This document discusses frameworks and theoretical concepts in nursing research. It defines key terms like framework, concept, construct, theory, and variables. A framework provides structure and guidance for a study. Quantitative research usually has an explicit framework while qualitative research may not. The document reviews different types of theories from grand theories, which are highly abstract, to middle range theories which are more specific. It also discusses how to evaluate existing theories and develop new research frameworks by identifying relevant theories, synthesizing from research, or proposing based on clinical experience.

1. 1Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Chapter 7
Frameworks

2. 2Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Framework
A framework is an abstract, logical structure
of meaning that guides the development of
the study and enables the reader to link the
findings to the body of knowledge in nursing.
 Used in quantitative research and sometimes
in qualitative research
 Rarely identified in qualitative research
 Always present in quantitative research,
although often unstated

3. 3Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Terms Related to Theoretical
Ideas and Their Application
 Concept: a term that abstractly describes and names
an object, a phenomenon, or an idea, thus providing
it with a separate identity or meaning (building block
of theory)
 Construct: concepts with high levels of abstraction
that have general meanings
 Relational statement: declares that a relationship of
some kind exists between or among two or more
concepts
 Conceptual model (grand theory): a set of highly
abstract, related constructs

4. 4Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Terms Related to Theoretical Ideas
and Their Application (Cont’d)
 Theory: an integrated set of defined concepts,
existence statements, and relational statements that
can be used to describe, explain, predict, or control
that phenomenon.
Existence statements within a theory declare
that a given concept exists or that a given
relationship occurs
 Scientific theories (sometimes called laws): theories
for which repeated studies have validated the
relationships among the concepts

5. 5Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Terms Related to Theoretical Ideas
and Their Application (Cont’d)
 Middle range (substantive) theories: less
abstract and address more specific
phenomena than grand theories
 Conceptual map (research framework):
diagram that summarizes and integrates what
we know about a phenomenon more
succinctly and clearly than a literary
explanation and allows us to grasp the bigger
picture of a phenomenon

6. 6Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Variables
 Measurable forms of concepts
 Can assume at least two values
 Present/absent
 Hot/cold
 Dead/alive

7. 7Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Links Among Constructs,
Concepts, and Variables

8. 8Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Conceptual Definition
 More comprehensive than Webster’s
dictionary
 Can be established through:
 Concept synthesis: describing and naming a
previously unrecognized concept
 Concept derivation: one concept is transposed
from one field of knowledge to another
 Concept analysis: identifies a set of characteristics
essential to the connotative meaning of a concept
 Example: frailty

9. 9Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Relational Statements
 Relational statements describe the direction,
shape, strength, symmetry, sequencing,
probability of occurrence, necessity, and
sufficiency of a relationship
 Statements may be expressed as words in a
sentence (literary form), as shapes and
arrows (diagram form), or equations
(mathematical form)

10. 10Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Three Forms of Simple
Statement

11. 11Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Three Forms of a More Complex
Statement

12. 12Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Direction

13. 13Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Direction (Cont’d)
 Direction of a relationship may be positive,
negative, or unknown
 Positive linear relationship implies that as one
concept changes (the value or amount of the
concept increases or decreases), the second
concept will also change in the same
direction
 Negative linear relationship implies that as
one concept changes, the other concept
changes in the opposite direction

14. 14Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Shape
 Linear relationship: the relationship between the two
concepts remains consistent regardless of the values
of each of the concepts

15. 15Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Shape (Cont’d)
 Curvilinear relationship: the relationship between two
concepts varies according to the relative values of the
concepts

16. 16Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Strength
 The amount of variation explained by the relationship
 Effect size explains how much “effect” variation in
one concept has on variation in a second concept
 Researchers usually determine the strength of the
relationship between concepts by correlational
analysis
 Correlation coefficient (r): obtained by performing the
Pearson's product moment correlation (r = 0.42, for
instance)

