Nursing Theory: Mirror, Microscope, and Telescope Views

Introduction

Theories are described as a set of interrelated concepts that give a systematic view of a phenomenon that is explanatory and predictive in nature (Nursing Theories, 2010). Theories are stated to be composed of concepts, definitions, models, propositions, and are based on assumptions (Nursing Theories, 2010). Theories furthermore enable the individual to organize the relationship among concepts in order to describe, explain, predict, and control practice (Nursing Theories, 2010). Concepts are the vehicles of thought that involve images as well as words that describe objects, properties, or events, and they are the basic components of theory. There are three types of concepts: (1) empirical concepts; (2) inferential concepts; and (3) abstract concepts (Nursing Theories, 2010).

Various nursing theories have been advanced over the years, beginning with Florence Nightingale, who sought to bring the nursing profession into professional standing. These theories have evolved and experienced growth and expansion, serving to make meaning for those in the nursing profession concerning their patients and their work in health care provision. Because the concepts within theories are empirical, inferential, and abstract, they can be compared to the view of nursing as seen through a mirror, a microscope, and a telescope by the nursing professional.

Kim (2000) states in The Nature of Theoretical Thinking in Nursing that a scientific field goes through stages of boundary redefinitions that are based partly on the kinds of major phenomena or subject matter it deals with — as with energy and matter in physics. Kim states that this idea agrees with Shapere's position (1977) regarding the formation and reformation of a scientific domain as constituting a unified subject matter. Well-established associations between phenomena in a scientific field are exposed to scientific scrutiny by a variety of methodologies and from entirely different perspectives (Kim, 2000). It is noted that the criteria for deciding the boundaries of fields "may also be considered superfluous or ambiguous." Therefore, subject matter may be redefined or reclassified across different fields, especially with the emergence of new scientific fields (Kim, 2000).

Nursing Theory Viewed as a Mirror

Reflective nursing practice is described in the work of Johns (2004) as follows:

"Reflection is being mindful of self, either within or after an experience, as if a window through which the practitioner can view and focus self within the context of a particular experience, in order to confront, understand, and move toward resolving contradiction between one's vision and actual practice. Through the conflict of contradiction, the commitment to realize one's vision and understanding why things are as they are, the practitioner can gain new insights into self and be empowered to respond more congruently in future situations within a reflexive spiral towards developing practical wisdom and realizing one's vision as a lived reality."

This description holds reflection — or reflective practice — as being both subjective and particular. It is "a fusion of sensing, perceiving, intuiting, and thinking related to a specific experience in order to develop insights into self and practice" (Johns and Freshwater, 2005).

Inductive and Deductive Approaches in Nursing Practice

Kim (2000) reports that micro-theory is a term scientists use in reference to "a set of theoretical statements, usually hypotheses, that deal with narrowly defined phenomena," and notes that there is a great deal of debate as to whether this should be called a "theory," since such a theory by itself tends to be rather limited in its explanatory power and is composed of mere postulations of hypothetical thinking. The difference among these levels of theory is not only in the level of abstraction with which concepts are delineated but also in the range of explanation the theory is trying to attain (Kim, 2000).

Theory development can be pursued, according to Kim (2000), through two approaches: (1) inductive and (2) deductive. The inductive approach "refers to developing or constructing theories beginning with empirical data or phenomena as they exist in actual situations" (Kim, 2000). There are regularities in the inductive approach that are both descriptive and explanatory — those which exist in reality and those which are discovered — as well as generalizations about the discovered regularities, which are "formulated into theoretical statements" (Kim, 2000). The deductive approach, according to Kim, "begins with generalized ideas about phenomena," is based on "a set of foundational notions about the nature of explanation," and proceeds using "a system of deductive logic to come up with a theory that moves from general ideas about phenomena to more specific theoretical relationships" (Kim, 2000).

The purposes of theory are stated to be multifaceted in that theory is "an intellectual tool used to understand and explain the world in which we live. Theory provides a systematic basis for sorting out regularities from irregularities. By knowing what is happening and then finding out how something occurs, we are able to move toward knowing the kinds of changes we must make for some things to occur" (Kim, 2000). As phenomena become within the human ability to predict, "both control and prescription become possible for us" (Kim, 2000).

Deductive reasoning is one in which "it is impossible for the premises to be true but the conclusion false. Thus, the conclusion follows necessarily from the premises and inferences" (Cline, 2010). This results in definitive proof of the claim (Cline, 2010). An inductive argument is stated to be one "in which the premises are supposed to support the conclusion in such a way that if the premises are true, it is improbable that the conclusion would be false. Thus the conclusion follows probably from the premises and inferences" (Cline, 2010). Schwartz (2011) defines the two forms of reasoning as follows:

(1) Inductive reasoning is thinking and problem solving based on solid empirical facts. These facts are concrete and can be observed.
(2) Deductive reasoning is thinking and problem solving that begins with a premise or theory and then attempts to prove that theory true. This type of reasoning can start with assumptions and beliefs.

Inductive reasoning can therefore be viewed as the type of reasoning gained from the view of a microscope — observable and concrete information that the nurse practitioner applies to their practice. Deductive reasoning can be viewed from the perspective of a telescope, in which thinking and problem solving begin with a theory assumed to be true, with the conclusion being the only reasonable one that can be drawn from the evidence.