Evaluation of a Nursing Theory

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Evaluation of a Nursing Theory
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Forming a Complete DescriptionSix Questions are
Propose for Describing Theory.
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• 1. What is the purpose of this theory?
• This question addresses why the theory was
  formu-lated and reflects the contexts and
  situations to which the theory can be applied.
• 2. What are the concepts of this theory?
• This question identifies the ideas that are
  structured and related within the theory. It
  questions the quali-tative and quantitative
  dimensions of concepts.
• 3. How are the concepts defined?
• This question clarifies the meaning for
  concepts within the theory. It questions how
  empiric experi-ence is represented by the ideas
  within the theory.

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• 4. What is the nature of relationships?
• This question addresses how concepts are
  linked together. It focuses on the various forms
  relationship statements can take and how they
  give structure to the theory.
• 5. What is the structure of the theory?
• This question addresses the overall form of
  the con-ceptual interrelationships. It discerns
  whether the theory contains partial structures or
  has one basic form.
• 6. On what assumptions does the theory build?
• This question addresses the basic truths
  that underlie theoretic reasoning. It questions
  whether assumptions reflect philosophic values or
  factual assertions factual assertions.

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Guide for the Description of Theory

• 1. PURPOSE
• Why is this theory formulated?
• Is there an overall purpose for the theory? A
  hierarchy of purposes? Separate numerous
  purposes?
• Is there a purpose for the nurse? The person
• receiving care? Society? Environment?
• How broad or narrow is the purpose?
• What is the value orientation of the purpose?
  Positive, negative, neutral?

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1. PURPOSE

• Does achieving the theoretic purpose require a
  nursing context?
• Does the purpose reflect understanding? Creation
  of meaning? Description, explanation, and
  prediction of phenomena?
• When would the theory cases to be applicable?
  What is the end point?
• What purpose not explicitly(???) embedded(??) in
  the matrix of the theory can be identified?

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• 2. CONCEPTS
• Is there one major concept with sub-concepts
  organized under it?
• How many concepts are there?
• How many major (or minor) ones?
• Can the concepts be ordered, related? Arranged
  into any configuration?

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• 2. CONCEPTS
• Are there concepts that cannot be interrelated?
• Are concepts broad in scope? Narrow?
• How abstract(??) or empiric(??) are the concepts?
• What is the balance between highly abstract and
  highly empiric concepts?

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3. DEFINITIONS

• Which concepts are defined? Which are not?
• Which concepts are defined explicitly? Which are
  implied(??)?
• How much meaning needs to be inferred ?
• Which concepts are defined specifically?
  Generally?
• Are there competing definitions for some
  concepts? Are there similar definitions for
  different concepts?
• Are any concepts defined contrary to common
  convention(??,??)?

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4. RELATIONSHIPS

• What are the major relationships within the
  theory?
• Which relationships are obvious? Which are
  implied?
• Do relationships include all concepts? Which are
  not included?
• Are some concepts included in multiple
  relationships?
• Is there a hierarchy of relationships? Do
  relationships create meaning and understanding?
  Do they do this by describing, explaining?
  Predicting? What mix of each?
• Are relationships illustrated?

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5. STRUCTURE

• How are overall and individual ideas organized?
• If outlined, what would the theory look like?
• Do relationships expand concepts into large
  wholes or vice versa(????)? Do they link concepts
  in a linear fashion?
• Does the structure move concepts away from or
  toward the purposes?
• Are there several structures that emerge(??)?
  What is their form? Do they fit together?

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6. ASSUMPTIONS

• What assumptions underlie the theory? Are
  assumptions explicit, implicit, or
  derivable(????) from context and meanings?
• What are the individual, nurse, society,
  environment, and health assumed to be like?
• Do assumptions have an obvious value orientation?
  What is it?
• Could assumptions be factually verified?
• Can assumptions be hierarchically arranged or
  otherwise ordered?

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Criteria for the Evaluation of Theory

• Dudley-Brown, S. L. (1997). The evaluation of
  nursing theory a method for our madness.
  International Journal of Nursing Study, 34(1),
  76-83.

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Accuracy (??,???)

• Accuracy, according to Websters, as a noun, is
  defined as exactness or precision, while as an
  adjective, as without mistakes or errors.
• Kuhn (1977) accuracy as a characteristic of a
  good theory.
• Synonyms(???) of accuracy include perfect, just,
  truthful, and correct.
• In relation to nursing theory, accuracy
  pertains(??) to describing nursing as it exists
  today, not the nursing of the future or of the
  past.

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Consistency (??,??)

• Consistency is used frequently in describing
  criteria for the evaluation of theory.
• Kuhn (1977) describes consistency in terms of the
  theory being internally consistent as well as
  being consistent with accepted theories.
• Internal consistency, however, has been described
  by another philosopher, Newton-Smith (198 l), as
  consistency in language, the existence of logical
  order, and connectedness.

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Consistency

• Inconsistencies should be avoided, a theory with
  an inconsistency does not necessitate that the
  whole theory be scrapped(??).
• Meleis (1985)describes, is to have consistent
  operational definitions and concepts that are
  consistent with assumptions and propositions.
• Meleis also uses the terms coherent and logically
  presented to describe clarity.

