雨 之 CHAPTE汉兰达 5(中国和英国对照)

On the Way to Theoretical Nursing:Stages and Milestones

反驳护理之路: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.

即便在上一章中涉嫌的理论思考和理论化障碍存在障碍,医护人员在一如既往和有集体地招呼人类方面一直加入某种格局的论争探讨。护理,舒适,互换,保护,康复和健康等概念被用于引导临床实践,然后才将它们标记为概念,并且在将它们总是在一块儿形成护理理论此前。但是,在一九五零年到一九七八年时期,爆发了叁个体面的标签和更系统的定义和辩护交换的进程。那个进程持续增进护文学科。

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世纪初第二遍尝试举办驳斥护理,描述了克里米亚战争中的护理重点和行动。南丁格尔被促使在广大出版物中阐释他的见地,并指出不一致的对象。那么些目标之一是赢得对国家对护师的须求的扶助,为看护的引导安顿的前行赢得接受,并揭暴露战争时期英帝国士兵忍受的不健康的条件条件。

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.

继而的理论化尝试由美利坚合众国医护人员教育工我在20世纪50时代中叶发布,须求证实区其余护师教育水准是理所当然的,并且须求为守护中的每一种教育级别制定学科。为了不相同课程设置,并抓好每门课程的引导品质,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“什么是看护目的?”和“护理目的应该是怎么?”等难题。那几个先前时代理论家意识到,通过支付代表护理观点的安顿,他们将辅助护工学生(即以往的治疗医生)专注于护理现象和难题,而不是治疗情状和题材。在U.S.A.的不等地区(随后或同时在世界任哪儿方)创建了小组,并创设了委员会来切磋护理的性格,护师工作的属性以及医护的异样方面。那些中期工作的目标还集中在将护理与其余常规不利学科区分开来。这个对话进一步探究了护理知识的性格。

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.

兴许考虑护理理论历史和剖析医护人员当前对理论的志趣的最好方法是在医护知识发展的例外等级考虑主导核心(参见第⑤章的看护观点钻探)。那里带有的比方是,文献中切磋的大旨是指示性的,并代表了该课程在其进步进度中不一致时代对怎么成员感兴趣。除了讲述那个主旨外,对理诗歌献的剖析为大家提供了说不定拉动理论护理发展的现实里程碑。那二种方法都提供了医护怎样演化成其目前事态的见地。

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,宗旨被讲演为影响知识发展历程的阶段。阶段是由里程碑来补充的,这几个里程碑描述了从二个阶段转移到另1个等级的转机。那些等级和里程碑有助于落成本学科近日的腾飞程度。

STAGES IN NURSING PROGRESS

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,护理在物色工作地位和概念其世界方面经验了不可胜计品级。值得注意的是,大家对护理理论思想,我们所生存的夫权社会以及医护人员和护理人士的观点和地方的辨析和评估或者会使得看起来各种阶段都距离了建立护农学科。不过,那么些等级中的每种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,促进或促成了护法学科的学问衍生和变化。逐个阶段都协助护士更接近鲜明护理领域,明确其任务,并规定其理论功底。

Stage of Practice

推行阶段

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.

作为生意的天堂护理版本的野史可追溯到19世纪末和20世纪初,是克里米亚战争的产物。由于须要照料受伤的兵员,弗Loren斯·南丁格尔公司了一群女人在她的监督下和烟尘血液科医务人员这里提供护理。南丁格尔以卫生为对象,以环境变迁为手段落成这一目的。

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.

开班护理的南部版本赋予Rufaida Bent Saad al-Aslamiya(也号称Koaiba Bent
Saad),他在佛教战火中陪伴先知穆罕默德。她也集体了一批妇女,专注于照顾伤员的卫生和条件。她建立了至极的活动帐篷来照料患者,伤员和残疾人。她仿效了急诊,迫切护理和长久治疗和看护。她关心伤者并陶冶妇女开展急救和医护(Fangary,1976;
SH
Hussein,个人通信,一九八七)。像南丁格尔一样,al-Aslamiya在穆斯林世界建立了第③所护艺术学校。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(1998年一月)。像南丁格尔一样,她在医护中的角色并没有乘势战事而终止。al-Asalmiya继续发起保健,预防保健和健康教育。

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.

Hussein(一九八五)描述了al-Aslamiya对医护的挚爱和他在确立新的条条框框和优质护理传统地点的打响,那些规则和古板是中东现代护理的前驱。在医护初步的东西方版本中,一名女士认为有必不可少社团其他女性照顾战争中的伤员;
在那两地点,他们都提供急切护理和长久照护。他们都注意于关怀,康复,促进健康条件,并作育其余护师。他们都遭受道德承诺的驱使,以减轻悲哀和增长临床。

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.

据此,在那个阶段,护理的沉重被定义为提供护理和舒适,以坚实康复和幸福感,并创制五个促进减少悲哀和恶化的常规条件。医护人员将其领域定义为包涵患者和提供护理的条件。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理由,其要点和任务。Nightingale(一九五〇)的描述护理目的和进度的论争着作申明了医护人员从理论上论述实践活动的潜力。那么些着作也指出护理作为一个举行领域的或然在理论上得到演讲。

Stage of Education and Administration

有教无类和行政阶段

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.

从早期对执行的讲究以及陪同的学徒和服务观念出发,转向了与培训布置和护理课程有关的题材。实践的“如何”最后被转接为升高的教程,以支撑差距层次的护理教育以及怎样教师它。将近三十年的年华花在品味差别的课程,准备教授的措施,为护理和劳动高校指引管理人员的不二法门,以及准备执业医护人员的不二法门。在这些阶段,重点是卫生员职能剧中人物的进化。那几个等级的要紧主旨是从医护人员的启蒙和行政角色演化而来的。

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.

这一品级在该科目理论发展中的主要意义在于它提供了护师向医护领域指出难点的引力。在制定面向不一样教育程度医护人员的学科时,护师问:什么是看护?由文凭结业生,副博士毕业生,管理学硕士学位或大学生学位结束学业生提供的守护服务有多不同?那几个问题促使护师用更多的争鸣术语来注解护理实践的着力(Henderson,1970)。奇怪的是,正是在那个等级,美利坚合作国看护先驱理论家的争论观念诞生了。因而,爱慕教学和教育可能为辩解护理的愈来愈发展铺平道路。

Stage of Research

讨论阶段

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.

商讨等级是通过一星罗棋布与执行和率领阶段重叠的事件演化而来的。Gortner(两千)指出,在20世纪20年间,案例商量被制定为教学工具,但它们也被当作标准化的动力。对那么些案例的系统评估引发了花旗国大萧条后的学士教育须要。战争时期须求多少收集和分析,由此需求在一九四九年创造U.S.集体卫生服务单位,创造护理财富机构。3个讨论公司的出生就此诞生。在20世纪70年间,护师探讨员委员会和负责人会成立。护师越来越多地在任何学科得到大学生学位,国家商量服务奖的本钱已经创设。

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.

守护在教育,课程开发,教学和学习策略以及管理方面的方向也造成教育工小编开展研究。护理课程专家认识到,即使没有研讨和系统切磋差距的教学/学习情势和教学/学习环境对成果的震慑,医护人员教育就不恐怕获取创新。由此,研商兴趣从教育和评估进程中冒出并汇总于难题。教学奖学金主导着中期的讨论型集团。

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,怎样保管,怎样领导以及哪些政策在教学和管理方面更实惠是造成护理探究提升和伸张的标题(Gortner
and
Nahm,一九七七)。一九五一年,美利坚联邦合众国树立了第壹份名为“护理琢磨”的护理研商杂志,南美地区教育委员会(SREB)和西方护理高等教育委员会(WCHEN)成立于一九五四年中。
20世纪50年份和60年份中叶。他们的对象须求革新护理教育,进步医护研商的生产率,提升研商质量。该杂志和SREB和WCHEN的集会支持护理人士发展其科学规范,即“一套文化古板和管理科学活动的文化”(默顿,一九七五年,第②70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).

