Great Significance in the Nursing Discipline Case Study Essay

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research.1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’.1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables.Great Significance in the Nursing Discipline Case Study Essay

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This study is about the discipline and control of nurses. More specifically it is about the use of disciplinary action to deal with perceived ‘problems’ in nursing. The study sets nursing discipline within its social and policy context and is concerned with the ways in which recent managerial and political changes have reshaped the boundaries and identity of nursing. This thesis is based on a study carried out under the auspices of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. The study used a case study design and involved qualitative interviews with 120 nurses and managers in three healthcare Trusts. Interviews were also carried out with Trust Nurse Executives in a further twelve Trusts. A large amount of supplementary data was also collected including records and documents, observation of disciplinary hearings and interviews with key informants at a regional and national level. The study highlights some of the tensions and paradoxes inherent in recent changes in the management of public services. Central to the thesis is an exploration of changing patterns in the distribution of responsibility and control, credit and blame. To this end the theories of Mary Douglas and Basil Bernstein have been employed to illuminate the data.Great Significance in the Nursing Discipline Case Study Essay

1 The relationship between medicine and nursing
Professor of Psychiatry and Internal Medicine at the University of Rochester, George L. Engel, once proposed that “in order to understand the determining factors of a disease and to establish rational treatment and health care models, the medical model must also consider the social environment of the patient, the patient’s life, and the complementary system that the society decides to use to deal with the devastating effects of the disease, that is, the role of doctors and the health care systems”.1 In the future, nursing care will extend to the entire person, the entire process, the entire family, and the entire society. As researchers in nursing science in the new era, we often reflect on the relationship between medicine and nursing. What are the current problems in the nursing discipline, and what is the trend of the development of the nursing discipline?

Nursing is an ancient art. Since the dawn of human beings, nursing activities have existed. Previously, nursing was a second-level discipline associated with clinical medicine. In 2011, in consideration of the needs of “Nursing science” development internationally and the specific status of undergraduate nursing education in China at that time, the Academic Degrees Committee of the Chinese State Council finally repositioned nursing science into a first-level science/discipline after repeated debates by experts from the Academic Degree and Graduate Education Committee of China.Great Significance in the Nursing Discipline Case Study Essay

Although nursing has become a first-level discipline, medical professionals are still constantly debating about the relationship between nursing and medicine, particularly, the relationship between clinical medicine and nursing care. From a philosophical point of view, the relationship of mutual dependency can be divided into sequential dependency, interdependency, North–South dependency, and deterministic dependency. Interdependency refers to the inseparable interaction between one subject and another, indicating that when one of these subjects exists, the other must also exist. If one subject disappears, then the other also loses its meaning of existence. From that perspective, medicine and nursing have an interdependent relationship and are mutually dependent on one another. Ancient nursing care in China focused on “30% treatment and 70% nursing”, in which “nursing” indicates patient care; similarly, today’s clinical medicine is composed of 30% treatment and 70% nursing care, suggesting that nursing has played a very important role in medicine from early on. In the nursing discipline, 70% of the workload comprises physical and psychological care, and 30% comprises medical treatment. Therefore, medicine and nursing are interdependent and mutually indispensable.Great Significance in the Nursing Discipline Case Study Essay

Although medicine and nursing have an interdependent relationship, they are also distinctive from one another. Clinical medicine focuses specifically on the diagnosis and treatment of diseases; thus, the learned clinical aspects are rigorous. Conversely, nursing requires direct contact with patients every day, and all aspects beyond medical treatment that are essential for a patient’s recovery and peaceful discharge from the hospital are performed by nurses.

2 Existing problems in the nursing discipline
Education is the foundation of a country. Good nursing education is not only a necessary prerequisite for clinical nursing practice and teaching in nursing, but it is also required for nursing management and research work in nursing science. As an independent discipline, nursing demands independent thinking and a separate educational system, theoretical system, and so on. The following issues that currently exist in nursing will be discussed from the aspects of theoretical education and practical education.Great Significance in the Nursing Discipline Case Study Essay

2.1 Theoretical knowledge
2.1.1 Curriculum
The current nursing education curriculum in China can be divided into three categories: (1) general public courses, such as physical education, college English, and so on; (2) basic medical courses, such as physiology, biochemistry, anatomy, pharmacology, and so on; and (3) nursing professional courses, such as General Nursing, Internal Medicine, Surgery, Obstetrics and Gynecology, Pediatrics, Community Nursing, and so on. The following areas have existing problems.

