Empirical Indicators: Conceptual and Theoretical Origins

This paper discusses the connections between nursing conceptual model concepts, middle-range theory, and situation-specific theory concepts, as well as between the theory concepts and how they are measured, that is, empirical indicators. Three types of empirical indicators are described—instruments, assessment tools, and interventions—and an example of each type is given. The paper’s central thesis is that a conceptual model concept is —or should be— the starting point for selecting or constructing an empirical indicator.

Self-care Behaviours and Technology utilised during COVID-19:Systematic Review (Preprint)

BACKGROUND Self-care behaviours are essential for people living with chronic conditions. However, the outbreak of the COVID-19 pandemic has imposed additional complications into their daily routines. Few studies have analysed how self-care behaviours have changed during COVID-19 and the role of digital technology, especially amongst people with chronic conditions. OBJECTIVE This study aimed to review how self-care behaviours have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period. METHODS A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, Excerpta Medica database (EMBASE), PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar, included studies from December 2019 onwards. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (i.e. self-care maintenance, monitoring, and management). Methodological quality of included articles were assessed with a modified version of McMaster Critical Review Forms for Quantitative or Qualitative studies. RESULTS In total, 36 primary research articles were included. Changes to self-care behaviours during COVID-19 amongst people with chronic conditions were organised according to middle-range theory of self-care of chronic illness focusing on self-care maintenance (i.e. medication adherence, physical activity, diet control), self-care monitoring (i.e. monitoring signs and symptoms), and self-care management (i.e. consultations with health care providers). Positive self-care behaviours observed include: individuals trying to maintain good glycaemic control during COVID increased their medication adherence in 27% of studies, and diet control improved in 50% of studies. Negative self-care behaviours observed include: decline in physical activities and increased sedentariness observed in 65% of studies; poor diet control in 57% of studies, and self-monitoring of health status dropped in 43% of studies. Use of technology to support self-care of chronic conditions during COVID were reported in 26 studies. Actual utilisation of telehealth in place of physical consultations during COVID was observed in 50% of studies and other digital technology (e.g. social media apps, smartphone apps, online platforms, web browsing )were used in 50% of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77% of studies. CONCLUSIONS The review highlighted the necessity to re-think how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) amongst a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions.

A Theory of Balanced Leadership

This chapter describes balanced leadership theory. It starts by discussing the need for theories for good practical work. A positioning follows, which locates balanced leadership as a middle-range theory between substantive and grand theories. The chapter continues with some of the required information to make sense of the theory. This includes the philosophical stance, which is critical realism, and the theoretical lens, which is realist social theory and its morphogenetic cycle. A detailed description of the theory follows. This description addresses the theory’s constituting variables (the what), the macro- and micro-processes that explain the flow of activities (the how), the internal functioning and its relation to contingency theory (the why), and finally, the limitations and areas of application where the theory holds (the where/when/who). Various cross-references are made to the subsequent chapters in this book.

Introduction to Rivera’s Gender Affirming Nursing Care Model: A Middle-Range Theory

Purpose: Currently, standards for transgender care guide surgical, hormonal, cosmetic and psychological care, yet do not include the domain of nursing care and nursing sensitive care outcomes. In response, the purpose of this project was to create a middle-range nursing theory to guide transgender nursing care. Methods: Rivera’s Gender Affirming Nursing Care (GANC) Model was developed using a community informed iterative process, combining and modifying two existing theories. Each theory was evaluated, construct templates were created, modified, and expanded to create the proposed gender transcendent model. Face validity was established through expert and community review. Findings: Concepts identified include: Relationship (Join With), Knowledge (Learn With) and Engagement (Partner With). Action within the model is propelled by drivers, including ongoing learning, ongoing research, ongoing self-assessment, and leadership. The model operates within the recognized domains of nursing, to support gender affirming nursing care. Conclusions: The middle-range theory was tested and found to stimulate gender neutral thinking; however, the model would benefit from additional testing to determine impact on nursing and patient outcomes. The model allows the nurse, through self-reflection and other internal growth mechanisms, to identify personal implicit and explicit bias. It is through these actions and shifting paradigms that nurses develop a personal gender affirming nursing practice.

Testing a Middle -Range Theory of Heart Failure Self-Care

A middle-range theory of heart failure self-care, derived from the self-care deficit theory of nursing, was tested among 175 Arab American older adults with heart failure. The middle-range theory achieved good statistical fit, but not all hypothesized relationships were supported. Specifically, conceptualizing basic conditioning factors as a single latent variable was not supported. However, individual factors of depression, social support, and time living with heart failure had a direct effect on both self-care agency and quality of life. Understanding predictors and outcomes of self-care within a theoretical framework is essential in caring for patients with heart failure.

