Theory Integration to Explore Complexity
Our new featured article is titled “Using Theory Integration to Explore Complex Health Problems” by Brenna L. Quinn, PhD, RN, NCSN. We invite you to download the article while it is featured and return here to join discussion of these ideas. In this message about her article, she describes the evolution of this article as a result of a rejection of another manuscript!
Brenna Quinn
The idea for this article was actually born out of another article’s rejection. I met with my colleague Dr. Barbara Mawn to seek commiseration over the outright rejection and ask for help in writing an article about the importance of theory use and interdisciplinary integration, given that reviewer suggestions included removing the entire section on the study’s conceptual framework. Barbara’s mentorship was invaluable to the development of this article. Said conceptual framework is described in the ANS article as an example of interdisciplinary theory integration.
Use of theory to guide nursing research and clinical practice is underreported at best, but more likely is extremely underutilized. This is due to several factors, such as nurses receiving little education on theory use or confusion about how to interpret and apply theories to clinical practice. Additionally, clinical nurses and nurse researchers may view nursing theories as too narrow to address the multi-faceted needs of patients or study populations.
Nurses know that they need to view patients and populations holistically, and cannot silo specific health problems.
Barbara Mawn
For example: school nurses experience difficulty when assessing pain in children with intellectual and developmental disabilities. What kind of pain assessment tools has the nurse learned about? Has the school offered any continuing education opportunities regarding pain assessment for special populations? Do classroom teachers know which behaviors may be indicative of student pain? What is the ability of the student to report painful experiences? Or, perhaps a nurse is working with a patient who has not been taking a medication prescribed for diabetes. The nurse must consider more than a presenting high blood glucose reading. Did the patient understand the nurse practitioner’s instructions for taking the medication? Can she access the pharmacy? Read the bottle? Administer the medication correctly? What is her level of cognition?
Many variables factor in to complex health problems faced by people today. However, this may not always appear clear to nurses and researchers when looking at nursing models. Using a non-nursing model, such as a model from psychology as described in the ANS article, can help frame the use of nursing theory components to the health problem at hand.
After reading this article, I hope nurses take the opportunity to explore both nursing and non-nursing theories that can guide and enlighten new approaches to clinical and research activities. Thank you for featuring this article on the ANS blog!
ANS: Advances in Nursing Science Blog 
This article demonstrates the understanding of theory that can move knowledge development forward in areas that are not deemed to be fundable at present. Theories that are integrated and open to modification with and by interdisciplinary or other disciplinary theories. The choice of theories illustrates this fairly well Neumans systems theory is based on General Systems Trheory, a borrowed theory. Nevertheless it was adapted to nursing and has nursing school “marks”. Identifying it. The diagram is clear in showing the substruction process. I think this is what we might do even if we begin with a conceptual model from another discipline such as theories of self-efficacy or epidemiological models.
Excuse the incomplete sentence and autocomplete errors. Theories such as Neumans, that can be open to modification through integration by middle range nursing and other disciplinary theories are more useful. I said that Neumans adaptation of GSS has nursing”s “marks” meaning that it is holistic and has a nursing “standpoint”. The word “school” was inserted automatically. Sorry.