Running head NURSING PROBLEM .docx

Running head: NURSING PROBLEM
1
NURSING PROBLEM
2
Nursing Problem
Student’s Name
Institutional Affiliation
Date
Specialization: Nursing Practitioner.
As a nursing practitioner, the major roles include the
assessment of the needs of the patients. A nursing practitioner
also orders and interprets test from laboratories, they do illness
and disease diagnosis, medication prescription and formulate
plans for treatment. There are a number of challenges that face
the nurse in their field of practices. This paper will focus to
discuss the hazards in the workspace of these practitioners. It
will also seek to find a way of solving these challenge using
innovative means.

The Problem of Interest
Hazard in The Nursing Field.
The nursing field of practice is one of the most dangerous
places of working as one does work in a delicate environment
where one is in the risks of being infected or even injuring
oneself. Nurses are faced with a number of risks in daily job
activities. Some of these hazards include injuries, flu germs,
hand washing –related dermatitis and pathogens that are based
in the blood among others.
According to the report produced by OSHA, about 5.6 million
of 12.2 million workers are under the risk of being exposed to
blood borne pathogens. This is a big number of health workers
under the risk meaning that soon there will be a shortage of
health nursing or health workers in general. Moreover, the rates
of risks are higher in the health care industry than any other
industries. This industry has registered around 35000 injuries
covering different parts of the body. These range from the
shoulders, hands, feet, and back. These statistics are according
to the Bureau Labor Statistics (Gooch, 2015).
Apart from the acute injuries discussed, they also suffer harm
exposed on their hands. From a recent study carried out in the
University of Manchester, the health workers that follow
protocols are 4.5 times exposed to skin damage risks. The
report also reported up to 25 percent of cases of irritant contact
dermatitis.
These individuals also get exposed to infectious diseases in
their areas of practice. One of the most commonly contacted
infection is Hepatitis B (HBV). This is infection can be
contacted via blood contact, feces, saliva, and semen. This
instrument of spreading the infection is in contact with the
patient and also the needles (Gooch, 2015). Nursing
practitioners also risk exposure to toxic substances in the
clinical environment. Radiation is another risk that comes
majorly from the ionizing radiation. Complications associated
with radiation include skin cancer, leukemia, and cancer among
others. One comes to contact with this radiation in the

instances of performing x-ray scans. Another challenge that
faces nursing practitioners is stress. This is experienced mostly
among the nurses who work with the patients that are terminally
or chronically ill (NCBI, 2016).
Research Strategy.
The focus of the research is on the articles that are based on
nursing practices. These articles also further narrow down to the
specific problems facing the nursing practitioners. The aim is to
find a solution to the above-identified problem.
Innovative
Solution
.
It was crucial to put up ways to protect nursing practitioners. It
is important to take extra measures when working in various
situations. Capacity building of the nurses on the safety
measures while working is very important. They should also be
educated on using the protective gear which will reduce
exposure to risks. For instance, the use of antiviral face mask
inactivates the 99.99 percent of the flu viruses tested in the
laboratory.

References
Gooch, K. (2015, August 13). 5 of the biggest issues nurses face
today. Becker's Hospital Review. Retrieved from
https://www.beckershospitalreview.com/human-capital-and-
risk/5-of-the-biggest-issues-nurses-face-today.html
Gooch, K. (2015, July 15) 4 common nursing hazards
demanding hospitals' attention. Clinical Leadership & Infection
Control. Retrieved from
https://www.beckershospitalreview.com/quality/4-common-
nursing-hazards-demanding-hospitals-attention.html
NCBI (2016). Nursing Health & Environment: Strengthening the
Relationship to Improve the Public Health. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK232400/

