2. INTRODUCTIONINTRODUCTION
According to Mercer (1984) andAccording to Mercer (1984) and
Silva (1986) states that research isSilva (1986) states that research is
the process through which thethe process through which the
knowledge base for nursingknowledge base for nursing
practice grows. Theorypractice grows. Theory
conceptualizes the abstract natureconceptualizes the abstract nature
of the relationship amongof the relationship among
concepts. Research, however, isconcepts. Research, however, is
the systematic inquiry into thethe systematic inquiry into the
possible relationships amongpossible relationships among
particular Phenomena.particular Phenomena.

3. Theoretical formulations supported byTheoretical formulations supported by
research findings may potentiallyresearch findings may potentially
become the foundations of theory-become the foundations of theory-
based practice in nursing. Theoreticalbased practice in nursing. Theoretical
knowledge derived from either aknowledge derived from either a
qualitative or a qualitative source mustqualitative or a qualitative source must
have clinical relevance to be useful tohave clinical relevance to be useful to
professionals in clinical practice and toprofessionals in clinical practice and to
society in general.society in general.


4. DEFINITION OF THEORYDEFINITION OF THEORY
““A theory is a statement thatA theory is a statement that
purports to account for or characterizepurports to account for or characterize
some Phenomenon” and that it “pullssome Phenomenon” and that it “pulls
out the salient parts of a Phenomenonout the salient parts of a Phenomenon
so that one can separate the Criticalso that one can separate the Critical
and necessary factors (or relationships)and necessary factors (or relationships)
from the accidental and unessentialfrom the accidental and unessential
factors (or relationships)factors (or relationships)

5. PURPOSE OF THEORY IN RESEARCHPURPOSE OF THEORY IN RESEARCH
 It serves to make research findingsIt serves to make research findings
meaningful and interpretable.meaningful and interpretable.
 It allows researchers to knit togetherIt allows researchers to knit together
observations into an orderly systems.observations into an orderly systems.
 It also serve to explain research findingsIt also serve to explain research findings
 It guides the researcher’s understanding notIt guides the researcher’s understanding not
only of the ‘what’ of natural phenomena butonly of the ‘what’ of natural phenomena but
also of the ‘why’ of their occurrence.also of the ‘why’ of their occurrence.
 It help to stimulate research and theIt help to stimulate research and the
extension of knowledge by providing bothextension of knowledge by providing both
direction and impetus.direction and impetus.

6. DEFINITION OF THEORETICALDEFINITION OF THEORETICAL
FRAMEWORFRAMEWOR
A theoretical framework isA theoretical framework is
analogous to the frame of a house.analogous to the frame of a house.
A theoretical framework provides aA theoretical framework provides a
context for examining a problem,context for examining a problem,
that is, the theoretical rationale forthat is, the theoretical rationale for
developing hypotheses, just as adeveloping hypotheses, just as a
direction indicator provides adirection indicator provides a
context for using a road map.context for using a road map.

7.  It is also a frame a reference that is aIt is also a frame a reference that is a
base for observations, definitions ofbase for observations, definitions of
concepts, research designs,concepts, research designs,
interpretations, and generalizations, muchinterpretations, and generalizations, much
as the frame that rests on a foundationas the frame that rests on a foundation
defines the overall design of a house.defines the overall design of a house.
 Finally, a theoretical framework servesFinally, a theoretical framework serves
as a guide to systematically identifyingas a guide to systematically identifying
logical, precisely defined relationshipslogical, precisely defined relationships
among variables.among variables.

