THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 2
Theoretical vs Conceptual Frameworks in Nursing Theory
Nursing theory dates back to the 19th century following Florence Nightingale’s
Environmental Theory which identified a clear link between a patient’s environment and their
ability to recover (American Nurses Association [ANA], 2023). Nurse researchers and scholars
share conventional ideas to ensure worldwide practices, and nurse education shapes curricula
based on the research created. This essay explores nursing theory in detail through the
identification of three ways theory is used in research. Additionally, Additionally, a selected
article will be evaluated on how the theory was used as a conceptual framework throughout the
nursing study.
Theory Use in Research
Theory helps organize the variables and concepts within a study, guiding its development
and linking findings to a broader body of knowledge (McEwen & Wills, 2017). Both nursing and
non-nursing theories are relevant to nursing research, and they typically appear in the research
process in one of three ways: as the outcome of a study, as the focus of a research project aimed
at testing the theory, or as the framework providing context for a study. Each of these uses in
research is detailed in the following paragraphs.
Theory Generating Research
Theory-generating research is research that creates theory, also known as descriptive
research, which is used to develop and define relations among phenomena without imposing
notations of what these spectacles mean (McEwen & Wills, 2017). This type of research includes
grounded theory, field observations, and phenomenology. A proposition stated as an empirical
generalization is created by a researcher by creating a theory from logical fact. The theory
generation process consists of several steps. Initially, a researcher finds observations with
THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 3
common characteristics and similar themes in an identified group or specific setting. After
finding the observations, they translate them into abstract concepts by analyzing the general
phenomenon the observations embody. Thirdly, relationship patterns are recognized between
observations and concepts. After pattern recognition, the research translates the findings into
propositional statements and develops a framework or tentative theory from the results.
Theory-Testing Research
The process of theory-testing research includes converting theoretical statements into
questions and hypotheses (McEwen & Wills, 2017). A propositional statement is selected by
choosing a theory of interest and identifying a specific statement from the theory to test. The
researcher then creates a hypothesis consisting of measurable variables that reflect the chosen
statement. A study is conducted in order to gather data which is then analyzed to see if the
findings support or contradict the propositional statement and overall theory. At the end of the
research, implications for further use of the theory in nursing practice are considered. True
theory testing involves a detailed examination of theoretical relationships and planning the study
to accept or refute these associations. Theory testing is rather rare in nursing research because of
a lack of clarity about what comprises theory testing.
Conceptual Framework or Context of a Study
Using theory as the conceptual framework involves the researcher identifying a
previously existing framework that can be applied to a study or creating a framework that is
distinctive to the study (McEwen & Wills, 2017). The existing framework used by the researcher
is known as theory fitting in which a research purpose or question is formulated and then a
theory is searched for to help guide the study. An extensive search of literature and a proper
understanding of theoretical progress in healthcare is required for theory fitting to be effective.
THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 4
Theory as a Conceptual Framework
A conceptual framework is like a roadmap for a study, helping researchers envision a
research project and put it into action (Charlesworth Author Services, 2022). In this section, the
article “The Influence of Work-Related Fatigue on New Nurses’ Intention to Leave” written by
Liu et al. (2015) is analyzed and broken down to evaluate how the theory was used as a
conceptual framework. The article investigates the factors that predict new nurses’ intention to
leave (ITL) their jobs. The study uses a cross-sectional design and surveys new nurses in
southern Taiwan, measuring and determining the extent to which personal characteristics, work
conditions, and work-related fatigue predict ITL among new nurses.
Study Variables
Key variables are specified within a framework that influences a phenomenon of interest
and alerts the researcher to examine how those certain variables might differ and under what
circumstances (Luft et al., 2022). There were two aims within the study to include testing the fit
of the hypothesized model for new nurses’ ITL and determining the degree to which personal
characteristics, work conditions, and work-related fatigue anticipate ITL among new nurses.
Conceptual Definitions
The conceptual definitions are derived from the framework within the study. Concepts
studied consisted of 10 observed variables and three latent variables (Liu et al., 2015). The three
latent variables labeled pertained to personal characteristics, work conditions, and work-related
fatigue. ITL was considered a measurable variable within the study. The personal characteristics
observed measured variables such as health, age, education, and work experience. The work
conditions observed measured variables consisting of work hours and workload. Finally, work-
THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 5
related fatigue measured variables observed acute fatigue, intershift recovery, and chronic
fatigue.
Instruments
Several instruments were used in the study to gather data pertaining to the project. A self-
rated health status (SRHS) was measured using one item with a 5-point Likert scale with 1 being
poor and 5 being an excellent rating (Liu et al., 2015). Overall workload was measured on a 0-10
scale where higher scores indicated higher workload. An Occupational Fatigue Exhaustion
Recovery (OFER) Scale was used to identify the most dominant work-related fatigue subscale.