科学随想的评审标准建立在正确探索必须由同行评议的根底上。因而,医护人员探讨人口开始遵守默顿的普遍主义规范,即透过合理标准对琢磨产品进行合理评价(默顿,一九七五年,第叁70页)。大学也对她们为其余助教担任的守护助教抱有同样的指望;
具体而言,护理高校的名师成员须求揭橥自个儿的想法,并经过在学术期刊上刊载的篇章和在学术会议上的学问演讲在不利领域拓展交换。由此,从天经地义的角度来看,“出版或消失”教条并非不具体,而是管理护理科学的另八个正经。

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).

医护在介绍想法和享用探讨成果方面的上马尝试遭到了任何医护同事严重的,有时甚至是毁灭性的批评。(那么些参预过早期琢磨会议的人或许会记得长日子和严谨的讨论批评,那几个研商批评让商讨人士和观者都备受了创伤。这么些批评的撰稿人大概没有设想过护理探讨的上进阶段。)由此,除了普遍性和共同性,此外多个正经衍生和变化:客观性和单身审查。研讨评估的成立标准通过了确认和共享,为商量细化和越来尤其展提供了多个之际(Leininger,一九六九)。

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.

探究进步阶段对当代的学术护理做出了重大进献。科学工具通过研究学科和计算课程的新产品以及通过编制和整合要紧切磋工具和工具的多少出版物在课程中留下主要标志的等级。

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.

那些等级是满世界平行的。国际教育水平也影响着文化发展的拓展。一些国度,如澳大温尼伯(Australia)和德意志联邦共和国,分别在20世纪80时期和90时代将护理教育从医院培育转向高校造就。随后,农学和理论对话以及学士产力的积累轨迹不断追加。

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.

这就是说,那一个就是医护调查和不易的开首。在那个等级,与其余科学一样,讨论者强调科学语法

经过而不是琢磨内容(Kuhn,一九六九)。收集到的真情的束缚框架或存储照旧不够。固然如此,该课程的语法已经制定。

Stage of Theory

辩护阶段

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题 – 其职分和对象 –
开端以更有系统的章程表现。一群尖锐的官员,护师认为理论应当引导医护实践,他写到理论的须求,护理理论的本质,教育家的反驳观点以及哪些创设护理理论。固然护历史学理论家在护经济学科的概念图式现身在科目标指导和管制阶段,但截止理论阶段出现后才被器重(Nursing
西奥ry Think Tank,一九七八)。

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.

在这些等级,关于护理是还是不是只是是医术的多个章节,大概它是生物学,自然科学照旧物理科学的一有个别(类似于早先时代的笛卡儿的概念,生物学仅仅是物法学的3个章节)的争持就出现了。笛卡儿的概念被否决了(生物学确实是3个万分的自治科学),护农学继续对抗它是医术一部分的意义。对新一代护师领导者

  • 教育家和理论家(或然概念主义者,就像是她们涉嫌的这一位)而言 –
    变得很明白 –
    护理不可以几乎地归咎为一种只涉及人的贰个上边的纯粹科学,似乎生物学一样无法简化为大体。护理是复杂的,必要其故事情节和办法的内在自主性。

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.

对定义一致性的言情从对语法的注意发展到对护理现实的小心和兼具想象力的钻研,以及指导其表现的含义和真理(表5-1)。从对科学情势的注目到揣测和虚幻的提升,令人回看18世纪和19世纪历史学思想的发展。18世纪受Newton和Bacon的影响非常的大,而Bacon又受到笛Carl的熏陶。19世纪由康德主宰,其假若的,演绎的和教条的措施鼓励科学的志同道合本质。护理中的投机者早先营造他们观察的有血有肉,他们拥有想象力的构造从她们的工学背景和他们的启蒙倾向进步而来。

图片 1

CHARACTERISTICS OF THE BEGINNING STAGE OF THEORY DEVELOPMENT

表5-1 理论发展开首阶段的特点
•  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.

辩论发展蒙受其余课程的范式,护师理论家的指引背景以及马上的艺术学基础的熏陶是很当然的。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些理论的发展,有时是无人不晓而且平时隐含的。护师还拔取了别样范式的概念和命题,如精神分析,发展,适应,互动以及人文主义,以指引其评估和行进。理论是为了应对对商量中单独的钻研结果的遗憾。新面世的争鸣阐释了人类在与医疗保健系统的并行和交易中的本质。

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.

纵然某些理论概念是从差距的范式综合而来,但唯有从护理的角度来看,大部分医护理论(如行为子系统,剧中人物补充,治疗触觉和自助)都以能够界定和剖析的。理论为科普的文人努力和看护的主导解释性职分提供了开始协议。这么些阶段提供了相关意况的知识,但医护学科及其智力目的仍存在不明确性。如同在核物教育学中

  • 当第三个已毕不是着眼或数学统计之一,而是智力想象 –
    概念图式之一在对护理的阅历范围有任何鲜明认识此前就衍变了。在护文学方面,理论协助该科目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.

罗吉尔斯(壹玖柒零)指出了护理概念,重点关心人与环境的随处沟通。Johnson(1978)发展了一种古板,即人类

  • 海洋生物系统 –

    也是以原始须求为主导的悬空系统。莱文e(1966)和Orem(一九七二)提议了护理疗法的指引方针,以保证人类的完整性,心绪学和社区维系

    简不难单,就是一切人。Orem(一九八五)提醒我们人类完全有力量自小编照顾,并理应朝着那个目的升高。

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.

由于较早关怀教育和职业认同,因为全国护理联盟规定了学科的定义框架,并且鉴于并未接纳经验实证主义者确证的正规规定理论的实事求是,所以没有使用新兴理论指点实践或钻研,而是用来指点教学。由此,在制订与那几个理论相对应的教程时,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.

即便如此理论恐怕影响了学生的履行,但那种影响在文献中并未记载,这个文献愈多地集中在教育序列辩护上。作为一名教育工作者,他曾是一所运用护理理论(也称为方式)作为课程框架的学堂的分子,在一九五九年间中期,笔者切身感受了陈设结业生在她们想要的时候碰到的争论使用护理框架,他们在实践中学习和心得过她们的教诲安插,并且由于其新颖性和深邃的概念而不能那样做。护理形式在教育中的使用是还是不是使护理特别可行和有功效是一个留下来进行测算的题材,并且仅在孤立事件中以及经过经验性叙述分析表明,因为它们缺乏普遍性和泛化。应该鼓励60时代早先时期和60年间早先时期护理理论课程的结业生用这几个根据理论的学科写出他们经历的故事,并经过那些科目告知或不报告他们的执行。

  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.

那几个题材继续导致一连串型的答案:让我们找到三个指引范式,或探寻一个对拥有医护维度具有解释力的宽广理论,一旦我们发现那么些包含万象的答辩,我们将可以回答有关的难题到纪律。那种措施提示大家,伽利略和笛Carl谈到地理学家的职务是力所能及破译大自然的机密并完结世界真相的“真正结构”。可是,那是Plato式的脍炙人口,而不是对正确商量义务的显然性描述。后来,地理学家起先扬弃那种追求。化学家和生法学家“未来相信那或多或少。。。我们应该在这么些世界做得更好,在逐年走向更相像的概念的还要,而不是从一开首就锲而不舍完全的常见“(Toulmin,一九八零,p。387)。图尔明指出,“人类的行为总体而言代表了三个太普遍的天地,被含有在2个理论体内”(第①87页)。当数学家接受多样反驳的需求,并且当他们承受科学的长河本质时,它将改为该科目中“成熟而不是战败主义的申明”(第三87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.

