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deuelopment of complications). [erry realized he needed a conceptual fiameUJork for tl-e project. His advisor suggested Penders Health PromotionModel. lmgth a/time on home health service. (i}CUS on . professi()nal competencies of the nurses providing the iI~fi}rmtltion.rcribed the model in depth. These include the quality and type ()f health information provided. he determined that mode/would be appropriate for UJe (IS the conceptualframeioori: fill' his research study. He has idenlt/led several areas to examine. Outcome variables he toil! measure . From the evaluation. He then read commentaries in nursing them). Jerry wants to compare the effectiieness ofhettith teaching in the hospital setting with the ejjt:ctilleness of health teadJing in the home Jetting. As his research project began to trlke shape. which de. For his research application project. the clienrs Jupp()rt system. cUI'IY'nt(JI case mrtnager for it horne health ftgency and hi)' goal is to become (In a agency director after he completes his degree. hospital readmissions. utilization of hUllth care [ie. [erry obtained the latest edition ofPenders boo]: (Pender. 1996). A/ier he had compiled these data. Jerry summarized his findings by using W'hrdl's I996) criteria for analysis and evaluation of middle-range theories.. and enulronmental resources.Analysis Melanie McEwen J Thompson is nearing completion a/his master's degree in nursing. He is .CHAPT:R 5 Theory . To determine if the model ioould be appropriate for his study. This exercise &tlped/eny gain imight into the major concept)' of the model and let him examine its import/tnt assumptions tlnrllinktlgeI. l: "x .uork. books that ana(yzed her work and completed a literature search to/ind examples a/research studies using the Health Promotion Model as a conceptual fi-amC'.

education. In research. a number of methods or techniques for theory evaluation were proposed. objective way of examining a theory that may lead to new insights and new formulations that will add to the body of practice or research (Walker & Avant. ill nd Purpose of Theory Evaluation Theory evaluation has been defined as the proces. and administration. Theory evaluation identifies a theory's degree of usefulness to guide practice. Theory evaluation has been described as a single-phase process (theory analysis) by Tomey (1998) or theory evaluation by Hardy (1974). a two-phase process . It will also provide information for developing and testing new theories by identifying gaps and inconsistencies. research. theory description. In this chapter. in turn. theory evaluation may provide a clinician with additional knowledge about the soundness of the theory. theory evaluation helps clarify the form and structure of a theory being tested or will allow the researcher to determine the relevance of the content of a theory for use as a conceptual framework.UNIT I INTRODUCTION TO THEORY As nurses began to participate in the processes of theory development in the 1960s. and testability (Walker & Avant. and critique theory was published in 1968. the first method to describe. administration. they realized there was a corresponding need to identify criteria or develop mechanisms to determine if those theories served their intended purpose. This will. In nursing practice. as described in the case study. For example. Criteria for this process are variable. The ultimate goal of theory evaluation is to determine the potential contribution of the theory to scientific knowledge. but it often leads to new insights about the theory being examined. Such evaluation gives insight into relationships among concepts and their linkages to each other and allows the reviewer to determine the strengths and weaknesses of a theory. theory evaluation. logical adequacy. 1995).'> of systematically examining a theory. It also helps identify which theoretical relationships are supported by research and provides guidelines for the choice of appropriate interventions and gives some indication of their efficacy. but they may include examination of the theory's origins. theory evaluation is used as a global term to discuss the process of reviewing theory. Evaluation will also identify inconsistencies and gaps in the theory used in practice or research (W~llker & Avant. Finally. The methods are described by several overlapping terms or terms that are used in different ways by different authors. help ensure that the theory is valid and is being used correctly. theory analysis. analyze. generalizibility. practice. usefulness. A general understanding of these methods will help the advanced practice nurse select an evaluation method for theory. education. and theory critique all describe the process of critically reviewing a theory to assess its relevance and applicability to nursing practice. theory evaluation provides a systematic. or education). Over the following decades. It abo assists in identifying the need for additional theory development or refinement. 1(95). research. which is appropriate to the stage of theory development and for the application of the theory (research. 1(95). Theory evaluation does not generate new information outside the confines of the theory. Various methods have been outlined to assist with this process. and administration. As a result. meaning.