8. USES OF THEORITICAL FRAMEWORKUSES OF THEORITICAL FRAMEWORK
AS A GUIDE IN A RESEARCH STUDYAS A GUIDE IN A RESEARCH STUDY
 It bringing meaning to the problem and studyIt bringing meaning to the problem and study
findings.findings.
 It summarizes the existing knowledge in the fieldIt summarizes the existing knowledge in the field
of inquiry and identifies the linkages amongof inquiry and identifies the linkages among
defined concepts, thereby establishing a basis fordefined concepts, thereby establishing a basis for
predicting specific outcomes or generatingpredicting specific outcomes or generating
hypotheses.hypotheses.
 These linkages or propositions spell out howThese linkages or propositions spell out how
concepts are interrelated and lay a foundation forconcepts are interrelated and lay a foundation for
the development of methods that test the validitythe development of methods that test the validity
and strength of predicted relationship orand strength of predicted relationship or
hypotheses.hypotheses.

9. PURPOSE OF THEORETICALPURPOSE OF THEORETICAL
FRAMEWORK IN A RESEARCHFRAMEWORK IN A RESEARCH
STUDYSTUDY
A theoretical rationale serves as aA theoretical rationale serves as a
guide or map to systematicallyguide or map to systematically
identifying a logical, precisely definedidentifying a logical, precisely defined
relationship between variables.relationship between variables.
Provides clear descriptions ofProvides clear descriptions of
variables, suggesting ways or methodsvariables, suggesting ways or methods
to conduct the study.to conduct the study.
Guiding the interpretation, evaluationGuiding the interpretation, evaluation
and integration of study findings.and integration of study findings.

10. MAJOR THEORIES AND CONCEPTUALMAJOR THEORIES AND CONCEPTUAL
MODELS USED BY NURSEMODELS USED BY NURSE
RESEARCHERSRESEARCHERS
Nurse researchers have used bothNurse researchers have used both
nursing and non-nursing framework whichnursing and non-nursing framework which
provide a conceptual context for theirprovide a conceptual context for their
qualitative and quantitative studies.qualitative and quantitative studies.
 Sister Callista Roy’s Adaptation ModelSister Callista Roy’s Adaptation Model
 Martha Rogers Unitary human beingMartha Rogers Unitary human being
 King’s Open Systems ModelKing’s Open Systems Model
 Neuman’s Health Care Systems ModelNeuman’s Health Care Systems Model
 Orem’s Model of Self-CareOrem’s Model of Self-Care
 Parse’s Theory of Human Becoming.Parse’s Theory of Human Becoming.

11. Other than these nurses have developedOther than these nurses have developed
other models and theories that focus onother models and theories that focus on
specific phenomena of interest to nurses.specific phenomena of interest to nurses.
 Nola Pender’s Health Promotion ModelNola Pender’s Health Promotion Model
 Mishel’s Uncertainty in illness Theory – whichMishel’s Uncertainty in illness Theory – which
focuses on the concept of uncertainty – the infocuses on the concept of uncertainty – the in
ability of a person to determine the meaningability of a person to determine the meaning
of illnesss – related events.of illnesss – related events.
 Becker’s Health Belief ModelBecker’s Health Belief Model
 Lazarus and Folkmans theory of stress andLazarus and Folkmans theory of stress and
copingcoping
 Azjen and Fishbein’s theory of ReasonedAzjen and Fishbein’s theory of Reasoned
Action.Action.

13. MAJOR THEORIES USED INMAJOR THEORIES USED IN
EXPERIMENTAL RESEARCHEXPERIMENTAL RESEARCH
Orem’s Self-Care Deficit ModelOrem’s Self-Care Deficit Model
Bertanlanffy General Systems TheoryBertanlanffy General Systems Theory
Stuffle Beam’s Programme EvaluationStuffle Beam’s Programme Evaluation
ModelModel
Kenny’s Open Systems ModelKenny’s Open Systems Model
Rosenstock’s Health Belief ModelRosenstock’s Health Belief Model
Imogene King’s system’s Theory ofImogene King’s system’s Theory of
Goal AttainmentGoal Attainment

14. APPLICATION OF OREM’S SELFAPPLICATION OF OREM’S SELF
CARE DEFICIT THEORYCARE DEFICIT THEORY
The central idea in Orem’s theoryThe central idea in Orem’s theory
is that the individuals areis that the individuals are
affected by limitations from timeaffected by limitations from time
to time that do not allow them toto time that do not allow them to
meet their self –care needs.meet their self –care needs.

