Nursing practice is multifaceted, demanding a strong theoretical foundation to guide effective and patient-centered care. Understanding the various nursing theories and their applications is crucial for nurses to deliver high-quality healthcare. The question then arises: Which Type Of Theory Most Often Guides Present Nursing Practice? This article explores the different levels of nursing theory and identifies the one most commonly used in contemporary clinical settings.
Nursing theories provide a framework for understanding, explaining, and predicting phenomena related to nursing practice. These theories can be broadly categorized into grand theories, middle-range theories, and practice-level theories.
Grand theories are broad in scope and complex, offering a comprehensive perspective on nursing. Examples include:
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Nightingale’s Environmental Theory: Emphasizes the impact of the environment on patient recovery. For instance, a nurse applying Nightingale’s theory would first evaluate the hospital room’s air quality and then arrange for the client to go outside, weather permitting, while keeping the room’s window blinds open.
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Orem’s Self-Care Deficit Theory: Focuses on the patient’s ability to perform self-care. This can be applied to a client who is blinded due to a motor vehicle accident, the nurse helps the client obtain a guide dog so the client may continue grocery shopping and visiting friends and family. This enables the client to cope with the handicap and perform activities of daily living.
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Rogers’ Science of Unitary Human Beings: Views humans as energy fields interacting with the environment. A nurse believes that humans use creativity and critical thinking to balance their connections with their surroundings. The nurse decides to conduct a study on the basis of this belief, this theory would be best for this study.
While grand theories offer a valuable overarching perspective, their broad nature can make them difficult to apply directly to specific clinical situations.
Middle-range theories are more focused and concrete than grand theories, addressing specific phenomena or concepts within nursing.
They offer a narrower scope and are often derived from or related to grand theories. Examples include:
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Peplau’s Theory of Interpersonal Relations: Focuses on the nurse-patient relationship as a therapeutic process. A client is hypertensive, and the doctor prescribes weight reduction. the client is excited about beginning the diet, but on arriving home the spouse states, “you have always been fat, and i am not going to starve because you can’t control yourself” the client becomes anxious and is unable to participate in the diet plan, resulting in a weight gain of 5 pounds in 2 weeks, this theorist could best be referred to for guidance regarding intervention in this situation.
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Leininger’s Culture Care Theory: Emphasizes the importance of cultural competence in nursing practice. which nursing theory might a nurse use a conceptual framework to determine how to meet the needs of immigrants while ensuring provision of high-quality and culturally sensitive care.
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Mishel’s Uncertainty in Illness Theory: Explores how patients cope with uncertainty during illness. A young child is having abdominal pain, and the doctor informs the parents that a computed tomography scan of the abdomen will be ordered. the doctor tells the child, “this CAT scan won’t hurt you” the child is visible upset because of a fear of cats. according to mishels uncertainty in illness theory, which stage of the framework is represented.
Middle-range theories are particularly useful in guiding nursing practice because they provide a framework for assessing patients, planning interventions, and evaluating outcomes in specific clinical areas.
Practice-level theories are the most specific and concrete, focusing on particular nursing interventions or patient populations. They are often developed by nurses working in specific clinical settings and are designed to address specific problems or issues. Examples include theories related to pain management, wound care, or patient education.
Considering the characteristics of each type of theory, middle-range theory most often guides present nursing practice. Their narrower scope and focus on specific phenomena make them highly applicable to clinical settings. They provide a bridge between the broad concepts of grand theories and the specific interventions of practice. Nurses can use middle-range theories to develop evidence-based practice guidelines, protocols, and standards of care that improve patient outcomes.
In conclusion, while grand theories provide a valuable foundation for nursing knowledge, and practice-level theories address specific clinical issues, middle-range theories offer the most practical and applicable framework for guiding present nursing practice. By using middle-range theories, nurses can deliver evidence-based, patient-centered care that improves health outcomes and promotes well-being.