R esearch
R o u n d ta b le Lynne M . C o n n e lly
Use o f Theoretical Frameworks
in Research
R eaders of research reports probably have noticed some studies
explicitly name a theory that guided the research and some do
not. It is not always clear
in reports what role the theory or theoretical framework
played (or did not play) in the research. In this issue,
Parker (2014) outlined a study about decision making by
medical-surgical nurses when they activate rapid response
teams. In the report, in the section called "Nurse Decision
Making," the author concisely discussed theories of deci-
sion making and the models of decision making that oth-
ers have used to examine the topic with nurses. In addi-

tion, Parker used an instrument to measure decision mak-
ing based on these various decision-making models. This
report is a useful example of how theory guides research
and also makes sense of the subsequent findings.
W hat Is a theory?
First, various terms are used to refer to the theoretic
basis of a study, including theory, theoretical framework,
conceptual framework, and models. Theory is a set of inter-
related concepts (or variables) and definitions that are
formed into propositions or hypotheses to specify the
relationship among the constructs (Creswell, 2013). A for-
mal theory is well-developed and is useful to predict
behavior or outcomes. A theoretical framework or con-
ceptual framework is less formal and typically less devel-
oped than a formal theory. Such a framework often is use-
ful when exploratory work is being done to expand the
theoretical ideas. A conceptual model usually is focused
more narrowly and structured more loosely than theories,
and does not link concepts (Polit & Beck, 2014). For
example, the Lauri and Salantera (2002) instrum ent is
based on a model that describes how nurses make deci-
sions but does not predict how effective each type is in
making decisions. For the purposes of this column, I use

the general word theory to encompass all these terms.
In simple terms, a theory is a representation of a por-
tion of reality that helps us make sense of complex phe-
nomena. It is not the reality itself; it is a tool for better
understanding. Theories are not right or wrong but some
theories offer a better fit for particular situations. Each
theory can provide a different lens for looking at a prob-
lem, allowing it to be examined from different perspec-
tives for full understanding of all its facets (Reeves, Albert,
Kuper, & Hodges, 2008).
Lynne M. Connelly, PhD, RN, is Associate Professor and
Director of
Nursing, Benedictine College, Atchison, KS. She is Research
Editor for
MEDSURG Nursing.
MEDSURG n u r s in g . May-june 2014 • Vol. 23/No. 3
Theory in a study can be stated clearly or it can be
implied (Bond et al., 2011). For example, in physiological
studies, the framework usually is drawn from current
understanding of physiology and pathophysiology. It
often is presented as the state of science in a particular

area. In more abstract areas of research, specific theory
can be useful to frame the problem, develop an interven-
tion, and guide the research study.
A theory about a phenom enon, such as nurse decision
making, parsimoniously explains how nurses make deci-
sions in the practice setting. Each theory will have a num -
ber of interrelated concepts. Concepts are abstract repre-
sentations of specific parts of the theory (Polit & Beck,
2014). In the Parker (2014) study, the decision-making
models described how different people have different
ways of making decisions. Some people are intuitive deci-
sion makers, some are analytical decision makers, and
others use both types of decision making. While it can
seem even more complex, this concise depiction helps us
understand the process of making a decision and measure
how each nurse in a study normally makes decisions.
Guiding Research
A theory should not be added to a study because the
researcher was told in school that a theory is needed for a
research study. A clear connection should exist among
the theory, the problem or phenom enon being studied,
and the research method. For example, Parker (2014)

used an instm m ent developed by Lauri and Salantera
(2002) based on the various models of decision making.
Using a valid instm m ent based on theory allows the
researcher to make comparisons between the results of
different studies that otherwise could not be made if the
researcher used a separate instm ment. In addition, when
conducting the study, the researcher also is testing the
theory to determine if it works in the study population.
In Parker's (2014) study, a factor analysis showed items
measuring analytic decision making correlated with each
other and intuitive decision-making items correlated
with each other; however, each of these did not correlate
significantly with the other type. In other words, intuitive
items were connected with other intuitive items, but not
with analytic items. The same is tm e for analytic items.
This supports the validity of the instm m ent and also sup-
ports the theory that guided development of this instru-
ment. W hen we review the results, then, we can have
some confidence they are measuring aspects of the theo-
ry appropriately. In addition, investigators should make
connections between their results and the theory clear in
187

