First of all, it is necessary to mention that your discussion post is dedicated to middle-range theories in nursing and their practical application may be regarded as highly thoughtful and informative. In general, the middle-range theory is nursing knowledge’s dimension designed for guiding health care research and practice. Its level is “below the more philosophical or grand theories and above empirical generalizations framed as hypotheses” (Liehr & Smith, 2017, p. 51). In the present day, middle-range theories are an intrinsic part of the nursing knowledge’s structure as their ongoing use helps to test, shape, enhance, and optimize this knowledge for the next decades.
Nine major middle-range theories include uncertainty, caring, self-transcendence, women’s anger, transitions, unpleasant symptoms, comfort, nursing intellectual capital, and inner strength (Liehr & Smith, 2017). The expediency of theories’ practical application is determined by their focus on patients’ well-being and description of processes for engaging and practice-relevant outcomes and actions. In other words, theories help health nurse practitioners understand patients’ behavior and suggest the most appropriate strategies for efficient health care delivery. At the same time, the theory of uncertainty was used at least 14 times in studies since its introduction (Liehr & Smith, 2017). In addition, another crucial function of middle-range theories is their contribution to distinguishing nursing from other professions in the health care sector.
In addition, you are right about addressing the need to evaluate middle-range theories and their effectiveness to make them suitable for modern standards of care. For instance, according to Riegel et al. (2019), the middle range theory of self-care for chronic illness introduced in 2012 should be revised and improved as there is a lack of clarity in particular areas. Thus, an appropriate theory should be beneficial for shaping research questions, developing interventions, and selecting outcome variables.
Your evaluation of the role of middle-range theories in nursing practice is well-elaborated and accurate. In particular, it is amazing that you have included your personal experience and reflection concerning your role as a health care provider considering middle-range theories as well. There are multiple examples of the ways how these theories are used to improve nursing practice and make it more effective both for patients and nurses. For instance, Lee and Sung (2017) address the violence coping program (VCP) created based on Polk’s middle-range theory of resilience and its impact on nursing resilience, burnout, competency, and “to cope with violence in nurses working in emergency rooms” (p. 332). According to their study’s result, the middle range theory and related programs considerably help to improve nurse practitioners’ life infrequently challenging medical settings (Lee & Sung, 2017).
Another example of middle-range theories’ benefits for the improvement of practice is presented in the research conducted by Jaarsma et al. (2017). The authors address the theory of self-care for chronic illness and examine the major factors describe in it. These factors include access to health care, experiences and skills, cultural values and beliefs, functional and cognitive abilities, motivation, habits, support, and confidence (Jaarsma et al., 2017). According to a recent finding, taking into consideration these factors helps to improve the patient’s condition in the case of self-care determined by heat failure. In addition, certain middle-range theories were specially developed for nurses in particular spheres of medicine for efficient health care delivery. For example, a middle-range theory of nursing in hypertension care was designed “to guide nurses in their practice, to improve the nursing of patients and design studies for investigating nursing in hypertension care” (Drevenhorn, 2018, p. 1).
Drevenhorn, E. (2018). A proposed middle-range theory of nursing in hypertension care. International Journal of Hypertension, 2018(2858253), 1-11. Web.
Jaarsma, T., Cameron, J., Riegel, B., & Stromberg, A. (2017). Factors related to self-care in heart failure patients according to the middle-range theory of self-care of chronic illness: A literature update. Current Heart Failure Reports, 14, 71-77. Web.
Lee, S. M., & Sung, K. M. (2017). The effects of violence coping program based on middle-range theory of resilience on emergency room nurses’ resilience, violence coping, nursing competency and burnout. Journal of Korean Academy of Nursing, 47(3), 332-344. Web.