Application of Middle Range Theories in Nursing Practice
1. Based on the Case Study of Ms G. (presented below) and your readings in Smith (2020) and/or Peterson and Bredow (2020), or theories from other health related disciplines, such as:
· Lazarus & Folkman Stress & Coping McCubbin’s Family Resiliency Model Fishbein’s Theory of Reasoned Action
· Ajzen’s Theory of Planned Behavior
· Health Belief Model
· Olson’s Circumplex Model (Family) Belsky’s Parenting Model
· Locus of Control
· Selye’s Stress Model
· Theory of Learned Resourcefulness Bandura’s Self-Efficacy Theory
· Family Life Cycle
· Aguilera & Messick’s Crisis Intervention Theory
SELECT ONE Middle Range Theory that you believe would be appropriate to guide the nursing care of Ms G.
1. Based on the Selected Middle Range Theory Discuss the Following:
· Theory Development
· Purpose
· Assumptions
· Key Concepts
· Propositions of the Theory
2. Based on the Middle Range Theory:
· Identify Three Nursing Assessment Questions
· Identify Three Nursing Actions (Interventions)
3. Write one research question based on the middle range theory and the care of Ms G.
4. Discuss how knowledge of a middle range theory has informed or guided your nursing practice in the care of Ms G.
Case Study of Ms. G
Demographic Information: 42-year old Hispanic female
Primary Care Clinic Visit: Appointment made in primary care clinic for recurrent vaginal infections and follow-up for atypical cells on pap smear.
Initial complaint: “I am having bleeding between my periods. I have pain in my abdomen and back. I have been feeling lousy for weeks.”
Diagnosis: Stage III Cervical Cancer
History of Present Illness
· Current admission to the medical-surgical unit for a total abdominal hysterectomy
· Post-operative day 3: Patient reporting abdominal pain (7/10 in intensity), intermittent nausea with vomiting, chills and sweats, anxious mood, generalized weakness and insomnia. No frequency on urination or urinary burning. Reports slight red vaginal discharge.
· Emotional Outlook: Crying: States “I knew something bad was going to happen to me. Am I going to die? God is angry with me.”
Past Medical and Surgical History
· History of constipation since childhood. Takes Metamucil daily to promote regularity
· History of asthma
· Termination of pregnancy six months before her divorce since her husband did not want any more children and unstable relationship
Psychiatric History
· Post-partum depression after each pregnancy. Treated with anti-depressants and counseling.
Social History
· No history of substance use
· Reports two to three glasses of wine with dinner every night
· Limited social network since divorce
· Unable to work at present- income $31,000 per year
Cultural/Spiritual History
· Family originally from Puerto Rico.
· Faith-Catholic though has not attended church recently.
Sexual and Reproductive History
· Menarche age 12; sexual abuse age 14 by family friend
· Two Cesarean sections (Patient’s age 24 and age 29)
· Used birth control pills
· Has new sexual partner who she met at work
Family History
· Sons have been delinquent at school; participation in gang activity
· Unavailability of support of parents due to their own chronic illness (Father-prostate cancer; Mother- depression)
Activities of Daily Living
· Limited energy to perform IADLs or ADLs.
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