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The increasing complexity of the nature and treatment of current mental health problems is revealing the significance of professional nursing's unique contributions to psychiatric-mental health care. Yet there remains, as a critical issue in the continuance of these contributions, the need for a clear conceptual base in psychiatric-mental health nursing (Hoeffer, 1983; Hoeffer, 1982; Mansfield, 1980; SiUs, 1977). In its absence a wide array of disparate and sometimes disparaging theoretical positions have dominated clinical teaching and practice. Psychiatricmental health nurses have often adopted the "eclectic" approach to intervention in an attempt to incorporate the wide variety of theories available, including psychoanalytic, behavioristic, and humanistic. Educational textbooks in psychiatric-mental health nursing frequently present students with a vast spectrum of psychological theories as background knowledge, but without a clear conceptual basis for the selection and application of these theories to practice.
While these non-nursing theories may provide valuable knowledge for practitioners, some may also be incongruent with or limit nursing's perspective of significant care issues. The "psychiatric-mental health" in "psychiatric-mental health nursing" does not limit the conceptual base to those theories that are primarily psychological in nature but, rather, serves to emphasize the clinical focus for the testing and application of nursing knowledge. It is suggested, then, that existing nursing conceptual models (also referred to as nursing theories) offer a means for clarifying psychiatricmental health nursing's conceptual base.
A Process Model has been proposed that outlines an approach to constructing conceptual frameworks for clinical specialty areas by linking compatible concepts derived from extant nursing theories (Reed, 1986). The purpose here is to present an example of applying this approach in explicating a conceptual base for psychiatric-mental health nursing practice. The intent of the Process Model is to provide just enough structure in the development of a conceptual framework to ensure congruence with nursing's metaparadigm without constricting the theoretical creativity and practical wisdom of a clinical specialty.
Process Model
The model for constructing a clinical specialty framework is organized according to nursing's fourconcept metaparadigm: environment, person, health, and nursing practice. The model links clinical concepts representing environmental, person, health, and practice phenomena. The structure in Figure 1 depicts the organization of the model. The environment, person, and practice planes revolve around the axis, health, implying an interconnectedness among...