Middle-range nursing theories provide a bridge between the more abstract grand nursing theories, research, and clinical practice. As such, middle-range nursing theories derived from extant nursing theories are critical for developing and advancing both nursing science and practice. This paper describes the strategy used in developing a middle-range theory of heart failure self-care. After integrating theoretical and empirical literature, a hypothetico-deductive approach was used to develop the middle-range theory of heart failure self-care from Orem’s theory of self-care. Theoretical substruction was used to provide a graphic representation of the conceptual-theoretical-empirical structure demonstrating the congruence between the theoretical and operational systems.
BackscheiderJ. E. (1971). Self-care requirements, self-care capabilities, and nursing systems in the diabetic nurse management clinic. American Journal of Public Health, 64(12), 1138-1146. https://doi.org/10.2105/ajph.64.12.1138
2.
BanduraA. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143-164.
3.
BenjaminE. J.ViraniS. S.CallawayC. W.ChamberlainA. M.ChangA. R.ChengS.. . . MuntnerP. (2018). Heart disease and stroke statistics—2018 update: A report from the American Heart Association. Circulation, 137(12), e67-e492. https://doi.org/10.1161/CIR.0000000000000558
4.
ClarkA. P.McDougallG.RiegelB.Joiner-RogersG.InnerarityS.MeravigliaM.DelvilleC.DavilaA. (2015). Health status and self-care outcomes after an education-support intervention for people with chronic heart failure. The Journal of Cardiovascular Nursing, 30(4 Suppl. 1), S3-S13. https://doi.org/10.1097/JCN.0000000000000169
5.
CocchieriA.RiegelB.D’AgostinoF.RoccoG.FidaR.AlvaroR.VelloneE. (2015). Describing self-care in Italian adults with heart failure and identifying determinants of poor self-care. European Journal of Cardiovascular Nursing, 14(2), 126-136. https://doi.org/10.1177/1474515113518443
6.
CodyW. K. (1999). Middle-range theories: Do they foster the development of nursing science?Nursing Science Quarterly, 12(1), 9-14. https://doi.org/10.1177/089431849901200106
7.
FawcettJ. (1999). The relationship of theory and research. F.A. Davis.
8.
FawcettJ.Desanto-MadeyaS. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. F.A. Davis.
9.
HeckmanG. A.BoscartV. M.McKelvieR. S.D’EliaT.OsmanO.KaasalainenS.. . . StrachanP. (2014). Perspectives of primary-care providers on heart failure in long-term care homes. Canadian Journal On Aging/La Revue Canadienne Du Vieillissement, 33(3), 320-335. https://doi.org/10.1017/S0714980814000245
10.
HwangS. L.LiaoW. C.HuangT. Y. (2014). Predictors of quality of life in patients with heart failure. Japan Journal of Nursing Science, 11(4), 290-298. https://doi.org/10.1111/jjns.12034
11.
MaedaU.ShenB. J.SchwarzE.FarrellK.MallonS. (2013). Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. International Journal of Behavioral Medicine, 20(1), 88-96. https://doi.org/10.1007/s12529-011-9215-0
12.
MertonR. K. (1968). Social theory and social structure. Simon and Schuster.
13.
OkJ. S.ChoiH. (2015). Factors affecting adherence to self-care behaviors among outpatients with heart failure in Korea. Korean Journal of Adult Nursing, 27(2), 242-250. http://doi.org/10.7475/kjan.2015.27.2.242
14.
OremD. E. (2001). Nursing: Concepts of practice (6th ed.). Mosby Year Book.
15.
PetersonP. N.CampagnaE. J.MaraviM.AllenL. A.BullS.SteinerJ. F.HavranekE. P.DickinsonL. M.MasoudiF. A. (2012). Acculturation and outcomes among patients with heart failure. Circulation: Heart Failure, 5(2), 160-166. https://doi.org/10.1161/CIRCHEARTFAILURE.11.963561
16.
PonikowskiP.VoorsA. A.AnkerS. D.BuenoH.ClelandJ. G.CoatsA. J.FalkV.. . . ESC Scientific Document Group. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Journal of Heart Failure, 18(8), 891-975. https://doi.org/10.1093/eurheartj/ehw128
17.
RiegelB.DicksonV. V.FaulknerK. M. (2016). The situation-specific theory of heart failure self-care: Revised and updated. Journal of Cardiovascular Nursing, 31(3), 226-235.
18.
RileyJ. (2014). Cognitive dysfunction and its impact on the person with heart failure. British Journal of Cardiac Nursing, 9(8), 382-386.
19.
SeahA. C. W.TanK. K.Huang GanJ. C.WangW. (2016). Experiences of patients living with heart failure: A descriptive qualitative study. Journal of Transcultural Nursing, 27(4), 392-399. https://doi.org/10/1177/1043659615573840.
20.
SedlarN.LainscakM.MårtenssonJ.StrömbergA.JaarsmaT.FarkasJ. (2017). Factors related to self-care behaviours in heart failure: A systematic review of European heart failure self-care behaviour scale studies. European Journal of Cardiovascular Nursing, 16(4), 272-282.
21.
WolfZ. R.HeinzerM. M. (1999). Substruction: Illustrating the connections from research question to analysis. Journal of Professional Nursing, 15(1), 33-37.
22.
XuJ.AbshireM.HanH. R. (2016). Decision-making among persons living with heart failure. The Journal of Cardiovascular Nursing, 31(5), E1-E9. https://doi.org/10.1097/JCN.0000000000000312