R esearch R o u n d ta b le
their discussion of the findings. They should relate their
results to other research in which the theory was used.
Parker compared his results to results by Lauri and
Salantera (2002).
In another example, Yoder (2005) described how the
Roy Adaption Model was used in several studies: a study
of quality of life in patients with cancer, a study of exer-
cise intervention in patients with cancer, and another
study of clinical outcomes in patients with burns. Yoder
presented figures outlining each aspect of the theory and
how each aspect was measured. Each of the studies pro-
vided results helpful to patients, but they also provided
support for the Roy Adaptation Model. The figures in this
article are useful examples of how to make clear connec-
tions between concepts within a theory or model and the
measurement instruments. This can be particularly useful
in research proposals.
Theory also is used to guide the development of effec-
tive interventions for patient care. In this case, theorists

may use both theory and empirical results to suggest one
variable (the intervention) can have a positive effect on
another variable (e.g., a person's behavior or physical
outcome). If a theory indicates, for example, that teach-
ing a patient about his or her disease will improve self-
management, th en we could conduct an intervention
study to test that proposition. Theory also may provide
us with other variables that can moderate this effect
(Polit & Beck, 2014).
O t h e r Is s u e s
W hen research results are not what were expected, two
reasons are possible: either the research design or measure-
m ent of variables was flawed, or the theory guiding the
research did not fit the situation or population. In the case
of an inappropriate theory, the researcher may be able to
suggest modifications to the theory. The modifications
then would need to be tested. Useful theory is refined by
this iterative process (Johnson & Webber, 2010).
In qualitative research, theory can have several purpos-
es. General theories, such as interactionism and critical
theory, can be used to guide qualitative research (Reeves
et al., 2008). These are theories that conceptualize how

we should study phenom ena (Polit & Beck, 2014;
Sandelowski, 1993). On the other hand, qualitative inves-
tigators often want to generate rather than test theory
based on what they find with their particular informants.
Prior to and during data collection, researchers often
avoid substantive theory about the specific phenom ena
to prevent being influenced by prior theorizing about the
topic. Thus, the theory generated in qualitative research
is grounded in data that come from directly observing
and talking to the participants (Creswell, 2013).
This short column can not cover all the nuances of
theory and research. Readers can refer to the references
cited or to a good research textbook to obtain more infor-
mation. Because theory is im portant to conducting and
understanding research findings, readers should under-
stand what theory is and how a researcher can use it effec-
tively to guide a study. i ’»:i
REFERENCES
Bond, A., Eshah, N., Bani-Khaled, M., Hamad, A., Habashneh,
S.,
Kataua’, H..... Maabreh, R. (2011). Who uses nursing theory? A
univariate descriptive analysis of five years’ research articles.

Scandinavian Journal o f Caring Sciences, 25(2), 404-409.
Creswell, J.W. (2013). The use of theory. In J.W. Creswell
(Ed.) Research
design: Qualitative, quantitative, and mixed methods approaches
(4th ed.) (pp. 51-76). Los Angeles, CA: Sage.
Johnson, B.M., & Webber, P.B. (2010). An introduction to
theory and rea-
soning in nursing. Philadelphia, PA: Wolters Kluwer/Lippincott
Williams & Wilkins.
Lauri, S., & Salantera, S. (2002). Developing an instrument to
measure
and describe clinical decision-making in different nursing
fields.
Journal o f Professional Nursing, 18(30), 93-100.
Parker, C.G. (2014). Decision making models used by medical-
surgical
nurses to activate rapid response teams. MEDSURG Nursing,
23(3), 159-164.
Polit, D.F., & Beck, C.T. (2014). Essentials o f nursing
research:

Appraising evidence for nursing practice. Philadelphia, PA:
Wolter
Kluwer/Lippincott Williams & Wilkins.
Reeves, S„ Albert, M., Kuper, A., & Hodges, B.D. (2008). Why
use theo-
ries in qualitative research? BMJ, 337, 631-634.
Sandelowski, M. (1993). Theory unmasked: The uses and guises
of the-
ory in qualitative research. Research in Nursing and Health, 16,
213-218.
Yoder, L.H. (2005). Using the Roy Adaptation Model: A
program of
research in a military research service. Nursing Science
Quarterly,
18(A), 321-323.
M
E
D
S
u
R