因为医护人员化学家在总体课程中找找一种理论,所以那么些义务照旧是压倒性的,要么太肤浅(罗吉尔s,1969),大概过于简单化和简化(Orem,壹玖柒叁)。从业人员的心思是对全部理论的恐怕和有用性提议质询,正如20世纪60时代和70时期在护理实践中应用护理理论的一线文献所验证的这样。护理实践须要一个纯粹的概念框架来辅导医护课程。护师从业者开首相信她们被要求在答辩之间作出采取,然后锲而不舍这一一定的辩解。因为这几个理论都未曾关系护理的种种方面,所以护士从业者避免了医护理论,忽视了医护理论,或许拒绝使用护理理论。传说正在形成,不过。

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.

护理的四个主旨是在这么些阶段发展的,接受护理的扑朔迷离和多样辩护的必然性;
接受在解散任何辩解以前测试和评释不相同理论的首要命题的急需;
以及经过积攒效应留在现场的定义或辩论成为发展具体意见的底子。二元论和多元论是论战阶段的规范。在这一阶段,护理人员开发了不可或缺的边际,以便将主要放在查询和必备的八面见光上,以便通过创立性努力落成扩张。

Stage of Philosophy

军事学的等级

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).

乘机护师开端反思护理实践的概念方面,界定护理领域以及最契合知识发展的格局,他们开始研究历史学难题。这一品级的根本是提议和回复有关护理知识本质的题材(Carper,壹玖柒玖;
Silva,1977),钻探的属性(艾利斯,一九八五)以及医护知识的真相与商讨形式之间的一致性(
Allen,Benner和Diekelman,1987)。在那么些等级,农学被认为是准备明白护理理论和探究的法学前提(Sarter,一九八七),并打算提高管理学切磋作为医护知识发展的法定形式(Fry,一九九〇)。

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).

这一阶段长远影响了医护文献中的知识分子话语。在这一个等级,认识论的各性情被接受,对道德,逻辑和认识论的切磋的要求被合法化,正如接受发布的累累基于管理学的手稿所验证的(艾利斯,一九八五)。

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.

本条等级的风味还在于该课程的学术成熟,因为它的成员认可限制适用的工具来考察基本和事实上难点。关于人类全部性,情境变量和完好护理的若是须求一律的调查工具,而护师学者认可使用现有工具捕捉护理现象的复杂性(Newman,壹玖玖壹;
Stevenson和伍德s,1989)。在保持现象的背景性和复杂的还要接受局限性代表了显着的学术成熟度,并且有大概将紧要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).

在这几个阶段早些时候,探究带有了护理中不一致的“认知艺术”,并提议超过经验的伸手(Carper,1977)。这几个有关文化结构,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探讨极大地推向了护经济学科身份的意识和建构。当理论家和变体论者探讨营造护理知识的工学基础时(Allen等,一九八八;
罗伊,壹玖玖叁),出现了一组新的难题。这一个题材更加多地突显了正在开发的学问的市值和含义以及这一个文化对护理实践的震慑,而更少关怀知识的布局和合理(Bradshaw,壹玖玖肆;
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.

对知识的强调与对“存在”的另一强调相得益彰。存在并不仅仅限于医护人员,也不限于患者,而是分别与每一个人以及双边都加入关注互动(Benner,一九九五;
Newman,壹玖玖壹)。那几个包涵认识论和本体论五个组成部分的军事学阶段为看护提供了选择多重管理学和申辩功底来打听和答复与价值,意义和切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.

以此理学阶段持续存在,与下一个结缘阶段重叠。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各样层次的医疗保健碰着的艺术学经验(Kirkham
and
Anderson,二零零零)。在种族,文化,种族,多种性和权杖差距的学科中,后殖民地护艺术学奖学金得到了通报。它是指和构架生活在殖民统治压迫下的大千世界经历的论战和实证工作。利用这一艺术学立场,大家可以更好地精晓色彩,宗教,性取向,种族和阶级多样性对作育健康和病魔反应的熏陶。

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,史学家对实证主义的反响,将护理翻译成Whall描述的“让大家摆脱全部医护理论”(Whall,1991;
Whall和希克斯,二零零二)。固然背景对后现代艺术学非常首要,不过大规模的一体化是不容许的。表征后现代主义的其余概念是相对主义,解构主义,语境,无理论叙事和布局影响。

Stage of Integration

结缘阶段

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.

以此等级有三个通用特征,每一种特征在随之的公文中都有描述。应该用它们来激发对小编国学科发显示象的沉思和商讨,无论是在国内依然在国际上。这些阶段与其间和表面其余学科整合的下一阶段不一样。这一品级的率先个特征是运用实质性的对话和座谈,侧重于规定整个护工学科及其特定专业领域的一律结构(Schlotfeldt,一九八九)。这一个社团包涵在意于护理领域及其现象的不利,理论,工学和治疗知识。这个对话发生在议会,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.

这一品级的第四个特征是经过理论,商量和实践的构成(例如环境与正规,症状管理或转型与常规)围绕实质性领域拓展教育布置。那也浮未来护理管理人士,临床医务人员和教导工我采取理论护理的便利性以及学科成员与学识,发现和升华连锁事项之间越是多的对话,那几个知识,发现和进步都汇聚在和发泄护理。

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.

这一品级的首个特征是由科目护理治疗医师,助教,管理人士,研讨人口和理论家对理论护理的不比方面展开评估。评估不压制理论测试;
它还包涵描述,分析和批评。由于其各类文学基础,那几个经过中的每2个对我们学科的上扬和发展都很重大。

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7个天性是,学科成员对文化发展战略给予的保养与该学科的三只如若一致,并设想到全体性,方式化,经验和意义的尺度(Newman,1992)。

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.

第一个特征是正规领域成员插足提升与特定领域现象有关的争辨。那种出席并不拔除对与护理领域现象有关的答辩的好像关怀;
例如,描述和干预症状的说理。

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).

第十个特点是对历史学和辩解功底的批判性重新评估,这么些基础指点了护理领域基本概念的概念和浮泛,以及用于转移知识的方法论。那种话语的三个例子是再一次评估护理文献中客户的定义以及那些概念与天地即使的一致性(阿伦,一九九零)。另一个事例是有关融合差别措施以爆发更合乎人类科学原理的文化的对话,如扎根理论,女权主义理论和批判理论(Kushner
and Morrow,贰零零贰)。

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.

这一等级的第二个特色是因此学术单位运行诊所(护理医院)或造就临床教员职位,使护历史学术单位参预病者看护的创制天性局。

Stage of Interdisciplinarity

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.

