Analyzing and Conceptualizing the Theoretical Foundations of Nursing

Janice M. Morse, PhD (Nurs), PhD (Anthro), FCAHS, FAAN, is a professor and Barnes Presidential Chair, College of Nursing, University of Utah, Salt Lake City, and professor emeritus, University of Alberta, Edmonton, Canada.

• CONTENTSContributorsPrefaceAcknowledgmentsSECTION I: DESPERATELY SEEKING THEORY1. The Fringes of KnowledgeJanice M. MorseThe Science of the ArtExploring the Fringes: The Clinical Utility of Concept InquiryThe Essentialness of Examining Our PracticeWhy Do We Have to Know?The Role of Values in Developing KnowledgeThe Rise of Nursing Research and the Use of Frameworks and Models2. Where We Came FromJanice M. MorseChasing Nursing TheoryThe Need for Nursing TheoryThe Need for Nurse ScientistsThe Need for Nursing ConceptsMid-Range and Situation-Specific TheoriesThe Need for Nurse EducatorsThe Performance and Products of Nurse ResearchersNursing Theory for Directing Nursing Actions for Patient CareThe Gap RemainsDid We Forget?Where Are We Now?Where Are We Going?3. Seeing What We Know: Knowing What We SeeLaura BohannanShakespeare in the Bush4. Incorporating Theory Into Practice ResearchJanice M. MorseScenarioNursing PerspectivesDialogueDiscussion5. Orientation 101: Definitions and Other Essential Extraneous NotesJanice M. MorseParadigm6. The Battlefield of Knowledge: Different Purposes, Different ApproachesJanice M. MorseInductive Approaches to Concept DevelopmentDeductive Approaches to Concept DevelopmentDeveloping Quantitative Models and TheoriesAbductionThe Complementary Relationship Between Qualitative and Quantitative KnowledgeLast ThoughtsSECTION II: ALL ABOUT CONCEPTSThe Conceptualization of Concepts7. Concepts in ContextJanice M. MorseWhat Is Context?What Is a Concept?Behavioral ConceptsThe Structure of ConceptsThe “Anatomy” of ConceptsRecontextualizationThe “Physiology” of ConceptsTypes of ConceptsApproaches to Understanding ConceptsThe Contribution of ConceptsFrameworks and ModelsTheoryLast Words8. Summary of Major Methods for Exploring ConceptsJanice M. MorsePhilosophical Methods for Concept AnalysisMeta-Analytic MethodsCombined Methods: Methods Using the Literature and Qualitative DataMethods Using Qualitative InquirySummary9. Inductive–Deductive Pitfalls in Concept DevelopmentJanice M. MorseThe Myth of InductionExploring Qualitatively Derived Concepts: Inductive TechniquesSummary10. The Pink Elephant Paradox (or, Avoiding the Misattribution of Data)Judith A. SpiersThe Importance of Nurse–Patient CommunicationThe Concept of VulnerabilityExploring Vulnerability in Home Care Nurse–Patient InteractionsSummary11. Concept Evaluation: Determining Appropriate Strategies for Concept DevelopmentJanice M. MorseDetermining Level of MaturityThe Process of Assessing ConceptsThe Level of MaturitySECTION III: EMERGING CONCEPTS12. Qualitative Strategies for Concept DevelopmentJanice M. MorseTargeting Concepts Using Qualitative InquiryBuilding Lay Concepts EpistemologicallyQualitative Methods for Developing ConceptsA Mapping Method to Locate a ConceptKristy K. MartynQualitative Strategies for Identifying ConceptsExample of Interpretative Coding: Getting Behind the DataJanice M. Morse, Kim Martz, and Terrie Vann-WardAnalytic Strategies for Identifying AttributesQualitative Research Strategies for Expanding ConceptsSummary13. Concept Identification Using Qualitative InquiryJanice M. MorseDeveloping a Concept From Data: The Example of CompathyRole of Compathy in Knowledge Development14. Building ConceptsJanice M. MorseConcept-Supporting DataThe