NURS 502 Week 6 Theory-Based Exemplar Paper Peer Review Example

Peer Review of a Theory-Based Exemplar Paper Draft: Swanson's Theory of Caring Applied to Parents in a Neonatal Intensive Care Unit

Summary of the Draft

The draft applies Kristen Swanson's middle-range theory of caring to the experience of parents whose infant, born at 27 weeks, spent ten weeks in a neonatal intensive care unit. The writer, a NICU nurse, argues that the nurses' care for the parents, not only for the infant, shaped how the parents coped, and uses Swanson's five caring processes to organize the account. The draft is six pages long, with an introduction, a summary of the theory, a description of the practice situation and a section applying each process. The exemplar is moving and clearly drawn from experience, and the paper has the makings of a strong final submission.

Accuracy of the Theory Description

The account of where the theory came from is accurate. Swanson (1991) built it from three earlier studies, one with women after miscarriage, one with parents and caregivers in a newborn intensive care unit and one with young mothers facing social risk, and treated caring as a way of relating marked by nurture, regard for the other person and a felt responsibility toward them. The draft names all five caring processes correctly, from knowing and being with through doing for, enabling, and, last, maintaining belief. However, the definition of enabling on page 3 describes it as "doing tasks the parents cannot do," which is closer to doing for. In the account Swanson (1991) gives, enabling means helping someone move through an unfamiliar event or transition, by explaining what is happening, offering information and affirming what the person feels. I recommend checking each definition against the original article and quoting or closely paraphrasing it with a citation, since McEwen and Wills (2014) treat an accurate account of a theory's concepts as the base on which any application rests.

Fit of the Exemplar

The situation is a strong exemplar because Swanson's theory was partly developed in this very setting, which makes the fit unusually close. The draft could make that point explicitly in the introduction, since it strengthens the argument that the theory explains the situation rather than being laid over it. The description of the infant's clinical course is longer than it needs to be; the paragraphs on ventilator settings could be shortened to two sentences, leaving more room for the parents' experience, which is the paper's real subject.

Application of the Concepts

The application section is the draft's strongest part. The account of a nurse who learned the mother's name, routines and fears before each shift is a clear example of knowing, and the night a nurse sat with the father after a setback shows being with. Two processes are applied more thinly. Maintaining belief, the process Swanson (1991) ties to keeping hope in the other person's ability to come through and find meaning afterward, gets one sentence; the parents' growing confidence before discharge would be a natural place to develop it. Doing for is illustrated only by routine infant care, which is care for the infant, not the parents; an example such as a nurse arranging a parking pass or a quiet room for the parents would fit the theory better. The paper will be stronger if each process is shown changing something for the parents, not only described as something the nurses did.

The application section would also benefit from one paragraph on what the nurses did not do. The draft mentions in passing that the parents felt shut out during the first week, when visiting hours were restricted and staff rarely explained the monitors. Read through the theory, that week shows the absence of knowing and enabling, and describing it would make the later caring stand out more sharply. It would also show the writer's critical eye, since an exemplar that admits where care fell short is more credible than one in which everything went well.

Organization, Sources, and APA Style

The draft is logically organized, but the headings use title case inconsistently and the theory summary appears under the heading "Introduction." Separate level one headings for the introduction, the theory, the situation, the application and the conclusion would help. The guide asks for at least three current, professional sources in the draft; the reference list has three, but one is a website for a NICU family support organization rather than a scholarly source. Adding a recent study of NICU parents' experience would strengthen the paper. On APA style, in-text citations are missing page numbers for direct quotations, and the references need hanging indents and DOIs where available (American Psychological Association, 2020).

Strengths to Keep

The voice of an experienced NICU nurse comes through clearly, the exemplar is detailed and believable, and the writer's respect for the parents shows on every page. The choice to tell the story through the parents' eyes rather than the infant's medical course is the paper's most distinctive feature and should remain at its center.

Recommended Revisions in Order of Importance

• 1. Correct the definition of enabling and check every process against Swanson's 1991 article, with citations.
• 2. Develop maintaining belief and replace the infant care example of doing for with care directed at the parents.
• 3. Replace the website with a recent peer-reviewed study of NICU parents and add page numbers to direct quotations.
• 4. Shorten the clinical details of the infant's course and add one sentence noting that the theory was developed partly in a NICU.
• 5. Revise the headings so that each section of the paper has its own level one heading.

Thank you for sharing such a careful and honest draft. It was a pleasure to review, and with these revisions it will make an excellent final paper.

References

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000

McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing (4th ed.). Wolters Kluwer Health.

Swanson, K. M. (1991). Empirical development of a middle range theory of caring. Nursing Research, 40(3), 161-166. https://doi.org/10.1097/00006199-199105000-00008