G
P ersistent D iffe re n c e s Found in
P re v e n tiv e Services Use w ith in th e
U.S. P o p u la tio n
Large differences in adult use of preventive serv-
ices persisted from 1996 through 2008 across popu-
lation groups defined by poverty, race/ethnicity,
insurance coverage, and geography. Researchers
examined trends in five preventive services: general
checkups, blood pressure screening, blood choles-
terol screening, Pap smears, and mammograms.
Among the population of nonelderly adults
(ages 19-64 years), the proportion of the population
having a general checkup increased 1.1% from
1996/1998 to 2007/2008; the proportion of those
with blood cholesterol screening within the prior 5
years increased by 8.2%. In contrast, the percentage
of the population having blood pressure screening
or mammograms (among women) increased mod-
estly between the first pair of time points, but
remained essentially constant thereafter. Finally,
the percentage of women having Pap smears

increased modestly (by 2.1%) from 1996/1998 to
2002/2003, but decreased by about a percentage
point subsequently to the end of the study period.
More details are in Abdus & Selden (2013).
Preventive services for adults: How have differences
across subgroups changed over the past decade?
Medical Care, 51(11), 999-1007. EB3I
188 MayJune 2014 • Vol. 23/No. 3 MEDSURG UXJHSIMG,
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Publications, Inc. and its content
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July 2014 | Volume 21 | Number 6 © RCN PUBLISHING /

NURSE RESEARCHER34
Nurse Researcher
Introduction
THIS PAPER aims to help the researcher to
understand the nature of theoretical and conceptual
frameworks and how they can be used to help give
direction to a study, or be identified as an outcome.
The use of theoretical and conceptual frameworks is
part of research, but is relatively obscure among the
myriad of literature available. In published research
reports, there is often no explanation as to what
theoretical and conceptual frameworks are, and they
are mentioned in many popular research textbooks
at best minimally and often as terms in a glossary.
There appears to be no manual about how theoretical
and/or conceptual frameworks should be used.
This paper examines what the literature says
in relation to theoretical and/or conceptual
frameworks and considers how researchers seem
to be using them. It also shows how a conceptual
framework was used in case study research to
determine the professional jurisdictions of doctors

and nurses in the supply and prescription of
medicines, and ultimately to the development of
a conceptual model.
Definitions of frameworks
Fain (2004) defined theory as ‘an organised and
systematic set of interrelated statements (concepts)
that specify the nature of relationships between
Correspondence
Helen Elise Green
[email protected]
Helen Elise Green PhD is
director of student education
at the University of Leeds, UK
Peer review
This article has been subject
to double-blind review and
has been checked using
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Author guidelines
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Abstract
Aim To debate the definition and use of theoretical
and conceptual frameworks in qualitative research.
Background There is a paucity of literature to
help the novice researcher to understand what
theoretical and conceptual frameworks are and
how they should be used. This paper acknowledges
the interchangeable usage of these terms and
researchers’ confusion about the differences between
the two. It discusses how researchers have used
theoretical and conceptual frameworks and the
notion of conceptual models. Detail is given about
how one researcher incorporated a conceptual
framework throughout a research project, the
purpose for doing so and how this led to a resultant
conceptual model.
Review methods Concepts from Abbott (1988) and
Witz (1992) were used to provide a framework for
research involving two case study sites. The framework
was used to determine research questions and give
direction to interviews and discussions to focus
the research.

Discussion Some research methods do not overtly
use a theoretical framework or conceptual framework
in their design, but this is implicit and underpins the
method design, for example in grounded theory. Other
qualitative methods use one or the other to frame the
design of a research project or to explain the outcomes.
An example is given of how a conceptual framework
was used throughout a research project.
Conclusion Theoretical and conceptual frameworks
are terms that are regularly used in research but rarely
explained. Textbooks should discuss what they are
and how they can be used, so novice researchers
understand how they can help with research design.
Implications for practice/research Theoretical and
conceptual frameworks need to be more clearly
understood by researchers and correct terminology
used to ensure clarity for novice researchers.
Keywords Theoretical framework, conceptual
framework, case study, conceptual model, qualitative
research, research design, case study research.

