Development of Nursing Theory

CONCEPT, STATEMENT
& STRATEGIES FOR

THEORIES
DEVELOPMENT
MR. SUDHIR SINGH

PH.D. SCHOLAR
NIMS UNIVERSITY JAIPUR
RAJASTHAN
DEVELOPMENT OF NURSING THEORIES
 INTRODUCTION
• Theories are a set of interrelated concepts that give a systematic view of a
phenomenon (an observable fact or event) that is explanatory & predictive
in nature.
• Theories are composed of concepts, definitions, models, propositions & are
based on assumptions.
• Theory gives planners tools for moving beyond intuition to design and
evaluate health behavior and health promotion interventions based on
understanding of behavior.[Robert T. Croyle (2005)].
• They are derived through two principal methods; deductive reasoning and
inductive reasoning. Nursing theorists use both of these methods.
• Theory is “a creative and rigorous structuring of ideas that projects a
tentative, purposeful, and systematic view of phenomena”.
• A theory makes it possible to “organize the relationship among the concepts
to describe, explain, predict, and control practice”
DEFINITION:-
 Nursing theories are organized, knowledge-based concepts that

essentially define the scope of nursing practice. This scope
would include what constitutes nursing, what nurses are
typically tasked with, and the reasons why these tasks are in
place.
 Theory is defined as “a belief, policy, or procedure proposed or
followed as the basis of action”. Nursing theory is “an
organized framework of concepts and purposes designed to
guide the practice of nursing”
Concepts:-
EMPIRICAL
CONCEPT
INFERENTIAL
CONCEPT
ABSTRACT
CONCEPT
NURSING METAPARADIGM
CONTI…
 Person
 Person (also referred to as Client or Human Beings) is the recipient of nursing care and may include
individuals, patients, groups, families, and communities.
 Environment
 Environment (or situation) is defined as the internal and external surroundings that affect the client.
It includes all positive or negative conditions that affect the patient, the physical environment, such
as families, friends, and significant others, and the setting for where they go for their healthcare.
 Health
 Health is defined as the degree of wellness or well-being that the client experiences. It may have
different meanings for each patient, the clinical setting, and the health care provider.
 Nursing
 The nurse’s attributes, characteristics, and actions provide care on behalf of or in conjunction with
the client. There are numerous definitions of nursing, though nursing scholars may have difficulty
agreeing on its exact definition. The ultimate goal of nursing theories is to improve patient care.
Who Develops Nursing Theories?
 The majority of nursing theories are developed by nurses, but

at times other healthcare professionals, such as physicians have
provided input into the development of nursing theories.
Nurses may develop a theory on their own or in collaboration
with other nurses. Nurse theorists often have a desire to
explain, predict and describe elements of nursing care and
practice
THEORY DEVELOPMENT
STRATEGIES:-
 There are four strategies in origin of nursing theories

 These are differentiated primarily by their origin of theory ,
practice, or research, and by weather, in addition to their
original sources, other sources were used in development the
theory.
 The major strategies are
 1. theory to practice to theory
 2. practice to theory
 3. research to theory
 4. theory to research to theory
THEORY DEVELOPMENT
STRATEGIES
THEORY TO
PRACTICE TO PRACTICE TO
THEORY THEORY
STRATEGIES STRATEGIES
THEORY TO
RESEARCH TO RESEARCH TO
THEORY THEORY
STARTERGIES
THEORY TO PRACTICE TO THEORY STRATEGIES
 The theorist who uses this strategy begins the process of theorizing by
selecting a theory to use in practice and then uses practice to refine the theory
further. This strategy is based on several premises:
 • An existing theory can help in describing and explaining nursing
phenomena; however, the theory’s assumptions are not completely congruent
with the assumptions that guide nursing.
 • The theory is not entirely useful in helping nurses meet their goals in nursing
practice. The theory does not define phenomena in ways that are useful for the
integrity of the nurse practice act definitions.
 • The theory does not directly help in defining actions for nurses. The focus of
the theory is different from the focus needed for nursing practice.
 • The theory does not provide adequate definitions of the central concepts of
nursing.
PRACTICE TO THEORY STRATEGIES
 Some theories are driven by clinical practice situations and are

inductively developed. They reflect experiences that evolve
from practice and are based on clinical situations and on the
experiences of theorists in practice.
RESEARCH TO THEORY
 The research to theory strategy is the most acknowledged and

accepted strategy for theory development, both by scientists in
other fields as well as by many within the discipline of
nursing. This strategy is used to develop theories that are based
on research. In fact, for empiricists, postempiricists, and
postpositivists, theory development is considered exclusively a
product of research. Therefore, according to this perspective,
the strategy par excellence is research to theory.
THEORY TO RESEARCH TO THEORY STARTERGIES
 In this strategy, theory drives the research questions and the

results that answer these research questions inform and modify
the theory.
 The difference between this strategy and the research to theory
strategy lies in the use or nonuse of theory as a guiding
framework for the research questions.
 Theorists who begin the research by defining a theory and
determining propositions for testing, and then go further to
modify and develop the original theories, are considered users
of this strategy.
Types of Nursing Theories
Grand Nursing Theories
Middle-Range Nursing
Theories
Practice-Level Nursing
Theories

