Discussion Question
Visit online library and review these two articles.
Next, review the evidence you are collecting for your proposed study. Which theories have others cited? Are you seeing a common theme? Next construct a conceptual map (see p. 138 in your textbook). Use Microsoft Word or Microsoft PowerPoint and include this as an attachment. Be sure you have defined the concepts and included relational statements.
Research Question
How does the integration of technology, such as mobile applications and digital tools, improve medication adherence in patients with chronic diseases, and what role does patient education through these technologies play in enhancing adherence and overall health outcomes?
Research
R oundtable
Lynne M . C onnelly
Use of Theoretical Frameworks
in Research
R
eaders of research reports probably have noticed
some studies explicitly name a theory that guided
the research and some do not. It is not always clear
in reports what role the theory or theoretical framework
played (or did not play) in the research. In this issue,
Parker (2014) outlined a study about decision making by
medical-surgical nurses when they activate rapid response
teams. In the report, in the section called “Nurse Decision
Making,” the author concisely discussed theories of decision making and the models of decision making that others have used to examine the topic with nurses. In addition, Parker used an instrument to measure decision making based on these various decision-making models. This
report is a useful example of how theory guides research
and also makes sense of the subsequent findings.
W hat Is a theory?
First, various terms are used to refer to the theoretic
basis of a study, including theory, theoretical framework,
conceptual framework, and models. Theory is a set of interrelated concepts (or variables) and definitions that are
formed into propositions or hypotheses to specify the
relationship among the constructs (Creswell, 2013). A formal theory is well-developed and is useful to predict
behavior or outcomes. A theoretical framework or conceptual framework is less formal and typically less developed than a formal theory. Such a framework often is useful when exploratory work is being done to expand the
theoretical ideas. A conceptual model usually is focused
more narrowly and structured more loosely than theories,
and does not link concepts (Polit & Beck, 2014). For
example, the Lauri and Salantera (2002) instrument is
based on a model that describes how nurses make decisions but does not predict how effective each type is in
making decisions. For the purposes of this column, I use
the general word theory to encompass all these terms.
In simple terms, a theory is a representation of a portion of reality that helps us make sense of complex phenomena. It is not the reality itself; it is a tool for better
understanding. Theories are not right or wrong but some
theories offer a better fit for particular situations. Each
theory can provide a different lens for looking at a problem, allowing it to be examined from different perspectives for full understanding of all its facets (Reeves, Albert,
Kuper, & Hodges, 2008).
Lynne M. Connelly, PhD, RN, is Associate Professor and Director of
Nursing, Benedictine College, Atchison, KS. She is Research Editor for
MEDSURG Nursing.
MEDSURG
n u r s in g .
May-june 2014 • Vol. 23/No. 3
Theory in a study can be stated clearly or it can be
implied (Bond et al., 2011). For example, in physiological
studies, the framework usually is drawn from current
understanding of physiology and pathophysiology. It
often is presented as the state of science in a particular
area. In more abstract areas of research, specific theory
can be useful to frame the problem, develop an intervention, and guide the research study.
A theory about a phenomenon, such as nurse decision
making, parsimoniously explains how nurses make decisions in the practice setting. Each theory will have a num ber of interrelated concepts. Concepts are abstract representations of specific parts of the theory (Polit & Beck,
2014). In the Parker (2014) study, the decision-making
models described how different people have different
ways of making decisions. Some people are intuitive decision makers, some are analytical decision makers, and
others use both types of decision making. While it can
seem even more complex, this concise depiction helps us
understand the process of making a decision and measure
how each nurse in a study normally makes decisions.
Guiding Research
A theory should not be added to a study because the
researcher was told in school that a theory is needed for a
research study. A clear connection should exist among
the theory, the problem or phenomenon being studied,
and the research method. For example, Parker (2014)
used an instmment developed by Lauri and Salantera
(2002) based on the various models of decision making.
Using a valid instmment based on theory allows the
researcher to make comparisons between the results of
different studies that otherwise could not be made if the
researcher used a separate instmment. In addition, when
conducting the study, the researcher also is testing the
theory to determine if it works in the study population.
