| Course | NURS 715 Theoretical Application for Advanced Practice Nursing (NURS715) |
|---|---|
| Module/Week | 3 |
| Assignment | Theory Presentation Part II: Evaluating and Applying Mishel's Uncertainty in Illness Theory |
| Paper type | Middle range theory presentation, Part II (12 slides total, 2 additional peer-reviewed sources) |
| Length | about 1,020 words, 4 double-spaced pages plus title page and references. Course guide: the completed PowerPoint, no more than twelve slides in total, adding evaluation and analysis of the selected middle range theory and at least two peer-reviewed sources beyond those in Part I |
| Format | APA 7 student paper |
| Points | 100 |
| School | Liberty University Online |
| Program | DNP |
| Where it sits | Module/Week 3 in Liberty's published NURS 715 course guide; current sections can differ |
| Updated | October 2026 |
Free sample paper for NURS 715 Week 3
Judging and Using a Theory: Mishel's Uncertainty in Illness Theory Evaluated for Foundation, Structure and Function, Then Applied to Cardiac Rehabilitation
[Student Name]
School of Nursing, Liberty University
NURS 715: Theoretical Application for Advanced Practice Nursing
Theory Presentation: Part II
[Instructor Name]
[Date]
The patient and the rehabilitation plan are composites carried from Part I; the theory, studies and textbook cited are real.
Judging and Using a Theory: Mishel's Uncertainty in Illness Theory Evaluated for Foundation, Structure and Function, Then Applied to Cardiac Rehabilitation
Slide 1: Recap of the Theory
- Mishel, 1988 and 1990
- Uncertainty as unreadable illness events
- Mr. Reyes: afraid of exercise after a stent
Speaker notes: As a reminder, Merle Mishel built her theory to explain what happens when people cannot make sense of what their illness is doing (Mishel, 1988), and she later extended it to chronic illness, where uncertainty may be permanent (Mishel, 1990). Our patient, Mr. Reyes, stayed away from cardiac rehabilitation because he could not tell whether his chest sensations were dangerous.
Slide 2: Concepts in One Picture
- Antecedents feed uncertainty
- Appraisal sets the path
- Coping leads toward adaptation
Speaker notes: In one picture, the theory runs from left to right: the way symptoms present, the supports a person has and their mental resources feed uncertainty; the person reads that uncertainty as a threat or as a source of hope; and the reading shapes how they cope and whether they adapt.
Slide 3: Why It Fits Our Problem
- Rehab avoidance as threat-driven coping
- Supports and familiarity can be changed
- Evidence in coronary disease
Speaker notes: The theory fits our problem because the antecedents it names are things nurses can change. A 2026 study in coronary heart disease found higher uncertainty associated with lower rehabilitation adherence, partly through lower self-efficacy and greater fear of activity (Wu et al., 2026).
Slide 4: Substantive Foundation
- Grounded in practice observation and research
- Clear assumptions about meaning-making
- Extended to chronic illness with new philosophy
Speaker notes: Smith and Liehr (2014) ask first whether a middle range theory has a substantive foundation: whether it is grounded in practice and research and whether its assumptions and philosophical base are clear. Mishel's theory scores well here. It grew from clinical observation and her own research on hospitalized patients, its assumptions about uncertainty as a cognitive state and about people's drive to make meaning are explicit, and its 1990 revision drew on a different philosophical base, chaos theory, to address chronic illness. One weakness is that the two versions rest on different assumptions, which a reader must keep straight.
Slide 5: Structural Integrity
- Concepts defined and linked
- Many concepts, some overlapping
- Appraisal and coping borrowed from stress theory
Speaker notes: Structural integrity asks whether concepts are clearly defined and logically related. Mishel defines her central concept carefully and states propositions that link antecedents, appraisal and coping. The structure is intricate, however, and some concepts, especially inference and illusion, are hard to separate in practice. The appraisal and coping section closely follows general stress and coping theory, which strengthens its logic but makes the nursing-specific contribution concentrated in the antecedents. On balance, the structure is sound but complex.
