Middle-Range Theory

Mishel’s Uncertainty of Illness Theory is a middle-range theory (Black, 2014). This means the theory is not overly broad or narrow. The theory was developed from studying men with prostate cancer who were watchfully waiting for the advancing signs of their disease (Black, 2014). The theory has three main components, which incorporate: the antecedents of uncertainty, impaired cognitive appraisal, and coping with uncertainty in illness (Neville, 2003). The antecedents of Mishel’s theory are the stimulus frame, cognitive capacities and event congruence (Neville, 2003). The stimulus frame concerns three parts including: symptom pattern, event familiarity and event congruency (Neville, 2003). Symptom pattern may be when symptoms of

Grand theory is highly abstract and is broad in scope. Middle-range theory is more focused and is normally the end product of a research study. Narrow-range theory is even more specific and while also being based on research findings, it guides specific actions in the achievement of desirable goals (p. 17).

The theory focuses on the ability of a person to meet his or her own needs. Developed in the year 1970, Orem’s theory focused on the three various concepts, namely self-care, self-care deficit, and the nursing system. Self-care is a group of activities or processes that a person performs to maintain health, life, and wellbeing (Orem, 2001). For instance, self-care is being demonstrated when a chronic heart failure patient checks his or her weight daily, takes prescribes medications, and avoids salty foods. Self-care deficit happens when an individual is not able to provide effective self-care (Orem, 2011). Nurses are able to assist patients in this state by educating them with their disease condition and treatment compliance. A nursing

The symptom management theory (SMT) of the University of California, San Francisco (UCSF), was revised by its faculty and students in 2001 (Smith & Liehr, 2014). According to Dodd et al. (2001), the subjective experience that suggests alterations in an individual’s functioning, sensation, and cognition is called a symptom. Dodd et al. state that their theory provides a nonspecific symptom management model to guide nursing practice and research. The SMT has three overlapping circles which contain the three domains of nursing science, also known as concepts of metaparadigm of nursing. The three nursing science domains are the person, the environment, and health & illness. In the theory’s model, the dimensions are affected by the three nursing science domains (Dodd et al., 2001).

Leventhal’s model of self-regulation is based on the idea that each person forms a cognitive representation of their illness, which allows them to make sense of their symptoms. This illness perception and the patient’s emotional response then guide behaviour towards managing the illness (Leventhal et al., 1984). An illness perception is made up of five major components. These are illness identity, potential cause, timeline, its consequences and how it may be controlled. Often patients with similar diseases can hold very different perceptions of their illness (Petrie and Weinman, 2012). Clinical severity of the condition does not necessarily predict how a patient will cope. This essay will outline strengths and weaknesses of whether the model can be used to explain health outcomes and coping strategies, implement successful interventions and predict or even improve adherence to treatment. Finally, the importance of constructs not included in the model, such as social support, will be discussed. The essay will evaluate the model using examples of illnesses such as stroke, cancer, diabetes and asthma.

When someone is suffering or living with a chronic illness it can have a huge impact on them psychologically and socially. Chronic Illness is a condition that is prolonged in duration, usually more than 3 months and is rarely cured (DoH, 2012). Having to cope with a chronic condition might lead to life changes, such as dependency on others, loss of income, which can cause feelings of loss and reduced self-esteem. They can also report feelings of social rejection, poor healthcare and workplace termination due to their presenting condition (Earnshaw, Quinn, & Park, 2011).

The most applicable borrowed theory would be Richard Lazarus’ Stress, Coping, Adaptation Theory. “Lazarus’ theory deals with how a person copes with stressful situations” (McEwen & Wills, 2011, p. 288). This theory is categorized under the stress theories. “The stress theories provide nursing with a framework to

C. The framework does an excellent job of stating and describing the relationships between the various concepts of interest. The framework was developed over a nine-year period of time and involves many different groups and institutions.

Self-efficacy, for the purpose of this study, may be defined as a person’s optimistic self-belief. This is the belief that a person can develop the skills to perform new or difficult tasks to cope with changes in health and functioning. When a person perceives self-efficacy, it will facilitate goal-setting, effort, investment, persistence, overcoming obstacles and recovery from disappointments and failures. It can be regarded as a positive outlook or proactive way to handle stress factors. It is the ability to successfully cope with health changes, and implies an internal and stable acceptance of changes and ability to successfully adapt to those changes. Perceived self-efficacy is functional in

o Conceptual model or theoretical framework: In what way was a conceptual model or theoretical framework used to guide this study?

Theory is a journey to uncover the past and improve the future. By uncovering and analyzing a discipline’s theoretical journey, insight and self-awareness are gained. According to Meleis (2012), “Theories are reservoirs in which related knowledge is articulated and organized into meaningful wholes” (p.33). By implementing and analyzing theories, empowerment and guidance for the future is obtained.

In 1970s and 1980s the scholars and practicing nurses started to incorporate nursing theories into their research and clinical practices. The most of the early theories fell into category of “grand theory”. While nursing researchers initially tried to utilize the grand theory in to their research, due to its wide range of information it made the effort difficult. The development of middle range theory started to emerge in attempt to incorporate in nursing research and practice. Middle range theory extend the understanding of nursing practice relevant to evidence based research and nursing practice. In this paper, I am going focus on two middle range theory chronic sorrow and unpleasant symptoms. I will discuss the brief historical background on each theory, compare and contrast internal and external criticism of each theory and finally which theory will I choose in clinical settings by providing reasons for my selection

Nursing theories can be categorized considering their levels of perception, and the literature mentions that there are two kinds of concepts: grand theories and middle-range theories. Whether concepts are grand or mid-range (MR), we establish corrective intellectual and influence practice and investigation. By description, grand concepts are theoretical, complex, and detached from practice. We are not destined to be simply grasped or experienced. Associated with grand theories, MR theories enclose less perception and interactions, are adjustable to an extensive range of practice and knowledge, can be made from numerous sources, and are solid enough to be experienced. For these reasons, MR principles are predominantly persuasive as nursing science statements the encounters of the 21st period.

Coping strategies refer to the specific efforts, both behavioral and psychological, that people employ to master, tolerate, reduce or minimize stressful events. There are two general coping strategies which have been distinguished. Problem-focused strategies are efforts to do something active to alleviate stressful circumstances, where as emotion-focused coping strategies involve efforts to regulate the emotional consequences of stressful or potentially stressful events. Typically, people use both problem-focused and emotion-focused coping in their stressful episodes, which suggests that both types of coping are useful for most stressful events (Folkman & Lazarus, 1980).

Description of theory: Include four subtopics regarding selected theory 's Purpose, Concepts and Definitions, Relationships and Structure, and Assumptions.