In Parker’s (2014) study, a factor analysis showed items
measuring analytic decision making correlated with each
other and intuitive decision-making items correlated
with each other; however, each of these did not correlate
significantly with the other type. In other words, intuitive
items were connected with other intuitive items, but not
with analytic items. The same is tme for analytic items.
This supports the validity of the instmment and also supports the theory that guided development of this instrument. When we review the results, then, we can have
some confidence they are measuring aspects of the theory appropriately. In addition, investigators should make
connections between their results and the theory clear in
187
Research R ou n d tab le
their discussion of the findings. They should relate their
results to other research in which the theory was used.
Parker compared his results to results by Lauri and
Salantera (2002).
In another example, Yoder (2005) described how the
Roy Adaption Model was used in several studies: a study
of quality of life in patients with cancer, a study of exercise intervention in patients with cancer, and another
study of clinical outcomes in patients with burns. Yoder
presented figures outlining each aspect of the theory and
how each aspect was measured. Each of the studies provided results helpful to patients, but they also provided
support for the Roy Adaptation Model. The figures in this
article are useful examples of how to make clear connections between concepts within a theory or model and the
measurement instruments. This can be particularly useful
in research proposals.
Theory also is used to guide the development of effective interventions for patient care. In this case, theorists
may use both theory and empirical results to suggest one
variable (the intervention) can have a positive effect on
another variable (e.g., a person’s behavior or physical
outcome). If a theory indicates, for example, that teaching a patient about his or her disease will improve selfmanagement, then we could conduct an intervention
study to test that proposition. Theory also may provide
us with other variables that can moderate this effect
(Polit & Beck, 2014).
O t h e r Is s u e s
When research results are not what were expected, two
reasons are possible: either the research design or measurem ent of variables was flawed, or the theory guiding the
research did not fit the situation or population. In the case
of an inappropriate theory, the researcher may be able to
suggest modifications to the theory. The modifications
then would need to be tested. Useful theory is refined by
this iterative process (Johnson & Webber, 2010).
In qualitative research, theory can have several purposes. General theories, such as interactionism and critical
theory, can be used to guide qualitative research (Reeves
et al., 2008). These are theories that conceptualize how
we should study phenomena (Polit & Beck, 2014;
Sandelowski, 1993). On the other hand, qualitative investigators often want to generate rather than test theory
based on what they find with their particular informants.
Prior to and during data collection, researchers often
avoid substantive theory about the specific phenomena
to prevent being influenced by prior theorizing about the
topic. Thus, the theory generated in qualitative research
is grounded in data that come from directly observing
and talking to the participants (Creswell, 2013).
This short column can not cover all the nuances of
theory and research. Readers can refer to the references
cited or to a good research textbook to obtain more information. Because theory is important to conducting and
understanding research findings, readers should understand what theory is and how a researcher can use it effectively to guide a study. i ’»:i
188
REFERENCES
Bond, A., Eshah, N., Bani-Khaled, M., Hamad, A., Habashneh, S.,
Kataua’, H….. Maabreh, R. (2011). Who uses nursing theory? A
univariate descriptive analysis of five years’ research articles.
Scandinavian Journal of Caring Sciences, 25(2), 404-409.
Creswell, J.W. (2013). The use of theory. In J.W. Creswell (Ed.) Research
design: Qualitative, quantitative, and mixed methods approaches
(4th ed.) (pp. 51-76). Los Angeles, CA: Sage.
Johnson, B.M., & Webber, P.B. (2010). An introduction to theory and reasoning in nursing. Philadelphia, PA: Wolters Kluwer/Lippincott
Williams & Wilkins.
Lauri, S., & Salantera, S. (2002). Developing an instrument to measure
and describe clinical decision-making in different nursing fields.
Journal of Professional Nursing, 18(30), 93-100.
Parker, C.G. (2014). Decision making models used by medical-surgical
nurses to activate rapid response teams. MEDSURG Nursing,
23(3), 159-164.
Polit, D.F., & Beck, C.T. (2014). Essentials of nursing research:
Appraising evidence for nursing practice. Philadelphia, PA: Wolter
Kluwer/Lippincott Williams & Wilkins.
Reeves, S„ Albert, M., Kuper, A., & Hodges, B.D. (2008). Why use theories in qualitative research? BMJ, 337, 631-634.
Sandelowski, M. (1993). Theory unmasked: The uses and guises of theory in qualitative research. Research in Nursing and Health, 16,
213-218.