Date of submission: May 22 2013. Date of acceptance: August
28 2013.
Cite this article as: Green H (2014) Use of theoretical and
conceptual frameworks in qualitative research.
Nurse Researcher. 21, 6, 34-38.
Use of theoretical and conceptual
frameworks in qualitative research
© RCN PUBLISHING / NURSE RESEARCHER July
2014 | Volume 21 | Number 6 35
Methodology
two or more variables, with the purpose of
understanding a problem or the nature of things’
and concepts as ‘symbolic statements describing
a phenomenon or a class of phenomena’.
It is a matter of interpretation as to when
concepts become organised and interrelated
enough to be deemed theories, which might explain

why the two terms are used interchangeably when
referring to frameworks. However, Parahoo (2006)
suggested that ‘theoretical framework’ should
be used when research is underpinned by one
theory and that a ‘conceptual framework’ draws
on concepts from various theories and findings
to guide research. This is a slightly different
interpretation to that of Fain (2004) because, instead
of suggesting that the concepts have been built
into a theory, it suggests that parts of multiple
theories have been taken.
Whether these distinctions matter is questionable.
Parahoo (2006) implied that it is fruitless to
consider whether a researcher has used the correct
terminology and it is far more important to consider
how theory has been used to underpin the study.
Authors use the terms ‘conceptual framework’
and ‘theoretical framework’ interchangeably
(Fain 2004, Parahoo 2006). Some authors only
refer to one. For example, Lacey (2010) referred
to conceptual frameworks, suggesting that they
identify researchers’ ‘world views’ of their research
topics and so delineate their assumptions and pre-

conceptions about the areas being studied. Fain
(2004) suggested that where a framework is based
on concepts, the framework should be called a
conceptual framework, and where it is based on
theories it should be called a theoretical framework.
Given that there is confusion between theoretical
and conceptual frameworks, it could be argued
that they are of questionable value. However,
frameworks have been described as the map for
a study, giving a rationale for the development
of research questions or hypotheses (Fulton and
Krainovich-Miller 2010). LoBiondo-Wood (2010)
similarly said that the framework is the design
and added that the research question, purpose,
literature review and theoretical framework should
all complement each other and help with the
operationalisation of the design.
It can be seen that the authors are saying that the
framework should be there to assist researchers in
ensuring that their research projects are coherent
and to focus their minds on what the research is
trying to achieve. Rathert et al (2012) illustrate
this confusion. In the title, the authors suggest

they have tested a theoretical framework but then
discuss a conceptual model. However, they use
the term ‘conceptual framework’ as a title for its
diagrammatic representation. There is no discussion
of what these terms mean.
Robson (2002) suggested that a conceptual
framework is often developed as a diagram, whereas
Parahoo (2006) refers to this as a conceptual model,
although again believes that researchers should not
get hung up on terminology.
It could be concluded that a diagrammatic
representation of a theoretical framework might
therefore be termed a theoretical model. It is,
however, less likely that one would diagrammatically
represent a single theory rather than concepts,
which either are being used to build up to a theory
or are taken from different theories.
While the confusion around the use of
conceptual and theoretical frameworks and models
may be understandable, a similar laissez-faire
approach to accuracy would not be considered

acceptable for other parts of research design.
More discussion in textbooks and journal articles
about how to use frameworks might allay
some of the confusion.
Using a framework
Some research approaches appear not to use a
conceptual or theoretical framework in their design.
‘Grounded theory’, for example, is an inductive
method in which theory generation comes from
the data. It was an approach that went against
the accepted wisdom of the 1960s that a study
should have a definite theory before it begins
(Robson 2002). It is an example of a methodological
approach that is based on a specific epistemology
or philosophy of knowledge (Avis 2003). Corbin
and Strauss (2008) discussed the epistemology of
grounded theory in some detail. However, as this
methodology has developed, the epistemology has
also developed (Hall et al 2013).
The development of theoretical or conceptual
frameworks can be undertaken as an outcome of
the research but it is unlikely that one will be stated
as part of the design. However, projects using

these methods do have a theoretical framework:
that of the philosophy or epistemology on which
the research approach is based. For example,
Curtis et al (2012) discussed how grounded theory
methodology is based on the epistemology of
symbolic interactionism and so they did not identify
a theoretical or conceptual model in the design
of their research. In their findings, they discussed
the concept that emerged from their research of
the dissonance for students of professional ideals
and the reality of practice. They then showed this
diagrammatically in a conceptual model.
NURSE RESEARCHER36
Nurse Researcher
There appear to be two main ways in which
researchers who use other qualitative methods use
theoretical and conceptual frameworks.
The first is in the design of the study where,