构成阶段导致并领先跨学科性阶段。美利坚合众国国立卫生探究院(NIH)在21世纪初的路子图为不一致品种的构成提供了强有力的推动力,那种结合向差别学科的分子指出挑衅,以创制纳入不一样理论和证据的探究安顿领域。即使护理一贯依靠,借鉴并享受其余科目的钻研和辩护,但跨学科教育和教学切磋的驱引力未来正在超级的讨论部门中拿走推广。这一阶段的主干核心是树立分化科目成员的探究人口和看病医务卫生人员之间的关系,发展共同切磋部门,推进探讨安插,或提供更健全的教育。睡眠讨论中央,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分化学科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类似举动。驱动那些机构的难题是它们是不是合宜突显纪律或不利领域。时间将报告大家,摆脱纪律部门是还是不是会继续支持横向和纵向学科的上扬。关于课程和跨学科的越来越多切磋在第二4章中提供。枪支受伤是内需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复杂的近乎举动。驱动这几个机构的标题是它们是或不是合宜展现纪律或不利领域。时间将报告我们,摆脱纪律部门是不是会一连援助横向和纵向学科的升华。关于课程和跨学科的越多商讨在第贰4章中提供。枪支受伤是内需不一样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复杂性的接近举动。驱动这几个机关的标题是它们是不是应当突显纪律或不利领域。时间将报告大家,摆脱纪律部门是不是会三番五次帮衬横向和纵向学科的腾飞。关于课程和跨学科的更加多探究在第二4章中提供。时间将告诉我们,摆脱纪律部门是或不是会三番八遍帮助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探讨在第壹4章中提供。时间将报告大家,摆脱纪律部门是不是会持续帮忙横向和纵向学科的发展。关于课程和跨学科的更加多切磋在第②4章中提供。

Stage of Technology and Information Systems

技巧和音讯种类阶段

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话音邮件指示是守护学科发展史上这一阶段的性情。包括与消息学和技能突破有关的变量和规范的驳斥是此阶段的画龙点睛驱动因素。将地理学家和临床医务人员经过互连网向民众传播的起首进和最新消息纳入个人和家园时,自作者保健实践将全数不一样的含义。自作者保健的做法和对象还蕴涵动用家用血压仪,葡萄糖试剂盒,自作者诊断协议和自个儿监测小工具等新型监测装备。

图片 2

THEORY DEVELOPMENT IN NURSING: MILESTONES

表5-2医护中的理论发展: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

MILESTONES IN THEORY DEVELOPMENT

反驳发展的里程碑

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.

理论护理的开拓进取和进化抱有多少个里程碑意义,这个里程碑是透过分析1947年至二零零一年之间选定的医护期刊中出现的答辩文献而规定的。这个里程碑大大改观了辩护在护理中的地位,深切地震慑了医护进一步提升理论护理。每一个里程碑都在此间开展了定义和精炼描述(表5-2)。识别和定义那几个里程碑会挑战别人探索逐个里程碑大概对医护知识的展开和进步暴发的熏陶。

Prior to 1955—From Florence Nightingale to Nursing Research

壹玖伍壹年事先 – 从弗Loren斯南丁格尔到护理讨论

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.

1952年事先影响全数医护科学后续发展的三个最紧要里程碑是树立了护理探讨期刊,目的是告诉护师和其余人对护理的不错调研(图5-1
)。该杂志最重视的目的是砥砺科学生产力。该杂志的成立证实了医护的确是一门科学学科,其展开将取决于护师是还是不是通过可敬的学科所拔取的路线追求真理,即切磋。尽管南丁格尔只怕为探讨和辩解提供了始于的引力,但早期,她的震慑在医护教育中最为敏感。医护人员教育首要性发生在文凭课程中。

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.

除外,护理商量出版物的创设提供了一种怀疑态度的框架,恐怕为查询创立了舞台,在晚年造成越来越多的理论话语,那段日子对于守护理论来说是平凡的。

图片 3

Chronology of the development of theoretical nursing

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

1954-壹玖陆零年 – 护理理论的降生:哥伦比亚共和国高校农林电影学院方法

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.

尽管如此弗Loren斯·南丁格尔关于护理的见识着眼于健康与环境之间的关联,可是在20世纪初发展兴起的,直到20世纪50时期中叶,护师才起来表明护理的驳斥观点。关于护理本质,其职责和目的以及护师剧中人物的题材促使护师教育工作者捕捉这一个标题标答案,并将其变今后越发贯通的一体化中。这几个题材根源对护师从文凭课程到学士学位课程的引导准备的转变的志趣,出于对课程内容或解除内容的忧患,以及医护人员要求上学怎么着担任护师。

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).

哥伦比亚(República de Colombia)大学农林外贸学院的首任护经济学助教M. AdelaideNutting被任命为硕士课程,紧要负责教育和治本,为结束学业生做好我们教育和治本的预备。尽管这一个老谋深算的安插的最首要不在于护理科学或护理理论,但该安排的参加者一定已经觉拿到她们处于促进军事学和申辩难题的对话和驳斥的环境中。值得注意的是,在1997年,护理教育陈设庆祝了100年的影响力,那是三个很好的庆祝活动,因为在那十年中提供护理概念的大部理论家都在财经大学接受教育;
包罗Peplau,Henderson,哈尔l,Abdellah,King,Wiedenbach和罗杰s(表5-3)。

图片 4

TABLE 5-3 NURSING THEORISTS: 1950–1980

表5-3守护理论:壹玖肆陆-一九八零
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.

为准备功用角色和感受准备教学大纲的力量,设置人员配置情势等或许已经释放了那么些学者对学术历程的任哪个地方方(如理论或概念模型开发)的创设能力。尽管其余经验和安排恐怕一向影响到这几个学者的论战追求(例如,罗杰斯在John霍普金斯高校的大学生杂文准备),但就好像师范高校的管理学直接地不仅影响了精神病学理论和钻研,而且还涉嫌全数医护的理论思考(Sills,一九八零)。询问和回应关于学术环境对准备有成果的学者的熏陶的标题或然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(1954)利用哈利 Stack
Sullivan的反驳标题和定义来支付协调的驳斥,爆发了医护作为人际关系的率先个肯定的概念,其中人际进度的组成部分要求被发明和剖析。精神病护理领域随后使用Peplau的想法大幅度进步。其他在20世纪60年份发展起来的辩论是依据那么些早期的守护概念。例如,维吉妮亚Henderson与Bell森哈默一起研发了医护理论的初期种子,该辩护于20世纪50年份中叶揭橥在医护原理和实践教科书上。

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.

国际护理管事人会(ICN)提议的范围护理及其义务的渴求致使1956年的ICN评释出现在广大分发的出版物中,并在国际上进行了调整(Henderson,一九六九年,第②5页)。Peplau和Henderson给出的新闻是,护理有1个一定的和特别的任务,而且那一个任务有一些方可传达的秩序和团协会。那些明显的完整代表护理理论的伊始。

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)高校的办事中发展而来的Abdellah的守护理论是该高查对理论护理影响的另三个例证(Abdellah,Beland,马丁和Matheney,壹玖陆伍)。1954年Abdellah大学生故事集在希尔德gard
Peplau领导下的师范高校专注于规定隐性方面的看护难点。她的切磋成果随后公布在护理研商中,标志着他尝试理论化护理进程的初始。她的护理概念化是从她的硕士散文切磋和从一九五五年成功的另一项讨论中,依据病者对护理的须求而更上一层楼而来的。后者是依照从伤者,护士和先生收集的数据。

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).

其它理论家的想法是环绕须求一个有约束力的框架来指引课程设计的,但他俩的著述和出版物并不曾像Peplau,Henderson和Abdellah那样对理论护理暴发即时影响。他们的价值观对医护爆发影响缓慢。Orem的想法第四回宣布于一九五六年制定实用护理课程的指南中。伤者须求也是第叁。霍尔于一九五九年支出并于1964年在勒布护理和大好大旨推行了一种基于要求和人际关系的看护概念。人们可以看到Peplau和Henderson在他的著述(哈尔l,1964)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.)

单身于电子财经政法大学的理论家小组,Johnson先导在空洞护理中发布大旨功效。Johnson(一九五八)对医护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提倡发展其特殊的知识基础方面的二个里程碑。当时,Johnson临时指出护理知识是依据与教育学诊断截然差其余医护诊断理论。那种诊断的实质性难点是约翰逊理论的上马,今后起先制定。(请参阅第30章,精晓每位理论家的非凡引文。)

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.

