Analysis, Evaluation, and Selection of a Middle Range Theory Assignment

2

http://pages.reply.lww.com/page.aspx?QS=3935619f7de112ef5892b3b4d17ef4cf54ac28f91e1a6af7d4eadd68d5316240

Middle Range
Theories
Application to
Research and Practice

Fourth Edition

Sandra J. Peterson, PhD, RN
Professor Emerita
Bethel University
St. Paul, Minnesota
Accreditation Partner
NurseTim, Inc.
Waconia, Minnesota

Timothy S. Bredow, PhD, RN, NP-C
Professor
Bethel University
St. Paul, Minnesota

3

4

Acquisitions Editor: Christina C. Burns
Product Development Editor: Helen Kogut
Editorial Assistant: Cassie Berube
Production Project Manager: Kim Cox
Design Coordinator: Holly McLaughlin
Illustration Coordinator: Jennifer Clements
Manufacturing Coordinator: Karin Duffield
Marketing Manager: Dean Karampelas
Prepress Vendor: SPi Global

4th edition

Copyright © 2017 Wolters Kluwer

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Copyright © 2004 by Lippincott Williams & Wilkins. All rights reserved. This
book is protected by copyright. No part of this book may be reproduced or
transmitted in any form or by any means, including as photocopies or scanned-in or
other electronic copies, or utilized by any information storage and retrieval system
without written permission from the copyright owner, except for brief quotations
embodied in critical articles and reviews. Materials appearing in this book prepared
by individuals as part of their official duties as U.S. government employees are not
covered by the above-mentioned copyright. To request permission, please contact
Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA
19103, via email at [email protected], or via our website at lww.com
(products and services).

9 8 7 6 5 4 3 2 1

Printed in China

Library of Congress Cataloging-in-Publication Data
Middle range theories : application to nursing research and practice / [edited by]
Sandra J. Peterson, Timothy S. Bredow. — 4th edition.
p. ; cm.
Includes bibliographical references.
ISBN 978-0-06-000044-8
I.Peterson, Sandra J., editor. II.Bredow, Timothy S., editor.
[DNLM:1. Theory.2. Research.WY 86]
RT84.5
610.7301—dc23

2015031790

5

mailto:[email protected]

http://lww.com

This work is provided “as is,” and the publisher disclaims any and all warranties,
express or implied, including any warranties as to accuracy, comprehensiveness, or
currency of the content of this work.

This work is no substitute for individual patient assessment based upon healthcare
professionals’ examination of each patient and consideration of, among other
things, age, weight, gender, current or prior medical conditions, medication history,
laboratory data and other factors unique to the patient. The publisher does not
provide medical advice or guidance and this work is merely a reference tool.
Healthcare professionals, and not the publisher, are solely responsible for the use
of this work including all medical judgments and for any resulting diagnosis and
treatments.

Given continuous, rapid advances in medical science and health information,
independent professional verification of medical diagnoses, indications,
appropriate pharmaceutical selections and dosages, and treatment options should
be made and healthcare professionals should consult a variety of sources. When
prescribing medication, healthcare professionals are advised to consult the product
information sheet (the manufacturer’s package insert) accompanying each drug to
verify, among other things, conditions of use, warnings and side effects and
identify any changes in dosage schedule or contraindications, particularly if the
medication to be administered is new, infrequently used or has a narrow
therapeutic range. To the maximum extent permitted under applicable law, no
responsibility is assumed by the publisher for any injury and/or damage to persons
or property, as a matter of products liability, negligence law or otherwise, or from
any reference to or use by any person of this work.

LWW.com

6

http://LWW.com

I am grateful to be involved in the development of this book. I appreciate
my colleague and partner in this project, all the amazing nurse scholars

who contributed, and the Wolters Kluwer staff who managed this
publication journey. But most of all, I am so thankful for my family:

husband (Ray), 98-year-old mother (Margaret Cairns), son (Christopher),
daughter-in-law (Alisa), grandchildren (Liam and Jane), and last but not

least (sorry for the cliché) daughter (Beth). They bring joy to my life.
Sandra J. Peterson

I would like to dedicate this fourth edition to my family who provides me
with the love and support to complete a project such as this: KTJBA, B, C,

Tiff, Ben, and also little Kata, Peper, Finley, and Maddy. And to all my
students with the hope that in using this book, they will more fully

understand the relationships between theory, research, and evidence-
based practice.