Course contents: Nursing education, in terms of both theory and knowledge, remains under the influence of previous biomedical models. The course adopts a three-stage approach. Most undergraduate colleges have gradually replaced “Diagnostics”, the clinical textbook in medical science once used by nursing majors, with “Health Assessment”,2, 3 which can weaken the influence of nursing students’ medical thinking and impede the establishment of a complete medical system that requires nurses to understand the basic concept of medicine. “Diagnostics” is one of the most important fundamental courses for medical students, which bridges the medical education system between nursing and medicine. It is particularly important for developing clinical thinking and practical abilities in the students. “Diagnostics” focuses on the understanding and recognition of diseases. Great Significance in the Nursing Discipline Case Study Essay It can provide guidance for disease diagnosis and confirmation of treatment measures, which is conducive to the clinical triage division of nursing students. In addition to the basic skills that are required during clinical practice, modern nurses should also possess a certain degree of general knowledge in psychological care and the concept of humanistic care. These humanities courses are not listed as mandatory courses but are elective courses in Chinese institutes of higher education. The current curriculum may produce students who lack humanistic concepts and neglect the humanity aspect in nursing care.4 Some institutions have assigned the humanities curriculum as a mandatory course. However, instructors who teach the course have no nursing background and only specialize in humanities studies. These teachers can only teach the theory to the students without any real experience in clinical practice. Thus, taking the course does not help the students obtain first-hand experience or understanding; they only learn confusing theories, and the concepts cannot be fully comprehended or applied in the future nursing careers of the student. Regardless, general humanities courses, nature-related courses, and social science courses are widely offered at universities in Denmark, Australia, the United States, and other countries.5, 6
Curriculum arrangement: Most of the undergraduate nursing curriculums in Chinese educational institutes begin with general medicine. Basic physiology and biochemistry courses are taught before beginning the nursing professional courses. Conversely, in other countries, courses such as “Introduction to Nursing” are offered from the beginning of enrollment so that students can have a general understanding of nursing to decide whether to continue to pursue a nursing major. Moreover, in the nursing education plan of those countries, humanities courses are taught at the beginning of the new school year or at the start of the second semester, with the intention that the students will remember the concept of humanistic care that they learned from the beginning of the school year.5, 6 However, the undergraduate nursing education curriculum in China lacks these systematic arrangements. For example, redundant knowledge is repeated in the internal medicine and surgery courses. The current textbooks and teaching require better integration with one another to avoid overlapping information.7 In addition, nursing science education in China has greatly emphasized medical science, whereas the international nursing education program curriculum is not biased toward medicine.Great Significance in the Nursing Discipline Case Study Essay Instead, it begins with health and then extends to involve all other areas of health, including physiological, psychological, spiritual, cultural, social, behavioral, and the environmental factors that affect an individual’s health.
2.1.2 Training objectives
Currently, based on the nursing training objectives, the College of Nursing of Jilin University has set goals in four areas of student education: concepts, knowledge, abilities, and quality. The School of Nursing of Central South University has proposed training requirements for quality, knowledge, and skills. The Nanjing Medical University School of Nursing proposed seven specific training objectives. Li et al.7 proposed three educational goals after studying the training objectives of undergraduate nursing courses in China: knowledge, ability, and quality.

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However, many problems exist in these training objectives. The National Bureau of Education noted that for professional nursing certification, a nursing program should cultivate critical thinking abilities, solid theoretical knowledge, strong practical abilities, and scientific research abilities in their nursing students.8 However, although our undergraduate nursing education programs have greatly emphasized the learning of theoretical knowledge in the curriculum setting, they have not paid sufficient attention to courses of practical value such as statistics. Moreover, undergraduate medical students can graduate without a thesis defense requirement, which further weakens the ability of most students to conduct scientific research. Furthermore, undergraduate nursing students are not required to take a diagnostics course, which is a major reason why nurses do not have the right to prescribe medication. Under this circumstance, we may want to reflect on whether nursing education under the guidance of a medical model is a better choice for the discipline.Great Significance in the Nursing Discipline Case Study Essay

