Introduction – Theoretical Frameworks
“Paradigms and worldviews of nursing are subtle and powerful, reflecting different values and beliefs about the nature of human beings, human–environment relationships, health, and caring.” (Smith & Parker, 2014, p. 10)
Learning Objectives
In this chapter, we will explore how worldviews, frameworks, theories, concepts, and variables shape the research process.
By the end of this section, you will be able to:
- Define key concepts in the philosophy of science.
- Identify and differentiate between theoretical/empirical, aesthetic, personal, sociopolitical, and ethical ways of knowing.
- Identify assumptions underlying the post-positivist, critical social, and interpretive/constructivist research views.
- Compare inductive and deductive reasoning.
- Differentiate between conceptual and operational definitions.
- Describe the relationships between theory, research, and practice.
- Discuss levels of abstraction related to frameworks guiding research.
- Describe the points of critical appraisal used to evaluate the appropriateness, cohesiveness, and consistency of a framework guiding research.
In order to conduct research and generate knowledge that can be used in practice, we must follow steps in the knowledge translation process. Knowledge development starts with identifying a knowledge gap, then generating knowledge, distributing knowledge, adopting knowledge, and reviewing and revising knowledge. We will be referring to this model throughout this resource as we review different aspects of the research process.
Here is a visual model of this knowledge translation process framework, adapted from Haber et al. (2022):
How do theoretical frameworks fit into this process? Theoretical frameworks play a role in framing what we know, what we can know, and how we can know it. Theoretical frameworks are useful at all stages of the knowledge development process, but they are especially important during the knowledge generation stage. They help researchers form a clear and focused research question and provide a conceptual lens to analyze existing literature. Theoretical frameworks also provide direction for research by establishing the foundation on which the study is built.
To help understand what a paradigm or theoretical framework is in the context of nursing, consider the evolving perspectives on medical assistance in dying (MAiD). In the past, the idea of intentionally ending a person’s life, even to relieve suffering, was largely viewed as incompatible with the values of nursing, which emphasize preserving life, providing comfort, and promoting healing. Many nurses saw MAiD as ethically unacceptable and outside the scope of compassionate care. However, as societal attitudes have shifted and legislation has changed, so too have nursing perspectives. In countries like Canada, where MAiD is now legally permitted, nursing has had to respond with new ethical frameworks, professional guidelines, and educational supports. Today, some nurses see MAiD as an extension of patient-centered care—one that respects autonomy and supports dignity at the end of life. The nursing profession remains divided, with some practitioners fully embracing MAiD and others conscientiously objecting. These differing perspectives reflect underlying paradigms—deeply held beliefs about life, death, suffering, and the role of the nurse. The change in how MAiD is viewed demonstrates how paradigms can evolve in response to new social, legal, and clinical realities.
Learning Activity
Applying the 5 Steps of the Nursing Research Process
Nursing research follows a systematic process that helps researchers move from identifying a clinical issue to applying evidence in practice. Understanding each step of the research process helps nurses critically evaluate evidence and participate in evidence-informed care. This activity will help students apply the 5 steps of the nursing research process using a real-world clinical example.
Case Scenario
Nurses working on a medical-surgical unit notice that many older adult patients report poor sleep during hospitalization. Staff members observe that disrupted sleep may contribute to increased confusion, fatigue, irritability, and delayed recovery.
The nursing team is interested in exploring whether implementing a nighttime quiet protocol could improve patient sleep quality.
The 5 Steps of the Nursing Research Process
Step 1: Identify the Problem
Researchers begin by recognizing a clinical issue, concern, or gap in practice.
Example:
Older adult patients report poor sleep during hospitalization.
Step 2: Review Existing Knowledge
Researchers examine existing literature and evidence to better understand what is already known about the issue.
Example:
The nursing team reviews studies on hospital noise, sleep disruption, and patient recovery outcomes.
Step 3: Develop a Research Question
Researchers create a focused question that guides the study.