if it is explicit, the framework can often be found
as a section in the literature review (Fulton and
Krainovich-Miller 2010). However, many authors
(Polit and Tatano Beck 2004, Parahoo 2006, Fulton
and Krainovich-Miller 2010) have found that
researchers often do not make the theoretical or
conceptual frameworks of studies explicit in relation
to how these guided their studies. This does not
mean that they did not have such frameworks,
simply that they may be embedded in the literature
review (Fulton and Krainovich-Miller 2010).
Somekh and Lewin (2005) suggested that most
social science research starts with a theoretical
framework, goes on to analyse the data, before
developing new theories or variations of existing
theories as outcomes.
Robson (2002) suggested that most new
researchers find it useful to develop a conceptual
model – the diagrammatic form of a conceptual
framework – and refine it as data collection and
analysis takes place. LoBiondo-Wood (2010) felt
that the fit between the theoretical framework and
the other steps of the research after the design

strengthens the study and gives the researcher
confidence in the evidence provided by the findings.
Even where theoretical or conceptual frameworks
are mentioned in the title of an article, it is unusual
for there to be a discussion of what these are in
the article itself. However, Goddard et al (2013)
used a theoretical framework in the design of
their randomised controlled trial and Smith et al
(2012) identified a theoretical framework before
researching the knowledge base of screening tools.
The second way in which researchers use
theoretical and conceptual frameworks is in
developing a framework. Parahoo (2006) argued
that generating theory is the purpose of most
qualitative research. Polit and Tatano Beck (2004)
suggested that the role of conceptual and theoretical
frameworks is to make the research findings
meaningful and generalisable. They suggested that
the linking together of findings into a coherent
structure can make them more accessible and so
more useful to others.
Fletcher et al (2012) used grounded theory in

relation to the organisational factors that cause
sports performers stress. They then used their
findings to develop a conceptual framework.
Again, although ‘conceptual framework’
is in the title of their article, there is no
explanation of what such a framework is.
Fulton and Krainovich-Miller (2010)
acknowledged that many researchers do not bother
to use a theoretical framework and the Critical
Appraisal Skills Programme (CASP) does not make
any mention of trying to identify a theoretical
or conceptual framework in a research article
(CASP 2010). This suggests that it does not see
the presence of one as crucial to the generation
of good qualitative research.
Nevertheless, it is not unusual for those
undertaking research as part of a programme of
learning to be asked to include such a framework
in their projects, usually at the proposal stage.
Because so little is written about frameworks, this
can confuse students trying to understand what
is being asked of them. Books written to support
students in achieving a PhD may not provide much

help, as some do not mention the use of theory in
study design (Phillips and Pugh 2005).
At this point in time, finding a theoretical or
conceptual framework can be seen as another
hurdle to overcome, rather than something to
assist researchers in keeping their projects focused
and on track.
Use of a framework in a PhD project
A PhD study by Green (2008) used a case study
approach to consider the professional jurisdictions
of nursing and medicine in relation to the supply
and prescription of medicines by nurses in the acute
hospital setting. The study was undertaken over a
period of time when the supply and prescription
of medicines by nurses was relatively new but the
regulations set by the Department of Health (DH)
were being relaxed (DH 2005).
The study aimed to examine the attitudes of
doctors and nurses in relation to their professional
boundaries in the light of the legalising of
prescribing for nurses. At this time, there was
some research evaluation of prescribing but this

tended to focus on the prescribing rather than what
professionals thought about the notion. Where
professional attitudes of doctors or nurses were
mentioned, it was as a secondary outcome, rather
than the main focus (Latter et al 2004, Bradley and
Nolan 2007, Courtenay 2007).
It terms of a framework to guide the study
and aid the way it was organised, the body of
work that has been undertaken in relation to
the Sociology of Professions appeared relevant
to the project. The theories of two sociologists
were used (Abbott 1988, Witz 1992). The focus
of the research was new work for the profession
of nursing and in an area that had been a monopoly
for doctors previously.
© RCN PUBLISHING / NURSE RESEARCHER July
2014 | Volume 21 | Number 6 37
Methodology
Abbott (1998) and Witz (1992) had both looked