15.  Self-care as theSelf-care as the
practice of activities thatpractice of activities that
individual initiate andindividual initiate and
perform on their ownperform on their own
behalf in marinating life,behalf in marinating life,
health and well-being.health and well-being.

16.  Dependent care is theDependent care is the
action performed by responsibleaction performed by responsible
adults to meet the components ofadults to meet the components of
their dependent therapeutic self-their dependent therapeutic self-
care demand.care demand.
 Dependent care agency is theDependent care agency is the
ability of responsible adults toability of responsible adults to
meet the continuing demands formeet the continuing demands for
self – care of their dependents.self – care of their dependents.

17. Dependent care deficit is an unequalDependent care deficit is an unequal
relationship between capabilities ofrelationship between capabilities of
responsible adults and the dependentresponsible adults and the dependent
persons who require therapeutic self-carepersons who require therapeutic self-care
demand.demand.
Nursing agency is defined as theNursing agency is defined as the
complex property or attributes of personscomplex property or attributes of persons
educated and trained as nurses that iseducated and trained as nurses that is
enabling others to know their therapeuticenabling others to know their therapeutic
self-care demand, for helping others to meetself-care demand, for helping others to meet
or in meeting their therapeutic self-careor in meeting their therapeutic self-care
demand and in helping others to regulatedemand and in helping others to regulate
the exercise or development of their self-the exercise or development of their self-
care agency or their dependent carecare agency or their dependent care
agency.agency.

18. Effectiveness of a structuredEffectiveness of a structured
teaching programme amongteaching programme among
mothers of asthmatic children onmothers of asthmatic children on
home management of childernhome management of childern
with asthma in a selectedwith asthma in a selected
hospitals of Udupi district,hospitals of Udupi district,
Nishe,2000.Nishe,2000.

20. Application of General SystemsApplication of General Systems
Theory by Bertanlanffy (1968)Theory by Bertanlanffy (1968)
Effectiveness of instruction cumEffectiveness of instruction cum
treatment on haemoglobin, serumtreatment on haemoglobin, serum
ferritin and intelligence level amongferritin and intelligence level among
anaemic adolescent girls in selectedanaemic adolescent girls in selected
schools, Mangalore district,schools, Mangalore district,
Karnataka.Karnataka.

21. Theoretical framework selected for this study isTheoretical framework selected for this study is
based on General Systems Theory bybased on General Systems Theory by
Bertanlanffy (1968). In this theory main focus isBertanlanffy (1968). In this theory main focus is
on the discrete parts and their interrelationship,on the discrete parts and their interrelationship,
which makes up and describes the whole. Hewhich makes up and describes the whole. He
defines system as a complex interaction whichdefines system as a complex interaction which
means that system consists of two or moremeans that system consists of two or more
converted elements which form an organizedconverted elements which form an organized
whole and which interest with each other. Thewhole and which interest with each other. The
elements in this study which are organized toelements in this study which are organized to
get the effect of treatment I & II in relation toget the effect of treatment I & II in relation to
haemoglobin and serum ferritin.haemoglobin and serum ferritin.

22. According to him ‘input’ refers toAccording to him ‘input’ refers to
energy, matter and information. Allenergy, matter and information. All
systems must receive varying typesystems must receive varying type
and amount of information from theand amount of information from the
environment. This system uses theenvironment. This system uses the
input to maintain its homeostasis.input to maintain its homeostasis.

23. According to him ‘throughput’According to him ‘throughput’
refers to the process by whichrefers to the process by which
the system process input andthe system process input and
release an output.release an output.

