Any professional discipline is theory-driven and evidence-based including nursing practice. Thus, a theoretical framework is designed to explain the phenomena observed in nursing practice and organize knowledge about them. The nursing theory uses concepts, propositions, and assumptions to describe, explain, and predict the phenomena observed in practice and prescribe nursing care. With the help of a scientific approach, researchers can determine in which direction the discipline should develop and accumulate knowledge. In other words, theory helps determine what is already known and what is needed to be learned in future research. The terms described in the paper are the tools for the formation of the theoretical basis of the discipline.
Like any other medical field, nursing is founded on research and theory. The basis and starting point for the creation of a theory is the discovery and observation of the phenomenon. The middle-range theory implies the presence of a certain statement, which was formed on the basis of an empirical phenomenon, and then tested by experimental data (Hoeck & Delmar, 2017). The phenomenon is rooted in personal experience or perception, and, therefore, must be supported by data to construct a theory (Galutira, 2018). Thus, the term provides a description or label given to an event or response about it. The basis of the theory is the observation of a certain phenomenon, and the goal of the theory is its explanation. Thus, a phenomenon is an event that is of interest to the researcher and makes one ask questions that can only be answered through study and data.
To describe the observed phenomena, it is necessary to give them a certain form. Therefore, a concept is used which can be defined as an “abstract term derived from particular attributes” (McEwan & Wills, 2018, p. 73). There can be many concepts, but they are interrelated in the research framework. Each of them is used to describe a specific feature of the phenomenon. Concepts can be defined as ideas or mental images, describing a phenomenon in language. They are constructed of words and help people communicate and convey ideas and statements about the phenomena. Concepts can consist of one or more words, or be a phrase that then helps to form a research hypothesis. They should be formulated clearly and distinctly in order to convey meaning as accurately as possible since “any form of scientific practice is expressed in and regulated by concepts” (Hoeck & Delmar, 2017, p. 2). Thus, the development of concepts is the first stage of work on the methodology of theory and its instruments.
After developing the concepts, the researcher examines the relationships between them. For this purpose, propositions are used, which then form propositional statements (McEwan & Wills, 2018). Propositions include the study of developmental factors and the results that a particular concept has (Galutira, 2018). Propositions link two or more concepts together to form a meaningful statement. Such statements explain how concepts interact and form a description of the observed phenomenon. Thus, a concept is a word or a number of them that convey the meaning of an idea, while a proposition contains a combination of such ideas. A hypothesis, as a proposition, is used to express assumptions about the connections between the concepts of a theory. However, the hypothesis must be supported by experimental data, while the proposition operates exclusively on ideas. The researcher can use it to express assumptions about the results of future experiments.
As the theory develops, the researcher needs to identify the statements which are presumed to be truthful for a specific purpose. Assumptions are statements that a researcher accepts as truth without any proof. They represent beliefs about a phenomenon that cannot be empirically proven. Assumptions are used to support propositions and represent logical inferences about the nature of a phenomenon. The theory is built on assumptions that then guide the empirical research. In contrast with hypotheses, assumptions are based on propositions that reflect the connections between concepts as part of the description of a phenomenon. Thus, they reflect the observations of the researcher of the nature and functioning of phenomena.
Phenomena, concepts, propositions, and assumptions form the theoretical basis of the nursing discipline. Each of the terms is a stage in the formation of a theory, which is then used as knowledge. The observed phenomenon reflects an event occurring in reality, which will be further investigated using theoretical tools. It is of interest to the researcher, who asks questions about the analyzed phenomenon, records it, and describes it. Concepts, used to define it, are the ideas denominated in words and phrases which convey particular meanings. With their help, the researcher describes the phenomenon and its parts for communication with other people. Further, it is necessary to establish relationships between concepts, which are called propositions. On the basis of identified connections, assumptions are formed, which are statements about the phenomenon not supported by experimental data. Thus, a scientific theory is shaped, which, in nursing practice, constitutes the basis of knowledge. The theory can then be used to form a hypothesis and to test it with experimental data.
Since nursing is aimed at improving the care provided for patients, then the phenomena are observed during practice. A phenomenon from nursing practice is the observation that the process of stabilization and adaptation of chronically diabetic patients often lasts continuously and does not have the same results over time. Thus, the outcomes of patients with equal medical and nursing activities are different. Related concepts that can be identified include patient, chronic illness, stabilization process, and outcomes. Based on the identified concepts, it is possible to form a proposition that the outcomes of stabilization and adaptation of patients with chronic diabetes are influenced not only by medical and nursing care but also by other factors.
Using a proposition, one can form an assumption that needs a number of logical conclusions. First of all, the related concept is also the patient, which implies their active participation in the process and the theory. Thus, the factors of influence can be either their actions or psychological aspects. The formed assumption is defined as the outcomes of the patient in the process of stabilization and adaptation in chronic diabetes depending on the self-management and psychological state of the person.
All four terms are interrelated to offer a framework for studying the effect of patient behavior and psychological state on the outcomes of therapy for chronic disease. The phenomenon observed in nursing practice provides a basis for research interest and questioning. The identified concepts allow to highlight the key aspects for determining the interrelationships of the parts of the phenomenon. Proposition establishes the links between the concepts to form an understanding of their influence on each other. Assumption uses the described results of observations and analysis to form a testable theory that can become an object for experimental proof.
Galutira, G. D. (2018). Theory of reflective practice in nursing. International Journal of Nursing Science, 8(3), 51-56. Web.
Hoeck, B., & Delmar, C. (2017). Theoretical development in the context of nursing: The hidden epistemology of nursing theory. Nursing Philosophy, 19(1), 1-10. Web.
McEwan, M., & Wills, E. M. (2018). Theoretical basis for nursing (5th ed.). LWW.