The nursing theories and models play a vital role of defining phenomena, directing, explaining and predicting different nursing situations. The models are useful in decision making process and responding to various challenges affecting the nursing profession. In the 21st century, some of the major issues in nursing include motivation, job satisfaction, productivity, leadership, and the relationship with patients. There is also a challenge of innovation in enhancing community health. While there are various nursing theories, only a few of them can help in responding to issues affecting the nursing profession in the 21st century. In the following discussion, the grand, middle-range, and situation-specific theories will be analyzed, before selecting the most appropriate in the 21st century.
Comparison of the Nursing Theories
Grand Theory
The grand theories do not address specific issues in healthcare. Instead, the grand theories provide much abstract information, which may not necessarily be useful in responding to phenomenon in the health sector (Chinn & Kramer, 2000). Most of the grand theories are based on concepts and principles that have not been tested. Therefore, it becomes difficult to generalize or use the grand theories in solving challenges in the health institution. The grand theories may also not useful in predicting the health phenomenon. An example of grand theory is Dorothea Oren’s self-care theory. According to Oren, people have the ability and the willingness to make informed choices about their health. This is an assumption and may not be necessarily true across all the cultures, classes, and statuses.
Delegate your assignment to our experts and they will do the rest.
Middle- Range Theory
The middle-range theories address some specific issues affecting a given population. The middle-range theories tend to breakdown the grand theories into components that are easier to put into practice. Most of the concepts of middle-range theories are testable, making them easier to be used in addressing different issues affecting the nursing profession (Corbin & Strauss, 1991). However, the middle-range theories have failed to address most of the emerging issues in the 21st century. An example of a grand theory is the Corbin and Strauss Chronic Illness Trajectory Framework, which provides steps that are useful in the management of chronic ailments. The model has been useful in the management of most of the chronic ailments because of the specific steps provided (Barnum, 1998). However, the concepts and principles provided in the model are general. For example, there is an assumption the model is applicable to all the chronic pains, across all races and cultures. Therefore, the middle range theories also tend be too simplistic, failing to address the actual problems effectively.
Situation-Specific Theories
The situation- specific theories are the most imperative in providing lasting solution to various existing and emerging challenges in nursing today. The situation-specific theories address specific issues affecting nursing and the health institution (Fawcett, 2005). Additionally, the situation-specific theories address specific goals and steps one should take to achieve them (Graneheim & Lundman, 2001). Unlike the grand and the middle-range theories, the situation-specific are population specific. This means that particular solutions are only applicable in one setting and another. The theory respects the cultural differences that affect the beliefs, perceptions, and attitudes towards health. The theory will only contain one specific concept that can also be operationalized.
Rationale for Selecting Situation-Specific Theory
Simple and Specific
The situation specific-theory is simple to understand and apply. It is also issue-specific. Its simplicity allows the policymakers formulate various rules and regulations that assist in addressing particular issues in the health care organization. For instance, in the case of nurses productivity issue, focuses on the main causes and prescribes the most effective and relevant approaches. Overworking and low remuneration could be some of the underlying issues behind the low productivity. These specific issues are addressed using specific approaches that are relevant to the existing challenges. As a result, it is possible to find an amicable solution to most of the emerging issues in the health care.
Population Specific
As mentioned above, generalization is the main weaknesses of the grand and the middle-range theories. It is imperative to appreciate that different population have different health care needs and perceptions. Different cultures also have varied belief, behaviors, and attitudes towards health. The access to information about health is disproportionately distributed within different cultures owing to various factors. As a result, the concepts and approaches used in the management of health in one particular population may not apply in another. Therefore, situation-specific theory is the most effective in addressing different health needs in various cultures. The theory allows nurses and other medical practitioners to work closely with the target populations to determine the actual issues affecting them. The solutions are also localized to ensure that they address the real issues amicably.
Goals and Outcomes are Defined
The situation-specific theory is result-oriented. It allows healthcare managers make the realistic, timely, and measurable goals. The managers also know the expected results and have internal mechanism of monitoring and evaluating the progress. If the desired results are not achieved, situation-specific goal allows for modification of the approaches. Unlike other models, the situation-specific theory is flexible, therefore providing more alternatives to the challenges facing the nurses. In conclusion, the situation-specific theory is the most appropriate in addressing the 21st issues affecting the nurses and the health care organizations.
References
Barnum, B. (1998). Nursing Theory: Analysis, Application, Evaluation. Lippincott Williams & Wilkins. ISBN 978-0-7817-1104-3.
Corbin, j. & Strauss, A. (1991) A Nursing Model for Chronic Illness Management Based upon the Trajectory framework. Scholarly Inquiry for Nursing Practice, 1991, 5, 155-174.
Chinn, P. & Kramer, M. (2010). Integrated Theory & Knowledge Development in Nursing (8 Ed.). St. Louis: Mosby. ISBN 0323077188.
Fawcett, J. (2005). Contemporary nursing knowledge: analysis and evaluation of nursing models and theories. 2nd ed. Philadelphia.
Graneheim, U. & Lundman, B (2004). "Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness". Nurse Education Today. 24 (2): 105–112. doi:10.1016/j.nedt.2003.10.001. ISSN 0260-6917
Villarruel, A. (2001). Borrowed theories, shared theories, and the advancement of nursing knowledge. Nursing Science Quarterly 2001; 14: 158-63.
