The middle-range theories in nursing offer a narrow focus, which helps to relate grand nursing concepts to nursing practice. These theories provide ideas and low levels of complexity while guiding nursing practices, approaches, and research that are based on theory. One of the most important aspects of these theories in the field of nursing is that they assist in generating concrete and testable results. Their primary function is to offer a description, an explanation, and a prediction of an occurrence. Compared to grand nursing theories, middle-range theories are direct and straightforward, with a limited number of variables. The theory selected for this assignment is the uncertainty in illnesses by Merle Mishel.
From the moment one is diagnosed through the time they are living with a chronic disease, they will always be surrounded by uncertainty. Uncertainty is the failure to establish the reasons behind illness-related occurrences. It happens when the responsible party is unable to attach a specific value to the occurrences. In due time, uncertainty reduces but returns the moment the disease reoccurs. During the diagnosis phase, uncertainty is the most agonizing feeling for a person. At this point, healthcare practitioners can help reduce the patient’s anxiety by educating them about their condition, demonstrating their confidence in treating it, and providing the patient with clear and easy-to-comprehend information. Early works on uncertainty stretch back to the 1960s. The preliminary research provided some insight into the relationship between patients’ mental conditions and ambiguity.
Bailey and Zhang, 2021 noted that the work of Merle Mishel was the first to concentrate entirely on the uncertainty of illnesses. In her book, Mishel supported her theories with investigations from a variety of professions, including nursing and psychology. The way an individual reacts to the news of their diagnosis of a specific disease is influenced by their personality (Bailey & Zhang, 2021). A more optimistic person can see their illness as a possible chance to rethink their lives. A person with a pessimistic outlook on life, in general, may have a lower standard of living after being diagnosed. A more pessimistic person may suffer from anxiety, depression, or PTSD personality (Bailey & Zhang, 2021). There are three primary themes in the theory of disease uncertainty, namely:
- Uncertainty’s antecedents: anything that happened before the onset of the illness and has an impact on the patient’s perception, such as pain and previous experiences.
- Uncertainty assessment: the procedure for putting a valuation on an unclear circumstance.
- Managing Uncertainty: Operations that are utilized to cope with uncertain situations.
Uncertainty in Illnesses Theory arose independently of any grand theory. This theory narrows its focus to a specific aspect of the nursing profession and it can be subjected to empirical testing, unlike the grand theories, which are not designed to undergo any kind of empirical testing (Indra, 2018). The critical nature of the relationship between conceptual models of nursing varies. One way is through the direct development of middle-range theories from a conceptual model. For instance, two of the family health theories were derived directly from the king’s conceptual systems (Brandão et al., 2018).
This middle-range theory is applicable in my current practice since it gives a sense of real perspective and, more particularly, generalist areas of practice. It also presents realistic ideas to the caregivers, which are restricted but quite beneficial. The three themes identified in this theory: uncertainty antecedents, uncertainty assessment, and managing uncertainty, is everything that nurses deal with every day whenever they are dealing with patients.
Bailey Jr, D. E., & Zhang, Y. (2021). Merle Mishel: Uncertainty in Illness Theory. Nursing Theorists and Their Work E-Book, 445.
Brandão, M. A. G., Martins, J. S. D. A., Peixoto, M. D. A. P., Lopes, R. O. P., & Primo, C. C. (2018). Theoretical and methodological reflections for the construction of middle-range nursing theories. Texto & Contexto-Enfermagem, 26. Web.
Indra, V. (2018). Nursing theories: a review. International Journal of Advances in Nursing Management, 6(3), 271-274.