It refers to a system atic process of objectively examining the content. Evaluation follows analysis and assesses the theory's potential contribution to the discipline's knowledge base (Fawcett. and theory critique/evaluation) by scholars including Meleis (1997) and Moody (1990). 1990). In theory description. A three-phase process is outlined briefly here. 1999). explain. Theory analysis is conducted if the theory or framework has potential for beir. to practice theories. with the pro. 1993). related works by others are examined to gain a clear understanding of the structural and functional componerus of the theory. The functional components consist of the concepts of the theory and how they are used to describe. theory analysis. In addition. a number of nursing scholars have published systems or methods for theory analysis/ evaluation. It has only been in recent years tha: the processes and methods have been applied to middle-range theories and. does not negate the need for analysis and evaluation (whether formal or informal) of middle-range and practice theories. 1993. rarely. Since the late 1960s. In theory evaluation.CHAPTER 5 THEORY ANALYSIS AND EVALUATION 83 (theory analysis and theory critique/evaluation) by Fawcett (1993. the processes should be applicable to all levels of the )fy. research. concepts. Theory analysis is a nonjudgmental. predict. Later sections provide more detailed discussions of each phase. the main aim of which is to understand the theory (Fawcett. detailed examination of a theory. two. Furthermore. 1995). is the final step of the process. or theory critique.g useful in practice. THEORY OESCRIPT' ON Theory description is the initial step in the evaluation process. lt should be noted that most of the processes/methods for theory analysis and theory evaluation were implicitly or explicitly developed to review grand nursing theories and conceptual frameworks. It should be noted that the methods are similar whether they describe one. THEORY EVALUATIJN Theory evaluation. Table 5-1 provides a list of these works. or three stages. Walker & Avant. or education. structure. critical reflection involves ascertaining how well a theory serves its purpose. and function of a theory. ANALYSIS Theory analysis is the second phase of the evaluation process. or control (Moody. . the works of a theorist are reviewed. or a three-phase process (theory description. The structural components include assumptions. and propositions.:ess of evaluation resulting in a decision or action about use of the theory (Chinn & Kramer. however. This observation. Basic components of the processes described by each are presented here. administration.1995) and Duffey and Muhlenkamp (1974).

1997 OF SIGNIFICANT THEORIES: ElLIS Probably the first nursing scholar to document criteria for analyzing theories for use by nurses was Rosemary Ellis. Contribution to understanding . theory critique Analysis and evaluation of practice theory. 1988. 1993. Her discussion of these characteristics produced the foundation on which later writers developed their criteria. theory analysis. Margaret Hardy wrote that theory should be evaluated according to certain universal standards. 1995 Theory evaluation Theory analysis and theory evaluation Theory evaluation-internal criticism Theory analysis Theory (conceptual framework) analysis and theory (conceptual framework) evaluation Theory description and critical reflection Theory description. Hardy provided a more detailed description of criteria for theory evaluation and presented personal insight on the processes needed. 1990. middle-range theory and nursing models Theory evaluation criticism. 1984. Although not specifically describing a process or method of theory analysis or evaluation.. testability. 1995 1983. external 1980. EJAlUAnml: HARDY A few years after Ellis.1991. implicit values of the theorist. 1996 . 1998 1983. In her writings. 1978 1974 1979. 1994. usefulness.1991.1987. information generation. complexity.1995.1997 1989. and meaningful terminology.1999 1985. Th~ characteristics she specified were scope. Criteria or standards she suggested for theory evaluation were as follows: Ii Ii Meaning and logical adequacy Operational and empirical adequacy Ii Testability '" Generality . Ellis (1968) identified characteristics of significant theorie~.UNIT INTRODUCTION TO THEDRY lAm 5·1 Publications of Methods for Nursing TheoryAnalysis Techniques Described and Evaluation Dates ot Publications Rosemary Ellis Margaret iardy Mary Duff lY and Ann Muhil!nkamp Barbara Barnum (Stevens) Lorraine Vtalker and Kay Avant Jacqueline Fawcett Peggy Chi 111 and Macona Kramer IJacobs) Afaf Mele s Ann Whal Sharon Dl dley-Brown (Most Recent Publication) 1974.

