milestone in nursing progress was the establishment of the
special nursing research fellowship program to facilitate, support, and
encourage nurses’ education for research careers. This program provided
financial incentive and support for nurses to pursue their doctoral
education in related fields such as biology, physiology, sociology, and
anthropology, among others.

守护进展的另七个里程碑是手无寸铁专门的护理研商奖学金陈设,以推进,援救和鼓励医护人员的研究生涯教育。该布署为看护在生物学,生经济学,社会学和人类学等相关领域持续开始展览大学生教育提供了财政激励和帮衬。

反射难点

1.对理论护理发展史的纪念在哪些方面阻碍或促进了医生和护师学科的前进?
2.哪些阶段和里程碑对推进护理理论至关心器重要?为啥?
3.您干什么认为 20世纪五 六十时代哥伦比亚共和国和耶路撒冷希伯来大学护理高校的条件和知识对
理论家和辩驳思考的上进起了促进效应?
4.反驳知识的同一性质是不是会造成理论切磋与实践之间的差距?借使是那样,那么
在21世纪的政治和社会制度中怎么样制止这一个出入啊?
5.你能找出越多当代的辩论思想流派吗?什么样的条件恐怕造成这一个理论话语中的每1个?
6.叩问您对理论护理发展的初期等级和里程碑所做的干活,你会如何预测今后的等级和里程碑?提供创立今后愿景的方针。
7.您觉得推进领会理论护理历史的哪些阶段和里程碑未蕴涵在本次研究中?
8.从你自个儿的角度分明首要阶段和里程碑。你从读书本章中取得了关于理论护理的哪些意见?
9.您什么描述您的学府(部门)的环境?你学校的条件以怎么着措施推进你的学术发展?

1961–1965—Theory: A National Goal for Nursing

致谢

本章的率先有的是基于AI Meleis(一九八一)。不断上扬的护法学学科。在PL
Chinn(小编),护理理论发展拓展,第二9-34页。转发于1985年的Aspen
Publishers许可。

一九六四-一九六四-理论:全国护理目的

From a reduced conception of a human being as “an illness” or “a
surgery,” with signs and symptoms, nursing theory in the late 1950s
refocused nursing attention on the individual as a set of needs and
nursing as a set of unique functions. Still, a reductionist approach to
nursing existed. The 1960s, with its turbulent society, the Camelot
goals of harmony and coexistence, and the influence of Peplau may have
prompted the refocusing of nursing from its stated mission of meeting
patients’ needs to the goal of establishing a relationship between the
nurse and client. If relationships are effectively established through
interpersonal interactions (as previously articulated by Peplau, 1952,
and as advocated by a new group of theorists), then nursing care can
meet the needs of the patient—not as defined by nurses, but as perceived
by the patient.

从压缩人的定义为“疾病”或“手术”出现体征和症状,20世纪50时代前期的护理理论将护理注意力重新集中在私有作为一组供给和作为一组杰出功效的守护上。即使如此,还存在一种还原手段。20世纪60年间,在波动的社会中,Camelot的和谐与存活的对象以及Peplau的影响大概驱使护理从其满足患儿须要的职务转向医护人员与病者之间确立关系的靶子。要是通过人际交往有效建立关联(如1952年Peplau以及一组新的理论家所倡导的那么),那么护理护理能够满意患儿的急需

  • 不像护师所定义的那么,而是由病者。

During this period, the Yale School of Nursing’s position, influenced by
the Columbia Teachers College graduates who became faculty members at
Yale, was beginning to be formulated. To these scholars, nursing was
considered a process rather than an end, an interaction rather than
content, and a relationship between two human beings rather than an
interaction between unrelated nurse and patient. Multiple social forces
helped the Yale group to develop its ideas into concepts of nursing.
Federal grant money was available for preparation ranging from
psychiatric nursing to teaching positions, for identifying psychiatric
concepts in nursing, and for developing an integrated curriculum. The
availability of time and resources, therefore, was significant in
providing the necessary push, as well as the appropriate environment in
which to reflect on nursing’s mission and goals.

在此时期,加州洛杉矶分校高学校护士理高校的身份受到了哥伦比亚共和国师范高校结业生的影响,该大学结业生成为加州理艺术高校的老师,正在开始制定。对于这么些我们的话,护理被认为是二个经过而不是终结,八个交互而不是内容,以及三个人以内的涉及,而不是井水不犯河水的护师和伤者之间的互动。三种社会力量援助加州理教院将其观点发展为看护概念。联邦拨款用于准备从精神病护理到教学岗位,用于分明护理中的精神病学概念以及支付综合科目。因而,时间和财富的可用性在提供必需的促进。

Although the work of the faculty of the Yale School of Nursing may have
profoundly influenced nursing research in the United States in the
1960s, its influence on theory was not as marked at the time. A revival
of that impact came in the 1980s, as nurses acknowledged Yale’s
strategies for theory development; this is evidenced by the
reconsideration of Orlando’s work (Schmieding, 1983, 1987, 1988) and by
the paradigmatic shift in nursing research to phenomenology (Oiler,
1982; Omery, 1983; Silva and Rothbart, 1984). These writers’
conceptualization of nursing, therefore, was not the milestone that
prompted the evolution of the next stage of theory. Rather, it was the
position paper of the American Nurses Association (ANA)—in which nursing
was defined as care, cure, and coordination, and in which theory
development was identified as a most significant goal for the profession
of nursing—that may have been influential in the further development of
theoretical nursing (ANA, 1965).

即便如此复旦护理大学的干活恐怕在20世纪60时期对美利哥的护理商讨发生了远大的熏陶,但其对理论的震慑在当时并没有那么显着。那种影响的复苏发生在20世纪80年间,因为医护人员承认北卡罗来纳教堂山分校的辩论发展战略性;
那浮现了奥兰多工作(Schmieding,1984,一九九零,一九八七)以及医生和医护人员切磋向现象学的范式转变(Oiler,壹玖捌壹;
Omery,1983; Silva and
Rothbart,一九八二)的重新考虑。由此,那几个笔者的看护概念化并不是推进下一阶段理论发展的里程碑。相反,它是美利坚合众国医护人员组织(ANA)的立场文件

  • 看护被定义为护理,治疗和协调。

Two other significant developments occurred during this period. First,
federal support was provided to nurses wishing to pursue doctoral
education in one of the basic sciences. The graduates of these programs
are those who, in the mid-1970s, further developed metatheoretical
ideas. The second development was the inauguration of the journal,
Nursing Science. Although shortlived, it was a medium for the exchange
of ideas on theory and science in nursing and a confirmation that
nursing is an evolving science with theoretical principles and
underpinnings.

在此时期产生了其余两项首要气象发展。首先,向希望在里头一门基础科学领域接受研究生教育的看护提供联邦补助。这个科目标结业生是那么些在20世纪70年份中叶进一步升华了复合理论的人。第3个升华是守护科学杂志的开幕。就算时间短促,但它是看护理论和不易观点调换的媒人,也表明护理是一门具有理论功底和底蕴的不止进步的没错。

1966–1970—Theory Development: A Tangible Goal for Academics

1967-一九六六年 – 理论发展:学术界的实际指标

With the ANA’s recommendation that theory development was of highest
priority in the profession, and with the availability of federal
support, a symposium sponsored by Case Western Reserve University was
held as part of the nursing science program. This symposium was divided
into three parts. The part focusing on theory was held on October 7,
1967, and was considered a milestone during this period (Table 5-4). The
papers were published in Nursing Research a year later. These
publications supported what were previously considered simply
perceptions and conceptions of theoretical nursing from an isolated
number of theorists. Not only did a group of significant people in
nursing get together to discuss theory in nursing, but the official
scientific journal of the field recognized the significance of these
proceedings by publishing them.

趁着全东瀛航空集团提议理论发展变成该行业的最高优先事项,并且在赢得联邦补助的事态下,凯斯西储高校援救的研究切磋会作为医生和医护人员科学安插的一部分进行。这一次研究商讨会分为三有的。理论部分于1969年13月十四日举行,在此时期被视为八个里程碑(表5-4)。那么些杂谈一年后揭橥在医生和医护人员钻探中。这几个出版物支持此前被认为是出自孤立数量的理论家对理论护理的简练明了和定义。不仅有一群主要的护理职员聚在一道探究护理理论,而且该领域的官方科学杂志通过刊登这几个杂谈来认识这一个程序的第②。

Nurses also received confirmation from two philosophers and a nurse
theorist (who had been involved in teaching nurses at Yale for 5 years)
that theories are significant for the practice of nursing, that the
practice of nursing is amenable to theoretical development, and that
nurses are capable of developing theories (Dickoff, James, and
Wiedenbach, 1968). The presentations and the subsequent series of
publications by Dickoff and James (1968) and Dickoff, et al. (1968a,
1968b) influenced the discipline of nursing profoundly, as evidenced by
the classic nature of those publications and by the subsequent
acceleration in publications related to theory. Nursing theory was
defined, goals for theory development were set, and the confirmation of
outsiders (people outside the field of nursing, nonnursing philosophers)
was productive.