Timothy S. Bredow

7

Contributors to the Fourth
Edition

Timothy S. Bredow, PhD, RN, NP-C
Professor
Bethel University
St. Paul, Minnesota

Lisa Burkhart, PhD, RN, ANEF
Associate Professor
Marcella Niehoff School of
Loyola University Chicago
Chicago, Illinois

Georgene Eakes, EdD, RN
Director, Clinical Education
Vidant Medical Center
Greenville, North Carolina

Audrey Gift, PhD, RN, FAAN
Professor Emeritus
Michigan State University, College of
East Lansing, Michigan

Marion Good, PhD, FAAN
Professor Emerita
Frances Payne Bolton School of
Lakewood, Ohio

Brian Goodroad, DNP, APRN,C-NP
Associate Professor
Metropolitan State University

8

St. Paul, Minnesota

Joan E. Haase, PhD, RN, FAAN
Holmquist Professor of Pediatric Oncology
Department of Clinical Science
Co-Director, The RESPECT Signature Center at IUPUI
Indiana University
Indianapolis, Indiana

Sonya Hardin, PhD, RN, CCRN, ACNS-BC, NP-C
Professor
East Carolina University
Greenville, North Carolina

Nancy S. Hogan, PhD, RN, FAAN
Distinguished Professor
Marcella Niehoff School of
Loyola University Chicago
Chicago, Illinois

Trine Klette, PhD
Associate Professor
Diakonova University College
Oslo, Norway

Katharine Kolcaba, RN, MSN, PhD
Associate Professor
The University of Akron, Ursuline College
Akron, Ohio

Elizabeth R. Lenz, PhD, RN
Professor Emeritus
The Ohio State University College of
Columbus, Ohio

Marjorie McCullagh, PhD, RN, FAAOHN, FAAN
Associate Professor and Director

9

Occupational Health Program
University of Michigan School of
Ann Arbor, Michigan

Renee Milligan, MD
Term Professor, School of
George Mason University
Fairfax, Virginia

Sandra J. Peterson, PhD, RN
Professor Emerita
Bethel University
St. Paul, Minnesota
Accreditation Partner
NurseTim, Inc.
Waconia, Minnesota

Celeste R. Phillips, PhD, RN, CPON
Assistant Professor
Indiana University School of
Indianapolis, Indiana

Mertie L. Potter, DNP, PMHNP-BC, PMHCNS-BC
Professor
MGH Institute of Health Professions
Boston, Massachusetts
Nurse Practitioner
MVCA
Nashua, New Hampshire

Linda C. Pugh, PhD, RNC, CNE, FAAN
Director, Graduate Programs in
York College of Pennsylvania
York, Pennsylvania

Barbara Resnick, PhD, CRNP, FAAN, FAANP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology

10

University of Maryland, School of
Baltimore, Maryland

Kristin E. Sandau, PhD, RN
Professor of
Bethel University
St. Paul, Minnesota

Marjorie A. Schaffer, PhD, RN
Professor Emerita
Bethel University
St. Paul, Minnesota

Ellen D. Schultz, PhD, RN, CHTP, AHN-BC
Professor of
Metropolitan State University
St. Paul, Minnesota

Marjorie Webb, PhD(c), DNP, APRN, C-NP
Associate Professor
Metropolitan State University
St. Paul, Minnesota

Danuta M. Wojnar, PhD, RN, MEd, FAAN
Associate Professor
Seattle University and Associate Dean for Undergraduate Programs
Seattle, Washington

Contributors to the Third Edition
Laurel Ash, DNP, CNP, RN
Assistant Professor
College of St. Scholastica
Duluth, Minnesota

11

Georgene Eakes, EdD, RN
Professor Emerita
College of
East Carolina University
Director, Clinical Education
Center for Learning and Performance
Pitt County Memorial Hospital
Greenville, North Carolina