Example Research Question:
Does implementing a nighttime quiet protocol improve sleep quality in hospitalized older adults?
Step 4: Design and Conduct the Study
Researchers select an appropriate research design and collect data.
Example:
The unit introduces quiet hours, dims hallway lights, and reduces overnight interruptions for four weeks. Patients complete a short sleep-quality survey before discharge.
Step 5: Analyze Findings and Apply Knowledge
Researchers interpret findings and consider how results may improve nursing practice.
Example:
Patients report improved sleep quality following implementation of the quiet protocol. The unit considers adopting the protocol permanently.
Student Activity
Using the case scenario above, answer the following questions:
1. Why is identifying a clinical problem an important first step in nursing research?
2. What types of information might researchers look for during the literature review stage?
3. Is the example research question broad or focused? How could it be improved?
4. What type of data might be collected in this study?
5. How could the findings influence nursing practice or patient care?
Extension Activity (Optional)
Working individually or in pairs, create your own brief clinical scenario and map it through the 5 steps of the nursing research process.
Key Takeaway
Nursing research begins with real clinical questions and concerns. By following a structured research process, nurses can contribute to evidence-informed practice and improve patient outcomes.
Key Definitions
Here are some key definitions related to this topic:
- Theory: A collection of explanations about a particular subject.
- Concept: An abstract notion (for example: language, stigma, bullying).
- Ontology: The study of “being”; Addresses questions such as, “What is reality?” and “What is true?”
- Epistemology: The study of knowledge; Addresses questions such as “What is truth?” and “How do we know what we know?”
- Methodology: The means to obtaining knowledge; Principles, rules, and procedures that guide the process, an analysis of all methods and procedures of the investigation; Research methodology addresses the specific rules and procedures that guide the process through which knowledge will be acquired.
- Method: The specific research tool used to collect data (e.g., survey, interview, focus groups).
- Context: The environment in which a phenomenon occurs (political, social, cultural, or institutional).
- Aim of inquiry: The goals or specific objectives of the research.
- Researcher values: The personal beliefs and assumptions the researcher brings to the study.
Remixed from:
- An Introduction to Research Methods in Sociology by Valerie Shepard (2019), published by Justice Institute of British Columbia and BCcampus, using a CC-BY-NC-SA 4.0 license.
Media Attribution
- Figure 2.1 Knowledge Translation Framework made on Canva by Katie Gregson subject to Canva Content License is adapted from content in Haber et al. (2022, p. 21.), used under fair dealing for education and non-commercial purposes.
References
Haber, J., Cameron, C., Singh, M. D., & Lobiondo-Wood, G. (2022). Nursing research in Canada: Methods, critical appraisal, and utilization (5th ed.). Elsevier Canada. p. 21.
Sheppard, V. A. (2019). An introduction to research methods in sociology. Justice Institute of British Columbia/ BCcampus. https://pressbooks.bccampus.ca/researchmethods/chapter/research-paradigms-in-social-science/
Smith, M. J., & Parker, M. E. (2010). Nursing theories and nursing practice (3rd ed.) [PDF]. F.A. Davis. Retrieved from https://vdoc.pub/documents/nursing-theories-and-nursing-practice-third-edition-701hg7nain50
A collection of explanations about a particular subject.
An abstract notion (for example: language, stigma, bullying).
The study of “being”; Addresses questions such as, “What is reality?” and “What is true?”
The study of knowledge; Addresses questions such as “What is truth?” and “How do we know what we know?”
Methodology: The means to obtaining knowledge; Principles, rules, and procedures that guide the process, an analysis of all methods and procedures of the investigation; Research methodology addresses the specific rules and procedures that guide the process through which knowledge will be acquired.
The specific research tool used to collect data (e.g., survey, interview, focus groups).
The environment in which a phenomenon occurs (political, social, cultural, or institutional).
The goals or specific objectives of the research.
The personal beliefs and assumptions the researcher brings to the study.