Conti…..
Grand Nursing Theories
• Grand theories are abstract, broad in scope, and complex,
therefore requiring further research for clarification.
• Grand nursing theories do not guide specific nursing
interventions but rather provide a general framework and
nursing ideas.
• Grand nursing theorists develop their works based on their own
experiences and their time, explaining why there is so much
variation among theories.
• Address the nursing metaparadigm components of person,
nursing, health, and environment.
Conti…..
 Middle-Range Nursing Theories
• More limited in scope (compared to grand theories) and
present concepts and propositions at a lower level of
abstraction. They address a specific phenomenon in nursing.
• Due to the difficulty of testing grand theories, nursing scholars
proposed using this level of theory.
• Most middle-range theories are based on a grand theorist’s
works, but they can be conceived from research, nursing
practice, or the theories of other disciplines.
Conti…..
 Practice-Level Nursing Theories
• Practice nursing theories are situation-specific theories that are
narrow in scope and focuses on a specific patient population at
a specific time.
• Practice-level nursing theories provide frameworks for nursing
interventions and suggest outcomes or the effect of nursing
practice.
• Theories developed at this level have a more direct effect on
nursing practice than more abstract theories.
• These theories are interrelated with concepts from middle-
range theories or grand theories.
By Goal Orientation
 Theories can also be classified based on their goals. They can be descriptive or prescriptive.
 Descriptive Theories
• Descriptive theories are the first level of theory development. They describe the phenomena
and identify its properties and components in which it occurs.
• Descriptive theories are not action-oriented or attempt to produce or change a situation.
• There are two types of descriptive theories: factor-isolating theory and explanatory theory.
 Factor-Isolating Theory
• Also known as category-formulating or labeling theory.
• Theories under this category describe the properties and dimensions of phenomena.
 Explanatory Theory
• Explanatory theories describe and explain the nature of relationships of certain phenomena
to other phenomena.
Other Ways of Classifying Nursing Theories
 Classification According to Meleis

 Afaf Ibrahim Meleis (2011), in her book Theoretical Nursing: Development and Progress,
organizes the major nurse theories and models using the following headings: needs theories,
interaction theories, and outcome theories. These categories indicate the basic philosophical
underpinnings of the theories.
• Needs-Based Theories. The needs theorists were the first group of nurses who thought of
giving nursing care a conceptual order. Theories under this group are based on helping
individuals to fulfill their physical and mental needs. Theories of Orem, Henderson, and
Abdella are categorized under this group. Need theories are criticized for relying too much
on the medical model of health and placing the patient in an overtly dependent position.
• Interaction Theories. These theories emphasized nursing on the establishment and
maintenance of relationships. They highlighted the impact of nursing on patients and how
they interact with the environment, people, and situations. Theories of King, Orlando, and
Travelbee are grouped under this category.
• Outcome Theories. These theories describe the nurse as controlling and directing patient
care using their knowledge of the human physiological and behavioral systems. The nursing
theories of Johnson, Levine, Rogers, and Roy belong to this group.
Classification According to Alligood
 Classification According to Alligood

 In her book, Nursing Theorists and Their Work, Raile Alligood (2017) categorized nursing theories
into four headings: nursing philosophy, nursing conceptual models, nursing theories and grand
theories, and middle-range nursing theories.
• Nursing Philosophy. It is the most abstract type and sets forth the meaning of nursing phenomena
through analysis, reasoning, and logical presentation. Works of Nightingale, Watson, Ray, and
Benner are categorized under this group.
• Nursing Conceptual Models. These are comprehensive nursing theories that are regarded by some
as pioneers in nursing. These theories address the nursing metaparadigm and explain the
relationship between them. Conceptual models of Levine, Rogers, Roy, King, and Orem are under
this group.
• Grand Nursing Theories. Are works derived from nursing philosophies, conceptual models, and
other grand theories that are generally not as specific as middle-range theories. Works of Levine,
Rogers, Orem, and King are some of the theories under this category.
• Middle-Range Theories. Are precise and answer specific nursing practice questions. They address
the specifics of nursing situations within the model’s perspective or theory from which they are
derived. Examples of Middle-Range theories are that of Mercer, Reed, Mishel, and Barker.
LEVELS OF NURSING THEORY
IMPORTANCE OF NURSING THEORIES
I. Nursing theory aims to describe, predict and explain the phenomenon of

nursing (Chinn and Jacobs1978).
II.It should provide the foundations of nursing practice, help to generate
further knowledge and indicate in which direction nursing should develop
in the future (Brown 1964).
III.Theory is important because it helps us to decide what we know and what
we need to know (Parsons1949).
IV.It helps to distinguish what should form the basis of practice by explicitly
describing nursing.
V.The benefits of having a defined body of theory in nursing include better
patient care, enhanced professional status for nurses, improved
communication between nurses, and guidance for research and education
(Nolan 1996).
VI.The main exponent of nursing – caring – cannot be measured, it is vital to
have the theory to analyze and explain what nurses do.
As medicine tries to make a move towards adopting a more
VII.
multidisciplinary approach to health care, nursing continues to strive to
establish a unique body of knowledge.
This can be seen as an attempt by the nursing profession to maintain its
VIII.
professional boundaries.

Development of Nursing Theory

Uploaded by

Copyright:

Available Formats

Development of Nursing Theory

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Development of Nursing Theory

Uploaded by

Copyright:

Available Formats

CONCEPT, STATEMENT

& STRATEGIES FOR

MR. SUDHIR SINGH

 Nursing theories are organized, knowledge-based concepts that

 The majority of nursing theories are developed by nurses, but

 There are four strategies in origin of nursing theories

 Some theories are driven by clinical practice situations and are

 The research to theory strategy is the most acknowledged and

 In this strategy, theory drives the research questions and the

Grand Nursing Theories

 Classification According to Meleis

 Classification According to Alligood

I. Nursing theory aims to describe, predict and explain the phenomenon of

You might also like