NUR 513 Topic 5 DQ 2 Select one theory discussed during Topics 4 and 5. Does application of this theory differ based on the population focus?
Select one theory discussed during Topics 4 and 5. Does application of this theory differ based on the population focus (individuals, families, communities, and special populations)? Why or why not? Use examples from your current practice to illustrate differences or similarities.
Re: Topic 5 DQ 2
One of the theories I discussed last week was Orem’s Self-care Deficit Theory. Orem’s theory promotes the idea of patient independence over self-care with the ultimate goal of overcoming human limitations to self-care (Current Nursing, 2020). By focusing on a person’s ability to perform self-care, maintain health and overall wellbeing, this empowers the individual to take responsibility for their health or the health of others (Shah, et. al, 2013). This theory can be highly individualized from patient to patient, or patient’s families, so the application of this theory can differ greatly based on population focus. For example, this theory would be applied differently between adult and pediatric populations based on age and developmental stages. In pediatrics, this theory would likely be heavily geared towards parent support and educations in performing cares. Additionally, this theory can great vary based on specific illness or disease state. For example, I work in a pediatric cardiovascular ICU where the patient’s defect, arrhythmia, or ailment greatly determines their self-care needs. A neonate with a congenital heart defect that is not yet fully repaired may have an oxygen requirement or tube feeding support. In this case, much more teaching would be geared towards the parent’s ability to use/manipulate these new medical devices. On this same unit, I may also take care of an adolescent patient who just had a mechanical valve replacement. Initially post op, this patient may require full or partial cares, and these deficits would change as the patient status improves and once again becomes independent. This same patient may also require teaching involving anticoagulant therapy; many adolescents have the physical and mental capacity to administer their own medications, so teaching and support would be given in this case.
Ultimately, how Orem’s Self-Care Deficit Theory is applied to a population focus is highly variable from situation to situation because deficits can be adaptable and dynamic in nature.
Current Nursing. (2020, March 12). Nursing theories: Open access articles on nursing theories and models. https://currentnursing.com/nursing_theory/self_care_deficit_theory.html
Shah, M., Abdullah, A., & Khan, H. (2013). Compare and contrast of grand theories: Orem’s self-care deficit theory and Roy’s adaptation model. International Journal of Science and Research. https://www.ijsr.net/archive/v4i1/SUB15564.pdf
I agree with you Gina that Orem’s theory promotes patient independence over self-care. The theory believes that patient autonomy enables the overcoming of human limitations to self-care. Self-care differs among patients due to their complications and personalities (Younas, 2017). Tailoring patient care based on their needs increases accuracy and service reliability. Tailoring patient services create individualized care. Therefore, Orem’s theory application differs based on the population’s character. The adult patients due to their age and nature of complication they may want unique medical care compared to the young population (Fernandes et al., 2018). Adult patients due to their age they are pre-exposed to various health problems. Orem’s theory flexibility allows nurses to adjust their nursing care based on the condition. The ultimate goal of Orem’s theory is to facilitate self-care. Successful self-care is individualized nursing care that considers patient’s needs. Teaching nurses on understanding patient’s needs is an integral activity towards integrating Orem’s theory. Creating an enabling environment allows patient to disclose their concerns improving healthcare services.
Fernandes, S., Silva, A., Barbas, L., Ferreira, R., Fonseca, C., & Fernandes, M. A. (2019, September). Theoretical contributions from Orem to self-care in Rehabilitation Nursing. In International Workshop on Gerontechnology (pp. 163-173). Springer, Cham.
Younas, A. (2017). A foundational analysis of dorothea orem’s self-care theory and evaluation of its significance for nursing practice and research. Creative Nursing, 23(1), 13-23.
Re: Topic 5 DQ 2
In Topic 4, I have mentioned the Environmental theory by Florence Nightingale in one of the discussions. This theory is not based on a specific population focus. This can be applied to every individual, families, communities, with no other special populations specified. The reason for this is that the theory is concerned on a person’s health in relation to its environment and the impact of the environment upon them (Gonzalo, 2021). Every person, young or old, has a variety of environmental factors that can be detrimental to their health. However, a person’s environment may also constantly change, temporary or permanent, depending on the circumstance.
The difference that would be observed in this theory would depend on the environmental factors affecting that population focus. An example is when I volunteered for a medical mission before and performed health assessments on families who lived near a mangrove, many of them reported GI symptoms or have history of gastrointestinal-related illnesses (e.g., diarrhea, vomiting, stomach pain). It was reported that the water from the mangrove had somehow entered through a leaked pipe, causing them to consume unclean water. It affected both children and adults. On the other hand, another family that I conducted health assessments on that did not live near the mangrove, exhibited no symptoms, and were all perfectly healthy. The idea here is that these families had different environmental conditions, which led to two different outcomes.
In order for APNs to incorporate this theory into practice, as Nightingale described it, the nursing process should include gathering of information and assessing the information on its relevancy (Tourville & Ingalls, 2003). Also, it is essential that nurses in an inpatient setting be able to provide an environment that fosters healing. Though some of the environmental factors can not be controlled, it is imperative for nurses to take the initiative in configuring the environmental settings appropriate for the gradual restoration of the patient’s health (Gonzalo, 2021). In my future practice, with emphasis in healthcare quality, one of my major goals is to ensure that I implement policies and procedures that promote environmental safety.
