Applying Theory to a Practice Problem: Part 2: Application of Middle-Range Theory to Problem Summary of the Problem of Nursing Burnout

Nursing burnout is a global phenomenon among nurses: it is problem that leads to negative effects for other nurses, health care facilities, and patients seeking quality care. The factors that lead to burnout among nurses have been studied in a variety of ways, and researchers have identified personality type (Canada-De la Fuente, Varga, San Luis, Garcia, Canadas & Emilia, 2015) as well as external environmental issues as causes of burnout (Sadati, Rahnavard, Heydari, Hemmati, Ebrahimzadeh & Lankarani, 2017), yet there is still no clear understanding of how to address this issue.

Middle-Range Theory of Unpleasant Symptoms

The mid-range theory of unpleasant symptoms developed by developed by Lenz, Suppe, Gift, Pugh and Milligan (1995) proposes that physiological factors, psychological factors and situational factors all play a part in determining the occurrence, intensity, timing, and level of distress of a person’s health status. As burnout among nurses can be considered a health issue related to situational, psychological and physiological issues, the theory of unpleasant symptoms provides a suitable approach to the problem just as it does for nurses attempting to diagnose and treat patients. In the case of nursing burnout, the nurses themselves are the patients.

Lee, Vincent and Finnegan (2017) state that “understanding multiple patient symptoms is essential, and the theory [of unpleasant symptoms] demonstrates that nurses should focus on multiple rather than individual symptoms” (p. 16). This approach applies appropriately to the problem of nursing burnout, as the issue has been shown by researchers to stem from a multitude of variables...

(1995) identified a need for a more substantive theory that could be used to better understand patients and the complexity of illnesses and health-related issues. Instead of viewing morbidities as isolated and unrelated problems, the theory of unpleasant symptoms gave health care providers the opportunity to view patients more holistically with a sense of how one set of issues could impact another set even if medically speaking the two conditions were unrelated. In other words, the theory allowed for the total experience of the patient to be understood more clearly, which could then allow health care providers to see new ways to treat the patient more effectively and completely.
Lee et al. (2017) assessed the theory of unpleasant symptoms and found that it “demonstrates good social and theoretical significance, testability, and empirical and pragmatic adequacy” (p. 16). As the purpose of the theory was to help nurses better understand how different symptoms may be related and how taking a whole picture of a patient’s health rather than a compartmentalized one could give the nurse a better footing for providing quality care, the theory’s applicability was shown via empirical analysis, which Lenz et al. (1997) likewise corroborated when they evaluated the “interactive nature of the symptom experience” that leads to health problems (p. 20).

How the Theory has been Previously Applied

The theory of unpleasant symptoms has been applied in various instances by using inductive reasoning (Lenz & Pugh, 2003). Tyler and Pugh (2009) showed how the theory of unpleasant symptoms can be applied in…