Theoretical Frameworks for Nursing Research, Practice, and Education
This Podcast and notes define the difference between theoretical frameworks and conceptual models, defines conceptual and operational definitions, introduces the nursing metaparadigm concepts, and introduces how theoretical frameworks and conceptual models guide research, practice, and education. Examples of these concepts are included. Scroll down to access the Podcast Player!
I developed this concept guide to help you in your theory classes! Click Here for Your Free Nursing Theory and Philosophy: Terms & Concepts Guide!
These are the concepts discussed in the Podcast:
Research links Theory, Education, and Practice
- Research is systematic inquiry into the possible relationships among phenomena.
- Theory is an abstract conceptualization of the relationships ascribed to certain phenomena.
- Education is the setting for learning that is guided by theory, research, and practice.
- Practice is the setting that nursing care is delivered and provides the opportunity to identify research topics.
What are Theoretical Frameworks?
- Provides a structure for the study
- Provides the rationale for the predictions of the relationships between the variables
- Frame of reference
- Basis for future study
- GUIDEs and directs the study
- Helps make sense of meaning of the study (meaningful interpretation)
For more information see my post on theoretical frameworks and conceptual models.
What is a Theory?
- Representation of reality whose purpose is to describe, explain, and predict phenomena of interest.
- Set of interrelated constructs [concepts], definitions, and propositions; specifies the relationships
- Why is it necessary for a research study?
- Road Map : Directions for designing and conducting the study
Theories, models, frameworks, schemes, maps
- Abstraction; Systematic explanation of what, when, how, why
- NEVER PROVED, only tested
- Research strengthens, refutes, refines
- Consist of concepts and propositions
Components of Theory
- Image or symbolic representation of an abstract idea:
- Linkages that spell out how the concepts are related
- Generated by Inductive Process
- Evaluated [propositions are tested] and modified by Deductive Process
Conceptual and Operational Definitions
- Conceptual: general meaning based on the theory: “Dictionary” definition
- Operational: specific direction of how concept is measured: follows the phrase “as measured by …”
Examples of Conceptual and Operational Definitions
Postoperative pain: discomfort an individual experiences after a surgical procedure
as measured by rating on a pain scale
State-anxiety: “ a transitional emotional state aroused in a situation that presents a perceived threat to self-integrity(Mullooly et al., 1988, p. 5)
as measured by the Spielberger State-Trait Anxiety Inventory (Spielberger et al., 1970)
Dyspnea: “the sensation of difficult breathing” (Gift et al., 1992, p. 242)
as measured by the Visual Analogue Dyspnea Scale.
Social support: “ a characteristic of the social situation that buffers the effect of stress on the health of the individual” (Northouse, 1988, p. 91)
as measured by the Social Support Questionnaire.
- Broad representation of common theme
- More loosely structured than theory
- Diagrams used to show theme and link concepts through symbols
- Pender’s Health Promotion Model
- Becker’s Health Belief Model
- Conceptual underpinnings of a study
- Theoretical or conceptual framework
- Every study has a framework
- May be implicit or explicit
- “Best fit”
- Did researcher choose the theory before or after study designed?
- Borrowed frameworks
For more details on how to use a theoretical framework to guide your research study, click the link to see this post.
- Maslow’s Hierarchy of Needs
- Selye’s General Adaptation Theory (Stress Theory)
- Lazarus & Folkman’s Theory of Stress and Coping
- Kohlberg’s Moral Reasoning Theory
- Bandura’s Social Learning Theory
- Azjen & Fishbein’s Theory of Reasoned Action
- Rogers’ Diffusion of Innovations Theory
- Physiologic frameworks, e.g., Germ theory, Infectious disease transmission, Immune defense, etc..
What is Nursing Theory?
“A relatively specific and concrete set of concepts and propositions that purports to account for or characterize phenomena of interest to the discipline of nursing” (Fawcett, 1989, p.23).
Students usually have to write a nursing theory paper for a class assignment. Click on the link so I can give you some advice on how to do this!
Nursing Phenomena of Interest = Nursing Metaparadigms
Each theorist defines the phenomena according to their worldview
Examples of Phenomenon of Person According to Theorists
- Biopsychosocial being (Roy, 1984)
- An energy field (Rogers, 1986)
- An integrated whole (Orem, 1990)
Examples of Phenomenon of Nursing
- A process in which individuals are aided in achieving maximum well-being within their potential (Rogers, 1994)
- To promote patient adaptation during health and illness (Roy, 1984)
- To help people meet their own therapeutic self-care demands (Orem, 1995)
Critiquing the Study Framework
- Guidelines in text
- I can’t argue with the researcher! YES you can!
- Is the theoretical framework or conceptual model explicit?
- Logical explanation for choice?
- Consistent with research paradigm?