护师还赢得了两位翻译家和1个人守护理论家的确认(他曾在南洋理管理大学护理教学工作5年),理论对于守护实践有非常重要意义,护理实践符合理论发展,而医护人员是能够升高理论(Dickoff,James和Wiedenbach,壹玖陆柒)。Dickoff和詹姆斯(一九六七)和Dickoff等人的发布以及随后的一多级出版物。(一九七〇a,1966b)深切地震慑了护军事学科,那一个出版物的经典性质以及与理论相关的出版物的继续加速表明了那或多或少。定义了医生和医护人员理论,制定了辩论发展对象,外界职员(护理领域以外的人,非理性国学家)的承认是有成效的。

TABLE 5-4 THEORY DEVELOPMENT IN NURSING:A HISTORICAL PERSPECTIVE
1860 Florence Nightingale addresses the need for research and the educational preparation of nurses.
1900–1950 Diploma schools served as major source of nurses—the Flexner Report for Medicine.
1952 Nursing Research first published.
1955 Establishment of the Special Nurse Research Fellowship Program in the National Institutes of Health, Division of Nursing.
1959 D.E. Johnson. The nature of a science of nursing. Nursing Outlook, 7, 292–294.
1960 R.N. Schlotfeldt. Reflections on nursing research. American Journal of Nursing. 60(4), 492–494.(The primary task of nursing research is to develop theories that serve as a guide to practice.)
1961 Surgeon General’s Consultant Group on Nursing appointed to advise the Surgeon General on nursing needs and to identify the appropriate role of the federal government in assuring adequate nursing services in the nation. This group strongly supported nursing research and recommended a substantial increase in funds.
1961 D.E. Johnson. Patterns in professional nursing education. Nursing Outlook, 9, 608. (Nursing science may evolve more easily through the identification of common but major problems of patients that are of direct concern to nursing.)
1962 Nurse Scientist Graduate Training Grants Program
1963 Nursing Science first published
1963 M.E. Rogers. Some comments on the theoretical basis of nursing practice. Nursing Science, 1,11–13. (The theoretical base of nursing practice is nursing science . . . a body of scientific knowledge characterized by descriptive, explanatory, and predictive principles . . . developed through synthesis and resynthesis of selected knowledges from the humanities and the biological, physical, and social sciences. . . . It assumes its own “unique scientific” mix through selection and patterning of these knowledges.)
1963 M.E. Rogers. Building a strong educational foundation. American Journal of Nursing, 63(6), 941.(The explanatory and predictive principles of nursing make possible nursing diagnosis and knowledgeable intervention toward predictable goals . . . nursing science is not additive, but creative.)
1964 D.E. Johnson. Nursing and health education. International Journal of Nursing Studies, 1, 219.(Nurses must be socialized as scholars and must develop commitment to inquiry and skill in the use of scientific knowledge.) J.S. Berthold. Theoretical and empirical clarification of concepts. Nursing Science, 406–422. M.I. Brown. (Spring). Research in the development of nursing theory. Nursing Research, 13, 109–112. (Assess progress of theory development in nursing and emphasize need for explicit relationship of research to theory.)F.S. Wald and R. C. Leonard. (1964). Toward development of nursing practice theory. Nursing Research, 13(4), 309–313.
1965 American Nurses’ Association. Educational preparation for nurse practitioners and assistants to nurses: A position paper.P. Putnam. A conceptual approach to nursing theory. Nursing Science, 430–442.
1967 V.S. Cleland. The use of existing theories. Nursing Research, 16(2), 118–121.
1967 L.H. Conant. (Spring). A search for resolution of existing problems in nursing. Nursing Research, 16, 115.Symposium on Theory Development in Nursing. (Reported in Nursing Research, 1968, 17(3).)
1967–1970 National Commission for the Study of Nursing and Nursing Education, Jerome F. Lysaught, director.
1968 First Nurse Scientist Conference on The Nature of Science in Nursing. Sponsored by University of Colorado School of Nursing, Dr. Madeleine Leininger, chair. (Reported in Nursing Research,1969, 18[5].)First Annual WCHEN Communicating Research Conference
1968 J. Dickoff and P. James. A theory of theories: A position paper. Nursing Research, 17(3), 197–206.(Professional disciplines are obligated to go a step further than explanation and prediction in theory construction, to the development of prescriptive theory.)J. Dickoff, P. James, and E. Wiedenbach. Theory in a practice discipline: Part I. Practice oriented theory. Nursing Research, 17(5), 415–435. Idem. theory in a practice discipline: Part II. Practice oriented theory. Nursing Research, 17(6), 545–554.R. Ellis. (1968). Characteristics of significant theories. Nursing Research, 17(3), 217–222.D.E. Johnson. Theory in nursing: Borrowed and unique. Nursing Research, 17(3), 206–209.M. Moore. Nursing: A scientific discipline. Forum, 7(4), 340–347.J.L. Sasmor. Toward developing theory in nursing. Nursing Forum, 7(2), 191–200.
1969 G. Mathwig. Nursing science: The theoretical core of nursing knowledge. Image, 3, 9–14, 20–23.R. McKay. Theories, models, and systems for nursing. Nursing Research, 18(5), 393–399.C.M. Norris (Ed.). Proceedings: First, second, and third nursing theory conference. University ofKansas, 1969 and 1970.
1971 F. Cleary. A theoretical model: Its potential for adaptation to nursing. Image, 4(1), 14–20.I.M. Harris. Theory building in nursing: A review of the literature. Image, 4(1), 6–10.M. Jacobson. Qualitative data as a potential source of theory in nursing. Image, 4(1), 10–14.J.F. Murphy (Ed.). Theoretical issues in professional nursing. New York: Appleton-Century-Crofts.I. Walker. Toward a clearer understanding of the concept of nursing theory. Nursing Research, 20(5),428–435.
1972 M. Newman. Nursing’s theoretical evolution. Nursing Outlook, 20(7), 449–453.NLN Council of Baccalaureate and Higher Degree Programs approved its “Criteria for the Appraisal of Baccalaureate and Higher Degree Programs in Nursing,” including criterion stating that curricula should be based on a conceptual framework.
1973 M.E. Hardy. The nature of theories. In M. Hardy (Ed.), Theoretical foundations for nursing. New York:MSS Information Corporation.The Nursing Development Conference Group. (1973). Concept formulation in nursing: Process andproduct. Boston: Little, Brown & Co.
1974 M.E. Hardy. Theories: Components, development, evaluation. Nursing Research, 18, 100–107.A. Jacox. Theory construction in nursing: An overview. Nursing Research, 23, 4–13.D.E. Johnson. Development of theory: Requisite for nursing as a primary health profession. Nursing Research, 18, 372–377.
1975 Nursing Theories Conference Group. (Formed out of a concern for the need for materials to help students of nursing understand and use nursing theories in nursing practice.)
1978 Advances in Nursing Science. S.K. Donaldson and D. Crowley. The Discipline of Nursing. Nursing Outlook, 26(2), 113–120.
1979 M.A. Newman. Theory development in nursing. Philadelphia: F. A. Davis.
1982 M.J. Kim and D.A. Moritz. Classifications of nursing diagnosis. New York: McGraw-Hill.
1983 L.O. Walker and K.C. Avant. Strategies for theory construction in nursing. New York: AppletonCentury-Crofts.J. Fitzpatrick and A. Whall. Conceptual models of nursing: Analysis and application. Bowie, MD: R.J.Brady Co.P.L. Chinn and M.K. Jacobs. Theory and nursing: A systematic approach. St. Louis: C.V. Mosby.H.S. Kim. The nature of theoretical thinking in nursing. New York: Appleton-Century-Crofts.I.W. Clements and F.B. Roberts. Family health: A theoretical approach to nursing care. New York:John Wiley & Sons.P.L. Chinn. Advances in nursing theory development. Rockville, MD: Aspen Systems.
1984 J. Fawcett. Analysis and evaluation of conceptual models. Philadelphia: F.A. Davis.
表5-4医生和医护人员中的理论发展:历史透视
1860 弗洛伦斯·南丁格尔满足了对研究和护士教育准备的需求。
1900-1950 文凭学校担任护士的主要来源 – Flexner医学报告。
1952年 护理研究首次出版。
1955年 在国立卫生研究院护理部建立特别护士研究奖学金计划。
1959年 德约翰逊。护理科学的本质。护理展望,7,292-294。
1960年 RN Schlotfeldt。对护理研究的几点思考。美国护理学杂志。60(4),492-494。(护理研究的主要任务是开发理论,作为实践的指导。)
1961年 外科医生总顾问护理顾问组任命向外科医生咨询护理需求并确定联邦政府在确保国内适当护理服务方面的适当角色。该团队大力支持护理研究,并建议大幅增加资金。
1961年 德约翰逊。专业护理教育模式。护理展望,9,608(护理科学可能通过识别与护理直接相关的患者的常见但主要问题更容易地发展。)
1962年 护士科学家研究生培训资助计划
1963年 护理科学首次出版
1963年 ME罗杰斯。关于护理实习理论基础的几点意见。护理科学,1,11-13。(护理实践的理论基础是护理科学……以描述性,解释性和预测性原则为特征的科学知识体……通过合成和重新合成来自人文学科以及生物学,物理学和社会科学的选定知识……它通过选择和模式化这些知识来承担自己的“独特的科学”组合)。
1963年 ME罗杰斯。建立强大的教育基础。美国护理学杂志,63(6),941.(护理的解释和预测原理使可能的护理诊断和对可预测目标的知识性干预……护理科学不是可叠加的,而是具有创造性的。)
1964年 德约翰逊。护理和健康教育。国际护理研究期刊,1,299。(护士必须作为学者社会化,必须发展对科学知识使用的探究和技能的承诺。)JS Berthold。概念的理论和经验澄清。护理科学,406-422。MI布朗。(弹簧)。护理理论发展研究。护理研究,13,109-112。(评估护理理论发展的进展,强调需要明确的理论研究关系。)FS Wald和RC Leonard。(1964年)。走向护理实践理论的发展。护理研究,13(4),309-313。
1965年 美国护士协会。护士从业人员和助理护士的教育准备:立场文件.P。普特南。护理理论的概念方法。护理科学,430-442。
1967年 VS克莱兰。现有理论的运用。护理研究,16(2),118-121。
1967年 LH Conant。(弹簧)。寻求解决护理中存在的问题。护理研究,16,115。护理学理论发展研讨会。(护理研究报告,1968,17(3))。)
1967- 1970年 国家护理和护理教育研究委员会主任Jerome F. Lysaught。
1968年 第一届护理科学性质护士科学家会议。由科罗拉多大学护理学院主持,Madeleine Leininger博士主持。(报告在护理研究,1969年,18 [5]。)第一届年度WCHEN通信研究会议
1968年 J. Dickoff和P. James。理论理论:立场文件。护理研究,17(3),197-206。(专业学科有义务比理论构造的解释和预测更进一步,对规定性理论的发展)。迪科夫,P.詹姆斯和E.维登巴赫。实践学科理论:第一部分。实践导向理论。护理研究,17(5),415-435。同上。理论在实践学科:第二部分。实践导向的理论。护理研究,17(6),545-554.R。埃利斯。(1968年)。重要理论的特点。护理研究,17(3),217-222.DE约翰逊。护理理论:借鉴与独特。护理研究,17(3),206-209.M。穆尔。护理:一门科学学科。论坛,7(4),340-347.JL Sasmor。走向理论发展的护理。护理论坛,7(2),191-200。
1969年 G. Mathwig。护理科学:护理知识的理论核心。Image,3,9-14,20-23.R。麦凯。护理理论,模型和系统。护理研究,18(5),393-399.CM Norris(编辑)。会议记录:第一,第二和第三届护理理论会议。堪萨斯大学,1969年和1970年。
1971年 F. Cleary。理论模型:其适应护理的潜力。图片,4(1),14-20.IM哈里斯。护理学理论建构:文献综述。图片,4(1),6-10.M。雅各布森。定性数据作为护理理论的潜在来源。图像,4(1),10-14.JF墨菲(编辑)。专业护理的理论问题。纽约:Appleton-Century-Crofts.I。沃克。更清晰地理解护理理论的概念。护理研究,20(5),428-435。
1972年 M.纽曼。护理的理论演变。护理展望,20(7),449-453.NLN学士学位和高等学位课程理事会批准了“评估护理学士学位和高等学位课程的标准”,其中包括标准,指出课程应基于概念框架。
1973年 我哈代。理论的本质。在M.哈代(编辑),护理理论基础。纽约:MSS信息公司。护理发展会议组。(1973年)。护理概念的制定:过程和产品。波士顿:Little,Brown&Co.
1974年 我哈代。理论:组件,开发,评估。护理研究,18,100-107.A。Jacox。护理理论建设:概述。护理研究,23,4-13.DE Johnson。理论的发展:作为一个初级卫生专业的护理的必要条件。护理研究,18,372-377。
1975年 护理理论会议组。(由于需要材料来帮助护理学生理解和使用护理理论在护理实践中形成。)
1978年 护理科学进展。SK唐纳森和D.克劳利。护理学科。护理展望,26(2),113-120。
1979年 马纽曼。护理理论的发展。费城:FA戴维斯。
1982年 MJ Kim和DA Moritz。护理诊断的分类。纽约:麦格劳 – 希尔。
1983年 LO Walker和KC Avant。护理学理论构建策略。纽约:AppletonCentury-Crofts.J。菲茨帕特里克和A.沃尔。护理概念模型:分析与应用。Bowie博士:RJBrady Co.PL Chinn和MK Jacobs。理论与护理:一种系统的方法。圣路易斯:CV Mosby.HS Kim。护理理论思维的本质。纽约:Appleton-Century-Crofts.IW Clements和FB Roberts。家庭健康:护理的理论方法。纽约:John Wiley&Sons.PL Chinn。护理理论发展进展。Rockville,MD:Aspen Systems。
1984年 J. Fawcett。概念模型的分析和评估。费城:FA戴维斯。

