Theory Evaluation Exemplar
Environmental Theory of Florence Nightingale
Scope of theory:Grand Theory
Purpose of the theory:“everyday sanitary knowledge, or the knowledge of nursing, or in other words, of how to put the constitution in such a state as that it will have no disease, or that it can recover from disease.” * Main focus was the control of the environment of individuals and families, both healthy and ill. * Because it explains the totality of the behavior.
Origins of theory: Nightingale’s model of nursing was developed before the general acceptance of modern disease theories (ie, the germ theory) and other theories of medical science. Nightingale knew the germ theory, and prior to its wide publication she had deduced that cleanliness, fresh air, sanitation, comfort and socialization were necessary to healing. She used her experiences in Scutari Army Hospital in Turkey and in other hospitals in which she worked to document her ideas on nursing. Major concepts:Major areas of the environment: health of houses, ventilation and warmth, light, noise, variety, bed and bedding, cleanliness of rooms and walls, personal cleanliness, and nutrition. Major theoretical propositions are as follows: Not stated
Major assumptions: NIGHTINGALE'S ASSUMPTIONS
1. Nursing is separate from medicine.
2. Nurses should be trained.
3. The environment is important to the health of the patient. 4. The disease process is not important to nursing.
5. Nursing should support the environment to assist the patient in healing. 6. Research should be utilized through observation and empirics to define the nursing discipline. 7. Nursing is both empirical science and an art.
8. Nursing’s concern is with the person in the environment. 9. The person is interacting with the environment.
10. Sick and well are governed by the same laws of health. 11. The nurse should be observant and confidential.
Context for use: Healthy environment promotes health by meeting client’s needs. Assisting the patient in his or her retention of “vital powers” by meeting his or her needs, and thus, putting the patient in the best condition for nature to act upon.
Theoretical definitions for major concepts:
Health of Houses
* Nightingale said, "Badly constructed houses do for the healthy what badly constructed hospitals do for the sick. Once insure that the air is stagnant and sickness is certain to follow." Ventilation and Warming
* Nightingale stated that it was essential to "keep the air he breathes as pure as the external air, without chilling him". * She urged the caregiver to consider the source of air in the patient's room. And stressed the importance of room temperature. Light
* Noted that “quiet real and tangible effects upon the human body". Noise
* Stated that patients should never be waked intentionally or accidentally during the first part of sleep. * She viewed it as the nurse's responsibility to assess and stop the noise. * While specific testing of the effects of noise has been done, it has not been under the framework of Nightingale. The exception is the work by McCarthy, Quimet, and Daun 1991 who extrapolated data from animal studies to support Nightingale's assertion that noise affects healing. Variety
* Discussed the need for changes in color and form. Including bringing the patient brightly colored flowers or plants. * Nightingale also advocated reading, needlework, writing, and cleaning as activities to relieve the sick of boredom. Bed and Bedding
* Noted that an adult in heath exhales about three pints of moisture through the lungs and skin in a 24-hour period. This organic matter enters the sheets and stays there unless the bedding is changed and aired frequently. * In modern hospitals mattresses are usually covered with plastic or other materials that can be washed to remove drainage, excreta or other matter. These...
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