How to choose a best-fit Theoretical Framework for Nursing Case Studies research?

In nursing case study research, various theories are used as a lens to guide the study and provide a deeper understanding of the phenomena under investigation. These nursing theories provide a theoretical foundation for understanding and addressing various aspects of patient care and healthcare delivery.

While conducting case study research in nursing, researchers may choose a theory based on the specific focus of their study and the aspects of nursing practice they aim to explore. It is essential to consult the original works of the theorists for a comprehensive understanding of each theory and its application in nursing contexts. Here are some theories, commonly used in nursing case studies:

1. Roy’s Adaptation Model:

• Developed by Sister Callista Roy (1999), this model focuses on individuals and groups adapting to changes in their environment.
• It includes concepts such as adaptation, stimuli, and coping mechanisms.
• This framework can be applied to explore how patients adapt to health challenges and the nursing interventions that facilitate adaptation.
• The model posits that individuals and groups strive to maintain integrity and well-being through adaptive responses to internal and external stimuli across various modes.
• The regulator and control processes facilitate feedback and adjustment while coping mechanisms represent strategies for managing stressors.
• The model provides a framework for understanding and guiding nursing interventions to support individuals in their adaptive processes.

2. Orem’s Self-Care Deficit Nursing Theory:

• Dorothea Orem’s theory (2001) emphasizes the patient’s ability for self-care and the role of nursing in assisting patients to meet their self-care needs.
• This theory emphasizes the concept of self-care, where individuals have the inherent ability and responsibility to meet their own needs for health.
• Self-care requisites and deficits are central concepts of this theory.
• Using this theory, researchers may investigate how patients engage in self-care and the factors contributing to self-care deficits.
• It emphasizes the patient’s ability for self-care and the role of nursing in assisting patients to meet their self-care needs.
• The theory introduces the notions of self-care requisites, self-care deficits, and nursing systems. Self-care requisites are categorized into universal, developmental, and health deviation requisites. When individuals are unable to fulfill these requisites, a self-care deficit occurs, requiring nursing interventions through wholly compensatory, partially compensatory, or supportive-educative nursing systems.
• The goal is to empower individuals to perform self-care and achieve optimal health outcomes.

3. Pender’s Health Promotion Model:

• The Nola Pender’s model (2015) focuses on promoting health and preventing illness.
• This model focuses on individual characteristics and experiences, behavior-specific cognitions and affect and behavioral outcomes to understand health-promoting behaviors.
• Key concepts of this model include perceived benefits and barriers, self-efficacy, interpersonal influences, and commitment to a plan of action.
• The model emphasizes the dynamic interplay between personal factors and environmental influences in shaping health behaviors.
• It provides a framework for designing interventions that enhance individuals’ motivation and ability to engage in health-promoting activities.
• In a case study, this framework can be applied to explore the factors influencing health-promoting behaviors in specific patient populations.

4. Watson’s Human Caring Theory:

• Developed by Jean Watson (2008), this theory emphasizes the importance of the nurse-patient relationship and caring as central to nursing practice.
• Carative factors and transpersonal caring are key elements. In a case study, researchers may explore how caring practices impact patient outcomes and experiences.
• Emphasizes the importance of the nurse-patient relationship and caring as a central component of nursing practice. Carative factors and transpersonal caring are key elements.
• The theory underscores the importance of fostering a caring environment that promotes healing, growth, and overall well-being.
• It encourages nurses to view patients holistically and engage in authentic, compassionate interactions to enhance the human experience of both the caregiver and the cared-for.

5. Leininger’s Transcultural Nursing Theory:

• Madeleine Leininger’s theory (1991), addresses cultural competence in nursing care, recognizing and respecting the diversity of patients’ cultural backgrounds.
• Cultural care diversity and universality are central concepts of this theory.
• It focuses on providing culturally congruent care by recognizing and respecting the diversity of individuals’ cultural backgrounds.
• The theory emphasizes the need for nurses to understand cultural influences on health beliefs and practices, ensuring that care is tailored to meet the unique cultural needs of each patient.
• It promotes cultural sensitivity and competence as essential components of effective nursing practice in a diverse healthcare landscape.
• In a case study, researchers may examine how cultural factors influence healthcare practices and outcomes.
• It addresses cultural competence in nursing care, recognizing and respecting the diversity of patients’ cultural backgrounds.