Although the insiders (the nurse theorists) may have charted the course
of action for theory development, the doubts and skepticism about theory
(from the critics who viewed theory as scientific and as evolving from
an empirical, positivistic model) that dominated nursing until then were
somewhat squelched by the presentations and discussions that went on
during that significant meeting in which Dickoff and James (1968, 1971)
and Dickoff, James, and Weidenbach (1968a, 1968b) presented their
metatheory of nursing. The evidence for skepticism is derived from
omission rather than commission. When theories were used during this
period, they were used in conjunction with education and not in practice
(except by New York and Yale Universities faculty and students) or
research. (Refer to the theory literature in Chapter 19 for
documentation of the omission.)

即使当中职员(护士理论家)或许制定了答辩发展的行进路线,但停止那时停止主导护理的辩护(从批评者认为理论是不易的和从经验的,实证主义情势演化而来的)的存疑和嫌疑是在Dickoff和詹姆士(一九六八,1975)和Dickoff,詹姆斯和Weidenbach(1967a,一九六九b)体现他们的医护元素的重庆大学会议时期举办的演讲和议论中有个别压抑。嫌疑主义的凭证来源于遗漏而非佣金。在那么些时代使用理论时,它们与教育结合使用,而不是在实践中(除了伦敦和南洋理哲高校的师生)或研商。

The metatheorists in nursing started their questioning during this
period. Questions of this era were related to what types of theories
nurses should develop rather than to the nature of the substantive
content of those theories. The first metatheorists were Ellis (1968) and
Wiedenbach (Dickoff et al., 1968a, 1968b). Dickoff and James (1968),
philosophers by training, addressed metatheoretical concerns that
focused on types of theories and content of theories. Debates occurred
about whether the theories should be basic or borrowed, pure or applied,
descriptive or prescriptive.

在那段时日内,护理中的变体者开端咨询。那个年代的难点与护师应该发展什么类型的争鸣有关,而不是那么些理论的青城山真面目内容的性质。第二个元变理论家是艾利斯(一九七〇)和Wiedenbach(狄克off等人,1969a,一九六八b)。Dickoff和James(1967)通过培养学习思想家,化解了关切理论类型和辩白内容的说理难点。关于那些理论是基础性的要么借用性的,纯粹的要么应用性的,描述性的或规定性的,都发生过争议。

Accomplishments at this stage can be summarized as:

• Nursing is a field amenable to theorizing.
• Nurses can develop theories.
• Practice is a rich area for theory.
• Practice theory should be the goal for theory development in
nursing.
• Nurses’ highest theory goal should be prescriptive theory, but it is
acceptable to develop descriptive and explanatory theories.

现阶段的姣好能够归纳为:

• 护理是契合理论化的园地。
• 护士能够支付理论。
• 实践是辩论的增加领域。
• 实践理论应当改成护理理论发展的对象。

医护人员的万丈理论指标应该是规定性理论,可是制定描述性和平解决释性理论是足以接受的。

1971–1975—Theory Syntax

一九七三-壹玖柒肆-理论句法

There was a period, just before the research enterprise in nursing
focused on answering significant questions in the field, when nurse
researchers focused on discussing and writing about research
methodology. A parallel exists in the area of theory. The period from
1966 to 1970 resulted in a beginning focus on theory development, which
was followed by attempts at identifying the structural components of
theory (see Table 5-4). Metatheorists dominated this period. The
emphasis was on articulating, defining, and explicating theory
components and on the processes inherent in theory analysis and
critique. Nurse theorists were no longer questioning whether nursing
needed a theory or whether or not theory could be developed in nursing;
questions of this period focused on what is meant by theory (Ellis,
1968, 1971; Walker, 1971), on what are the major components of theory
(Hardy, 1974; Jacox, 1974), and on ways to analyze and critique theories
(Duffey and Muhlenkamp, 1974). Education of nurses in basic, natural,
and social sciences through the federally supported nurse–scientist
programs produced a cadre of nurses who shared a common goal: the
establishment of the unique knowledge base of nursing. Discussions of
what constituted theory and the identification of theory syntax seemed
to be the means to achieve that goal.

