Chapter 007

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

Chapter 7

Frameworks


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


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


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


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


Variables

Measurable forms of concepts Can assume at least two values

Present/absent Hot/cold Dead/alive


Links Among Constructs, Concepts, and Variables


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


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)


Three Forms of Simple Statement


Three Forms of a More Complex Statement


Direction


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


Shape

Linear relationship: the relationship between the two concepts remains consistent regardless of the values of each of the concepts


Shape (Cont’d)

Curvilinear relationship: the relationship between two concepts varies according to the relative values of the concepts


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)


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)


Symmetry


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


Sequencing


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


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)


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


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


Statement Hierarchy


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


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


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


Appraising Theories and Research Frameworks For Possible Study Use

Attempt to construct a theory, using theconcepts in the study


Appraising Theories and Research Frameworks For Possible Study Use (Cont’d)



Examine its logical structure: Is it clear? Does it have consistency?



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



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)



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”?


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


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)


Synthesis From Research Findings

Read related literature and sketch out how the variables relate to one another

Most accepted strategy of theory development


Proposing a Framework From Clinical Experiences


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)


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?


Conceptual Map (Cont’d)(example)

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