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“Theory development in nursing science is critical for evolution of the discipline” (Clarke & Lowry, 2012, p.333), and growth of the profession is dependent on nurses knowing and using nursing theoretical works in their practice of nursing.Theory can be considered grand when it is nearly as abstract as the model itself and when the usefulness of the model depends on the soundness of that theory.
A key part of this chapter presents points to be considered when selecting a nursing theoretical work to guide your practice.
You may discover thatcertain of the works resonate with you more than others.
Although Nightingale (1946) did not present her philosophy on the relationship of patients and their surroundings as a theory, her philosophy contains implicit theory that guides nursing practice.
• Grand theory (e.g., Neuman’s Theory of Optimal Client System Stability) is next as the level of abstraction descends.
• The metaparadigm is the most abstract set of central concepts for the discipline of nursing (i.e., human being, environment, health, nursing), and these concepts are defined within each of the conceptual models and according to the philosophy of that model.
• Philosophies present the general meaning of nursing and nursing phenomena through reasoning and logical presentation of ideas (Alligood, 2005).Descriptions of the levels of abstraction of these nursing works from seven nursing models, three philosophies of nursing, and six theories of nursing illustrate their linkages with the practice level in middle-range theory.The theoretical frameworks guide professional practice; organizing the thought processes for decision making and reasoning for quality nursing practice.The reader is referred to The philosophies, models, and theories of a discipline are theoretical structures that address the central concepts of that discipline.The science of nursing is recognized as a fundamental pattern of knowing for nurses (Carper, 1978).A good fit between the nurse and the theoretical work selected is important and is usually related to mutual values inherent in a theoretical work and the nurse.Chapter 4 presents an insightful discussion of the moral obligations and values inherent in theoretical works.Once a theory is selected it is recommended that you expand your understanding of that theory by reading published materials written by the theorist.I want to introduce you to the use of the clinical case of Debbie in this text. The idea for this feature sprang from a classroom teaching/learning exercise I had used with graduate students.• Finally, as mentioned earlier, middle-range theory is the least abstract set of concepts and the most specific to nursing practice (e.g., promoting Optimal Client System Stability through a stress reduction intervention in the work environment).The understanding of theory terminology is developed over time with knowledge of works at the different levels of abstraction (Fawcett, 2005; Reynolds, 1971).