Nursing Research: Levels of Theory

What Is Nursing Theory?
A nursing theory is a way to bring a new perspective on a particular set of facts, a problem, a phenomenon, or other situation. Reed (2012) defines theory as “a structure of ideas in which two or more concepts are linked to propose a description or explanation of a process or event with logic, purpose, and significance” (p. 129). A theory offers a different way of viewing the situation so that fresh ideas and approaches can be used to deal with that situation more effectively. A theory bundles concepts and correlates them in ways that allow greater understanding. Generally, theories have to be both logical—they have to make sense—and broad—they do not apply so specifically to one patient or one symptom (Reed, 2012). Once a theory is created, that theory can then generate a hypothesis—an idea about a situation—that can be tested in a research project in order either to refute the theory or to expand its application. It is through such hypothesis-testing that theories expand our understanding of nursing (Reed, 2012). This allows theories to guide nursing practice by ensuring that the guidance offered by theory is consistent and reliable. Thus, nurses can use theories to help formulate their care of patients. Nursing Research: Levels of Theory

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Defining Concepts and Relational Statements
A concept can be thought of as a basic building block of a theory. Concepts are terms that are specifically defined by the person creating the theory, which explain the specific areas that theory addresses. For example, in Kolcaba’s comfort theory, three key concepts of comfort are defined, including relief (as in, having needs met), ease (as in, being relaxed and contented), and transcendence (as in, the experience of rising above and past problems) (Kolcaba, 2010). The specific definitions of “ease,” “relief,” and “transcendence” as used by this theory are key concepts underlying this theory. Thus it is critical in evaluating a theory to first understand the concepts used by that theory to make sure the theory is properly understood. Relational statements are those statements that identify specifically how concepts relate to each other according to the theory (Smith & Liehr, 2008). The idea that one concept, A, is a causal factor to another concept, B, is the relational statement that links them: A  B.

Concept Map as It Relates to Research
A concept map is simply a way of visualizing a set of concepts and how they relate to each other. For example, if one concept is believed to be a factor that causes another concept, that relationship can be diagrammed. Concept mapping allows researchers to clearly define and visualize exactly what they are testing as they formulate their research plans. In qualitative studies in which the framework emerges as a result of the study rather than being known beforehand, concept maps can be particularly useful for understanding the emerging framework and identifying relationships among concepts (Whiting & Sines, 2012). It allows researchers to identify which concepts are the causes and which are the effects according to the theory being tested. This determines independent and dependent variables, as one example.Nursing Research: Levels of Theory

The Purpose of Research Study Frameworks
Since any theory is an abstraction of available evidence, it is important to identify ways to translate that abstraction into more practical terms where it can be researched and, potentially, moved into a practice situation. The mechanism for accomplishing that change from abstract to testable is via the creation of a theoretical framework. This framework represents the evidence available to the researcher in a manner that allows the theory to be tested. Frameworks provide structure to approaching a research question by providing a guide to the research process (Smith & Firth, 2011). A framework transforms a set of concepts to a testable structure whereby a useful research project can be undertaken.

Differences between Middle Range and Practice Theories
A middle-range theory coalesces into more concrete terms the ideas generated by a grand theory. Typically, middle-range theories can be tested and validated by research. A middle-range theory moves a grand theory’s abstractions into more specific, testable frameworks (Smith & Liehr, 2008). The results of that research of a middle-range theory generates evidence, which in turn becomes the basis for practice theories and general evidence-based nursing practices (Reed, 2012). Smith & Liehr (2008) noted that practice theories are very specific to a single situation or phenomenon, whereas middle-range theories are broader in scope and cover a wider range of situations. Nursing Research: Levels of Theory