Theory Use and Usefulness in Scientific Advancement

Rita H. Pickler

his issue of Nursing is focused on theory in This would particularly be the case if theories for nursing Tnursing, including how theories historically devel- were focused on , explaining, and oped in nursing and how they have evolved over time. predicting those phenomena that are of interest to our dis- Also included in this issue are new thoughts on theory develop- cipline and, by extension, to our practice. Our conundrum ment as well as emergent theoretical . But to what end is here is that the phenomena of interest in nursing science theory in the rapidly changing scientific world? Do theories and practice are highly varied and—importantly—not agreed and, particularly, “grand” theories of the sort that many of us upon by the discipline. Many years ago, the historically impor- of a “certain age” were required to “use” in our own first efforts tant grand theories identified broad phenomena of interest— at research lead to scientific advancement? Is theory useful in person, environment, health, and nursing. In the ensuing today’s seemingly atheoretical age where new scientific “dis- years, these broad phenomena have been challenged, modified, coveries” are announced daily on social media? Do we need or even discounted as meaningless because of their broad- theory to advance science? ness. And yet, it seems that much of what we study as nurse Like most , I was taught very early in my train- scientists does fall into one or more of these broad categories ing that a theory is a set of interrelated and proposi- of phenomena. That begs a further question about the utility tions that explains or predicts events or situations. But I also of grand theories: Have grand theories resulted in a clear defini- learned that what “counts” as theory could be many different tion of nursing science? However, from an historical perspec- things depending on who you ask. A theory could be “grand” tive, the grand theories have helped advance nursing science or macro level, setting forth the phenomena of interest to by articulating these phenomena, even if we choose to let the the discipline using rather abstract concepts. A theory could phenomena represent almost anything we wish to study. be “grounded,” addressing contextual of very Thus, we acknowledge the importance of grand theories specific phenomena experienced by select people. Or a to explication of phenomena of interest to nursing science. Re- theory could be “middle range” or meso level, aimed at inte- grettably, grand theories do not particularly help us to under- grating and focused on linking macro stand relationships among these broad phenomena. Rather, and micro level concepts and theories. Clear in all of this we need middle range or grounded theories to explicate re- was the that theories are abstract, varying in the extent lationships among concepts embedded within these phe- to which they are conceptually developed and empirically nomena in order that scientists can test those proposed tested. However, in the end, theory development and testing relationships. But should all our research be focused on were deemed to be critically important to advancing science. the development and testing of these theories? Perhaps. Scientific advancement is of course critical to any disci- Certainly it would be hard to document that our science is pline, and nursing is no different; science is generally thought advancing in this way; many research papers do not name to advance when theories exist that explain and predict phe- a theory upon which the is based nor identify a theo- nomena. A full discussion of how science advances is beyond retical model being tested. Most rare of all are papers the scope of this editorial. However, whether you think sci- reporting on a theory that has been developed. If theory is ence advances only when current theories fail to explain the necessary for scientific advancement, nurse scientists need phenomena of interest—resulting in a paradigm shift—or at to pay greater attention to theory use in their research and the other extreme that science advances by a steady accumula- their research reports. Certainly if theory has been used to tion of knowledge that occurs with rigorous and repeated the- inform research, that use should be clearly articulated. ory testing, theory and scientific advancement would appear And if theories are tested, then scientists should report on to interact. But is theory necessary to science? More impor- how the theory actually performed. tantly, should all science or research within a scientific Rather than clear delineation of theory use, much re- be focused on theoretical development and testing. I certainly ported nursing science is a collection of empirical studies on consider myself a . Am I also a theorist? many phenomena of interest. Rarely do we have clear under- The answers to these questions, I believe is, “perhaps.” In- standing of how or why the results of these studies contribute deed, perhaps theory is necessary for scientific advancement. to scientific advancement within the discipline. Perhaps as a

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scientific community, we do not think this is necessary. Or per- mation gathered through empirical research into practice. In- haps we need to encourage theory development using the em- deed, perhaps more than ever, clear use of theory in research pirical we have collected over many years and many may be even more important to further advance nursing sci- studies. I might hazard a guess that many of us who have been ence. Thus, the question is not: should we use theory in our studying very specific phenomena over a long period of time scientific work? The question is: are we making explicit the have sufficient data accumulated from which theories could theories we are using? The papers collected in this issue will be developed and tested. Certainly we need more “basic” re- hopefully advance science by reminding us of important past search to develop and test theories, particularly those that theoretical work and providing guidance for the way forward. may lead to interventions designed to improve patient out- To each of us engaged in nursing science, our challenge is to comes. Greater rigor and precision in theory development carefully consider the function of theory in our own work and and testing is much needed. to further advance nursing science by making theory use Science advances because of and sometimes in spite of our more evident in our research reports. efforts. Theory should help that advancement, providing ex- planations of phenomena and their relationships. Using theory in research allows us to refine the definitions and scope of the discipline of nursing. Theories may change and the way that Rita H. Pickler, PhD, RN, FAAN, is Editor of Nursing Research. they are interpreted may change, but these changes and inter- The Editor has no conflicts of interest to disclose. pretations based on are most likely to result in Accepted for publication November 20, 2017. advancements because they occur within the context of Corresponding author: Rita H. Pickler, PhD, RN, FAAN, The FloAnn theory. In nursing science, given the broad scope of our interests, Sours Easton Professor of Child and Adolescent Health and Director, PhD & MS in Nursing Science Programs, The Ohio State University we are likely to need many theories to describe, explain, and predict College of Nursing, 324 Newton Hall, 1585 Neil Avenue Columbus, the complexity in the relationships among those concepts. OH 43210 (e-mail: [email protected]). Theories have long been thought to be the foundations Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. for furthering scientific knowledge and for putting the infor- DOI: 10.1097/NNR.0000000000000267

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.