A theory is said to be middle range when it proposes a relationship between different concepts, all of which can be measured and easily subjected to research (Hutch & Moore, 1998). Compared to a grand theory, it has a limited scope because it involves a lesser number of concepts and explains only one phenomenon in nursing which is also just one aspect of a person. It is concrete with a focus on what is commonly encountered in nursing practice rather than an abstract idea such as what nursing is. It is also founded on a paradigm related to the phenomenon being investigated and is easier to apply to practice.
An example of a middle-range theory is Eakes, Burke & Hainsworth’s (1998) theory of chronic sorrow. It relates the concepts of loss, disparity and chronic sorrow which have been the subject of extensive nursing research in the early 1990s. Loss can either be a single event (e.g. amputated foot) or ongoing (e.g. a loved one with terminal cancer) and is subjective. Disparity is a situation that is drastically different from what one otherwise desired. Chronic sorrow is a sense of sadness which can be pervasive, progressive, periodic or permanent. Eakes, Burke & Hainsworth hypothesize the relationship of the concepts as: loss results in disparity which, when unresolved, is a preceding circumstance to chronic sorrow. General coping strategies have also been identified which the nurse can use to plan specific interventions. The theory is based on a particulate-deterministic paradigm of a cause-and-effect relationship between loss, disparity and chronic sorrow and also reflects the paradigm shift from a view that chronic sorrow is pathologic to an acceptance that it is a normal human response.
Similar to a middle-range theory, a micro theory examines only one nursing phenomenon and only one aspect of a person. However, it has an even narrower focus. While the middle-range theory of chronic sorrow can be generalized to most clinical settings and patients, a micro theory is applicable only to a limited patient population or clinical setting. The micro theory cannot be used to explain the same phenomenon in a different context than the one studied. It generates guidelines in the provision of nursing care and is therefore the easiest to adopt into practice (Ahmad, n.d.). Unlike the middle-range theory which can always be tested through research, the micro theory may not be amenable to empirical testing. An example of a micro theory is one in which grief is described from the perspective of caregivers of patients with dementia. The concept of grief is applied to the experience of the selected population whose losses stem from the effects of dementia on family members and the eventual death of these loved ones. The precise role of the nurse is to facilitate grief in caregivers before and after patient death and specific interventions during the different phases of grief are outlined.
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