Slide 6: Functional Adequacy
- Measurable with established scales
- Tested in many populations
- Generates interventions
Speaker notes: Functional adequacy asks whether the theory is useful for practice and research. Here the theory is strong. Its scales make it measurable, and it has been tested across conditions and ages. Recent work illustrates the range. A network analysis of adolescents with cancer found moderate uncertainty, with concerns about the expected course of illness, changes in condition and outcomes at the center of the network (Liu & Wang, 2026). A study of 413 women with gynecologic and breast cancer identified latent classes of uncertainty and examined its mediating role between social support and depressive symptoms (Zeng et al., 2026). A theory that works for an adolescent with leukemia and a man after a heart attack has earned the label middle range.
Slide 7: From Theory to Nursing Action, Part 1
- Make symptoms readable: a chest sensation guide
- Build familiarity: a pre-rehab visit to the gym
- Name a credible authority: one rehab nurse
Speaker notes: The antecedents point directly to interventions. To give Mr. Reyes's symptoms a pattern, we can give him a written guide to common post-stent sensations and the warning signs that need a call. To build familiarity, we can invite him and his wife to tour the rehabilitation gym before his first session. To provide credible authority, one named rehabilitation nurse calls him before the first session and stays his contact.
Slide 8: From Theory to Nursing Action, Part 2
- Monitored first sessions reframe exercise as safe
- Family included as social support
- Measure uncertainty before and after
Speaker notes: Early monitored sessions let him exercise while watching his own heart rate and rhythm on the monitor, turning an unknown into evidence. Including his wife strengthens social support. We measure uncertainty with the Mishel scale at referral and after six sessions, alongside attendance, which tests whether the intervention works through the mechanism the theory predicts.
Slide 9: Limits of the Theory
- Hard to test whole
- Cultural meanings of uncertainty vary
- Less guidance on organizational change
Speaker notes: The theory has limits. Most studies test parts of it, so the full model is rarely examined. Much recent research comes from China and other settings where expectations of clinicians and families differ, so findings may not transfer directly. And the theory focuses on individuals, offering less guidance on the organizational changes, such as staffing a pre-rehab call, that a DNP must lead.
Slide 10: A Christian Perspective on Uncertainty
- Uncertainty is part of human finitude
- Faith as a resource, not a cure-all
- Presence of the nurse as structure provider
Speaker notes: Scripture does not promise certainty about tomorrow. James reminds believers that they do not know what tomorrow will bring and that life is like a mist (English Standard Version Bible, 2001/2016, James 4:14). Mishel's affect-control coping includes faith, and for many patients faith is a real resource. A Christian nurse can honor that resource without using it to dismiss fear, and can be, in the theory's terms, a credible authority whose presence makes uncertainty bearable.
Slide 11: Implications for DNP Practice and Research
- Design rehab referral around uncertainty
- Use the scale as a process measure
- Test the full model in a DNP project
Speaker notes: For DNP practice, the theory suggests redesigning rehabilitation referral around uncertainty rather than logistics. For research and quality improvement, the uncertainty scale offers a process measure that explains why attendance changes. A DNP project could test a bundle built from the theory and measure both uncertainty and attendance.
Slide 12: Conclusion
- Strong foundation and function
- Complex but coherent structure
- A practical guide for Mr. Reyes and others
Speaker notes: Mishel's theory has a strong substantive foundation and high functional adequacy, with a structure that is coherent though complex. For patients like Mr. Reyes, it turns a vague problem, a patient who does not come, into specific, testable nursing actions. Thank you.
References
English Standard Version Bible. (2016). Crossway. (Original work published 2001)
Liu, F., & Wang, B. (2026). Mapping illness uncertainty in adolescents with cancer: A cross-sectional network analysis. European Journal of Oncology Nursing, 84, Article 103294. https://doi.org/10.1016/j.ejon.2026.103294
Mishel, M. H. (1988). Uncertainty in illness. Image: The Journal of Nursing Scholarship, 20(4), 225-232. https://doi.org/10.1111/j.1547-5069.1988.tb00082.x
Mishel, M. H. (1990). Reconceptualization of the uncertainty in illness theory. Image: The Journal of Nursing Scholarship, 22(4), 256-262. https://doi.org/10.1111/j.1547-5069.1990.tb00225.x
Smith, M. J., & Liehr, P. R. (Eds.). (2014). Middle range theory for nursing (3rd ed.). Springer Publishing.