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Fruitful (????,???)

• Fruitful, is related conceptually to criteria
  proposed by others.
• Synonymous with fertile, bountiful, productive,
  and prolific.
• Kuhn (1977), in describing fruitful, states that
  theory should expose new feelings, new
  phenomenon, or previously unknown relationships
  among phenomenon already known.
• Fruitful refers to success in explaining
  observable phenomenon, and the evaluation of
  empirical work resulting from a theory.

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Fruitful

• Newton-Smith (1981) describes (fertile) as the
  scope for further development.
• The theory should contain ideas to further
  research.
• Consistent with this is Elliss (1968) criteria
  of generation of information-the theory should
  generate hypotheses.
• Ellis (1968) states A theory that generates many
  hypotheses, even some without high probability,
  or some that are difficult to test, can
  contribute to understanding.

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Simplicity(????)

• Simplicity as an important evaluative criterion
  (Kuhn, 1977 Newton-Smith, 1981 Chin and Jacobs,
  1983) others propose complexity (Ellis, 1968
  Barnum, 1990).
• Meleis (1985) takes a more pragmatic(???)
  approach whether the theory has a lot of
  phenomena and relationships (complexity) or if it
  focuses on fewer concepts and few relationships
  (simplicity)?
• Kuhns, (1977) describes as bringing order to
  phenomenon that in its absence would be isolated
  and confused.
• Simplicity is a seemingly(??? ) useful
  characteristic of a good theory in nursing, and
  important in the evaluation of nursing theory.

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Scope(??)

• Scope has been dichotomized as either broad or
  narrow.
• Ellis (1968) and Hardy (1974). The broader the
  scope, in terms of the number and variety of
  facts or concepts related, the greater is the
  significance of the theory .
• Hardy (1974) states the more general a theory,
  the more useful it is.
• Broad vs. narrow scope can also be dichotomized
  in relation to its generalities, or the use of
  the term theory and conceptual framework/ model.
• Scope may be conceptualized in relation to the
  level of theory, eg. a grand theory or middle
  range theory.

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Acceptance

• Meleis (1985)states acceptance when the theory
  begins to cross several concentric circles from
  where it originated, its circle of
  contagiousness(???) increases and we can infer
  that the theory is receiving more acceptability,
  uninfluenced by the theorist .
• Laudan (1977) discusses the importance of
  acceptance and pursuit by other members of the
  discipline in that the theory shows promise if
  others are accepting and buying into the
  theory.
• It is important for the advancement(??) of
  nursing as a profession to have members of the
  discipline communicate regarding its
  multicultural acceptance and adoption(?? ) by
  others.

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Testability

• Testability refers to the theorys research
  potential or empirical adequacy.
• Testability has been long felt to be an important
  criterion for the evaluation of nursing theory,
  and touted (??) as a method to advance the
  science of nursing.
• Acton et al. (1991)and Silva (1986) describe how
  the lack of empirical validation of nursing
  theory has hindered the development of nursing
  science.
• Silva and Sorrel1 (1992) have proposed criteria
  for evaluating theory-testing research, and
  discuss important philosophical and
  methodological issues in the testing of nursing
  theory.

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Socio-cultural utility

• Socio-cultural utility encompasses(??) social
  congruence(??) and social significance
• Johnson (1974), Meleis (1985) and Fawcett
  (1989)in their criteria for the evaluation of
  theory.
• Social congruence encompasses the beliefs, values
  and expectations of different cultures that
  should shape and direct the type of theory most
  useful to it.
• As Meleis (1985) explains, self-care and
  independence are goals consistent with some
  cultures value systems but not others.
• Theories with such goals would be
  incongruent(????) and inappropriate in some
  societies and cultures, and should be avoided.

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Conclusion of criteria for the evaluation of
theory

• Nurses in all roles will hopefully use these
  criteria proposed here to guide their choice of
  theory when using nursing theory in practice,
  education and research.
• There has been a dearth (??) of empirical testing
  of theories in nursing, testing is only one part
  of the evaluation of theory.
• A set of criteria for the evaluation of theory
  has been proposed here that includes accuracy,
  consistency, fruitfulness, simplicity/complexity,
  scope, acceptability and socio-cultural utility.

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Theory Critique

• Meleis, A. I. (2007). Theoretical Nursing
  Development Progress (4rd ed.). Philadelphia.
  PA Lippincott.(Ch9)(pp.186-211)

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Table 11-5 THEORY CRITIQUE RELATIONSHIP
BETWEEN STRUCTURE AND FUNCTION DIAGRAM OF
THEORY AND CIRCLE OF CONTAGIOUSNESS
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Table 11-6 THEORY CRITIQUEUSEFULNESS
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Table 11-7 THEORY CRITIQUEEXTERNAL COMPONENTS
OF THEORY
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Forming a complete critical reflection

• Is this clear?
• This question addresses the clarity and
  consistency of presentation.
• Clarity and consistency may be both semantic and
  structural.
• 2. Is this simple?
• This question addresses the number of structural
  components and relationships within theory.
• Complexity implies numerous relational components
  within theory simplicity implies fewer
  relational components.