护理进展的另二个里程碑是起家专门的看护探究奖学金安排,以促进,支持和鼓励医护人员的博士涯教育。该布置为看护在生物学,生教育学,社会学和人类学等相关领域持续开展大学生教育提供了财政激励和支撑。

1961–1965—Theory: A National Goal for Nursing

壹玖陆伍-壹玖陆肆-理论:全国护理目标

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.

从压缩人的概念为“疾病”或“手术”出现体征和症状,20世纪50年间早先时期的看护理论将护理注意力重新集中在个体作为一组须要和当作一组特殊功用的医护上。就算如此,还设有一种还原手段。20世纪60时代,在多事的社会中,Camelot的协调与存活的目的以及Peplau的熏陶或然驱使护理从其满意患儿须求的重任转向护师与病者之间建立关系的目的。假如经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),那么护理护理可以满意患儿的须要

  • 不像医护人员所定义的那么,而是由伤者。

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,加州伯克利分校学院护理高校的地位碰到了哥伦比亚(República de Colombia)外国语大学结束学业生的震慑,该大学结束学业生成为加州圣地亚哥分校高校的教工,正在伊始制订。对于这几个学者的话,护理被认为是二个进度而不是终止,一个互为而不是内容,以及多人之间的关系,而不是井水不犯河水的医护人员和伤者之间的相互。多样社会能力资助俄亥俄州立高校将其眼光发展为护理概念。联邦拨款用于准备从精神病护理到教学岗位,用于明确护理中的精神病学概念以及支付综合科目。由此,时间和能源的可用性在提供须要的惹事生非。

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).

虽说加州戴维斯分校高校护理大学的行事或许在20世纪60时期对United States的医护切磋暴发了远大的熏陶,但其对理论的熏陶在当下并从未那么显着。那种影响的再生暴发在20世纪80年代,因为护师认可南卡罗来纳Madison分校的申辩发展战略;
那呈现了奥兰多工作(Schmieding,1984,一九八八,1986)以及医护探讨向现象学的范式转变(Oiler,一九八五;
Omery,一九八五; Silva and
Rothbart,一九八一)的重新考虑。因此,那些笔者的护理概念化并不是牵动下一阶段理论发展的里程碑。相反,它是U.S.A.护师协会(ANA)的立场文件

  • 护理被定义为看护,治疗和和谐。

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.

在此时期暴发了别的两项首要气象发展。首先,向希望在里头一门基础科学领域接受大学生教育的看护提供联邦辅助。那个学科的毕业生是那么些在20世纪70年间早先时代进一步升高了复合理论的人。第贰个发展是守护科学杂志的揭幕。即便时间短促,但它是守护理论和科学观点交换的介绍人,也证实护理是一门具有理论功底和根基的无休止升华的不易。

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

一九六八-1968年 – 理论发展:学术界的切实可行目的

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.

乘胜全日空指出理论发展成为该行业的最高优先事项,并且在取得联邦资助的情状下,凯斯西储大学帮扶的探究会作为医护科学安插的一片段进行。本次探讨会分为三部分。理论部分于一九七〇年九月二十15日举行,在此时期被视为1个里程碑(表5-4)。那个随想一年后发布在护理商讨中。这个出版物帮衬以前被认为是出自孤立数量的理论家对理论护理的简便明了和概念。不仅有一群主要的护理人士聚在同步谈谈护理理论,而且该领域的合法科学杂志通过发布这个故事集来认识这么些程序的第壹。

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.

护士还得到了两位史学家和壹个人守护理论家的肯定(他曾在麻省交通大学护理教学工作5年),理论对于守护实践有根本意义,护理实践符合理论发展,而医护人员是力所能及升高理论(Dickoff,詹姆士和Wiedenbach,壹玖陆柒)。Dickoff和James(一九七零)和Dickoff等人的刊登以及随后的一多元出版物。(1969a,1966b)深入地影响了护历史学科,那个出版物的经典性质以及与理论相关的出版物的接续加快注解了那或多或少。定义了医护理论,制定了辩解发展对象,外界人士(护理领域以外的人,非理性国学家)的认同是有效应的。

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。

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.)

即便其中人士(医护人员理论家)只怕制定了驳斥发展的步履路线,但截至那时甘休主导护理的答辩(从批评者认为理论是不易的和从经验的,实证主义情势衍生和变化而来的)的猜忌和可疑是在狄克off和James(1969,一九七四)和狄克off,詹姆斯和Weidenbach(一九六九a,壹玖陆柒b)显示他们的守护元素的重中之重集会时期开展的发言和议论中稍微压抑。猜疑主义的证据来源于遗漏而非佣金。在那个时期采纳理论时,它们与教育结合使用,而不是在实践中(除了London和加州伯克利分校高校的师生)或钻研。

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.

在那段时间内,护理中的变体者发轫发问。那些年代的标题与医护人员应该提升如何品种的辩护有关,而不是那些理论的精神内容的习性。第3个元变理论家是艾利斯(1970)和Wiedenbach(狄克off等人,一九六八a,1966b)。Dickoff和詹姆士(一九六九)通过创设学习翻译家,化解了关爱理论类型和申辩内容的申辩难点。关于那几个理论是基础性的要么借用性的,纯粹的或者应用性的,描述性的或规定性的,都暴发过争议。

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.

现阶段的姣好能够包含为:

• 护理是切合理论化的小圈子。
• 医护人员可以付出理论。
• 实践是辩论的丰裕领域。
• 实践理论应当改成护理理论发展的对象。

医护人员的最高理论目标应该是规定性理论,不过制定描述性和平消除释性理论是尚可的。

1971–1975—Theory Syntax

1975-1971-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,就在护理研商公司注意于回复该领域的基本点难点在此之前,医护人员琢磨人士注意于探究和行文商讨方法论。理论领域存在并行。一九六七年至1968年中间初始关切境论发展,随后尝试显然理论的布局组成部分(见表5-4)。Metatheorists统治了那么些时代。重点在于表达,定义和讲演理论部分以及理论分析和批判中原本的进度。护理理论家们不再猜疑护理是或不是须要一种理论,可能理论是还是不是足以在医护中提升;
这么些时期的难点汇总在争鸣的含义上(艾利斯,一九六八,壹玖柒叁;
沃克,壹玖柒肆),关于理论的紧要性组成部分(哈代,一九七四;

Jacox,一九七一)以及分析和批判理论的措施(Duffey和Muhlenkamp,一九七一)。通过联邦协助的看护

地理学家陈设对基础,自然和社会科学医护人员举行教育,暴发了1个全部一块目标的看护队伍容貌:建立十分的守护知识库。商量哪些构成理论和申辩语法的明确如同是兑现这一对象的手法。

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.