Yoder, L.H. (2005). Using the Roy Adaptation Model: A program of
research in a military research service. Nursing Science Quarterly,
18(A), 321-323.
M
E
D
Persistent D ifferences Found in
P reventive Services Use w ith in th e
U.S. P o pulation
differences in adult use of preventive servS icesLarge
persisted from 1996 through 2008 across popu-
u
R
G
lation groups defined by poverty, race/ethnicity,
insurance coverage, and geography. Researchers
examined trends in five preventive services: general
checkups, blood pressure screening, blood cholesterol screening, Pap smears, and mammograms.
Among the population of nonelderly adults
(ages 19-64 years), the proportion of the population
having a general checkup increased 1.1% from
1996/1998 to 2007/2008; the proportion of those
with blood cholesterol screening within the prior 5
years increased by 8.2%. In contrast, the percentage
of the population having blood pressure screening
or mammograms (among women) increased modestly between the first pair of time points, but
remained essentially constant thereafter. Finally,
the percentage of women having Pap smears
increased modestly (by 2.1%) from 1996/1998 to
2002/2003, but decreased by about a percentage
point subsequently to the end of the study period.
More details are in Abdus & Selden (2013).
Preventive services for adults: How have differences
across subgroups changed over the past decade?
Medical Care, 51(11), 999-1007. EB3I
MayJune 2014 • Vol. 23/No. 3
MEDSURG
UXJHSIMG,
Copyright of MEDSURG Nursing is the property of Jannetti Publications, Inc. and its content
may not be copied or emailed to multiple sites or posted to a listserv without the copyright
holder’s express written permission. However, users may print, download, or email articles for
individual use.
Use of theoretical and conceptual frameworks in
qualitative research
Green, Helen Elise
ProQuest document link
ABSTRACT
Aim To debate the definition and use of theoretical and conceptual frameworks in qualitative research.
Background There is a paucity of literature to help the novice researcher to understand what theoretical and
conceptual frameworks are and how they should be used. This paper acknowledges the interchangeable usage of
these terms and researchers’ confusion about the differences between the two. It discusses how researchers have
used theoretical and conceptual frameworks and the notion of conceptual models. Detail is given about how one
researcher incorporated a conceptual framework throughout a research project, the purpose for doing so and how
this led to a resultant conceptual model.
Review methods Concepts from Abbott ( 1988 ) and Witz ( 1992 ) were used to provide a framework for research
involving two case study sites. The framework was used to determine research questions and give direction to
interviews and discussions to focus the research.
Discussion Some research methods do not overtly use a theoretical framework or conceptual framework in their
design, but this is implicit and underpins the method design, for example in grounded theory. Other qualitative
methods use one or the other to frame the design of a research project or to explain the outcomes. An example is
given of how a conceptual framework was used throughout a research project.
Conclusion Theoretical and conceptual frameworks are terms that are regularly used in research but rarely
explained. Textbooks should discuss what they are and how they can be used, so novice researchers understand
how they can help with research design.
Implications for practice/research Theoretical and conceptual frameworks need to be more clearly understood by
researchers and correct terminology used to ensure clarity for novice researchers.
FULL TEXT
Introduction
THIS PAPER aims to help the researcher to understand the nature of theoretical and conceptual frameworks and
how they can be used to help give direction to a study, or be identified as an outcome. The use of theoretical and
conceptual frameworks is part of research, but is relatively obscure among the myriad of literature available. In
published research reports, there is often no explanation as to what theoretical and conceptual frameworks are, and
they are mentioned in many popular research textbooks at best minimally and often as terms in a glossary. There
appears to be no manual about how theoretical and/or conceptual frameworks should be used.
This paper examines what the literature says in relation to theoretical and/or conceptual frameworks and considers
how researchers seem to be using them. It also shows how a conceptual framework was used in case study
research to determine the professional jurisdictions of doctors and nurses in the supply and prescription of
medicines, and ultimately to the development of a conceptual model.
Definitions of frameworks
Fain ( 2004 ) defined theory as ‘an organised and systematic set of interrelated statements (concepts) that specify
the nature of relationships between two or more variables, with the purpose of understanding a problem or the
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nature of things’ and concepts as ‘symbolic statements describing a phenomenon or a class of phenomena’.
