CLASSIFICATION OF

NURSING THEORIES
Classification

 Theories are classified depending on their

 function,
 levels of abstraction, or
 goal orientation.
 Descriptive-to identify the properties and workings of a discipline
 Explanatory-to examine how properties relate and thus affect the discipline
-This type of theory specifies relations between dimensions or characteristics of individuals,
groups, situations or events.
 It sets out to explain how the parts of the phenomena under study relate to each other.
 Predictive-to calculate relationships between properties and how they occur
-Type of theory goes beyond whether one thing is related to another and seeks to identify
cause and effect relationships.
-May build on explanatory theories and generated and tested by experimental research.
 Prescriptive -to identify under which conditions relationships occur
-Theories addressing nursing therapeutics and the outcomes of interventions.
-Includes propositions that call for change and predict the consequences of a certain
strategy of a nursing intervention.
Classification by level of abstraction
 Conceptual Models
• Are concepts and their relationships that specify a perspective and
produce evidence among phenomenon specific to the discipline.
• Address broad metaparadigm concepts that are central to their
meaning in the context of a particular framework and the discipline
of nursing.
• Provides perspectives with different foci for critical thinking about
persons, families, and communities and for making knowledgeable
nursing decisions.
 A. Grand Nursing Theories
-Are composed of relatively abstract concepts and propositions that are
less abstract than those of conceptual models and may not be directly
amenable to testing (Butts, 2015 ; Fawcett & DeSanto-Madeya,2013
;Higgins & Moore,2000).
- They were developed through thoughtful and insightful appraisal of
existing ideas as opposed to empirical research and may provide the
basis for scholars to produce innovative middle range or practice
theories.
- Concepts that derive from a conceptual model and propose a testable
proposition that tests the major premise of the model
- Based on: Human Needs,Interactive Process & Unitary Process
Grand Nursing Theories

• Grand theories are the most complex and broadest in scope.

• Characteristics of Grand theories:
(i) Focus on broad and general areas and concepts.
(ii) It deals with nonspecific and relatively abstract concepts.
(iii) Concepts mentioned in grand theories lack operational definitions.
(iv) Grand theories are not directly amenable to testing.
(v) These can be used in variety of setting and populations.
 Nursing Theories
• Nursing theories are organized bodies of knowledge to define what
nursing is, what nurses do, and why do they do it.
• Nursing theories provide a way to define nursing as a unique
discipline that is separate from other disciplines (e.g., medicine).
• It is a framework of concepts and purposes intended to guide the
practice of nursing at a more concrete and specific level.
• Practice nursing theories are situation specific theories that are
narrow in scope and focuses on a specific patient population at a
specific time.
• Practice-level nursing theories provide frameworks for nursing
interventions and suggest outcomes or the effect of nursing
practice.
 Middle Range Theories
• Lie between the most abstract theories (grand nursing theorist ,
models or conceptual frameworks).
• More circumscribed , concrete theories (practice theories ,
situation-specific theories , or microtheories).
• More specific , have fewer concepts , and encompass a more
limited aspect of the real world.
• Concepts are relatively concrete and can be operationally defined.
Proposition are also relatively concrete and maybe empirically
tested.
• Many researchers prefer to work with middle range theories rather
than grand theories or conceptual framework because they
provide a better basis for generating testable hypotheses and
addressing particular client populations.
• Easier to apply in practice situations and to use as frameworks for
research studies.
• Have the potential to guide nursing interventions and change
conditions of situation to enhance nursing care.
• Concepts most specific to practice that propose precise questions
& include details such as patient age group,family situation, health
condition,location of the patient & action of the nurse.
• Finally, the major role of middle range theory is to define or refine
the substantive component of nursing science & practice.
Characteristics of Middle Range theories:

 These are characteristics of good mid-range theory as described by Whall (1996):

(i) Its concepts and propositions are specific to nursing;
(ii) it is readily operationalized;
(iii) it can be applied to many situations;
(iv) propositions can range from causal to associative, depending on their application;
and
(v) Assumptions fit the theory.
(vi) It should be relevant for potential users of the theory, i.e. nurses; and
(vii) It should be oriented to outcomes that are important for patients, not merely describe
what nurses do.
(viii) It should describe nursing-sensitive phenomena that are readily associated with the
deliberate actions of nurses.
Practice Theories/Micro theories/prescriptive theories

 Practice theories are narrowly defined;

 Address a desired goal and the specific actions needed to achieve it.
 Practice-level nursing theories provide frameworks for nursing
interventions and suggest outcomes or the effect of nursing practice.
 Theories developed at this level have a more direct effect on nursing
practice as compared to more abstract theories.
 These theories are interrelated with concepts from middle-range
theories or grand theories.
Characteristics of Practice theories:

(i) Least complex in nature.

(ii) More specific than middle range.
(iii) Provides specific directions.
(iv) Limited to specific populations.
(v) Often use of knowledge of other discipline.
(vi) Specific to population and setting (oncology, obstetrics).
(vii) Cannot be applied in all setting.
 Other Ways of Classifying Nursing Theories

Classification According to Meleis

 Afaf Ibrahim Meleis (2011), in her book Theoretical
Nursing: Development and Progress, organizes the
major nurse theories and models using the following
headings:
 needs theories,
 interaction theories, and
 outcome theories.
 Needs- Based Theories.
 The needs theorists were the first group of nurses who thought of giving nursing
care a conceptual order.
 Theories under this group are based on helping individuals to fulfill their physical
and mental needs.
Interaction Theories.
 These theories placed the emphasis of nursing on the establishment and
maintenance of relationships and highlight the impact of nursing on patients and
how they interact with the environment, people, and situations.
Outcome Theories
 These theories describe the nurse as controlling and directing patient care by
using their knowledge of the human physiological and behavioral systems.
Classification According to Alligood
 In her book, Nursing Theorists and Their Work, Raile Alligood (2017)
categorized nursing theories into four headings:
 nursing philosophy,
 nursing conceptual models,
 nursing theories and grand theories, and
 middle-range nursing theories.
 Nursing Philosophy
 Is the most abstract type and sets forth the meaning of nursing phenomena through analysis,
reasoning, and logical presentation.
Nursing Conceptual Models
 Are comprehensive nursing theories that are regarded by some as pioneers in nursing.
 These theories address the nursing metaparadigm and explain the relationship between them.
Grand Nursing Theories
 Are works derived from nursing philosophies, conceptual models, and other grand theories that are
generally not as specific as middle-range theories.
Middle-Range Theories.
 Are precise and answer specific nursing practice questions.
 They address the specifics of nursing situations within the perspective of the model or theory from
which they are derived.
E. Evidenced-Based Practice and Nursing Theory
Fig.1 Relationship among practice,theory,research and the EBP & PBE

THEORY

EVIDENCE-BASED PRACTICE-BASED
PRACTICE EVIDENCE
PRACTICE

RESEARCH