altering. Hardy discussed logical adequacy (diagramming) and stan-d that because a theory is a set of interrelated concepts and statements. Is the theory parsimonious? . Does the theory guide practice or can it be used as a body of knowledge? 3. and the form of the relationship. empirical adequacy is the single most important crite rion for eval uating a theory applied in practice. Writng at approximately the same time as Hardy. Predictability I Pragmatic adequacy In a later work (1978). the type of relationship (whether positive or negative). synthesis)? is the character of the subject matter dealt with by the theory? kind of outcomes of testing propositions are generated by the theory? THEORY EVALUATION 1.ccording to Hardy (1974). constructs. or manipulating major variables and conditions specified by the theory to realize a desired outcome. the criteria of user ilness and significance refer to the theory's use in controlling. Duffey and Muhlenkamp publishe I a two-phase approach to critically examining nursing theory. Diagramming involves identifying all major theoretical terms (concepts. each component can be represented by a symbol and a model may be drawn illustrating relationships or linkages between or among the terms. referents). Is the theory complete in terms of subject matter and perspective? 4. Theory analysis was the first phase for which they posited four questions for examination. For theory evaluation they suggested six additional questions (Box 5-1). operational definitions. Finally.CHAPTER 5 THEORY ANALYSIS AND EVALUATION 35 . T ~EORY ANALYSIS 1 2 3 4 What What What What is the origin of the problemls] with which the theory is concerned? methods were used in theory development (induction. The entire body of relevant studies should be evaluated in terms of the extent to which it supports the theory or a part of the theory. it is necessary to determine if hypotheses testing the theory are clearly deduced from the theo-y. Assessing empirical adequacy requires reviewing literature and critically reading relevant research. Are the relationships among the propositions made explicit? 6. Once identified. j. 'These linkages should specify the direction. Does the theory generate testable hypotheses? 2. its stru :ture can be analyzed for internal consistency by examining the syntax of the thecry as well as its content. deduction. Are the biases or values underlying the theory made explicit? 5.

which involves concept and statement analysis. 19(5) used a two-phase process for analysis and evaluation of theories and conceptual frameworks.evef of theory development :XTERNAl CRITICISM 1eality convergence (how the theory relates to the real world) Jtility :. they expanded the processes to include theory analysis. detailed examination of a theory. external criticism examines how a theory relates to the extant world.i Jacqueline Fawcett (19RO. Barnum suggested a method of theory evaluation that differentiates internal and external criticisms. grand theory. Building on multiphase background of concept and statement development. context. In her writings she noted that analysis is a nonjudgmental. 1994. middle-range theory). and derivation. ANALYSIS WALKER ArW AVArH Lorraine Walker and Kay Avant first presented their detailed methods for theory analysis in 1983. Table 5-2 gives a brief synopsis of the process of theory analysis they propose. . and content. Box 52 lists points to be examined for both. 1990. synthesis. Subsequent editions were published in 1984. In Fawcett's method. and 1998. 1993. person) are included in the theory.ignificance lis crimination (differentiation between nursing and other health professions) lcope ~omplexity . The theory's scope refers to the evel or abstractness of a theory (ie. theory analysis specifically identifies whether and how the concepts and propositions of the metaparadigm (nursing. and the context of the theory describes the nature of the nursing world and the client's world. Their work was subsequently revised in 1988 and 1995. Components of the analysis process include scope.96 UNIT I INTROIUCTION ro THEORY Barbara Barnum (Stevens) first published her ideas for theory evaluation in 1979. Internal criticism examines how the components of the theory fit with each other. She also stresses that the context within :larity :onsistency ~dequacy _ogica! development . environment health.

Is the theory practical and helpful to nursing? Does it contribute to understandinq and predicting outcomes? Can the theory be stated briefly and simply or is it complex? Can the theory be supported with empirical data? Can testable hypotheses be generated from the theory? Is the theory Examine the meaning of the theory. Examine definitions and their use (theoretical and operational definitions). research reports. parsimony. structure. Evaluation is based on review of previously published critiques. empirical adequacy. Determine if scientists agree on predictive ability of the theory.WhY was it developed? Was the process of development inductive or deductive? Is there evidence to support or refute the theory? Identify concepts. Theory critique analyzes clarity and consistency of the theory . relationships. and assumptions. Table 5-3 presents these clements and their defining characteristics. 1995) method includes explication of concepts and propositions. Theory critique involves critical reflection to determine how well a theory serves its purpose. Theory description has six dements: purpose. Analysis of content in Fawcett's (1993.s of the theory? 'What are the propositions of the theory? Which propositions are relational and which are nonrelational? Theory evaluation requires judgments to be made about it theory's significance (Fawcett. content (internal consistency. Analyze tho logical adequacy of the structure of the theory. Walkor & Avant (1995). Identif\lthe bas'tspftheorlginaldeY!lloPment ()ftheJheory. Define the degree of generalizibility and parsimony. highly generalizible or specific? Source. one would examine the theory's context. They use the terms theory description and theory critique to describe a two-phase process. Examine relationships. Identify any logical fallacies. DESCRIPTION CHIN~J ANI) KRAMER Pegg'{ Chinn and Manoa Kramer (Jacobs) initially w-rote on theprocesses used to analyze theory in 1983. testability).CHAPTER 5 THEORY ANALYSIS Alin EVALUATION fJ7 lADlE 5-2 Theory Analysis: Walker and A. definitions. and pragmatic adequacy. During the proCt~Ssof theory evaluation. and reports of practical application of the theory. Determine the testability of the theory. Diagram elements of the theory. Representative questions include: What are the C011cept. 1993). Determine the usefulness of the theory.valll Determine the ori~ ins of the theory. Identify statements. which the theory was developed provides insight into philosophical claims on which the theory is based and on conceptual models from which the theory was derived. Determine if the content makes sense. concepts.