Wu, L., Xue, H., Tian, C., & Lu, Y. (2026). Associations between uncertainty in illness and cardiac rehabilitation adherence in patients with CHD: A cross-sectional chain mediation and latent profile analysis of cardiac self-efficacy and fear of activity. Frontiers in Cardiovascular Medicine, 13, Article 1846950. https://doi.org/10.3389/fcvm.2026.1846950
Zeng, H., Lu, Y., Zhao, Q., Gong, J., Mao, L., Wei, Y., & Li, X. (2026). Illness uncertainty in individuals with gynecologic and breast cancer: A latent profile analysis and structural equation modeling. PLOS ONE, 21(9), Article e0358366. https://doi.org/10.1371/journal.pone.0358366
What the NURS 715 Week 3 instructions ask
Part II completes the middle range theory presentation begun in Week 2. The full PowerPoint may contain no more than twelve slides in total, which means the student must condense the Part I material to make room, and it must include at least two peer-reviewed scholarly resources in addition to those used in Part I. Where Part I described the theory, Part II evaluates and analyzes it: how well it is grounded, how logically it is built and how useful it is for practice and research. The Week 3 reading returns to the opening chapters of Smith and Liehr, which present a framework for evaluating middle range theory, and to Chism on the DNP's use of theory.
How this NURS 715 Week 3 example is built
Three opening slides compress Part I into a reminder of the theorist, the concepts and the propositions, with new wording rather than repeated text. Three slides then apply Smith and Liehr's evaluation framework: substantive foundation, examining the theory's origins and assumptions; structural integrity, examining whether its concepts and relationships are clear and consistent; and functional adequacy, examining whether it can guide practice and research. Two slides turn the theory into specific nursing actions for the cardiac rehabilitation case, one slide addresses limits, one addresses the Christian worldview, and the final slides summarize implications for DNP practice and research.
NURS 715 Week 3 grading rubric: where the points go
Part II is typically assessed on the depth and accuracy of the theory's evaluation, the use of an explicit evaluation framework, the quality of the application to practice, adherence to the twelve-slide limit, the addition of at least two new peer-reviewed sources, and design and APA. Instructors expect each criterion to be judged with reasons and evidence, not simply named. An application that converts the theory's concepts into concrete nursing interventions, with a way to measure their effect, demonstrates the DNP's role in translating theory into practice. Honest discussion of the theory's limitations strengthens rather than weakens the evaluation. A closing slide that states the overall verdict in one or two sentences helps the audience remember the evaluation.
NURS 715 Week 3 help: mistakes that cost points
The most frequent difficulty in Part II is space: students try to keep all nine Part I slides and add evaluation in three, which cannot be done well. Others evaluate the theory with general praise, calling it useful and well developed, without applying a framework. Some forget to add the two new sources, or add sources that only repeat Part I. Condense Part I into two or three slides, devote a slide to each evaluation criterion with specific evidence, translate concepts into named interventions, acknowledge where the theory is weak and cite at least two new peer-reviewed studies. Check the final count against the twelve-slide ceiling before uploading.
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Other NURS 715 weeks
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- NURS 715 Week 2: Theory Presentation Part I
- NURS 715 Week 4: Personal Philosophy of Nursing
- NURS 715 Week 5: Discussion Board Forum 2
- NURS 715 Week 6: Theory Guided Practice Paper Outline
- NURS 715 Week 7: Theory Guided Practice Paper
- NURS 715 Week 8: Professional Statement
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NURS 715 Week 3 questions, answered
What is NURS 715 Theory Presentation Part II?
The 100-point completion of the theory presentation in Module/Week 3, limited to twelve slides in total, which evaluates and analyzes the theory and adds two peer-reviewed sources.
Where can I find a free NURS 715 Week 3 sample paper?
This page holds, at no cost, the complete twelve-slide NURS 715 Week 3 deck evaluating and applying Mishel's theory, notes and references included.
How do you evaluate a middle range theory?
One widely used framework examines substantive foundation, structural integrity and functional adequacy: how well the theory is grounded, how logically it is built and how useful it is.
How can Mishel's theory guide nursing interventions?
By targeting the antecedents of uncertainty: making symptoms recognizable, building familiarity, providing a credible authority, education and social support, and helping patients appraise uncertainty.
What are limitations of the Uncertainty in Illness Theory?
Its many concepts are hard to test together, most research tests only parts of it, and its appraisal and coping concepts can overlap with general stress and coping theory.
Use it as a model, or ask for your own
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