Nursing Theory

Middle-Range Theory in Nursing Presentation Transcript

Narrator: First developed in sociology in the 60’s and introduced into nursing into 1974, middle-range, or mid-range, theory was appropriate for a discipline that was developing. They are in the middle between Grand and Practice theories.

Mid-range theory provided a bridge between grand theories and nursing practice as they could be more easily utilized in research and applied to patient outcomes in patient care. Mid-range theories have more specificity than grand theories and have a closer link to practice. Mid-range theories have a limited aspect of the real world, a limited number of concrete concepts, and concrete propositions. Concepts in mid-range theory are defined operationally.

Middle-range theories serve several purposes in nursing. Mid-range theories help us to understand phenomena relevant to nursing. They enable us to state what they are, how they occur, and to discover connections between interventions and outcomes.

Here we can think about middle-range theory and how it can be connected to research on patient care and measuring patient outcomes. Thus, evidence-based practice research is aligned with middle-range nursing theories.

Mid-range theory emerged from the combination of research and practice and can be applied across disciplines in nursing.

Middle-range theories can also be refined through literature reviews, qualitative research, field studies, conceptual models, nursing diagnoses and interventions, theories from other disciplines, and statistical analysis of empirical data.

Many principles for the analysis and evaluation of grand theories also apply to middle-range theories. One such method was developed by Jacqueline Fawcett. Fawcett’s criteria emerged through the historical evolution of models, her own motivation, philosophical assumptions about nursing and other work, and the worldwide view of models.

Fawcett’s method presents a unique focus wherein the metaparadigm concepts included in the theory are considered and different problems in nurse-patient situations are considered. The content of the model is also considered as Fawcett’s criteria help to analyze abstract and general concepts and propositions, consider how person is defined in the model, and take into account the goal of nursing within the model.

The criteria of Fawcett’s analysis include parsimony, testability, empirical adequacy and pragmatic adequacy.

To begin, the Fawcett criteria considers the parsimony of the model. In other words, is it economically stated?

With regards to testability, the Fawcett criteria considers how the research method reflects mid-range theory as well as to what degree theory concepts are observable through empirical indicators.

As it relates to empirical adequacy, the Fawcett model considers to what degree findings from descriptive studies are congruent with concepts and propositions of theory.

Regarding pragmatic adequacy, the Fawcett model considers to what degree nursing actions are compatible with nursing practice; whether nurses need special training to apply the theory to practice; if outcomes from using the theory for nursing actions are favorable; and whether the theory’s applications are designed for comparison of the use of the theory against when the theory is not used.

Additional criteria for the analysis and evaluation of theory include usefulness, accuracy, logical adequacy, testability, and sociocultural utility.