Assumptions Source: Chinn & Kramer (1999). as well as its complexity. During the process of theory description. theory analysis. Chinn and Kramer's (1999) critique would examine: II Semantic clarity-Are the concepts defined? Do the concepts establish empirical meaning'? !If Semantic consistency-Are the concepts used consistently? Are the concepts congruent with their definitions? II Structural clarity-Are the connections and reasoning within the theory understandable? II Structural consistency-Is the structure of the theory consistent in its form? . research. AND CRITIQUE: MElEIS According to Meleis (1985. In assessing clarity and consistency.UNIT INTRODUCTION TO THEORY Components of Theory Description: Chinn and Kramer Characteristics Purpose Concepts Definitions Relationships Structure Theputpuseof the. and theory critique. definitions. 19(7). and education? II DESCR!PTION. The functional assessment considers the anticipated consequence of the theory and its purpOs(~. may not be explicitly stated. be stated eXPlicitly arat least be The concepts of the theory should be linguistically expressed. ANALYSIS. concepts. Concepts are structured into a systematic form that links each concept with others. the reviewer closely examines the structural and functional components of the theory. structure makes it possible to follow the reasoning of the theory. and propositions. and structure. Generality-Does the theory cover a wide scope of experiences and phenomena? Accessibility-c-How accessible is the theory? How well are concepts grounded in empirically identifiable phenomena? II Importance=-How can the theory contribute to nursing practice.thetiry should identifiable in the text of the theory. The relationships are linked to form a whole when the ideas of the theory interconnect. accessibility.. purpose. Simple or complex-s-Is the theory simple? Is the theory complex? . Assumptions refer to underlying truths that determine the nature of concepts. Components that .. Meanings of concepts are conveyed in theoretical definitions. relationship. and importance. The structural components include assumptions (implicit and explicit). these definitions give character to the theory. there are three stages involved in theory evaluation: theory description. generality.

and tautology/ teleology. diagram of the theory. . and how it addressed the client. Teleology occurs when definitions of concepts. Finally. the reviewer would consider references. 111(' final component of this method is to review external components of the theory. educational background. nursing. and employment history. Secondly. and internal dimensions of the theory. abstractness of the theory. and method of development. Critique of a theory may follow analysis. scope of the theory. as well as the theorist's experiential background. circle of contagiousness. In evaluating usefulness.CHAPTER 5 THEORY ANALYSIS AND EVALUATION should be examined are the focus of the theory. During the analysis procedure. the nurse-client interactions. Meleis :. Finally. or to recognize other theorists who may have influenced the development of the theory. Meleis argues that careful consideration of use of theories from other fields or paradigms is to be encouraged. These include implicit and explicit personal values of both the theorist and the critic. Likewise. a reconstruction of the professional and academic networks that surrounded the theorist while the theory was evolving should be examined. This will provide information on the rationale on which the theory is built. goal of the theory. conditions. research. which Meleis claims will decrease the clarity of the theory. and Meleis (1997) identified five elements to consider in this phase: the relationship between structure and function. environment. the reviewer would observe for needless repetition of an idea in different parts of the theory. Meleis (1997) recommends reviewing external and internal factors that influenced the theorist. educational and experiential background of the theorist. In assessing the tautology of the theory. and nursing therapeutics. health. and to what extent. enhance clarity of the theory. It also refers to congruence with other professional values as well as with social values. the critic would determine if the theory has social significance. thereby. and administration. internal dimensions of the theory should be analyzed. and the sociocultural context of the theory as it was developed. The circle of contagiousness refers to if. and events are described by consequences rather than properties and dimensions. Theory analysis involves considering important variables that may have influenced the development of the theory. paradigmatic origins of the theory. These include the theorist. level of simplicity or complexity. education.uggests analysis of the theory's usefulness in practice. nursing problems. The relationship between structure and function involves evaluating the theory's clarity and consistency. the model or theory has been adopted by other experts in the field. usefulness. The reviewer should determine if the model does indeed help clarify linkages among the concepts and propositions and. Although not all theories contain models graphically or pictorially depicting the structure of the theory. Meleis (I 9(7) sta tes that theories and models are enhanced by visual representation. systems of relationships. '10 identify the paradigms fromwhich the theory may have evolved. context of the theory. content of the theory. and external components. this should be avoided.

