MN502M3-3: Apply a model of practice to advanced nursing roles

Introduction

There is a strong relationship between nursing theory, research, and practice. Nursing theory is foundational to nursing research and practice, and theory is also informed and developed by the results of research and practice. Nurses may select a theory to describe or explain phenomena encountered in practice, and during application in practice the theory is further defined. Nurse researchers test theories’ applicability in practice through clinical research, and nurse scientists develop new theories to explain research findings.

Directions

In this assessment, you will identify a grand nursing theory used in a research article and a middle-range nursing theory used in a research article. You will examine how each theory was applied within the respective research study and then analyze the utility of grand and middle-range nursing theories to advance the discipline of nursing and its impact upon your advanced nursing practice.

Assessment Details

  1. Introduce the reader to the content of this paper with an introductory paragraph.
  2. Provide general background information about grand, middle and practice theories.
  3. Examine a research article in which a Grand Nursing Theory was applied in the research. Describe how the theoretical concepts and propositions were used.
  4. Examine a research article in which a Middle Range Nursing theory was applied in the research. Describe if the theory was used as a descriptive, explanatory, predictive, or prescriptive theory in the research.
  5. Explain the importance of theory to your advanced nursing role and how research informs and advances the discipline of nursing.

Answer

Applying a Model of Practice to Advanced Nursing Roles.

Nursing practice is grounded on theory and research. Several major theories in nursing inform nursing practice and nursing education. Practices, research, and education programs founded on theoretical frameworks have various characteristics that promote aspects of the nursing profession. The research outcomes, shaped by these theories, vividly portray the differences in these theories. Theories can inform advanced nursing roles in education, practice, and research. This essay evaluates the application of grand and middle theories in nursing research and their differences, the importance of theories to FNP, and research to nursing practice.

Grand, Middle-range, and Practice Level Theories

Grand theories address significant areas of concern in nursing, addressing a variety of propositions and concepts in nursing (Roy, 2018). Middle-range theories focus on a concept and not the whole discipline and often have the concepts name in the title, for example, The self-care theory. Practice-level theories are narrower and more specific than grand and middle-range theories and address particular problems or interventions. Theories at this level are the best in proposing best nursing practices and best solutions or strategies for specific problems.

The major difference between grand theories and middle-range theories is that those grand theories provide a comprehensive scope of concept abstracts, most often the discipline as a whole. In contrast, middle-range theories focus on an aspect of nursing and often result from the research (Roy, 2018). The concepts in middle-range theories tend to be more focused and can be hypothetically tested. Grand theories can be tested, but their abstractness makes them challenging. Thus, middle-range theories are a product of grand theories and nursing practice. These theories all inform nursing practices, education, and research, as shall be explored in other paper sections.

Grand Nursing Theory Application

Sister Callister Roy is a grand nursing theorist who developed the grand theory- Roy’s adaptational model (RAM). RAM’s conceptual framework focuses on an interconnected and holistic view of an individual’s interaction with the environment. Its primary focus is manipulating the patients’ environment to promote their health and holistic well-being. Dharma et al. (2018) carried out a study to investigate the effect of a caregiver educational program based on RAM. The study utilized the adaptation themes as a framework for their educational interventions. RAM was used to explain the stroke patient adaptation process.

The education program is based on RAM’s postulation that the human being is an adaptive system capable of adapting to various situations across the lifespan (Dharma et al., 2018). In addition, using coping strategies leads to an adaptive response. The researchers found themes of adaptive responses, which they divided into stressors or stimuli, adaptive coping strategies, and effective adaptation behavior and integrated them with RAM (Dharma et al., 2018). They then decided on the best medical and educational interventions based on merit. The education content also borrows from RAM postulations and focuses on increasing patients’ and their families’ adaptive responses, coping with various disabilities, and resuming optimal life post-stroke. The research utilizes the theory’s abstractions and postulations to develop an effective education program for post-stroke patients.