Audrey Gift, PhD, RN, FAAN
Professor Emeritus
Michigan State University, College of
East Lansing, Michigan

Marion Good, PhD, FAAN
Professor Emerita, Frances Payne Bolton School of
Case Western Reserve University
Cleveland, Ohio
Visiting Professor, Hong Kong University School of , 2010–2011

Joan E. Haase, PhD, RN, FAAN
Holmquist Professor of Pediatric Oncology
Department of Clinical ScienceCo-Director, The RESPECT
Signature Center at IUPUI
Indiana University
Indianapolis, Indiana

Barbara Hoglund, EdD, MSN, RN, FNP-C
Associate Professor of
Bethel University
St. Paul, Minnesota

Trine Klette, PhD
Associate Professor
Diakonova University College
Oslo, Norway

Katharine Kolcaba, PhD, RN, MSN

12

Associate Professor, Emerita and Visiting Professor
The University of Akron, Ursuline College
Akron, Ohio

Elizabeth R. Lenz, PhD, RN, FAAN
Dean, Professor
College of
The Ohio State University
Columbus, Ohio

Marjorie McCullagh, PhD, RN, APHN-BC, COHN-S
Assistant Professor and Director, Occupational Health Program
School of
University of Michigan
Ann Arbor, Michigan

Renee Milligan, PhD, RN
Associate Professor, School of
Georgetown University
Washington, District of Columbia

Mertie L. Potter, DNP, PMHNP-BC, PMHCNS-BC
Professor
MGH Institute of Health Professions
Boston, Massachusetts
Nurse Practitioner
MVCA
Nashua, New Hampshire

Linda C. Pugh, PhD, RNC, CNE, FAAN
Director, Graduate Programs in
York College of Pennsylvania
York, Pennsylvania

Barbara Resnick, PhD, CRNP, FAAN, FAANP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland, School of

13

Baltimore, Maryland

Kristin E. Sandau, PhD, RN
Professor of
Bethel University
St. Paul, Minnesota

Marjorie A. Schaffer, PhD, RN
Professor Emerita
Bethel University
St. Paul, Minnesota

Ellen D. Schultz, PhD, RN, CHTP, AHN-BC
Professor of
Metropolitan State University
St. Paul, Minnesota

Danuta M. Wojnar, PhD, RN, MEd, FAAN
Associate Professor
Seattle University and Associate Dean for Undergraduate Programs
Seattle, Washington

Reviewers
Kim Siarkowski Amer, MD
Associate Professor
DePaul University, School of
Chicago, Illinois

Lori Bork, PhD, MSN, RN, CCRN
Professor
Dakota Wesleyan University
Mitchell, South Dakota

Julie Brandy, PhD, RN, FNP-BC

14

Assistant Professor
College of and Health Professions
Valparaiso University
Valparaiso, Indiana

Cynthia Brown, DNS, RN, AHN-BC, CNE
Assistant Professor
University of West Georgia
Tanner Health System School of
Carrollton, Georgia

Maria A. Connolly, PhD, CNE, ANEF, FCCM
Professor of Adjunct
Marcella Niehoff School of
Loyola University Chicago
Chicago, Illinois

Beth D. Crouch, MSN, RN, BS
Assistant Professor of
Milligan College
Milligan College, Tennessee

Karen V. Duhamel, MSN, MS, RN
Instructor of
The University of Hartford
West Hartford, Connecticut

Tresa Kaur Dusaj, PhD, RN-BC, CNE, CHSE, CTN-A
Faculty Program Director
Excelsior College
Albany, New York

Michelle Edmonds, PhD, FNP-BC, CNE
Professor of
Jacksonville University
Jacksonville, Florida

15

Susan Sweat Gunby, PhD, RN
Professor
Georgia Baptist College of
Mercer University
Atlanta, Georgia

Kathryn Van Dyke Hayes, PhD, RN, CNE
Professor and Director of Graduate Programs
Holy Family University
Philadelphia, Pennsylvania

Phyllis Jeans, MSN, RN
Assistant Professor
Baptist College of Health Sciences
Memphis, Tennessee