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Forming a complete critical reflection

• 3. Is this general?
• This question addresses the scope of experiences
  covered by theory.
• Generality infers a wide scope of phenomena,
  whereas specificity narrows the range of events
  included in theory.
• 4. Is this accessible?
• This question addresses the extent to which
  concepts within the theory are grounded in
  empirically identifiable phenomena.
• 5. Is this important?
• This question addresses the extent to which
  theory leads to valued nursing goals in practice,
  research, and education.

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1.HOW CLEAR IS THIS THEORY?
Guide for the critical reflection of theory

• Are major concepts defined?
• Are significant concepts not defined? Are
  definitions clear? Congruent(???)? Consistent?
• Are words coined? Are coined words defined?
• Are words borrowed from other disciplines and
  used differently in this context?
• Is the amount of explanation appropriate? Too
  much? Not enough?
• Are examples or diagrams helpful? meaningful?
• Not helpful? Needed and not present?

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1.HOW CLEAR IS THIS THEORY?

• Are basic assumptions consistent with purposes?
• Is the view of person and environment
  compatible(??? )?
• Are the same terms defined differently?
• Are different terms defined similarly?
• Are concepts used in a manner consistent with
  their definition?
• Are compatible and coherent(?????) structures
  suggested for different parts of the theory?
• Can the theory be followed?
• Are there any ambiguities(????) as a result of
  sequence of presentation?
• Does the theorist accomplish what she or he sets
  out to do?

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2.HOW SIMPLE IS THIS THEORY?

• How many relationships are contained within the
  theory?
• How are the relationships organized?
• How many concepts are contained in the theory?
• Are some concepts differentiated into
  sub-concepts?
• Can concepts be combined without losing theoretic
  meaning?
• Is the theory complex some areas and not in
  others?
• Does the theory tend to describe, explain, or
  predict? Impact understanding? Create meaning?

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3.HOW GENERAL IS THIS THEORY

• How specific are the purposes of this theory? Do
  they apply to all or only some practice areas?
  When?
• Is thus theory specific to nursing? If not, who
  else could use it? Why?
• Is the purpose justifiably a nursing purpose?
• If subpurposes exist, do they reflect nursing
  actions? How broad are the concepts within the
  theory?

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4.HOW ACCESSIBLE IS THIS THEORY

• Are the concepts broad or narrow?
• How specific or general are definitions within
  the theory?
• Are the concepts empiric indicators identifiable
  in reality? Are they within the realm of nursing?
• Do the definitions provided for the concepts
  adequately reflect their meanings?
• Is a very narrow definition offered for a broad
  concept? A broad meaning for a narrow concept?
• If words are coined, are they defined?

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5.HOW IMPORTANT IS THIS THEORY?

• Does the theory have potential to influence
  nursing actions? If so, to what end?
• Does the theory influence nursing education?
  research? If so, to what end? Is that end
  desirable?
• Hoe specific are the purposes of the theory? Do
  they provide a general framework within which to
  act or a means to predict phenomena?
• Is the theorys position about people, about
  nursing, and about the environment consistent
  with nursings philosophy?
• Given the purpose of the theory and its
  orientation, what of significance for nursing or
  health care has been omitted?

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5.HOW IMPORTANT IS THIS THEORY?

• Is the started or implied purpose one that is
  important to nursing? Why?
• Will use of the theory help or hinder nursing in
  any way?
• Will application of this theory resolve any
  important issues in nursing? Will it resolve any
  problems?
• Is the theory futuristic and forward-looking?
• Will research based on the theory answer
  important questions?
• Are the concepts within the domain of nursing?
• Do I like this theory? Why?

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Conclusion

• Theory development and evaluation are cyclical,
  continuous, and dynamic process. One can not
  exist without the other.
• Theory evaluation including description, concept
  analysis, theory critique, testing and support.
• These process are based on the view that science
  is a human process that includes not only valid
  findings but also observation, agreements, useful
  solutions to problems.
• Theory evaluation is central to the development
  of theory it is the responsibility of each
  clinician, academician.

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Conclusion

• Kuhn(1977) we can delineate such criteria and
  that accuracy, consistency, broad scope,
  simplicity and fruitfulness in research are
  essential as objective criteria for judging
  competing theories
• However, every individual's choice between
  competing theories depends on a mixture of
  objective and subjective factors
• The subjective factors are dependent on
  individual's preferences and personalities.
• Both objective and subjective factors have a
  place in our understanding of the philosophy of
  science.

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Adaptation Model
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Exercise Application of Roy's Adaptation Model
in Nursing Practice

• http//currentnursing.com/nursing_theory/applicati
  on_Roy's_adaptation_model.html
• 1. What is the purpose of this theory?
• 2. What are the concepts of this theory?
• 3. How are the concepts defined?
• 4. What is the nature of relationships?
• 5. What is the structure of the theory? .
• 6. On what assumptions does the theory build?