building blocks of theory
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Marie Flannery, PhD, RN, AOCN®
Explicit Assumptions About Knowing
Conceptual Foundations is a new column for Oncology Nursing Forum (ONF) that focuses on the frameworks that underpin research and practice initiatives. The purpose of this inaugural column is to provide an overview of what conceptual frameworks are, related terms, the role of conceptual frameworks in the research process, and why these frameworks matter. The majority of articles published in ONF are research manuscripts. Readers include student nurses, practicing oncology nurses, nurse managers, advanced practice on- cology nurses, nurse scientists, and people in other disciplines who are interested in patients with cancer. In the guidelines for ONF articles, peer reviewers are asked to address the conceptual model/ theory (if needed) that is included in the manuscript. For all who read, apply, and create knowledge, un- derstanding the conceptual frame- work underlying a research study is an essential skill to master. The conceptual framework may be ex- plicitly identified by the author or may be implicit. If not specifically stated, the reader must detect the underlying assumptions that form a conceptual foundation.
Definitions and Related Terms
What is a conceptual framework? Concept is defined as “an abstract or generic idea generalized from
Marie Flannery, PhD, RN, AOCN®, Associate Editor CONCEPTUAL FOUNDATIONS
Flannery is a research assistant professor in the School of Nursing at the University of Rochester Medical Center in New York.
No financial relationships to disclose.
Flannery can be reached at Marie_Flannery@URMC .Rochester.edu, with copy to editor at ONFEditor@ ons.org.
Key words: concept; theory; framework; model; oncology
ONF, 43(2), 245–247.
particular instances” (“Concept,” n.d., para. 1). Framework is de- fined as “the basic structure of something: a set of ideas or facts that provide support for some- thing” or “a supporting structure” (“Framework,” n.d., para. 1). Taken together, a conceptual framework consists of specified abstract ideas that are joined in an identified structure. Conceptual frameworks identify what is important in un- derstanding a phenomenon and provide guidance for relationships. No universally accepted definition exists for conceptual framework, and the term is sometimes used interchangeably with conceptual model, theoretical framework, and theory (Powers & Knapp, 2011).
Many terms are related to con- ceptual frameworks (see Table 1). Epistemology is a branch of philosophy that studies “how we know” and the justification of knowledge claims. Varying epis- temologic philosophic traditions have emphasized different aspects and views of knowledge, certainty, and truth, and have provided dif- fering interpretations of theory and concepts. Empirical philosophic traditions influence much of the current research and emphasize the systematic observation of real- ity through sensory observation (Powers & Knapp, 2011). Worldview refers to a general orientation or set of beliefs about how the world operates. Paradigm, a term coined by philosopher Thomas Kuhn,
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also refers to a system of beliefs about knowledge, often specific to a discipline. Theory is a term with many definitions; in the research realm, a scientific theory includes a set of statements or principles that explain phenomena. A theory is one type of a conceptual frame- work that always will include at least two concepts and at least one relational statement. Of note, not all conceptual frameworks will qualify as a theory. A model refers to a graphic representation; it may be a two-dimensional diagram or a three-dimensional mock-up. A con- ceptual model is a diagram or draw- ing of the conceptual framework.
A conceptual framework may be reflected in the worldview, ma- jor paradigm, or general orienting framework of the author. A con- ceptual model may be referenced or drawn in the article. A theory
may be referenced and explained. A conceptual framework may not be explicitly stated but may be discern- ible to the reader by the author’s stated and unstated assumptions. Specifically, the reader may be able to discern the framework used by what is studied, how it is studied, and what is measured. What is not included in the study also may be an indication of the implied framework. A concept that may seem vital to a clinician or researcher but was not included in the study may reflect its relative lack of prominence in the author’s conceptual framework.
Conceptual Frameworks and the Research Process
In the guidelines for manuscripts submitted to ONF, reviewers are asked to critique the use of con- ceptual frameworks in two specific
components of the manuscript. The literature review and discussion section guidelines specifically ask reviewers to consider the concep- tual framework or theory (if need- ed) that is used in the manuscript.
However, the integration of a con- ceptual framework actually threads and weaves through all compo- nents of the research process. The orienting framework or worldview provides a specific lens as to how an area of study is seen and how a clinical problem is identified. The choice of a theory or conceptual framework provides structure for the content that is included in the background and literature review. The framework or theory may be specifically discussed and a figure of the conceptual model included. The conceptual framework influ- ences the choice of method, set- ting, sample, instruments, proce- dures, and analysis strategies. The reviewer (and reader) often looks for a sense of coherence, logical consistency, and logical flow in a research study. The integration of a conceptual framework through all phases of the research process can provide a sense of coherence. For example, if the conceptual frame- work specifies that both patient and caregiver experiences are criti- cal to understanding the clinical issue, one might choose to conduct a descriptive longitudinal study conducted in the home setting; include patients and caregivers in the sample; include open-ended in- terviews, in addition to structured questionnaires, as measurement modalities; and include dyadic eval- uation techniques in the analysis.
