A nursing "grand theory" is a systematic construction pertaining to the nature of nursing care, according to Afaf Meleis in "Theoretical Nursing." With grand theories, there is not just one overall theory. They are constructed from a synthesis of experiences, observations, insights and research findings. Grand theories are characterized by the broadness of their scope. Examples of grand theories would be "Leininger's Cultural Care Diversity" and "Parse's Theory of Human Becoming."
Grand theories, according to Marilyn Parker in "Nursing Theories & Nursing Practice," developed from the deliberate effort of committed scholars who reflected on and studied the many contexts of nursing over time. Grand theories represent a theoretical point of view held by the community of scholars, according to Julia George in "Nursing Theories." Therefore, grand theories contain traditional arguments or received positions. These positions include specific assumptions and principles, a focus of inquiry, and congruent approaches to research and practice. In short, grand theories provide a strong academic foundation for patient care, which has been tested and proven over time.
Grand theories, according to Parker, provide guidance to the nurse practitioner (NP). Grand theories offer general concepts and propositions which pertain to professional nursing. They provide insights of those who have already encountered problematic situations in patient care. Grand theories are used in directing, explaining and predicting the delivery of quality nursing care. Most importantly, grand theories are pertinent to all aspects of nursing practice.
Individual Practice Pros
Grand theories, according to Meleis, help the NP identify the focus and goals of his practice. They provide the foundation upon which the NP can build a practice in a specific area of nursing care. Grand theories also increase the autonomy of the NP, as with increased understanding of the field of nursing comes more independence in practice. Lastly, grand theories allow the NP to have better control over the "subject matter," or particular aspects, associated with nursing practice.
Professional nursing encompasses many abstract concepts and theories, such as "Holistic Care," related to the delivery of quality patient care. According to Meleis, grand theories can provide relationships between the abstract concepts in professional nursing. Moreover, grand theories, by making these relationships, can help to make these abstract concepts relative, or connected, to the individual NP. In other words, grand theories, by their broad nature, can help to make abstract concepts more understandable to the NP and, consequently, enhance patient care.
There are three major types of nursing theory: "grand"; "middle range," which is oriented to nursing practice strategies; and "practice "theory," which deals with the day-to-day practical experiences of nursing. According to Meleis and Parker, grand theories are too broad-based to lend themselves to "empirical testing," or experimentation and observation in individual cases. However, grand theories provide a clear base from which middle range and nursing practice theories can progress.
Therefore, grand theories, by providing this base of research and experiential models, facilitates the middle range and nursing practice theories which help the NP deliver quality nursing care in every situation with every patient.
- "Theoretical Nursing"; Afaf Meleis; 2007
- "Nursing Theories & Nursing Practice"; Marilyn Parker; 2006
- "Nursing Theories"; Julia George; 2008
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