Nursing Theory

The Mid-Range theories


The development of any profession depends heavily on the body of knowledge that has is dispensed to the students. Traditionally, profession of nursing relied on theories from external disciplines such as psychology, and sociology on which they formed the basis for nursing practice. Nursing must have its own system of dissemination of knowledge so that it can effectively define its activities and develop its research methodologies. Normally, the knowledge is expressed in terms of theories and conceptual models. Nursing theories provide features that help in defining the term nursing, in description of nursing, and also in setting the boundaries and objectives of nursing activities (Katharine, 2001). The purpose of theories in nursing practice is to guide research to facilitate the science while generating new knowledge and supporting the existing nursing ideas. Therefore theories provide a framework for which researchers examine situations and hence they provide structure of the organization analysis and decision making. Nursing theories also help in classifying values, believes and goals hence forming a background on which it makes contribution to the people. In order to gain more insights about theories in nursing, this paper will focus on the mid-range theory and it will discuss the background of the theory, theory description, evaluation, and application of the theory in nursing practice.


The mid-range theory was developed by Robert K Merton. Merton was born in 1910 in Philadelphia, went to South Philadelphia High school. He started his sociological career at Temple University but the development of the theory started in when he enrolled at Harvard. His work is usually compared to that of Talcott Parsons since he admired his work as it introduced him to European methods of theory while expounding his knowledge on sociology (Hedström and Udehn, 2009). Merton based the mid-range range theory on the works of Emile Durkheim such as The Suicide and The Protestant Ethic and the Spirit of Capitalism by Max Weber. Merton noticed that theories developed by the early scholars did not focus on the social behavior and hence he came up with the mid-range theory which he believed would help in investigating human behavior with the respect to their social setting (Ahmad, 2005). While other theories focused on the society as a whole, Merton believed that mid-range theory would concentrate on human behavior rather than the entire society.

Merton has been opposed to theories that consider society in general and that tries to cover all aspects of the life. As a means of developing his theory, he advocates that sociologists are supposed to concentrate on measurable aspects of social reality that can be researched as a separate discipline rather than attempting to explain the entire social world. Additionally, his publications have also played a great role in the development of his work. For instance the Social Theory and Social Structure which was established in 1949, On Social Structure and Science (1985) and Science, Technology and Society in Seventeenth Century England. The books have also formed a platform over which researchers can reference their works from.

As stated earlier, nursing practice used theories from other disciplines while disseminating knowledge. It was difficult to develop a reliable methodology that could be used to conduct a research in nursing profession. Mid-range theory provided a methodology that helps researchers to develop a study that is valid and reliable. Mid-range theory provides an operationalized structure that helps in describing, predicting, and explaining the phenomena relating to the research question (White, 2000). This theory addresses the research hypothesis hence providing a clear way of responding to the questions. Additionally, mid-range theory provides a tool that test relationship of human behavior and the health outcomes.

Theory description

The mid-range theory has been essential in the nursing science since it is used to narrow the gap between nursing theories and practice. Mid-range theory uses deductive reasoning to facilitate the research. Deductive reasoning moves from more general to more specific. This system is referred to as ‘top-down’ approach since it works from the top and more complicated stage to the less complicated that can be well understood. Mid-range theory uses the deductive reasoning since it is a directive theory, which presents alternative solution and action models that helps in achieving the best possible end results (Elo et. al, 2013). Mid-range theory follows a logical analysis and synthesis. For instance, the theory develops hypothesis that is used to test the research question in the nursing practice. Then next step after hypothesis is observation; in this stage the researcher goes into the field to collect the necessary data which will be used in testing the hypothesis. The last step is confirmation; this step transforms the study from a theoretical view to one aspect that can be used to make conclusions.

A concept is the vehicle of thought and Leahy asserts that a concept is a complex mental formulation of the world perceptions (Leahy, 2005). The concept helps in formulating mental image about a situation. Mid-range uses various concepts that influence and determine the nursing practice and they include patient and nursing. Patient is the person who is the subject to the nursing practices; basically he is the client to the health sector. Nursing is discipline that integrates training of medical professions, how they can identify health problems, and how they can use research methods to provide a solution to the problems

The mid-range theory demonstrates adequacy since its scope associate any professional communication that helps in meeting needs of a patient at any level of the health care system. The theory uses the concepts implicitly in the sense that the nurse will validate the needs of the patients who are mute, who are cognitively impaired, and who are compromised by means of other than direct verbal communications (Stark, Chase and DeYoung, 2010). Another structural element of the mid-range theory is the statement that proposes a relationship between concepts. A nursing propositional statement represents the theorist’s particular view of how the concepts affect one another. In this case, nursing is expected to improve the health outcomes of the society. Due to the dynamic nature of the health problems, health professionals are expected to conduct research so that they can come up with the solutions of such problems.


Mid-range theory considers the human behavior and it concentrates on the social aspects in order to determine factors that affect their health. However, society is dynamic and there are various factors that affect human behavior hence it is practically impossible to meet all of them. Hence there are assumptions that guide mid-range theory; for instance it assumed that patients require the expertise of professional nurses so that they can meet their health needs. Second, each nursing situation with a patient is unique and they are dynamic. Lastly, the desired outcome of nursing is that the reports demonstrates adequacy of well-being of the patient (Sharoni and Wu, 2012).