2.1.3 The faculty team
Nursing science education aims to train students to gain a solid theoretical foundation, practical ability, scientific research ability, humanistic qualities, as well as strong evaluation and observation abilities. The faculty team in nursing education plays critical roles in achieving these goals. Presently, the personnel engaged in nursing professional teaching in Chinese colleges and universities can be roughly divided into three groups: (1) the specialized nursing teachers who are no longer clinical practitioners; (2) clinicians who also serve as nursing faculties; and (3) senior head nurses who have extensive clinical experience. The advantage of having clinicians as teaching faculties for the nursing major lies in their strong background in medical theories. However, because the doctors are not graduates from the nursing major, their teaching may lack insight into nursing care. Specialized nursing teachers often have solid knowledge of the theories of nursing, but they are out of touch with clinical practice, and these staff members are in short supply.9, 10 Studies have shown that the academic qualifications of current nurses in the clinic are generally poor, and they have limited theoretical knowledge compared to that of the specialized teachers. However, nursing is a practical and application-oriented discipline. Thereby, more clinical nurses with higher academic qualifications, better nursing skills, and better comprehensive quality should be encouraged to become nursing educators. As clinical nurses, they innately have some core qualities that qualify them as great teachers, such as the ability to keenly observe a situation, perform medical treatment, provide life support, ensure safety and security, conduct health education, provide human care, and perform technical operations.Great Significance in the Nursing Discipline Case Study Essay

There are many advantages to recruiting clinical nurses to join the nursing education faculty team.10 First, clinical nurses can introduce the latest technology and more advanced knowledge from the first line of clinical practice into the content of teaching so that the phenomenon of education lagging behind clinical practice can be changed. To a certain extent, clinical nurses can also add new elements to the connection between theoretical knowledge and clinical practice. Second, clinical nurses have long been engaged in clinical work and have a wealth of clinical experience. In teaching professional knowledge, they can use personal examples from their own work to explain the theories, thus helping the student better understand and promote more active thinking. For example, to explain the measures adopted in nursing care, by combining clinical cases, the teacher can simplify concepts that may appear boring and difficult for the students to remember; they can also assist the student in making connections between textbook knowledge and clinical practice in real life. However, clinical nurses lack the clinical experience of doctors; therefore, she or he will not be able cultivate the students’ diagnostic thinking or simplify the textbook concepts for application in clinical practice. The teaching may lead to the students’ systemic disconnection from the entire disease that they have learned. Third, every nursing student will be in clinical contact with patients in the future. In clinical settings, nurse–patient communication and humanistic care are essential core qualities that reflect nurses’ competency. Specialized nursing teachers can only teach textbook theories to students, whereas clinical nurse faculties can use the actual case studies encountered in their work to explain the theories to the students. Consequently, the students can recognize the importance of having active communication and providing personal care to the patient and appreciate the immense value of the work performed by each nurse or nursing student. Most of the nursing educators in the United States and other countries are senior practitioners in clinical care.Great Significance in the Nursing Discipline Case Study Essay

2.1.4 Teaching format
The traditional nursing education model is a singular model. It emphasizes the transfer of knowledge and is accustomed to methods such as “injection” or “full house irrigation”, which are passive methods of placing knowledge into students’ brains.11 The single indoctrination mode of “teacher speaking, student listening” is commonly accepted by students. In the classroom, teachers teach textbook knowledge either in strict accordance with the textbook or in combination with some of their own cases while students merely listen. Most of the teachers complete the task mechanically and rarely ask the students any questions or initiate any interactions or discussions. The students, conversely, are often confused, and their minds shut down, not allowing them to think independently or creatively. Naturally, given our large population, adopting some teaching methods used by well-developed countries with much lower teacher-to-student ratios will be difficult. However, we can still select some educational approaches that are suitable for the situations in our country, for instance, “discovery teaching”, in which the teachers guide the students to discover, explore, and solve problems to drive everyone’s interest and lead the students to acquire knowledge through active learning, thinking, and participation.Great Significance in the Nursing Discipline Case Study Essay

2.2 Current status of clinical practice
2.2.1 The disconnection between theory and practice
Currently, the 4-year undergraduate degree in nursing science education in China is mainly composed of a 3-year theoretical study and a subsequent clinical internship for at least 8 months. In this type of curriculum arrangement, connections between the textbook knowledge and clinical practice are weak, and knowledge learned from the textbooks is not applied to clinical practice in a timely manner.12 Because of the long time interval between theoretical study and clinical practice, the textbook theories are not further reinforced through practice quickly enough. Consequently, when the clinical internship begins, the knowledge learned before has faded and fails to be adopted into clinical practice. Furthermore, during clinical practice, the nursing students only learn ward care and professional skills required by the internship department and do not take the initiative to study the theories again to further comprehend the knowledge learned in the classes. Conversely, in Australia and some other countries, nursing students complete a clinical internship after the end of each semester and also undergo a rigorous internship evaluation.Great Significance in the Nursing Discipline Case Study Essay