24. According to him ‘output’ refers toAccording to him ‘output’ refers to
matter, energy and information thatmatter, energy and information that
leave a system.leave a system.
According to him the feed back refersAccording to him the feed back refers
to the output that is returned to theto the output that is returned to the
system that allows it to monitor itselfsystem that allows it to monitor itself
overtime in an attempt to move closerovertime in an attempt to move closer
to a steady state known as equilibriumto a steady state known as equilibrium
or homeostasis. Feedback may beor homeostasis. Feedback may be
positive, negative or neutral.positive, negative or neutral.

25. According to him system as a whole; aAccording to him system as a whole; a
dysfunction of a part causes a symptomdysfunction of a part causes a symptom
disturbance rather than loss of a singledisturbance rather than loss of a single
function. In all system activity can befunction. In all system activity can be
resolved in to an aggregation ofresolved in to an aggregation of
feedback circuits such as the input,feedback circuits such as the input,
through put and output. The feedbackthrough put and output. The feedback
circuits helps in the maintenance of intactcircuits helps in the maintenance of intact
system.system.

27. Application of Context- Input-Application of Context- Input-
Process-Product [CIPP] modelProcess-Product [CIPP] model
 A study to determine theA study to determine the
effectiveness of need basedeffectiveness of need based
teaching protocol on nursesteaching protocol on nurses
responsibility in ABG Analysis forresponsibility in ABG Analysis for
the, nursing personal working inthe, nursing personal working in
critical care units in a selectedcritical care units in a selected
hospital in Karnataka – Sonali,hospital in Karnataka – Sonali,
2003 used this model.2003 used this model.

28. The present study has aimed at developing andThe present study has aimed at developing and
evaluating a teaching protocol on “Nurses’evaluating a teaching protocol on “Nurses’
Responsibility in ABG Analysis” for the nursingResponsibility in ABG Analysis” for the nursing
personnel working in the critical! care units.personnel working in the critical! care units.
The conceptual framework of this study wasThe conceptual framework of this study was
based on Stufflebeam’s, (1973)based on Stufflebeam’s, (1973) Context-Context-
Input-Process-Product (CIPP)Input-Process-Product (CIPP) model. It’smodel. It’s
a four-step model of programme evaluationa four-step model of programme evaluation
developed for obtaining useful information fordeveloped for obtaining useful information for
taking decisions. It provides a comprehensive,taking decisions. It provides a comprehensive,
systematic, continuous, ongoing framework forsystematic, continuous, ongoing framework for
programme-evaluation.programme-evaluation.

29. Stufflebeam has identified four types ofStufflebeam has identified four types of
decision.decision.
 Planning decision will determine thePlanning decision will determine the
objectives of the programme.objectives of the programme.
 Structuring the decision in which theStructuring the decision in which the
procedure strategies need to achieve theprocedure strategies need to achieve the
objectives is made.objectives is made.
 The model involves implementing theThe model involves implementing the
decision and lastly, recycling decision todecision and lastly, recycling decision to
make changes in response to the outcomemake changes in response to the outcome
of the programme.of the programme.
 With each step comes a specific type ofWith each step comes a specific type of
evaluation, which Stufflebeam labeled asevaluation, which Stufflebeam labeled as
context, input, process and output.context, input, process and output.

30. Context evaluation defines theContext evaluation defines the
environment in which theenvironment in which the
programme will operate in bothprogramme will operate in both
the actual and desiredthe actual and desired
conditions, observation,conditions, observation,
interview and archival datainterview and archival data
provide the basis for contextprovide the basis for context
evaluation.evaluation.

31. Input evaluation is necessary toInput evaluation is necessary to
make structural decisions. Itmake structural decisions. It
includes assessing relevantincludes assessing relevant
capabilities of those involved incapabilities of those involved in
the programme, strategies forthe programme, strategies for
achieving objectives and waysachieving objectives and ways
of implementing the strategies.of implementing the strategies.