It is a matter of interpretation as to when concepts become organised and interrelated enough to be deemed
theories, which might explain why the two terms are used interchangeably when referring to frameworks. However,
Parahoo ( 2006 ) suggested that ‘theoretical framework’ should be used when research is underpinned by one
theory and that a ‘conceptual framework’ draws on concepts from various theories and findings to guide research.
This is a slightly different interpretation to that of Fain ( 2004 ) because, instead of suggesting that the concepts
have been built into a theory, it suggests that parts of multiple theories have been taken.
Whether these distinctions matter is questionable. Parahoo ( 2006 ) implied that it is fruitless to consider whether a
researcher has used the correct terminology and it is far more important to consider how theory has been used to
underpin the study.
Authors use the terms ‘conceptual framework’ and ‘theoretical framework’ interchangeably ( Fain 2004 , Parahoo
2006 ). Some authors only refer to one. For example, Lacey ( 2010 ) referred to conceptual frameworks, suggesting
that they identify researchers’ ‘world views’ of their research topics and so delineate their assumptions and
preconceptions about the areas being studied. Fain ( 2004 ) suggested that where a framework is based on
concepts, the framework should be called a conceptual framework, and where it is based on theories it should be
called a theoretical framework.
Given that there is confusion between theoretical and conceptual frameworks, it could be argued that they are of
questionable value. However, frameworks have been described as the map for a study, giving a rationale for the
development of research questions or hypotheses ( Fulton and Krainovich-Miller 2010 ). LoBiondo-Wood ( 2010 )
similarly said that the framework is the design and added that the research question, purpose, literature review and
theoretical framework should all complement each other and help with the operationalisation of the design.
It can be seen that the authors are saying that the framework should be there to assist researchers in ensuring that
their research projects are coherent and to focus their minds on what the research is trying to achieve. Rathert et al (
2012 ) illustrate this confusion. In the title, the authors suggest they have tested a theoretical framework but then
discuss a conceptual model. However, they use the term ‘conceptual framework’ as a title for its diagrammatic
representation. There is no discussion of what these terms mean.
Robson ( 2002 ) suggested that a conceptual framework is often developed as a diagram, whereas Parahoo ( 2006 )
refers to this as a conceptual model, although again believes that researchers should not get hung up on
terminology.
It could be concluded that a diagrammatic representation of a theoretical framework might therefore be termed a
theoretical model. It is, however, less likely that one would diagrammatically represent a single theory rather than
concepts, which either are being used to build up to a theory or are taken from different theories.
While the confusion around the use of conceptual and theoretical frameworks and models may be understandable, a
similar laissez-faire approach to accuracy would not be considered acceptable for other parts of research design.
More discussion in textbooks and journal articles about how to use frameworks might allay some of the confusion.
Using a framework
Some research approaches appear not to use a conceptual or theoretical framework in their design. ‘Grounded
theory’, for example, is an inductive method in which theory generation comes from the data. It was an approach
that went against the accepted wisdom of the 1960s that a study should have a definite theory before it begins (
Robson 2002 ). It is an example of a methodological approach that is based on a specific epistemology or
philosophy of knowledge ( Avis 2003 ). Corbin and Strauss ( 2008 ) discussed the epistemology of grounded theory
in some detail. However, as this methodology has developed, the epistemology has also developed ( Hall et al 2013
).
The development of theoretical or conceptual frameworks can be undertaken as an outcome of the research but it is
unlikely that one will be stated as part of the design. However, projects using these methods do have a theoretical
framework: that of the philosophy or epistemology on which the research approach is based. For example, Curtis et
al ( 2012 ) discussed how grounded theory methodology is based on the epistemology of symbolic interactionism
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and so they did not identify a theoretical or conceptual model in the design of their research. In their findings, they
discussed the concept that emerged from their research of the dissonance for students of professional ideals and
the reality of practice. They then showed this diagrammatically in a conceptual model.
There appear to be two main ways in which researchers who use other qualitative methods use theoretical and
conceptual frameworks.