2.2.2 Rigid training objectives in clinical internship
Although the Chinese clinical nursing model has shifted from a functional nursing care model to a holistic nursing care model, the number of clinical nurses still only matches the functional nursing model, resulting in a shortage of nursing professionals. Moreover, the large number of nursing interns requires more teaching members; thus, some nurses who are not well-experienced or qualified began to conduct clinical teaching to these interns. Because of their heavy workload and lack of fundamental knowledge in theories, these nurses can only show the interns how to perform rigid procedures of care but not with critical and comprehensive thinking during the process, which causes the nursing students to repeat the daily mechanical execution of the doctor’s orders. Hence, the clinical work procedures are never truly mastered during the 8-month internship.Great Significance in the Nursing Discipline Case Study Essay

2.2.3 Lack of evidence-based clinical practice
Evidence-based thinking and executing ability are the new objectives in the development of clinical nursing education. Presently, evidence-based nursing care is a new trend in the development of nursing science in the international nursing community. Its scientific and practical features have attracted broad attention from many domestic nursing staff members. However, evidence-based nursing is still in its infancy in China. Because clinical nurses have very limited knowledge and experience in evidence-based nursing, its teaching in clinical practice remains significantly behind that of other developed countries. Our clinical nursing care is still conducted at a simple and mechanically repeating level. Conversely, in some developed countries, evidence-based medicine is not only adopted in clinical nursing care but also applied to the investigative studies of the psychological health of nurses for nursing management and nursing research.Great Significance in the Nursing Discipline Case Study Essay

2.2.4 The shortage of clinical staff and the incompletely accomplished functions of nurses
According to the statistics of the World Health Organization and the National Health Bureau, the bed-to-nurse ratio in China still fails to meet the standard guidelines. Clinical nurses should be able to provide care services in areas, such as life care, health education, safety and security, human care, condition observation, medical treatment, and so on. However, because of the nurse shortage, each nurse is responsible for more than a reasonable number of patients. With such a heavy workload, the nursing staff only handle work that requires little time to complete, such as observing the patient’s condition, and have no time to provide psychological or other forms of care. This leads to the simplification of the job function and failure to truly appreciate the value of the nursing staff and the characteristics of nursing disciplines.Great Significance in the Nursing Discipline Case Study Essay

3 The developing trend of the nursing discipline
After more than a century of development, particularly in some Western countries, nursing has become an independently developed discipline that is associated with medicine yet also distinctive from medicine. From nursing education to nursing management and from nursing research to clinical nursing care, nursing science has established a complete and independent knowledge system in its own entirety.

Studies have shown that the characteristics of a matured discipline should include a sound theoretical system, mature research methods, and specific research objects. To become an independent discipline, nursing must have developed the following: a specific philosophical foundation, subject-specific values and beliefs, conceptual systems, research methods, and a field of knowledge. Li14 has demonstrated that the key differences between the nursing discipline and other disciplines are a clear philosophical foundation, a conceptual framework that describes exactly what nursing care is, an accepted methodological development of care, and content associated with social behaviors.Great Significance in the Nursing Discipline Case Study Essay

Currently, people still lack a clear understanding of the relationship between nursing and medicine. The nursing model evolves with the development of the medical model, and nursing is a subdivision of medicine. The advantages of teaching nursing under the medical model, as mentioned above, also cause people to consider the nursing discipline as a part of medicine and as a field that cannot develop or think independently. However, the independent development and cogitation of a discipline must be based on the inherent relationship of the discipline with its original field. The independent development of nursing first requires reorganization, in which care and medicine are interdependent and there is an accurate understanding of the philosophical relationship between the two factors. If the independent development of the nursing discipline indicates that there is no connection between nursing and medicine, this idea is contradictory to fundamental philosophical principles. Without medicine, nursing will not exist, let alone develop independently. Some Chinese scholars believe that the formation of an independent discipline should have the following three characteristics: the discipline must have specific and other irreplaceable research objects and fields; there must be a unique theoretical system and research methods; and judging if a subject is independent or mature is dependent upon its characteristics in both theory and practice.Great Significance in the Nursing Discipline Case Study Essay