Middle Range Theory: Peaceful And Of Life Theory

Teori Peaceful End Of Life dikembangkan dari standar dengan tujuan dapat hidup tenang sebelum kehidupan berakhir. Standar dari kekhawatirandikembangkan oleh satu group berpengalaman dari perawat yang berasal dariNorwegia. Perawat tersebut berada pada satu unit gastroenterological dimanasetengah dari pasien didiagnose dengan cancer dan dihadapkan pada pasienterminal dalam setiap harinya

Toward a conceptualization of personalized services in apparel e-commerce fulfillment

Purpose Today, customers’ perceived value does not only depend on the products, but also on the services provided by a firm. In e-commerce, it is important to shift the focus beyond the product and discuss the value of personalized services in the context of e-commerce fulfillment. Therefore, the purpose of this paper is twofold: to develop a conceptual framework proposing satisfaction through personalized services as a middle-range theory; and to suggest foundational premises supporting the theoretical framework, which in turn shape middle-range theory within the context of apparel e-commerce fulfillment. Design/methodology/approach In this theory-driven paper, the authors apply the scientific circle of enquiry, as it demonstrates the role of theorizing with the help of middle-range theory and empirical evidence and as such provides a methodological scaffolding that connects theory formulation and verification. The authors synthesize literature related to customer perceived value (CPV) and satisfaction, followed by abduction focusing on understanding the empirical domain as it occurred in practice from company cases. The presented case studies are based on semi-structured interviews with three Swedish online retailers within the apparel industry. The theory-driven analysis results in suggestions of foundational premises. Findings Based on the theoretical foundations and empirical generalizations, three propositions are suggested. The premises regarding satisfaction through personalized service applied in the domain of apparel e-commerce fulfillment are: to ensure customer satisfaction requires a value co-creation perspective using data during the pre-purchase phase; to ensure customer satisfaction and retention require added-value perspective during the post-purchase phase of the shopping journey; and to ensure satisfaction and convenience require an added-value perspective at the last mile. Practical implications The apparel firms lose a substantial amount of revenue because of poor online customer satisfaction, leading to e-commerce not reaching its full potential. To enhance customer value, online retailers need to find a resort in advanced technologies and analytics to address customer satisfaction, and it is suggested that retailers shift their focus beyond the products and find ways to improve personalized service offerings to gain market advantage, improve fulfillment, drive sales and increase CPV. Originality/value To consider personalized services as a source for improving e-commerce fulfillment and CPV, the main contribution of this study is conceptual as it presents a theoretical model developed from general theory, middle-range theory and verified with empirical claims.

Towards a middle-range theory of ‘Stability of home-based care arrangements for people living with dementia’ (SoCA-Dem): findings from a meta-study on mixed research

BackgroundMost people with dementia and their informal carers live at home and strive to create a stable care situation for as long as possible. This preference of dyads is consistent with the global policy of ageing in place. Therefore, we aimed to develop a middle-range theory of stability guided by two research questions: How is stability of home-based care arrangements for people living with dementia constituted? What are the essential factors influencing stability?MethodsWithin the 'Stability of home-based care arrangements for people living with dementia' project (SoCA project) at the German Center for Neurodegenerative Diseases (DZNE), we conducted a meta-study on mixed research. The analytical steps of meta-data analysis, meta-method and meta-theory are merged in an integrative synthesis. Eligible publications were identified through systematic database searches (MEDLINE, CINAHL and PsycINFO; last searched on 3 January 2017), backward/forward citation tracking and snowballing. All publications were screened against predefined inclusion criteria and evaluated through a quality appraisal. The analytical approach was thematic synthesis.Results99 publications were included. The middle-range theory conceptualises stability as a complex phenomenon comprising three components including eight concepts that are dynamically inter-related. The conceptual model visualises: (1) the trajectory of the dementia care arrangement, which involves a cyclic process of change and balancing over time; (2) the characteristics of the care arrangement, including needs, the carer role, the dyadic relationship and resources; and (3) the context, which is determined by society and culture and the respective healthcare system. The relevance of each concept in relation to stability changes over time. The forming of each concept is actively shaped by the informal carer.DiscussionThis middle-range theory provides a thorough understanding of the stability of home-based care arrangements for people living with dementia and can be used to guide future research and practice.OtherThis meta-study was funded by the DZNE and registered in PROSPERO (registration number CRD42016041727).