Theory development and testing (5 ECTS)

This field-specific doctoral level course discusses the process of theory development, the content of theory as well as the validity, and reliability of theory.

Event information



Venue location

Hybrid event: Kontinkangas campus / Zoom



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8th of February 2024

9.00 - 9.15 Introduction to the course, Prof. Kristina Mikkonen
9.15 - 10.30 Development and testing of middle range theory in nursing science, Prof. Kristina Mikkonen
10.30 - 10.45 Coffee break
10.45 – 11.30 Inductive and deductive content analysis in nursing science - Low vision rehabilitation, health-related quality of life and related factors among older adults with visual impairments, Dr. Heidi Siira
11.30 – 12.30 Lunch break
12.30-13.30 Development of a hypothetical model – a practical perspective, Dr. Varpu Wiens
13.30-14.30 Instrument development and psychometric validation, Prof. Kristina Mikkonen & Prof. Marco Tomietto
14.30-14.45 Coffee break
14.45 – 15.45 Instrument development and psychometric validation, exercise, Prof. Kristina Mikkonen and Prof. Marco Tomietto
15.45-16.00 Closing of the day, task for tomorrow, Prof. Kristina Mikkonen

9th of February 2024

9.00 – 10.00 Testing models: a crossroad between theoretical coherence and statistical possibilities, Prof. Marco Tomietto
10.00 - 10.15 Coffee break
10.15 – 11.15 Statistical testing in theory development, case of organizational psychology in nursing science, Prof. Marco Tomietto
11.15 - 12.15 Lunch break
12.15 -13.30 Developing and testing a situation-specific theory of an infected adult’s experiences of living with a sexually transmitted disease, Dr. Toni Haapa
13.30 – 13.45 Coffee break
13.45 - 15.00 Reporting evidence-based research in health sciences, Prof. Amanda Kenny
15.00 – 15.15 Closing of the day, Prof. Kristina Mikkonen


Target group

Priority is given to PhD students

Place (hybrid learning)

University of Oulu, Research Unit of Nursing Science and Health Management, Aapistie 5A, P117 (8.2.), F101 (9.2) OR Zoom: (Meeting ID: 688 3681 3377)

Registration for the course

Registration period: 01.12.2023-31.01.2024
University of Oulu students: (course code 356013J)
Application for cross-institutional study: Other Universities:

Course leader

Professor Kristina Mikkonen, University of Oulu,

Professor Kristina Mikkonen, University of Oulu
Professor Marco Tomietto, Northumbria University & University of Oulu
Invited lecturers:
Professor Amanda Kenny, University of La Trobe
Dr. Heidi Siira, University of Oulu
Dr. Toni Haapa, Helsinki University Hospital
Dr. Varpu Wiens, University of Oulu

Learning outcomes

  • After the course, student is able to explain and analyze the fundamentals of theory development in health sciences.
  • The student is able to make difference between strategies of theory development.
    Student is able to describe and plan a process of middle range theory developing including development, evaluating and testing the theory.
  • The students improve their understanding about measurements/instrument developing in part of the theory developing process.
  • Student is able to apply gained knowledge on theory development critically in a task of the course.

Credits: 5 ECTS (active participation in lectures 1 ECTS, additional task 4 ECTS)

Learning methods: Preliminary reading, lectures, workshops and independent work.


Current literature, research reports and lecture materials.
Kyngäs H., Mikkonen K., Kääriäinen M. (Editors), 2019. The application of content analysis in Nursing Science. Springer Publisher. doi: 10.1007/978-3-030-30199-6

Outcomes and evaluation:
Active participation in contact teaching and workshops using digital media, and written assignments with self-evaluation.

Instructions for the course assignment:
I. Preliminary assignment, students write 1 page evaluation:
a. What as is my research aim and objective?
b. What are my main concepts in the study?
c. How are the concepts designed?
d. What is the research gap?
e. Do I have study hypothesis?
f. Is my study inductive or deductive?
g. Do I use existing theory in the research?

II. Read Chapter 7 prior lectures

III. Please choose one theory or model connected to your study. Analyze and evaluate the theory and its testing which you chose for the assignment. Analyze and evaluate 1) the process of theory development, 2) the content of theory, 3) validity and reliability of theory (including psychometric validation of instrument), and 4) usefulness of theory.
The criterion of theory analysis and evaluation can be found in the following references: McEwen, M. & Wills, E.M. 2002 and/or Lauri, S. & Kyngäs, H. 2005 and/or Peterson, SJ & Bredow, TS. 2009.

