...Grand and Middle Range Theories Meriam Izobo Oakland University Grand and Middle Range Theories When one thinks of the word theory the next thought should be nursing because the foundations of nursing are built from nursing theories. The history of nursing holds a significance to theory in that theories help establish nursing as a profession (Smith & Liehr, 2014). Theories from the past in the Nightingale era and new theories today in the 21st century aid in the guidance of nursing practice and research (Smith & Liehr, 2014). In the twentieth century, nursing was not recognized as an academic discipline or a profession (Alligood, 2013). As theories such as the middle range and grand theories are being brought to the forefront of nursing education, nursing is being viewed now more than ever as a profession. The purpose of this paper is to compare and contrast the middle range and grand theories and discuss how they are relevant to nursing practice. A relevant and important concept for nurses to understand is that theory informs practice and research in the everyday world of nursing and that the existence of nursing is founded on theories (Smith & Liehr, 2014 ). Every procedure, assessment, and nursing intervention is related to and guided by nursing theory and it is every nurses obligation and responsibility to utilize theory into their practice. Theory is a key component in the history of nursing as an academic discipline and it is vital to the practice...
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...Application of Theory DeepaK USF NR 501 Theoretical Basis for Advanced Nursing Practice Nursing Theories In nursing there are theories that determine how the profession is going to be handled. Scholars and other practitioners of medicines have proved these theories. In our case we will be looking how these theories are applicable in the entire world of nursing medicine. What are nursing theories? Nursing theories are theories that describe, develop, and provides on how nursing profession should be carried out. These theories provide information on how or on the ground on how the terms of nursing terms can be defined and even touches on how principles of nursing and how the basis of nursing and how it can be improved. In the nursing, there are many theories in nursing but in our case we will only touch on Grand theory and Middle range theory. These two theories are very vast when it comes to nursing and we need to divulge some details as we go on. Grand theory: Adaptation concept and Behavior concept This is a very broad theory that does not intend to achieve a certain goal, or we can also state that this theory is composed of concepts that represent global or wide and extremely complex phenomena. It is actually the widest in the scope and also it represents the most abstract in nursing in which several things are checked and tested. Generally a grand theory is not intended for the formation for the particular...
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...Florence Nightingale, the mother of nursing, is the creator of nursing theories in 1850s. Till 1950s, nursing practice was predominantly originated from social, biologic, and medical theories. Hildegard Peplau, the first lady who published nursing theory, started emphasizing on nurse-client relationship as the base of nursing practice with the publication of her book in 1952. This began a transformation in nursing. In 1950s and 1960s, it inspired many nurse theorists to deliver freethinking theoretical context for nursing education and practice. Their explanations of nursing and nursing models flourished from their personal, professional, and educational experiences sharing their opinion of ideal nursing practice. In late 1970s and early...
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...Across Theories Comparison and Analysis across Theories The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories. The grand nursing theories are a conceptual model, which identifies the focal point of nursing inquiry and guide the development of mid-range theories that will become useful to nurses and also to other health professionals. According to Walker and Avant (2011), these theories contributed in “conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives.” In this essay, Orem’s Health Care Deficit Theory and Sister Callista Roy’s Adaptation Model are compared and analyzed for their importance in nursing. Orem’s Self-Care Deficit Theory Orem’s Self-Care Deficit Theory is one of three grand theories written by Dorothea E. Orem. According to Orem, nursing becomes necessary when an individual can no longer care for him or herself. Nursing provides...
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...I. What is a concept? a. A building block of a theory, can be a few of them, b. abstract ideas that cannot be visualized. Such as pain or coping or social support. You can have an idea in your mind of what these are but you cant actually touch any of these. Can you touch social support? You can probably touch a part of your body that may feel some sense of pain but the actual concept itself cannot be touched. c. Tend to be universal which means they apply equally to everything related. d. Concepts tend to be the basic elements of propositions (or statements that result from reason). If you remember geometry they had the proposition they had the “if A equaled B and B equaled C.Does A equal C.” That is the idea of what propositions are and they take concepts and build on them to create these statements to help define whatever we are discussing such as theory, research study. e. Help to integrate unrelated phenomena into a hypothesis which creates research. Critical to have very defined concepts and the concepts needed to be created into hypothesis so that you had something to study. That is critical when we discuss concepts and research i. Phenomenon is any even that can be experiences via senses, it is observable and can be seen. ii. Proposition: closed sentence or statement 1. Like geometry: If A=B and B=C, then A=C 2. Tend to be true or false 3. Content of beliefs and or assertions...
