Conceptual theoretical empirical structure evaluation framework

¶ … Theoretical-Empirical Structure (CTE) Evaluation of the Roy Adaptation Model

There are a number of valuable outcomes that can be achieved using conceptual models, theories, and empirical indicators for advanced nursing practice, including the application of models or theories to real-world nursing practice, research, and education. To develop some first-hand experience in this area, this paper examines how the Conceptual-Theoretical-Empirical (CTE) structure translates into nursing practice based on the Roy Adaptation Model. A translation and application of this theory to nursing practice using actual examples is followed by a summary of the research and important findings concerning the CTE structure and its implications for nursing practice in the conclusion.

Evaluation of the conceptual-theoretical-empirical linkages

There is an inextricable linkage between the conceptual, theoretical and empirical models that can help guide its application to nursing practice, research and education. For instance, according to Fawcett (2009), "It is impossible to conduct nursing research or to practice nursing without guidance from a conceptual model. It is absurd to assume that development of any theory can occur without guidance from a conceptual model" (p. 16). For this purpose, the CTE structure for theory-generating research proceeds inductively from a conceptual model to relevant empirical indicators in order to first generate theory (Fawcett, 2009). By contrast, the deductive steps that are involved in the CTE structure that are used for nursing practice or theory-testing research flow "from the conceptual model to the theory to the empirical indicators" (Fawcett, 2009, p. 17). In this step-wise fashion, then, the CTE structure can be used for a wide range of applications, including conceptualizing the manner in which individuals adapt to and interact with their environment drawing on the Roy Adaptation Model as discussed further below.

Evaluation of the selected theory

In sum, the Roy Adaptation Model (RAM) conceptualizes individuals as being "adaptive holistic system[s] that interact with environmental stressors (i.e., stimuli)" (Alkrisat & Dee, 2014, p. 368). Applied to the RAM as shown in Figure 1 below, the CTE structure includes a number of "abstract concepts as environmental stimuli, coping processes, and modes of adaptation; the statements that broadly define each concept; and the statements that link the concepts" (Fawcett, 2009, p. 17).

Figure 1. The CTE structure applied to the Roy Adaptation Model

Source: Fawcett, 2009, p. 17

The first step in the CTE structure (conceptual model) requires nurses to develop a thorough understanding of the conceptual model's content and to review the corresponding guidelines for research and practice as depicted in Figure 1 above (Fawcett, 2009). The second step (theory) involves reviewing the relevant and timely literature concerning the practice situation or research topic of interest (Fawcett, 2009). Researchers can use a worksheet during this step to facilitate the identification of empirical indicators and to organize the results of the literature review as shown in Table 1 below.

Table 1

CTE structure literature review worksheet for the RAM

Stimuli

Coping Processes

Modes of Adaptation

Intervention

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Author, date

Source: Fawcett, 2009, p. 17

Drawing on this research, the final step in the CTE structure involves developing appropriate empirical indicators for directly observing the theory (Fawcett, 2009) and these are discussed further below.

Evaluation of the empirical indicators

According to the definition provided by Fawcett (2009), an empirical indicator is "a very concrete and specific substitute for a theory concept that allows the concept to be measured for research purposes or observed in practice situations" (p. 18). The empirical indicators used for the RAM include, for example, patients' perception of the birth experience itself which can be measured using the Perception of Birth Experience Scale or their responses to a cesarean birth event using the Cesarean Birth Experience Questionnaire (Fawcett, 2009) which can then be used to develop a narrative or graphic conceptualization for nursing practice as depicted in Figure 2 below.

Figure 2. Example of theory-testing research or nursing practice

Source: Fawcett, 2009, p. 18

Evaluation of research findings

A growing number of nursing scholars are citing the need for research strategies that can provide the evidence-based practices needed by advanced practice nurses today. Indeed, some nurse scholars even argue that, "The discipline of nursing can survive and advance only if nurses acknowledge their own knowledge base by adopting explicit nursing discipline-specific conceptual-theoretical-empirical systems to guide their activities" (Smith, 2001, p. 93). As Fawcett (2009) and others have emphasized, however, the CTE structure is complex and can be challenging for novice researchers. In this regard, Fawcett (2009) concedes that, "The use of a conceptual model to guide nursing research and/or practice sometimes seems very complicated" (p. 19). There are some guidelines available to facilitate this process, however, and their use will contribute to the utility and soundness of the resulting practice theory as discussed below.

Evaluation of the utility and soundness of the practice theory