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Theoretical Framework
Nursing professionals have emphasized the need for theory to structure nursing
knowledge and research to develop and authenticate it. Nursing science encompasses both
nursing-specific and interdisciplinary knowledge, yet there is ongoing debate if the reliance on
acquired theory has stymied the field’s progress. The coexistence of theory and research in
nursing dates back to the early beginnings as noted in Florence Nightingale’s work Notes on
Nursing. She introduced the concept of organizing nursing knowledge, which led to the idea of
integrating theory and research. Historically, research in the nursing field focused on nurse
training and personality features but has since expanded its scope to include nursing
interventions and practice. (McEwen & Willis, 2019). The purpose of this paper is to identify
the correlation of theory in research and evaluate the theoretical framework as it relates to a
study regarding new nurses' intent to leave (ITL) due to work-related fatigue, work conditions, or
personal characteristics (Liu et al., 2016).
Theory Use in Research
Theoretical frameworks may be useful for choosing a measurement technique, data
processing method, research design, and result validation criteria. The framework of the study
describes the goals, phenomena, and methods while evaluating the research’s contributions to
knowledge are assessed by placing the findings within the context of existing knowledge. The
advancement of nursing science and the promotion of evidence-based practice (EBP) may be
greatly enhanced when nursing research uses an appropriate theoretical framework. The three
common ways theories are categorized include descriptive, explanatory, or predictive (McEwen
& Willis, 2019).
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Descriptive Theory
Descriptive theory is a hypothesis-based framework that defines the key components of an event
by speculating on its cause, relationships, and consequences. The process includes observation
and data collection through interviews and questionnaires which may be qualitative or
quantitative (McEwen & Willis, 2019). The research study provided for this paper indicated that
approximately thirty to fifty percent of new nurses leave their current positions within the first
two years of employment. This study obtained quantitative data using cross-sectional surveys of
new nurses to evaluate their ITL (Liu et al., 2016).
Explanatory Theory
One way that correlational research could be used to develop and test explanatory theory
is by using statistics to look at the underlying features of occurrences. Qualitative and
quantitative data may generate information gathered through self-report tools or nonparticipant
observation. In statistical analysis, both unstructured and standard measures of associations are
used (McEwen & Willis, 2019). The study evaluates the framework variables, data collection,
and results on nursing practice, as well as strategies for nurse management to retain nurses (Liu
et al., 2016).
Predictive Theory
Predictive theories hypothesize and evaluate associations between characteristics or
events in different groups through experimental research. This requires the collection of
quantifiable data and the use of statistical analysis; the objective is to influence a particular trend
to discover its impact on another (McEwen & Willis, 2019). In the provided research study, the
statistical analysis was manipulated by removing the age, education level, and work experience
from the data as it was not significantly related to the new nurses’ ITL (Liu et al., 2016).
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Theory as a Conceptual Framework
One typical approach to incorporating theories into research is to use them as a
conceptual framework. Incorporating the topic inside an existing theoretical framework guides
the investigation and improves its findings. While reviewing the relevant literature, either a new
conceptual framework is developed, or an existing one is discovered. A framework that provides
context is often a part of research methodologies (McEwen & Willis, 2019).
The present research examines the consequences of ITL on work-related fatigue, personal
traits, and working environment. Acute or chronic workplace fatigue is a key factor leading to
new nurses’ premature resignation within their first year of practice. Acute fatigue is a temporary
phenomenon, but chronic fatigue results from long-term adjustment to occupational stress.
Sufficient recuperation is required to maintain adaptive responses (Liu et al., 2016).
Rest and recuperation are foundations of Biblical principles as indicated when God rested
on the seventh day. Genesis 2:2 states “By the seventh day God had finished the work he had
been doing; so on the seventh day, He rested from all his work” (NLT, 2015). In Matthew 11:28,
He instructs the weary (fatigued) to come to Him for rest and place our burdens on Him (NLT,
2015).
Study Variables
The study examined for this paper indicated that researchers determined how implied
variables such as occupational fatigue, personality traits, and work conditions impacted the
quantitative variable of newly hired nurses’ ITL. Additional variables included age, educational
level, work experience, and health. Researchers contacted 200 nurses through convenience
sampling, of which 171 met the criteria, and 162 were used in the final data analysis (Liu et al.,
2016).