The discussion section may in- clude comments on whether the conceptual framework worked or was helpful in the study, if the framework was supported or incon- sistent with study findings, or what revisions to the framework may be needed. Similarly, any practice implications and knowledge trans- lation may be influenced by the
TABLE 1. Terminology and Definitions for Conceptual Frameworks and Related Terms
Concept Abstract idea; building blocks of theory
A conceptual framework consists of specified abstract ideas that are joined together in an identified structure. Conceptual frame- works identify what is important in understanding a phenomenon and how the important ideas fit together and are related to one another.
Empirical Originating in or based on observation or experience
Epistemology A philosophy of knowledge that includes an understanding of “how we know” and a justification of knowledge claims
Model Graphic or symbolic representation of a phenomenon
Paradigm Patterns or systems of beliefs about science and knowledge pro- duction that may be discipline-specific
Theory A set of statements or principles devised to explain a group of facts or phenomena, particularly one that has been repeatedly tested or is widely accepted and can be used to make predictions about natural phenomena; a set of interrelated concepts that guide thinking; an idea or set of ideas that is intended to explain facts or events, the general principles or ideas that relate to a particular subject
Worldview “A global pattern of beliefs that constitute a school of thought and its attendant knowledge claims” (Powers & Knapp, 2011, p. 203)
Note. Based on information from “Concept,” n.d.; “Framework,” n.d.; Powers & Knapp, 2011.
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guiding paradigm of the conceptual framework. Reviewers and readers want the description of the con- ceptual framework to be clear and understandable. The framework or theory generally feels to be the best fit and most meaningful when it is integrated throughout the study and manuscript and does not come across as a framework that was “tacked on” as an afterthought.
Conceptual frameworks are as- sociated with a wide range of re- search designs. In the case of an intervention study, the conceptual framework or theory establishes the required components for the intervention and proposes how they will work. In a study model- ing relationships or explaining an outcome, the conceptual frame- work determines what factors will be examined and the nature or valence of the relationship. In a descriptive study, a conceptual model provides guidance on what characteristics are necessary to include in the description. When a theory is presented or hypotheses are proposed, the statement of the important concepts and their struc- tural relationships is very clear.
When a Conceptual Framework Is Not Stated
Sometimes, perhaps often, an author does not explicitly identify his or her conceptual framework. However, clues often exist as to the underlying assumptions the author holds about the topic under study. In the introduction and background, the author provides information on what factors are important. These
factors often translate into the con- cepts that may reflect the operating framework for the author. This may be evident from past research that is cited and how the clinical issue is described. The instruments used in the research also provide informa- tion on the conceptual framework. For example, if the concept of self- efficacy is measured in a study, one can infer that self-efficacy is an important part of the unstated conceptual framework for under- standing the phenomenon being examined. Without an explicit state- ment of the conceptual framework, the reader or reviewer only can at- tempt to identify what concepts the author thought were important and what the assumed relationships were. Each person has assump- tions about what is important, how things may be related, and what counts as evidence. The use of a conceptual model makes these un- derlying assumptions explicit.
Conceptual frameworks are im- portant because they underlie ev- ery study and article. Frequent- ly used analogies for conceptual frameworks are that they are maps or blueprints. The blueprint tells the overall structure of relation- ships (framework) and the materi- als (concepts) that will be used in the design. Attention to conceptual frameworks is essential to building science. In addition to the facts and information about the focus of a study, knowledge about the success or failure of a conceptual framework or theory can provide
Authorship Opportunity Conceptual Foundations pro- vides readers with an overview of the role of conceptual frame- works in the research process. Materials or inquiries should be directed to Associate Editor Ma- rie Flannery, PhD, RN, AOCN®, at Marie_Flannery@URMC.Roch ester.edu.
understanding for other situations and future research. Insight into the underlying mechanism of why or how something works (or did not) is examined in light of the proposed relationships of the framework or theory. For example, a conceptual framework for symptom manage- ment can be used for many differ- ent symptoms. As the conceptual framework is developed and refined, insight is gained into what needs to be included in effective symptom management interventions. The use of a conceptual framework or theory can advance understanding of multiple clinical problems.
Future columns wil l review specific theories and conceptual frameworks as they apply to oncol- ogy nursing and clinical problems for individuals with cancer.
Concept. (n.d.). In Merriam-Webster.com. Re- trieved from http://www.merriam-webster .com/dictionary/concept
Framework. (n.d.). In Merriam-Webster.com. Retrieved from http://www.merriam -webster.com/dictionary/framework
Powers, B.A., & Knapp, T.R. (2011). Diction- ary of nursing theory and research (4th ed.). New York, NY: Springer.
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