comparison draft

Running head: MIDDLE RANGE AND GRAND NURSING THEORIES 1

MIDDLE RANGE AND GRAND NURSING THEORIES

Arisbel Delgado

West Coast University

MIDDLE RANGE AND GRAND NURSING THEORIES 2

Introduction

In nursing, there are different theories that are there that help in explaining different concepts in

nursing. These theories can be categorized as being grand theories or middle range theories. Grand

theories can be basically said to being the theories that have a scope that is broad when it comes

to addressing a variety of concepts and happenings of assumptions that nurses are likely to

encounter in the in line of duty. In most cases, the grand theories usually tend to be oriented around

concepts and models frameworks that are used to define practice in different ways and in different

care environments and it is these perspectives that are used in examining these different

phenomena. Middle range nursing theories on the other hand are theories that are more narrow and

specific in focus and in most cases they tend to offer connections that are considered to be more

concrete between nursing practice and grand nursing theories. The different concepts that are there

in the middle range theories usually tend to be less abstract and are usually more verifiable

specifically through testing. This paper will therefore use the theory of comfort as the middle range

nursing theory and the general system theory as the grand theory in nursing.

Background Information

General Systems Theory

General systems theory is basically a theory that studies systems in an interdisciplinary manner,

and specifically these are considered to be in cohesive groups of interrelated and interdependent

parts that are human made or natural. Every systems therefore under this theory is considered to

being bounded by time and space and is specifically influenced by the environment that surround

it, it is also defined by its purpose and structure and it is expressed through functioning. A system

in this case therefore can be more than the total or the sum of its different parts specifically if it is

expresses emergent or synergy behavior (Florczak et al., 2018). In this theory therefore, it is

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considered that, the change of one specific part of the general system may end up affecting the

other different parts of the whole system. Under this theory also, it is considered that one can easily

predict these changes by looking at the patterns of behaviors that are happening around the same.

Systems in this case should therefore ensure that they do support each other and this will help in

ensuring that the other systems are prevented from failing. The main goals of general systems

theory are to model a systems conditions, dynamics, and constraints and elucidate principles such

as methods, tools, purpose etc. which can be used or discerned to other systems at the same level

and this will in the long run help in achieving optimized equifinality.

Theory of Comfort

This theory was one that was developed by Kathrine Kolcaba, the theory specifically explain

comfort as a very important and core for all human beings and this is used to achieve ease, relief

or even transcendence that is arising from healthcare situations that are considered to be successful.

Comfort therefore according to this theory can be specifically be used to enhance and create

behaviors that are health seeking for family, patients, and even nurses (Puchi et al., 2012). Under

this theory therefore, the major concern that the proponent of this theory seek to tackle is comfort,

other related concepts under this consist of comfort measures, caring, health seeking behaviors,

intervening variables and institutional integrity.

Philosophical Underpinnings

Under the general systems approach, the main philosophical ideas that do surround this theory is

to come up with principles and concepts that can be broadly applicable in different areas unlike

the concepts that ca only be applied to one system or domain of knowledge. This theory

specifically tries to differentiate between active or dynamic systems from static or passive systems.

In this theory therefore, it specifically tries to look at the different systems in terms of closed and

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open systems and this specifically stresses on the importance and role or environment and context,

equifinality which is basically the way in which systems can reach the same goal through different

routes or paths (Florczak et al., 2018).

On the other hand, the philosophical underpinning under the comfort theory is basically works

with six concepts that it considers to be very central when it comes to looking at how specifically

the system works. These philosophical concepts include nursing interventions, healthcare needs,

patient comfort, intervening variables, institutional integrity and health seeking behaviors. It is

from these philosophical concepts that this whole theory is based on and the concepts that are

discussed and are tackled under this is where they whole concept is derived and the theory is based

and measured using these concepts.

Clinical Application

The general systems theory as the grand nursing theory is specifically very effective if the same is

applied specifically in patients with mental issues. By using this theory, people and nursing staffs

do have the ability to establish communication patterns and at the same time addressing diversities

of behaviors among this population, this also comes along with a better understanding specifically

in a large variety of patients with different diversities (Katrakazas et al., 2020). By using this theory

therefore, people do have the ability to identify factors that are considered to be important that are

affecting a population or patients and this will lead to an evaluation that will look at the impacts

of the factors on the treatment outcomes and at the same time show complexity of potential

pathways that are resulted to the wellbeing for the patients with mental problems.

Under the theory of comfort, this can be applied in the clinical sector in many ways, specifically,

this theory was applied in the clinical area specifically in caring for the surgical patients who were

young. The integration of this specifically in patient care was very successful and it was also result

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oriented (NG, 2017). This theory in the clinical approach or sector was specifically very important

as it specifically helped in covering fully the needs that the surgical patients has in a holistic

manner.

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References

Florczak, K., Poradzisz, M., & Hampson, S. (2018). Nursing in a complex world: A case for grand

theory. Nursing Science Quarterly, 25(4), 307-312.

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Katrakazas, P., Grigoriadou, A., & Koutsouris, D. (2020). Applying a general systems theory

framework in mental health treatment pathways: the case of the Hellenic Center of

Mental Health and Research. International Journal of Mental Health

Systems, 14(1), 1-8. https://link.springer.com/article/10.1186/s13033-020-00398-z

NG, S. H. (2017). Application of Kolcaba's Comfort Theory to the Management of a Patient with

Hepatocellular Carcinoma. Singapore Nursing Journal, 44(1).

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Puchi, C., Paravic-Klijn, T., & Salazar, A. (2018). The comfort theory as a theoretical framework

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