Chapter 19

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 19
Application of Theory in
Nursing Research

Overview of Theory and Research
• In any discipline, science is the result of the
interchange between research and theory.
• The purpose of research is to build knowledge in a
discipline through the generation or testing of
theory.

Overview of Theory and Research—(cont.)
• To build knowledge, research should develop within a
theoretical structure that facilitates analysis and
interpretation of findings.
• When a study is placed within a theoretical context, the
theory guides the research process; forms the questions;
and aids in design, analysis, and interpretation.

Overview of Theory and Research—
(cont.)
• A theory (model or framework) provides parameters
for research and enables the scientist to weave the
facts together.

Theory and Research in Nursing
• It has been debated whether nursing can form a discrete
body of knowledge without using theories from other
disciplines.
• However, most agree that nursing science is a blend of
knowledge unique to nursing and knowledge that is
imported from other disciplines.

Theory and Research in Nursing—(cont.)
• Debate over use of “shared theories” has contributed to
problems connecting research and theory in nursing.

• Research and theory were first integrated by Florence
Nightingale.
• In Notes on Nursing, Nightingale identified the need to
organize nursing knowledge through observation,
recording, and statistical inferences.
• She supported her theories through research using
statistical data.

• After Nightingale, reports of nursing research were
rare and for the most part, research and theory
developed separately in nursing.
• Nursing Research was initially published in 1952, and
the amount and quality of research in nursing grew
rapidly.

• In the early years, research focused on education and
characteristics of nurses rather than clinical practice.
• Since the mid-1990s, clinical studies have comprised
more than 75% of published nursing research.

Relationship Between Research and Theory
• Knowledge development (science) is cumulative.
• Knowledge generated from separate research studies
should be integrated into a comprehensive understanding
of the subject or phenomenon being studied.
• Thus, research gains its significance from its theoretical
context.

Question
Tell whether the following statement is true or false:
The first nurse theorist was Virginia Henderson.

Answer
False
Rationale: The individual considered to be the first nurse
theorist is Florence Nightingale.

Relationship Between Research and
Theory—(cont.)
• In nursing, knowledge development (science) has
lagged because of
– Limited theoretical base
– Abundance of isolated studies not tied to a
theoretical framework or placed in context
– Inadequate efforts to link theory, measurement,
and data interpretation within research

Theory—(cont.)
• Research is the “systematic inquiry into phenomena.”
• Research is conducted to describe, explain, and/or
predict variables and in practice discipline to prescribe.

Theory—(cont.)
• Nursing research is concerned with the holistic study
of individuals in interactions with their environments
and with discovering interventions that promote
optimal functioning and self-care to foster maximum
wellness across the life span.

Theory—(cont.)
• In nursing, researchers study:
– Life processes
– Well-being and optimal functioning of humans
– Patterns of behavior
– Processes that bring about positive
changes in health status

Steps of the Research Process
• Identify the problem/phenomena to be studied.
• Link the research questions or hypotheses to a
theoretical framework.
• Design the study to define the problem, variables, and
measurement methods.
• Refine research questions/hypotheses and measurement
instruments.
• Specify the sample to be studied.

Steps of the Research Process—(cont.)
• Collect data.
• Analyze data.
• Interpret the findings.
• Identify conclusions and recommendations.
• Disseminate findings.

Types of Theory and Nursing Research
• Descriptive Theory—descriptive or exploratory studies
• Explanatory Theory—correlational studies
• Predictive Theory—experimental or quasi-experimental
studies

Descriptive Theory and Research
• A descriptive theory looks at a phenomenon and
identifies it major elements or events.
• Does not explain why
• Descriptive research involves observation of a
phenomenon in its natural setting.
• Methods include concept analysis, case studies, surveys,
phenomenology, grounded theory, ethnography, and
historical inquiry.

Question
Most descriptive research studies involve collecting
quantitative data.

Answer
False (mostly)
Rationale: Descriptive studies typically involve qualitative
data collection. Descriptive studies include case studies,
concept analysis, grounded theory, and ethnography.
Surveys are a more quantitative method that can be
considered “descriptive.”

Explanatory Theory and Correlational
Research
• Explanatory theories specify relationships between
characteristics of individuals, groups, situations, or
events.
• They explain why and the extent to which one
phenomenon is related to another.
• Correlational research measures dimensions or
characteristics of phenomenon.