有一段时间,就在医生和医护人员钻探公司注意于回复该领域的主要难点此前,医护人员切磋人口只顾于钻探和行文商量方法论。理论领域存在并行。1968年至一九六六年中间起头关切理论发展,随后尝试明确理论的组织组成都部队分(见表5-4)。Metatheorists统治了这几个时期。重点在于表明,定义和论述理论部分以及理论剖析和批判中原来的长河。护理理论家们不再质疑护理是或不是供给一种理论,可能理论是或不是足以在护理中进步;
那些时期的难题汇总在答辩的含义上(艾利斯,1967,一九七三;
沃克,壹玖柒肆),关于理论的关键组成都部队分(哈帝,壹玖柒叁;

Jacox,一九七四)以及分析和批判理论的主意(Duffey和Muhlenkamp,1972)。通过联邦援助的看护

化学家布置对基础,自然和社科护师进行教育,发生了3个怀有共同目的的看护队容:建立特殊的守护知识库。商讨哪边构成理论和理论语法的显明就好像是达成这一对象的手段。

Just before the close of this period, a milestone was achieved. Just as
the ANA acknowledged the significance of theory development during the
previous period, the National League for Nursing (NLN) not only
acknowledged theory but also made theory-based curriculum a requirement
for accreditation. Schools of nursing were expected to select, develop,
and implement a conceptual framework for their curricula. This
requirement for accreditation was both a moving force and a major
barrier to theory development. To use theory for curriculum development
further heightened awareness of academic nursing to the significance of
theory and to the available nursing theories. However, this requirement
diverted the goal of developing theories for practice (those theories
that would answer significant questions related to practice) to the goal
of using theory for education. Nevertheless, this milestone increased
the use of theory and discussions about theory and prompted more writing
about the syntax of theory to help academicians and students understand
and use theories in curriculum and teaching. The limited number of
journals that acknowledge and promote theoretical nursing, the focus on
promoting the publication of empirical research findings, and the
growing financial difficulties of some journals were barriers to written
exchanges on theory and theorizing.

在那段时日截至在此之前,那是2个里程碑。正如全东瀛航空公司在前一以内确认理论发展的严重性意义一样,全国护理联盟(NLN)不仅认可理论,而且还将答辩课程作为验证须求。臆度护理高校将为他们的课程选用,开发和履行1个概念框架。那种认证须求既是引力,也是辩论发展的显要障碍。利用理论进行学科开发,进一步升高了学术护理对理论意义和水土保持护理理论的认识。然则,这一渴求将执行理论(那两个将回应与履行有关的要害难点的说理)的靶子转向了将答辩用于教育的对象。可是,那个里程碑扩充了对理论的论争和研讨的施用,并敦促越来越多关于理论语法的文字,以赞助大家和学生知晓和动用理论课程和教学。承认和推进理论护理的刊物数量少于,带动实证研商成果公布的严重性以及部分杂志财困的增多是论战和申辩方面包车型客车封皮沟通的绊脚石。这一里程碑增添了对理论的争论和议论的选用,并促使更多的关于理论语法的作文补助大家和学习者明白和行使理论课程和教学。认可和带动理论护理的杂志数量少于,带动实证研究成果公布的首要以及一些刊物财困的增多是理论和驳斥方面包车型大巴封皮交换的阻碍。这一里程碑扩张了对理论的驳斥和斟酌的利用,并敦促愈多的有关理论语法的编写帮忙我们和学生知晓和平运动用理论课程和教学。认同和推进理论护理的刊物数量有限,拉动实证探讨成果公布的主要性以及一些杂志财政困难的增多是论战和辩驳方面包车型客车封皮沟通的绊脚石。

1976–1980—A Time to Reflect

一九七九-一九七六年 – 反映时间

Nurse theorists were invited to participate in presentations,
discussions, and debates in conferences sponsored by nurse educators,
marking a significant milestone in the progress of theoretical nursing.
A national conference devoted to nursing theory and the formation of the
Nursing Theory Think Tank in 1978 further supported the direction of the
profession toward the utilization of existing theory and the development
of further theory to describe and explain nursing phenomena, to predict
relationships, and to guide nursing care (Preview, 1978). This was the
time for nurse academicians, who had used nursing theories as guiding
frameworks for curricula, to consider putting theory to other uses,
particularly in practice.

医护人员理论家被约请到场由医护人员教育工小编主办的会议上的演讲,钻探和辩驳,那标志着守护理论进行中的3个主要里程碑。一九七七年举行的举国护理理论会议和护理理论智囊团的演进更为帮忙了标准方向,即采纳现有理论和进一步理论的前行来叙述和平解决说护理现象,预测关系,以及指引医生和护师(预览,一九八〇)。那是看护院士们将护理理论作为课程的点拨框架,考虑将答辩应用于其余用途的时候,尤其是在实践中。

The inauguration of the journal, Advances in Nursing Science, with its
focus on “the full range of activities involved in the development of
science,” including “theory construction, concept, and analysis” and the
application of theory, was another significant milestone during this
period (Chinn, 1978) (see Table 5-4). The focus of the journal on theory
and theory development added more support to the significance of
theoretical nursing and simultaneously gave nurses who were interested
in theory the necessary medium in which to present and discuss their
ideas. It allowed for the questioning and debate that is necessary for
the development of theoretical bases in any discipline.

该杂志“护理科学开始展览”的开幕式侧重于“涉及科学提高的整个活动”,包蕴“理论营造,概念和剖析”以及理论应用,是里面另一个根本的里程碑那几个时期(Chinn,1977)(见表5-4)。该杂志在辩论和辩白发展地点的显要为理论护理的意思增添了越来越多的协理,同时让理论上感兴趣的看护有必不可少介绍并探讨他们的想法。它同意在别的学科中前行理论功底所需的质询和驳斥。

This period was characterized by questioning whether nursing’s progress
would benefit from the adoption of a single paradigm and a single theory
of truth (Carper, 1978; Silva, 1977). More sophisticated debates about
what types of theory nursing needs (Beckstrand, 1978a, 1978b, 1980) and
about issues in theory (Crawford, Dufault, and Rudy, 1979) appeared in
nursing literature. A more solid commitment to the development of theory
emerged, combined with a specific direction to nurses’ efforts in theory
development (Donaldson and Crowley, 1978; Hardy, 1978). The links
between theory and research were considered and discussed (Batey, 1977;
Fawcett and Downs, 1986), the path was charted for bridging the
theory–research gaps between theory and practice (Barnum, 1990), theory
and philosophy were examined (Silva, 1977), and the role of each in the
development of nursing knowledge was clarified (see Fig. 5-1). Domain
concepts were beginning to be identified, and their acceptance was
demonstrated in the next period.

其权且代的风味是思疑护理的进化是不是会从使用单一范式和纯粹真理理论中收益(Carper,一九七六;
Silva,一九七七)。护理文献中出现了越来越多关于理论护理须求项目(Beckstrand,一九七七a,一九八〇b,1976)和辩论难点(克劳福德,Dufault和Rudy,1980)的理论。对理论发展的更坚毅的承诺出现了,并且与护师在辩论发展地点的用力的实际方向相结合(唐纳德son
and Crowley,1979;
哈帝,一九八〇)。理论与商量时期的联系被考虑和座谈(Batey,一九八零;
Fawcett和Downs,1989),该路线被用来修复理论与执行之间的论战商讨差异(Barnum,一九九〇)
,一九七六),并强烈了独家在医生和医护人员知识发展中的功用(见图5-1)。领域概念起始被识别出来,并在下1个时期被接受。

1981–1985—Nursing Theories’ Revival: Emergence of the Domain Concepts

1982年至1983年 – 护理理论的再生:域概念的产出

In this period, theory began to be questioned less and pluralism debated
less. This period was characterized by an acceptance of the significance
of theory for nursing and, furthermore, by the inevitability of the need
for the development of nursing theory. Doctoral programs in nursing
incorporated theory into their curricula and considered it a core
content area, ranking it at the top of all other core content (Beare,
Gray, and Ptak, 1981). This period was also characterized by enlightened
international interest in theoretical nursing as manifested in
conferences in Sweden and demand for consultations on theory teaching in
Thailand, Korea, and Egypt, among other countries.

在这些时期,理论初始被质问得越来越少,多元论辩论也越来越少。那暂且代的特点是承受护理理论的要紧,并且还有要求费用护理理论。护文学博士课程将答辩纳入其课程并将其正是主旨内容领域,将其列为全体别的主旨内容(Beare,格雷和Ptak,一九八四)的顶部。那暂时期的特征还反映在国际上对理论护理的兴趣,那呈今后瑞典王国的集会上,并要求在泰国,韩国和埃及(Egypt)等国家展开驳斥教学磋商。

A review of theory literature during this period reveals the lack of
debate on whether to use theory–practice versus basic theory or borrowed
versus nursing theory. Instead, there appeared to be more writing on the
examination of nursing theories in relation to different research and
practice problems and on comparisons between the different
conceptualizations (Jacobson, 1984; Spangler and Spangler, 1983).
Questions of this period included:
• What have we learned from theory?
• How can we use theory?

在此时期对理诗歌献的追忆揭发了对于是还是不是采纳理论实践与基础理论或借用与医生和医护人员理论的争辨。相反,就像有越来越多的关于分裂研商和进行难题以及分化定义之间比较的守护理论商量的编慕与著述(Jacobson,1983;
Spangler和Spangler,一九八四)。这么些时期的标题总结:
• 大家从理论中学到了怎么着?
• 大家如何利用理论?