Melanie Kalman, PhD, RN
Professor, College of
Upstate Medical University
Syracuse, New York

Theresa A. Kessler, PhD, RN, ACNS-BC, CNE
Professor of and Kreft Endowed Chair for the Advancement of
Science
Valparaiso University
Valparaiso, Indiana

Donna Koestler, EdD, MSN, RN
Assistant Professor of
Delta State University
Cleveland, Mississippi

Regina Lederman, RN, BSN, MN Ed, MA, PhD, FAAN
Professor, University of Texas Medical Branch at Galveston
School of
Graduate School of Biomedical Sciences
Adjunct Professor, UT-Health Science Center
School of Public Health

16

Galveston, Texas

Jerrilee LaMar, PhD, RN, CNE
Associate Professor of
Dunigan Family School of and Health Sciences
University of Evansville
Evansville, Indiana

Patricia A. Mattingly, MD
Associate Professor of
Keuka College
Keuka Park, New York

Ann M. Mayo, DNSc, RN
Professor of
University of San Diego
San Diego, California

Diane B. McNaughton, PhD, APHN-BC
Associate Professor
Rush University College of
Chicago, Illinois

Bernita Missal, PhD, RN
Professor
Bethel University
St. Paul, Minnesota

Aroha Page, PhD, (UCSF), MPhil(N), BA, BScN, Grad Dip Health
Sci, RN, FRCNA
Associate Professor
Nipissing University
North Bay, Ontario, Canada

Carole A. Pepa, PhD
Professor
Valparaiso University

17

Valparaiso, Indiana

Kathy Reavy, PhD, RN
Professor
Boise State University
Boise, Idaho

Liz Seabrook, RN, MScN, DOHN
BScN Professor
Lambton College
Sarnia, Ontario, Canada

Nuananong Seal, PhD, RN
Professor
UW–Milwaukee, College of
Milwaukee, Wisconsin

Denice Kopchak Sheehan, PhD, RN
Associate Professor
Kent State University College of
Kent, Ohio

Christie Shelton, PhD, RN, CNE
Dean/Associate Professor
Jacksonville State University
Jacksonville, Alabama

Phyllis Skorga, PhD, RN, CCM
Professor of
Arkansas State University
Jonesboro, Arkansas

Amy Rex Smith, PhD
Professor
Belhaven University
Jackson, Mississippi

18

Julie Strunk, PhD, RN
Professor
James Madison University
Harrisonburg, Virginia

Angela Thompson, DNP, BC-FNP, BC-WHNP
Assistant Professor of
Director FNP Program
Wheeling Jesuit University
Wheeling, West Virginia

Ching Eng H. Wang, PhD, APN, NP-C
Associate Professor of
North Park University
Chicago, Illinois

Debra J. Bohlender Welch, PhD, RN-BC
Assistant Professor, Post-Licensure (RN-BSN) Division
Indiana Wesleyan University, School of
Marion, Indiana

19

Preface

Middle range theories have understandably emerged as the focus of
knowledge development in nursing with a broad acceptance of the need to
develop middle range theories to support nursing practice.

There is a dynamic relationship between theory, research, and practice.
Research is a source of theory development, and theory is a source of
research questions. Theory is used to improve practice, and practice is
used to generate, test, and refine theories. Basically, it is by testing the
theories through research that the evidence for practice is generated. In this
fourth edition, the change of the title to Middle Range Theories
Application to Research and Practice better reflects this dynamic
relationship with increased emphasis on applications of middle range
theories to practice. We continue to hope that this edition can serve as a
resource for nurse scholars and practitioners, making middle range theories
more accessible and useful. The ultimate goal is the advancement of
nursing as a profession and improving the quality of its practice.

With the increase in the number of middle range theories being
developed, determining which to include in this edition is always a
challenge. As for the previous editions, we reviewed published research
and practice applications of theories. We also solicited input from
practitioners. The goal was to identify those theories, though in the middle
range of abstraction, are not particularly narrow in their possible
applications. That process resulted in the addition of two middle range
theories: the theory of change and the Experiential Theory of Spiritual
Care in Practice.

