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Chapter 7
Frameworks
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Framework
A framework is an abstract, logical structure of meaning that guides the development of the study and enables the reader to link thefindings 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
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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
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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 declarethat a given concept exists or that a givenrelationship occurs
Scientific theories (sometimes called laws): theories for which repeated studies have validated the relationships among the concepts
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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
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Variables
Measurable forms of concepts Can assume at least two values
Present/absent Hot/cold Dead/alive
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Links Among Constructs, Concepts, and Variables
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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
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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)
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Three Forms of Simple Statement
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Three Forms of a More Complex Statement
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Direction
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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
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Shape
Linear relationship: the relationship between the two concepts remains consistent regardless of the values of each of the concepts
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Shape (Cont’d)
Curvilinear relationship: the relationship between two concepts varies according to the relative values of the concepts
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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)
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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)
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Symmetry
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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
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Sequencing
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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
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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)
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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
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Sufficiency
Sufficient relationship: when the first concept occurs, the second concept will occur, regardless of the presence or absence of other factorsIf 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) variableIf A, then B, but only if C
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Statement Hierarchy
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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
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Grand Theories
Table 7-4: Selected Grand Nursing Theories
Author (Year) Descriptive Label of the TheoryHenderson, 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 CareOrem, Dorothea (2001) Self -care Deficit Theory of NursingNeuman, Betty (Newman & Fawcett, 2002)
Systems Model of Nursing
Newman, Margaret (1986) Health as Expanding ConsciousnessNightingale, Florence (1859) Environmental Health
Parse, Rosemarie (1991) Human Becoming TheoryPeplau, Hildegard (1988, 1991) Interpersonal Relations TheoryRogers, Martha E (1970) Unitary Human BeingsRoy, Calista (1988) Adaptation ModelWatson, Jean (1979) Philosophy and Science of Caring
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Application of Middle-range Theories
Closer to the day-to-day substance ofclinical practice
Guide the practitioner to understanding theclient’s behavior, enablinginterventions that are more effective
Substantive/practice theories Used more commonly than grand theories
as frameworks for research
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Appraising Theories and Research Frameworks For Possible Study Use
Attempt to construct a theory, using theconcepts in the study
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Appraising Theories and Research Frameworks For Possible Study Use (Cont’d)
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Appraising Theories and Research Frameworks For Possible Study Use (Cont’d)
Examine its logical structure: Is it clear? Does it have consistency?
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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
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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)
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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”?
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Developing a Research Framework
Three basic approaches to beginning theprocess 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
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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)
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Synthesis From Research Findings
Read related literature and sketch out how the variables relate to one another
Most accepted strategy of theory development
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Proposing a Framework From Clinical Experiences
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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)
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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?
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Conceptual Map (Cont’d)(example)