Nursing is a constantly developing profession. Nowadays, nurses obtain unique knowledge and skills that are based on profound scientific research. This knowledge forms a complex system composed of various theories and concepts. Three main categories are high-range, middle-range, and low-range nursing theories. The main goals of this paper are to differentiate these theories and discuss results and implications of research based on middle-range theory.
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Differences between Theories
The main difference between these theories is their application grounds. High-range nursing theories are applied in psychiatric and mental health nursing (McEwen, n.d.). They have different purposes. The first is to describe psychiatric nursing practices and highlight the nature of people’s experience that is associated with constant changes and unpredictability. The second is to demonstrate the application of physical, emotional, and intellectual elements in comprehensive health care. The third is to focus on the process of adaptation in order to gain independence. The fourth is to describe the ways for improving, protecting, and restoring the health of the employees and show the effect of external and internal work settings on nursing practice. The major concepts of high-range nursing theories are personhood, client, health, environment, and autonomy. Middle-range nursing theories aim at self-help, chronic diseases, client health behavior, and self-efficacy (McEwen, n.d.).
Their main purposes are to demonstrate processes that improve the quality of life, show the phases of chronic diseases, provide a theoretical model of health behavior, and help patients be independent to manage their health problems. The major concepts of such theories are disease characteristics, life quality, cognitive assessment, health information, and outcome expectations. Low-range nursing theories are used for interventions for postsurgical pain, acute pain management, and assisting in the acceptance of death (McEwen, n.d.). In order to address the mentioned above issues, such theories highlight specific purposes. They describe approaches to assess pain and intervene, taking into account circadian variation. Also, they demonstrate nursing activities that aim at reducing postsurgical pain, avoiding severe side effects. Finally, they describe principles of medical care for terminally ill patients. The major concepts of low-range nursing theories are pain intensity, compensatory life processes, pain assessment, comfort, dignity, and respect.
A middle-range theory is the most comprehensive area. It might be defined as a set of concepts that have certain connections describing specific nursing responsibilities. These concepts form a complex model. Middle-range theories are necessary to guide everyday nursing practice and scientific research in this field.
Middle-range theories are widely used in scholarly research. For example, a study conducted in Malaysia demonstrates insight on “self-efficacy with managing type 2 diabetes among a sample of 388 adults” (Mareno, 2015, p. 121). Self-efficacy was assessed by means of the Diabetes Management Self-Efficacy Scale (DMSES). This is a Likert scale “that addresses an individual’s confidence in managing blood glucose, diet, and exercise” (Mareno, 2015, p. 121). The author appraised self-efficacy and found its connection with self-care behavior that was measured by a participant’s level of glycosylated hemoglobin. The patients with a higher level of self-efficacy had better glycemic control. On the other hand, the lack of education had a negative effect on glycemic control among participants. These results allow implying that patients with a lower level of education are more vulnerable.
The mentioned above theories are practically implemented throughout the world. They allow improving the quality of medical services and increase the competence of staff. However, the current situation in most medical settings requires the further development of such concepts. Therefore, it is highly necessary to continue research in this area.
Mareno, N. (2015). Applying middle-range concepts and theories to the care of vulnerable populations. Web.
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McEwen, E. (n.d.). Overview of selected middle-range nursing theories. Web.