在那段时日截止之前,那是四个里程碑。正如全日空在前一以内确认理论发展的最首要意义一样,全国护理联盟(NLN)不仅承认理论,而且还将理论课程作为验证要求。揣度护理高校将为他们的课程接纳,开发和推行3个概念框架。那种认证须求既是引力,也是理论发展的主要障碍。利用理论举办学科开发,进一步提升了学术护理对理论意义和现有护理理论的认识。然则,这一必要将实施理论(那四个将回应与执行有关的要害难点的申辩)的靶子转向了将理论用于教育的对象。然则,这些里程碑增加了对理论的说理和切磋的运用,并敦促越来越多关于理论语法的文字,以助手大家和学生驾驭和采用理论课程和教学。认同和促进理论护理的刊物数量少于,推动实证商讨成果发布的严重性以及部分期刊财政困难的加码是论战和辩护方面的书面沟通的阻力。这一里程碑增加了对理论的理论和讨论的运用,并驱使越多的有关理论语法的编著帮忙大家和学习者知晓和拔取理论课程和教学。认同和推进理论护理的期刊数量少于,拉动实证研商成果公布的第③以及部分杂志财政困难的加码是辩论和辩论方面的书面交换的拦Aston。这一里程碑伸张了对理论的反驳和座谈的运用,并促使更加多的有关理论语法的编著协助大家和学员知道和采纳理论课程和教学。认可和牵动理论护理的杂志数量有限,牵动实证研商成果发布的最首要以及一些刊物财政困难的加码是理论和驳斥方面的书面沟通的阻碍。

1976–1980—A Time to Reflect

壹玖柒捌-一九七九年 – 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.

看护理论家被特邀在座由护师教育工作者主办的议会上的演讲,商量和辩论,那标志着守护理论进行中的一个根本里程碑。1980年举行的举国护理理论会议和医护理论智囊团的演进更为援助了规范方向,即接纳现有理论和进一步理论的腾飞来描述息争说护理现象,预测关系,以及指引医护(预览,一九七九)。那是看护院士们将护理理论作为课程的点拨框架,考虑将理论应用于其余用途的时候,特别是在实践中。

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“护理科学开展”的开幕式侧重于“涉及科学进步的整个活动”,包罗“理论打造,概念和剖析”以及理论应用,是中间另一个重中之重的里程碑这几个时代(Chinn,一九七九)(见表5-4)。该杂志在辩论和辩护发展地方的首要为理论护理的意义增添了越多的协助,同时让理论上感兴趣的看护有必不可少介绍并讨论他们的想法。它同目的在于其它学科中迈入理论功底所需的狐疑和辩护。

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.

那么些年代的特色是可疑护理的升高是还是不是会从使用单一范式和单一真理理论中受益(Carper,一九七九;
Silva,1980)。护理文献中出现了越多关于理论护理须求项目(Beckstrand,1980a,1979b,1977)和驳斥难题(Crawford,Dufault和鲁迪,一九七八)的辩解。对理论发展的更坚定的承诺出现了,并且与医护人员在答辩发展地方的奋力的实际方向相结合(唐Naderson
and Crowley,一九八零;
哈迪,一九七六)。理论与探讨时期的联系被考虑和座谈(Batey,1980;
Fawcett和唐斯,一九九〇),该路线被用来修复理论与实施之间的答辩探究差异(Barnum,1987)
,一九七七),并强烈了分别在护理知识发展中的功效(见图5-1)。领域概念开首被辨认出来,并在下一个时日被接受。

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

一九八一年至1983年 – 护理理论的复兴:域概念的出现

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.

在那么些时期,理论开始被质问得越来越少,多元论辩论也越来越少。那权且代的特征是经受护理理论的基本点,并且还有须要开支护理理论。护艺术学大学生课程将舌战纳入其课程并将其视为大旨内容领域,将其列为全部此外主旨内容(Beare,格雷和Ptak,1982)的顶部。这一时期的表征还浮以往列国上对理论护理的趣味,那反映在瑞典王国的会议上,并须要在泰王国,南韩和埃及(Egypt)等国家开展申辩教学磋商。

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?

在此时期对理杂谈献的回想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不一致研究和实施难题以及差异定义之间相比较的看护理论研商的行文(雅各布森,一九八五;
Spangler和Spangler,一九八二)。这些时期的题材归纳:
• 大家从理论中学到了哪些?
• 大家什么使用理论?

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

其次个难题是治病医务卫生人员早先询问的题材,并且有广大实用的对话。

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).

新出现的语法被用来分析现有的驳斥(Fawcett,一九八三;
Fitzpatrick和Whall,壹玖捌伍)。其余,现有理论被认为是支付独特护理知识的招数。明确了护理的主导概念,并且现有理论(已规定的概念的来源)反过来在越发的升高和立异地方开展了再度审视(Crawford,1985;
Reeder,壹玖捌贰)。

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.

那权且代的特点是医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(艾达m,1982;
Dickson和Lee-比利亚senor,一九八五)。(参见护理科学开展,护理管理杂志和美国护经济学杂志关于美利坚合众国支持者的例子和国际扶助者例子中的高级护理杂志)。在这么些时代还出现了另一组:理论合成器。提倡者与合成者之间的距离处于分析范围的程度。倡导者提倡护理理论,并将其用来讨论项目或少于的施行领域。这几个合成器超出了区区的运用范围来讲述和分析护理理论怎样影响护理实践,教育,研商和治本。合成器的事例包罗但不限于Fitzpatrick和Whall(1982,一九九八)和Fawcett(壹玖捌伍,一九九三)。罗吉尔斯第③遍全国会议(1982年)及随后的理论家,实践者和探究人士从不一致的角度谈谈了罗杰斯理论的效应,这是立见作用综合理论分裂用法的另3个事例。这次会议的策划者属于理论合成器组。是论战不一样用途的卓有功用综合的另一个例证。本次会议的策划者属于理论合成器组。是辩论不一样用途的管用综合的另二个例子。本次会议的发行人属于理论合成器组。

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.

有的反驳合成器在20世纪70时期中叶从纽约大学毕业。有一件不容忽视的事情是纽约大学护理项目对促进理论护理的震慑。通过对一九四五年至1984年London高校护艺术学大学生杂文标题标回想可以精晓地来看那或多或少,那清楚地表明了1个运用连贯的说理框架的看护高校怎样推动连贯的研讨议程。半数以上杂文标题都标明了医护观点,就像是积累知识发展的尝尝。但是,那种情势如何以及以何种方法影响和恐怕连续影响理论发展是2个值得进一步查明和剖析的圈子,大家每隔一段时间就汇合到1遍罗吉尔里安集会,会让无数护师学者一起讲同样的辩论语言并出示他们的研讨成果。这么些关于护理知识的发现,整合和换代的团圆饭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.

本条时期的性状是承受理论作为1个工具,从首要的推行难题,可用以带领实践和探讨工具。这么些时代的特性是论战和钻研时期的涉嫌比理论和施行之间的涉及进一步清晰。

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.)

在那段时日里剩余的一个模糊与语义有关。概念模型被叫做概念框架,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③3章有关罗吉尔斯理论的议论。)

1986–1990—From Metatheory to Concept Development

壹玖捌玖-1989-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.

那一个里程碑的多少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。这一时半刻代的另三个特点是认识到理论与履行之间的反差。认识论辩论包涵与讲述知识发展的别样方法有关的标题,如气象学的行使,批判理论,女性主义或经验主义方法论,以及哪些将方言方法与辩论和施行联系起来(如阿伦,1983;
Allen et al。 1987; Hagell,1988;
Leonard,一九九零)。即便辩论的基本点集中在文化发展上而不是课程的反驳发展上,但这个理论与辩论护理的升华也有涉嫌。

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.

实惠的剖析主要集中在与中心护理概念有关的本体论信念,例如环境(Chopoorian,壹玖捌玖;
史蒂文斯,1986)和例行(Allen,1982,一九八七;
Benner,壹玖捌贰)。这一个分析大大扩充了驾驭每种概念的更加多田地方法。那么些分析还狠抓了护师对利用框架的须要性的认识和发现,那些框架允许对医护现象开展归结,全体和情状描述,这个情形超出了民用客户的限量。那几个作者注脚,那样的框架保持了历史上引导医护实践的基本本体论信念的完整性,例如全体论,综合反应和与环境的关系。

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.