External consistency examines the model in relation to views external to the model (ie. she noted that middle-range and practice theories have achieved status equal to that of nursing conceptual models. According to Whall (1996). criteria for evaluation of all three levels of nursing theory using a three-phase approach that reviews basic considerations. and external analysis and evaluation. Following this observation she outlined distinct. is neutral. environment. although similar. . Table 5-4 lists some of the questions for consideration by Whall in analysis and evaluation of all three levels of nursing theory. Examination of ethical. It examines if the theory fits with the existing nursing perspective and domains. The assumptions of the theory should be considered in light of historical and current perspectives of nursing. Analysis should examine whether the definitions of the concepts and statements are consistently used throughout the model and whether the interrelationships among the concepts are consistent. Operational definitions and descriptions of how to apply practice theory are also important. Propositional statements should be examined to determine! if they are causal or associative in nature. Internal analysis considers the assumptions and philosophical basis of the model and looks at the uniformity of discussion throughout the model. or is in opposition. questions regarding the fit with empirical data are important in the evaluation process. Internal analysis of practice theory may be accomplished by diagramming the interrelationships of all concepts to detect lapses and inconsistencies in the theory's StfLICture. to assess their relative importance. Because practice theory is designed for immediate application to practice. and social policy implications is crucial. but it has only been nursing models that have been systematically examined.UNIT I IIHRIlOUCTION TO TflEORY MIDDLE-RANGE Whall (1996) is the only nurse scholar to explicitly outline three separate criteria for analysis and evaluation for the three levels of nursing theory. Whall (1996) believes nursing conceptual models should be assessed from. External analysis should compare standards of care with the theory and examine nursing research to determine if it supports the theory. and to find missing linkages between concepts. In her most recent edition. Analysis and evolution of middle-range theory modifies the guidelines used for nursing conceptual models. Concepts should be operationally defined to support empirical adequacy. practice theory is produced from practice and deduced from middle-range theory as well as from research. It is suggested that diagramming of the relationships may help identify missing relationships. internal analysis and evaluation. This should include ethical and cultural implications of the theory. External analysis refers to congruence with more global theories and other related middlerange theories. whether the model is being evaluated consistent with other nursing conceptual models and with nursing intervention classification systems). conceptual models should consider the major paradigm concepts (person. a post-modern view. health. In addition. cultural. and nursing) as wen as additional concepts specific to the model.

health. and envirc nmsnt? What are the interrelationships amonq the metaparadigm concepts? What are the descriptions 01 other concepts found in the model? One of the most contemporary methods for theory evaluation was presented by Dudley-Brown (1997). who strongly relied on Kuhn's (1977) criteria for theory evaluation. nursir g. acceptability.CHAPTER 5 THEORY ANALYSIS AND EVALUATION H Criteria for Analysis and Evaluation of Theory: Whall Basil: Cons"domtiolls Practice theory Can the concepts be operationalized? Are operationalized concepts congruent with empirical data? Do statements lead to directives for nursing care? Are statements sufficient to practice and not contradictory? What are the definitions and relative importance of major concepts? What is the type and relative importance of major theoretical statements? Internal and Evaluation tXt(. and social policy issues are related to the theory? Is nursing research based on the model or related to the model? Is nursing education based on the model or related to the model? Is nursing practice based on the model? What is the relationship to existing nursing diagnoses and interventions systems? Are tlier&>gapsor incfJl1sistencles within the theory that may lead to conflicts and difficulties? Are assumptions congruent with nursing's historical perspective? Are assumptions congruent with ethical standards and social policy? Are assumptions in conflict with given cultural groups? Middle-range theory What are the assumptions of the theory? Are concepts related/not related via statements? Is there internal consistency and congruency of all component parts of the theory? What is the empirical adequacy of the theory? Has the theory been examined in practice and research and has it held up to this scrutiny? What are the underlying assumptions of the model? What are the definitions of other components of the model? What is the relative importance of basic concepts or other components of the model? What are the analyses of internal and external consistency? What are the analyses of adequacy? Nursing models What are the definitions of person. consistencv. To Dudley-Brown (1997). accuracy is essential because the theory should describe nursing as it exists today-not the Blasing of the future or of the past. evaluation should consider accuracy. scope. In this method. fruitfulness. The . the domains. and the persistent questions? What ethical. cultural. and socioc~ltural utility.t!w! am! Evaluation IsthetneOry prodUced with existing nursing standards? Is the theory consistent with existing standards of education within nursing? Is the theory related to nursing diagnoses and nursing intervention practices? Is the theory supported by existing research internal and external to nursing? What is the congruency with related theory and research internal and external to nursing? What is the congruence with the perspective of nursing. simplicity/complexity.