Data–Concept LinkDeveloping Concepts to Using Studies to Support an Emerging ConceptEmerging ConceptsThe Case of “Preserving Self”Summary15. Qualitative Structured TechniquesJanice M. MorseTargeted Strategies for Concept and Attribute DevelopmentSummary16. The Prototypical MethodJanice M. MorseThe Prototypical MethodThe Case of HopeSummarySECTION IV: PARTIALLY DEVELOPED CONCEPTS17. Concept Clarification: The Use of Pragmatic UtilityJanice M. MorseProcedures: Doing Pragmatic Utility18. Research Using Pragmatic UtilityJanice M. MorseExample I: Concept Clarification Inside a Concept: The Conceptualizations of Caring and Caring as a ConceptComparing the Conceptualizations and Theories of CareDiscussion on Caring as a ConceptExample II: Concept Clarification: Accounting for Strategies of Empathetic ComfortingSummary: Back to Pragmatic Utility as a Method19. Concept ComparisonJanice M. MorseThe Patterns and Uses of Concept ComparisonAllied ConceptsConcept Comparison as a MethodPatterns of Concept ComparisonThe Example: The Conceptual Cohesion of Social SupportJudith E. HupceyEvaluating Concepts for Appropriate ApplicationThe Example: TrustJudith E. HupceyRecognizing When It Is Good: Criteria for Excellence in Concept DevelopmentHints for Getting It Right“What About Reliability and Validity?”Criterion for AdequacySummary20. Self-Transcendence and Self-Reformulation: One Concept or Two?Patricia L. Eldershaw and Janice M. MorseSelf-TranscendenceSelf-ReformulationComparing the ConceptsMethodResultsDiscussionSECTION V: TOWARD MID-RANGE THEORY21. From Concept Development to Qualitatively Derived Theory: Ethical Sensitivity in Professional PracticeKathryn WeaverOverviewConcept Analysis Using Pragmatic UtilityExplicating Concept AnatomyMoving From Anatomy of the Concept to Its PhysiologyEvaluating Concept MaturityAdvancing the Concept of Ethical Sensitivity Using Critical AppraisalToward Clearer Understanding of the ConceptBeyond Concept Analyses to Systematic Classification and Theory ConstructionSummary22. Linking and Ordering ConceptsJanice M. MorseThe Process of Qualitatively Developing Mid-Range TheoriesLinking ConceptsLinking Concepts in the Process of InquiryContext Dependency and Linking ConceptsDetermining Linkages Between ConceptsOrdering ConceptsConceptual Development: The Maturity of the TheoryOther Techniques for Developing Concepts to TheoryDiagramming as a ToolQualitative GeneralizabilityThe Last Thought23. Making Useful Theory: Making Theory UsefulJanice M. MorseMaking Useful TheoryWhat Is Mid-Range Theory?The Role of TheoryThe Structure of Mid-Range TheoriesTypes of Qualitatively Derived TheoryThe Process of Qualitatively Developing Mid-Range TheoriesProcesses of Theory ConstructionThe Structure of Mid-Range TheorySetting Up Your Study to Develop Qualitatively Derived TheoryDeveloping Theory Using Conceptual InquiryExamples of Qualitatively Derived Mid-Range TheoriesThe Place of Concept Development: Understanding Its Contribution in Research Programs and Its Contribution to Knowledge and PraxisIndices of Theoretical AdequacyToward CertaintyRigorThe Place of Concept DevelopmentSummary24. Modes of Releasing in the Praxis Theory of Suffering: The Responses of Women to the Results of Breast BiopsyJanice M. Morse and Charlotte PoolerLiteratureMethodsResultsDiscussionSECTION VI: MIXED- AND MULTIPLE-METHOD APPROACHES25. Expanding Theory Using Mixed MethodsJanice M. MorseMixed-Method ApproachesExample of Qualitatively Driven Mixed-Method Design: Patterns of Attending26. Developing Theory Using Mixed Methods: Patterns of