Middle-range nursing theory discussion

What is the difference between high-, middle-, and low-range theories?


Explain your understanding of a middle-range nursing theory.

Identify a research study in which a middle-range theory was applied. Discuss the study results and implications for practice.


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Response 1: Kristine

Middle-Range Theories are known to fill the gap between grand nursing theories and nursing practice (Mcewen & Wills 2017, p 74). Middle range theories have a more limited scope, and they are clear and testable, meaning hypotheses can be taken from these theories Middle- Range Theories are further subdivided into High, Middle, and Low-Middle Range Theories. High middle-range theories are broad and abstract. Examples of this is the concepts of caring, transcendence, adaptation, and culture (Mcewen & Wills (2014). High Middle-Range theories can most often be identified as the most used nursing theories. Middle Middle-Range Theories are theoretical, specific, and unpredictability of illness, unpleasant symptoms, and chronic sorrow (Mcewen & Wills (2014). Low Middle-Range Theories are more so defined and specific that Middle Middle- Range Theories.

An example of a research study in which a middle-range theory was applied is the Neglecting and Ignoring the Menopausal Transition Study. This study was performed to identify how post-menopausal women viewed themselves. The study included twenty-one low-income Korean subjects including both perimenopausal and postmenopausal women (Meleis et al., 2000). Largely identified with this theory was that women were ignoring their postmenopausal needs or symptoms due to the many other demands in their lives. The study identified that these demands mostly consisted of issues surrounding immigration as well as the patriarchal mentality of their heritage (Meleis et al., 2000). With this study, the women involved were able to identify this as an actual problem and concern within their society.


Response 2: Lorraine

Middle-range nursing theory as one might derive from the name, lies somewhere in the middle, between the most abstract of theories like grand nursing theories, and more concrete theories like situation specific theories. Middle-range nursing theories are more specific than grand theories, and it’s concepts and propositions are relatively concrete (McEwan, 2017, pg 207).

Middle-range nursing theory is often used and preferred  in research, and the reason stated is that “they provide a better basis for generating testable hypotheses and addressing particular client populations (McEwan, 2017, pg 208). Middle range theories “describe, explain, or predict phenomena, and, unlike grand theory, they must be explicit and testable” (McEwan, 2017, pg 208).

Middle-range theories can be hard to  categorize, so some nursing scholars have divided mid-range theory into three sub-categories; high-middle theories, middle theories, and low-middle theories. They seem to be categorized based on how close they are to either end of the theory scope with grand theories on one end and more concrete theories on the other end.  “High-middle theories included concepts such as caring, growth and development, self-transcendence, resilience, and psychological adaptation. Middle theories included concepts such as uncertainty in illness, unpleasant symptoms, chronic sorrow, peaceful end of life, cultural brokering, and nurse-expressed empathy. Low-middle theories, those that are closer to practice or situation-specific theories, included hazardous secrets, women’s anger, nurse midwifery care, acute pain management, helplessness, and intervention for postsurgical pain” (McEwan, 2017, pg 211).

There are many instances where middle-range theories are used in research and one example is The Theory of Chronic Sorrow by Georgene G. Eakes, Mary L. Burke and Margaret A. Hainsworth. This  middle-range theory was used in research that led to the development of the Kendall Chronic Sorrow Instrument to screen for and measure the experience of chronic sorrow (2021).


Response 1: Kristine Reply

I agree with you that middle-range theories are important in trying to fill the gap between nursing practice and grand nursing theories. However, I believe there are three distinctive types of Middle-range Theory which include descriptive, explanatory, and predictive middle-range theories. Descriptive mid-range theories are the most common type of middle-range theories in that they encompass just a single concept and actively describe a phenomenon. Peplau’s Theory of interpersonal relations can therefore be classified as an example of immediate descriptive Theory. Explanatory middle-range theories are also common and help serve the purpose of specifying relations between different concepts. Each explanatory Theory, therefore, explains the extent of the relationship between a concept to another concept. On the other hand, predictive middle-range theories have to actively move beyond the prediction of the relationship between concepts or relationships between one or more concepts. Predictive middle-range theories help to explain why a given phenomenon occurs (Warren, 2016).


Warren, H. (2016). Middle-Range Theories. Plastic Surgical Nursing, 36(1), 9–11. https://doi.org/10.1097/psn.0000000000000124

Response 2: Lorraine Reply

I agree with you that middle-range nursing theories are important. Middle-range nursing theories are therefore formed as a result of rigorous procedures that theorists want to describe in detail according to their worldview. For middle-range theories, the description of various concepts are important, especially when seeking to present the world view of a given theory and insert the social-cultural movement in which are given theories are designed. Inserting the socio-cultural concept of a middle-range theory is therefore important to determine its usefulness in nursing and society in general. The development of middle-range nursing theories requires specific knowledge of the phenomenon and theoretical creativity to accurately theorize such a phenomenon (de Carvalho Félix, 2020).


De Carvalho Félix, N. D. (2020). Components of the Development of Middle-Range Nursing Theories. Biomedical Journal of Scientific & Technical Research, 30(3). https://doi.org/10.26717/bjstr.2020.30.004953