32. Both context and input evaluationBoth context and input evaluation
begin before the programmebegin before the programme
starts but the process evaluationstarts but the process evaluation
is a formative evaluation and asis a formative evaluation and as
such provides feedback data tosuch provides feedback data to
guide programme modificationguide programme modification
before implementation.before implementation.

33. After implementation of theAfter implementation of the
programme product evaluation isprogramme product evaluation is
done which measures programmedone which measures programme
achievements, leading to recyclingachievements, leading to recycling
decisions by determining if theydecisions by determining if they
have met the objectiveshave met the objectives..

34. Schematic Representation of the CoSchematic
Representation of the Conceptual Framework
nceptual Framework
Context Evaluation Input Evaluation Process Evaluation Product Evaluation
•· Critical care nursing
units.
• Nursing personal
with diploma, working
in the critical care units
having working
experience less than 2
years, 2-4 years and
above 4 years.
• Assessed learning
need by a Structured
Knowledge
Questionnaire in all
aspects of “Nurses’
Responsibility in ABG
Analysis”.
• Quality nursing care
• Existing knowledge
and practice of nursi
Existing knowledge and
practice of nursing
personnel assessed by
a Knowledge
Questionnaire and
practice level by
Observation Checklist.
• Developing a
teaching protocolon
“Nurses’ Responsibility
in ABG Analysis”.
• Teaching strategy
Lecture cum
discussions and
demonstration.
• Need Assessment
• Establishing Need
Assessment
• Establishing validity
of the research tools.
• Establishing reliability
of the tools.
• Pilot study.
• Modification of tools
and teaching protocol.
• Conducting pre-test,
teaching and post-test.
• Analysis of the effectiveness
of the teaching protocol in
terms of effectiveness of the
teaching protocol in terms of
gain in knowledge and
practice of the nursing
personnel
• gain in knowledge and
practice of the nursing
personnel
Conceptual framework for development and evaluating of a teaching Protocol on “Nurses’ Responsibility in ABG Analusis” modified
from Stufflebeam’s (1973. CIPFig .1 Conceptual framework for development and evaluating of a teaching Protocol on “Nurses’

35. APPLICATION OF KENNY’S OPEN
SYSTEM MODEL
ASSESS THE EFFECTIVENESS OF
PLANNED NURSING CARE FOR THE
PATIENTS WITH LOWER SEGMENT
CESAREAN SECTION IN K.N RAO
HOSPITAL, SALEM, 2006.

36. It was developed based on system theory of
Ludwing Von Bertalanffy (1968). According
to Kenny, all living systems are open; they
are in continuous exchange of matter,
energy, and information which results in
varying degree of interaction with the
environment from which the system
received input and gives back output in the
form of matter, energy and information.

37. INPUT
The input can be matter, energy and
information from the environment.
THROUHPUT
The matter, energy and information
are continuously processed through
the system which is also called
complex transformation known as
throughput.

39. FEEDBACK
For feedback information and
environmental responses by the
system needs adjustment, correction
and accommodation to the interaction
with the environment.

40. APPLICATION OFAPPLICATION OF
ROSENSTOCK’S HEALTHROSENSTOCK’S HEALTH
BELIEF MODELBELIEF MODEL
 A study to determine theA study to determine the
effectiveness of planned patienteffectiveness of planned patient
teaching programme on diabeticteaching programme on diabetic
diet, prescribed medication anddiet, prescribed medication and
foot care for diabetic clients in afoot care for diabetic clients in a
selected hospital of Udupi District,selected hospital of Udupi District,
Usha OV, 2001.Usha OV, 2001.

41. The present study aims atThe present study aims at
developing and evaluating adeveloping and evaluating a
planned patient teaching programplanned patient teaching program
on diabetic diet, prescribedon diabetic diet, prescribed
medications and foot care inmedications and foot care in
terms of their gain in knowledgeterms of their gain in knowledge
and compliance. The conceptualand compliance. The conceptual
framework of the study was basedframework of the study was based
on modified Health Belief Modelon modified Health Belief Model
of Rosenstock.of Rosenstock.

