Discussion 1: Describe your thoughts on the use of middle range nursing theories in relation to nursing practice as compared to the use of other levels of nursing theory – Solution

Middle range nursing theories in relation to nursing practice

Describe your thoughts on the use of middle range nursing theories in relation to nursing practice as compared to the use of other levels of nursing theory.  

According to Polit & Beck, middle range theories, compared to its broader, and more abstract counterpart; grand theories, explain human phenomena at a smaller conceptual scale (2019). As its name implies, middle range theories fall within the middle range of the abstract-concrete spectrum of nursing theories.

Because its scope is more limited, middle-range theories tend to be more generalizable to nursing and amenable to empirical testing, making it more useful to the clinician (Moran, et al 2020). Moreover, its concrete nature gives way to more focused, specific descriptions, explanations or predictions about a nursing-phenomena of interest (Zaccagnini & White, 2014).

The least abstract level of theory, the practice theories, are very concrete and narrow in scope, often used to guide specific areas of practice.

As the aforementioned authors note, middle-range theories provide a broad (but not too broad) yet also somewhat specific scope, in the level of abstraction in nursing theories. This is helpful in that it allows for a broader generalization of concepts to apply in nursing practice, yet concrete enough to be tested, and applied in clinical practice. Grand theories, unlike middle-range theories, are so broad and abstract, that it can be difficult for the nurse to intentionally integrate into practice.

On the other hand, practice theories or situation-specific theories are so concrete, and only cover a narrow scope, making it difficult for the nurse to apply in general nursing practice (Moran, et al. 2020). The appeal of middle range theories in nursing practice is that it has a broad enough scope to cover a wide range of ideas, yet also concrete enough to be amenable to empirical testing and applied to clinical practice.

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Middle range nursing theories in relation to nursing practice
Middle range nursing theories in relation to nursing practice

B & C. Briefly share what theory/theories you are considering for your scholarly DNP project and why.

Relate your response to the clinical issue or problem that you have identified  for your scholarly project and the PICOT question you wrote  earlier in the course. How can the theoretical concepts ( from the chosen theory) be used to describe, support, or explain practice? (Related to MO1,3,5)

I would like to determine cancer screening among kidney transplant recipients at the Cincinnati VA Medical Center, using middle range theory: Health Belief Model as my conceptual framework.

P- ages 40-75, Kidney transplant recipients at the Cincinnati VA Medical Center

I – routine cancer screening

C – compared to the general population at the Cincinnati VA Medical Center

O –adherent to current clinical practice guidelines

T – 5 years from 2017-2021

Among Cincinnati VA Medical Center kidney transplant recipients ages 40-75 years, (P), what is the compliance with routine cancer screening (I) compared to the general population at the Cincinnati VA Medical Center (C), in adhering to current practice guidelines (O), from 2017-2021 (T)?

Using the Health Belief Model (HBM) as a conceptual framework for my study, I plan to evaluate the compliance rate of routine cancer screening among Cincinnati VA kidney transplant recipients compared to the general population at the Cincinnati VA. The HBM focuses on patient compliance and preventative health care practices. This model proposes that certain health care behaviors stem from one’s perception of threat by a health problem (in this case, cancer) and the value associated with actions aimed at reducing the threat (early cancer detection to reduce morbidity and mortality).

According to Polit & Beck, “the major components of the HBM include perceived susceptibility, perceived severity, perceived benefits and costs, motivation, and enabling or modifying factors” (2017). Understanding kidney transplant patients’ perceived susceptibility to cancer, their perceived severity of what would happen if they do develop cancer, the benefits and costs of routine cancer screening, the motivation, or their desire to comply with treatment, and modifying factors such as personality variables, satisfaction with their care, health provider trust, and sociodemographic factors can affect their rate of compliance with routine cancer screening.

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