1990. The methods proposed by Walker . There appears to be an evolution of the processes over the past three decades Similarities of criteria were evident based on time of initial writing. a theory should. Both simple and complex theories are needed. contribution to understanding (5 of 9).UNIT I INTRODUCTION TO THEORY theory should contain a world view of nursing consistent with the present reality. Consistency relates to the importance of the nursing theory being internally consistent. and should be presented logically. For this criter-ion. definitions of concepts (6 of 9). consistency (6 of 9). There should belogical order. In general. Moody. origins of the theory. Another criterion Dudley-Brown (1997) identifies for evaluation isfmit/ulness. context. Table 5-5 provides a list of the methods reviewed and criteria specified by each author. and Hardy were the first nurses to describe tI~('processes (. and application of or to nursing therapeutics. the theory should be useful in generating information and significant in contributing to the development of nursing knowledge. The theory should be measured against the criterion of social utility according to the culture for which it was proposed. A number of similarities can be found between and among all the methods. Scope should be dependent on the phenomenon and its context Acceptance refers to the adoption of the theory by others. Social congruence encompasses the beliefs. Theories should be useful in practice. Simplicity/complexily is a fourth criterion for evaluation. usefulness (6 of 9). consequences. or administration. Criteria mentioned in only one or two methods were implicit values of the theorist. 'The theory should describe the phenomenon consistently in terms of simplicity or complexity. Ellis. education. Comparisons of Methods Several authors (Dudley-Brown. the most common criteria identified among the theory evaluation methods were an examination of complexity /simplidty (7 of 9) and scope/generality (7 of 9 methods). and statements should be used consistently and defined operationally. Sociocultural utility is the final criterion for evaluation. Tomey 1998) have compared many of the theory analysis and evaluation methods described here. Other common criteria were inclusion of meaningful terminology.1' theory evaluation and their criteria are similar. As Table 5-5 shows. Theories proposed for Western societies need to be evaluated for their philosophical and theoretical relevance in other societies and cultures. and validity/accuracy/empirical adequacy (4 of 9). concepts. It is important to note that different authors use different terms for similar concepts. discrimination between nursing and other health professions. Duffey and Muhlenkamp. '[997. and expectations of different cultures. method of development. be balanced and logical. reality convergence. pragmatic adequacy. correspondence to existing standards. should be coherent. testability (4 of 9). values. information generation. logical adequacy (4 of 9). Scope is a fifth criterion because theories of both broad and limited scope are needed. some interpretation of meaning of terms was necessary for the comparison. thus. terms. research.

this chapter presents an exemplar of the proposed theory evaluation method. administration. and critique) and Whall's examines three levels of theory. In addition. . Barnum and Whall are similar in that they describe separate internal and external dimensions. Following the detailed review and comparison of the many methods for theory analysis and evaluation. The later work of Whall. To further help the reader understand this process. Tomey and Alligood (1998) and Chinn and Kramer (1999) also discuss some middle-range nursing theories in their works. Fitzpatrick and Whall (]996). with very few exceptions. there will be a concurrent emphasis on the analysis and evaluation of those theories.199. rcsearch. The most commonly used methods were described in some detail and compared. Meleis' system has three components (description. It is hoped that with the current emphasis on development and use of both practice and middle-range theories. is often confusing. Meleis. This chapter has presented and analyzed a number of different methods for evaluation of theory. the process of theory evaluation. the methods or techniques were developed and used almost exclusively to analyze and evaluate grand nursing theories. research. Fawcett's model is similar to Chinn and Kramer's approach and to Barnum's internal criticism criteria. and Dudley-Brown are similar because they include characteristics of circle of contagion and consideration of social and cultural significance as evaluation criteria. and Tomey and Alligood (1998). Books that focus on analysis and evaluation of grand nursing theories include those by Fawcett 0993. should know how to analyze or evaluate a theory to determine if it is reliable and valid and to determine when and how to apply it in practice. education. a method specifically designed to evaluate middle-range and practice theories was developed (Box 5-3). McQuiston and Webb (1995). Following this comparison. Indeed. as well as graduate students like Jerry Thompson from the case study. Nurses in clinical practice. or education. a synthesized and simplified method for examination of theory was presented. Most methods for analysis and evaluation 'were developed and used to review grand nursing theories. Meleis and Whall present the most detailed methods.CHAPTER 5 THEORY ANALYSIS AND EVALUATION and Avant are also consistent with those of Hardy and Ellis. although important. These criteria were synthesized from the works of noted nursing scholars described above and are intended to be contemporary and responsive to both recent and anticipated changes in use of theory in nursing practice. analysis. George (1995).5). Like many issues in the study of use of theory in nursing. a literature review resulted in no published report of theory evaluation in nursing beyond those in nursing theory textbooks. and administration.