The second question was one that clinicians began to ask and for which
there have been many useful dialogues.

第二个难题是临床医务卫生人士初始了然的问题,并且有不可胜言得力的对话。

The newly emerging syntax was used to analyze existing theories
(Fawcett, 1984; Fitzpatrick and Whall, 1983). In addition, existing
theories came to be thought of as the means to develop unique nursing
knowledge. Concepts central to nursing were identified, and existing
theory, the source of the identified concepts, was in turn re-examined
in terms of further development and refinement (Crawford, 1982; Reeder,
1984).

新面世的语法被用来分析现有的理论(Fawcett,一九八三;
Fitzpatrick和Whall,壹玖捌叁)。其余,现有理论被认为是开发独特级护理理知识的手法。分明了医生和护师的宗旨概念,并且现有理论(已规定的定义的发源)反过来在一发的发展和校订地点开始展览了再也审视(Crawford,一九八三;
Reeder,1981)。

This period was characterized by the nursing theory advocates who
pleaded for the use of a nursing perspective in general or for the
specific utilization of nursing theory (Adam, 1983; Dickson and
Lee-Villasenor, 1982). (See Advances in Nursing Science, Journal of
Nursing Administration, and American Journal of Nursing for examples of
the American advocates and Journal of Advanced Nursing for examples of
international advocates.) Another group also emerged during this period:
the theory synthesizers. The difference between the advocates and the
synthesizers was in the level of the scope of analysis. The advocates
promoted nursing theory and demonstrated its use in research projects or
in a limited practice arena. The synthesizers went beyond that limited
use to describe and analyze how nursing theory had influenced nursing
practice, education, research, and administration. The synthesizers are
exemplified by, but not limited to, Fitzpatrick and Whall (1983, 1996)
and Fawcett (1984, 1995). The Rogerian First National Conference (1983)
and subsequent ones, in which theoreticians, practitioners, and
researchers discussed the utility of Rogers’ theory from different
perspectives, is a different example of an effective synthesis of
different uses of a theory. The planners of this conference belong to
the group of theory synthesizers.

那近期代的特色是守护理论倡导者主张选拔一般护理观点或具体应用护理理论(Adam,壹玖捌贰;
Dickson和Lee-比利亚senor,一九八四)。(参见护理科学进行,护理管理杂志和U.S.看护学杂志关于美利坚联邦合众国协助者的例证和国际接济者例子中的高级护理杂志)。在那么些时代还现出了另一组:理论合成器。提倡者与合成者之间的反差处于分析范围的程度。倡导者提倡护理理论,并将其用来斟酌项目或少于的实施领域。这个合成器超出了区区的运用范围来描述和剖析护理理论怎么样影响护理实践,教育,讨论和治本。合成器的例子包括但不限于Fitzpatrick和Whall(一九八二,壹玖玖玖)和Fawcett(一九八三,1991)。罗吉尔斯第三回全国会议(1984年)及事后的理论家,实践者和钻研人士从不相同的角度谈谈了罗杰斯理论的效能,那是一蹴而就综合理论分歧用法的另2个事例。本次会议的策划者属于理论合成器组。是论战差异用途的得力综合的另二个例证。这次会议的策划者属于理论合成器组。是辩论差别用途的实用综合的另多个例证。本次会议的策划者属于理论合成器组。

A few theory synthesizers graduated from New York University in the
mid-1970s. One thing that cannot be ignored, is the influence of New
York University nursing program on advancing theoretical nursing. This
is made evident by a review of the titles of doctoral dissertations in
nursing from New York University from 1941 to 1983, which provide a
clear example of how a school of nursing using a coherent theoretical
framework can drive a coherent research agenda. Most of the titles of
the dissertations indicate a nursing perspective, and there appears to
have been an attempt at cumulative knowledge development. How and in
what ways such a pattern may have influenced and may continue to
influence theory development is an area worth further investigation and
analysis, however, we do see a Rogerian conference every once in a while
that brings many nurse scholars together to speak the same theory
language and to show their research. The outcome of such gatherings on
discovery, integration, and innovation of nursing knowledge is yet to be
documented.

局地答辩合成器在20世纪70年间中叶从纽约高校结束学业。有一件不容忽视的事体是London大学护理项目对拉动理论护理的影响。通过对壹玖肆伍年至一九八一年纽约大学护艺术学博士故事集题指标想起可以领会地来看那或多或少,那清楚地评释了1个行使连贯的反驳框架的看护大学怎么样推进连贯的钻研究商议程。半数以上诗歌标题都证明了护理观点,就如是积累知识发展的尝尝。然则,那种情势怎么着以及以何种措施影响和恐怕一连影响理论发展是二个值得进一步查明和分析的领域,大家每隔一段时间就会看出一回罗吉尔里安集会,会让众多医护人员学者一起讲同样的答辩语言并突显他们的商讨成果。那么些关于护理知识的发现,整合和换代的相聚的结果没有形成文件。

This period was characterized by an acceptance of theory as a tool that
emanates from significant practice problems and that can be used to
guide practice and research. This period was also characterized by a
greater clarity in the relationship between theory and research than
between theory and practice.

本条时代的特点是经受理论作为三个工具,从重大的履行问题,可用来指引实践和钻研工具。那么些时期的风味是理论和钻探时期的涉及比理论和实施之间的涉及更是清楚。

One remaining confusion during this period was related to semantics.
Conceptual models were referred to as conceptual frameworks, theories,
metatheories, paradigms, and metaparadigms and, when differentiated,
boundaries were not totally clear and properties not entirely distinct.
(See discussion about Rogers’ theory in chapter 13.)

在那段日子里剩余的贰个模糊与语义有关。概念模型被叫作概念框架,理论,元数据,范式和元类,并且当区分时,界限并不完全明了,属性也不完全两样。(见第叁3章有关罗吉尔斯理论的探究。)

1986–1990—From Metatheory to Concept Development

壹玖玖零-一九八六-从理论到概念发展

Three characteristics of this milestone were epistemological debates,
ontological analyses, and an increase in concept development and
analyses. One other characteristic of this period was the acknowledgment
of the gap between theory and practice. The epistemological debates
included questions related to describing alternative approaches to
knowledge development, such as the use of phenomenology, critical
theory, and feminist or empiricist methodologies, and how to connect the
dialectal approach to theory and practice (e.g., Allen, 1985; Allen et
al., 1986; Hagell, 1989; Leonard, 1989). Although the debates were
focused on knowledge development in general rather than on theoretical
development of the discipline, these debates were related as well to the
development of theoretical nursing. Concept development emerged as a
potential link between the theoretical knowing and the practical doing.

其一里程碑的四个特点是认识论辩论,本体论分析以及概念发展和分析的加码。这一时期的另叁个表征是认识到理论与履行之间的差距。认识论辩论包蕴与讲述知识发展的其余方法有关的难题,如气象学的行使,批判理论,女性主义或经验主义方法论,以及怎么样将方言方法与辩论和实施联系起来(如Allen,1984;
Allen et al。 1987; Hagell,一九九〇;
伦Nader,1987)。固然辩论的主要集中在知识发展上而不是课程的辩解发展上,但那么些理论与辩论护理的上扬也有关系。

Effective analyses were those that focused on ontological beliefs
related to central nursing concepts, for example, environment
(Chopoorian, 1986; Stevens, 1989), and health (Allen, 1985, 1986;
Benner, 1984). These analyses added substantially to a more contextual
approach to understanding each concept. These analyses also raised the
awareness and the consciousness of nurses to the necessity of using
frameworks that allow for an integrative, holistic, and contextual
description of nursing phenomena, phenomena that go beyond the
individual clients. Such frameworks, these authors demonstrated,
maintained the integrity of the basic ontological beliefs that have
historically guided nursing practice, for example, holism, integrated
responses, and relationship with environment.

有效的辨析主要集中在与大旨护理概念有关的本体论信念,例如环境(Chopoorian,一九九零;
Stevens,一九八七)和例行(Allen,1983,一九八七;
Benner,一九八四)。那几个分析大大扩展了知情每种概念的越多田地点法。这几个分析还做实了医护人员对利用框架的要求性的认识和意识,这几个框架允许对护理现象实行综合,全体和田地描述,这么些意况超出了民用客户的限制。这么些小编注解,那样的框架保持了历史上教导医生和医护人员实践的基本本体论信念的完整性,例如全部论,综合反应和与环境的关联。

The third property of this milestone was an increase in writings related
to concept development. These developments were different from earlier
theory developments that included answers to such general questions as
“What is nursing?” These analyses were more practice oriented, were
integrative, and represented early attempts in the development of single
domain theories. This was also the period in which a plea for substance
was made (Chinn, 1987; Downs, 1988; Meleis, 1987; Woods, 1987). These
authors echoed the sentiment of other discipline members by urging
discourse that was more focused on substantive issues that were
confronting health care recipients.