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Conceptual Definitions
Occupations such as nursing, characterized by long shifts of more than ten to twelve
hours and heavy workloads due to short staffing, are more prone to experience workplace
fatigue. High levels of mental and physical stress increase the likelihood of fatigue in nurses,
particularly in younger and less experienced nurses. To combat the negative impacts of
workplace fatigue, non-work recovery time is crucial. Decreased performance, health problems,
and resignation are just a few of the concerns resulting from insufficient restoration. A nurse’s
flexibility in the workplace is affected by each of these characteristics (Liu et al., 2016).
Instruments
Researchers conducted visits to the units where new nurses were stationed, verifying that
their participation was voluntary. The study used a questionnaire package, accompanied by
informed consent, to gather data from nurses who had been practicing for a period ranging from
one to twelve months. The questionnaire aimed to collect demographic information from the
participants. Additional measurements such as the Likert scale were used to determine ITL, self-
related health status (SRHS), workload, and occupational fatigue (Liu et al., 2016).
Findings
The study found that new nurses’ ITL was not significantly influenced by personal
characteristics such as age, education, or work experience, but by occupational fatigue, increased
workload, long shifts, inability to recover between shifts, and poor health status (Liu et al.,
2016).
Relationship of Findings to Framework
Nurses working longer than ten hours per day, some as high as sixteen hours per day,
showed increased fatigue and less recovery ability between shifts leading to higher rates of ITL.
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Many new nurses in this study were still doing homework after their shifts to review questions or
problems presented during their orientation process. Chronic fatigue is the most prevalent type of
fatigue experienced by newly licensed nurses, and these individuals have a difficult time
distancing themselves from their profession for extended periods of rest (Liu et al., 2016).
Implications for Nursing Practice
It is advisable for nurse managers to consistently assess new nurses who work lengthy
overtime hours or have extended working hours, using a workload scale as a screening
instrument. Mentors should evaluate the degrees of fatigue, challenges connected to
employment, and solutions for adaptability. Implementation strategies to reduce fatigue, such as
frequent breaks and mentor assistance, may positively influence nurse retention. Mentors should
reassess the orientation process related to fatigue levels and modify it to suit individual
requirements (Liu et al., 2016).
Recommendations for Further Research
Subsequent research should analyze the progression of occupational fatigue to identify
trends and provide efficient solutions (Liu et al., 2026). This author recommends updated
research to enhance the knowledge and skills of new nurses and their ITL in diverse healthcare
settings such as long-term care facilities, home health agencies, and communities. A similar
research study found that more than ten percent of experienced nurses and nurse supervisors had
an increased ITL at the height of the COVID-19 pandemic. The impact of vacant positions
suggests significant impacts on staffing shortages needing immediate attention (Raso et al.,
2021).
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Nursing vs Non-Nursing
Nursing research should use a combination of nursing and non-nursing theories to
examine data from several viewpoints of the interdisciplinary team. A combination of theories
shapes policies and procedures while increasing knowledge, building relationships, and
promoting evidence-based practice. The combination of theories gives nurses the ability to make
sound decisions to provide high-quality patient care.
Conclusion
By using a combination of theories, Biblical principles can be integrated by building
relationships within the interdisciplinary team of nurses, scientists, physicians, patients,
pharmacists, and caregivers. The Bible indicates in Philippians 2:3-5 “Do nothing out of selfish
ambition or vain conceit. Rather, in humility value others above yourselves, not looking to your
own interests but each of you the interests of others. In your relationships with one another, have
the same mindset as Christ Jesus” (NLT, 2015). Applying this concept will advance nursing
research and provide our patients with the safest and best quality of care.
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References
The Holy Bible, New International Version. (2015).
BibleGateway.JJhttps://www.biblegateway.com/versions/New-Living-Translation-NLT-
Bible. (Original work published 1996)
Liu, Y., Wu, L., Chou, P., Chen, M., Yang, L., & Hsu, H. (2016). The influence of work-related
fatigue, work conditions, and personal characteristics on intent to leave among new
nurses.Journal of Nursing Scholarship,48(1), 66-73. https://doi.org/10.1111/jnu.12181
McEwen, M., & Wills, E. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer
Health.
Raso, R., Fitzpatrick, J., Masick, K. (2021) Nurses' intent to leave their position and the
profession during the COVID-19 pandemic: The Journal of Nursing Administration
51(10):p 488-494, October 2021. | DOI: 10.1097/NNA.0000000000001052
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