Organization

Part I

20

Part I is devoted to an overview of the state of nursing’s body of
knowledge and the processes by which it is evaluated.

Chapter 1 introduces the interrelationship between nursing theory,
research, and practice. In addition to a brief discussion of epistemology
with a summary of Carper’s conceptualization of nurses’ ways of knowing,
the majority of the chapter addresses the hierarchy of nursing knowledge.
The emphasis, of course, is on the place of middle range theory within that
hierarchy (i.e., paradigm, philosophy, conceptual framework, and
theories). For each component of the hierarchy, the chapter includes a
description of its nature, review of its development, a discussion of its
contributions to nursing knowledge, consideration of controversies related
to its nature or use, and examples of nurse scholars’ work. The section
devoted to middle range theories includes an expanded and updated table
with multiple examples of middle range theories referenced. Also included
is an expanded discussion of practice or situation-specific theories with a
table that provides recent examples of this level of theory development.

Chapter 2 emphasizes the analysis and evaluation of middle range
theories, including issues to consider in the selection of a middle range
nursing theory for research purposes. This chapter also describes a brief
evaluative process for theory analysis. Using this evaluation process,
readers can compare and contrast their conclusions about the theory as
presented in the chapter with those of a nurse scholar who has also used
this evaluation process. The theory analysis exercises related to each
chapter are available in the Student Resources located on
(http://thepoint.lww.com/Peterson4e).

Parts II to VI
Parts II to VI are devoted to specific middle range theories. The selected
theories are labeled by their developers or by nurse scholars as middle
range theories and are ones frequently cited in published nursing research
or practice applications. Many of the chapters contain unique nursing
theories; some are borrowed from related disciplines but are, nonetheless,
useful to nursing. All theories in the text, however, have the intrinsic
capability to be applied to nursing research and practice. They address a
wide range of phenomena that allow the researcher to consider a variety of
nursing research questions and uses in practice. The theories have been
organized by categories to reflect a general focus of research questions or

21

http://thepoint.lww.com/Peterson4e

practice applications. The categories are not presented as absolute, but
more as a guide to direct the user of the book to the theories that might be
most relevant to their issue of interest.

Physiological—Pain: Balance of Analgesia and Side Effects;
Unpleasant Symptoms
Cognitive—Self-efficacy, Reasoned Action
Emotional—Empathy, Chronic Sorrow, Experiential Theory of
Spiritual Care in Practice
Social—Social Support, Interpersonal Relations, Attachment
Integrative—Modeling and Role-Modeling, Comfort, Heath-Related
Quality of Life, Health Promotion, Deliberative Process,
AACN Synergy Model, Resilience, Change

Special Features
Each theory chapter provides the nurse researcher with a variety of tools.
Key features include the following:

Definitions of Key Terms appear at the beginning of each chapter to
define concepts and aid the reader’s understanding of the theory.
Using Middle Range Theories in Research boxes provide examples
of how the theory has been used in published research. These have
been updated and reformatted, using an outline based on the research
process.
Using Middle Range Theories in Practice boxes provide examples
of theories applied to a specific clinical practice situation. They too
have been reformatted so that the clinical issue and the use of the
theory as a foundation for nursing intervention are clearly identified.
Examples of Theory in Practice tables are included in each chapter.
The headings on these tables are similar to the matrix used to critique
research as a basis for evidence-based practice.
Critical Thinking Exercises at the end of each chapter engage
readers in analysis of the theory and its application to practice.
Instruments are discussed in the chapters, with specific examples
available in the Student Resources located on
(http://thepoint.lww.com/Peterson4e).

22

http://thepoint.lww.com/Peterson4e

Resources on
A variety of resources designed to enhance the teaching and learning

experience are available on
(http://thePoint.lww.com/Peterson4e).

