NURSING THEORY DIAGRAM Introduction Lenz, Suppe

Lenz, Suppe, Gift, Pugh and Milligan (1995, p. 1) inform that, "One promising approach to strengthening theory-research and theory-practice linkages is to place greater emphasis on developing and using theories of the middle range to underpin nursing research and practice." The authors define middle range theories as moderately abstract, inclusive, organized within a limited scope with a limited number of variables, which are testable in a direct manner. The mid-range theories are said to have a stronger relationship with research and practice.

This paper presents a nursing diagram based on the development of a middle-range nursing theory related to coping with chronic illness. The paper delineates each level of the theory and provides supportive documentation for all statements, postulates, claims, and other notions central to the presented theory.

Phenomena of Interest, Constructs, and Related Concepts

The phenomena of interest associated with the presented middle-range theory is human coping with chronic illness. Thus, the basic constructs are: (1) coping and (2) chronic illness. These constructs can be defined and linked to nursing theory.

According to Ritchie (1999) coping refers to a process whereby people try to manage a discrepancy between the perceived demands of a situation and their available resources. She notes that "coping with illness" is an element of almost all nursing theories and states that

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associated with learning how to cope. The theory presented in the diagram involves patients coping with a chronic illness or with the obstacles and challenges associated with the progressive deterioration that is part of the chronic illness process. Examination of the presented diagram shows that the concept of "self help" can be related to the human response to illness, an element of which is coping, using the axiom: Developing coping mechanisms and skills will help the patient to adjust to those life changes required by his or her chronic illness. It can be noted that this axiom is in accord with Register's (1999) notion of coping mechanisms helping a person to manage or respond to a given illness condition, most especially a chronic illness. In addition to the foregoing, the concept of self-help can be related to the concept of coping mechanisms and skills through the following postulate: Skills and coping mechanisms ease the transition needed to deal with chronic illness. This notion that coping skills and mechanisms help people to make the transition required to live with chronic illness has been verified in hundreds of health and medical studies (Register, 1999). Operational System The theoretical concepts and c

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