Based on the above standards for the maturity of disciplines and the existing problems in nursing, we propose the following changes in the independent development of the nursing discipline in the future: (1) reform the nursing education curriculum, add humanities courses, and emphasize learning the diagnostics and statistics; the curriculum and teaching objectives should be coordinated; (2) improve the nursing educational system and clinical practice evaluation system; (3) follow guidelines by national policies and future social needs, increase the number of clinical nurses, and train more specialist nurses, community nurses, home nurses, and elderly nurses who will fill practical social needs; (4) integrate practice into education and provide internship opportunities soon after completing theoretical study to ensure that practice and theory are closely connected; (5) enhance the team of nursing faculties and improve the academic level of nursing disciplines; and (6) innovate consistently to build a nursing theory system based on philosophical thinking.Great Significance in the Nursing Discipline Case Study Essay

4 Conclusions
In summary, nursing is a practical science, and its research objects are all humans in society. We should use humans as study objects to identify suitable research methods for the nursing discipline and build a unique nursing theoretical system that fits our county’s situation based on certain philosophies. This approach will truly allow the discipline to develop independently. In an age when health is the core focus of health care, modern nursing care must focus on the entire health chain of prevention, treatment, and rehabilitation. Establishing multidisciplinary cooperation will become the future direction of the nursing discipline.Great Significance in the Nursing Discipline Case Study Essay

Theories are formulated to explain, predict, and understand phenomena and, in many cases, to challenge and extend existing knowledge within the limits of critical bounding assumptions. The theoretical framework is the structure that can hold or support a theory of a research study. The theoretical framework introduces and describes the theory that explains why the research problem under study exists.

Abend, Gabriel. “The Meaning of Theory.” Sociological Theory 26 (June 2008): 173–199; Swanson, Richard A. Theory Building in Applied Disciplines. San Francisco, CA: Berrett-Koehler Publishers 2013.Great Significance in the Nursing Discipline Case Study Essay

Importance of Theory
A theoretical framework consists of concepts and, together with their definitions and reference to relevant scholarly literature, existing theory that is used for your particular study. The theoretical framework must demonstrate an understanding of theories and concepts that are relevant to the topic of your research paper and that relate to the broader areas of knowledge being considered.

The theoretical framework is most often not something readily found within the literature. You must review course readings and pertinent research studies for theories and analytic models that are relevant to the research problem you are investigating. The selection of a theory should depend on its appropriateness, ease of application, and explanatory power.Great Significance in the Nursing Discipline Case Study Essay

The theoretical framework strengthens the study in the following ways:

An explicit statement of theoretical assumptions permits the reader to evaluate them critically.
The theoretical framework connects the researcher to existing knowledge. Guided by a relevant theory, you are given a basis for your hypotheses and choice of research methods.
Articulating the theoretical assumptions of a research study forces you to address questions of why and how. It permits you to intellectually transition from simply describing a phenomenon you have observed to generalizing about various aspects of that phenomenon.Great Significance in the Nursing Discipline Case Study Essay
Having a theory helps you identify the limits to those generalizations. A theoretical framework specifies which key variables influence a phenomenon of interest and highlights the need to examine how those key variables might differ and under what circumstances.
By virtue of its applicative nature, good theory in the social sciences is of value precisely because it fulfills one primary purpose: to explain the meaning, nature, and challenges associated with a phenomenon, often experienced but unexplained in the world in which we live, so that we may use that knowledge and understanding to act in more informed and effective ways.

