Desarrollo de las teorías de medio alcance en enfermería

Leandro, Tânia Alteniza; Nunes, Marília Mendes; Teixeira, Iane Ximenes; Lopes, Marcos Venícios de Oliveira; Araújo, Thelma Leite de; Lima, Francisca Elisângela Teixeira; Silva, Viviane Martins da

doi:10.1590/0034-7167-2017-0893

Brasil

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REVISÃO • Rev. Bras. Enferm. 73 (1) • 2020 • https://doi.org/10.1590/0034-7167-2017-0893 linkcopiar

Desarrollo de las teorías de medio alcance en enfermería

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo: Identificar en la literatura cómo las Teorías de Medio Alcance (TMA) se están desarrollando en enfermería.

Método: Revisión integrativa en las bases de datos: LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science y PubMed, utilizando la palabra clave middle range theory, el descriptor nursing y sus equivalentes en portugués (LILACS) y el operador booleano AND. La muestra constó de 25 artículos.

Resultados: Todos los artículos presentaron conceptos relacionados con las TMA. La mayoría desarrolló un cuadro resumen. Algunas teorías presentaron proposiciones, plantearon hipótesis y nombres específicos. Solamente 16 artículos citaban el referencial metodológico, mientras que 22 utilizaban teorías o modelos en la fundamentación teórica y 11 hicieron revisión de la literatura.

Consideraciones finales: El desarrollo de las TMA incluyó la presentación de conceptos fundamentales, de cuadro resumen, de proposiciones, hipótesis y nombre específico. Se reconocen las TMA como forma de desarrollar conocimiento para orientar la práctica en enfermería.

Descriptores: Enfermería; Teoría de Enfermería; Revisión; Conocimiento; Construcción