以此里程碑的第多个属性是与概念开发有关的着作增添。那一个提高与早期的论战发展不一致,那些发展包含对“什么是看护”这样的貌似难题的回应。这一个分析越发以实施为导向,是全部的,并且表示了单领域理论发展的中期尝试。那也是对物质实行抗辩的一代(Chinn,1989;
唐斯,1986; Meleis,1990;
伍德s,1986)。这个笔者答疑了任何课程成员的看法,并促使更关怀医疗对象面临的实质性难点的言辞。

Process debates became more a potential force for theory development
when and if they were grounded in substantive disciplinary content.
Therefore, instead of debating whether critical theory or feminist
theories were more appropriate as a philosophical base for the
discipline, one may argue whether it was more effective to view
environment or comfort from either or both perspectives. Such
substantive debates then would add to or revise parameters and
dimensions of that area of knowledge.

在实质性纪律内容的根基上,进度辩论成为辩论发展的潜在力量。因而,与其辩解批判理论或女权主义理论是不是更契合营为该课程的军事学基础,人们大概会争执从那三种意见或二种意见来看环境照旧舒适都特别有效。那样的实质性辩论会大增或改动该文化领域的参数和维度。

1991–1995—Middle-Range and the Beginning of Situation-Specific Theorizing

一九九二-一九九五-中间范围和特定情境理论化的发端

One significant milestone that marks the considerable progress in
knowledge development in nursing is manifested in the numerous
middle-range theories that evolved during this period. Some of these
were labeled as theories (e.g., Younger’s Theory of Mastery [1991] or
Mishel’s Theory of Uncertainty [1990]). Others were considered in the
process of becoming theories. (See Funk, Tornquist, Champage, Copp, and
Wiese [1990] for discussions about key aspects of recovery and
Hagerty, Lynch-Sauer, Patusky, and Bouwsema [1993] for their emerging
theory of human relatedness.) Middle-range theories focus on specific
nursing phenomena that reflect and emerge from nursing practice and
focus on clinical process (Meleis, 1987). They provide a conceptual
focus and a mental image that reflect the discipline’s values, but they
do not provide prescriptions for practice or specific practice
guidelines (Chinn, 1994).

标志着守护知识发展获得长足升高的三个最首要里程碑映未来这权且期发展兴起的很多中级范围理论中。其中一些被标记为理论(例如,Younger的控制理论[1991]或Mishel的不明显性理论[1990])。其余人被认为正在变成辩论。(请参阅Funk,Tornquist,Champage,Copp和Wiese
[1990]关于苏醒和Hagerty,Lynch-Sauer,Patusky和Bouwsema
[1993]至于她们关于人类相关性的新生理论的基本点方面的研讨。)中等范围理论重点对反映并从护理实践中涌现出来并尊重治病进程的求实护理现象(Meleis,一九九〇)。它们提供了浮现学科价值的定义宗旨和心绪图像。

Situation-specific theories may be emerging as another milestone,
although they were better defined in later years. They are theories that
are more clinically specific, theories that reflect a particular
context, and may include blueprints for action. They are less abstract
than middle-range theories but far more abstract than individual nurses’
frameworks for practice designed for a specific situation (Meleis, 1997;
Im and Meleis, 1999; Im, 2005). These situation-specific theories may
emerge from synthesizing and integrating research findings and clinical
exemplars about a specific situation or population with the intent of
giving a framework or blueprint to understand the particular situation
of a group of clients. They are theories that are developed to answer a
set of coherent questions about situations that are limited in scope and
limited in focus. For example, a conceptualization of patterns of
responses to health–illness transitions of Middle Eastern immigrants
could be developed from the results of research studies, the clinical
exemplars, and the experience of nurses in their care of this population
(Meleis, Isenberg, Koerner, Lacey, and Stern, 1995). An example is work
that has focused on Middle Eastern immigrants (Afghans, Iranians,
Egyptians, and Arabs), supported by similar work on these populations in
their native countries, which helps illuminate patterns of behavior and
responses before immigration and helps in providing a historical and
sociocultural context for the responses of immigrants in their new
country.

具体意况的辩白只怕正在成为另2个里程碑,固然它们在晚些时候有更好的概念。它们是更具临床意义的争鸣,反映特定背景的理论,并且也许包涵行动蓝图。他们与其说中层理论抽象,但比单个护师针对具体意况设计的执行框架更抽象(Meleis,一九九八;
Im and Meleis,一九九八;
Im,二零零七)。那个针对具体景况的答辩也许出现于综合和重组有关特定情景或人群的商讨结果和医治样本,以期提供框架或蓝图来驾驭一组客户的一定情景。它们是为着回应关于限制有限且主要有限的情事的一密密麻麻连贯难题而制定的辩白。例如,能够从商讨结果,临床样本以及医护人员对那些人群的守护经验中前行出中东移民健康疾病转变反应形式的概念(Meleis,Isenberg,Koerner,莱西和斯特恩,一九九一年)。贰个事例是珍视于中东移民(阿富汗人,伊朗人,埃及(The Arab Republic of Egypt)人和阿拉伯人)的劳作,这一个工作获得那个人在作者国的接近工作的支撑,这促进表明移民前的行为和反应情势,并推进提供历史以及移民在新江山的反响的社会文化背景。能够从研究结果,临床样本以及医护人员在这一人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中发展出中东移民对正规疾病转变反应情势的定义。斯特恩,一九九四年)。叁个事例是珍视于中东移民(阿富汗人,伊朗人,埃及人和阿拉伯人)的行事,那个工作取得这个人在本国的接近工作的支撑,那有助于注脚移民前的一言一行和影响格局,并促进提供历史以及移民在新江山的反馈的社会文化背景。能够从探究结果,临床样本以及医护人员在那壹个人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中迈入出中东移民对平常疾病转变反应格局的概念。斯特恩,一九九四年)。3个例子是重视于中东移民(阿富汗人,伊朗人,埃及(Egypt)(The Arab Republic of Egypt)人和阿拉伯人)的干活,那些工作得到这个人在本国的近乎工作的支撑,那有助于评释移民前的行事和反馈情势,并推动提供历史以及移民在新江山的反射的社会文化背景。以及护理职员照顾这个人群的经验(Meleis,Isenberg,Koerner,Lacey和Stern,一九九一)。3个例证是重视于中东移民(阿富汗人,伊朗人,埃及(Egypt)人和阿拉伯人)的做事,那一个干活儿获得那几个人在我国的好像工作的援救,这促进评释移民前的表现和反应情势,并有助于提供历史以及移民在新国家的感应的社会文化背景。以及护理职员照顾那些人群的阅历(Meleis,Isenberg,Koerner,Lacey和Stern,1993)。一个事例是注重于中东移民(阿富汗人,伊朗人,埃及(Egypt)人和阿拉伯人)的行事,那一个工作取得这一个人在作者国的近乎工作的支撑,那有助于注脚移民前的一坐一起和影响格局,并促进提供历史以及移民在新江山的反馈的社会文化背景。

1996–2000—Evidence Means Research, Not Theory

1997年至3000年 – 证据意味着钻探,而不是理论

Evidence-based practice evolved after much discourse in the literature
from evidence-based practice to evidence-based nursing. During this
milestone, the focus of the literature written about the discipline was
on identifying the similarities and differences between utilizing models
of care with best evidence, translating research into practice, and
using applied research (French, 1999). To determine evidence,
methodologies were discussed for defining the quality of individual
studies, the methods for integrating study findings, and criteria for
judging integrative findings and what constitutes evidence that could be
used in the literature (Goode, 2000; McKee, Britton, Black, McPherson,
Sanderson, Bain, 1999). Several properties distinguish this milestone.
First, most of the dialogues were initially based on arguments from the
medical field, which reduced “the evidence” to biomedical, empirical,
and positivist variables and criteria (Lohr and Carey, 1999). A second
property is a critical dialogue about eclectic views of evidence that
may incorporate components that are more congruent with nursing science
and emanate from how nursing knowledge and knowing have been defined.
This critical dialogue includes discussions on widening the meaning of
evidence to make it more pluralistic, to incorporate humanistic
experiences as well as personal experiences as evidence of models of
care to be used (Clarke, 1999). However, the criteria for judging
evidence from within this framework have not been explored, and no
definitive ideas been reached. A third property of this milestone is a
focus on best strategies to implement the best evidence in health care
institutions. Different models and approaches to utilizations are
defined and explored utilizing teaching-learning theories as well as
organizational change theories (Grol and Grimshaw, 1999).

传闻证据的实践在文献中从循证实践到循证护理的诸多口舌中国对外演出集团变而来。在这些里程碑时期,关于该学科的文献注重于分明利用保健模型与极品证据,将琢磨转化为执行以及使用使用研商(法语,一九九七年)之间的相似之处和分歧之处。为了明显证据,研讨了定义个体斟酌品质的方式,整合商量结果的方法,判断综合发现的正式以及能够用于文献的证据(Goode,三千;
McKee,Britton,Black,
McPherson,Sanderson,Bain,1997)。多少个天性区分了那个里程碑。首先,当先55%对话最初都以依据军事学领域的争辩,那将“证据”下跌到生物医学,经验和实证主义的变量和行业内部(Lohr
and
凯里,壹玖玖陆)。第二个天性是关于证据的退让观点的批判性对话,这一个看法也许带有与护理科学更平等的组成都部队分,并且来自于怎么样定义护理知识和知识。那一个主要的对话包蕴研究扩充证据的含义以使其更为多元化,将人文经验和个体经历当做待用格局的证据(Clarke,壹玖玖陆)。但是,从这么些框架内判断证据的规范还不曾被追究,也远非汲取显明的想法。这一里程碑的第叁项属性是关切在卫生保健机构推行最佳证据的超级策略。

The Cochrane Database of Systematic Review plays a major role in
providing frameworks for rigorous reviews of data-based evidence, for
integrating reviews for determining best supported evidence, and for
developing and implementing best organizational infrastructures to
implement and promote best practices (Foxcroft, Cole, Fullbrook,
Johnston, Stevens, 2001).

