Chalmers H A
Recent Adv Nurs. 1989;24:32-46.
In summary, nursing models can be evaluated by carefully considering how human beings are conceptualised within a model, how adequately the model guides nurses in the decision-making associated with all stages of the nursing process and how appropriate is the expected role of the nurse. Reference to the criteria for evaluating nursing theory (Fig. 1) demonstrates that not only can nursing models be regarded as the precursors of nursing theory but some evaluative criteria for nursing theory develop from ways of evaluating nursing models (Fig. 2). The essence of this paper has been to consider nursing theory and its place in the current climate of concern both about nursing's professional status and about standards of patient care. The difficulty in defining theory has been briefly explored and suggestions have been made of possible ways of evaluating nursing theory. A distinction has been drawn between nursing models and nursing theory with a rationale for considering nursing models as precursors of nursing theory especially as there are similarities in the criteria used to evaluate them both. The nursing process has been described as a systematic, problem-solving approach to care. It is neither a nursing model nor a theory but rather one way of organising nursing activities. A major dilemma has been omitted from this paper, however, which nonetheless deserves mention here. This dilemma is identified and summarised by Jacox (1974) among others. The question posed is: Can and should we develop nursing theories?' (Jacox's emphasis). The main competing arguments put forward by Jacox are on the one hand that there are no phenomena or activities peculiar to nursing around which nursing theory can develop, and on the other hand that there is a need for a specified body of knowledge to inform nursing practice. Efforts to establish a firmer body of knowledge on which to base nursing practice may help to identify the unique function of the nurse. This will only be achieved if practising nurses take a keen interest in developing rigorous approaches to the evaluation of nursing models and theories. Craig (1980) has linked theory development and its integration with nursing practice to professional survival. If nurses cannot identify phenomena and activities that are peculiar to nursing and if they are not prepared to safeguard these areas of practice, then the future of nursing looks bleak. Project 2000 (UKCC 1986) offers an opportunity for nurses to be more willing and able to critically consider nursing's unique contribution to health care.
总之，可以通过仔细考量以下几个方面来评估护理模式：在一个模式中人类是如何被概念化的；该模式在指导护士进行与护理过程各阶段相关的决策时的充分程度；以及护士的预期角色的恰当性。参照评估护理理论的标准（图1）可以看出，护理模式不仅可被视为护理理论的先驱，而且护理理论的一些评估标准是从评估护理模式的方式发展而来的（图2）。本文的核心在于探讨护理理论及其在当前既关乎护理专业地位又关乎患者护理标准的关注氛围中的地位。已简要探讨了定义理论的困难，并提出了评估护理理论的可能方式。已对护理模式和护理理论进行了区分，给出了将护理模式视为护理理论先驱的理由，特别是因为用于评估二者的标准存在相似之处。护理过程已被描述为一种系统的、解决问题的护理方法。它既不是护理模式也不是护理理论，而是组织护理活动的一种方式。然而，本文遗漏了一个重大困境，不过在此仍值得一提。这个困境由雅科克斯（1974年）等人指出并总结。提出的问题是：“我们能够且应该发展护理理论吗？”（雅科克斯的重点）。雅科克斯提出的主要相互竞争的观点一方面是不存在护理特有的现象或活动可供护理理论围绕其发展，另一方面是需要有特定的知识体系来指导护理实践。努力建立更坚实的知识体系以作为护理实践的基础，可能有助于确定护士的独特功能。只有当执业护士对开发严谨的护理模式和理论评估方法产生浓厚兴趣时，这一目标才能实现。克雷格（1980年）将理论发展及其与护理实践的整合与专业生存联系起来。如果护士无法识别护理特有的现象和活动，并且不准备捍卫这些实践领域，那么护理的未来将一片黯淡。“2000计划”（英国中央助产士和健康访视员委员会，1986年）为护士提供了一个机会，使他们更愿意且有能力批判性地思考护理对医疗保健的独特贡献。
