From practice to theory: tightening the link via three fieldwork strategies

Background. Theory that is directly linked with clinical experience has far greater relevance for nursing practice; however, problems continue to persist with the establishment of that linkage. The use of fieldwork as a strategy for developing and linking theory has enormous potential for enhancing the number of theories that truly fit the clinical practice realities of nursing. Traditionally, fieldwork has been conducted in contexts that are unfamiliar to the researcher. However, nurses have a wealth of clinical understanding in their areas of practice. Conduct of inquiry in a familiar practice area may facilitate identification of significant, clinically relevant concepts and expedite theory development that is closely linked to nursing practice. Aim of paper. A two-step fieldwork approach and three specific strategies are presented that have been found useful for developing theory that is tightly aligned with nursing practice. The strategies of theoretical selectivity, theoretical integration, and theory creation are described and an example of each presented. The strategies are an extension of the Hybrid Model of Concept Development. These strategies identify alternative paths for concept clarification and theoretical congruence through fieldwork in clinical settings. The focus of theoretical selectivity is elaboration of concept definition with selection among theories. In contrast, the focus of theoretical integration is the linking of a central concept with an existing theory or perspective in the prefieldwork phase and then using the full fieldwork to evaluate its usefulness. Lastly, the theory creation strategy emphasizes describing a phenomenon of interest, identifying influencing factors, and beginning to create relational statements. It is closest to standard inductive theory development.