Middle Range Theory

The caring, supportive, sympathetic features of nursing, is immeasurable. Theories are essential to have. They provide a description of what nurses do and give meaning and purpose. When nursing theories are developed this new knowledge can greatly impact the future of nursing practice (McCrae, 2012).

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

When reflecting on current trends of clinical practice, I feel that middle-range theories are more applicable. Middle-range theories are broad enough to incorporate in everyday clinical practice for the average floor nurse without being too narrow in scope as the situation-specific theories. Additionally, middle-range theories are less abstract than grand theories and are easier to relate to and put into practice (Liehr & Smith, 1999, p. 85).

The profession of nursing has, in recent years, been trying to further develop, test and use proposed nursing theory. To utilize theory appropriately, in all domains of practice, education and research, it is important to know how to describe, analyze and evaluate

Health promotion includes providing activities that improve a person’s health. These activities assist patients to “maintain or enhance their present levels of health. Health promotion activities motivate people to act positively to reach more stable levels of health” (Potter & Perry, 2005, p. 97). In order for nurses to assist patients in obtaining healthy lifestyles, they must first assess a patient’s perception of health. The World Health Organization defines health as a “state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity” (as cited in Potter & Perry, 2005, p. 91). There are many nursing theories that are based on an individual’s perception of health. This paper will

The AACN Synergy Model for Patient Care falls in the middle range nursing theories classification. According to McEwen (2014a) middle range nursing theories can be found in between abstract theories and concrete theories because they are specific. Middle range nursing theories have the ability to be operationally defined with a view into

Discuss the worldviews of science (perceived, received, etc.) that influence nursing theory development and nursing science.

Middle range nursing theories are abstract, testable theories that contain a limited number of variables. According to Chinn and Kramer (2011), middle range nursing theories can lead to new practice approaches as well as examine factors that influence the desired outcomes in nursing practice. One beneficial and widely used middle range nursing theory is the theory of unpleasant symptoms, developed collaboratively by Lenz, Pugh, Milligan, Gift, and Suppe in 1995.

In comparison, Middle range theory is composed by clear propositions and can contain testable hypothesis (Armstrong, & Kelly, 1995). As a result, Peplau’s Interpersonal relationship theory is a middle range theory because the proposition of her theory are testable, specific and limited (Armstrong, & Kelly, 1995). In her theory, she applies the principle of human relationships and explained that the nurse and patient should work together to gain more knowledge in the care process (Gastmans, 1998). She used deductive reasoning in her theory because she integrated ideas of other theorists

There are various methods used in the implementation of health promotion that encompasses entire areas of nursing. Providing education, providing information and increasing the knowledge to the patient and the community. In this nursing process a complete assessment, planning, nursing diagnosis; creating plan of care, rendering care and outcome evaluation is done. This nursing process is used during the entire nursing practice in very particular stages and in the progression of the quality care.

To this end, I believe middle-range theories are best suited to advance nursing knowledge and practice in the 21st century. “Middle-range theories are at those levels of conceptualization that could inform nursing practice and research, and thus continue the cycle of advancing foundational knowledge and enhancing quality care”, (Meleis, 2012). Middle-range theories were created to help the nursing profession realize its overall mission and goal, now and in the future; to alleviate pain, suffering and distress, as well as promote health-seeking behaviors which will lead to improved health outcomes and attainable goals. Because middle-range theories lie in the middle of grand theories and situation specific theories, they are directed more toward specific interventions that can be implemented at the ‘bedside’. As such, they are designed to provide frameworks to manage patients’ experiences with symptoms, as well as the ability to understand responses to health and illness phenomenon.

Often in practice, we as nurses deal with a variety of diseases and treatments and often have to react to the illness that the patient presents with upon our interaction. While this is an essential piece of our practice, we also have a duty to our patients to be proactive in preventing specific health-related consequences based on their risk factors and to promote their health and well being. Health promotion as it relates to nursing is about us empowering our patients to increase their control over their lives and well beings and includes: focusing on their health not just illness, empowering our patients, recognizing that health involves many dimensions and is also effected by factors outside of their control (Whitehead et al. 2008)..

Meleis (2012) further classifies theories into distinct categories: grand theories, middle-range theories, and situation specific theories. Grand theories consist of the construction and synthesis of knowledge; which includes the mission of nursing, and the goals in nursing practice (Meleis, 2012). Grand theories are broad in range and consist of a framework for which to practice. Grand theories can be applied to all aspects of nursing and patient care. An example of a grand theory would be Dorothea Orem’s’ Self-Care Deficit Nursing Theory. The central aspect of this theory is that all humans want to thrive and care for themselves (Nursing theory.org n.d.). Middle-range theories have a more limited scope. The notable difference between grand theories and middle-range theories is that middle-range theories are based on scientific and empirical evidence (Meleis, 2012). An example of a middle-range theory is the theory or discussion of quality of life (Meleis, 2012). The final theory classification is

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

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.