at the movement of work from one profession to
another. However, concepts from their theories were
used, rather than the full theories. The research was
based on the following concepts (Abbott 1988):
■ Professional jurisdictions: the boundaries of work
‘owned’ by a profession.
■ Authority: the type of authority that a profession
has to undertake its work.
And from Witz (1992):
■ Exclusion: attempts to ensure that members of
a profession are prevented from undertaking
specific aspects of work.
■ Usurpation: attempts to include specific
aspects of work normally carried out by
another profession.
These concepts were used to frame the research
questions and were also used to develop a model
to try to explain the past and present situation in
relation to doctors, nurses and prescribing.

The research data were then collected through
observation, semi-structured interviews and
document analysis at two case study sites.
Categories and sub-categories were identified from
the data and described as part of the study.
The discussion could have centred on the
categories identified. However, it was at this point
the data were brought back to what the categories
had to say about the above concepts and how the
research questions centred on these concepts were
answered. There were new conceptual models
developed from the data that represented variation
between the two sites in terms of the concepts
identified at the beginning of the research.
An example of a conceptual model can be seen in
Figure 1. As this shows, the weight of intervention
by the management of the organisation to support
nurse prescribing seemed to have an effect on
its introduction to the organisation but the main
concepts are visible in the model.
A conceptual framework was present throughout

the research project and report. It helped frame
the research’s questions, design and outcomes. The
same data may have been collected if a different
theoretical or conceptual framework had been used
or if no framework had been there, but it is likely
that it would have been represented differently.
The use of a framework helped the researcher to
order her thoughts and organise the way the data
would be represented.
The use of a conceptual framework had started
as an academic exercise to fulfil the demands of
an academic supervisor and the expectations of
a PhD project. It is probably only now, looking
back at the project, that the extent to which the
conceptual framework pervaded it is apparent.
The existence of the conceptual framework was
helpful in ensuring the research was given order
and achieved completion in a way that could clearly
be communicated to its readers.
Figure 1 Workplace authority for the supply and prescription of
medications by nurses
Supportive

doctors
The state
Supply and
prescription:
intellectual
jurisdiction
Exclusion
Usurpation
Organisation
Non-supportive
doctors
Nurses
Supportive
doctors
The state
Supply and
prescription:

intellectual
jurisdiction
Exclusion
Usurpation
Organisation
Non-supportive
doctors
Nurses
NURSE RESEARCHER38
Nurse Researcher
Conflict of interest
None declared
Online archive

For related information, visit
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using the keywords
Conclusion
As with many topics, in research there is a language
to be learned by those who are going to become
expert researchers. Much of this is explicit and
can be read about in research texts and published
papers. Although researchers can read extensively
about research methodologies and data collection
methods, this is not the case for theoretical and
conceptual frameworks. This may be because, to
seasoned researchers, it is so ingrained that it is
unworthy of comment, or perhaps it is because
these concepts are not overtly discussed and
many researchers are confused about the correct
terminology. Certainly, it might be expected that
where a term – such as conceptual or theoretical
framework – was included in a title of a published
research paper there would be an explanation of it
somewhere in the paper. However, this rarely occurs.
If the apparent mysticism of theoretical and
conceptual frameworks is to be debunked,

then they need to be included as significant
sections in publications. The focus of the
frameworks as an aid to researchers to help ensure
that they have framed their research coherently
throughout their design should be ensured. For
those who find diagrammatic representation
helpful, the use of models as a way of illustrating
the framework for others should be encouraged.
It would be good to see the nuances of
differences between concepts and theories discussed
more regularly so all researchers understand their
meaning or why variation in meaning is acceptable
when using different approaches. This occurs
with other parts of research and if we are to
assist future researchers, it needs to happen with
theoretical and conceptual models and frameworks.
Novice researchers need to know that frameworks
and models are there to help them and are not just
another hurdle to be overcome to in the battle to
achieve accreditation as a researcher.
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