17. 17Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Strength (Cont’d)
 r = 0 indicates no relationship between the two
variables (example: Musical aptitude and last three
numerals of one’s Social Security number)
 r = +1 or r = –1 indicates VERY strong relationship
between the two variables (example: number of
hours spent daily playing Angry Birds and GPA)

18. 18Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Symmetry

19. 19Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Symmetry (Cont’d)
 Asymmetrical relationship: if A occurs (or
changes), then B will occur (or change); but
there may be no indication that if B occurs (or
changes), A will occur (or change)—like a
one-way street
 Symmetrical relationship: complex and
contains two statements, such as if A
changes, B will change; if B changes, A will
change—like a two-way street

20. 20Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Sequencing

21. 21Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Sequencing (Cont’d)
 The amount of time that elapses between one
concept and another is stated as the
sequential nature of a relationship
 Concurrent relationship: both concepts occur
simultaneously
 Sequential relationship: one concept changes
and the second concept changes later

22. 22Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Probability of Occurrence
 A relationship can be deterministic or
probabilistic depending on the degree of
certainty that it will occur
 Deterministic (or causal) relationships:
statements of what always occurs in a
particular situation (If A, then always B)
 A probability statement: expresses the
probability (p) that something will happen in a
given situation (If A, then probably B)

23. 23Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Necessity
 Necessary relationship: one concept must
occur for the second concept to occur
If A, and only if A, then B
 Substitutable relationship: a similar concept
can be substituted for the first concept and
the second concept will still occur
If A1, or if A2, then B

24. 24Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Sufficiency
 Sufficient relationship: when the first concept occurs,
the second concept will occur, regardless of the
presence or absence of other factors
If A, then B, regardless of anything else
 Contingent relationship will occur only if a third
concept is present. The third concept, in this case
effective coping strategies, is referred to as an
intervening (or mediating) variable
If A, then B, but only if C

25. 25Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Statement Hierarchy

26. 26Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Statement Hierarchy (Cont’d)
 General propositions (grand theory,
conceptual models): high levels of abstraction
 Specific propositions (middle-range theory):
moderate levels of abstraction
 Hypotheses: specific statement with low
levels of abstraction
 Operational definitions: link the framework to
reality

27. 27Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Grand Theories
Table 7-4: Selected Grand Nursing Theories
Author (Year) Descriptive Label of the Theory
Henderson, Virginia (1964) Nursing as Promoting Patient Independence with 14
Activities of Daily Living
Johnson, Dorothy (1974) Behavioral Systems
King, Imogene (1981) Interacting Systems Theory of Nursing (includes
middle range theory of Goal Attainment)
Leininger, Madeline (1997) Transcultural Nursing Care, Sunrise Model of Care
Orem, Dorothea (2001) Self -care Deficit Theory of Nursing
Neuman, Betty (Newman & Fawcett,
2002)
Systems Model of Nursing
Newman, Margaret (1986) Health as Expanding Consciousness
Nightingale, Florence (1859) Environmental Health
Parse, Rosemarie (1991) Human Becoming Theory
Peplau, Hildegard (1988, 1991) Interpersonal Relations Theory
Rogers, Martha E (1970) Unitary Human Beings
Roy, Calista (1988) Adaptation Model
Watson, Jean (1979) Philosophy and Science of Caring

28. 28Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Application of Middle-range
Theories
 Closer to the day-to-day substance of
clinical practice
 Guide the practitioner to understanding the
client’s behavior, enabling
interventions that are more effective
 Substantive/practice theories
 Used more commonly than grand theories
as frameworks for research

29. 29Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Appraising Theories and Research
Frameworks For Possible Study Use
 Attempt to construct a theory, using the
concepts in the study

30. 30Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Appraising Theories and Research
Frameworks For Possible Study Use (Cont’d)

31. 31Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Appraising Theories and Research
Frameworks For Possible Study Use (Cont’d)
 Examine its logical structure:
 Is it clear?
 Does it have consistency?