Analysis Exercises are provided for each theory chapter allowing
readers to arrive at their own conclusions about the theory and then
compare them to a nurse scholar’s evaluation. By analyzing the
particular theory with the detail suggested in Chapter 2, the student or
reader becomes more intimately involved with the theory and is more
likely to develop an understanding of the theory through the deeper
evaluation of its constructs. This allows the person doing the analysis
to grapple with the theory and to appreciate more fully its application
to nursing research and ultimately to the building of the foundation of
evidence-based practice for nursing.
Web Resources provide links to pertinent websites to aid readers in
their own research.
Journal articles, related to each chapter, help further understanding
of concepts and their applications.

23

http://thePoint.lww.com/Peterson4e

Acknowledgments

There is a sense of accomplishment that accompanies the completion of a
project such as this text. We would have never been able to experience that
rather pleasant sensation without the significant involvement of many
others. The quality of the scholarship of the chapter authors will be evident
to all those who read the text. Their willingness to invest themselves in this
project, consistently providing what was needed in a timely fashion, is
much appreciated. Those who completed the Analysis of Theory, that is
available on , have added what we believe will be a useful
resource to readers, enabling them to clarify their understanding of the
theories.

The staff at Wolters Kluwer was invaluable. Christina C. Burns,
Senior Acquisitions Editor, continued to see this book as a contribution to
the body of nursing literature. Helen Kogut, Senior Product Development
Editor, expertly coordinated the project. We would also like to thank
Eileen Wolfberg, Development Editor, for shepherding this project to
completion. And finally, we are profoundly grateful for the forbearance of
our family and friends (especially husband, Ray Peterson, and wife, Kate
Bredow). They helped us have “lives” beyond the scope of completing this
book.

24

Contents

PART I Overview of Theory

1 Introduction to the Nature of Knowledge
Sandra J. Peterson
Philosophy
Metaparadigm and Paradigms
Conceptual Models
Theory: General Issues
Grand Theory
Middle Range Theory
Practice Theory/Micro Theory/Situation-Specific Theory
Summary

2 Analysis, Evaluation, and Selection of a Middle Range
Theory

Timothy S. Bredow
Historical Background
Theory Analysis
Theory Evaluation
Selecting a Theory for Research
Middle Range Theory Evaluation Process

Part II Middle Range Theories: Physiological

3 Pain: A Balance Between Analgesia and Side Effects
Marion Good
Historical Background
Definition of Theory Concepts
Description of the Theory of Pain: A Balance Between Analgesia and
Side Effects
Applications of the Theory
Use of the Theory in Practice

25

Summary

4 Unpleasant Symptoms
Elizabeth R. Lenz, Linda C. Pugh, Renee Milligan, and Audrey Gift
Historical Background
The Theory of Unpleasant Symptoms
Description of the Theory of Unpleasant Symptoms
Models That Expand or Modify the Theory of Unpleasant Symptoms
Assessment of Symptoms
Instruments Used in Empirical Testing
Summary

Part III Middle Range Theories: Psychological

5 Self-Efficacy
Barbara Resnick
Historical Background
Definition of Theory Concepts
Relationships Among the Concepts: The Mode
Application of the Theory in Research
Application of the Theory in Practice
Summary

6 Chronic Sorrow
Georgene Eakes
Historical Background
Current Research on Chronic Sorrow
Middle Range Theory of Chronic Sorrow
Research Applications of Chronic Sorrow
NCRCS Chronic Sorrow Instrument Development
Summary

7 Spiritual Care in Practice (SCiNP)
Lisa Burkhart and Nancy S. Hogan
Historical Background
Empirical Development of the Spiritual Care in Practice
Theory
Definition of Theory Concepts
Instruments Used in Empirical Testing

26

Application of the Theory in Practice
Application of the Theory in Research
Summary

Part IV Middle Range Theories: Social

8 Social Support
Marjorie A. Schaffer
Historical Background
Definition of Theory Concepts
Application of the Theory in Practice
Application of the Theory in Research
Challenges to Social Support Theory Development and Research
Summary

9 Caring
Danuta M. Wojnar
Historical Background
Theory Development
Definitions of Theory Concepts
Description of the Theory of Caring
Application of the Theory in Research
Application of the Theory in Practice
Summary

10 Interpersonal Relations
Sandra J. Peterson
Historical Background
Definitions of Theory Concepts
Description of Theory of Interpersonal Relations
Applications of the Theory: Research
Applications of the Theory: Practice
Applications of the Theory: Theory and Model Development
Summary

