A theoretical framework helps the researchers structure the study and move the investigation forward, using principles and terms grounded in the existing body of scientific literature. In nursing, theories allow one to imagine a problem under examination from a certain viewpoint and focus on its specific details (Gray et al., 2017; McEwen &Wills, 2019). For example, in the study “Analysis of the UCSF Symptom Management Theory: Implications for Pediatric Oncology Nursing,” Linder (2010) uses the Symptom Management Theory (SMT) in the field of pediatric oncology. To ensure that this theory is suitable for research, a theory evaluation is necessary.
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As stated above, Linder (2010) chose the Symptom Management Theory to investigate issues in pediatric oncology nursing. SMT was developed published in 1994, although it has been re-released with revisions later (Landers, 2014). According to the basic ideas of SMT, the process of symptom management can be systematized to ensure the best patient outcomes. The theory comprises three elements – symptom experience, symptom management strategies, and symptom status outcomes (Landers, 2014). These concepts are interconnected, and they influence one another; for example, a person’s response to a symptom can influence their perception of that symptom (Landers, 2014).
Linder (2010) selected this theory for oncology as symptom management is a large part of dealing with cancer. The author suggests that the multidimensional description of symptoms makes SMT a suitable approach to assessing pediatric oncology nursing research. Linder (2010) appraises the theory using Walker and Avant’s method and determines that SMT is a good fit for their investigation sphere. In particular, SMT origins are related to conditions such as diabetes, cardiac disease, chronic pain, and cancer. Thus, as SMT was initially developed with cancer patients in mind, its suitability for cancer-related research is significantly increased.
The assumptions in SMT address a wide variety of scenarios of symptom management. For instance, the gold standard is the perception and self-reporting of patients’ symptoms (Landers, 2014). SMT considers cases where people are nonverbal or cannot describe their symptoms, and the interpretation given by the guardian or caregiver is treated as valid (Landers, 2014; Linder, 2010). Here, the theory’s authors demonstrate how it can be used in a pediatric setting.
Linder (2010) states that the meaning of SMT and its main concepts are limited to the middle range theory, which grounds it in practice. The three components of SMT raise some questions when using it in pediatric nursing. For example, parents can be less perceptive of the children’s symptoms, thus lowering the quality of perception-based evidence for treatment; technology and observation can mitigate this risk. Linder (2010) argues that symptom outcomes are underdeveloped in SMT, as the relationships between different dimensions of the outcomes are not specified.
Nevertheless, Linder (2010) finds SMT to produce consistent results in other studies. Cwiekala-Lewis et al. (2017) and Linder (2010) show that both adult and pediatric studies can benefit from using SMT as the framework. The several logical fallacies that Linder (2010) documents deal with applying the theory in pediatric settings. The author believes that parental reports may be insufficient for initiating treatment (Linder, 2010). SMT has limitations in describing the plurality of symptoms in cancer and similar conditions (Linder, 2010). Therefore, it may be necessary to test SMT with such symptom clusters in mind further.
Overall, SMT is an empirical middle-range nursing theory used for various conditions; it has shown positive results in its applicability. Its basic concepts are grounded and clear, although some statements raise questions when applied in pediatric nursing. SMT has limitations in this area and its inability to capture changing and multiplying symptoms characteristic of cancer. SMT has the potential for being helpful in pediatric oncological nursing if it addresses these problems.
Cwiekala-Lewis, K., Parkyn, B. H., & Modliszewska, K. (2017). Analysis of University of California in San Francisco (UCSF) symptom management theory and theory implication for persons with neurological disorders/diseases. The Journal of Neurological and Neurosurgical Nursing, 6(2), 55-65. Web.
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Saunders Elsevier.
Landers, M. G. (2014). Symptom management theory. In J. Fitzpatrick & G. McCarthy (Eds.), Theories guiding nursing research and Practice: Making nursing knowledge development explicit (pp. 35-50). Springer Publishing Company.
Linder, L. (2010). Analysis of the UCSF symptom management theory: Implications for pediatric oncology nursing. Journal of Pediatric Oncology Nursing, 27(6), 316-324. Web.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Wolters Kluwer Health.