Collaborative development of middle-range nursing theories: toward a theory of unpleasant symptoms.

One promising approach to strengthening theory-research and theory-practice linkages is to place greater emphasis on developing and using theories of the middle range to underpin nursing research and practice. In this article, a postpositivistic definition of middle-range theory is advanced, an argument is made for shifting nursing's theory development activities from discipline-defining grand theories to middle-range theories, and a collaborative and incremental approach to middle-range theory development is described and illustrated. A sustained substantive example is provided by the beginning development of a theory of unpleasant symptoms.