Middle Range Theories, Internal, And External Criticism
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Jabbour, C. J. C., Sarkis, J., de Sousa Jabbour, A. B. L., Renwick, D. W. S., Singh, S. K., Grebinevych, O., … & Godinho Filho, M. (2019). Who is in charge? A review and a research agenda on the ‘human side’of the circular economy. Journal of cleaner production, 222, 793-801.

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MSN5270: Advanced Theoretical Perspectives in Nursing
DNP-C, FNP-BC, MSN, APRN

Introduction

Middle-range theories play a crucial role in nursing practice by bridging the gap between abstract grand theories and specific nursing interventions. It is important to provide a theoretical framework and rationale for critically scrutinizing internal and external criticisms of theory (George et al., 2019). Medically managed patients are individuals with both physical and mental illnesses who receive lifesaving treatments to maximize effectiveness while minimizing risks. The choice of a unique “middle range” theory influences physician influence, patient decisions, nursing care delivery, and outcomes (TM et al., 2021). These theories are supported by current scientific research and provide a framework for understanding and explaining phenomena in nursing practice. However, like any scientific theory, middle-range theories are subject to internal and external criticism.

Explanation of Middle-Range Theories

Middle-range theories are more specific and concrete than grand theories, but they still provide a level of abstraction that can be applied across various nursing contexts. They focus on specific aspects of nursing phenomena, such as pain management, patient satisfaction, or stress reduction (Northoff and Tumati, 2019). These theories adopt patient-centered approaches and humanistic theories, emphasizing practice and patient experience. Internal criticism is an important component of middle-range theories, involving the rigorous Assessment of underlying assumptions. Middle-range theories serve as a theoretical foundation for developing interventions, assessing outcomes, and promoting evidence-based nursing care, as they are derived from grand theories and developed through research and empirical evidence. They also facilitate communication and collaboration among nurses by providing a common language and understanding of nursing concepts.

Internal Criticism of Middle-Range Theories

Internal criticism involves evaluating the logical consistency, clarity, and coherence of a theory’s concepts, propositions, and assumptions to ensure internal validity and coherence. It aims to identify any logical gaps, inconsistencies, or ambiguities that may undermine the credibility and utility of a middle-range theory (Tamilmani et al., 2021). For example, if a middle-range theory proposes that educating patients with diabetes improves self-management behaviors and glycemic control, internal criticism would involve examining the clarity of concepts such as defining “education” and “self-management behaviors” and assessing the logical consistency of the proposed causal relationship between education and glycemic control (Jabbour et al., 2019). Through internal criticism, researchers and clinicians can refine and strengthen middle-range theories, ensuring their relevance and applicability in nursing practice.

External Criticism of Middle-Range Theories

External criticism focuses on determining whether a middle-range theory has been accepted in nursing practice and provides useful insights into nursing phenomena. It ensures that a middle-range theory has empirical grounding and is supported by scientific research. For instance, if a middle-range theory proposes that nurse-led interventions improve patient satisfaction, external criticism would involve reviewing studies investigating the relationship between nurse-led interventions and patient satisfaction (TM et al., 2021). It is important to consider the quality and consistency of empirical evidence, as a small-to-moderate amount of evidence may support a middle-range theory, but a large amount of low-quality or biased research may also support it. Strong theoretical and empirical underpinnings of a middle-range theory, as determined through external criticism, can guide nursing practice and research. Different areas of nursing may be subject to varying levels of scrutiny, highlighting the significance of evaluating a theoretical perspective in light of empirical evidence.

Application of Student Learning Outcomes

The process of internal and external criticism encourages students to evaluate the empirical evidence supporting middle-range theories, fostering critical thinking and the ability to assess the quality and relevance of research findings. Students can determine the applicability of theories MSN5270: Advanced Theoretical Perspectives in Nursing

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