6. Neuman’s Systems Model:

• Betty Neuman’s model (2010) views the patient as an open system responding to stressors.
• Key concepts of this model include the normal line of defense, flexible line of defense, and lines of resistance.
• In a case study, researchers may explore how patients’ adaptive systems respond to stressors in different healthcare contexts.
• Views the patient as an open system responding to stressors in their environment. The model includes concepts such as the normal line of defense, flexible line of defense, and lines of resistance.
• The model emphasizes the dynamic interplay between the individual’s protective mechanisms and stressors, influencing their overall stability and well-being.
• Nursing interventions aim to strengthen the lines of defense, enhancing the individual’s capacity to adapt and maintain optimal health in the face of environmental challenges.

7. Swanson’s Theory of Caring:

• Kristin Swanson’s theory (1991) focuses on the different ways nurses express caring, including knowing, being with, doing for, enabling, and maintaining belief.
• In a case study, researchers may investigate the impact of these caring processes on patient outcomes.
• Focuses on the different ways in which nurses express caring. The five caring processes of this theory include knowing, being with, doing for, enabling, and maintaining belief.
• These processes reflect the essential components of effective nursing care, emphasizing the nurse’s understanding of the patient’s needs, active presence, practical assistance, empowerment, and fostering hope.
• The theory underscores the multidimensional nature of caring and highlights the importance of a holistic approach to nursing that encompasses both emotional and physical aspects of patient care.

8. Peplau’s Interpersonal Relations Theory:

• Hildegard Peplau’s theory (1952) emphasizes the importance of the nurse-patient relationship in the therapeutic process. Phases of the nurse-patient relationship include orientation, identification, exploitation, and resolution.
• In a case study, researchers may explore how effective interpersonal relations contribute to patient well-being.
• It emphasizes the importance of the nurse-patient relationship in the therapeutic process.
• Key concepts of the theory include therapeutic communication, nurse as a facilitator, and the patient’s psychosocial needs.
• The theory guides nursing practice by highlighting the significance of interpersonal interactions in promoting patient well-being and fostering a collaborative approach to healthcare.

9. Benner’s Novice to Expert Model:

• Patricia Benner’s model (1984), describes the stages of nursing proficiency from novice to expert. The model postulates that novice nurses follow rules, while expert nurses rely on intuition and experience.
• In a case study, researchers may explore how nurses at different proficiency levels approach patient care.
• Key concepts of the theory include the acquisition of knowledge, skills, clinical judgment, and intuition over time and experience.
• The model recognizes the progression from rule-based practice to intuitive decision-making, emphasizing the importance of experiential learning in developing nursing expertise.

10. Sullivan’s Interpersonal Theory:

• Harry Stack Sullivan’s theory (1953), focuses on interpersonal relations and the impact of individual and environmental factors on mental health. Concepts include anxiety and interpersonal security. In a case study, researchers may explore how interpersonal factors influence mental health outcomes in patients.
• The theory focuses on the impact of interpersonal relationships on mental health.
• Key concepts of the theory include anxiety, which arises from interpersonal interactions, and the significance of interpersonal security.
• The theory underscores the role of social interactions and the therapeutic potential of nurse-patient relationships in promoting mental well-being and addressing emotional challenges.

These nursing theories offer frameworks for understanding patient care, nurse-patient relationships, and the broader context of healthcare. These frameworks provide a foundation for understanding and interpreting nursing phenomena in various clinical and healthcare contexts. When choosing a theoretical framework for a nursing case study, researchers should consider the specific focus of their study and the aspects of nursing practice they aim to explore. Additionally, it’s important to engage with the original works of these theorists to gain a comprehensive understanding of their theories and principles.

It is worthwhile to remember that while selecting a theoretical framework for nursing case study research, it’s crucial to consider the specific research questions and objectives. Researchers may also combine elements from different theories to provide a more comprehensive understanding of the complex phenomena under investigation.

References:

1. Benner, P. (1984). From Novice to Expert: Excellence and Power in Clinical Nursing Practice.
2. Leininger, M. M. (1991). Culture Care Diversity and Universality: A Worldwide Nursing Theory.
3. Neuman, B. (2010). The Neuman Systems Model.
4. Orem, D. E. (2001). Nursing Concepts of Practice.
5. Peplau, H. (1952). Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing.
6. Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health Promotion in Nursing Practice.
7. Rosenstock, I. M. (1974). The Health Belief Model and Preventive Health Behavior.
8. Roy, C., & Andrews, H. A. (1999). The Roy Adaptation Model.
9. Sullivan, H. S. (1953). The Interpersonal Theory of Psychiatry.
10. Swanson, K. M. (1991). Empirical Development of a Middle Range Theory of Caring.
11. Watson, J. (2008). Nursing: The Philosophy and Science of Caring.