The first is in the design of the study where, if it is explicit, the framework can often be found as a section in the
literature review ( Fulton and Krainovich-Miller 2010 ). However, many authors ( Polit and Tatano Beck 2004 ,
Parahoo 2006 , Fulton and Krainovich-Miller 2010 ) have found that researchers often do not make the theoretical or
conceptual frameworks of studies explicit in relation to how these guided their studies. This does not mean that they
did not have such frameworks, simply that they may be embedded in the literature review ( Fulton and KrainovichMiller 2010 ).
Somekh and Lewin ( 2005 ) suggested that most social science research starts with a theoretical framework, goes
on to analyse the data, before developing new theories or variations of existing theories as outcomes.
Robson ( 2002 ) suggested that most new researchers find it useful to develop a conceptual model – the
diagrammatic form of a conceptual framework – and refine it as data collection and analysis takes place. LoBiondoWood ( 2010 ) felt that the fit between the theoretical framework and the other steps of the research after the design
strengthens the study and gives the researcher confidence in the evidence provided by the findings.
Even where theoretical or conceptual frameworks are mentioned in the title of an article, it is unusual for there to be
a discussion of what these are in the article itself. However, Goddard et al ( 2013 ) used a theoretical framework in
the design of their randomised controlled trial and Smith et al ( 2012 ) identified a theoretical framework before
researching the knowledge base of screening tools.
The second way in which researchers use theoretical and conceptual frameworks is in developing a framework.
Parahoo ( 2006 ) argued that generating theory is the purpose of most qualitative research. Polit and Tatano Beck (
2004 ) suggested that the role of conceptual and theoretical frameworks is to make the research findings meaningful
and generalisable. They suggested that the linking together of findings into a coherent structure can make them
more accessible and so more useful to others.
Fletcher et al ( 2012 ) used grounded theory in relation to the organisational factors that cause sports performers
stress. They then used their findings to develop a conceptual framework. Again, although ‘conceptual framework’ is
in the title of their article, there is no explanation of what such a framework is.
Fulton and Krainovich-Miller ( 2010 ) acknowledged that many researchers do not bother to use a theoretical
framework and the Critical Appraisal Skills Programme (CASP) does not make any mention of trying to identify a
theoretical or conceptual framework in a research article ( CASP 2010 ). This suggests that it does not see the
presence of one as crucial to the generation of good qualitative research.
Nevertheless, it is not unusual for those undertaking research as part of a programme of learning to be asked to
include such a framework in their projects, usually at the proposal stage. Because so little is written about
frameworks, this can confuse students trying to understand what is being asked of them. Books written to support
students in achieving a PhD may not provide much help, as some do not mention the use of theory in study design (
Phillips and Pugh 2005 ).
At this point in time, finding a theoretical or conceptual framework can be seen as another hurdle to overcome,
rather than something to assist researchers in keeping their projects focused and on track.
Use of a framework in a PhD project
A PhD study by Green ( 2008 ) used a case study approach to consider the professional jurisdictions of nursing and
medicine in relation to the supply and prescription of medicines by nurses in the acute hospital setting. The study
was undertaken over a period of time when the supply and prescription of medicines by nurses was relatively new
but the regulations set by the Department of Health (DH) were being relaxed ( DH 2005 ).
The study aimed to examine the attitudes of doctors and nurses in relation to their professional boundaries in the
light of the legalising of prescribing for nurses. At this time, there was some research evaluation of prescribing but
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this tended to focus on the prescribing rather than what professionals thought about the notion. Where professional
attitudes of doctors or nurses were mentioned, it was as a secondary outcome, rather than the main focus ( Latter
et al 2004 , Bradley and Nolan 2007 , Courtenay 2007 ).
It terms of a framework to guide the study and aid the way it was organised, the body of work that has been
undertaken in relation to the Sociology of Professions appeared relevant to the project. The theories of two
sociologists were used ( Abbott 1988 , Witz 1992 ). The focus of the research was new work for the profession of
nursing and in an area that had been a monopoly for doctors previously.
Abbott ( 1998 ) and Witz ( 1992 ) had both looked at the movement of work from one profession to another.
However, concepts from their theories were used, rather than the full theories. The research was based on the
following concepts ( Abbott 1988 ):
Professional jurisdictions: the boundaries of work ‘owned’ by a profession.
Authority: the type of authority that a profession has to undertake its work.