- Does the chosen framework guide the study?
- Language consistent? Conceptual definitions?
- Research problem, questions, hypotheses consistent with theoretical framework?
- Is the Theoretical Framework or Conceptual Model used to explain the findings? Tie back? Findings used to support/refute the framework?
Update April, 2017: Introduction to Theoretical Frameworks for Nursing Research, Practice, and Education (not discussed in podcast, fyi)
This is just a brief introduction to the use of theoretical frameworks in nursing research, practice, and education. I’ll provide more details about specific frameworks in future posts.
I’m not going to list popular theories that can be used in your research study because, in fact, any theoretical framework or conceptual model can be used in nursing research – from nurse theorists or borrowed theory. But here’s a guide: Descriptive theories can guide descriptive studies, explanatory theories can guide correlational research, and predictive theories can guide experimental research (Fawcett, 2015).
Carper’s original Ways of Knowing (1978/2013) provided a way to think about theories that can be used to examine issues of interest in nursing. The five ways of knowing included empirical (nursing science), aesthetic (nursing art), ethical, personal knowing (relationships); and sociopolitical (policies and politics), which was added by White in 1995 (Fawcett, 2015).
The theory you choose to guide your study will depend on what you are interested in studying! For example, if you are studying the effects of stress on a physiologic phenomenon then you might use a biological theory like Selye’s General Adaptation Theory or you could use a nursing theory such as Roy’s Adaptation Model. If you are interested in the lived experience of patients with spinal cord injury you would look to phenomenology to use as your framework.
Again, you might be interested in reading my post on how to use a theoretical framework to guide your research study, click the link to read this post.
As far as theoretical frameworks or conceptual models for nursing education — again there are many to choose from to guide your own educational practice. There are learning theories that are used in psychology and education: (a) behaviorist theory (e.g., Pavlov, Skinner), (b) cognitive theory (e.g., Piaget, Bandura, Ausubel) (c) psychodynamic theory (e.g., Freud, Erickson), and (d) humanistic theory (e.g., Maslow) (Butts & Rich, 2015). I personally base my teaching practice on Cognitive Learning Theories, especially Constructivist approaches such as Ausubel’s Meaningful Learning Theory; I also use Knowles’ Adult Learning Theory.
Theoretical frameworks and conceptual models for nursing practice are many. Philosophies and theories that could be used as a practice framework, which can include interdisciplinary team members, include complexity science and complex adaptive systems, emancipatory knowing, feminist perspectives, ethics, educational and learning theories, health behavior theories, interpersonal relationship theories, environmental and ecological theories, economics, organizational behavior and leadership, and quality improvement (Butts & Rich, 2015; Cody, 2013).
Any nursing theory is appropriate for testings its effects on nursing practice, of course. There are nursing theories based on systems; those that emphasize nursing goals, functions, roles, competencies, and skills; those “focused on human existence and universal energy” (think Martha Rogers, Margaret Newman, Rosemarie Parse); professionalism; caring; culture; patient-centered care; personhood; care related to older adults, children, transplant patients; healing, and suffering to name a few (Butts & Rich, 2015; Cody, 2013).
The choice of theoretical framework to guide your project depends, again, on your purpose — are you doing an organizational assessment, changing practice by translating research/evidence into practice, conducting original research, implementing a quality improvement project, educating staff/patients/families, encouraging behavior change? You’ll want to match your purpose with a theory that can help you answer your questions!
I’ll do more of a deep dive on specific theoretical frameworks for nursing research, practice, and education in future posts!
Source and References:
Butts, J. B., & Rich, K. L. (Eds.). (2015). Philosophies and theories for advanced nursing practice (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Carper, B. A. (1978/2013). Fundamental patterns of knowing in nursing. In W. K. Cody (Ed.). Philosophical and theoretical perspectives for advanced nursing practice (5th ed., pp. 23-33). Burlington, MA: Jones & Bartlett Learning. Classic article from 1978 is reprinted in this textbook.
Cody, W. K. (Ed.). (2013). Philosophical and theoretical perspectives for advanced nursing practice (5th ed). Burlington, MA: Jones & Bartlett Learning.
Engebretson, J. C., & Hickey, J. V. (2013). In W. K. Cody (Ed.). Philosophical and theoretical perspectives for advanced nursing practice (5th ed., pp. 111-137). Burlington, MA: Jones & Bartlett Learning.
Fawcett, J. (2013). Using theory in evidence-based advanced nursing practice. In W. K. Cody (Ed.). Philosophical and theoretical perspectives for advanced nursing practice (5th ed., pp. 613-629). Burlington, MA: Jones & Bartlett Learning.
LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MO: Mosby.
White, J. (1995). Patterns of knowing: Review, critique, and update. Advances in Nursing Science, 17(4), 73-86.