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Analyze and evaluate the Middle Range Theory. Identify application of nursing theories into clinical practice.
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Topic: Kolcaba’s Theory Evaluation Recommendations end page 121 to beginning 123

Kolcaba’s Theory Evaluation Recommendations
A recent contribution to this discussion of theory evaluation comes from Kolcaba. According to Kolcaba (2001), there are several criteria that determine a good middle range theory. Her criteria involve evaluation and do not mention steps for theory analysis. They include questions concerning the theory’s concepts and propositions and whether or not they are specific to nursing. She also wants to determine if the theory has components that are readily operationalized and can be applied to many situations. She asserts that a middle range theory’s propositions can range from causal to associative, depending on their application. The assumptions provided fit the middle range theory. The theory should be relevant for the potential users. The middle range theory should be oriented to outcomes that are important for patients and not merely describe what nurses do. Finally, Kolcaba thinks that middle range theory should describe nursing-sensitive phenomena that are readily associated with the deliberate actions of nurses.
An interesting review process of the Synergy Middle Range Theory (see Chapter 5, Synergy Model) took place during its development. A committee of experts in the analysis of theoretical and conceptual frameworks was assembled to review this theory in order to identify its strengths and weaknesses and to obtain recommendations regarding the refinement of the model (Sechrist, Berlin, & Biel, 2000). This review committee was made up of the following nurse leaders: Barbara Stevens Barnum, RN, PhD; Marion Broome, RN, PhD; Rose Constantino, RN, PhD; Jacqueline Fawcett, RN, PhD; Edna Menke, RN, PhD; Carolyn Murdaugh, RN, PhD; Patricia Moritz, RN, PhD; Bonnie Rogers, DPH, COHN-S; and Marilyn Frank-Stromborg, EdD, JD, ANP. This esteemed committee developed a review instrument that was organized into six criteria. These criteria included the headings of clarity, consistency, adequacy, utility, significance, and summary. When compared to the recommended criteria listed in this chapter, the expert review committee decided to evaluate the synergy theory on fewer criteria. Their evaluation left out “logical development” and “determining the level of theory development” in the appraisal of internal theory analysis. When determining which criteria to include for the external middle range theory analysis, they chose to reduce the list to just three criteria, leaving out complexity, discrimination, reality convergence, pragmatic, and scope. They did add one new criterion, which may act as a “catch all” for the criteria left out, which they called the summary. In a PowerPoint presentation that was posted on the World Wide Web, Fawcett has suggested an even smaller set of criteria to evaluate middle range theories. Her list is short and includes just four total criteria: significance, internal consistency, and two new criteria, parsimony and testability (Fawcett, 2005).
It is evident that there are several distinct differences between the analysis and evaluation process for grand theories and middle range theories. At the same time, there are several similarities. Many of the principles applied to the analysis and evaluation of grand theories can be readily applied to middle range theories and, with some minor modification, can be used to determine the adequacy of a middle range theory. With this in mind, the next section will address the selection of a middle range theory for use in nursing research.