以此里程碑的第三个属性是与概念开发有关的着作扩大。那么些提高与早先时期的申辩发展差异,那一个发展包含对“什么是医护”那样的貌似难题的回应。这个分析特别以实施为导向,是完好的,并且表示了单领域理论发展的中期尝试。那也是对物质举行抗辩的时代(Chinn,一九八八;
唐斯,1989; Meleis,1986;
伍德s,一九八八)。那几个小编答疑了其他课程成员的见地,并促使更关心医疗对象面临的实质性难题的言辞。

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功底上,进度辩论成为辩论发展的潜在力量。由此,与其辩解批判理论或女权主义理论是不是更适同盟为该课程的艺术学基础,人们或者会争辨从那二种意见或三种观点来看环境依旧舒适都尤其实用。这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启幕

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取得长足进步的一个根本里程碑显示在那权且期发展兴起的广大中级范围理论中。其中一部分被标记为理论(例如,Younger的操纵理论[1991]或Mishel的不分明性理论[1990])。其余人被认为正在成为辩论。(请参阅Funk,Tornquist,Champage,Copp和Wiese
[1990]有关复苏和Hagerty,Lynch-Sauer,帕特usky和Bouwsema
[1993]关于她们关于人类相关性的新生理论的首要方面的议论。)中等范围理论重点对反映并从护理实践中涌现出来并敬重治病进程的现实护理现象(Meleis,一九八七)。它们提供了浮现学科价值的概念主旨和思维图像。

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.

具体情形的说理恐怕正在变成另1个里程碑,纵然它们在晚些时候有更好的定义。它们是更具临床意义的论争,反映特定背景的反驳,并且或然包含行动蓝图。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进行框架更抽象(Meleis,一九九七;
Im and Meleis,1996;
Im,二〇〇七)。这一个针对具体意况的理论大概出现于综合和组合有关特定情景或人群的钻研结果和诊疗样本,以期提供框架或蓝图来驾驭一组客户的一定情景。它们是为着酬答关于限制有限且首要有限的景况的一名目繁多连贯难点而制定的论战。例如,可以从切磋结果,临床样本以及护师对那几个人群的医护经验中升华出中东移民健康疾病转变反应情势的定义(Meleis,Isenberg,Koerner,莱西和斯特恩,一九九三年)。1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,这个干活儿取得这个人在本国的切近工作的支撑,那有助于注解移民前的一言一行和影响形式,并有助于提供历史以及移民在新江山的反应的社会文化背景。可以从钻探结果,临床样本以及医护人员在这一位群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中发展出中东移民对平常疾病转变反应格局的定义。斯特恩,1994年)。1个例证是器重于中东移民(阿富汗人,伊朗人,埃及(Egypt)人和阿拉伯人)的工作,那一个干活儿赢得这么些人在小编国的近乎工作的扶助,那促进讲明移民前的表现和反应方式,并促进提供历史以及移民在新国家的反馈的社会文化背景。可以从商讨结果,临床样本以及医护人员在那一人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中前行出中东移民对正规疾病转变反应情势的概念。斯特恩,一九九一年)。多个例子是器重于中东移民(阿富汗人,伊朗人,阿拉伯埃及共和国(The Arab Republic of Egypt)(The Arab Republic of Egypt)人和阿拉伯人)的工作,那个工作得到那么些人在作者国的类似工作的支撑,那促进申明移民前的行事和反应方式,并推进提供历史以及移民在新国家的感应的社会文化背景。以及护理人士照顾这么些人群的经历(Meleis,Isenberg,Koerner,Lacey和Stern,一九九二)。二个例子是重视于中东移民(阿富汗人,伊朗人,埃及(The Arab Republic of Egypt)人和阿拉伯人)的办事,这一个干活儿取得这一个人在本国的接近工作的支撑,那有助于声明移民前的行为和反应方式,并有助于提供历史以及移民在新国家的反响的社会文化背景。以及护理人员照顾那么些人群的经历(Meleis,Isenberg,Koerner,Lacey和Stern,一九九三)。三个例子是爱戴于中东移民(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,那些工作得到这几个人在小编国的近乎工作的帮衬,那促进申明移民前的表现和反应格局,并拉动提供历史以及移民在新国家的反馈的社会文化背景。

1996–2000—Evidence Means Research, Not Theory

1999年至三千年 – 证据意味着讨论,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).

按照证据的履行在文献中从循证实践到循证护理的洋洋讲话中衍生和变化而来。在这么些里程碑时期,关于该科目标文献敬爱于分明利用保健模型与顶尖证据,将商讨转化为推行以及选取使用商讨(丹麦语,1998年)之间的相似之处和差别之处。为了显然证据,探讨了概念个体研讨质量的方法,整合商量结果的法子,判断综合发现的正统以及可以用来文献的凭据(Goode,三千;
McKee,Britton,Black,
McPherson,Sanderson,Bain,一九九七)。几特性子区分了那些里程碑。首先,超越二分一会话最初都是基于教育学领域的争持,那将“证据”下落到生物农学,经验和实证主义的变量和正式(Lohr
and
凯雷,一九九七)。第②个本性是关于证据的投降观点的批判性对话,这个理念大概带有与护理科学更平等的组成部分,并且来自于如何定义护理知识和知识。这么些关键的对话包蕴商讨扩充证据的含义以使其更为多元化,将人文经验和私家经验作为待用情势的凭证(Clarke,1998)。可是,从这一个框架内判断证据的正规还平昔不被追究,也尚无查获显著的想法。这一里程碑的第③项属性是关爱在卫生保健机构实施最佳证据的特级策略。

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从严审批数据证据提供框架,整合评审以明确最佳支持证据,开发和推行最佳团队基础设备以履行和放手最佳实践方面发挥着关键职能(Foxcroft,Cole,
Fullbrook,Johnston,史蒂Vince,2004)。

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.)

这一里程碑的第六项属性是其在海内外各市的魅力和选择基于证据的定义。分化地方的护士,讨论人口和临床医生加入了关于医疗医务人员按照研讨的文化的汇总评估和可访问性的对话。(见汤普森,McCaughan,Cullum,Shelton,Mullhall和Thompson二零零一)

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.)

这一里程碑的尾声3个特征是贫乏关于理论或经济学在推进证据性质方面的兵不血刃的反驳对话,扶助艺术多元化的前提,解释框架和结果拔取偷偷的尺码。从以实施为根基的循证论述转变为以研究为底蕴的对话恐怕会挑起对护理实践的开拓性理论研讨。(Doane和Varcoe,2009;
霍姆斯,Murray,Perron和Rail,贰零零柒; 霍姆斯,罗伊和Perron,2010)

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

2004-二〇〇七 – 思想的三种性:联系理论与执行

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).

关怀多元化是本学科理论发展历程中这一里程碑的标志。随着专家的地点,种族和价值观三种化,并且随着他们对出入越发中意,他们的静脉曲张起初产出在文献中,反映了他们分歧的历史观,信仰和目的。思想和辩解各类化的例子是来自不一致国家的看护的例证。理论是由芬兰共和国和瑞典王国的医护人员开发的,并且有关更实际的辩护表明的对话反映了不一致国家的切实越来越受欢迎(Salas,二零零五)。

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.

同一,在那么些里程碑时期,从局地扎根理论商讨项目提升理论以及因而结合不一致理论出发的二种见识出现了比原先更为强有力的对话。例如,Olshansky(二〇〇〇)举行了多个扎根理论项目并升华了一种“身份不孕”的争辩,并将这一答辩与Miller(一九九四)的“关系文化”理论相结合,以分解女性苦恼的绝密脆弱性,被显然为“不孕女孩子”。三种理论都被整合,并为这个女性在妊娠后发出的地点转变提供了更强劲的分解。该辩护解释说,纵然被分明为“不孕女人”的半边天可以怀孕,但他们很难认为本身是怀孕的。

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.