A well-established theory should integrate other several factors in the area of study. In nursing, paradigms provide the basic parameters and framework on which the knowledge of nursing is organized. Metaparadigm is a global concept that is specific to the discipline and the propositions that define and relate the concepts. Mid-range theory associates the four concepts namely environment, human beings, health and nursing. The theory uses the Metaparadigm as the primary source of providing means of focusing everything that is inherently nursing while marginalizing everything that does not relate to nursing. Mid-range theory uses the deductive reasoning to develop its ideas and hence it concentrates on the four elements so that it can make findings and conclusions relevant to the area of study. Additionally, the theory uses the metaparadigm for the analysis, developing of framework and provides a perspective of comparison of various nursing theorists.

The use of the metaparadigm helps in enhancing the relevance of the theory. While other theories generalize the situation, mid-range theory focuses on the key areas hence avoiding irrelevance. For instance the use of the four concepts of Metaparadigm are specific in nursing ensures that a medical researcher stay focused only on these four areas. This makes it easy to use and apply the theory. The concept and propositions are readily operationalized and the theory can be applied in various situations in the nursing field. The theory is oriented to results that are significant to the patients that is, the theory assists in qualitative research that indicates what patients want and needs and hence provides a means through which nurses assist them.


The major objective of the nurses is to develop and facilitate business in nursing industry. Mid-range theory has changed the perspective of nursing and it can be used in creating a new picture of nursing sector. The mid-range can be used to provide structure that is necessary for the nurses to enable them understand roles of nurses and what is required of them. The theory helps nurses to address the issues at the acute care setting and provides a way of imagining solutions to the challenges they face. The theory provides a framework on which knowledge acquired from the college is applied creatively and in a practical manner. The theory can be used in breaking down the boundary that exists between the theoretical knowledge and the nursing practice. Merton realizes that the values of practitioners, the philosophy and health perspectives are embodied in the practice and hence facilitating the concept of “doing what we know and knowing what we do” (Hedström and Udehn, 2009). Therefore, nurses can take advantage of this theory in order to provide better patient care.

Secondly, mid-range theory is part of the structure of the nursing discipline. It addresses the substantive knowledge of nursing by explicating and also expanding specific phenomena that are associated with caring-healing process. Health entails many issues and hence it may be inefficient to study everything at the nursing course level. The mid-range theory will break down the contents and provide a specific area to be studied as a means of enhancing specialization and nursing course hence enhancing professional status for nurses.

Third, mid-range theory is essential in researching since it has direct linkages to research and practice, and this is achieved deductively through synthesis of ideas and logical analysis of the observations. The theory has enhanced the development of research and nursing practice. The mid-range theory can provide a research methodology that helps researchers to develop research questions and research hypothesis. With regard to this, nurses in practice can take mid-range theory to develop practice guidelines on health matters. For instance the oncology nurses are situated such that they interact with the patients receiving thermotherapy. By using the mid-range theory, nurses may design a research to get the feedback of the effectiveness of their services. This will help them in extending nursing practice and contributing to the development of research on oncology. Mid-range theory is commendable since it can be used to structure research and also develop practice in nursing that builds the substance, organization as well as the integration of the discipline (Risjord, 2010).

Fourth, the mid-range theory is based on the metaparadigm of the health industry. With this regard, the theory helps in explaining how human behavior and the environmental factors affect the health of an individual thus the theory is essential in orienting the practice of any nurse working in holistic health care (Sandra and Timothy, 2013). The mid-range theory can help nurses to understand how human beings relate with one another and through the element of sociology; nurses are able to understand behavior of human beings. Therefore, they will be able to handle the patients as they will pay attention to the needs of the human bodies and this is important for the nurses caring or the patients experiencing chronic illness. Additionally, they acquire skills that helps them to handle special patients such as those experiencing life-threatening illness, and also illness that may disrupt personal or professional goals. Hence this can be used as a guidance of research and education for people willing to excel in nursing.

I can use the mid-range theory to examine the situations at hand hence I can use the frameworks provided by the mid-range theory to make crucial decisions in my nursing practice. Mid-range theory makes conclusions deductively and hence I can apply this concept in my workplace. By considering the problem, I can be able to use the system used by the theory to come up with specific solutions. Mid-range theory provides a framework of studying the behavioral change process and I can take advantage of this to understand the barriers to good health outcomes. This will give me chance of making interventions in the social and also environmental factors that influence health of a person hence I will be able to increase the opportunity for personal mastery and I will also develop professional skills so that I may deliver my services efficiently. Since mid-range theory emphasizes on the dissemination of knowledge on a certain discipline, I will use the theory to continue developing and evolution of the nursing discipline.


The use of nursing theories as a guideline to the evolution of nursing continues to be used on daily basis. The mid-range theory provides a framework for nurses on which they base their nursing practice on. However, nurses need to understand the mid-range theory better since it provides a foundation of the nursing practice. The theory should also be considered important by the tutors since it helps in generating further knowledge and it is an indication of the direction that nursing should develop in the future. Additionally, the mid-range theory is important since it helps nurses in deciding what we know and what we are supposed to in the health profession.


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