To be a nursing theory, the theory must be about nursing-related concepts. The metaparadigm concepts of person, environment, health, and nursing serve as an umbrella for other concepts that may be present in a nursing theory. Nursing theories vary in their scope and level of abstraction. The following are types of nursing theories.
Conceptual Model or Conceptual Framework - A conceptual model is a group of concepts that flow from the same paradigm perspective. It describes a certain approach and view of the discipline. Although it may contain more than one concept, the relationships among concepts are not clearly delineated and not testable. A conceptual model is intended as an organizing framework from which a more concrete theory will be derived.
Grand Theory - A grand theory is similar to a conceptual model in that it describes a certain viewpoint that is applicable across many different fields within nursing. A grand theory is broad in scope; it is composed of related concepts but the relationships are not concrete. A grand theory is a highly abstract description of proposed truth. Although grand theory is testable, the concepts and relationships involved make testing difficult. Martha Rogers’ science of unitary human beings proposes ideas about humans that are highly abstract and difficult to test using accepted research methods.
Theory – A theory is less abstract than a grand theory and has a narrower scope. A theory applies to a specific aspect or practice area of nursing, but is not as limited as a middle range theory.
Middle Range Theory - A middle-range theory is less abstract than a grand theory. It is more concrete, more usable and closer to practice. Often a middle range theory is developed from a grand theory. The concepts and relationship in a middle-range theory are directed more at a specific nursing situation than in the preceding types of theory. Middle-range theories are more amenable to testing through research.
Practice Theory - A practice theory describes a theory that is very concrete. It has a low level of abstraction. An example of a very simple practice theory would be something like "turning every 2 hours decreases the risk of pressure sores". You can see how this could be easily tested to see if it is supported.
Development of Nursing Theory
- Describe the process of nursing theory development
A theory is generated from observations made regarding a given phenomena. In everyday life, people often create theories about how and why things happen. To develop formal theory requires structured observations and subsequent testing.
Knowledge that is gained through observing multiple instances of the same phenomena is from an inductive approach. Inductive reasoning takes information gathered from specific events and derives a general statement or theory to describe the underlying principle. For example, multiple observations could be made of clients who are experiencing a similar situation; some general statements could be developed that might be expected to apply to other people who also experience that situation. Qualitative research is an inductive process that is valuable to generate theoretical ideas.
Once a theory is proposed, it must be tested to see whether the proposed generalities seem to hold true, and under what circumstances. In research, this proposed relationship is called a hypothesis. A hypothesis is an educated hunch about what is thought to be true. Hypothesis testing is a deductive approach that examines how well a general statement applies to a specific case. Deductive reasoning is the type of thought process used in the scientific method. Although traditional experiments are done in a lab, that type of environment does not usually work for the things about which nurses are concerned. When testing a theory, other contextual aspects of the situation must be considered, making nursing research quite complex. It is impossible to actually "prove" something beyond a shadow of a doubt, so nurse researchers attempt to find "support" for a theory.