A profession has been defined as “an occupation whose incumbents create and explicitly utilize
systematically accumulated general knowledge in the solution of problems posed by a clientele” [1].
The development of a body of knowledge, gained through research and theory building is one hallmark
of a profession [1–3]. This body of knowledge is influenced by the knowledge from other disciplines,
sometimes termed ‘borrowed knowledge’ [4,5], yet it remains crucial that practice disciplines such as
nursing develop their own unique knowledge base [5,6]. Importantly, the recent exponential growth in
nursing research has contributed to nursing as a unique scientific discipline with its own language and
knowledge. While in recent years, nursing research has maintained an agenda of evidence-based
patient care and the research outcomes have contributed to translation into practice and policy, developing
new nursing theories alongside this empirical knowledge is needed to help the profession to identify
knowledge strengths and gaps and guide the future direction of clinical practice, future research and
nursing education. Importantly, new nursing theory can explain what nurses do and why and in doing
so potentially reduce conflict between the care team through a consistent approach; allow care to be
mutually understood by patients and families as well as other healthcare professionals; improve patient
care; and enhance professional status.
In nursing, the development of theories has taken place on a number of levels [4]. Meta-theory
refers to the theory of theory and is focused at the “big” philosophical and methodological level. Grand
theories provide a conceptual framework that emphasises broad perspectives on practice but these are
abstract and difficult to test [4]. Middle-range theories are the bridge between grand theories and practice
theories. Such theories present concepts and propositions at a lower level of abstraction, they only deal
with specific phenomena and a limited number of variables ensuring they are narrower in scope than
grand theories, but still have a reasonably broad perspective [4,7]. Finally, practice theories have a limited
scope and level of abstraction as they explore one particular situation found in nursing practice [4,7],
the essence of which has been described as “a desired goal and prescriptions for actions to achieve the
goal” [4]. A new level, termed situation-specific theory has emerged, with the intent to more closely
link theory to research [8–10]. Situation-specific theories focus on specific phenomena and practices,
and may be limited to specific populations