Theories are concepts or notions used in inferring observations, unfolding relationships and elucidation experiences of project results. According to nursing theorists, theories are expedient in helping to know what they know and decide on what they need to know. On the other hand, nursing is apprehensive with laws and principles governing the life processes and functioning of sick or well human beings. Nursing theories are beneficial in understanding the knowledge of nursing and its application (Smith & Liehr, 2008). Nursing theories are of three types, and they are crucial in different abstraction aspects of the nursing profession. For instance, the grand theory has a broad scope and is extremely abstract. In most cases, it presents general propositions and concepts hence not useful in empirical testing, thus; limiting its use. Situation-specific theory is a narrow range concept that has high specificity as compared to the others. It is useful in guiding certain actions into achieving desirable objectives. Middle-range theory is the most used in nursing practices, because it is often focused on the result of a research outcome (Fawcett, 2005). The theory has a broad scope vital in complex situations and during empirical testing. Most nursing practices in the 21st century utilize the middle-range theories due to several reasons.
Middle range theory is narrower and concrete than the grand theory, because it is made up of limited propositions and conceptions, which are written at a level that is concrete and certain. They form part of the nursing discipline through addressing the substantive knowledge of nursing discipline. This is done by expanding and explicating certain phenomena that are related to the nursing and healing processes. Some of the vastly utilized middle range theories include the Watson’s theory of human caring, the Orlando’s theory of deliberative nursing process and the Peplau’s theory of interpersonal relations (Fawcett, 2005). There are several examples of middle range theories used in nursing today. Nursing scholars prefer using the middle range theory mainly because of the great difficulty in using and testing the grand theories. The concept of middle range theory can be observed and measured using an empirical indicator. The indicator gives information known as data that are in turn utilized to generate and test theories. Empirical indicators in most cases yield data, which can be sorted qualitatively or calculated quantitatively. The indicators often tell the nursing practitioner what to do in a precise manner (Parker, 2005).
Middle range theories can be descriptive, explanatory or predictive depending on the event of its usage. Descriptive middle range theories are most basic since they majorly classify or describe a phenomenon. In most cases, the theories concentrate on a single concept. Descriptive theories when describing a phenomenon, often name the commonalities present in the discrete observations of situations and events. During its classification of a phenomenon, it essentially categorizes the described commonalities into dimensions that can be hierarchical, mutually exclusive, sequential or overlapping (Smith & Liehr, 2000). The middle range descriptive theories are always generated and tested through qualitative or quantitative, descriptive research. An example of this theory is the Peplau’s theory of interpersonal relations. Middle range explanatory theories are used in showing relations between concepts. They explain the reason and the extent to which contents are related. Their testing and generation is done through correlational research, which often has a quantitative design. An example of that is the Watson’s theory of human caring (Fawcett, 2005). Middle range predictive theories try to explain how phenomenal changes occur, and they are generated and tested through experimental research, a quantitative design. Its principal example is the Orlando’s theory of deliberative nursing process (Smith & Liehr, 2000).
Nursing theories, in this case middle range nursing theory, is essential for the provision of communication structure through which nurses relate with other health care team members. It is useful in the clarification of nursing beliefs, goals and values, hence the ultimate contribution of nurses in the health care field. A clear focus on the contribution of nursing portrays substantial professional autonomy, which in turn, leads to full control of nursing aspects (Ahmad, 2006).
The theories have direct linkages to practice and research, thus using them gives a surety of continued development in the nursing field. Nurses can use these theories in the creation of practice guidelines. For instance, the oncology nurses can develop protocols with their basis on the unpleasant symptoms theory and use it in caring for chemotherapy patients. By using this protocol in real practice, it can feed back to the middle range theory; moreover, it can extend the evidence of the nursing practice and advance on the ongoing theory development. Middle range theories are often utilized in structure practice and research, where they help in building the organization, substance and integration of the nursing discipline. The growth and development of the nursing discipline depends on systematic application of existent nursing knowledge and continuous development of new ideas and knowledge (Smith & Liehr, 2008). Nursing requires necessary and sufficient attention in order to maintain its unique field of practice and inquiry. Today, nursing knowledge and practices are blossoming, and this is attributed to the practicality of the middle range theories. They enable nursing discipline to have valuable organization frameworks useful in different researches. The researchers are able to relate different phenomena that share similar concerns. Using these theories, nurses are capable of administering quality care, thus their retention. Theory guided practices in most instances, elevate the nurses’ work leading to tremendous satisfaction and fulfillment, thus providing a desired and satisfying professional practice model. The world health care practices often change on a daily basis due to the continued evolution and development of the nursing discipline (Smith & Liehr, 2000). Therefore, nursing requires continuous expansion in its knowledge base, in order to respond to alterations in the desires of the health care society.