Explanatory Theory and Correlational
Research—(cont.)
• Data are generally gathered by observation or self-report
instruments.
• Instruments can be fixed-choice, open-ended
questionnaires, or structured interviews.
• Statistical analysis is used to measure association.

Question
Correlational research typically involves instruments that
measure or quantify variables of interest.

Answer
True
Rationale: In correlational research studies, data are
gathered by self-report instruments, and statistical
analysis is used to measure associations.

Predictive Theory and Experimental
Research
• Predictive theories move beyond explanation to
prediction or relationships between characteristics or
phenomena among different groups.
• Experimental research involves manipulation of
phenomena to determine how it affects or changes
dimension or characteristics of another phenomenon.
• Experimental research requires quantifiable data.
• Statistical analyses are used to measure differences.

How Theory Is Used in Research
• Theory brings organization to the variables of interest.
• Theory provides a guide for developing a study.
• Theory allows the findings to be placed in, or linked to, a
larger body of knowledge.

How Theory Is Used in Research—
(cont.)
• Theories are used in the research process in one of three
ways.
– Theory is generated as the outcome of a research
study.
– Research is undertaken to test a theory.
– Theory is used as a research framework as the
context for a study.

Theory-Generating Research
• Research that generates theory—that is, descriptive
research—is undertaken to develop and describe
relationships between and among phenomena.
• It is inductive.

Theory-Generating Research—(cont.)
• Several steps in theory generation
– Researcher identifies observations that have shared
characteristics or common themes in an identified
group or setting.
– Researcher translates these observations into more
abstract concepts by determining what general
phenomenon the observations represent and
identifying patterns of relationships.
– Researcher translates observations into statements
and weaves concepts and propositions together into
a framework or tentative theory.

Theory Testing Research
• Studies can be conducted to test a theory or assessing
its explanatory value in a specific situation.
• Theoretical statements are translated into questions and
hypotheses.
• It is deductive.

Theory Testing Research—(cont.)
• Theory testing research requires several steps.
– Researcher chooses a theory of interest and selects a
propositional statement to be tested.
– Researcher develops hypotheses, which have
measurable variables that reflect the propositional
statement.
– Researcher conducts the study and interprets the
findings.
– Researcher determines if there are any implications
for further use of the theory in nursing practice.

Theory as a Conceptual Framework for a
Research Study
• Most common way of incorporating a theory into
research.
• A theory is used as the context and basis of
interpretation of the research.
• The theory guides the study and enhances the value of
its findings.

Research Study—(cont.)
• Steps in using theory as a conceptual framework for
research
– Researcher identifies a theory or existing framework
that can be meaningfully applied to the study.
– Research questions/hypotheses are consistent with
the framework.
– Conceptual definitions may be taken from the
framework.
– Data collection instrument may be based on the
framework.

Research Study—(cont.)
• Steps in using theory as a conceptual framework for
research—(cont.)
– Findings are interpreted with regard to explanations
provided by the framework.
– Researcher determines support for the framework
based on study findings.
– Implications for nursing are based on the explanatory
power of the framework.
– Recommendations for future research address the
concepts and relationships designated by the
framework.

Writing a Research Report
• To illustrate the impact of the theoretical framework in
the research study and to show the context within which
the findings should be interpreted, discussion of the
theoretical framework should be incorporated into
several sections of the research report.

Writing a Research Report—(cont.)
• In the problem statement, the theoretical framework
should be introduced and an explanation about why it
was chosen discussed.
• At the end of the literature review, the framework should
be described and application to the study explained;
similar studies using the framework should be discussed.

Writing a Research Report—(cont.)
• In the methodology section, there should be an
explanation of how the framework is used in this study’s
design and how data collection methods (i.e.,
questionnaire items) reflect concepts in the framework.
• In the discussion section, describe how the findings are
consistent (or not) with the framework and offer
suggestions for practice or further research congruent
with the framework.

Areas of Evolving Nursing Science
• Health needs of vulnerable populations
• Practice strategies and outcomes (evidence-based
practice)
• Family health and transitions
• Health promotion and risk reduction
• Biobehavioral manifestations of health and illness

Areas of Evolving Nursing Science—
(cont.)
• Women’s health
• Health and illness of older adults
• Environments for optimizing client outcomes
• Genetics
• End-of-life issues

Chapter 19

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