The Conceptual Framework. College of Education. Alabama State University; Corvellec, Hervé, ed. What is Theory?: Answers from the Social and Cultural Sciences. Stockholm: Copenhagen Business School Press, 2013; Asher, Herbert B. Theory-Building and Data Analysis in the Social Sciences. Knoxville, TN: University of Tennessee Press, 1984; Drafting an Argument. Writing@CSU. Colorado State University; Ravitch, Sharon M. and Matthew Riggan. Reason and Rigor: How Conceptual Frameworks Guide Research. Second edition. Los Angeles, CA: SAGE, 2017; Trochim, William M.K. Philosophy of Research. Research Methods Knowledge Base. 2006; Jarvis, Peter. The Practitioner-Researcher. Developing Theory from Practice. San Francisco, CA: Jossey-Bass, 1999.Great Significance in the Nursing Discipline Case Study Essay

Strategies for Developing the Theoretical Framework
I. Developing the Framework

Here are some strategies to develop of an effective theoretical framework:

Examine your thesis title and research problem. The research problem anchors your entire study and forms the basis from which you construct your theoretical framework.
Brainstorm about what you consider to be the key variables in your research. Answer the question, “What factors contribute to the presumed effect?”
Review related literature to find how scholars have addressed your research problem. Identify the assumptions from which the author(s) addressed the problem.Great Significance in the Nursing Discipline Case Study Essay
List the constructs and variables that might be relevant to your study. Group these variables into independent and dependent categories.
Review key social science theories that are introduced to you in your course readings and choose the theory that can best explain the relationships between the key variables in your study [note the Writing Tip on this page].
Discuss the assumptions or propositions of this theory and point out their relevance to your research.
A theoretical framework is used to limit the scope of the relevant data by focusing on specific variables and defining the specific viewpoint [framework] that the researcher will take in analyzing and interpreting the data to be gathered. It also facilitates the understanding of concepts and variables according to given definitions and builds new knowledge by validating or challenging theoretical assumptions.

II. Purpose

Think of theories as the conceptual basis for understanding, analyzing, and designing ways to investigate relationships within social systems. To that end, the following roles served by a theory can help guide the development of your framework.

Means by which new research data can be interpreted and coded for future use,
Response to new problems that have no previously identified solutions strategy,
Means for identifying and defining research problems,Great Significance in the Nursing Discipline Case Study Essay
Means for prescribing or evaluating solutions to research problems,
Ways of discerning certain facts among the accumulated knowledge that are important and which facts are not,
Means of giving old data new interpretations and new meaning,
Means by which to identify important new issues and prescribe the most critical research questions that need to be answered to maximize understanding of the issue,
Means of providing members of a professional discipline with a common language and a frame of reference for defining the boundaries of their profession, and
Means to guide and inform research so that it can, in turn, guide research efforts and improve professional practice.
Adapted from: Torraco, R. J. “Theory-Building Research Methods.” In Swanson R. A. and E. F. Holton III , editors. Human Resource Development Handbook: Linking Research and Practice. (San Francisco, CA: Berrett-Koehler, 1997): pp. 114-137; Jacard, James and Jacob Jacoby. Theory Construction and Model-Building Skills: A Practical Guide for Social Scientists. New York: Guilford, 2010; Ravitch, Sharon M. and Matthew Riggan. Reason and Rigor: How Conceptual Frameworks Guide Research. Second edition. Los Angeles, CA: SAGE, 2017; Sutton, Robert I. and Barry M. Staw. “What Theory is Not.” Administrative Science Quarterly 40 (September 1995): 371-384.

Structure and Writing Style
The theoretical framework may be rooted in a specific theory, in which case, your work is expected to test the validity of that existing theory in relation to specific events, issues, or phenomena. Many social science research papers fit into this rubric. For example, Peripheral Realism Theory, which categorizes perceived differences among nation-states as those that give orders, those that obey, and those that rebel, could be used as a means for understanding conflicted relationships among countries in Africa. A test of this theory could be the following: Does Peripheral Realism Theory help explain intra-state actions, such as, the disputed split between southern and northern Sudan that led to the creation of two nations?Great Significance in the Nursing Discipline Case Study Essay

However, you may not always be asked by your professor to test a specific theory in your paper, but to develop your own framework from which your analysis of the research problem is derived. Based upon the above example, it is perhaps easiest to understand the nature and function of a theoretical framework if it is viewed as an answer to two basic questions:Great Significance in the Nursing Discipline Case Study Essay

What is the research problem/question? [e.g., “How should the individual and the state relate during periods of conflict?”]
Why is your approach a feasible solution? [i.e., justify the application of your choice of a particular theory and explain why alternative constructs were rejected. I could choose instead to test Instrumentalist or Circumstantialists models developed among ethnic conflict theorists that rely upon socio-economic-political factors to explain individual-state relations and to apply this theoretical model to periods of war between nations].
The answers to these questions come from a thorough review of the literature and your course readings [summarized and analyzed in the next section of your paper] and the gaps in the research that emerge from the review process. With this in mind, a complete theoretical framework will likely not emerge until after you have completed a thorough review of the literature.