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DJI DJI DJI SO[fOW. unresolved disparity. prescribe) What is the scope or level of the theory? (grand. experience of significant loss.the thti!ory relevant cross-culturally? Doesthethti!ory~olltribute to the discipline of nursing? Wh~t are irnpliqatlons for nursing related to implementationofthe theory? EXEMPLAR & Hainsworth. or f1l. statements. 30(2). Origins of theory: The theory was inductively developed using concept analysis.' Journai of Nursing Scholarship.UNIT I INTRODUCTION TO THEORY THEORY. and validation in 10 qualitative studies of various loss situations. Major concepts: Chronic sorrow. M. nursing researchers. explain. bereaved individuals . Scope 01 theory: Middle-range Purpose 01 theory: explanatorv theory--"to explain the experiences of people across the lifespan who encounter ongoing disparity because of significant loss" (p. nigger events (milestones). 179). DESCRIPTlo. individuals with chronic Of life-threatening illnesses. 11998) fv1tddle-range theory of chronic Image.range. releva nt? Is.!fsing administrators? Is the theory socially.179-185.practice) What are the origins of the theory? What are the major concepts? What are the major theoretical propositions? What are the major assumptions? Is the context for use described? THEORY ANALYSIS Are concepts theoretically and operationally defined? Are statements theoretically and operationally defined? Are linkages explicit? Is the theory logically organized? Is there a model/diagram? Does the model contribute to clarifying the theory? Are the concepts. family caregivers.N What IS thepIJrposeof the theory? (describe. critical review of research. A. and assumptions used consistently? Are outcomes or consequences stated or predicted? THEORY EVALUATION Is the theory congruent with current nursing standards? Is the theory congruent with current nursing interventions or therapeutics? Has the theory been tested empirically? Is it supported by research? Does it appear to be accurate/valid? Is there evidence that the theory has been used by nursing educators. middla. predict.

Logical organization Theory is logically organized. 3 4. and groups.' The theory is useful and appropriate for nurses practicing in a variety of settings. 5. implied that it may be used in multiple settings and nursing situations.{ Evaluatiofl Congruence with nursing standards: Theory appears congruent with nursing standards. Assumptions am not explicitly addressed. Theory was derived from multiple research studies and a review of the literature. TlrBOf. but more study is needed to test the theory and to identify strategies to reduce disparity created by loss (prescriptive interventions) Conclusions and implicatiolls. TImor}. . developmental or personal). 2. Theory is relevant to individuals. Theoretical definitions are provided for major concepts. . disparity between the idealiled and actual is associated with developmental milestones. theorist notes that "relevance for various cultural groups should be explored" (p. Social relevance. statements. Use bV nursing educators. LinkagES explicit: Linkages are inferred in the text. Major assumptions. chronic sorrow is most often triggered when the individual experiences disparity with accepted norms (social. and assumptions: Concepts and propositions are used consistently. No evidence of use by nurses in practice. For bereaved Individuals. Theory is potentially relevant across CUltures. Model/diagram' A model is provided and assists in explaining linkages of the concepts Consistent use of concepts. For family caregivers. For individuals with chronic or life-threatening illnesses. Predict'Jd or stated outcomes or consequences: Outcomes are stated. Unknown if the theory has been directly tested. irrespective of age or socioeconomic status. Operati}nal definitions for major concepts: No operational definitions are provided Statements theoreNcally defined' Theoretical propositions are implicitly stated in the body of the text. AUf/lysis Theoretical definitions for major concepts. Evidence of empirical testing/research support/valid/tv. Further development of the theory is warranted to better explicate relationships and operationalize the concepts and propositions to allow testing. education. disparity from the ideal is created by the absence of a person who was central in the liie of the bereaved. families. 184i. or administration. Implications for research were described and implications for education can be inferred. research. nursing researchers. Transcultural relevance. Contribution to nursing: Authors note that the theory is applicable to different groups. Trigger events bring the negative disparity into focus or exacerbate the experience of disparity. Statements operationally defined: Theoretical propositions are not operationally defined. Congruence with current nursing interventions or therapeutics: Theory is applicable to nursing practice.CHAPTER 5 THEORY ANALYSIS AND EVALUATION 107 Major theoretical plOpositions are as follows' Disparity between a desired relationship and an actual relationship or a disparity between current reality and desired reality is created by loss experiences. or nursing administrators.' Not stated Context for use: "Experienced by individuals across the lifespan".

