It is becoming widely accepted in modern nursing practice that theory is a pillar of nursing. It influences theory and research by acting as both a framework and a driving force for further investigation. Each theory is built from conceptual components and relationships between them – statements (McEwin & Wills, 2019). By understanding the essence of conceptual components and the types of connections between them, one can use theory in practice, modify existing theories, or introduce new frameworks for viewing healthcare problems.
Conceptual components are the building blocks of any existing or future theory. According to McEwin and Wills (2019), concepts can be defined as the “linguistic labels that are assigned to objects or events” (p. 98). For example, such words as “anxiety” or “motivation” are conceptual components when they are defined within the practice. Gray et al. (2017) provides an example of “anxiety” and describes the feelings that are usually associated with it, including uneasiness, and physiological responses – increased pulse rate and sweating palms. By using these simple descriptions, a concept is formed, which can then be used in a statement to define a relationship and create a hypothesis and, with enough evidence, a theory.
Structural Relationship of Components and Statements to a Specific Theory
Therefore, one can see that theory development is directly related to the creation and definition of concepts. It is possible to present any theory as a sum of concepts and their connections. These links, also called statements, can be relational and non-relational (existence statements). Existence statements clarify meanings of the concepts without relating several concepts to one another. An example of an existence statement in Newman’s Health as Expanding Consciousness Theory is that a pattern is the “information that depicts the whole” (Endo, 2017, p. 51). In contrast, relational statements link two or more concepts in a theory; for instance, “health” is a pattern that involves “patterns of disease” (Endo, 2017, p. 51). The fundamental concept of “health” that is defined in all nursing theories is connected to the specific concept of a “pattern” specific to this theory. As a result, a new vision of health is created, allowing nurses to envision nurse-patient relationships in a new way.
In the example of Newman’s Health as Expanding Consciousness Theory, the concept of patterns is used to explain the constantly evolving health of people; nurses’ role is to help the patient see these patterns and reveal paths for improvement. Rushing (2008) uses this approach to improve a patient’s recovery from drug and alcohol addiction. Thus, the grand theory’s conceptual components are reimagined and applied in practice. Nurses view their patient’s health and behaviors of addiction as patterns that can be changed to reach a better state of being (Rushing, 2008). As an outcome, a specific theory is applied to practice in more than one way, revealing the flexibility of using well-structured, concept-based frameworks.
Theory informs nursing practice and creates a foundation for making changes in people’s health. In turn, conceptual components are the building blocks of any theory – they help define the main ideas and objects present in the framework. At the same time, their relationships explain the phenomena that nurses want to address. In the theory of Health as Expanding Consciousness, the concept of “pattern” is taken as the basis of understanding the changing nature of health, and it can be used by nurses to explain various patient behaviors, including addiction.
Endo, E. (2017). Margaret Newman’s theory of health as expanding consciousness and a nursing intervention from a unitary perspective. Asia-Pacific Journal of Oncology Nursing, 4(1), 50-52. doi: 10.4103/2347-5625.199076
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Saunders Elsevier.
McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Wolters Kluwer Health.
Rushing, A. M. (2008). The unitary life pattern of persons experiencing serenity in recovery from alcohol and drug addiction. Advances in Nursing Science, 31(3), 198-210. doi: 10.1097/01.ANS.0000334284.73730.75