Just as a research problem in your paper requires contextualization and background information, a theory requires a framework for understanding its application to the topic being investigated. When writing and revising this part of your research paper, keep in mind the following:Great Significance in the Nursing Discipline Case Study Essay

Clearly describe the framework, concepts, models, or specific theories that underpin your study. This includes noting who the key theorists are in the field who have conducted research on the problem you are investigating and, when necessary, the historical context that supports the formulation of that theory. This latter element is particularly important if the theory is relatively unknown or it is borrowed from another discipline.
Position your theoretical framework within a broader context of related frameworks, concepts, models, or theories. As noted in the example above, there will likely be several concepts, theories, or models that can be used to help develop a framework for understanding the research problem. Therefore, note why the theory you’ve chosen is the appropriate one.
The present tense is used when writing about theory. Although the past tense can be used to describe the history of a theory or the role of key theorists, the construction of your theoretical framework is happening now.Great Significance in the Nursing Discipline Case Study Essay
You should make your theoretical assumptions as explicit as possible. Later, your discussion of methodology should be linked back to this theoretical framework.
Don’t just take what the theory says as a given! Reality is never accurately represented in such a simplistic way; if you imply that it can be, you fundamentally distort a reader’s ability to understand the findings that emerge. Given this, always note the limitations of the theoretical framework you’ve chosen [i.e., what parts of the research problem require further investigation because the theory inadequately explains a certain phenomena].
The Conceptual Framework. College of Education. Alabama State University; Conceptual Framework: What Do You Think is Going On? College of Engineering. University of Michigan; Drafting an Argument. Writing@CSU. Colorado State University; Lynham, Susan A. “The General Method of Theory-Building Research in Applied Disciplines.” Advances in Developing Human Resources 4 (August 2002): 221-241; Tavallaei, Mehdi and Mansor Abu Talib. “A General Perspective on the Role of Theory in Qualitative Research.” Journal of International Social Research 3 (Spring 2010); Ravitch, Sharon M. and Matthew Riggan. Reason and Rigor: How Conceptual Frameworks Guide Research. Second edition. Los Angeles, CA: SAGE, 2017; Reyes, Victoria. Demystifying the Journal Article. Inside Higher Education; Trochim, William M.K. Philosophy of Research. Research Methods Knowledge Base. 2006; Weick, Karl E. “The Work of Theorizing.” In Theorizing in Social Science: The Context of Discovery. Richard Swedberg, editor. (Stanford, CA: Stanford University Press, 2014), pp. 177-194.Great Significance in the Nursing Discipline Case Study Essay

An increasingly important trend in the social and behavioral sciences is to think about and attempt to understand research problems from an interdisciplinary perspective. One way to do this is to not rely exclusively on the theories developed within your particular discipline, but to think about how an issue might be informed by theories developed in other disciplines. For example, if you are a political science student studying the rhetorical strategies used by female incumbents in state legislature campaigns, theories about the use of language could be derived, not only from political science, but linguistics, communication studies, philosophy, psychology, and, in this particular case, feminist studies. Building theoretical frameworks based on the postulates and hypotheses developed in other disciplinary contexts can be both enlightening and an effective way to be more engaged in the research topic.

CohenMiller, A. S. and P. Elizabeth Pate. “A Model for Developing Interdisciplinary Research Theoretical Frameworks.” The Qualitative Researcher 24 (2019): 1211-1226; Frodeman, Robert. The Oxford Handbook of Interdisciplinarity. New York: Oxford University Press, 2010.Great Significance in the Nursing Discipline Case Study Essay

Another Writing Tip
Don’t Undertheorize!

Do not leave the theory hanging out there in the introduction never to be mentioned again. Undertheorizing weakens your paper. The theoretical framework you describe should guide your study throughout the paper. Be sure to always connect theory to the review of pertinent literature and to explain in the discussion part of your paper how the theoretical framework you chose supports analysis of the research problem or, if appropriate, how the theoretical framework was found to be inadequate in explaining the phenomenon you were investigating. In that case, don’t be afraid to propose your own theory based on your findings.

