Nursing Theory

Middle-Range Theory in Nursing Presentation Transcript

Narrator: First developed in sociology in the 1960’s and introduced into nursing in1974, middle-range-or mid-range-theories were appropriate for a developing discipline. They are in the middle of grand and practice theories.

Mid-range theories provide a bridge between grand theories and nursing practice because they could more easily be utilized in research and applied to patient outcomes in patient care. Mid-range theories have more specificity than grand theories and also are more closely linked to practice. Mid-range theories have limited relationship to the real world, are limited in number of concrete concepts and concrete propositions. Concepts in mid-range theories are operationally defined.

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

Middle-range theories can be connected to research specifically when looking at patient care and measuring patient outcomes. Thus, evidence-based practice research is aligned with middle-range nursing theories.

Mid-range theories emerged from the combination of research and practice; they can be applied to many nursing disciplines.

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 methods used for analyzing and evaluating grand theories also apply to analyzing and evaluating middle-range theories. One such principle was developed by Jacqueline Fawcett. Fawcett’s criteria emerged through 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 her theory or model are considered, and different problems in nurse-patient situations are considered. The content of the model is also considered as Fawcett’s criteria help in analyzing 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.

The Fawcett model criteria consider the parsimony of the model. In other words, is it economically stated?

Regarding testability, the Fawcett criteria consider how the research method reflects mid-range theories, 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.