Authors/year	Object of study	Main outcomes of the study	How the middle-range theory was developed
Dobratz⁽¹⁰⁾, 2016	Population in general, especially vulnerable groups such as the elderly and adolescents.	Six propositions on the relationship between spirituality and key concepts identified and three hypotheses, in addition to the conceptual definition of adaptive spirituality. middle-range theory of adaptive spirituality.	Based on the middle-range theory described by Roy, using the Roy Adaptation Model and literature review for the construction of the middle-range theory.
Lopes, Silva and Herdman⁽⁵⁾, 2015	-	Synthesis picture of the relationship between the nursing diagnosis elements and the nine propositions for them. middle-range theory of causality in nursing diagnosis.	Based on the medium-range theory described by Roy, using the models of diagnostic reasoning, validation of nursing diagnoses and causal epidemiological models.
Fearon-Lynch and Stover⁽¹¹⁾, 2015	People with diabetes mellitus.	Synthesis picture of the relationships between the key elements and three propositions. middle-range theory for diabetes self-care.	Proposes a new middle-range theory and merges two existing theories, namely: the domain theory and the organicist integration theory. Used Walker and Avant to provide conceptual clarity.
Payne⁽¹²⁾, 2015	-	Synthesis picture on the relationship between the concepts involved and six propositions. Middle-range theory of the Intuitive Decision-Making in Nursing.	Developed through the use of Walker and Avant's Theory synthesis, the synthesis between Damasio's "Hypothesis of somatic markers" and Benner's theoretical framework "From beginner to expert", as well as empirical evidence derived from research.
Pickett, Peters e Jarosz⁽¹³⁾, 2014	Risk population for obesity.	Synthesis picture of the relationships between the concepts involved, eight hypotheses and four propositions. Middle-range theory of weight management.	Derived from Orem's self-care theory and literature research.
Elo et al.⁽¹⁴⁾ , 2013	Older people.	Hypothetical model in a synthesis picture, three hypotheses. Theory with good results of reliability and validity. middle-range theory of physical environment to support the well-being of older home residents.	Follows adapted steps of the stages of formation of a Lauri and Kyngas's theory; clinically tested in older adults.
Phillippi e Roman⁽¹⁵⁾, 2013	Pregnan Women.	Synthesis picture with the concepts and their relations. Middle-range theory of motivation-facilitation of access to prenatal care.	Developed from Lewin's great theory of human behavior. Employed a literature review.
Riegel, Jaarsma and Stromberg⁽¹⁶⁾, 2012	People with chronic diseases (self-care).	Synthesis picture, three hypotheses and seven propositions. middle-range theory of self-care for chronic diseases.	Derived from Orem's self-care theory and literature research.
Castillo-Arcos, Benavides-Torres⁽¹⁷⁾, 2012	Adolescents.	Synthesis picture of relationships between the main concepts and five propositions. Middle-range theory of sexual resilience in adolescents.	Derived from a model of resilience in adolescents and followed five steps of Fawcett's theoretical method of derivation for the development of the middle-range theory.
Dobratz⁽¹⁸⁾, 2011	-	Three propositions, four hypotheses and synthesis picture with the conceptual-theoretical structure. Middle-range theory of psychological adaptation in death and dying.	Derived from the conceptual-theoretical framework of Roy's Adaptation Model and a literature review.
Davidson⁽¹⁹⁾, 2010	Families of patients hospitalized in intensive care units.	Synthesis picture of the relationships between the elements of the middle-range theory and the set of specific nursing actions improve the understanding of families. Middle-range theories to assist family members of patients in the intensive care unit.	Developed through literature review and Weick's organizational theory of understanding, as well as Roy's Adaptation Model.
Reimer and Moore⁽²⁰⁾, 2010	Flight nurses.	Synthesis picture; nine concepts; five propositions. middle-range theory of the in-flight nursing experience.	Developed based on Walker and Avant's theory of empirical evidence and a bibliographic research.
Murroc and Higgins⁽²¹⁾, 2009	Adults exposed to music as a form of therapy.	Synthesis picture of the relationships between concepts and table with definitions and how to measure them. Middle-range theory of music, humor and movement.	Developed from the physical activity guidelines and musical theory, using the strategies of synthesis of statements and Walker and Avant's theory synthesis, as well as a literature review.
Covell⁽²²⁾, 2008	-	Synthesis picture of the relationships between the elements of the middle-range theory; five propositions. Middle-range theory of the nursing intellectual capital.	Developed using the concept and derivation strategies of the theory described by Walker and Avant, literature review and intellectual capital theory.
Noiseux and Ricard⁽²³⁾, 2008	People with schizophrenia, family members and health professionals.	Understanding of the interaction dynamics between the reciprocal influences of microscopic and macroscopic elements in the schizophrenia recovery process. Middle-range theory of the recovery of people with schizophrenia.	Based on a grounded theory and on the concept of Human Responses of the American Nurses Association.
Dunn⁽²⁴⁾, 2004	People with chronic pain.	Synthesis picture of the relationships between concepts, six hypotheses and five propositions. Middle-range theory of adaptation to chronic pain.	Developed based on the methodology described by Merton, using Roy's Adaptation Model and a literature review.
Mefford⁽²⁵⁾, 2004	Preterm newborns.	Synthesis picture and eight propositions. Middle-range theory of health promotion for preterm infants.	Developed based on the theoretical synthesis process described by Walker and Avant and the Levine conservation model.
Tsai⁽²⁶⁾, 2003	Caregivers of people with chronic diseases.	Synthesis picture of the relationships between the elements of the theory, four hypotheses and 11 propositions. Middle-range theory of the caregiver's stress.	Developed based on Roy's Adaptation Model.
Whittemore and Roy⁽²⁷⁾, 2002	People with diabetes mellitus.	Synthesis picture of the relationships between the elements of the theory and six propositions. Middle-range theory of adaptation to diabetes mellitus.	Developed based on Roy's Adaptation Model, in the adaptation of the Chronic Disease Model to patients with diabetes mellitus, literature search and relevant empirical evidence.
Sanford⁽²⁸⁾, 2000	Population in general (patient education).	Synthesis picture of the relationships between the elements of the middle-range theory, definitions of concepts and five propositions. Middle-range theory for patient education.	Developed from the philosophical and theoretical perspectives of two fields: Nursing and Education; and from the recommendations of Liehr and Smith for the development of middle-range theory.
Jirovec et al.⁽²⁹⁾ , 1999	-	Synthesis picture of the relationships between the elements of the middle-range theory of urine control.	Developed based on Roy's Adaptation Model.
Huth and Moore⁽³⁰⁾, 1998	Infants and children with acute pain.	Synthesis picture with synthesis of the relationships between the elements of the middle-range theory and three propositions. Table with definitions and ways to measure the main concepts. Middle-range theory of acute pain management in infants and children.	Developed from methodological strategies described by Walker and Avant and by Good and Moore; theoretical assertions were derived from the content of the Guidance Panel for Acute Pain Management.
Olson and Hanchett⁽³¹⁾, 1997	-	Three propositions, three hypotheses, synthesis picture with the concepts of the Orlando model, of the middle-range theory and of the empirical indicators used to measure each concept. Middle-range theory on nurse-patient empathy. Clinically tested.	The middle-range theory resulted from Orlando's theory and from a correlational research between nurses and patients.
Good and Moore⁽³²⁾, 1996	Adults with acute pain.	Synthesis picture of the relationships between the elements of the middle-range theory, table with definitions and ways of measuring the main concepts involved and three propositions. Middle-range theory on acute pain.	Relied on Walker and Avant, using a guide for acute pain management.
Thompson et al.⁽³³⁾ , 1989	Obstetrical nurses.	Presents the concepts and the relationships among them. Middle-range theory of the obstetric nursing care process.	Developed from the Philosophy of the American College of Nurse-Midwives and Fawcett's notes.

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