Cochrane系统评价数据库在为严刻查处数据证据提供框架,整合评定审查以明确最佳援助证据,开发和推行最佳团队基础设备以进行和放大最佳实践方面发布重视庆大学功能(Foxcroft,Cole,
Fullbrook,Johnston,Stevens,2002)。

The fourth property of this milestone is its global appeal and
utilization of evidence-based concepts in different parts of the world.
Nurses, researchers, and clinicians in different regions engaged in
dialogues about integrative reviews and accessibility of research-based
knowledge for clinicians. (See Thompson, McCaughan, Cullum, Shelton,
Mullhall, and Thompson 2001.)

这一里程碑的第陆项属性是其在天下各省的吸重力和选拔基于证据的概念。区别地方的医护人员,商讨职员和诊治医生参预了有关医疗医务职员依照研商的学识的综合评估和可访问性的对话。(见汤普森,McCaughan,Cullum,Shelton,Mullhall和汤普森二〇〇三)

The last property of this milestone is the absence of a robust
theoretical dialogue about the place of theory or philosophy in driving
the nature of evidence, the premises supporting pluralism in methods,
the framework for interpretation, and the principles behind the
selection of outcomes. Shifting from an evidence–based discourse about
practice to an inquiry–based dialogue could bring back a critical
theoretical discourse to nursing practice. (Doane and Varcoe, 2008;
Holmes, Murray, Perron, and Rail, 2006; Holmes, Roy, and Perron, 2008.)

这一里程碑的末段3个特色是不够关于理论或教育学在推动证据性质方面包车型地铁兵不血刃的理论对话,辅助措施多元化的前提,解释框架和结果采纳偷偷的基准。从以推行为底蕴的循证论述转变为以探索为根基的对话大概会挑起对医生和护师实践的开拓性理论商量。(Doane和Varcoe,2009;
霍姆斯,Murray,Perron和Rail,2007; 霍姆斯,罗伊和Perron,二零零六)

2001–2005—Diversity in Thought: Linking Theory and Practice

贰零零叁-二〇〇七 – 思想的三种性:联系理论与履行

A focus on diversity is a hallmark of this milestone in the ongoing
journey toward the theoretical development of the discipline. As the
agents of scholarship become diverse in identity, ethnicity, and
heritage, and as they become more comfortable with their differences,
their varices began to appear in the literature reflecting their
different values, beliefs, and goals. Among the examples of the
diversity in thought and in theories are those by nurses from different
countries. Theories were developed by nurses from Finland and Sweden and
dialogues about more authentic theoretical formulations reflecting the
realities of different countries gained more popularity (Salas, 2005).

关注多元化是本学科理论发展历程中这一里程碑的注明。随着专家的地位,种族和观念各个化,并且随着他们对出入越发中意,他们的静脉曲张起始产出在文献中,反映了她们不等的思想意识,信仰和目的。思想和辩驳三种化的例子是出自不一样国度的看护的例证。理论是由芬兰共和国和瑞典王国的医护人员开发的,并且有关更实际的理论表明的对话反映了分歧国家的切实可行越来越受欢迎(Salas,二零零六)。

Similarly, during this milestone, diversity of views on developing
theories from a number of grounded theory research projects as well as
through integrating different theories emerged with more robust
dialogues than ever occurred before. Olshansky (2003), for example,
conducted six grounded theory projects and developed a theory of
“identity as infertile” and combined this theory with Miller’s (1991)
theory of “relational cultural” theory to explain potential
vulnerability to depression of women whose identity is established as
“infertile women.” Both theories were integrated and provide a stronger
explanation for identity shifts that occur post pregnancy for these
women. The theory explains that although the women identified as
“infertile women” were able to become pregnant, it is very difficult for
them to perceive themselves as pregnant. This difficulty in identity is
an obstacle to forming relationships with other pregnant women.

一样,在那一个里程碑时期,从局地扎根理论探究项目升高理论以及因此结合不一致理论出发的多样见识出现了比原先更加强有力的对话。例如,Olshansky(二〇〇三)举办了多少个扎根理论项目并升华了一种“身份不孕”的答辩,并将这一答辩与米勒(一九九一)的“关系文化”理论相结合,以分解女性干扰的绝密脆弱性,被鲜明为“不孕女人”。三种理论都被整合,并为那些女性在怀孕后发出的地点转变提供了更强硬的分解。该辩解解释说,就算被鲜明为“不孕女生”的巾帼能够怀孕,但他们很难认为本人是怀孕的。

Diversity as a hallmark of this milestone was manifested in a variety of
health–illness situations requiring a careful analysis of the factors
that create diversity. Among these are age, race, ethnicity, country of
heritage, gender, and sexual orientation. This awareness led theorists
and researchers to critique prevailing approaches and assumptions and
propose alternative and more contextually situated theoretical thoughts.
Examples are Berman (2003) on the myths surrounding the power of
children, Im and Meleis (2001) in their proposal for developing
gender-sensitive theories that focus on health and illness, and Anderson
et al. (2003) who rewrote a conceptualization of cultural safety within
postcolonial and postnationalist feminist theories.

用作这一里程碑的表明,种种性表未来各个健康疾病的事态下,供给细致分析造成五种性的因素。当中囊括年龄,种族,民族,遗产,性别和性方向。那种认识导致理论家和研究人员对未来的方法和借使实行批判,并提议替代性和更具内容的答辩思想。例如伯曼(Berman,二〇〇二)关于围绕小孩子权力的神话,Im和Meleis(2004)在他们关于开发关怀健康与病魔的性别敏感理论的提出中,以及Andersonet
al。(2000)重写了后殖民主义和后民族主义女权主义理论中的文化安全概念。

Georges (2003) defined the prominent discourses that reflect this
milestone. Her thesis is that there are two discourses in nursing that
are shaping epistemic diversity in contemporary nursing. These are the
discourses on science that are more broad and enlightened and a
postmodernism discourse on marginalization. Both of these discourses
provide a critique of dominant understanding and agreements on
scholarship allowing freedom to represent the different perspectives on
knowledge development. Epistemic diversity in an era that honors
diversity in its broadest sense may free members of the discipline to be
inclusive and may transform the discipline to make it truly reflective
of the people nurses need to serve. Such diversity would also allow
critique of power inequity as well as existing networks that support
such inequities and transform social practices that tend to
institutionalize dominant approaches to theory (Gustafson, 2005). Once
again Hall (2003) reminds us in a powerful autobiographical note from
her illness experience about how medicalization of illness experiences
and about how the stronghold of the biomedical model are not in the best
interest of patients and their families. Georges (2005) uses a critical
feminist perspective to uncover her journey in rewriting her own
identity as a clinician-theorist-academician-researcher. She provides a
robust philosophical argument for the linking of theory and practice
within the political and social context of the first decade of the 21st
century. Such linking could occur through teaching theory using
strategies that help students to develop their authentic voices about
their practice. Properties of this milestone are critique of status quo,
reconceptualization that is situated and contexted, and attention to
analysis that honors diversity in cultures, ethnic backgrounds,
heritage, language proficiency, gender, and sexual orientation.

格奥尔格e(格奥尔格es,二零零四)定义了反映这一里程碑的首要性话语。她的杂文是医生和医护人员中有二种话语正在培育当代医生和护士中的认知各个性。那么些是关刘芳确的语句更普遍和开始展览,以及关于边缘化的后现代主义话语。那多个话语都提供了对有关同意私自代表不相同文化发展意见的主流掌握和协议的评头品足。在八个强调最广马虎义上的各类性的时期中,认识的多样性大概使该学科的分子免于包容,并恐怕转变学科,使其确实展示医护人员必要服务的人。那种两种性还会允许对权力分化等的批判以及援救那种不平等的共处网络以及变更倾向于将主流理论方法制度化的社会实践(格斯tafson,2007)。霍尔(二零零零)再度提醒大家,在他的病魔经历中,有一段强有力的自传体记录,关于疾病经历的经济学化以及生物历史学模型的桥头堡怎么样不切合伤者及其眷属的最佳利益。乔治(二零零七)使用批判女权主义的视角来公布她改写自身当做医疗医师

  • 理论家 –
    院士切磋员身份的旅程。她为在21世纪头十年的政治和社会背景下将舌战与实践联系起来提供了贰个强硬的理学论证。那种联系能够经过教学说理运用政策来贯彻,这一个策略能够帮忙学员提高他们的施行真实的鸣响。这么些里程碑的表征是对现状的批判,所处地方和理念的再度概念化,以及对学识,种族背景,遗产,语言能力,性别和性取向的五种性予以爱抚的解析。

2006–2010––Nurses Empowered: Evidence and Technology as Resources

二〇〇七-二零零六年 – 护师授权:证据和技艺作为财富

The post positivism age, the age of interdisciplinarity, and the age of
postcolonial feminism are marked by a major milestone in nursing, the
empowerment of nurses and the nursing profession in affecting nursing
care. Call me an optimist but let me give some reasons why I believe
that such a turning point is happening. Many addressed the
decolonization of nursing from the biomedical model, from the
patriarchal hierarchy, and from nonnursing institutional regulatory
mechanisms (Holmes and Gastaldo, 2004; Holmes, Roy and Perron, 2008).
Separating nursing from these paradigms is in itself liberating;
however, more compelling indicators of this liberation is the use of
different paradigms to guide theory development and research, as is
evident in the nursing literature produced at the end of the first
decade of the 20th century (see examples in Advances in Nursing Science,
Nursing Inquiry, and Nursing Scholarship). The prominence of nurses in
prime-time television and their depiction as forceful independent
clinicians are other examples of the changing image and visibility of
nurses. The media finds that nursing stories are worth printing, which
is an indication that reporters are recognizing that the public is
interested in these valuable experiences. Improving compensation, the
availability of diverse employment options, and the selection of nurses
to staff independent mini-clinics are all indications of the shifting
power structures in health care systems.

