Classification (Types/Levels) of Nursing Theories
Classification (Types/Levels) of Nursing Theories
Nursing theories are logical, generalizable, and consistent with everyday observations. They provide a basis for nurses to test hypotheses and guide the nursing practice. Given their importance, nursing theories can be classified into three levels depending on abstraction: grand theory, middle-range theory, and practice-level (nursing practice) theory.
Let's explore each level in-depth.
Grand Nursing Theories
In a simple definition, grand theories are abstract, broad, and complex concepts that offer a general framework for nursing ideas relating to components such as people, environment, and health. They are primarily based on the experiences of the nursing theorists that postulate or develop them.
The grand nursing theories have the broadest scope for addressing diverse concepts and propositions that nurses are likely to encounter in their nursing practice. These theories are centered around conceptual frameworks and models for defining nursing practice in different situations and care settings and the ways of examining phenomena based on these points of view.
The grand nursing theories describe abstract nursing concepts that provide a framework for understanding nursing behavior and do not have too many details.
Examples of grand nursing theories include:
- Environmental theory by Florence Nightingale
- General systems theory by Imogene King
- Roy adaptation model by Sister Callista Roy
- Self-care theory by Dorothea Orem
- Philosophy and theory of transpersonal caring by Jean Watson
- Interpersonal relations model by Hildegard E Peplau
- Science of Unitary Human Beings by Martha E. Rodgers
- Humanistic nursing theory by Josephine Paterson and Loretta Zderad
- Theory of human becoming by Rosemarie Rizzo Parse
- Nursing process theory by Ida Jean Orlando
- Health as expanding consciousness by Margaret Newman
- Modeling and Role Modeling Theory by Erickson, Tomlin, and Swain
- Emancipated decision-making in healthcare by Wittman-Price
Florence Nightingale and Jean Watson are the two most popular grand theorists who have contributed to nursing theory by developing theories used in nursing practice, research, education, and administration.
Middle-Range Nursing Theories
The middle-range theories are more specific in focus and offer more concrete links between grand nursing theories and nursing practice. Notably, the concepts of the middle-range theories in nursing tend to be less abstract and more verifiable through testing or experimentation. In addition, these theories often describe, expound on, explain, and predict certain phenomena related to clinical practice.
Middle-range nursing theories focus on the concept and not all of the nursing, mainly including the concept's name within its title.
While the grand theories are broader and provide an overall framework for structuring ideas, the middle-range theories address narrowly defined phenomena and can be used to suggest an intervention.
Some of the most common middle-range theories include
- The framework of the systematic organization by Marie-Louise Friedemann
- Synergy model by AACN
- Health brief model by Blanche Mikhail
- Theory of uncertainty in illness by Merle Mishel
- Advancing technology, caring, and nursing by Rozzano C Locsin
- Behavioral systems model by Dorothy Johnson
- Quality of nursing care theory by June H Larrabee
- Nurse as a wounded healer by Marion Conti O'hare
- Theory of comfort by Katherine Kolcaba
- Theory of maternal role attainment by Ramona Theme Mercer
- Theory of group power within organizations by Christina Sieloff
- Acute pain management theory
- 11 functional health patterns by Gordon
Practice-Level Theories
The nursing practice theories focus on specific concepts relating to a defined patient population.
These theories are patient-centered and are often used by bedside nurses in their daily practice. They are scenario or situation-specific theories that focus on a specific patient group at a given time.
They directly influence nursing practice compared to the grand and middle-range theories. In most cases, these theories are interrelated with concepts from the middle-range and the grand theories.
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