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...McEwen and Wills (2014) defines the metaparadigm as a representation of a discipline’s wordview (McEwen & Wills, 2014, p. 27). In week one, the group learned about the nursing metaparadigm consisting of the concepts of person, environment, health, and nursing, and how it was utilized in in grand theories. This week, the group learned about middle range nursing theories and how it differs from grand nursing theories. McEwen and Wills (2014) differentiates both levels of theories, “Compared to grand theories, middle range theories are more specific, have fewer concepts, and encompass a more limited aspect of the real world. Concepts are relatively concrete and can be operationally defined. Propositions are also relatively concrete and may be...
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...Historical Perspective Essay 518 University of Phoenix December 16, 2012 Historical Perspective Essay The theory of adaption model developed over 40 years ago by nursing theorist Castilla Roy, is used in many fields of nursing especially areas of humanities and human science. Nursing theory provides the structural framework necessary for practice, and helps to further nursing knowledge providing an understanding of the scientific process, and the nurse’s role in the health care setting (Colley, 2003). According to Shosha and Kaladeh (2012) Roy’s model provided the nursing profession with a framework to help further model-based research with a methodological soundness not yet known to the profession. This short essay will explain why I believe that Roy’s early model of adaption has contributed to research and nursing development more than other theorists of her time and significantly helped to shaped nursing practice and the profession. Contribution to Research and Nursing Development From a historical perspective Roy’s Adaption Model (RAM) is one of the most useful conceptual frameworks backed by years of research that has guided nursing practice. According to Fawcett (2005) Roy’s model has provided the foundation for the survival of nursing practice and is used globally to further nursing research, practice, and education. RAM has helped to link the concept of the human element of response to stress and adaptation— that is an intricate part of...
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...A grand theory in nursing would be Doretha Orem’s self care theory. This theory encompasses the entire concept of nursing in the fact that it states individuals will strive to meet healthcare needs to maintain health and wellness. This is very broad, can not be tested and is used in a variety of settings and populations. Self-Care Deficit Nursing Theory is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they're ablethat it can easily be applied to a variety of nursing situations and patients. The generality of its principles and concepts make it easily adaptable to different settings, and nurses and patients can work together to ensure that the patients receive the best care possible, but are also able to Middle range theories focus on experiences that are commonly recognized in nursing. Mishel’s Uncertanity in illness theory was formed specifically for nurses to understand how patients comprehend illness and the stress that comes with it and how patients handle that stress. Mishel was able to measure this with the Mishel Uncertanity in Illness Scale. Nursing interventions to reduce stress,helps patients to adapt and cope with hospitilization Dorothea E. Orem: Known as the Self-Care Theory, Orem's vision of health is a state characterized by wholeness of developed human structures and of bodily and mental functioning. It includes physical, psychological, interpersonal...
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...Grand Nursing Theorist Assignment # 2 Grand Nursing Theorist Assignment # 2 Descriptive Analysis For this assignment, I chose to study grand nursing theorist Dorothy Orem and the nursing concept she introduced, the self-care deficit theory (also known as the Orem model of nursing). I chose to study Dorothy Orem because she is well known in Indiana, the state in which I reside. Orem’s grand nursing theory “was developed between 1959 and 2001…[and] is particularly used in rehabilitation and primary care settings where the patient is encouraged to be as independent as possible” (Orem & Taylor, 2011). Background of Theorist “Dorothy Orem was born in Baltimore, Maryland in 1914. She received her diploma in nursing in 1934 from Providence Hospital School of Nursing, Washington, D.C. Orem received her bachelor of science in nursing education in 1939 and a master of science in nursing education in 1945 from Catholic University of America, Washington, D.C. She had a varied background in clinical practice: OR, pediatrics, adult med-surg, private duty, and ER supervisor. She taught biological sciences, served as a director of nursing service and director of the school of nursing at Providence Hospital, Detroit, Michigan. In 1949, she went to the Indiana State Board of Health, Hospital Division, where she worked to help upgrade the nursing services in general hospitals in Indiana” (Hartweg, 1991). “As part of her master’s degree work, Orem had to formulate a definition of nursing...
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...and Analysis across Theories The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories. The grand nursing theories are a conceptual model, which identifies the focal point of nursing inquiry and guide the development of mid-range theories that will become useful to nurses and also to other health professionals. According to Walker and Avant (2011), these theories contributed in “conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives.” In this essay, Orem’s Health Care Deficit Theory and Sister Callista Roy’s Adaptation Model are compared and analyzed for their importance in nursing. Orem’s Self-Care Deficit Theory Orem’s Self-Care Deficit Theory is one of three grand theories written by Dorothea E. Orem. According to Orem, nursing becomes necessary when an individual can no longer care for him or herself. Nursing provides care through...