42. In this model human behaviour is seen asIn this model human behaviour is seen as
being dependent upon two primary variables.being dependent upon two primary variables.
(1). the values placed by a person upon a(1). the values placed by a person upon a
particular outcome and (2) the persons beliefparticular outcome and (2) the persons belief
that a given action will result in that outcome.that a given action will result in that outcome.
The individual perception about the susceptibilityThe individual perception about the susceptibility
and occurrence of the disease will make theand occurrence of the disease will make the
person take preventive action to avoid theperson take preventive action to avoid the
disease. The assumption in this model is that thedisease. The assumption in this model is that the
perception will always have a personalperception will always have a personal
implication, that by taking a particular action theimplication, that by taking a particular action the
susceptibility of developing diabeticsusceptibility of developing diabetic
complications would be reduced or diabetes cancomplications would be reduced or diabetes can
be controlled.be controlled.

43. The perceptions in the present study areThe perceptions in the present study are
perceived susceptibility to complications.perceived susceptibility to complications.
The attitude of the diabetic clients whichThe attitude of the diabetic clients which
can be influenced by the teaching programcan be influenced by the teaching program
and which will determine their healthand which will determine their health
behaviour i.e. prevention of complicationsbehaviour i.e. prevention of complications
and reduce the cost of care. It is alsoand reduce the cost of care. It is also
assumed that a particular teachingassumed that a particular teaching
program will improve the diabetic client’sprogram will improve the diabetic client’s
knowledge towards their care, which willknowledge towards their care, which will
result in improvement in compliance.result in improvement in compliance.

45. APPLICATION OF IMOGENEAPPLICATION OF IMOGENE
KING’S SYSTEMS THEORY OFKING’S SYSTEMS THEORY OF
GOAL ATTAINMENTGOAL ATTAINMENT
 A study to find the side effects ofA study to find the side effects of
chemotherapy as experienced by thechemotherapy as experienced by the
cancer patients and the effectiveness ofcancer patients and the effectiveness of
information guide on the knowledge andinformation guide on the knowledge and
practice of cancer patients regarding itspractice of cancer patients regarding its
relieving measures in a selected hospitalrelieving measures in a selected hospital
of Udupi Disk,Jacob JA, 2002of Udupi Disk,Jacob JA, 2002

46. The framework is adopted from ImogeneThe framework is adopted from Imogene
King’s System’s Theory of GoalKing’s System’s Theory of Goal
Attainment. King (1989) states that “theAttainment. King (1989) states that “the
structure of a system interacting withstructure of a system interacting with
an environment”.an environment”.

47.  According to King “nursing function includeAccording to King “nursing function include
viewing, recognizing, observing, synthesizing,viewing, recognizing, observing, synthesizing,
interpreting and analyzing which are within theinterpreting and analyzing which are within the
context of nursing process. It includes thecontext of nursing process. It includes the
interpretation of specific information to plan,interpretation of specific information to plan,
implement and evaluate the nursing care. Sheimplement and evaluate the nursing care. She
further states that “…the major focus of thefurther states that “…the major focus of the
theory is the interpersonal system, becausetheory is the interpersonal system, because
what nurses do with and for individual is whatwhat nurses do with and for individual is what
makes the difference between nursing and anymakes the difference between nursing and any
other health profession.other health profession.

48.  Action is based on the perceptionsAction is based on the perceptions
and judgement of the nurse and the clientand judgement of the nurse and the client
engaged in interactions and leads toengaged in interactions and leads to
transaction. Goal attainment is thetransaction. Goal attainment is the
transaction phase of the nursing processtransaction phase of the nursing process
which takes place through mutual goalwhich takes place through mutual goal
setting, exploration and agreement tosetting, exploration and agreement to
means to achieve goal and the evidencemeans to achieve goal and the evidence
of behaviour that moves toward goalof behaviour that moves toward goal
attainmentattainment