Mid-Range Theory of Stress and Adaptation

Mid-Range Theory of Stress and Adaptation

The mid-range theory of stress and adaptation proposes ways to identify, alleviate, monitor and evaluate progress. The model follows six steps to ensure its effectiveness. First, nurses have to assess and identify problematic patient behaviors (King, Sieloff, and Frey, 2007). This can be done through observation or interviews with the patient and their caregivers. Second, the nurse has to identify the triggers of these behaviors or reactions. This can be effectively done by retracing the patient’s steps to pinpoint the exact place and time the behavior was triggered. Third, the nurse must make a diagnosis of the patient’s ability to adapt to the stimuli and manage their behavior and reactions. Fourth, the nurse has to develop goals in cooperation with the patient. These goals are to help the patient increase the rate of his adaptation process. It has been proven that having measurable targets significantly promotes a person’s ability to progress faster. Fifth, the purpose of these interventions by nurses is to help the patient manage stimuli which increases their tolerance and increases their adaptation. Last, nurses have to monitor progressively and evaluate the effectiveness of their methods and models. This helps in making the patient’s adaptation more sustainable by allowing the nurses the opportunity to tweak scenarios and variations of stimuli. This model is based on comprehensive and thorough examination of a patient’s holistic environment (McKenna and Slevin, 2008). By looking at all patient behaviors, nurses can identify the ones that are beneficial to promoting patient health and well-being.

Patient G.N.’s young age increases her interactions and activities due to school and her natural development. This coupled with her medical complications increases the number of interactions and activities she has to do in her life. It also increases the number of people she has to interact with which significantly increases the risks to her medical issues. For a young child, play and socialization are very important to their wellbeing (Aymer and Okitikpi, 2010). Retracing her steps to find where she starts “feeling bad” would enable nurses to pinpoint what exactly triggers these feelings. And although G.N. asserts that she does not feel depressed or unhappy, it would be hard for a person her age to distinguish between those feelings and just generalize them as “not feeling well.” Due to her relatively low level of emotional development, this would help the nurses to ascertain whether the patient is emotionally overwhelmed that is manifesting itself physically. Once this is ascertained, the nurses can then determine the exact triggers of her “bad feelings.” Her parents living situation could also be aggravating G.N.’s problems. The parents should be involved in the process to ensure that they promote a safe and conducive environment for their child’s health to improve. Advising them to have separate pairs of drugs at both houses would ensure their child’s medication has a continuity which is critical to her health. Improving their communications channels would also allow them to communicate better among themselves as well as with their daughter. This would increase the child’s feeling of safety and encourage her to open about her challenges and problems which would provide the nurses and caregivers with more information to facilitate the development of better and more sustainable measures to help her adapt and cope. This would also facilitate the monitoring and evaluation of the strategies effectiveness and ensure that they are tweaked continuously to enhance their performance and increase the patient’s health and wellbeing. This would also make the whole experience a bit more fun for the patient as she can share her milestones with her friends and teachers which would also see her performance at school improve significantly.



McKenna, H. P., & Slevin, O. D. (2008). Nursing models, theories and practice. Oxford: Blackwell.

Aymer, C., & Okitikpi, Toyin. (2010). Sage Key Concepts: Key Concepts in Anti-Discriminatory Social Work. SAGE.

King, I. M., Sieloff, C. L., & Frey, M. A. (2007). Middle range theory development using King’s conceptual system. New York: Springer Pub. Co.

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