Attending in NursingJoan L. BottorffThe Study of Nurse–Patient InteractionsA Model of Nurse–Patient InteractionsDevelopment of a Coding Scheme to Explore Patterns of NPIDiscussionSummarySECTION VII: THE QUANTITATIVE MINDFRAME27. Developing Quantitative TheoryJanice M. MorseThe Role of Quantitative TheoryCreating Theoretical FrameworksEvaluating the LiteratureIdentifying the ConceptsOperationalizationPlanning Your Research DesignBuilding the ModelThe Theoretical FrameworkExamples of Models for Multivariate ResearchFrameworksEvaluating Quantitative TheorySummary28. The Social Determinants of Health: An Expanded Conceptual Framework for NursingShirley M. SolbergWhat Are the Social Determinants of Health?Evolution of Social Determinants of HealthBeginning the DebateThe Social Determinants IdentifiedModels Used for Social Determinants of Health FrameworkAssumptions and Principles of the Committee on the Social Determinants of Health ModelEvidence for Social Determinants of Health FrameworkResearch and the Social Determinants of HealthStrategies for Research and Policy Development on the SDHSocial Determinants of Health in Nursing: PossibilitiesSECTION VIII: TOWARD CERTAINTY: BUILDING A MATURE THEORETICAL BASE29. Toward Certainty: Qualitative Meta-SynthesisJanice M. MorseThe Development of Meta-Synthesis30. Meta-Synthesis of Nursing PresenceDeborah Finfgeld-ConnettMeta-Synthesis of Nursing PresenceMethodologyFindingsDiscussionSummary31. Perceived Competency and Resolution of Homelessness Among Women With Substance Abuse ProblemsDeborah Finfgeld-Connett, Tina L. Bloom, and E. Diane JohnsonMethodologyFindingsProvision of Services in the Context of Distorted Perceptions of CompetencyDiscussionSummaryFunding32. Developing Theory Using Meta-AnalysisJanice M. MorseMeta-AnalysisDoing Meta-AnalysisDeveloping the Illness-Constellation Model33. Toward a Theory of Illness: The Illness-Constellation ModelJanice M. MorseStage I: The Stage of UncertaintyStage II: Stage of DisruptionStage III: Striving to Regain SelfStage IV: Regaining WellnessDiscussionOther Examples of Qualitative Meta-AnalysisSECTION IX: TOWARD THEORY-BASED INTERVENTIONS34. Theoretical CoalescenceJanice M. MorseThe Limited Scope of Mid-Range Theory35. The Evolution of Our Understanding of Suffering: The Praxis Theory of SufferingJanice M. MorseBackgroundThe Physiology of the Model36. Toward Understanding Comfort and ComfortingJanice M. MorseAssumptions About Comfort and ComfortingDoing Theoretical CoalescenceAxiomsSummary37. The Praxis Theory of Comfort and ComfortingJanice M. MorseContextual Factors Influencing Comfort and ComfortingThe Praxis Theory of Comfort and ComfortingNursing ApproachAttaining ComfortThe Comforting InteractionThe Interactive ComponentsThe Complexity of Providing Comfort: The Comforting RelationshipSummary38. The Theory of Becoming Resolute: Guiding Mental Health Practice With Survivors of MaltreatmentJoanne M. HallMarginalization as the ParadigmNarrative and TheoryResearch Underpinnings of the Theory of Becoming ResoluteNarrative Threads of Becoming ResoluteSupportive ThreadsCentral Dynamic Threads of Becoming ResoluteClinically Relevant FindingsDiscussion of the Study FindingsNarrative Threads and Conventional ConceptsRelationships Among Narrative Threads of Becoming ResoluteBecoming Resolute: From Theory to PracticeClinical Principles Toward Becoming ResoluteThe Story From HereSECTION X: POSTFACE39. The Myth of a Theory BaseJanice M. MorseDissemination or Dissipation?The Problem of DisseminationSummaryPostface: The (R)Evolution of NursingIndex