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AnPa
Discussion Post Reply #1
Theory Description
The theory and theorist I have chosen to present is Dorothea Orem’s Self-Care
Deficit Theory. This theory’s origin, also known as the Orem Model of Nursing, was
developed between 1959 and 2001 to shift focus from just providing care to patients to
encouraging them (Petiprin, 2023). Petiprin noted that the purpose centered around the
philosophy that patients want to care for themselves, and by performing their own self-
care as much as possible, they can recover more quickly. The theory was influenced by
Orem’s own nursing practice experience and her own education (Nickle, n.d.). Petiprin
(2023) highlights that this theory is considered a grand nursing theory with a broad
scope that covers all occurrences in nursing. According to Petiprin, the Self-Care
Deficit Theory has three main concepts. The first is the structure of the theory, which is
described as the universal self-care basics that all people require, like water and food.
The second is described as developmental self-care, which includes maturational,
which progresses the patient to a higher level of maturation, or situational, which
prevents harmful effects in development. The third category is health deviation, defined
as needs that appear based on the patient’s condition. Petiprin also describes that a
nurse’s support includes total care, partial care, education, and/or support.
Analysis
Assumptions that could be made based on the Self-Care Deficit Theory are that
complete nursing care is automatically required when a patient is in a care facility. That
is not always the case, and a patient should be evaluated thoroughly before assuming
they need help. Nurses believe their job is to help, but sometimes, too much help can
hinder the patient, even though the intention behind it is good. The clarity of this theory
is distinct and can be understood by any professional studying it. The theory is widely
accessible and can be searched quickly. It is available in forms that include the theorist
herself explaining it and in forms from other people who have studied and applied the
theory. The Self-Care Deficit Theory is highly generalizable, applying to almost all
patient populations, health issues, and healthcare settings. The context of the theory is
based on developing interventions for what the patient needs based on their ability to
perform their own care. The sources of Orem’s theory can be traced to her nursing
practice experience for the essential ideas and her formation/education to solidify
those ideas (Nickle, n.d.). This theory is enormously important in motivating patients to
return to themselves as soon as possible, which is the foundation of healthcare in
general.
Evaluation
Dorothea Orem’s Self-Care Deficit Theory is widely used and recognized as a
foundation for nursing. A supportive theory could include Kristen Swanson’s Theory of
Caring, which focuses on knowing, being with, doing for, enabling, and maintaining
belief and then applying it to nursing practice to improve a patient’s overall well-being
(Al Yasin, 2023). On the contrary, Hildegard Peplau’s Theory of Interpersonal Relations
highlights the importance of patients’ personal experiences with nursing care (Hagerty
et al., 2017). Hagerty describes the theory as focusing more on the patient’s emotional
journey than the tasks needed to get them back to their baseline. Orem’s theory can be
used to guide general or advanced practice by providing the framework to address
patient’s needs. It contributes to patient outcomes by allowing a nurse to determine
the appropriate interventions to assist the patient back to health with the full ability to
care for themselves, allowing the patient and their families to regain normalcy. The
theory can assist advanced practice in deciding what interventions the patients need to
regain that normality.
Development
Dorothea Orem’s theory is considered testable. An example is Khademian et
al.’s (2020) article testing this theory in hypertensive patients. Khademian et al.
conclude that training for this theory helped improve patient outcomes, proving its
testability. This theory’s application to research is widely used to assess and improve
patient care outcomes. Researchers can determine how patient deficits can affect the
patient, the illness, and the specific population of patients, as well as how this applies
to various diseases. After some research, Orem’s theory appears more supported
among scholars than not. Proof of the support includes numerous articles that can be
found explaining the use of this theory and how it significantly improves patient
outcomes, like Kristen Swanson’s Theory of Caring. This class provides students with
the opportunity to emphasize the significance of this theory and conduct a thorough
evaluation. My belief in Orem’s theory and the need for further development, research,
or refinement is based on my ICU experience as a nurse. Complex situations call for
increased interventions by the nurse as opposed to non-complex situations that require
less. Further research and developments could be done to acknowledge the help
needed in an ICU setting and at what point patients benefit from completing their own
self-care. ICU settings contain complex, multidisciplinary approaches, which could
affect the use of this theory, potentially needing more work on this subject.
TaJo
Discussion Post Reply #2
Theory Description
The health promotion model (HPM) is a middle-range nursing theory developed by Nola
Pender. This theory shifts clinical practice from disease treatment to disease prevention
and believes nurses play an integral role in promoting wellness. It first appeared in
nursing literature in 1982 but was later revised in 1996 (Pender, 2011). Pender notes the
influence of expectancy-value theory (EVT) and social cognitive theory (SCT) as the
basis for the HPM. The HPM comprises three main components: individual
characteristics and experiences, behavior-specific cognitions and affects, and
behavioral outcomes (Pender, 2014). Each of these components is further broken down
for a more holistic view of the patient, including prior behavior, personal factors,
benefits and barriers to action, self-efficacy, environmental influences, and
commitment to a plan of action. The HPM provides nurses with a framework to
understand significant determinants of health behavior and promote a healthier
lifestyle.
Analysis
A few assumptions the HPM is based on are 1) persons seek to create conditions to
improve health conditions, 2) persons have the capacity for reflective self-awareness,
3) individuals seek to regulate their own behavior, 4) health professionals constitute a
part of their interpersonal environment (Pender, 2011). Meleis (2024) describes clarity
as consistency through definitions, assumptions, and propositions. The HPM is highly
clear as definitions are consistently defined, and it describes a clear relationship
between health, person, environment, and nurse (Koshnood, 2018). The HPM is
accessible regarding its conceptual framework as it establishes a direct link to clinical
practice and allows for straightforward interventions (Turner & Reed, 2023). Its
generalizability is high as it is utilized across various health behaviors and disciplines,
including nursing, public health, psychology, and medicine. The HPM applies to many
contexts, including education, participation in treatment plans, disease screenings, and
participation in health-promoting activities. It is highly relevant to the field of nursing
through its use in education, policy, research, and practice across many nursing
disciplines.
Evaluation
Koshnood and Turner agree that the HPM is relevant and valuable to nursing practice.
The HPM guides nursing interventions to promote a healthy lifestyle through a holistic
approach. It can promote health behaviors in various ways, including smoking
cessation, weight management, mental health, nutrition, and exercise. Tailoring
interventions to fit a specific patient’s needs improves health outcomes and increases a
patient’s overall wellness.
Development
The testability of the HPM is shown in several studies. One example is Habibzadeh’s
(2021) study of the effect of educational interventions based on the HPM in CHF
patients. This study concluded that educational interventions based on HPM improve
health-promoting behaviors. The HPM has been effective in many studies that increase
health and wellness. One limitation of the model is its focus on a single patient rather
than entire communities. While this model is effective in various patients, it is not set up
to reach the whole community at once. Another limitation is the person’s willingness to
improve their health. The HPM could be expanded to include interventions to improve
health when aiding an obstinate patient. Overall, the HPM has proven beneficial to the
nursing profession and the health of our patients.
