Nursing is a profession that has changed substantially in the last few decades. Nurses’ role has evolved as well – it gained a much more theoretical foundation, and now nursing education offers an advanced understanding and creation of theory. The history of nursing reveals that theories were not always a part of this discipline, and the discussion surrounding them continues to shape nursing today. This paper will review the evolution of nursing in connection to theories and discuss how theory influences research and practice.
The Evolution of Nursing Theory
In the nineteenth century, nursing became a recognized occupation, but it did not distinguish itself from medicine until the end of World War II. Before the war, nurses were seen as assistance to physicians who had to follow instructions and have a basic understanding of procedures (McEwen & Wills, 2019). As nurses started to define themselves in the healthcare field, the idea of nursing theory arose – nurses began discussing nursing goals and the concepts that surrounded their practice (McEwen & Wills, 2019). Throughout the twentieth century, nursing became a separate theoretic discipline with a strong focus on how knowledge is connected to other learning and practice. It is currently accepted that theory is based on practice, but it also serves as a foundation for research and further evolution (McEwen & Wills, 2019).
Classification of Nursing Theories
Nursing theories are classified in two major ways, according to their scope and purpose. The classification of theories by purpose distinguishes descriptive, explanatory, predictive, and prescriptive theories (McEwen & Wills, 2019). The scope of nursing theories describes their level of abstraction and the areas in which one theory is implemented. The largest, most abstract ones are metatheories – they discuss such issues as the acquisition of knowledge or the development of the nursing discipline (McEwen & Wills, 2019). Then, grand theories talk about nursing’s major concepts, such as “what is nursing” and “what is health.” Middle range theories are less abstract, as they introduce some particular phenomena. For example, the idea of comfort and its relationship with pain or health can be seen as a part of a middle-range theory (McEwen & Wills, 2019). Finally, practice theories are specific to a situation and explain a certain problem, such as postpartum depression (McEwen & Wills, 2019).
Importance and Influence of Theory
As can be seen, theories aim to cover all aspects of nursing, from its abstract meaning to specific issues. As a result, nursing theories can be used to guide one’s research and influence practice. As McCurry et al. (2010) note, a theory is a framework that helps a professional to conduct practice and acquire knowledge. Theories systematize and explain findings; at the same time, an idea for a theory can arise from a practical experience, leading to the creation of a research question (Gray et al., 2017). O’Connell (2009) provides an example of theories for smoking cessation programs. Smoking behaviors and cessation were analyzed through the lens of self-efficacy, planned behavior, and other nursing concepts (O’Connell, 2009). As a result, theory penetrates every aspect of nursing research, and it structures the acquisition and use of knowledge in a clinical setting.
To conclude, theory has gained recognition in the discipline of nursing. Arguably, it is one factor that led to nursing evolving from a simple helping occupation to a research-based profession. Throughout the last few decades, nurses discussed in-depth the abstract ideas of nursing and how this profession can tackle real-life problems of their patients and health overall. Nursing theory’ importance, therefore, it undeniable in both practice and scholarship.
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Saunders Elsevier.
McCurry, M. K., Revell, S. M. H., & Roy, S. C. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer Health.
O’Connell, K. (2009). Theories used in nursing research on smoking cessation. Annual Review of Nursing Research, 27, 2733–2762.