后实证主义时期,跨学科时代和后殖民女权主义时期的特色是医生和护师的一个最主要里程碑,护师和护理专业人士在影响护理方面包车型地铁权限。称自家为乐观主义者,但让自家付出一些缘由,为何自个儿觉得那种转折点正在发生。许多斟酌从生物管经济学格局,夫权制等级和非注重制度管理机制(Holmesand Gastaldo,二零零二; 霍姆斯,罗伊 and
Perron,二〇一〇)对护理的非殖民化实行了座谈。将护理与那个范式分开本人正是解放的;
不过,更相信的解放指标是行使分裂的范式来教导理论发展和钻探,这点在20世纪初期十年的看护文献中很扎眼(见护理科学,护理调查和护工学奖学金的演示)。黄金时段TV中医护人员的崛起地点以及他们当作强大的独自临床医务职员的叙说是卫生员变化的印象和有名度的其余例子。媒体发现,护理传说值得印刷,那注解记者正在认识到民众对这几个难得经验感兴趣。改革补偿,多种化就业选择的可用性,以及为职员和工人独立的小型诊所选用医护人员都是医疗保健系统权力结构变迁的一望可知。黄金时段TV中护师的凸起地位以及他们当作强大的独门临床医务人士的叙说是卫生员变化的形象和知名度的别的例子。媒体发现,护理逸事值得印刷,那标志记者正在认识到群众对这一个珍惜经验感兴趣。改良补偿,各个化就业采取的可用性,以及为职工独立的小型诊所选取护师都以医疗保健系统权力结构转变的马迹蛛丝。黄金时段电视机中医护人员的凸起地位以及她们作为有力的独立临床医师的讲述是看护变化的影象和盛名度的任何例子。媒体发现,护理传说值得印刷,那标志记者正在认识到Citroen对那几个高贵经验感兴趣。改良补偿,多种化就业采取的可用性,以及为职员和工人独立的小型诊所选取医护人员都是医疗保健系统中权力结构转变的征象。

The health care reform discourse surrounding the moral obligation of the
government to provide safe, quality, and equitable health care for the
U.S. population includes an acknowledgment that the nurse’s role is
central to the health care reform. The inclusion in the discourse of the
need for increasing the number of nurses in the workforce, as well as
ensuring the utilization of their full capacity, is in itself empowering
for nurses. Therefore, the increasing dialogue about primary health
care, patient-centered care, and collaborative partnerships between
physicians and nurses, whether in conferences or in Institute of
Medicine publications, honors and acknowledges the value of nursing
knowledge and nursing care (Frenk et al., 2010; IOM, 2011). These in my
view, are indicators of a milestone: Nurses are empowered.

有关政坛为奥地利人口提供安全,优质和公平医疗保健的德性职分的医治改善话语包涵承认医护人员的剧中人物是诊疗改良的主导。在解说中提到须求追加工作职员的看护人数,并保管足够利用其能力,那自身就予以了护师权力。因而,关于初级卫生保健,以病者为中央的守护以及医生和看护之间的通力合营伙伴关系(无论是在会议上或然在医研院出版物中),对护理知识和医生和护师的市场股票总值予以强调和承认(Frenk等,
二零零六; IOM,二零一三)。那个在作者眼里,是2个里程碑的指标:医护人员有权力。

There are other indications of nurses’ power to make a difference.
Entering hospitals and observing nurses handling patient tracking
systems, health care records, automated medication carts, and remote
monitoring systems raises many questions. In particular, how do nurses
integrate theoretical frameworks with technological development and the
increasing reliance on communication through computers? How do nurses
maintain their focus on the goals of nursing—patient-centered goals of
health promotion, caring, comforting, decreasing suffering, and
promoting self-care and a sense of well-being—while being attentive to
the new demands imposed by the information and monitoring technology
characteristic of hospitals and home care in the 21st century?

还有任何迹象表明护师有力量有所作为。进入医院并观看处理伤者追踪系统,医疗保健记录,自动药物车和远程监护系统的看护提议了不少标题。尤其是,护师怎么样将理论框架与技术提高相结合,以及特别注重通过电脑举办交换?医护人员怎么样将注意力集中在护理和病人为大旨的常规促进,关爱,安慰,减轻忧伤,促进本身照顾和幸福感的指标上,同时注意护理人士施加的新必要21世纪医院和家庭护理的新闻和监测技术特点?

The juxtaposition of caring for the individual and her family within the
environment of innovation and complexity of information and technology
requires the development of new frameworks and models of care. This
stage of the discipline’s development is enriched by forging different
and new partnerships between such disciplines as engineering, pharmacy,
and the information sciences.

在信息和技巧的立异和复杂环境中关怀个人和家园的并置供给开发新的框架和医生和医护人员情势。学科发展的这几个等级通过在工程学,药学和音信科学等课程之间确立分裂和新的同盟关系而得到丰裕。

An aging population, as well as an increase in the numbers of people
aging at home and of families living and caring for chronically ill
individuals through the lifespan, requires the development and use of
theories that are more specific to the particular needs of a more
defined population. Requirements for compensation and reimbursement by
insurance companies and the consequences of massive health care reform
frame patterns in advancing knowledge during this stage. Research
evidence is vital for credibility, safety in providing care, and
reimbursement for services. And nurses are taking full advantage of the
evidence and the technology.

人口老化,以及家庭老龄化人口和家园生活和照料长期患有个体的食指高居不下,供给开支和使用更现实的争鸣,以知足越来越明朗的一定需要人数。保证企业的补偿和报废供给以及在此阶段推进文化的广阔医疗改进框架格局的后果。钻探证据对于信誉,提供护理的安全性以及对劳动的补偿根本。护师正在丰富利用证据和技艺。

CONCLUSION 结论

This chapter presented significant historical themes that are related to
an interest in theoretical nursing. Progress and development in
theoretical nursing was defined in terms of stages and milestones. A
view of historical development offers a significant perspective on which
current and future theoretical thinking can be built. Analysis of
present development is deficient without tracing these historical
themes.

本章介绍了与辩论护理相关的首要性历史大旨。理论护理的展开和提高是依照等级和里程碑来定义的。历史发展观提供了多个关于当前和现在的理论思考能够建立的要紧见解。没有追溯那一个历史核心,分析当前的上进是欠缺​​的。

56net亚洲必赢手机 6

REFLECTIVE QUESTIONS

反射难点

1.对理论护理发展史的想起在哪些方面阻碍或促进了医生和护师学科的提升?
2.什么样阶段和里程碑对促进护理理论至关心注重要?为啥?
3.你干吗觉得 20世纪五 六十时代哥伦比亚(República de Colombia)和哈工业余大学学大学护理大学的条件和学识对
理论家和驳斥思想的上进起了推进职能?
4.驳斥知识的一律性质是不是会导致理论商讨与执行之间的差异?若是是如此,那么
在21世纪的政治和制度中什么幸免那一个出入啊?
5.您能找出越来越多当代的驳斥思维流派吗?什么样的条件只怕造成这一个理论话语中的每2个?
6.打听您对理论护理发展的早期等级和里程碑所做的办事,你会什么预测今后的级差和里程碑?提供创设今后愿景的国策。
7.你认为推进通晓理论护理历史的怎么阶段和里程碑未包蕴在这次斟酌中?
8.从你自个儿的角度明确第2阶段和里程碑。你从阅读本章中获得了有关理论护理的哪些意见?
9.您怎么描述您的该校(部门)的条件?你学校的条件以如何方法促进你的学术发展?

Acknowledgments 致谢

The first part of this chapter is based on A.I. Meleis (1983). The
evolving nursing scholarliness. In P.L. Chinn (Ed.),Advances in nursing
theory development, pp. 19–34. Reprinted with permission of Aspen
Publishers, 1983.

本章的率先部分是基于AI Meleis(1982)。不断升华的护历史学学科。在PL
Chinn(主要编辑),护理理论发展进行,第贰9-34页。转发于一九八四年的Aspen
Publishers许可。

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