Theory and Rationale for Selection
The theory that I chose for this project was Jean Johnson’s theory of self-regulation. Johnson (1999) stated that there was uncertainty as to what information patients needed most to understand and be active in their care, and she theorized that interventions consisting of informational preparation might help to reduce anxiety, aid coping, and assist the healing process after medical procedures. Her model of self-regulation has been successfully utilized among various patient populations to help achieve better coping results.
I work on a trauma step-down floor, and all too often I see patients who experience anxiety related to their injuries and hospitalization. The typical response I see is the provider writing a prescription for the problem, rather than exploring other non-pharmacological alternatives. I figured if this theory could aid in assisting patients to cope with anxiety across a myriad of situations in the hospital setting without just resorting to drugs, then it is something I can incorporate into both my current and future practice in nursing.
Barnum’s Theory Critique Model
I have decided to use Barnum’s theory critique model consisting of internal and external criticisms. This model examines a theory through internal and external criticism. According to Meleis (2011), Barnum’s internal critique criteria consists of “clarity, consistency, adequacy, logic development, and level of theory development” (p. 181). The external critique criteria consist of “reality convergence, utility, significance discrimination, scope of theory, and complexity” and evaluates the theory as it applies to “human beings, nursing, and health” (p. 181).
Internal Theory Critique
I believe Johnson’s (1999) self-regulation theory has a relatively high amount of clarity and consistency. Johnson clearly outlined two pathways for coping (functional and emotional) and gave adequate descriptions and definitions of each. The pathways were also illustrated in a well-organized diagram, enhancing a visual understanding of the concepts discussed. Johnson’s interventions were also clearly defined, and consisted of either objective or subjective information to be given to subjects.
In regards to simplicity and complexity, I would place Johnson’s (1999) theory somewhere in the middle, but I believe it to be more simplistic than complex. Since the theory is primarily focused on one intervention (information) and its relationship to one outcome (coping), there are less potential variables, and this makes the theory more simplistic. That being said, the scope of self-regulation theory is not as narrow as perhaps was initially intended, and can be applied broadly to a multitude of patient situations.
While logically constructed, self-regulation theory may not be fully developed. This could be due to the fact that it is still a relatively new nursing theory, and Johnson (1999) believed that future research could help to further its development in key areas, such as explaining how patients select coping goals for example. Johnson also claimed self-regulation theory could benefit from future research to see if the propositions suggested are accurate or not.
External Theory Critique
Johnson’s (1999) theory of self-regulation utilized existing research to formulate a proposed framework for guiding and aiding patient coping. Even though self-regulation theory is quite new in comparison to other nursing theories, it has already proved itself useful in research. The scope is broad enough to be applied to a variety of patient populations ranging from chemotherapy and radiation therapy recipients to parents of children with diabetes for example (Johnson, 1996; Sullivan-Bolyai et al., 2014). While the scope is broad enough to be versatile, it is also narrow enough to be useful in research by focusing on specific concepts. I would categorize self-regulation theory as a mid-range nursing theory.
As far as significance and discrimination, self-regulation theory specifically addresses nursing phenomena such as information interventions and coping outcomes, and the theory can be easily applied to future research. I consider the boundaries to be defined within the scope of nursing.
Johnson, J. E. (1996). Coping with radiation therapy: Optimism and the effect of preparatory interventions. Research in Nursing & Health , 19 (1), 3–12.
Johnson, J. E. (1999). Self-regulation theory and coping with physical illness. Research in Nursing & Health , 22 (6), 435–448.
Meleis, A. I. (2011). Theoretical nursing : Development and progress (5th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Peterson, S. J., & Bredow, T. S. (2009). Middle range theories: Application to nursing research . Wolters Kluwer Health/Lippincott Williams & Wilkins.
Sullivan-Bolyai, S., Johnson, K., Cullen, K., Hamm, T., Bisordi, J., Blaney, K., … Melkus, G. (2014). Tried and true: Self-regulation theory as a guiding framework for teaching parents diabetes education using human patient simulation. Advances in Nursing Science , 37 (4), 340–349.