Middle-range nursing theories

11 Critical Middle-Range Nursing Theories

Posted: June 22nd, 2022

The middle-range theories are some of the vital theories in the nursing profession. Each one has its unique perspective on the role of nurses and the care they provide.

Some of the more well-known nursing theories, like Hildegard Peplau’s Interpersonal Nursing Theory, emphasize the importance of the nurse-patient relationship and how this can help promote healing.

Middle-range nursing theories are essential to every nurse that wants to stay ahead in their profession. They provide insights on patient care and support. Here is an in-depth look at nursing theories, including middle-range nursing theories. 

Classification of nursing theories

The classification of the theories follows a few methods. One way is to classify them according to their level of abstraction.

Grand Nursing Theories: These theories are broad in scope and provide a general framework for understanding nursing.

Middle-Range Nursing Theories: These theories are more specific and focus on a narrow aspect of nursing.

Nursing Practice Theories: These theories are even more specific and focus on how nurses can best care for their patients.

No matter what level of abstraction a nursing theory is, they share some commonalities. Nursing theories typically define nursing, the nurse-patient relationship, and an explication of how nurses can promote healing. Middle-range nursing theories can guide nurses in their practice and provide a framework for understanding the complex phenomena of nursing.

Nursing meta-paradigm

The Nursing Meta-Paradigm consists of four concepts that define the scope of nursing. These concepts are person, environment, health, and nursing.

Person: The person is the focus of nursing care. It involves patients, families, communities, and populations.

Environment: The environment is everything that surrounds the person. It includes physical, social, cultural, and spiritual factors.

Health: Health is a state of being that is positive and dynamic. Nursing care promotes health and prevents illness.

Nursing: Nursing is the art and science of caring for people. Nurses use their knowledge, skills, and abilities to provide quality care for their patients.

Middle-range nursing theories provide a framework for nurses to understand and care for their patients. They help to guide nursing practice and research and can improve patient outcomes.

Importance of Middle-range Nursing theories

– Understand the patient’s experience of illness

– Plan and deliver individualized care to the patient’s needs

– Evaluate the effectiveness of nursing interventions

– Improve communication between nurses and other health care providers.

What is a nursing theory?

Nursing theory is a way of thinking about nursing and the role of nurses in providing care. Nursing theories have underlying assumptions about nursing, the role of nurses, and the relationship between nurses and patients. 

Middle-range nursing theories provide a framework for nurses to understand and care for their patients. 

Middle-range nursing concept

Middle-range theories are more specific than grand nursing theories but are not clinical Nursing models. These theories typically focus on a narrower scope of Nursing practice. Also, they guide nursing practice and research. Middle-range theories are easier to test and measure. 

Middle Range Nursing theories

Some well-known middle-range nursing theories include:

Roy’s Adaptation Model

Sister Calister L. Roy is a professor, nursing theorist, and author. The adaptation model theory focuses on people and society. The health care provider’s role is to promote health to the people and society at large.

This theory focuses on how people adapt to changes in their environment. The nurse should adjust and manipulate the stimuli to promote healing. 

Everett Rogers’s diffusion of innovation theory

The diffusion of innovation theory has 5 different categories that describe how people adopt new things. These are:

Innovators (2.5%): These people are the first to try new things. They’re risk

takers and are usually very knowledgeable about the subject matter.

Early Adopters (13.5%): They adopt new things before others do. They’re usually opinion leaders and have a lot of influence over others.

Early Majority (34%): These people adopt new things after the Early adopters, but before the Late Majority. They’re usually well-educated and have a lot of resources available to them.

Late Majority (34%): These people adopt new things after the Early Majority but before the Laggards. They’re usually more skeptical of new things and take their time before adopting them.

Laggards (16%): These people are the last to adopt new things. They’re usually resistant to change and may not have the same resources or knowledge as the other adopters.

Comfort care- Kolcaba’s Theory of Comfort

There are three types of comfort that this theory addresses: physical, psychological, and social.

– Physical comfort is the relief of pain and other physical symptoms.

– Psychological comfort is bursting anxiety and other mental/emotional symptoms.

– Social comfort is providing support and belonging from positive interactions with others.

The four modes of comfort that this theory addresses are:

Nursing interventions: These are things nurses do to comfort their patients.