obtain a copy of the oldest version and a copy of the most recent version and compare the strategies suggested.. How are the conclusions similar? How are they different> 2.). Fitzpatrick & A. CT: Appleton & l. applica fioll. . {19(6). P. L (1997). middle- /uirunce« in Nursing Science. In). Perspectives on nursing theory. Norwalk. L. Loui. Chinn. 100····107. B. pp.I. S. & Avant. C[ Appleton &. Fl. C. Nursing Research. Suppe (Ed). Ord ed.: C. (1993). L. o/nur..ange. Harriv. Philadelphia: Davis.. O. Allalysis and c"lliurilioll of conceptual IIIlIdel. How are conclusions similar? How are they different? 4. J. The structure of nursing knowl- edge: Analysis and evaluation of practice.ial models of nursing. Second 1(1). Boston: Little. Hardy. A. Mosby. t'Dalu'ltiOiI or 1'. Meleis).M.g: /1I1t'gmttd hilmi/edge derclopment (5th ed.Brown. M. 3-15). L (1997). S.Nllrsillg theory: Analysis.48. Theory and / Tomey A.:. K. A. Il. & Kramer. M. Louis: Mosby. Norwalk. & Whall. A. Nursing Olil/(\)k. L (1996). '/7(:l).). Use the synthesized method for theory evaluation to evaluate a grand nursing theory. Obtain the original works of two of the nursing scholars whose theory analysis/evaluation strategies are discussed. Philadelphia: Lippincott Williams & \Vilkins. A.). Barnum. Whall (Eds. R Alligood (1'.). Newbury Park. L.108 UNIT I INTRODUCTION TO THEORY t EAR~JING ACTIVITIES 1. Use the strategies to evaluate a recently published middle-range nursing theory (see ChapterlO for examples). For one of the nursing scholars who has published several versions or editions of her work (eg. & jacobs. Conceptual models of nursing: Aualysis ilwl application (3r<1 ed. Pender. (1983). Norwalk. Share your findings with classmates. (1974). CT: Appleton & Lange. Health promotion ill 11lIrsil1g practice (Jrd ed. 217·222. Stevens. J.'inS (.1s.esearch.). L E. Chinn & Kramer. CT: AppletonCenturv-Crofts. B.. K. Fitzpatrick. Theorcticat nursing: Dcvc/opml'llt and progn:ss. B. illicrltationai lourna! of :\'ursillX Studies. (1998). CA: Sage.27·0. Brown. (1996). &: Wt~bb.). . J. Compare findings with published evaluations of the same theory. M.: University of Illinois Press. 1. Du(fcy. Norwalk.). Louis: Mosbv. L. M. Kuhn. A. M. 13-SJ). Theories: Components. The evaluation of nursing theory: . ([980).. [. Fawcett. CA: Sage. A. Introduction to analysis of nursing theories. 119(0). Fawcett. St.Meleis. Thousand Oaks. Analy:.570-574. (1968). N. Walker. Norwalk. Philadelphia: Lippincott-Raven. R. Lippincott . tv1eleis... Norwalk. Nursing theorists and their work (4th ed. Dudlev . Strategies for theory constructioll ill nursms.. 23. eraiuauon.. CO/lceptual models nursing: Al1illysis fmd application (Jrd ed. Advllllcing nursing science through research. L. 34(1)' 76--83. [. .. A framework of analvsis and evaluation otconcept. CT: Appleton & Lange. !j()Il. 459~f82). St. Louis: Mosby. Fawcett. (1977).'lrd ed. Nurse Edu cater. Foundations of nursing theory: Contributions of '12 key theorists. Philadelphia: J. t\1.('l995). (1985).). evaluation. R. E. M.. REFERENCES B. Nursing tucor»: Aliilly. 5(6). A. In range and grand theory. St. & i\IHgood. 22(9) . (1979). development. Tomey. 0. (1978). . M. & Avant. Fawcett. ) . (1983). M. (19(5). & Muhlenkamp. Lange.). thoughts on paradigms. applica("th ed. (1999). Walker. F. Philadelphia: Davis. pp. McQuiston.).). CT: Appleton & and eraluatu»: of nursing theories. Urbana. 1O-J4. Chinn. In A. T. (1998). St. I. Search the literature for examples of published accounts of nursing theory evaluation or theory analysis. K. A framework for theory analysis. MvTomev &. Nursing theorists and their ·i.vork (4th ed. PL. E. K. S. (1995~ __Nursing theories: The hase {tH' pro practice (4th ed. (1974). (1998). ~(1995). Have they changed? 3. The structure of scientific theory (pp. Ii. Ellis.. A. \Vh"ll. Moody. Theoretical nursing: Development and I'rogn'% Ord cd. Characteristics of Significant theories. Theoru und 11111'5" illg. Strategies for theory cOllsirucliOll ill rwrsing.\ method for our madness. Ceorgc.

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