Introduction
A nursing theory is an organized body of knowledge that defines nursing, nurses’ work, and the motivations behind their actions. For instance, in the pre-theoretical stage, Orem explored the early ideas and concepts that would eventually lead to the development of their theory. This is the stage where the theorist asks questions, observes, and collects data. The theorist is also beginning to formulate hypotheses and develop ideas about how they think the world works. In the second stage, which was the theoretical stage, Orem began to develop the formal theory. The theorist refines his ideas and conceptions in this phase and develops formal hypotheses and assertions. The theorist started to test their ideas through research. In the next stage, post-theoretical, the nurse theorist continued to refine his theory. The theorist began to develop applications of their theory to practice. In the final step, Applied, Orem began using his theory to inform and guide practice. At this level, Orem was developing tools and resources to help. Therefore, this article will apply a four-step process to reconstruct Orem’s self-care theory to make it more useful.
Nursing Metaparadigm
An essential point to remember about nursing theories is that they fall into one of three distinct camps. Nursing theories can be classified as either “practice-level,” “middle-range,” or “grand (Brando et al., 2019).” Complex, generalized, and sweeping ideas form the basis of a grand nursing theory. Typically, these theories offer a solid foundation for nursing practice ideas on people and health (Brando et al., 2019). Note that the experience of the theorist is often the starting point for a grand theory. Middle-range nursing theories, in contrast, focus on a narrower subfield of nursing rather than more general ideas.
Theories in nursing in the middle range can originate either in academia or clinical practice. The final group comprises theories applicable to actual nursing practice. Creating a theory specifically for clinical nursing practice will further restrict its applicability (Pfettscher, 2021). Therefore, concepts relevant to a particular population or patient at a particular time tend to dominate practice-level nursing theories. While theoretical and conceptual nursing frameworks can affect patients, practice-level nursing theories often have the greatest effect. What a nurse offers and why they do it is defined by nursing theories, so it’s clear that they’re crucial. Consider Orem’s concept of self-care as an example of a nursing theory, as improved patient self-care is the focus of this theory.
Step 1- Theorizing
Nursing is a distinct field since it focuses on improving people’s health and quality of life. One way to accomplish this is to improve access to high-quality medical services. Finding and meeting individuals’ unique healthcare needs is only part of what nurses do. So, nursing care and other experts meet community demands. Experts in nursing are committed to assisting patients in realizing their healthiest possible states (Jolley, 2020). Professionals in the nursing field exhibit unwavering commitment and empathy for the people they serve as they work relentlessly. Another essential element of nursing practice is teaching other medical professionals, such as the Family Nurse Practitioner, how to diagnose and provide treatments. Access to trained medical personnel guarantees timely and accurate diagnosis and treatment of even the most minor health concerns (McEwan & Wills, 2021). Therefore, it will have accomplished nurses’ overarching objective of improving people’s health and happiness.
Step 2- Syntax
Orem’s self-care theory was developed to guarantee high-quality care within healthcare systems and institutions (Younas, 2017). Throughout this theory, one will hear two keywords; one term is self-care, while the other is the deficit. Patient self-care is empowering individuals to take an active role in their healthcare. Thus, it is within the patient’s power to participate actively in their healthcare. Therefore, this will significantly impact the patient’s health, quality of life, and longevity. Family Nurse Practitioners and other medical staff can be inspired to do their best by adopting a self-care strategy.
Since patients see others taking an active role in their recovery, doctors have more confidence in their ability to restore health. The term “deficit” describes the second set of words. If the patient has a deficit, the nurse may need to pay closer attention to them. A deficit implies that a patient is facing challenges they cannot overcome (Perera & Agboola, 2019). When people are sick or injured, they need a nurse’s help more than ever to get back to being healthy. Orem’s theory of self-care advocates for systematically addressing preexisting health deficits as a first step toward actualizing self-care.
Step 3- Testing
The theory requires two main elements to be true. First, healthcare providers like family practice nurse practitioners are responsible for addressing patients’ needs. Second, individual patients are accountable for their medical care. This process, however, is only initiated after consultation with a trained medical professional. One of the main tenets of this approach is educating patients so that they not only understand what care they require but also how to take an active role in meeting those needs, whether at home or elsewhere. When seeking medical attention, patients should follow the advice of professionals in the field.
Education on the underlying pathologic issues is critical for identifying the best treatments for patients. This approach was implemented in numerous healthcare programs around the country. The results of the tests indicated that the theory was promising (Brandão et al., 2019). Patients, though, need to be taught the skills necessary to thrive in their new home-based care environments before that can happen. There was also some effort put into gathering qualitative data. Knowledge of health issues and how self-care can be implemented improves patients’ ability to cope with those conditions and also patients’ overall sense of well-being, as was found in this qualitative study.
Step 4- Evaluation
Evidence-based procedures are the most reliable means of evaluating the theory’s efficacy. In other words, evidence-based healthcare techniques can demonstrate the theory’s efficacy in practice. The evidence-based practices demonstrate the strategy’s efficacy across the healthcare system and its ability to enhance patient care (Mackey & Bassendowski, 2017). Multiple methods were used to determine how well the theory worked. For instance, researchers, nursing theorists, and students compared the theory to others in the field. After the theory was tested, the results were scrutinized for unexpected behavior. Included are the theory’s numerical and qualitative uses (Khademian et al., 2020). The possible drawbacks of this self-care theory’s application to nursing practice were also factored into the analysis. And finally, the theory recommends interventions to boost patient health outcomes. As a result, an assessment would investigate whether or not there is a correlation between self-care theory implementation and better clinical results for patients.
Conclusion
The profession of nursing is committed to improving people’s health via the careful delivery of medical care. Nursing professionals provide invaluable expertise in the delivery of care. Existing nursing theories serve as a crucial framework that protects the nursing profession. As was previously indicated, Orem’s idea of self-care plays a critical role in guaranteeing proper patient care. The theory’s key jargon is “self-care” and “deficient.” Self-care implies that a patient may provide care for themselves, with instruction from a licensed care professional, whereas the phrase “deficient” implies the need for care. In both quantitative and qualitative settings, the theory has been shown to work well enough to meet the assessment criteria.
References
Pfettscher, S. A. (2021). Florence Nightingale: modern nursing. Nursing Theorists and Their Work E-Book, 52.
Brandão, M. A. G., Barros, A. L. B. L. D., Caniçali, C., Bispo, G. S., & Lopes, R. O. P. (2019). Nursing theories in the conceptual expansion of good practices in nursing. Revista Brasileira de Enfermagem, 72, 577-581.
Jolley, J. (2020). Introducing research and evidence-based practice for nursing and healthcare professionals. Routledge.
Khademian, Z., Ara, F. K., & Gholamzadeh, S. (2020). The effect of self-care education based on Orem’s nursing theory on quality of life and self-efficacy in patients with hypertension: a quasi-experimental study. International journal of community-based nursing and midwifery, 8(2), 140.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55.
McEwan, M., & Wills, E. M. (2021). Theoretical basis for nursing. Lippincott Williams & Wilkins.
Perera, N., & Agboola, S. (2019). Are formal self-care interventions for healthy people effective? A systematic review of the evidence. BMJ Global Health, 4(Suppl 10), e001415.
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.