Contemporary nursing is profoundly connected with the application of middle-range theories and frameworks as they allow to enhance the process of caregiving. This paper aims to discuss the Scholarly Project (SP) theme, the approach to its application, and middle-range theories which are employed in support of the project.
First of all, it is essential to observe the clinical problem which is addressed in the SP. The goal of the project is to develop a program that detects the risk factors, associated with the development of obesity in the school-age Hispanic population. This issue is of critically high importance since Mexican American children are 1.6 times more likely to be obese than white children (Ma 1). The role of a qualified caregiver is immense for this issue because it is essential to prevent the development of obesity and to establish meaningful relationships between nurses and families.
Since the problem is identified, it is possible to observe the approach which should be employed to solve the mentioned issue. According to Ma, three key policies should be implemented:
- to establish trusting relationships with patients
- to respect cultural differences and their influence
- to employ teaching and learning methods for promoting a healthy nutrition attitude (7).
All the policies mentioned above are connected with cross-cultural communication because the issue could not be separated from the cultural norms of Mexican Americans. It is also important to notice that obesity adversely affects society as a whole (Jackson 9).
Furthermore, it is essential to consider two middle-range theories that could be employed as a framework for ameliorating the process of caregiving (Chism 98; Butts and Rich 74). Firstly, Watson’s explanatory theory of human caring could be successfully applied to the issue of SP. The principal advantage of Watson’s approach is that it supports the expression of positive and negative emotions and thus trusting relationships are established between nurses and patients (Jackson 11). When addressing such delicate matters as weight management, it is of high importance for a patient, to be honest with a caregiver.
Concerning the second middle-range theory, it would be useful to employ Peplau’s descriptive theory of interpersonal relations. According to the method, there are four stages of nurse-client relationships: orientation, identification, exploitation, and resolution (Brandenburg 8). In the orientation phase, the nurse describes the plan of caregiving, in the second stage the patient identifies their needs, then they exploit all the resources provided by the nurse, and, finally, the resolution phase relates to the fulfillment of the patient’s requirements. The application of this approach appears to be significantly beneficial since it is a patient-oriented framework that is focused on the needs of people (Hagerty 2).
After the application of middle-range theories to the Scholarly Project was discussed, it is possible to observe specific strategies which could be implemented by advanced nurses to improve the discipline of nursing. The implementation of such strategies was elaborately discussed by Jacqueline Fawcett in her book “Applying conceptual models of nursing.” She argues that conceptual models of nursing serve as the basis for practical nursing activities (Fawcett vii). Further, she states that these models translate into practice through the conceptual-theoretical-empirical (CTE) structures. CTE framework is structured as a three-stage process, which consequently transcends a chosen conceptual model to guidance for practical nursing activities. As an example, it is possible to mention Orem’s self-care framework, which focuses on the patients to “meet their own and their dependent others’ therapeutic self-care demands” (Fawcett 189). Fawcett provides an example of CTE structure’s application to the practical problem of obesity: C component comprises the establishment of therapeutic self-care demand, T component includes nutrition decision making, and E component is the assessment of the previous element by the nutrition self-care inventory survey.
Additionally, it is essential to mention examples of the correlation between the four types of theories with the level of inquiry. As it is stated by Butts and Rich, nursing theories, based on their levels of abstraction and scope, are divided into four distinct categories: metatheories, grand theories, middle-range theories, and practice theories (92). Metatheory comprises the worldview of the nursing discipline and methods for generating knowledge, while grand theory is preoccupied with the following meta-paradigm concepts: person (human being), environment, health, and nursing, which are too broad to state hypotheses in empirical terms (Butts & Rich 93). Also, there are four philosophical areas of inquiry (ontological, epistemological, ethical, and logical), which are investigated primarily by metatheories and grand theories. Further, their findings are translated into nursing practice with the implementation of middle-range theories (categorized as descriptive, explanatory, predictive, and prescriptive) and practice theories (sometimes referred to as situation-specific theories), which are narrow approaches that result from empirical testing (Butts & Rich 106).
In conclusion, it is possible to mention that the employment of Watson’s and Peplau’s theories to the Scholarly Project’s field of study would give vastly positive results. Since the problem of obesity still prevails throughout the population of the United States (especially among adolescent Mexican Americans), it is essential to apply theoretical frameworks to nursing practice.
Butts, Janie B., and Karen L. Rich, editors. Philosophies and Theories for Advanced Nursing Practice. 2nd ed., Jones & Bartlett Learning, LLC, 2015.
Brandenburg, Sara J. Nurse Perceived Barriers to Effective Nurse-Client Communication. Thesis, University of Central Florida, 2017.
Chism, Lisa Astalos, editor. The Doctor of Nursing Practice: A Guidebook for Role Development and Professional Issues. 4th ed., Jones & Bartlett Learning, LLC, 2017.
Fawcett, Jacqueline. Applying conceptual models of nursing: quality improvement, research, and practice. New York, NY: Springer Publishing Company, LLC, 2017.
Hagerty, Thomas Arthur. Testing Peplau’s Theory of Interpersonal Relations in Nursing Using Data from Patient Experience Surveys. Dissertation, City University of New York, 2015.
Jackson, Kimberly. Quality Improvement Initiative to Improve Weight Management in Primary Care. Dissertation, East Carolina University, 2017.
Ma, Jacqueline. “The Lived Experience of a Hispanic Family and Childhood Obesity: A Case Study.” International Journal of Nursing Student Scholarship, vol. 2, 2015, pp. 1-10.