32. 32Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Appraising Theories and Research
Frameworks For Possible Study Use (Cont’d)
 Ask specific questions to decide whether the
framework fits the study, or whether it is
merely gratuitous:
 Do the definitions of the constructs or concepts in
the study agree well with the definitions in the
theory or framework?
 Are the variables representative of the
framework’s concepts?
 Are conceptual definitions references to the
literature?
 Are the relational statements logical

33. 33Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Appraising Theories and Research
Frameworks For Possible Study Use (Cont’d)
 Evaluate the extent to which the framework guided
the methodology:
 Did the framework REALLY guide the methodology?
 Do the operational and conceptual definitions agree?
 Do the constructs/concepts track down through the
hypothesis/questions to the operational level?
 Is the researcher really studying what the researcher
believes is being studied? (a validity issue, for sure)

34. 34Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Appraising Theories and Research
Frameworks For Possible Study Use (Cont’d)
 Analysis portion of the study:
 Did the researcher refer back to the framework
when analyzing the study findings?
 Did this help the reader understand the reasons
the findings occurred?
 Did all of this make sense, or was the researcher
“reaching”?

35. 35Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Developing a Research
Framework
 Three basic approaches to beginning the
process of constructing a study framework:
 Identifying an existing theory using the literature
from nursing or another discipline
 Synthesizing a framework from research findings
 Proposing a framework from clinical practice

36. 36Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Identifying and Adapting an
Existing Theory
TABLE 7-9 Potential Theories for Different Research Topics
Research Topic Theory (Theorist, Year)
Light and noise as influences on patient recovery in
acute care settings
Environmental Theory (Nightingale, 1979)
Peer support group for adolescents to decrease their
use of illegal substances
Roy’s Adaptation Model (Roy & Andrews, 2008)
Sleep quality and dementia progression in long-term
care facilities
Cognitive Brain Reserve (Stern, 2009)
Medication adherence of men on antihypertensive
medications
Information Motivation Behavioral Skills Model (Fisher,
Williams, Fisher, & Mallory, 1999)
Screening for diabetes mellitus among women with a
history of gestational diabetes
Cardiometabolic Model (Ruhr, 2009)
Task shifting in low resource settings Theory of Self -regulating Teams (Millwood, Banks, &
Riga, 2010)
Fear of HIV infection and sexual behavior of young gay
men
Theory of Planned Behavior (Ajzen, 1991)
New graduate nurses’ clinical competency and use of
high-fidelity simulation in baccalaureate nursing
education
NLN-Jeffries Simulation Framework (Jeffries et al.,
2007)
Children’s post-operative pain and parental anxiety Philosophical approach: Externalist perceptual view of
pain (Pesut & McDonald, 2007)
Nurse retention and environmental factors in rural
hospitals
Theory of Structural Empowerment (Kanter, 1977)

37. 37Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Synthesis From Research
Findings
 Read related literature and sketch out how
the variables relate to one another
 Most accepted strategy of theory
development

38. 38Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Proposing a Framework From
Clinical Experiences

39. 39Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Developing A Research
Framework
 Combine all three approaches to get the best explanation of
reality: a tentative theory
 Conceptually define the concepts that relate to the idea under
study
 Decide how these are related, and develop statements about
the relationships
 Try to define
 The conceptual/construct level (and proposition or relational
statement)
 The variables (and the hypothesis)
 The operational definitions
 Operational definitions link the framework to reality (what is
really being studied)

40. 40Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Conceptual Map
 A visual representation of the framework
 No one single way to represent this: anything that
makes sense is okay
 Put down all of the important concepts that have
been defined
 Left-to-right represents the passage of time
 Use arrows to denote relational statements
 Look at the map: does it capture the essence of the
ideas?
 Show it to others: does it make sense to them?

41. 41Copyright © 2013, 2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc.
Conceptual Map (Cont’d)
(example)