Page 328 - Encyclopedia of Nursing Research

MIDDLE-RANGE THEORIES n 295

theory. Middle-range theory is a set of related for viewing the world. With the particulate-
ideas that are focused on a limited dimen- deterministic lens, processes are causal in
sion of the reality of nursing. These theories nature with antecedents and consequences. M
are composed of concepts and suggested With the interactive-integrative lens, pro-
relationships among the concepts that can be cesses are relational with rich contexts that
depicted in a model. Middle-range theories contribute to understanding. With the uni-
are developed and grown at the intersection tary-transformative lens, processes are pat-
of practice and research to provide guidance terns unfolding over time. The majority of
for everyday practice and scholarly research middle-range theories in nursing are concep-
rooted in the discipline of nursing. Typically, tualized through the interactive-integrative
middle-range theories are conceptualized lens, whereas a smaller number are concep-
and referred to by a topical focus such as story tualized through the unitary-transformative
theory (Liehr & Smith, 2008b), uncertainty lens and even fewer through the particulate-
theory (Mishel & Clayton, 2008), or theory deterministic lens. For instance, in the Smith
of symptom management (Humphreys, Lee, and Liehr (2008) book, the editors include
Carrieri-Kohlman et al., 2008). nine middle-range theories designated as
More than three decades ago, Ada Jacox consistent with the interactive-integrative
(1974) addressed middle-range theory in lens (uncertainty, community empower-
a classic paper on theory construction in ment, symptom management, unpleasant
nursing. Since then, there has been ongoing symptoms, self-efficacy, family stress and
attention to middle-range theory, and it is adaptation, cultural marginality, caregiving
increasingly recognized for its potential as dynamics, and moral reckoning) and three
a foundation guiding practice and research. consistent with the unitary-transformative
Smith and Liehr (2008b) report 27 new mid- lens (meaning, self-transcendence, and
dle-range theories for a 7-year period begin- story). Although there are no middle-range
ning in 2000. There are two current books theories conceptualized through the particu-
dedicated to middle-range theory (Smith & late-deterministic lens included in the book,
Liehr, 2008; Peterson & Bredow, 2008), and it is possible to create such a theory, but it
Parker and Smith include a large section on would tend toward a microrange rather than
middle-range theories for practice in their a middle-range level.
2010 book. Considerable evidence documents the
Although theory has always been fore- use of middle-range theory to guide research.
front in PhD nursing education, the recent A few middle-range theories have associ-
development of the doctor of nursing prac- ated measurement tools, such as Mishel’s
tice degree as well as the push by the nation’s Uncertainty in Illness Scale (Mishel, 2008) and
hospitals to achieve Magnet designation has Reed’s Self-Transcendence Scale (Reed, 2008).
created a niche for middle-range theory as a Availability of measurement tools that corre-
guide for nursing practice and corresponding spond with the theory facilitates use of the
research. Liehr and Smith (2008a) propose a theory in research. One of the middle-range
10-step process for scholars wishing to trans- theories, the story theory, has an inquiry
late practice ideas into structures for research method that is consistent with the concepts
that can culminate in middle-range theory. of the theory (Liehr & Smith, 2008a).
Middle-range theory is developed within Since Merton introduced middle-range
a paradigmatic perspective. For instance, theory in academic circles more than 40 years
Newman, Sime, and Corcoran-Perry (1991) ago, there has been an escalation in the devel-
proposed the particulate-deterministic, opment of middle-range theories for nursing.
interactive-integrative, and unitary-transfor- However, it is essential that nursing scholars
mative paradigms. Each paradigm is a lens persist in testing these theories to maintain