Environmental manipulations: These are things like changing the lighting or temperature in a room to make it more comfortable.

Distraction techniques: These are things like providing entertainment or diversion to take a person’s mind off their discomfort.

Relaxation techniques: These are things like breathing exercises or progressive muscle relaxation.

Emancipatory Theory of Compassion

Nursing is a process that liberates both the nurse and the patient. It is an act of compassion that allows for the recognition and embrace of human suffering.

The theory also states that nursing is a process of liberation that enables both the nurse and the patient to reach their fullest potential.

Madeleine Leininger: Cultural Care Diversity and Universality Theory

Nursing is a culturally based profession that should be responsive to the needs of all cultures.

Nursing care should have a basis on an understanding of the cultural beliefs and practices of the patient.

Nursing care should be universal in its provision. Also, it should be culturally specific when necessary.

Peplau’s Nursing Process Theory

Peplau’s nursing process is a four-step process that includes:

Assessment: This is the first step in which the nurse collects information about the patient’s health condition.

Diagnosis: This is the second step in which the nurse judges the patient’s health condition.

Planning: This is the third step in which the nurse develops a care plan for the patient.

Implementation: This is the fourth step in which the nurse carries out the care plan.

Merle H. Mishel Nursing Theory

The uncertainty on illness theory by Merle H. Mishel focuses on the strain and struggle when one gets an acute and chronic illness. It provides ways a patient or nurse can adjust to the change. 

The theory follows three themes, antecedents of uncertainty, coping with uncertainty, and the process of the uncertainty appraisal. 

Evelyn Adam’s Nursing Theory of Goal Attainment

The theory upholds the thought that nursing is a process of helping people to achieve their goals. It is a process of assisting people to reach their potential.

Nursing is a process of supporting people to achieve their dreams. Additionally, it involves professional interventions and the consequences of help. 

Orlando’s Nursing Process Theory- Deliberative nursing process theory

Ida Jean Orlando-Pelletier founded the theory. She was a theorist and a psychiatric nurse. The deliberative nursing process theory allows nurses to create a care plan for undertaking their duties if and when complications arise.

The theory also states that patients have their understanding and interpretation of situations. That prompts nurses to understand before they make conclusions.

The middle range theory defines a mental health inclusive approach to nursing. Healthcare providers and their patients need to create a reciprocal relationship where their actions are interconnected.

Phil Barker

Barker’s Tidal Model emphasizes best care policies for people with mental health struggles. Also, the nursing theory talks about caring and empathy for people going through difficulties in life.

The tidal model has ten commitments. They include; valuing the voice, respecting the language, becoming the apprentice, developing genuine curiosity, Using the available toolkit, giving time, revealing wisdom, acknowledging change, and embracing transparency.

– Nursing is a process of caring for people in a state of flux.

– Nursing is a process of helping people to cope with change.

– Nursing is a process of supporting people through transitions.

Ramona T. Mercer- Maternal role attainment theory

The Maternal role attainment theory focuses on the journey of helping mothers attain their maternal roles. It focuses on supporting mothers to bond with their children and build confidence in their mothering skills. 

The maternal role theory advocates for a non-traditional approach to providing proper healthcare interventions for new mothers as they attain their maternal identity. 

Dorothea Orem’s Self-Care Deficit Nursing Theory

Nursing is a process of assisting people by offering self-care services. The assistance improves human function at the home level. It sheds light on someone’s ability to take care of themselves. 

More theories from the self-care theory include the self-care deficit theory, the theory of self-care, and the nursing system theories. 

Each of these theories has its strengths and weaknesses, and there is no one ‘right’ theory. Nurses need to be aware of the different theories and select the one that best fits their practice.


What are some examples of middle-range theory?

Some examples of middle-range theory are the self-care deficit nursing theory, the Orlando’s Nursing Process Theory, and the Tidal Model.

What is the goal of Nursing?

The goal of Nursing is to help people achieve their potential.

What theories are middle-range theories?

Some examples of middle-range theory are the self-care deficit nursing theory, the Orlando’s Nursing Process Theory, and the Tidal Model.

What is a key feature of Nursing?

A key feature of Nursing is that it is a process of caring for people in a state of flux.

What is a middle-range concept in nursing?

A middle-range concept in nursing is a Nursing theory that falls somewhere between the grand Nursing theories and the specific Nursing interventions.

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