The relationship between nursing theory and research is integral. One cannot exist without the other. At all stages in the development and implementation of nursing theories, research plays a central role. Research, including clinical practice and experience, must be at the core of all theory because theory eventually must be put into action.
The basic approach to theory laid out by nursing theorists Barbara Dossey and Lynn Keegan has four components: description, explanation, prediction and prescription. These are fairly simple steps in the development of real theory-based nursing practice. Description is the arrangement of concepts, including care, support and assistance, where the explicit connections among them are laid out. A description is really a concept map where factors like emotional support and hands-on care can be connected to a speedy recovery. Explanation is the relationship among them. Prediction is what these concepts are supposed to accomplish, and prescription is putting them into practice. Each of these stages is tightly connected to clinical research.
The purpose here is to lay out the connection between the four stages of theory development and their connection to research. For descriptions, concepts in nursing must be backed up by and derive from experience and clinical practice or they are useless. Explanation is complex in that it shows how nursing concepts interrelate and reinforce one another. The concept of recovery is connected with the concept of care. Precisely how the connection works out in practice is the domain of research. Prediction is the more formal area of research, since these connections must be proven statistically, which involves substantial research. Lastly, prescription is the most active part of nursing theory, and is the real testing ground of all previous research.
Consider, for example, the relation between medication and positive reinforcement from nurses. Clinical research might hold that there is a close relationship between the benefits of medication when part of nursing care. Nurses in this case might assist the action of medication through a constantly positive and supporting attitude with patients. Recovery is then a connection between positive support and the proper medication. If research can establish this connection, then nurses in day-to-day practice will realize that their attitudes and positive support has a lot to do with recovery.
The main effect is to bring all the relevant concepts in nursing into an interrelated whole. The actions of real nursing and patient care cannot be isolated from one another. Research is central here because nurses (and especially students) must come to recognize how the main concepts interrelate in both theory and practice. Nursing is a holistic science, not isolated sets of routinized tasks. It is holistic in that it can never be reduced to mere clinical care, it concerns the whole the person: spiritual, physical, emotional and social. Without grasping these values, a real ethic of care can never truly show itself.
The real significance here is that nursing is coming into its own. So much prior thinking on nursing had nurses as adjuncts to doctors. This is not the case, especially since nurses spend the most time with patients and are central to basic patient needs. Therefore, the relation between nursing and clinical research is based around the idea that nursing is a medical field and a profession in its own right, not just a group of assistants who help doctors do their jobs.
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