And from Witz ( 1992 ):
Exclusion: attempts to ensure that members of a profession are prevented from undertaking specific aspects of
work.
Usurpation: attempts to include specific aspects of work normally carried out by another profession.
These concepts were used to frame the research questions and were also used to develop a model to try to explain
the past and present situation in relation to doctors, nurses and prescribing.
The research data were then collected through observation, semi-structured interviews and document analysis at
two case study sites. Categories and sub-categories were identified from the data and described as part of the
study.
The discussion could have centred on the categories identified. However, it was at this point the data were brought
back to what the categories had to say about the above concepts and how the research questions centred on these
concepts were answered. There were new conceptual models developed from the data that represented variation
between the two sites in terms of the concepts identified at the beginning of the research.
An example of a conceptual model can be seen in Figure 1 . As this shows, the weight of intervention by the
management of the organisation to support nurse prescribing seemed to have an effect on its introduction to the
organisation but the main concepts are visible in the model.
A conceptual framework was present throughout the research project and report. It helped frame the research’s
questions, design and outcomes. The same data may have been collected if a different theoretical or conceptual
framework had been used or if no framework had been there, but it is likely that it would have been represented
differently. The use of a framework helped the researcher to order her thoughts and organise the way the data would
be represented.
The use of a conceptual framework had started as an academic exercise to fulfil the demands of an academic
supervisor and the expectations of a PhD project. It is probably only now, looking back at the project, that the extent
to which the conceptual framework pervaded it is apparent. The existence of the conceptual framework was helpful
in ensuring the research was given order and achieved completion in a way that could clearly be communicated to
its readers.
Conclusion
As with many topics, in research there is a language to be learned by those who are going to become expert
researchers. Much of this is explicit and can be read about in research texts and published papers. Although
researchers can read extensively about research methodologies and data collection methods, this is not the case for
theoretical and conceptual frameworks. This may be because, to seasoned researchers, it is so ingrained that it is
unworthy of comment, or perhaps it is because these concepts are not overtly discussed and many researchers are
confused about the correct terminology. Certainly, it might be expected that where a term – such as conceptual or
theoretical framework – was included in a title of a published research paper there would be an explanation of it
somewhere in the paper. However, this rarely occurs.
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If the apparent mysticism of theoretical and conceptual frameworks is to be debunked, then they need to be included
as significant sections in publications. The focus of the frameworks as an aid to researchers to help ensure that they
have framed their research coherently throughout their design should be ensured. For those who find diagrammatic
representation helpful, the use of models as a way of illustrating the framework for others should be encouraged.
It would be good to see the nuances of differences between concepts and theories discussed more regularly so all
researchers understand their meaning or why variation in meaning is acceptable when using different approaches.
This occurs with other parts of research and if we are to assist future researchers, it needs to happen with
theoretical and conceptual models and frameworks. Novice researchers need to know that frameworks and models
are there to help them and are not just another hurdle to be overcome to in the battle to achieve accreditation as a
researcher.
References
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Courtenay M ( 2007 ) Nurse prescribing: the benefits and the pitfalls. Journal of Community Nursing . 21, 11, 502506.
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Research: Methods and Critical Appraisal for Evidence-Based Practice . Seventh edition. Mosby Elsevier, St Louis
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DETAILS
Subject:
Studies; Theory; Qualitative research; Research methodology; Textbooks;
Epistemology; Researchers
Identifier / keyword:
Theoretical framework; conceptual framework; case study; conceptual model;
qualitative research; research design; case study research.
Publication title:
Nurse Researcher (2014+); London
Volume:
21
Issue:
6
First page:
34
Publication year:
2014
Publication date:
Jul 2014
Publisher:
RCNi
Place of publication:
Lo ndon
Country of publication:
United Kingdom, London
Publication subject:
Medical Sciences–Experimental Medicine, Laboratory Technique, Medical Sciences-Nurses And Nursing
ISSN:
13515578
e-ISSN:
20478992
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Source type:
Scholarly Journal
Language of publication:
English
Document type:
Journal Article
DOI:
https://doi.org/10.7748/nr.21.6.34.e1252
ProQuest document ID:
1784988328
Document URL:
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copied, transmitted or recorded in any way, in whole or part, without prior permission
of the publishers.
Last updated:
2016-04-28
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ProQuest One Academic
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