School essay: outsourcing some brain work

I seem unable to come up with specific criticisms of what this nursing theory is missing

Can you go over the exercises suggested in comments on the "Be specific" post, and see if any of them sounds likely to help, or even merely dislodges new ideas for you?

For instance, along the lines of "Filing a bug report", could you try writing a letter to the Department of Theories Department at Knol-Mart, starting with the line "Dear Sirs, I am hereby returning to you my shipment of Roy's Adaptation Theory (nearly unused) which I found defective in the following ways. First, when I tried turning the Health knob on this Theory..."

For a more specific exercise, try locating the opposites of the definitions given. For instance, given a definition for "health", you should be able to invert the terms to get a definition for "illness".

For another, try comparing the theory with some other model - for instance the "naive" model of whatever-it-is that you would have used if you hadn't ever been exposed to the Roy thing, your "intuition" of these things - does the latter give you some specific conclusions, predictions and angles of attack? If so it's doing at least one thing better. Find out why.

For a third, try listing some things that you absolutely wouldn't expect a sane Theory to lead you to do (say, tell the poor guy to "stop whining and get a job"), and based on the general idea that theories should add up to normality, ask how Roy's Adaptation Theory specifically prohibits you from doing them. (If it doesn't, that's where it's broken.)

I thought nursing theory was something invented just to close the prestige gap with doctors.

The Wikipedia article makes it clear, perhaps unwittingly, that "theory" here does not mean what it means in science. In science, a theory is a coherent set of beliefs about how some phenomenon works that constrains your expectation about what you will observe to some subset of what you might observe. In the humanities and in most of social science, and apparently in nursing, it is the other way round: a theory is a coherent set of beliefs about how some phenomenon works that constrains your actual observations to lie within what the theory says they will be. This is why there are so many theories of the same thing, and no-one seems to care whether any of them are true, or even think that is a sensible question to ask.

But maybe you can't say that to your professor.

Maybe I don't understand the request entirely, but wouldn't any criticism depend not on the details of the theory, but on how well it works?

The point of a nursing theory is presumably to help nurses do their job. So if you want to know if a nursing theory is good, come up with some metric to measure nurse performance, train some nurses in the theory, and measure their performance compared to a control group.

The theory could be absolutely ridiculous to people looking at it on paper, but that doesn't matter much if it turns out that it helps people be good nurses.

The most glaring problem I see with this theory is that it would allow a potted spider plant to be considered a 'person', and Patrick Bateman to be considered 'healthy'.

Are you familiar with SOAP notes? The S and O are Subjective and Objective. One thing I don't see from your description is a separation or clarification about what is subjective and what is objective. For example, the patient's "self-concept mode" which I'm reading refers to "level of anxiety, involvement in self-care, relationship with family and friends and general outlook" sounds like it is all subjective (if we are simply talking asking the patient, "What is your level of anxiety?" and so forth). I think it is important to clearly distinguish what is subjective and objective, which seems to be lacking (at least from your description).

Ugh. What verbal diarrhea. This is why I hated some classes with a white hot intensity. You're supposed to stuff things into gibberish. What fun.

I'd note that despite having that tedious definition for health, and having it come first, it is not referred to again in any definition, goal, or step, and so is apparently superfluous to the rest of the theory, and in particular, the nurse's goal.

One "step" is setting a goal, which I thought we had already set with "The nurse's goal is..."

This is probably unfair to Roy, since it's just your brief overview.

Looking at the "diagnosis" list, it includes some immediate observables and other huge inferences. Distinguishing between observables and inferences seems important to me.

The definition given for "health" is only tangentially related to biological functioning, which sounds to me like the primary domain of a nurse.

Defines a 'person' as an 'adaptive system with coping processes.'

You could point out that this definition gives personhood to animals and a few electronic systems/computer programs.

Most of these seem like fancy ways of saying simple things.

I think that you can derive a strong argument from "your definitions aren't specific enough," if the theory allows for more than one interpretation (which should arise as a result of nonspecific definitions being used). The "specific" criticism could come from looking at your answer for the first part of the essay, suggesting an analysis that is sufficiently different from yours that they differ in key points, and then supporting this alternative analysis using the theory as well. Or, as an alternative way of phrasing question - is there one clear answer to the first part, or does the theory allow for multiple courses of action with non-trivial differences?

So although the original problem arose from the definitions, the actual criticism would be along the lines of "the theory is not specific/developed enough to prescribe a unique course of action in all circumstances."