Middle Range Nursing Theories
Middle range nursing theories are different from grand nursing theories and nursing practice theories in a way that the latter lies somewhere between the two latter theories in terms of scope and limitations. Middle range nursing theories also act as a bridge between nursing practice and grand nursing theories . In this paper, the middle range nursing theory of parent to child interaction as proposed by Kathryn Barnard will be discussed. The discussion will focus on the background of the theorist and how some significant life experiences affected his work as a nursing theorist; scrutinizing the principles as presented by the author of the theory, identifying and discussing the different problems and or issues that the theory tries to address, and an overall discussion of the theory itself, checking if there are relationships between it and other middle, grand and nursing practice theories.
Kathryn E. Barnard
Kathryn E. Barnard is the author of the parent to child interaction theory, one of the most famous and commonly used middle range nursing theories. She currently works as a professor in and the director of Center on Infant Mental Health and Development School of Nursing, Psychology, and Center of Human Development and Disability. A significant portion of her career has been devoted towards the creation of evidence-based clinical assessment tools aimed at helping educate parents get educated in a lot of ways. The protocols that have been developed wherein Professor Barnard is a part of have been popularized and are now being used worldwide. Most of her works have greatly contributed to the process of revolutionizing the clinical care and practice for parents and their infants. Another significant part of her career is her devotion to the creation of programs and protocols aimed at promoting infant and child development, mostly by encouraging changes in local and even national health policies. Professor Barnard believes that a strong, healthy, and well-planned infant development greatly depends on the caretaker or preferably, the parents’ response to the signals or feedbacks coming from the child and his or her environment, not only in a responsible manner but also in a loving and dependable one. Also according to her, infant development does not have to start once the child reaches the age of infancy; it has to start from the end of inception or from the moment of birth. Barnard started to devote so much time on child and infant development in 1970s which is why no wonder around 1979; she was already able to spearhead a middle range nursing theory which we now refer to as the Parent to Child interaction theory. This middle range nursing theory embodies Professor Kathryn Barnard’s three decades of research and effort on parent child interactions. Due to the worldwide recognition of her theory by both the local and international nursing community, the results of her work have been continuously incorporated in training programs, seminars, awareness and advocacy programs related to parent education, and especially, infant and child development, some of which have been delivered to health professionals across the continental United States and in other countries in the planet.
The Parent to Child Interaction Theory
The second half of the 20th century was faced with a high prevalence rate of premature babies, ill newborns, and violence against women and children, by their parents or a non-distant relative . This is where the recognition for a nursing theory or a framework that would help eliminate the adverse effects of these issues started. It has been identified that the key to the problem was early intervention for children at risk. These children at risk refer to a group of children who have low or impaired chances of thriving. These are the ill and sick newborns, premature babies, and those who were neglected and abused. What Professor Kathryn Barnard proposed is that there should be a unified framework that other healthcare practitioners can follow to assess the behaviors of the parents and their children, all in an effort to improve the level and type of relationship between them, which would later on directly contribute to the children’s development as an infant, then as a child, and later on as an adolescent . The fact that everything starts during infancy has long been established and for Professor Kathryn and for other researchers, early intervention is the real key. According to the same theory, the responses of the parents and the environment with which the infant or the child interacts are the two pillars of a positive infant and child development because these are the two most significant factors that can considerably affect a child’s well-being .
Theory Description
The Parent to Child Interaction Theory: Induction, Deduction, Retroduction
Nursing and other theories from other disciplines can almost always be categorized into three, based on the type of reasoning or logic used in presenting or formulating them: inductive, deductive, and retroductive. Inductive reasoning is the process of inferring or elaborating general rules, principles or merely statements from specific facts. In a way, it is a process of digging as much things or facts that can be expounded from an overall statement. Deductive reasoning is simply the opposite of inductive reasoning because it involves the creation of a general fact or statement based on a collection, often larger, of facts or statement. Lastly, retroductive reasoning is a mode of reasoning wherein statements or facts are explained by identifying and postulating the various mechanisms that could lead to them or are capable of producing or reproducing them. In this case, the parent to child interaction theory appears to have been created using the inductive reasoning. If we are going to track the history of the creation of this theory, we will see that it all started with Professor Barnard’s belief that the type and quality of interaction between the parents or the caretaker, and the child or an infant from the time of birth can greatly influence things like the person’s cognitive, language, and personality development. After this discovery, a lot of things, statements, facts, principles, followed, until a collection of principles have been created in the form of the parent to child interaction theory. All of the principles contained in the theory were inducted from the general principle that Professor Barnard and possibly her colleagues developed or discovered during the latter half of the 21st centuries, around the 60s. In fact, even after being recognized as a theory or a collection of principles, more and more principles were still being derived from that general idea, hence the reason why the parent to child interaction theory should have been created using inductive reasoning.
