Theories of Nursing and Their Applicability - Research Paper Example

? Middle Range Nursing Theories Middle Range Nursing Theories Introduction Individuals engaged in nursing field must critically analyze various bases of their attitude which determine the ethics of their professional practices. Admittedly, basic qualities like respect, impartiality, dignity and tolerance inculcate the value of social justice in a person’s mind. In order to promote result-oriented social policies in healthcare settings, nurses must possess leadership skills as well along with the above stated qualities. In the same way, it is necessary for nurses to understand the different concepts of nursing strategies and various psychological and philosophical aspects of quality nursing care. Theoretical frameworks including middle range theories clearly define the nursing standards for the modern world. This paper will provide an overview of the concept and evolution of Middle Range Theories of Nursing and their applicability in today’s healthcare scenario. Concepts: Origin and Development Middle range theories are precise and moderate, and possess limited number of variables; hence, they effectively define nursing care standards. To be specific, middle range theories can be effectively applied in the field of nursing research and practice as their practicality can be directly tested. To define, “mid-range theories stand midway between the all encompassing global grand theories that address the entire discipline and hypotheses and theories that are very specific to a particular phenomenon or population” (Lenz, 2006, n.p). As compared to grand theories, Middle range theories are more concrete and narrow. To illustrate, they are written relatively at specific level with limited number of propositions and ideas. Theory of Human Caring (Watson), Theory of Interpersonal Relations (Peplau), and Theory of the Deliberative Nursing Process (Orlando) are some of the well known middle range nursing theories. With regard to the progress of middle range theories, they are based on the results derived from practice and research that can provide clear direction for casual practice and intellectual practice in the discipline further. The past century witnessed a notable level of progress in the middle range theories. Except a few, most of the middle-range theories have come directly from clinicians’ experience. The middle-range theory helps to mark certain condition of the related signs and future approach for symptom management in caring patients. The theory also emphasis on the result of various expressions or conditions with regard to the patient’s performance, and encourages the clear evaluation of patient’s working outcomes. Lieher and Smith (1999), has listed “the relationship between the intellectual process and the source of content related to the development of middle-range theories”; they include “Inductive theory-building theory through practice, Deductive theory. Building from grand nursing theories, Combining existing nursing and non-nursing theories, and Developing theories from clinical practice guidelines “ (Source: Approaches for generating middle range theory. Para. 1. As cited Peterson & Bredow, 2009, in p. 31). Middle range theories are of mainly three types; Middle-range descriptive theories, Middle-range predictive theories, and Middle-range explanatory theories. These variations could be analyzed on the basis of their characteristics and with most relevant examples. Among these, Middle-range descriptive theories usually encompass only a single main concept to classify a phenomenon. While doing so, it simply lists the generalities observed in individuals and groups, and these theories are normally tested by means of descriptive research. The interpersonal Relations (Peplau, 1952) is an example of a middle-range descriptive theory. Peplau’s theory focused on the therapeutic relationship between the nurse and the patient, which is termed as the Nurse-Client Relationship. In contrast, Middle-range explanatory theories analyze the relationship between more than one concept, and explain how and to what extent one concept is related to the other. Correlational mode of research, which is quantitative in design, is often initiated to test such theories. Theory of human caring (Watson) is the best example for Middle-range explanatory theories. Caring is the central point to Watson’s theory. According to her, a caring environment develops potential and thereby promotes health better than curing. She explains how a complete physical, mental, and social well being is possible and how can caring promote and restore health by preventing illness. Finally, as the name indicates, Middle-range predictive theories are much more based on prediction. To illustrate, they predict the relationship between concepts. In other words, they predict how the effects or changes in a phenomenon occur. These theories are developed and tested through experimental research that is of quantitative design. Theory of the deliberative nursing process (Orlando, 1950) is an example for Middle-range predictive theories. According to Orlando’s theory, the concept of professional nursing is all about finding and meeting the patient’s need for help. Applicability of Mid-range Theories Middle range theories emphasis on a view of reality, limited number of variables, and specific phenomena with apparent implications for nursing practice. The utility of nursing theories is a topic often demands discussion in curriculum. Obviously, utility is the factor that determines the relevance of a theory in a specific clinical situation. Hence, the utility expected will vary as the levels of theories applied vary. In other words, same utility cannot be expected from different levels of theories in nursing practice. This is the context when middle-range theories become more relevant, because they are situation-specific theories that can align with practice in both language and specificity. These characteristics make middle-range theories more like guidelines or protocols rather than formal obscure theories. Middle-range theories address unique nursing issues including but not limited to chronic sorrow, pain or symptom management even though the scope of the theories is much broader. This uniqueness assists clinicians to identify a particular patient trouble and the variables that could be influencing the specific situation. The result derived from the application of middle-range theory is that it clearly indicates what aspects one needs to consider in order for determining how to approach one particular instance. It is important to learn how grand theories differ from middle-range theories. As compared to middle-range theories, grand theories are more abstract and least useful when it comes to practice. However, the possibilities they put forward cannot be undermined; they define what it means by being a nurse, what and how it is a nurse attends to, what a nurse hope to achieve through their interventions, and the overall objectives of nursing. To be more specific, grand theories define and distinguish nurses from the wide pool of healthcare professionals. As Lenz (2006) points out, theories of these sorts have the potential to guide nursing practice either by ‘giving general approaches or more specific guidelines’; also, they can “direct the design of specific preventive or therapeutic interventions” (Lenz, 2006, n.p). Conclusion Middle range theories are much narrower which encompass limited variables and fewer concepts while grand theories address one discipline as a whole. The origin and development of middle range theories occur different ways like building theory through practice, building from grand nursing theories, combining existing nursing and non-nursing theories, and developing theories from clinical practice guidelines. Middle range theories are of three types such as Middle-range descriptive theories, Middle-range explanatory theories, and Middle-range predictive theories. Middle range theories can be effectively applied in the field of nursing research and practice, because their practicality can be directly tested. Middle range theories assist nurses to identify a particular patient problem and the influencing variables in a specific clinical situation. It will also clearly point out the aspects to be considered while determining how to approach one particular case. References Lenz, E. R. (2006). “Mid-range theory: Impact on knowledge development and use in practice”. In Roy, S. C & D. A. Jones (Eds.) (2006). Nursing Knowledge Development and Clinical Practice: Opportunities and Directions. Springer Publishing Company. Peterson, S. J & Bredow, T. S. (2009). Middle Range Theories: Application to Nursing Research. US: Lippincott Williams & Wilkins. Read More