Subscales included chronic fatigue, acute fatigue, and intershift recovery. Each subscale
contained five items rated on a 7-point Likert scale, 0 being strongly disagree and 7 being
strongly agree. Lastly, an Intent to Leave Scale used three items to measure ITL. The three items
included questions such as “I am considering leaving this hospital”, “I am considering leaving
nursing”, and “I want to keep doing my nursing work”. The ITL Scale also used a 7-point Likert
scale.
Findings
The study found a significant relationship between work conditions and work-related
fatigue as new nurses experienced longer working hours and higher workloads resulting in
higher levels of work-related fatigue. The work-related fatigue considerably predicts a nurse’s
ITL. Personal characteristics did not significantly predict ITL and might have been due to a
relatively uniform sample of young, new nurses, and the measure of health status used.
Relationship of Findings to Framework
The researchers described the findings using the hypothesized model. Specifically,
Structural Equation Modeling (SEM) was used to analyze the relationship among personal
THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 6
characteristics, work conditions, work-related fatigue, and ITL. The final model showed a
suitable fit as work-related fatigue, work conditions, and health justified 65% of the variance in
new nurse’s ITL.
Implications for Nursing Practice
The article suggests that Nurse Managers should be more attentive to new nurses with
extended overtime hours or working hours (Liu et al., 2015). Levels of workload and work-
related fatigue should be routinely checked. The overall workload scale could serve as a fast
screening tool within the work environment. Strategies related to reducing fatigue should be
implemented to boost new nurses’ intent to stay. Finally, nurse mentors can continuously
evaluate the effect of training programs on new nurses’ fatigue levels, and then make appropriate
adjustments to fit needs.
Recommendations for Further Research
The article proposes future studies to focus on longitudinal change of work-related
fatigue (Liu et al., 2015). The focus may be able to observe a trend of fatigue changes, and
intervention strategies can be developed to mitigate these challenges.
Nursing vs. non-nursing
There is an ongoing debate regarding the usage of nursing and non-nursing theories to
steer research within the nursing community. Nursing theories have become more important
within nursing science since its recognition as an academic field (Jensen, 2019). Though its
prevalence in nursing science is slim with findings as low as 21% of articles from seven leading
nursing journals used nursing theory. Most nursing theories were developed in the USA, in the
1980s and earlier. Some nursing theorists and researchers believe it is vital to use solely nursing
theories and models in nursing research because nursing theories truly deal with the range and
THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 7
direction of nursing interventions (McEwen & Wills, 2017). Using both nursing and non-nursing
theories is essential for evolving the field of nursing science research. To limit nurses to using
only nursing theories is shortsighted, instead, nurses should continue to borrow outside theories
to help define and explain occurrences that affect nursing practice.
Conclusion
The use of theory in nursing research is intricate as it encompasses theory generation,
theory testing, and the use of conceptual frameworks. Each of these roles contributes to the
development of nursing knowledge and practice. The theoretical models created in the field
develop conceptual blueprints, ultimately determining the purpose that drives nurse-patient
interactions (American Nurses Association [ANA], 2023). By integrating both nursing and non-
nursing theories, nursing research can continue to evolve, providing deeper insights into nursing
practice and improving patient care outcomes. Practice these things, immerse yourself in them,
so that all may see the progress, and by persisting in this for by doing so you will save both
yourself and your hearers (Bible English English Standard Version, 2012, 1 Timothy 4:15-16).
The ongoing dialogue about the use of theory underscores the dynamic nature of the field and its
commitment to advancing healthcare through arduous research.
THEORETICAL VS CONCEPTUAL FRAMEWORKS IN NURSING 8
References
American Nurses Association. (2023, July 5). What is Nursing Theory . Retrieved July 13, 2024,
from https://www.nursingworld.org/content-hub/resources/becoming-a-nurse/nursing-
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2Dpatient%20interactions.
Bible English English Standard Version. (2012). Holy bible: English standard version. Collins.
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framework – and constructing each. https://www.cwauthors.com/article/conceptual-
framework-versus-theoretical-framework-in-research. Retrieved July 11, 2024, from
https://www.cwauthors.com/article/conceptual-framework-versus-theoretical-framework-
in-research
Jensen, K. (2019). Nursing research: A marriage of theoretical influences. Nursing open , 6 (3),
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Liu, Y., Wu, L., Chou, P., Chen, M., Yang, L., & Hsu, H. (2015). 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. Retrieved July 11, 2024, from
https://doi.org/10.1111/jnu.12181
Luft, J. A., Jeong, S., Idsardi, R., & Gardner, G. (2022). Literature reviews, theoretical
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