11 Attachment
Trine Klette and Sandra J. Peterson
Historical Background
Description of Attachment Theory

27

Definition of Key Concepts
Internal Working Models
Patterns of Attachment
Attachment as a Basic Need
Attachment and Care
Attachment and Health
Development and Change
Applications of Attachment Theory: Research
Applications of Theory: Practice
Further Research
Summary

Part V Middle Range Theories: Integrative

12 Modeling and Role-Modeling
Ellen D. Schultz
Historical Background
Expanded Definitions of Modeling and Role-Modeling Concepts
Description of the Theory of Modeling and Role-Modeling
Applications of the Theory in Research
Instruments Used in Empirical Testing
Application of the Theory in Practice
Outcome
Summary

13 Comfort
Katharine Kolcaba
Historical Background
Definitions of Theory Concepts
Description of Theory: Major Components and Their Relationships
Research Applications for the Theory of Comfort
Instruments Used in Empirical Testing
Summary

14 Health-Related Quality of Life
Kristin E. Sandau, Timothy S. Bredow, and Sandra J. Peterson
Historical Background
Definition of Theory Concepts
Description of the Theory of Quality of Life and Health-Related

28

Quality of Life
Application of the Theory in Research
Instruments Used in Empirical Testing
Health-Related Quality of Life as an Outcome Measure in
Summary

15 Health Promotion
Marjorie McCullagh
Historical Background
Pender’s Definition of Health
Description of the Health Promotion Model
Implications of the Model for Clinical Practice
Summary

16 Deliberative Process
Mertie L. Potter
Historical Background
Definition of Theory Concepts
Description of the Theory of Deliberative Process
Applications of the Theory
Instruments Used in Empirical Testing
Conclusion
Summary

17 Resilience
Joan E. Haase and Celeste R. Phillips
Historical Background and Current Perspectives
Definition of Resilience and Concepts
Description of Resilience: the Theory
Application of a Theory: The Resilience in Illness Model
Instruments Used in Empirical Testing of Resilience
Summary

18 Planned Change
Brian Goodroad, Marjorie Webb, and Timothy S. Bredow
Historical Background
Definition of Theory Concepts
The Health Belief Model
Theory of Planned Behavior

29

Transtheoretical Model
Organizational Change Theories
Summary

19 The AACN Synergy Model
Sonya Hardin
Historical Background
Description of the Theory of Synergy Model
Use of the Theory in a System
Summary

Appendix Instruments
Burke/Eakes Chronic Sorrow Assessment Tool©
General Comfort Questionnaire
Comfort Behaviors Checklist
Scoring of the Behaviors Checklist
Pediatric Asthma Quality of Life Questionnaire With Standardized
Activities (PAQLQ[S])

Index

30

PART I Overview of
Theory

31

1 Introduction to the
Nature of
Knowledge

Sandra J. Peterson

Definition of Key Terms

Concept Symbolic representation of a phenomenon or set of
phenomena

Conceptual model “Set of abstract and general concepts and
the propositions” (Fawcett, 1997, pp. 13–14) that represents a
phenomenon of interest

Deduction Reasoning from the general or universal to the
particular or specific

Discipline A field or branch of knowledge that involves
research

Domain Related components or items that reflect the unified
subject matter of a discipline

Empiricism A philosophical theory of knowledge acquisition
through experience, observation, and experiment

Ethics A branch of philosophy concerned with moral principles

32

Epistemology A branch of philosophy concerned with the
sources of knowledge of truth and the methods used to acquire it

Induction Reasoning from the individual or particular to the
general or universal

Logic A branch of philosophy concerned with sound reasoning
and validity of thought

Logical positivism Philosophical perspective that espouses
logic, objectivity, falseness/truth, observable and operationally
defined concepts, and prediction

Metaparadigm Global concepts specific to a discipline that are
philosophically neutral and stable

Metaphysics A branch of philosophy concerned with the study
of ultimate cause and underlying nature of that which exists

Metatheory A philosophical theory about …