IV. Search the literature to find out how the theory you have evaluated and analyzed has been used.

V. Assignment is not longer than 5 pages including references. Send the assignment to by the 22.4. The assignment needs to be completed in pairs (2-3 people). The feedback will be given oral in assessment discussion of small groups.

Preliminary recommended reading:
Bannigan K, Watson R (2009) Reliability and validity in a nutshell Journal of Clinical Nursing 18, 3237-3243

Elo S, Kääriäinen M, Isola A, Kyngäs H. 2013. Developing and testing a middle-range theory of the well-being supportive physical environment of home-dwelling elderly. The Scientific World Journal vol. 2013, Article ID 945635, 7 pages. doi:10.1155/2013/945635.

Gasmin CJ, Happell B (2014) On exploratory factor analysis: a review of recent evidence, an assessment of current practice, and recommendations for future use International Journal of Nursing Studies 51, 511-521

Kääriäinen M, Kanste O, Elo S, Pölkki T, Miettunen J & Kyngäs H. 2011. Testing and verifying nursing theory by confirmatory factor analysis. Journal of Advanced Nursing 67(5), 1163–1172. doi: 10.1111/j.1365-2648.2010.05561.x

Kähkönen O, Kankkunen P, Saaranen T, Miettinen H, Kyngäs H, Lamidi ML. 2015. Motivation is a crucial factor for adherence to a healthy lifestyle among people with coronary heart disease after percutaneous coronary intervention. Journal of Advanced Nursing, 71 (10), 2364–2373. doi: 10.1111/jan.12708.

Kähkönen O, Saaranen T, Kankkunen P, Lamidi M-L, Kyngäs H & Miettinen H. 2018. Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention. Journal of Clinical Nursing DOI: 10.1111/jocn.14153.

Kyngäs H., Mikkonen K., Kääriäinen M. (Editors), 2019. The application of content analysis in Nursing Science. Springer Publisher. doi: 10.1007/978-3-030-30199-6

McEwen, M. & Wills, E.M. 2002. Theoretical Basis for Nursing. Lipincott Williams & Wilkins. pp. 3-125, 202-228, 347-449.

Mikkonen K., Elo S., Miettunen J., Saarikoski M., Kääriäinen M. (2017). A development of the new scale as a sub-dimension to the clinical learning environment and supervision (CLES+T) scale for culturally and linguistically diverse students in clinical placements in Finland. Journal of Advanced Nursing 00(0), 000–000. doi: 10.1111/jan.13268

Oikarainen A.*, Mikkonen K.*, Tuomikoski A.M., Elo S., Pitkänen S., Ruotsalainen H., Kääriäinen M. (2017). Mentors’ competence in mentoring culturally and linguistically diverse nursing students during clinical placement. Journal of Advanced Nursing 00(0), 000–000. doi: 10.1111/jan.13388 (*equal contributions)

Peterson, SJ. & Bredow, TS. 2009. Middle Range Theories. Application to nursing research. Williams & Wilkins, Lipincott.

Polly, R. & Sawin, K. 2009. The Individual and Family Self-Management Theory: Background and perspectives on context, process and outcomes. Nursing Outlook 57, 217-225.

Riegel, B., Jaarsma, T & Ströomberg A. 2012. A Middle-Range Theory of Self-Care of Chronic Illness. Advances in Nursing Science 35(3), 194–204.

Räsänen P., Kanste O. & Kyngäs, H. 2010. Kotona asuvien ikääntyvien itsestä huolenpito: keskitason teorian ydinrakenteen testaaminen. Hoitotiede 3, 218-230.

Snowden A, Watson R, Stenhouse R, Hale C (2105) Emotional intelligence and nurse recruitment: Rasch and confirmatory factor analysis of the trait emotional intelligence questionnaire short form Journal of Advanced Nursing 71: 2936–2949

Tomietto, M., Rappagliosi, C. M., Sartori, R., & Battistelli, A. (2015). Newcomer nurses’ organisational socialisation and turnover intention during the first 2 years of employment. Journal of nursing management, 23(7), 851-858.

Watson R, Thompson DR, Wang W, Meijer RR (2014) Investigating invariant item ordering in the Mental Health Inventory: An illustration of the use of different methods Personality and Individual Differences 66, 74-78

Ylimäki E-L, Kanste O, Heikkinen H, Bloigu R & Kyngäs H. 2015. The effects of a counseling intervention on lifestyle change in people at risk of cardiovascular disease. Eur J Cardiovasc Nurs. 2015 Apr;14(2):153-61. doi: 10.1177/1474515114521725. Epub 2014 Jan 23.

Last updated: 21.12.2023