Fleetwood, Steve and Anthony Hesketh. “HRM-Performance Research: Under-theorized and Lacking Explanatory Power.” The International Journal of Human Resource Management 17 (2006): 1977-1993.Great Significance in the Nursing Discipline Case Study Essay
Yet Another Writing Tip
What’s a Theory? What’s a Hypothesis?

The terms theory and hypothesis are often used interchangeably in newspapers and popular magazines and in non-academic settings. However, the difference between theory and hypothesis in scholarly research is important, particularly when using an experimental design. A theory is a well-established principle that has been developed to explain some aspect of the natural world. Theories arise from repeated observation and testing and incorporates facts, laws, predictions, and tested assumptions that are widely accepted [e.g., rational choice theory; grounded theory; critical race theory].

A hypothesis is a specific, testable prediction about what you expect to happen in your study. For example, an experiment designed to look at the relationship between study habits and test anxiety might have a hypothesis that states, “We predict that students with better study habits will suffer less test anxiety.” Unless your study is exploratory in nature, your hypothesis should always explain what you expect to happen during the course of your research.Great Significance in the Nursing Discipline Case Study Essay

The key distinctions are:

A theory predicts events in a broad, general context; a hypothesis makes a specific prediction about a specified set of circumstances.
A theory has been extensively tested and is generally accepted among scholars; a hypothesis is a speculative guess that has yet to be tested.
Cherry, Kendra. Introduction to Research Methods: Theory and Hypothesis. About.com Psychology; Gezae, Michael et al. Welcome Presentation on Hypothesis. Slideshare presentation.

Still Yet Another Writing Tip
Be Prepared to Challenge the Validity of an Existing Theory

Theories are meant to be tested and their underlying assumptions challenged; they are not rigid or intransigent, but are meant to set forth general principles for explaining phenomena or predicting outcomes. Given this, testing theoretical assumptions is an important way that knowledge in any discipline develops and grows. If you’re asked to apply an existing theory to a research problem, the analysis may include the expectation by your professor that you should offer modifications to the theory based on your research findings. Indications that theoretical assumptions may need to be modified can include the following:Great Significance in the Nursing Discipline Case Study Essay

Your findings suggest that the theory does not explain or account for current conditions or circumstances,
The study reveals a finding that is significantly incongruent with what the theory attempts to explain or predict, or
Your analysis reveals that the theory overly generalizes behaviors or actions without taking into consideration specific factors [e.g., factors related to culture, nationality, history, gender, ethnicity, age, geographic location, legal norms or customs, religion, social class, socioeconomic status, etc.].

Philipsen, Kristian. “Theory Building: Using Abductive Search Strategies.” In Collaborative Research Design: Working with Business for Meaningful Findings. Per Vagn Freytag and Louise Young, editors. (Singapore: Springer Nature, 2018), pp. 45-71; Shepherd, Dean A. and Roy Suddaby. “Theory Building: A Review and Integration.” Journal of Management 43 (2017): 59-86.Great Significance in the Nursing Discipline Case Study Essay

Researchers describe how case studies examine complex phenomena in the natural setting to increase understanding of them.3 4 Indeed, Sandelowski5 suggests using case studies in research means that the holistic nature of nursing care can be addressed. Furthermore, when describing the steps undertaken while using a case study approach, this method of research allows the researcher to take a complex and broad topic, or phenomenon, and narrow it down into a manageable research question(s). By collecting qualitative or quantitative datasets about the phenomenon, the researcher gains a more in-depth insight into the phenomenon than would be obtained using only one type of data. This is illustrated in the examples provided at the end of this paper.Great Significance in the Nursing Discipline Case Study Essay

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain.6 ‘We study what is similar and different about the cases to understand the quintain better’.6

Method
The steps when using case study methodology are the same as for other types of research.6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge.6Great Significance in the Nursing Discipline Case Study Essay

Benefits and limitations of case studies
If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development.6 Great Significance in the Nursing Discipline Case Study Essay

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus.2 Reporting of findings from multiple-case research studies is also challenging at times,1 particularly in relation to the word limits for some journal papers.

Examples of case studies
Example 1: nurses’ paediatric pain management practices
One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.Great Significance in the Nursing Discipline Case Study Essay

These datasets were analysed separately and then compared7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices.7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice.8 There was also a difference in self-reported and observed practices9; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)
The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada.10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.Great Significance in the Nursing Discipline Case Study Essay

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care.10

Conclusion
These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.Great Significance in the Nursing Discipline Case Study Essay