The main nursing theories are divided into grand theories, middle-range theories, and practical theories. Major differences between grand and middle-range theories are the focus of middle-range theories on a concrete aspect of nursing, the possibility to test middle-range theories, and the possibility to apply middle-range theories to particular cases in the nursing practice (Parker & Smith, 2010, p. 24; The health belief model, 2012, p. 41). To understand the nature of the differences, it is necessary to discuss grand and middle-range nursing theories in detail.
Grand theories are used to formulate and discuss the most general concepts followed in nursing. These concepts can be effectively applied to explain different phenomena in the sphere of nursing, regardless of their specific character. From this perspective, grand theories provide the general and broad theoretical background for nursing, while stating and discussing widely used concepts and ideas (Florczak, Poradzisz, & Hampson, 2012, p. 308).
For instance, Leininger’s Theory of Culture Care Diversity and Universality is often discussed as one of the grand and caring theories because Dr. Leininger focused on broad concepts of culture, care, and diversity. Dr. Leininger also developed the idea of transcultural nursing to address the main challenges in the sphere of nursing associated with the lack of competent and humanistic care for representatives of different cultural backgrounds (Parker & Smith, 2010, p. 319).
One more grand theory in nursing is Rogers’ Science of Unitary Human Beings, according to which nursing care is discussed from the perspective of the human being and the environment, rather than health and nursing (Parker & Smith, 2010, p. 261). From this point, grand theories provide the perspective from which it is possible to discuss the idea of nursing. Still, grand theories do not provide nurses with the important information for empirical testing to use concrete guidelines in particular cases.
Middle-range theories cannot be classified as grand theories or practical theories because they have the features typical for both those categories. On the one hand, middle-range theories are similar to grand theories because they provide the conceptual context for nursing. On the other hand, they are similar to practical theories because middle-range theories can be tested. Thus, the main difference is the use of middle-range theories for empirical testing even though these theories also have a broad scope and utilize a range of theoretical concepts because middle-range theories were formulated using the nursing practice as a background (Pickett, Peters, & Jarosz, 2014, p. 243).
If grand theories cover all the concepts in nursing, middle-range theories focus on the concrete aspect. An example of a middle-range theory is Swanson’s theory. Swanson concentrates only on the discussion of the importance of caring as an aspect of the nursing practice (Parker & Smith, 2010, p. 420). Furthermore, the role of care in improving nursing outcomes can be effectively researched and tested. On the contrary, the role of grand theories’ concepts cannot be tested appropriately.
If the difference between practical and the other theories is rather obvious and depends on the reflection of issues important for nurses’ practice, it is problematic to determine differences between grand and middle-range theories because of the scope of concepts they cover. However, the differences are in the fact that grand theories are more general and broad than middle-range theories, and they cannot be tested and directly applied to practice. In this case, middle-range theories are more focused, they discuss only one aspect of the nursing practice, and their ideas can be directly used in practice.
Florczak, K., Poradzisz, M., & Hampson, S. (2012). Nursing in a complex world: A case for the grand theory. Nursing Science Quarterly, 25(4), 307-312.
Parker, M., & Smith, M. (2010). Nursing theories and nursing practice. Philadelphia, PA: F. A. Davis.
Pickett, S., Peters, R., & Jarosz, P. (2014). Toward a middle–range theory of weight management. Nursing Science Quarterly, 27(3), 242-247.
The health belief model. (2012). Web.