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Theoretical Framework
Tammy Ransom
Liberty University
NURS 502
Dr. Crawford
December 6, 2020
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Theoretical Framework
Theory being involved in research is not a new concept. Theory in research initially
began in the works of Florence Nightingale (McEwen & Willis, 2019). By combining research
and nursing models in the 1970s, theorists began studying ways to test their models. Using
nursing models as a framework for a research guide presented a way for research to be used in
nursing's unique perspective (McEwen & Willis, 2019). A theory offers a set of concepts and
propositions that can be applied consistently and studied systematically across clinical problems
studies (Lor et al., 2017). When researchers communicate about what theory was applied in their
study, it allows others to synthesize evidence more readily where the same theory was used,
allowing researchers to build scientific knowledge efficiently.
Theory in research serves multiple purposes. Theory serves to make research findings
meaningful and interpretable. The theory allows the researchers to join together observations
into an orderly system. The theory also serves to explain the research findings. Theory guides
the researchers' understanding of what of a natural phenomenon and the why of their occurrence.
The theory also helps to stimulate research and the extension by providing both direction and
drive.
Theory Use in Research
A theory provides a guide for developing a study and allows the findings to be linked to a
larger body of knowledge (McEwen & Willis, 2019). Research guides the science of nursing and
builds knowledge for theory (Hickman, 2019). Theory is applied in research in three significant
ways: theory-generating research, theory testing research, and theory as a conceptual framework
or context of a study. Theory generating research, also known as descriptive research, is
designed to develop and describe a relationship between phenomena without imposing
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preconceived notions of what the phenomena mean (McEwen & Willis, 2019). Theory
generating research is an effective method for investigating people's experience and actions, as
well as their preconceptions and thoughts regarding their actions (McCann & Polacsek, 2018).
Theory generating research studies can be found throughout the nursing literature. Several
nursing theories were developed using this method of grounded research. Several steps are used
in the process of theory generation, which include: (1) the researcher recognizes common themes
in a particular group or setting; (2) the researcher interprets the observations into more abstract
concepts; (3) identifies patterns of relationship between observation and concepts; (4) the
researcher formulates a propositional statement that is obtained from the observations; and (5)
the concepts and propositions are merged into a tentative theory (McEwen & Willis, 2019).
Theory-testing research is conducted to assess the explanatory value of the theory in
different situations to derive logical predictions. Theory-testing research is used to evaluate a
theory's explanatory power by exploring the applicability and usability of a theory. In theory-
testing research, theoretical statements are translated into a hypothesis; this requires a deductive
reasoning process that follows several steps. These steps include the following: (1) choosing a
theory and selecting a propositional statement; (2) researcher develops a hypothesis that has
measurable variables that are reflective of the propositional statement; (3) the study is performed
and interprets the findings as to rather it supports or contradicts the propositional statement; and
(4) the researcher concludes if there is an implication for further use of the theory in nursing
practice (McEwen & Willis, 2019).
Theory of a conceptual framework or context of a study is the most common way of
incorporating theory into the research; the chosen theory drives the study. The problem that is
being investigated is fitted into an existing theory, which guides the study and enriches the value
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of its findings. According to McEwen and Wills (2019), the process of using theory as a
conceptual framework involves several steps, which are as follows: (1) identifying an existing
framework that can be applied to the study, (2) origination conceptual definitions from the
framework, (3) confirmation of congruency of data collection instruments within the framework,
(4) interpretations of findings in light of the explanations provided by the framework, (5)
researcher identifies of whether findings support or challenge the framework, (6) Implications
for nursing practice are developed based on the explanatory power, and (7) formulation of
recommendations for future research.
Theory as a Conceptual Framework
In the study conducted by Liu et al. (2016), a conceptual framework was developed to
determine how personal characteristics, working conditions, and work-related fatigue served as
predictive factors for intent to leave among new nurses. This study will be examined using the
seven criteria defined by McEwen and Willis (2019) to include the study variables, conceptual
definitions, congruency of data collection instruments, interpretations of findings, and conclusion
whether finding support of contradicting the framework in nursing practice and
recommendations for future research.
Study Variables
Four identified variables included three latent variables: personal characteristics, work
conditions, and work-related fatigue (Liu et al., 2016). One measurable variable identified was
the intent to leave (ITL) (Liu et al., 2016).
Conceptual Definitions
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Information obtained regarding personal characteristics included age, education level,
work experience, and overall health status. The ability to adapt to the work environment is
affected by each of these characteristics.
Work conditions included average working hours per day in the past week and overall
workload. Average working hours were self-reported, and the overall workload was measured
on a 0-10 scale (Liu et al., 2016).