The Major Concepts of the Theory
Any nursing theory is generally composed of a set of concepts, assumptions, and definitions. These three components all contribute to create a phenomenon which would be at the center of the nursing theory. A concept can be any mental idea of any presumed phenomenon and are the building blocks or the primary elements of a theory. The major concepts in this case are the parents and the children. All of which contribute to the phenomenon which is the successful development of an infant or a young kid into adolescent, with the help of his or her parents or caregivers. The main problem that the parent to children interaction theory is of course, as the name of the theory implies, all about the interaction between the parents or the caregiver and the children. This theory was not actually made for normal and able bodied children but for those who are handicapped either physically, socially, or emotionally. Obviously, these are the children at risk that Professor Barnard tries to repetitively pertain to in his works—children who need help and assistance, and are very dependent. The thing is that infants and young children are very prone to things like violence and neglect. It shall be a given, even in almost all cultures that it is a major part of a person’s responsibility as a parent to take care of their child from the moment of giving birth until he or she is to set forth out of the protection of his or her parents and provide for him or herself. Unfortunately, this appears to simply be an ideal scenario and is in reality, not the case for everybody. There are parents who tend to abuse and neglect their children despite their young age. The aim of the parent to child interaction is to educate the parents and health professionals—who will most likely be the ones who will spread the word to the parents, about the utmost importance of establishing a high level of interaction with their children as early as possible because it is from such interactions where there child can get the foundation that they need to develop cognitively, socially, and intellectually.
Definition of Concepts: Implicit or Explicit; Operational or Theoretical
Relationships among Major Concepts
Over the course of years, people have derived concepts after concepts from the original parent to children interaction theory and when asked to examine the relationship between each major concept, anyone would really be able to see that they are very directly related. If there were any real differences and or discrepancies between the major concepts, they should be at a very minimal extent. One of the good things about the parent to children theory or model is that it is already being used as a model for therapeutic programs that aim to minimize the occurrence of behavioral and psychological problems among infants and children by a very natural way that is by improving the children’s level of interaction with their parents .
Evaluation
Assumptions Underlying the Theory
The Parent to children interaction middle range nursing theory operates under the assumption that a high level of interaction between the parents and their children, aged 2 to 8 years old will almost always lead to an optimized cognitive, emotional, psychosocial, and personality development, which are one of the most common problems of parents these days. It can also be inferred based on the main principles of the theory that by using the concepts that can be found in it, a family-centered model that aims to educate both parents and caregivers about proven and effective approach in handling abused and at risk children and one that will promote the development of positive behaviors can be formulated and used . This middle range theory also operates under the assumption that both the child and the parents’ reactions can be tweaked or adjusted in order to achieve the target type and or quality of interaction between the two; and that various factors that affect each group’s reactions may also be tweaked or adjusted in order to elicit the type and extent of reaction that the parents or the caregivers want to achieve.
The Theory and the Four Metaparadigms Concepts of Nursing
So far, all four metaparadigms concepts of nursing have been touched in the author’s discussion of the parent to children interaction theory. The recipient of care can either be the children or the parent—through the therapist or the healthcare provider who had been educated about the core principles of the theory; environment can pertain to the conditions that may lead to the development of either positive or negative behaviors, or the deterioration or progression of interactions between the parents and the child; health may refer to the type and level of interaction between the parents and the child since there is really no medical conditions focused on in the theory except for children who are at risk of being neglected and abused; the nursing part refers to the process of educating the parents and other healthcare providers of the core principles of the theory.
Clarity of the Theory
Application to Nursing Actions
The concepts that a nursing professional can obtain from this theory can be used in almost any part or aspect of nursing practice. This theory deals with the type and quality of interaction between the caregiver or the parent and the children—which is technically the receiver of care. I firmly believe that the principles talking about interaction that can be found in this theory can be paralleled to the interaction between a nurse and his patient. Maintaining a high quality of interaction with the patient as a nurse can be very similar to a parent trying to establish and then maintain a high quality of interaction with his infant son or daughter. The effects would of course be rewarding. The patient can for example become more cooperative and motivated to get well just because of the type and quality of relationship that he has with his caregiver.
References
Borrego, J., Anhalt, K., Terao, S., Vargas, E., & Urquiza, A. (2006). Parent to Child Interaction Therapy with a Spanish Speaking Family. Journal of Cognitive and Behavioral Practice, 121-133.
Butts, J., & Rich, K. (n.d.). Philosophies and Theories for Advanced Nursing Practice. 61-66.
Chaffin et al. (2005). Families in which child abuse has Occurred. Journal of Pediatric Studies, 21-25.
Fernandez, M., Butler, A., & Eyberg, S. (2011). Treatment Outcome for Low Socioeconomic Status African American Families in Parent Child Interaction Therapy. Journal of Child and Family Behavior Therapy, 32-48.
Fisher, P., & Kane, C. (2008). Coercion Theory: Application to the Inpatient Treatment of Conduct-disoriented Children. Journal of Child and Adolescent Psychiatric Nursing, 129-134.
Pincus, D., Choate, M., Eyberg, S., & Barlow, D. (2005). Treatment of Young Children with Separation Anxiety Disorder using Parent Child Interaction Therapy. Journal of Cognitive and Behavioral Practice, 126-135.