Tourville, C., & Ingalls, K. (2003). The living tree of nursing theories. Nursing Forum, 38(3), 21-30, 36. doi:http://dx.doi.org.lopes.idm.oclc.org/10.1111/j.0029-6473.2003.t01-1-00021.x
Gonzalo, A. (2021). Florence nightingale: Environmental theory. Nurselabs. https://nurseslabs.com/florence-nightingales-environmental-theory/
Maria, I agree with you that environmental factors impact people regardless of their age. Nurses attend to different patients with different medical needs. Environment affects the medical intervention. The environmental theory insists that healthcare facilities
should be clean and suitable to facilitate patient’s recovery (Fernandes & Silva, 2020). Unfortunately, the environment might change due to various environmental occurrences. A clean environment, water, and proper lighting are environmental factors that facilitate smooth patient’s recovery. Some patients may not prioritize clean water since they are used to drinking untreated water. Therefore, these patients may want other environmental factors that will enable them to be comfortable. Prioritizing environmental factors when attending to patients (Sayani, 2017). Nightingale’s theory dictates that the APNs should gather crucial environmental information before integrating the environmental theory. Obtaining the information allows healthcare providers to understand patients’ environmental needs. The inability to understand the patient and the environment that enable the patient’s recovery paralyzes the nurses’ efforts to improve healthcare quality.
Fernandes, A. G. O., & Silva, T. D. C. R. D. (2020). War against the COVID-19 pandemic: reflection in light of Florence Nightingale’s nursing theory. Revista Brasileira de Enfermagem, 73.
Sayani, A. H. (2017). Nightingale’s Theory and its Application to Pediatric Nursing Care. i-Manager’s Journal on Nursing, 7(2), 38.
Re: Topic 5 DQ 2
Virginia Henderson is a theorist that emphasizes the importance of increasing the patient’s independence so that progress after hospitalization would not be delayed. “Her emphasis on basic human needs as the central focus of nursing practice has led to further theory development regarding the needs of the patient and how nursing can assist in meeting those needs. The four major concepts addressed in the theory are the individual, the environment, health, and nursing. Hendersons theory does not differ from the application when it comes to individuals, families, communities, and special populations. An example that can be applied to Hendersons theory is the elderly population. They may require assistance to achieve health and independence, or assistance to achieve a peaceful death. For the individual, mind and body are inseparable and interrelated, and the individual considers the biological, psychological, sociological, and spiritual components. This theory presents the patient as a sum of parts with biophysical needs rather than as a type of client or consumer” (Nursing theory, 2020).
In the elderly population education is a major factor when it comes to medications. Teaching the patient how to properly take or administer medications can benefit them in many ways in turn lowering death rates. The environment plays a major role as well, because it determines how the patient can adapt to their surroundings. Henderson stated that maintaining a supportive environment conducive to health is one of her 14 activities for client assistance. If a patient is placed in a situation where he/she is surrounded by people educating and informing them about self-care they will more likely follow what is recommended. Health and nursing go hand in hand. Having a passionate nurse that is worried about the well-being of the patient will bring about change within the individual. Henderson states “Nurses temporarily assist an individual who lacks the necessary strength, will, and knowledge to satisfy one or more of the 14 basic needs. She states: “The nurse is temporarily the consciousness of the unconscious, the love life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge, and confidence of the young mother, the mouthpiece for those too weak or withdrawn to speak” (Nurse lab, 2021). It is important to emphasize education to the elderly population so that we can continue to address any issues that may arise.
Nursing theory, (2020). Henderson Nursing need theory.
Nurse lab, (2021). Virginia Henderson. Nursing need theory.
RESPOND TO HERE
Jackyvan I agree with you that Virginia Henderson’s theory focuses on basic human needs. The focus has led to the advancement of more theories. The theory emphasizes on patient’s independence in minimizing delays in the medication process. The individual, the environment, health, and nursing are four concepts in Henderson’s theory (Gligor & Domnariu, 2020). The theory is rigid when applied in healthcare facilities. Therefore, healthcare providers are forced to ensure that their population meets conditions to use Henderson’s theory. However, the model’s concepts increase its preference especially in healthcare facilities that respect patient’s autonomy. The elderly population is exposed to various complications. Thus, elderly patients may need health and independence assistance due to their state. Environment plays a significant role in dictating medical intervention (Fernandes et al., 2019). Hospitals ensure that they create a suitable environment. Poor environment reduces patient chances to recuperate. Furthermore, the environment may generate new health complications. Nurses’ proximity to their patients allows them to understand the suitable environmental factors that will improve their recovery rates.
Fernandes, B. K. C., Clares, J. W. B., Borges, C. L., Nóbrega, M. M. L. D., & Freitas, M. C. D. (2019). Nursing diagnoses for institutionalized elderly people based on Henderson’s theory. Revista da Escola de Enfermagem da USP, 53.
Gligor, L., & Domnariu, C. D. (2020). Patient Care Approach Using Nursing Theories-Comparative Analysis of Orem’s Self-Care Deficit Theory and Henderson’s Model. Acta Medica Transilvanica, 25(2), 11-14.