Work-related fatigue was measured using the Occupational Fatigue Exhaustion Recovery
Scale. The scale contains three subscales: chronic fatigue, acute fatigue, and inters shift
recovery, with five items for each subscale and each item rated on a 7-point Likert scale (Liu et
al., 2016).
The intent to leave scale was measured using three items, which included "I am
considering leaving the hospital," "I am considering leaving nursing," and "I want to keep doing
my nursing work" (Liu et al., 2016). Participants were asked to rate the three items on the 7
points Likert scale.
Instruments
Participants were chosen for the study using a convenience sampling method (Liu et al.,
2016). Participants that consent to the study was given a questionnaire package, which they
completed at their convenience. Once the questionnaires were completed, they were collected by
the researchers.
Findings
The study demonstrated how health, work conditions, and fatigue contributed to new
nurses' ITL. The findings showed that new nurses' ITL to leave was not significantly related to
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age, sex, or work experience. However, fatigue, inter-shift recovery, overall workload, working
hours, and health status did play a role in the nurses' ITL.
Relationship of Findings to Framework
The conceptual framework used for the study found that the personal characteristics of
new nurses did not significantly affect their ITL. However, fatigue, inter-shift recovery,
workload, working hours, and health did play a role in nurses' ITL. There was also a relationship
found between the nurse's self-reported health status and their ITL.
Implications for Nursing Practice
The study's findings showed that work conditions and work-related fatigue influenced
new nurses' ITL, while personal characteristics had no direct effect on new nurses' ITL. Work-
related fatigue was confirmed to be the major contributor to new nurses' ITL. In order to
enhance nurse's intent to stay, Liu et al. (2016) suggest that nurse managers should pay greater
attention to the working hours and overtime hours of new nurses. Several additional strategies
were recommended to increase new nurses' intent to stay, including mentoring programs, regular
evaluation of new nurses' workload and work-related fatigue, and implementing fatigue
reduction strategies.
Recommendations for Further Research
Recommendations are for further research studies to focus on a longitudinal change of
work-related fatigue so that fatigue-related changes can be trended and new strategies developed
for interventions (Liu et al., 2016).
Nursing Theories vs. Non-nursing Theories
Theories form the framework of procedures and interventions in nursing. The debate
continues in the nursing discipline regarding the source of the theories utilized in nursing
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research. The first proponents believe that only nursing theories should ensure relevance and
suitability to the nursing practice. Proponents believe that only the sole use of nursing theory
can truly detail nursing interventions' scope and direction (McEwen & Willis, 2019). The second
school of thought is that it is acceptable to use non-nursing nursing research theories as long as
they can be relevant to the nursing discipline.
Nursing can adopt applications of both nursing and non-nursing theories. When caring
for patients, ' nurses rely on nursing theories to guide their actions; however, these theories are
not enough to provide positive patient outcomes. Many non-nursing theories are used with
nursing theories the including theories from psychology, physiology, sociology, medicine, and
physics, to name a few. One such theory would be Maslow's hierarchy of needs. Maslow's
theory is based upon a man being a social being whose actions are motivated by caring for
oneself and being loved. Maslow's theory components include psychological, safety, love and
belongingness, self-esteem, and self-actualization (Shih et al., 2018). When nurses provide care
for patients, they need to be aware of how action contributes to realizing these needs.
Conclusion
The source of nursing theory used in research can be unique to nursing, or it may be used
in other disciplines. Caring for patients requires a holistic approach, so using theories from
multiple disciplines to guide research can improve a patient's outcome and overall well-being.
Proverbs 18:15 KJV, "The heart of the prudent getteth knowledge; and ear of the wise seeketh
knowledge."
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References
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https://doi.org/10.1097/ans.0000000000000255
Liu, Y., Wu, L.-M., Chou, P.-L., Chen, M.-H., Yang, L.-C., & Hsu, H.-T. (2016). The influence of
work-related fatigue, work conditions, and personal characteristics on intent to leave
among new nurses. , (1), 66–73. Journal of Nursing Scholarship 48
https://doi.org/10.1111/jnu.12181
Lor, M., Backonja, U., & Lauver, D. R. (2017). How could nurse researchers apply theory to
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https://doi.org/10.1111/jnu.12316
McCann, T., & Polacsek, M. (2018). Understanding, choosing, and applying grounded theory:
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McEwen, M., & Willis, E. M. (2019). Theoretical basis for nursing-with access (5th ed.).
Philadelphia, PA: Lippincott-Raven Publishers.
Shih, C., Huang, C., Huang, M., Chen, C., Lin, C., & Tang, F. (2018). The association of
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