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...Do you believe your theory systems when followed enables health care providers to better meet the needs of the patient, or do you believe the strict protocol hinders and prevents care therapies that might otherwise be more effective for the patient, and why? My theory is very simple; a person must have the ability to take care of himself. I believe it enables health care providers to better meet the needs of the patient. Nurses use my theory on a daily basis for taking care of the patients such as making the patient’s transition from the hospital to their own home much smoother. An example of using my Self Care Theory is educating a patient on their diabetes so they can be independent about taking care of their diabetes and outcomes. Education to the patient is very critical. Eventually the nurse set s goals set by the patient and evaluates the results of the plan. #11. Your “Self Care Theory” is considered a grand nursing theory, which is reflective of personal insights, useful practices designed by empirical testing, therefore one may considered this biased, would you agree why and why not? What do you consider to be the differentiation of your theory over some others classified under the same “Grand Theory” Category? No I don’t feel my Self Care Theory is biased because it’s a requirement of every person, not just a certain age group. Every person can benefit from my theory. My Self Care Deficit theory is said to be one of the Grandest Theories because it is most...
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...Emmanuel Okoroafor. Educational Preparation. Grand Canyon University January 2013 Educational Preparation * BSN means Baccalaureate of Science in Nursing and ADN means Associate Degree in Nursing. Both degrees will qualify a student to take the same NCLEX exam for a practicing license. There are different competency levels in these two programs. BSN is a four year university program with focus on knowledge, theories, research and clinical and an overall emphasis on the entire field of nursing. The program tend to expose the student to human diversity, global perspective, ethical, legal, health promotion, spiritual perspective, political, and social influences using liberal arts for a complete understanding of the field(Punturi,2010)The ADN is a two year program with focus on the clinical skills and more task oriented. The ADN program does not go into too much details of different aspects of health sector like leadership, political, ethical, policy and other global perspectives. BSN prepared nurse posess the following competency according to leddy and Peppers Conceptual Bases of Professional Nursing(Lucy J Hood,2010)provide direct care with different nursing diagnosis using nursing process, within allowed parameters, and independent nursing decisions. * A mentored clinical learning situation in both classroom and practice setting helps nurses to apply theoretical knowledge with actual event(Field,2004) In a study by Benner, on competency of nurses the study highlighted...
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...Comparison and Analysis Across Theories Comparison and Analysis across Theories The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories. The grand nursing theories are a conceptual model, which identifies the focal point of nursing inquiry and guide the development of mid-range theories that will become useful to nurses and also to other health professionals. According to Walker and Avant (2011), these theories contributed in “conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives.” In this essay, Orem’s Health Care Deficit Theory and Sister Callista Roy’s Adaptation Model are compared and analyzed for their importance in nursing. Orem’s Self-Care Deficit Theory Orem’s Self-Care Deficit Theory is one of three grand theories written by Dorothea E. Orem. According to Orem, nursing becomes necessary when an individual can no longer care...
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...Middle Range Theory Continues to Guide Nursing Practice Judy John Maryville University Middle Range Theory Continues to Guide Nursing Practice Nursing theory has three distinct categories to describe the level of abstraction: Grand, Middle-Range, and Situation-Specific (Meleis, 2012, p. 33). Hugh McKenna (1997) defined these three categories, stating: 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). When thinking about nursing theory, one might ask: What is the purpose of theory? Is it even relevant to current nursing practice? The best response to answer these questions I have found is from Meleis (2012): The primary uses of theory are to provide insights about nursing practice situations and to guide research. Through interaction with practice, theory is shaped and guidelines for practice evolve. Research validates, refutes, and/or modifies theory as well as generates new theory. Theory then guides practice (p. 35). This explanation of theory by Meleis identifies nursing as a profession. Without theory to shape and guide nursing practice and research, nursing would not evolve and would remain stagnant. Additionally, without theory could nurses really claim that we are a profession...
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...Initially, when I graduated from my nursing program with an Associate’s Degree of Applied Science in Nursing, I thought I had reached the pinnacle of my formal education. After all, the rest was ‘on the job’ training. The opinion I held of Bachelor degree nurses was, quite frankly, that they were more educated in research and theory than they were in actual patient care. In my eyes, only nurses who wanted to pursue administrative roles were interested in furthering their degree. Pursing a greater nursing experience, I sought out any and all continuing education opportunities in my respective field. I completed short courses pertaining to critical care and hemodynamics, attended seminars and presentations, and acquired any certifications I was able. This served me well for several years. As my career progressed, I came to realize the irony of my prior sentiment. Ever more appreciative of the nursing process and affected by changes in modern medicine, I found myself looking for ways to improve the environment in which I devoted so much time and energy. In the pursuit of improving my department’s methods and practice, for both patient satisfaction and financial efficiency, I accepted my first leadership position in the cardiac catheterization lab. The rest, as they say, is history. A new passion was formed, and the love of contributing to continuous process improvement was born. Suddenly, I needed the formal education and degree I had previously rebuffed. So here I stand, humbled...
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