Advanced Theoretical Perspectives For Nursing
QUESTION
The development of nursing knowledge is an ongoing process. Discuss the case for the ongoing development and use of nursing grand theories and conversely, make a case for the obsolescence of nursing grand theories for today’s practice and research.
Advanced Theoretical Perspectives For Nursing
ANSWER
Nursing theories are critical for guiding education, research, and practice, as well as for strengthening the connections between these areas. Nursing theories are essential to the nursing discipline; they define the body of nursing knowledge, promote further knowledge development, establish nursing as a profession, and aim to direct nursing practice. Nursing theory, according to Fawcett (1983), is “characterized as sets of concepts, definitions, and propositions that address the metaparadigm phenomena of person, environment, health, and nursing by specifying relations among variables derived from these phenomena” (p. 11). Furthermore, Meleis (1997) stated that nursing theory provides insights into nursing practice situations and research, as well as guiding nursing practice. As a result, nursing theory is viewed as contributing to a well-founded basis for nursing practice (Chinn & Kramer, 1995), and it is useful in describing nursing phenomena, analyzing and explaining relationships between those phenomena, predicting outcomes, and prescribing actions (Chinn & Jacobs, 1987, Meleis, 1997).
Nursing theories are typically derived from conceptual models that clearly identify the nursing metaparadigm phenomena (Fawcett, 1983). As a result, the conceptual model is regarded as a forerunner of nursing theory (Peterson, 1977; Fawcet 1983). A nursing conceptual model is a collection of abstract concepts and propositions that are integrated into a meaningful configuration and represent an involvement in theoretical formulations by abstractly describing nursing phenomena and their interrelationships (Fawcett, 1983). As a result, it is implied that a nursing theory’s concepts, definitions, and propositions are derived from a nursing conceptual model.
Nursing theories differ in scope, or in the level of abstraction. Grand range theories are theories with a broader scope. These abstract theories provide a broad perspective on the goals and structures of nursing practice (Fawcett, 1994; Walker & Avant, 1995). They are not testable; rather, they are regarded as knowledge-generating models from which hypotheses can be derived and tested (Wilson, 1989), and they serve as a theoretical framework for the development of middle range theories (Armb & Kelly, 1995). Middle range theories have a limited scope and number of variables (Fawcett, 1994; Walker & Avant, 1995); they “involve abstractions, of course, but they are close enough to observed data to be incorporated in propositions that permit empirical testing” (Merton, 1968, p. 39). Thus, they are theories that describe, explain, and predict phenomena of concern to nursing, as well as prescribe actions in response to those phenomena (Wilson, 1989).
Both grand and middle range theories are important for nursing knowledge development. Grand range theories are useful for providing a broader picture of the phenomenon. Middle range theories, on the other hand, provide a more in-depth understanding of the relationships between those phenomena. As a result, the nursing discipline should focus its efforts on developing more middle-range theories capable of directing research and practice while also strengthening the link between those areas (theory, research, and practice). Speedy (1989) agreed with this viewpoint. She stated that the majority of nursing scholars believe that theories guide practice, practice is a source of theory development, and theories and practice inform each other.
As a result, the nursing discipline must go beyond simply explaining and predicting in terms of theory development; members of the discipline must develop prescriptive theories (Dickoff & James, 1968).