There are several different types of theories in nursing. Grand theories look at nursing from a broad perspective of human needs. In contrast, middle-range theories are narrower in focus, and look at specific aspects of the nursing profession. Due to their narrower scope, middle-range theories are more applicable for use in actual nursing practice.
High level middle-range theories can be quite complex (for example, Benner’s “Novice to Expert Theory” and Leininger’s “Theory of Culture Care Diversity and Universality”). Less complex middle-range theories include Mishel’s “Uncertainty in Illness Theory,” Kolcaba’s “Comfort Theory,” and Lenz and Pugh’s “Theory of Unpleasant Symptoms.” Some middle-range theories are even more specifically focused. For example, Beck’s “Postpartum Depression Theory” or Eakes et al.’s “Theory of Chronic Sorrow."
For this Discussion, you will identify a practice or organization issue of importance to you. Then, you select two middle-range theories and apply them to address the practice or organization issue.
Note: The practice issue you select will also inform your work in Week 3 (and can potentially be utilized throughout the remainder of this course).
Resources
• Reflect on your nursing practice to identify issues of particular interest or concern to you and/or your organization.
• Select one practice or organization issue on which to focus for this Discussion.
• Review the Learning Resources for this week, focusing on specific middle-range theories that may apply to the practice or organization issue that you selected.
• Select two middle-range theories that you believe are relevant and valuable in addressing the practice or organization issue you selected.
• Identify the practice or organization issue you selected. Explain why you chose it.
• Describe the two middle-range theories that you selected. Explain why you chose them.
• Explain how you would apply each middle-range theory to the practice or organization issue. Be specific and provide examples.
Full Answer Section
- Kolcaba's Comfort Theory: This theory emphasizes the importance of comfort in promoting healing and well-being. By addressing physical, psychosocial, and environmental comfort, healthcare providers can reduce patient anxiety and agitation, which can contribute to falls.
Applying the Theories to Patient Falls
Mishel's Uncertainty in Illness Theory:
- Assessment:
- Identify patients who are experiencing uncertainty related to their hospitalization or treatment plan.
- Assess the level of uncertainty and its impact on their emotional state and behavior.
- Intervention:
- Provide clear and concise information about the patient's condition, treatment plan, and expected outcomes.
- Encourage open communication and answer questions honestly and compassionately.
- Involve family members in the care process to provide support and reduce uncertainty.
- Evaluation:
- Monitor the patient's level of anxiety and distress over time.
- Assess the effectiveness of interventions in reducing uncertainty and improving patient outcomes.
Kolcaba's Comfort Theory:
- Assessment:
- Identify factors that may contribute to discomfort, such as pain, fatigue, or environmental stressors.
- Assess the patient's perception of comfort and their specific comfort needs.
- Intervention:
- Implement comfort measures to address physical, psychosocial, and environmental factors.
- Use evidence-based interventions, such as pain management strategies, relaxation techniques, and noise reduction.
- Create a calm and supportive environment.
- Evaluation:
- Monitor the patient's comfort level and adjust interventions as needed.
- Evaluate the effectiveness of comfort interventions in improving patient satisfaction and outcomes.
By applying these theories, healthcare providers can develop comprehensive strategies to address the issue of patient falls. By reducing uncertainty and promoting comfort, we can improve patient safety and enhance the overall quality of care
Sample Answer
Practice Issue: Patient Falls
Why I Chose This Issue:
Patient falls are a significant safety concern in healthcare settings, leading to injuries, prolonged hospital stays, and increased healthcare costs. Addressing this issue is crucial to improve patient outcomes and reduce healthcare expenditures.
Selected Middle-Range Theories:
- Mishel's Uncertainty in Illness Theory: This theory focuses on the impact of uncertainty on individuals' responses to illness. Uncertainty can lead to anxiety, distress, and impaired coping mechanisms, which can increase the risk of falls.