Middle-Range Theories in Nursing

Middle-range theories aid nurses in bridging the gap between nursing practice and grand theories. Since grand theories are broad in scope, remote from empirical findings, and complex in abstraction, middle-range theories narrow down the scope, enhance proximity to empirical findings, and simplify abstraction (Jaarsma, Riegel, & Stromberg, 2012). In the quality of the scope, middle-range theories narrow down the scope by using a few concepts while focusing on the specific phenomenon. The proximity to empirical findings is an important quality of middle-range theories since they are closer to empirical findings than grand theories and models. Regarding the quality of abstraction, middle-range theories simplify the abstraction of concepts and constructs by focusing on specific situations. In essence, middle-range theories enhance the empirical application of grand theories and models in nursing practice. Thus, this essay cites the application of middle-range theories in nursing practice.

Self-care is a middle-range theory that nurses apply in the management of chronic diseases that are prevalent among adults. The middle range theory of self-care bridges Dorothea Orem’s grand theory of self-care and the practice of nursing patients with chronic illnesses. According to Jaarsma, Riegel, and Stromberg (2012), “self-care maintenance, self-care monitoring, and self-care management” are key concepts that the middle-range theory of self-care examines (p. 195). Self-care maintenance entails the sustenance of lifestyles and interventions aimed at ameliorating chronic diseases. For instance, among diabetic patients, maintenance of a healthy diet, physical exercise, and medication adherence constitute self-care management.

Self-monitoring is another concept of the middle-range theory of self-care that requires patients to check their chronic conditions regularly. For instance, monitoring diabetes requires patients to measure their blood sugar regularly and take appropriate action before the blood sugar gets out of the normal range. Self-care management is a concept that enables patients with chronic illnesses to assess their conditions and determine whether they need to seek medical attention or not. Healthy coping behavior and problem-solving skills are central to the management of diabetes (Shrivastava, Shrivastava, & Ramasamy, 2013). Therefore, the middle range theory of self-care is effective in the management of chronic conditions such as diabetes.

Swanson Caring Theory is a middle-range theory that is applicable in bridging the gap between Caring Theory and nursing practice in Carolina according to the Carolina Caring Model. Swanson Caring Theory perceives nursing practice as processes, actions, and expectations, which emanate from informed caring. Tonges (2011) states that maintaining belief, understanding others, having empathy, helping others, and facilitating care are five basic processes that enhance the capacity of nurses to take care of patients. Effective interaction of these processes is dependent on the competence of nurses since they facilitate care and help patients through understanding, compassion, and empathy, and thus improve their wellbeing. Hence, the application of Swanson Caring Theory has enhanced the state of nursing practice in Carolina.

Self-transcendence is another middle-range theory that nurses apply in reducing depression among patients who are in nursing homes. Self-transcendence offers a holistic approach that improves human health because it targets the body, the mind, and the spirit. Fundamentally, self-transcendence theory enables patients to find meaning in life, improve their wellbeing, and attain new perspectives, which are central in the resolution of psychological, social, and spiritual crises. Haugan and Innstrand (2012) argue that facilitating self-transcendence among patients at the interpersonal and interpersonal levels decreases depression. Thus, nurses should apply self-transcendence theory when caring for patients in nursing homes because it relieves depression


Haugan, G., & Innstrand, S. (2012). The effect of self-transcendence on depression in cognitively intact nursing home patients. Psychiatry, 12(1), 1-10.

Jaarsma, T., Riegel, B., & Stromberg, A. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194-204.

Shrivastava, R., Shrivastava, S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes and metabolic Disorders, 12(1), 1-5.

Tonges, M. (2011). Translating caring theory into practice: The Carolina Care Model. The Journal of Nursing Administration, 41(9), 374-381.

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