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Applying Nursing Theories to Research

Bruce Chesson

School of Nursing, Purdue University Global

MN502: Theoretical Foundations of Advanced Nursing Practice

Dr. Hannah Binding

May 28, 2024

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Applying Nursing Theories to Research

Nursing theories are fundamental to understanding nursing as a profession. The nursing

paradigm is defined by four key areas: patient, nurse, health, and environment. Nursing

philosophies help to understand each sector of this paradigm further while explaining a particular

worldview, outlook on life, and how things work. Conceptual frameworks, or grand nursing

theories, help further describe nursing philosophies. Finally, middle-range theories provide

concepts that are directly applicable to clinical practice.

This analytical assignment will identify grand and middle-range nursing theories and

their use in research. It will examine the application of each theory to research and then apply it

to advanced nursing practice, specifically as a nurse executive.

Background on Grand and Middle-Range Nursing Theories

Grand nursing theories help to describe nursing philosophies further. Philosophies define

how a person views the world. They help one understand how the world works and can often

include a spiritual component that motivates the individual. Grand nursing theories provide a

broad overview of nursing research and practice principles.

In contrast, middle-range theories offer a more specific definition of the conceptual

framework in which it operates. They focus on a particular area of nursing practice and guide

actual interventions or testable concepts. Middle-range theories bridge the gap between grand

nursing theories and nursing practice.

Grand Theories in Research

McEwen and Wills (2018) note that “grand nursing theories guide research and assist

scholars to integrate the results of numerous diverse investigations so that the findings may be

applied to education, practice, further research, and administration” (p. 130). An example of a
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grand nursing theory that guides research is Florence Nightingale’s environmental theory. The

pioneer of modern-day nursing posited that the environment significantly affects the health of the

patient (and the nurse, for that matter).

A study published in the Nurse Leader Journal found just that. Nurse leaders are

responsible for influencing facility design decisions and evaluating their outcomes (Gregory et

al., 2022). Environmental adaptation should improve the delivery of care and follow evidence-

based design. This is because the nurse can be positioned to deliver care, which improves patient

health outcomes optimally. Suboptimal floor layouts and cluttered patient rooms lead to

increased medication administration errors, higher incidence of pressure injuries, more falls, and

overall poorer outcomes for the patient (Gregory et al., 2022). In this example, Nightingale’s

environmental theory was prescribed to suggest floor layouts and ergonomic designs.

Middle-Range Theories in Research

Mercer’s Conceptualization of Maternal Role Attainment Theory, or Becoming a Mother

Theory, is a middle-range nursing theory described by Ramona Mercer in the early 1980s. This

theory defines the action of a woman stepping into the role of motherhood and achieving

competence in this area (McEwen & Wills, 2018). However, there was little consensus on the

practical definition of neonatal nursing until The Iranian Journal of Nursing and Midwifery

Research studied Mercer’s theory in 2020. Becoming a mother is a transformational event in a

woman’s life, so neonatal nurses must understand this process to care for their patients (Rafii et

al., 2020). Their research found apparent factors in maternal role attainment, such as maternal

identity formation and maternal resiliency.

The study concluded that becoming a mother is an intense, broad, multidimensional

process influenced by many factors. Understanding this process is essential to improving the
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quality of care for infants and their parents (Rafii et al., 2020). In this case, Mercer’s model was

used in a descriptive and explanatory manner to guide practice. A neonatal intensive care unit or

nursery manager could apply this research to guide care in their setting, thereby improving

outcomes and lowering costs.

Applying Theories to Advanced Nursing Practice

The above discussion exemplifies how nursing theories have been used in research to

improve clinical practice. Nurse administrators, including managers and executive-level officers,

can use theories like the ones previously mentioned to continue improving outcomes, controlling

costs, and creating policy. This is the primary function of nurse executives.

Using the above examples, a nurse leader uses Nightingale’s environmental theory to

suggest unit layout and improve design to optimize patient care delivery (Gregory et al., 2022).

In the second example, the nurse leader uses Mercer’s Becoming a Mother theory to understand

further the principles behind attaining the maternal role. By understanding these principles,

neonatal nurses can understand their patients better and deliver higher-quality care, thus

improving outcomes (Rafii et al., 2020). Furthermore, a research article in The Scandinavian

Journal of Caring Sciences concludes that practice guided by nursing theory has a higher

efficacy than traditional nursing practice and that theory-guided practice should continue to be

used in the clinical setting (Younas & Quennell, 2019).

Conclusion

Grand nursing theories help to define broad concepts of nursing philosophies, whereas

middle-range theories assist in describing interventions that can be used in clinical practice. Each

can be descriptive, explanatory, predictive, or prescriptive. Theory-guided practice can be used

in advanced nursing practice to implement evidence-based practice within their settings to

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improve the quality of healthcare delivery, control costs, and create policy. Theory-guided

practice has a proven track record of improving patient outcomes (Younas & Quennell, 2019).

The future of advanced nursing practice is bright, and nursing theories are paramount to

sustaining that brightness. Nurse practitioners and leaders alike will be required to continue to

expand their theoretical knowledge to improve the quality of life for their patients. Theories are

essential to developing advanced nursing practice, and postgraduate programs must embrace and

encourage the development of nursing theories (Hansen & Dysvik, 2022).

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References

Gregory, D. D., Stichler, J. F., & Zborowsky, T. (2022). Adapting and creating healing

environments: Lessons nurses have learned from the covid-19 pandemic. Nurse leader,

20(2), 201–207. https://doi.org/10.1016/j.mnl.2021.10.013

Hansen, B., & Dysvik, E. (2022). Expanding the theoretical understanding in advanced practice

nursing: Framing the future. Nursing Forum, 57(6), 1593–1598. Retrieved May 28, 2024,

from https://doi.org/10.1111/nuf.12827

McEwen, M., & Wills, E. M. (2018). Theoretical basis for nursing (5th ed.). LWW.

Rafii, F., Alinejad-Naeini, M., & Peyrovi, H. (2020). Maternal role attainment in mothers with

term neonate: A hybrid concept analysis. Iranian journal of nursing and midwifery

research, 25(4), 304–313. https://doi.org/10.4103/ijnmr.IJNMR_201_19

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: An integrative

review. Scandinavian Journal of Caring Sciences, 33(3), 540–555.

https://doi.org/10.1111/scs.12670