Middle-Range Theory Application

Jean Watson is a mid-range nursing theorist and the proponent of Watson’s Theory of Human Caring. The theory postulates that humans cannot be treated as objects or be separated from others, self, nature, or. The theory primarily applies to interpersonal relationships, especially the nurse-patient relationship. Evangelista et al. (2021) carried out an explorative qualitative study to analyze nurses’ role in palliative care, especially spiritual care, utilizing the mid-range theory- Watson’s theory of human caring. The research observes the principles of intentionality, authentic presence, and caring to safeguard humanity. The researchers describe that showing care rejuvenates a patient’s strength, leading to optimal life and a calm dying process (Evangelista et al., 2021). It also improves their quality of life through acceptance and conforming to a superior being. Providing spiritual care is challenging, but it plays a vital role during patient care. Watson’s theory postulates that healing occurs from within when care is pertinent. According to the research, nurses share attitudes with Watson and assist patients with spiritual dimensions during patient care.

Nursing Theory and FNP

Nursing theories remind FNPs of the importance and overall nursing goals, thus informing nursing practice. FNPs have many roles as caregivers, researchers, and educators, and nursing theories provide frameworks for developing care interventions (Owens, 2018). They also form theoretical and conceptual frameworks in research to improve healthcare delivery in primary care settings. Nursing theories help improve FNP education through effective education planning using theory postulations and major concepts hence high-quality patient and student education in clinical settings (Finneran & Kreye, 2021). Thus, nursing theories are integral to FNP.

Research in Informing and Advancing Nursing

Nursing practice is largely evidence-based and requires extensive research. Research leads to new knowledge leading to increased understanding (Tappen, 2022). Knowledge in nursing changes nurses’ perceptions and shapes policies and regulations, improving nursing as a profession globally (Heng-Hsin, 2020). It tests existing knowledge and supports or refutes it with empirical evidence, hence developing and maintaining highly effective nursing practices (Tappen, 2022). Nursing relies heavily on evidence-based practices for care provision. Thus, research is a vital non-dismissible part of nursing.

Conclusion

Nursing theories inform nursing practice, research, and education. Grand, middle-range, and practice-level theories are integral to the nursing profession. Their scope narrows down the hierarchy, and nurses choose the levels that suit their needs. They can be used in research to determine the best interventions in care. Theories inform education, research, and practice in advanced practice nursing. Research improves the nursing discipline by testing theories, adding new knowledge, and priding empirical evidence-based nursing practices.

References

Chien, L. Y. (2019). Evidence-based practice and nursing research. The Journal of Nursing Research, 27(4), e29. https://dx.doi.org/10.1097/jnr.0000000000000346

Dharma, K. K., Damhudi, D., Yardes, N., & Haeriyanto, S. (2018). Increase in the functional capacity and quality of life among stroke patients by family caregiver empowerment program based on adaptation model. International Journal Of Nursing Sciences5(4), 357-364. https://doi.org/10.1016/j.ijnss.2018.09.002

Evangelista, C. B., Lopes, M. E. L., Costa, S. F. G. D., Batista, P. S. D. S., Duarte, M. C. S., Morais, G. S. D. N., & Gomes, B. D. M. R. (2021). Nurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring. Revista Brasileira de Enfermagem, 75. https://doi.org/10.1590/0034-7167-2021-0029 

Finneran, J. M., & Kreye, J. M. (2021). Empowering the novice family nurse practitioner: Promoting readiness to practice through immersion in an innovative educational strategy. Journal of the American Association of Nurse Practitioners, 33(5), 383-390.

Heng-Hsin, T. U. N. G. (2020). Curial Role of Nursing Research in the Healthcare Delivery System. Journal of Nursing Research28(1), e59. https://doi.org/10.1097/jnr.0000000000000375

Owens, R. A. (2018). Transition experiences of new rural nurse practitioners. The Journal for Nurse Practitioners, 14(8), 605-612. https://doi.org/10.1016/j.nurpra.2018.05.009

Roy, C. (2018). Critical issues in nursing theory: Developments, challenges, and future directions. Nursing Research, 67(2), 81-92. https://doi.org/10.1097/NNR.0000000000000266

Tappen, R. M. (2022). Advanced nursing research: From theory to practice. (3rd Ed.). Jones & Bartlett Learning.

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