Schwartz-Barcott Donna, Patterson Barbara J, Lusardi Paula, Farmer Bonnie Cashin
College of Nursing, University of Rhode Island, Kingston, USA.
J Adv Nurs. 2002 Aug;39(3):281-9. doi: 10.1046/j.1365-2648.2000.02275.x.
Theory that is directly linked with clinical experience has far greater relevance for nursing practice; however, problems continue to persist with the establishment of that linkage. The use of fieldwork as a strategy for developing and linking theory has enormous potential for enhancing the number of theories that truly fit the clinical practice realities of nursing. Traditionally, fieldwork has been conducted in contexts that are unfamiliar to the researcher. However, nurses have a wealth of clinical understanding in their areas of practice. Conduct of inquiry in a familiar practice area may facilitate identification of significant, clinically relevant concepts and expedite theory development that is closely linked to nursing practice.
wo-step fieldwork approach and three specific strategies are presented that have been found useful for developing theory that is tightly aligned with nursing practice. The strategies of theoretical selectivity, theoretical integration, and theory creation are described and an example of each presented. The strategies are an extension of the Hybrid Model of Concept Development. These strategies identify alternative paths for concept clarification and theoretical congruence through fieldwork in clinical settings. The focus of theoretical selectivity is elaboration of concept definition with selection among theories. In contrast, the focus of theoretical integration is the linking of a central concept with an existing theory or perspective in the prefieldwork phase and then using the full fieldwork to evaluate its usefulness. Lastly, the theory creation strategy emphasizes describing a phenomenon of interest, identifying influencing factors, and beginning to create relational statements. It is closest to standard inductive theory development.
与临床经验直接相关的理论对护理实践具有更大的相关性;然而,建立这种联系的问题仍然存在。将实地考察作为发展和联系理论的一种策略,对于增加真正符合护理临床实践现实的理论数量具有巨大潜力。传统上,实地考察是在研究人员不熟悉的背景下进行的。然而,护士在其执业领域拥有丰富的临床知识。在熟悉的执业领域进行探究可能有助于识别重要的、与临床相关的概念,并加快与护理实践紧密相关的理论发展。
提出了一种两步实地考察方法和三种具体策略,这些方法和策略已被证明有助于发展与护理实践紧密结合的理论。描述了理论选择性、理论整合和理论创造的策略,并给出了每个策略的一个示例。这些策略是概念发展混合模型的扩展。这些策略通过临床环境中的实地考察,确定了概念澄清和理论一致性的替代途径。理论选择性的重点是在各种理论中进行选择,以详细阐述概念定义。相比之下,理论整合的重点是在实地考察前阶段将一个核心概念与现有理论或观点联系起来,然后利用整个实地考察来评估其有用性。最后,理论创造策略强调描述感兴趣的现象,识别影响因素,并开始创建关系陈述。它最接近标准的归纳理论发展。