用作这一里程碑的注解,多样性表以往种种健康疾病的情景下,须求细致分析造成种种性的因素。其中包蕴年龄,种族,民族,遗产,性别和性方向。那种认识导致理论家和研商人士对以后的格局和假使进行批判,并提议替代性和更具内容的争辨思想。例如伯曼(Berman,2000)关于围绕孩童权力的轶闻,Im和Meleis(2004)在他们关于开发关心健康与疾病的性别敏感理论的提出中,以及Andersonet
al。(2004)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,二〇〇〇)定义了彰显这一里程碑的紧要话语。她的舆论是医护中有两种话语正在造就当代看护中的认知各种性。这一个是有关科学的说话更宽广和开明,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同意专擅代表不一样文化发展意见的主流领会和协和的评介。在3个强调最普遍意义上的二种性的时期中,认识的两种性恐怕使该课程的积极分子免于包容,并大概变化学科,使其确实呈现医护人员需求服务的人。那种二种性还会同意对权力差其他批判以及帮忙那种不雷同的共处互连网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,二〇〇五)。霍尔(2001)再度指示大家,在她的疾病经历中,有一段强有力的自传体记录,关于疾病经历的农学化以及生物历史学模型的碉堡怎么样不吻合病者及其眷属的特级利益。格奥尔格e(二〇〇六)使用批判女权主义的观点来发布她改写自身看做治疗医务卫生人员

  • 理论家 –
    院士探讨员身份的旅程。她为在21世纪头十年的政治和社会背景下将舌战与实践联系起来提供了三个强劲的法学论证。那种联系可以经过教学说理运用政策来贯彻,这个方针可以帮助学生发展他们的实践真实的声息。这么些里程碑的特征是对现状的批判,所处地方和见地的再一次概念化,以及对学识,种族背景,遗产,语言能力,性别和性取向的各类性予以敬重的辨析。

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

二零零六-二〇〇八年 – 护师授权:证据和技巧作为财富

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,跨学科时期和后殖民女权主义时代的特征是看护的3个根本里程碑,医护人员和看护标准人士在潜移默化护理方面的权杖。称作者为乐观主义者,但让自身付诸一些原因,为何小编以为那种转折点正在发生。许多商量从生物经济学方式,男权制等级和非器重制度管理机制(霍姆斯and Gastaldo,2003; 霍姆斯,罗伊 and
Perron,二零零六)对护理的非殖民化举办了座谈。将护理与那一个范式分开本人就是解放的;
可是,更相信的解放目标是选拔不相同的范式来率领理论发展和商量,那点在20世纪初期十年的看护文献中很显然(见护理科学,护理调查和护法学奖学金的演示)。黄金时段TV中医护人员的崛起地位以及他们当作强大的独门临床医务卫生人员的叙说是看护变化的形象和盛名度的别样例子。媒体发现,护理轶闻值得印刷,那标志记者正在认识到SUZUKI对那个珍重经验感兴趣。改良补偿,两种化就业选取的可用性,以及为职工独立的微型诊所采纳医护人员都以医疗保健系统权力结构变迁的一望可见。黄金时段电视机中护师的隆起地点以及她们作为有力的单身临床医师的讲述是看护变化的映像和盛名度的任何例子。媒体发现,护理传说值得印刷,那申明记者正在认识到Chevrolet对那几个宝贵经验感兴趣。改良补偿,七种化就业拔取的可用性,以及为员工独立的微型诊所采纳医护人员都以医疗保健系统权力结构变迁的马迹蛛丝。黄金时段电视机中护师的优秀地位以及他们作为有力的独立临床医务卫生人员的叙述是卫生员变化的形象和盛名度的别样例子。媒体发现,护理传说值得印刷,那标志记者正在认识到民众对那一个尊贵经验感兴趣。改良补偿,三种化就业选用的可用性,以及为员工独立的袖珍诊所选取护师都以医疗保健系统中权力结构变化的迹象。

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.

有关政坛为美利坚联邦合众国总人口提供安全,优质和公平医疗保健的道德职分的看病革新话语包含认可医护人员的角色是医疗改善的骨干。在论述中关系要求增加工作人士的看护人数,并有限援救充裕利用其能力,那本人就予以了医护人员权力。因此,关于初级卫生保健,以伤者为中央的护理以及医务人员和看护之间的同盟伙伴关系(无论是在议会上恐怕在管理学商量院出版物中),对医护知识和护理的价值予以尊重和认可(Frenk等,
二零零六; IOM,二零一二)。那一个在作者看来,是五个里程碑的目标: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?

还有任何迹象评释医护人员有能力有所作为。进入医院并察看处理患者追踪系统,医疗保健记录,自动药物车和远程监护系统的医护人员提议了累累标题。特别是,医护人员怎么着将理论框架与技术发展相结合,以及越发看重通过电脑举行交换?医护人员如何将注意力集中在医护和患者为主干的例行促进,关爱,安慰,减轻惆怅,促进作者照顾和幸福感的目的上,同时注意护理人士施加的新须要21世纪医院和家庭护理的音讯和监测技术特点?

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.

在音讯和技能的革新和错综复杂环境中关怀个体和家中的并置供给开发新的框架和护理情势。学科发展的那几个阶段通过在工程学,药学和消息科学等课程之间确立差异和新的搭档关系而赢得丰裕。

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.

人口老龄化,以及家庭老龄化人口和家园生活和照料短期患有个体的食指越多,要求开发和使用更实际的驳斥,以满足越来越显眼的一定须要人数。保险公司的补充和报废须求以及在此阶段推进文化的科普医疗改正框架方式的后果。商讨证据对于信誉,提供护理的安全性以及对劳动的增补根本。护师正在丰盛利用证据和技艺。

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.

本章介绍了与理论护理相关的重大历史大旨。理论护理的展开和前进是依据等级和里程碑来定义的。历史发展观提供了3个关于当前和前景的理论思考可以成立的主要性观点。没有追溯那一个历史核心,分析当前的上进是欠缺​​的。

图片 5

REFLECTIVE QUESTIONS

反射难题

1.对理论护理发展史的追忆在哪些方面阻碍或促进了医护学科的升华?
2.怎么阶段和里程碑对推进护理理论非常主要?为啥?
3.您怎么觉得 20世纪五 六十时期哥伦比亚共和国和加州洛杉矶分校大学护理高校的环境和学识对
理论家和申辩思维的进化起了促进作用?
4.抵触知识的等同性质是不是会造成理论探讨与实践之间的出入?假设是那样,那么
在21世纪的政治和制度中如何防止那几个差异啊?
5.你能找出更加多当代的反驳思考流派吗?什么样的环境只怕引致这一个理论话语中的每二个?
6.询问您对理论护理发展的早先时期等级和里程碑所做的劳作,你会怎么着预测今后的等级和里程碑?提供创设未来愿景的政策。
7.您觉得推进精晓理论护理历史的哪些阶段和里程碑未包涵在此次商量中?
8.从你本人的角度明确首要阶段和里程碑。你从阅读本章中拿走了有关理论护理的什么样观点?
9.您怎样描述您的学府(部门)的环境?你学校的环境以什么样形式推进你的学术发展?

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.

本章的首先有个别是基于AI Meleis(一九八二)。不断前行的护工学学科。在PL
Chinn(主编),护理理论发展进行,第①9-34页。转载于1982年的Aspen
Publishers许可。

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