Overview and Examples of Middle Range Nursing Theories
Whether you realize it or not, you’re likely already using nursing theories in your practice. For example, nurses are expected to give culturally congruent care — but this wasn’t always the case. This idea, like many others, originated as one of many middle range nursing theories. Understanding these theories can enhance your decision-making, improve patient outcomes, and elevate care. But what is a middle range nursing theory?
Nursing theories are conceptual frameworks that guide and inform nursing practice by explaining concepts, relationships, and strategies to improve patient care and outcomes. They fall into one of these categories:
- Grand nursing theories are broad and sometimes abstract perspectives that can originate in the experience of nurse theorists or nursing philosophies. For example, Lewin’s change theory is a grand framework.
- Middle range nursing theories bridge the gap between grand theories and clinical practice, providing evidence-based guidance on patient issues, specialties, and interventions. A middle range theory example is the self-care deficit theory.
- Practice nursing theories are specific theories that impact daily practice and individual patient outcomes. One example is the theory of human caring, developed by Jean Watson.
The Importance of Middle Range Theories in Nursing
Want new ideas, perspectives, and frameworks for your practice? Look no further than middle range theories of nursing, meaning that these theories can impact how you approach your day-to-day practice. While you might not spend a lot of time thinking about these theories in your everyday life, they help guide the profession as a whole.
Examples of Middle Range Nursing Theories
Looking for specific frameworks? Here’s a middle range nursing theories list to guide your research. This list is by no means exhaustive — new nursing theories are being developed and published every year.
1. Afaf Meleis: Transitions Theory
Experiences change people, and illness is no exception. How can nurses facilitate these changes in a healthy way? Meleis’ transitions theory examines the changes people go through as they experience illnesses and focuses on guiding nursing interventions that support patients as they navigate these changes.
2. Albert Bandura: Self-Efficacy Theory
Do you believe in yourself? Self-efficacy is the belief that you can do what needs to be done to achieve your goals, and Bandura’s theory posits that people with high self-efficacy are generally healthier and more effective. In nursing practice, this framework helps nurses encourage patients to pursue their health goals, but it also has implications for nursing students — if you believe you can pass an exam, you might be more likely to do so.
3. Dorothea Orem: Self-Care Deficit Theory
Someone who is experiencing an acute illness or decline may not be able to bathe themselves, go to the bathroom on their own, or feed themselves. Yet when caregivers perform every task for them, patients can lose even more functioning. Orem’s self-care deficit theory outlines a series of steps that a nurse can take to evaluate a patient’s needs, plan assistance methods, and carry out a plan that encourages independence.
4. Eakes, Burke, and Hainsworth: Chronic Sorrow Theory
Grief and loss are not one-and-done emotions: Patients experience them on an ongoing basis as they process conditions, disabilities, death, and other challenges. In chronic sorrow theory, researchers explain that this is a normal response to major negative life events, and that nurses can support patients by promoting positive coping strategies and emotional comfort.
5. Kristen Swanson: Theory of Caring
What does it mean to care for others? Swanson’s theory of caring supports a holistic vision of caring that applies to how nursing educators care for students and how nurses care for patients and families. Her theory outlines five processes for caring:
- Knowing
- Being with
- Doing for
- Enabling
- Maintaining belief
6. L.V. Polk: Resilience Theory
Resilience is the ability to bounce back and overcome hardships. Polk theorized that illness, and the adversity it creates, can be a transformative experience that increases resilience. In fact, Polk’s theory breaks down resilience into four parts:
- Dispositional
- Relational
- Philosophical
- Situational
7. Marylin Dodd: Symptom Management Theory
How does dysphagia (difficulty swallowing) affect the lives and experiences of patients with cancer? How are patients with schizophrenia affected by depressive symptoms? These questions relate to symptom management theory, which provides a framework for assessing and managing symptoms that impact patient outcomes.
8. Madeleine Leininger: Transcultural Nursing Theory
Nurses care for diverse groups of people that have different beliefs, expectations, and needs. Nursing professionals have a duty to respect, attempt to understand, and integrate a patient’s cultural background in their plan of care. While transcultural nursing theory may sound basic now, when it was presented in 1988, it was a major shift from the predominant Western approach to nursing.
9. Merle H. Mishel: Uncertainty in Illness Theory
Being sick introduces uncertainty in a patient’s life. Will they be able to care for themselves? Will they recover to their full level of functioning? Merle Mishel’s uncertainty in illness theory addresses how patients cope with the uncertainty of illness and its outcomes, emphasizing the psychological processes that patients go through. Mishel’s work has been used in nursing research to guide interventions that help manage patients’ apprehensions while sick.
10. Nola Pender: Health Promotion Theory
Someone who grew up in a family who exercises will likely find it easier to implement healthy workout routines in the future. Yet the same person may face a busy schedule, and their exercise practice can suffer. This is the core idea of health promotion theory: A patient’s pursuit of health is impacted by environmental and interpersonal dynamics. Pender’s theory helps inform nurses’ health promotion practices and supports a holistic vision for health.
Put These Middle Range Nursing Theories to Use in a New Role
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