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Differences Between Nursing Grand and Middle Range Theories

According to Smith & Parker (2015), grand theories define a broad perspective for nursing practice and approach nursing practice from a philosophical point, hence, are not testable, and also they can be applied in a range of topics.

On the other hand, middle-range theories define a narrower phenomenon in nursing practice,  are testable, they focus on one specific topic, and approach nursing issues from a scientific perspective as evidenced by the use of variables (Smith & Parker, 2015).  Additionally, grand theories can guide nursing research scholars in integrating the findings into vast areas such as practice, research, and administration while middle-range theories research are used for a particular purpose, to enhance nursing care.

Sister Callista Roy is a nursing theorist who contributes immensely to the advancement of the nursing theories, and her adaptation model has extensively influenced the nursing practice, curricula and nursing education. Roy’s adaptation model explains that adaptation happens when individuals react in a positive way to changes in the environment; further, Roy stated that adaptation is the expected goal from nursing care by using interventions that promote coping in health and illness.

Thus, Roy’s adaptation model offers a perspective from where to view a complex nursing condition as well as the guideline of intervention. As reported by Akyil and Ergüney (2013) in their research, the use of Roy’s adaptation model increases adaptation in patients when the model is used to deliver education.

Afaf Meleis is a nurse researcher and sociologist who helped nurses to develop and advance knowledge, and she has brought tremendous changes in nursing education, policy, research, and care models. Her Transitions theory is a mid-range theory that assists nurses in facilitating transitions for patients, families, and the community. These three parties look upon the nurse to support patients undergoing major life transitions of illness, pregnancy, and recovery.

The transitions can include relocation of the patient from hospital to home, from survival to recovery, from self-care to palliative care and from helplessness to independence. Research by Ramsay et al. (2013) revealed that Meleis’ Transitions theory provided a framework to explain the aspects that facilitate, impede and characterize transition process in patients from intensive care to general ward-base care. Furthermore, the study identified that the use of the theory emphasized the need for the provision of psychological support in transitions to ward-based care.

1 thought on “Differences Between Nursing Grand and Middle Range Theories

Messili April 1, 2019 at 2:19 pm

In reference to the works of Smith & Parker (2015), this discussion describes nursing grand
theories a framework that represent a way of thinking about the means in which complex things
function as they do. Nursing grand theories are not specific to any point of practice and therefore
cannot be empirically tested. In contrast, middle range theories present a way for constructs to be
measured in specific nursing situations. There approach is precisely designed to address a
particular can be used for practical testing. Further, the writer is keen on the point that grand
theories are only used to shape the dimensions of nursing research where it requires no
categorization while middle rage theories are used to explain, predict and describe specific
research topics.

 Additionally, the writer goes on to explain the works of two theorists namely; Sister Callista
Roy’s adaptation theory and Afaf Meleis’s Transitions theory, both who are dedicated to provide
a foundation for the development nursing practice. Roy’s adaptation model provides a
perspective from where to view adaptation to change as ‘inevitable’ while Meleis’s transition
model provides a platform for clarification on the aspects that assist, impede and describe the
process of transition in nursing care. In the whole, I agree with the writer that, be it grand or middle range theory, the ultimate goal for both is to shape nursing interventions designed to support practice.


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