Please see Attachment
WK40: Discussion Post
WHAT : REPLY to the TWO Discussion Posts
FORMAT : APA with In-text Citation and Reference List
REFERENCES : TWO Peer-Reviewed references minimum within last 5 years
* Please and THANK YOU *
______________________________________
MadHo
Discussion Post Reply #1
Grand, Mid-Range, and Situation-Specific Theory
Grand nursing theories provide broad, abstract concepts guiding nursing practice, research,
and education. Mid-range theories focus on more specific nursing concerns and application to
practice. Situation-specific theories are highly focused and address particular patient
populations or specific health conditions of a patient. Dorothea Orem’s Self-Care Deficit
Nursing Theory, considered a grand theory or a situation-specific theory, emphasizes the need
for nursing interventions when an individual cannot meet their own self-care needs. In Calvin’s
case, his difficulty managing his asthma and his lack of adherence to allergy medications
suggest a self-care deficit requiring nursing intervention (Khademian et al., 2020).
Calvin is experiencing poorly controlled asthma with possible allergic triggers and tobacco use
as exacerbating factors. His inconsistent medication use and exposure to allergens suggest a
need for improved asthma self-management. A suitable mid-range theory is The Theory of
Chronic Illness Trajectory by Corbin and Strauss, which describes how individuals adapt to
chronic conditions (Cooley, 1999). This theory is relevant because asthma requires long-term
management, including lifestyle modifications and medication adherence. The theory
emphasizes phases of illness, including periods of stability and exacerbation, aligning with
Calvin’s experience of worsening symptoms and emergency room visits.
Research Article Supporting the Theory
A study by Corbin and Strauss (1991), titled “A Nursing Model for Chronic Illness
Management”, applies the Chronic Illness Theory to conditions like asthma (Corbin & Strauss,
1991). The study highlights that effective chronic disease management involves three key
components. The first is illness work by managing symptoms, medications, and treatments.
Everyday life work by adjusting routines, diet, and habits to accommodate the illness.
Biographical work by redefining one’s self-identity with the chronic condition. Calvin’s
inconsistent medication adherence and continued smoking suggest difficulties in “illness work”
and “everyday life work,” reinforcing the need for structured nursing interventions grounded in
Chronic Illness Theory (Corbin & Strauss, 1991). Based on the Chronic Illness Trajectory Theory
improving adherence to asthma medication, reducing emergency room visits, and enhancing
patient education on triggers are critical. This research aligns with Calvin’s needs, reinforcing
the importance of patient education, smoking cessation support, and consistent medication
use.
Most Useful Theory Level for Advanced Practice
For advanced nursing practice in the 21st century, situation-specific theories are the most
useful because they offer a balance between conceptual frameworks and practical, evidence-
based applications. Situation-specific theories provide guidance for specific patient
populations, conditions, and interventions, making them particularly effective in clinical
decision-making. For instance, using The Theory of Chronic Illness Trajectory, an advanced
practice nurse (APN) can develop personalized asthma management plans, improve patient
education, and facilitate long-term behavioral changes to reduce hospitalizations and improve
quality of life (Cooley, 1999).
KriJo
Discussion Post Reply #2
A grand theory is a broad explanation of a large-scale phenomenon. Examples of generalization
and universal inclusion are human behavior or society as a whole. Grand theories are highly
abstract, meaning they focus on very general concepts and principles. Grand theories in nursing
would include broad topics such as the “nature, mission, and goals of nursing” (Meleis, 2018).
The simplest way to define mid-range theory is that it fits between broad and highly specific
explanations. Mid-range theories have specific concepts or behaviors within a particular domain
and are more easily observed and tested (Meleis, 2018). Mid-range theories give more specific
guidance to nursing practice by focusing on substantive context that is easier to observe and
access that can lead to new practice approaches that can influence positive outcomes desired
in nursing (Chinn & Kramer, 2011).
The scope of situation-specific theories include specific nursing phenomena in specific
populations or in a specific field. Situation-specific theories are not universal or generalized, but
they do respect diversities (Meleis, 2018). These theories address unique needs of a particular
group of people in a specific context. Evidence-based practice benefits from situation-specific
theories since the content is most easily tested and researched (Chinn and Kramer, 2011).
In the case scenario, Calvin reports trouble breathing, chest tightness, and wheezing. Calvin is
mindful of the cats at his grandmother’s, but he continues to smoke. Dorothea Orem’s self-care
deficit theory is a theory that describes how nurses can educate patients to improve their health.
Calvin has asthma but still smokes. Calvin needs to take the necessary medication and adapt
his lifestyle to prevent exacerbations of his symptoms. The theory will educate Calvin that he is
responsible for controllable actions that affect his health, and that his own self-management will
directly affect his health and wellbeing (Uslu & Canbolat, 2022).
Mid-range theories are the most useful because they address particular areas of care including
pain management, chronic diseases, and patient education just to name a few. Mid-range
theories have significant amount of research for the APRN to ensure best practice and
evidence-based practice.
