Running head: THEORY DEVELOPMENT Where Did the Theory Come From Martha Rivera, RN, BSN Kaplan University – School of Nursing MN 502 Theoretical Foundations of Advanced Nursing Dr. A. White-Williams, DNS, APRN-CNS April 22, 2017 1 2 THEORY DEVELOPMENT Introduction The author of this paper will assume the role of the theorist Dorothea Orem, the study will discuss how the author used the four stages of theory development while developing the theory. Prior to application of the concepts to an evidence-based practice, there are a number of stages that a theory has to go through. This systematic theory development is necessary for giving guidelines on how a particular theory came into existence. Therefore, the purpose of this study will focus on the development of Self-Care Deficit Nursing Theory (SCDNT) by Dorothea Orem. The following stages are of interest to the study: the first stage will encompass theorizing of the theory, the second stage will discuss the development of the syntax, the third stage will focus on theory testing, whereas the last stage will discuss the evaluation of the theory. The study aims at increasing the understandability of the different aspects used in Self-Care Deficit Nursing Theory as discussed below. Stages in the Development of the Self-Care Deficit Nursing Theory by Dorothea Orem The process of theorizing involves discussing main reasons cited by the author for the development of the theory. In the theory, the author defines nursing a provision of human needs of health care so as to maintain healthy living, aid in the recovery process from diseases and how a patient can live up with the effects caused by the diseases. Therefore, nursing is entrusted with the ability to promote a healthy living in the society by understanding health needs of members of the community and addressing them effectively. This indicates that nursing must encompass the concept of the whole human being. It is necessary that nurses ensure healthcare services are provided to human beings as a whole as depicted by the author. This indicates that nurses should ensure healthcare services to a human being in terms of physical, mental, social and psychological among others. THEORY DEVELOPMENT 3 Moreover, in the development of the theory, the author indicated that nursing involves the concept of creating a favorable environment for the patient’s recovery. Provision of health care services involves the aiding of the recovery process by portraying the right attitude and offering of the best healthcare services. The author indicated that human being health is dependent on the environment. Since the environment and individual’s health are interrelated, nurses have a responsibility to maintain a healthy environment when providing self-care services. Another important concept is health that outlines the responsibility of the nurses in the provision of self-care services. When an individual healthcare capability surpasses his ability, nurses are required to provide self-care services. Therefore, nurses have a responsibility in assisting patients in meeting their health care needs (Orem, 2011). The second stage outlined by the author is the development of syntax. Under this stage in theory development, the author used terms in the text that portrayed different meanings at different stages. The term self-care has had different meaning through different generations, for example, self-care referred to an individual care of self-heath without the involvement of other medical practitioners of consultants. The author defined self-care as personal activities that an individual performs without the help of other people that is aimed at improving personal health and prevention of diseases. This definition developed over time to include self-care as the intervention of nurses to assist a client in the maintaining of personal health when the need arises. Such interventions are dependent on the client’s ability or inability to take care of his personal health. The second term of interest to the study is an agency. Agency was defined as the process of acting in a position of another person’s authority. However, the author defined agency as a personal a decision on self-care needs and ability to perform self-care actions. Orem also defined agency as the ability of a person in performing actions that are directed toward the THEORY DEVELOPMENT 4 achievement of personal goals. Orem defined the self-care agency as personal actions in maintaining and sustaining individual’s healthcare. After further development of the theory, the author defined self-care agency as the ability in meeting an individual’s recurring healthcare needs that improve the human development and enhances his well-being and regulation of life processes. The third stage of the theory development involves testing to determine if the theory is able to address issues that may arise in practice. Banfield (2011) explains the role of environment in the development of the theory. In the study, the author presents how Orem’s ideas on the environment and the theory are related. The Orem’s theory was applicable to the self-care practice because AIDS is an infection that affects the functioning of individual’s immune system. Living a healthy life is dependent on the self-care of the patient with the help of nurses. It is the responsibility of the patient to take the medications and maintain a healthy life by adhering to all the doctor’s instructions (Barroso et al, 2010). The study employed the five help methods that were identified by Orem in her theory. Orem’s theory is used to explain the practice of maternal literacy and how to comprehend information on child immunization. Fex, Ek & Söderhamn, (2009), in their study, used information from Orem’s theory on self-care in the explanation of how to improve the self-care of people suffering from chronic diseases using the increasing technological advances in the industry. The study further identified the factors that affect self-care on the persons that are using advanced technology using information from Orem’s theory. The study provides analytical information on aspects discussed by the author of the theory in relation to how technological advances have impacted positively on improving self-care. In addition, how studies on increased mobile applications have led to the improvement of self-care of patients. This is because both the patients and the physicians are THEORY DEVELOPMENT able to monitor the health care so that precautions and corrective measures may be taken. When analyzing results this has an effect in the information from Orem’s theory on self-care and it is applied in the practice (Anderson, Burford & Emmerton, 2016). The last stage is an evaluation of how the theory has been applied in the provision of nursing care. Clinical decision support is one of the aspects that apply information from selfcare theory. This is through the provision of timely information to have an influence on the decision making process on a patient’s self-care. In addition, through self-care policy, there is a provision of health education so as to improve the quality of self-care services. Self-care policy also provides competencies in practice to improve the self-care services. Self-care leads to the adoption of the evidence-based organization by improving the nurses’ expertise and putting into consideration patient’s preference and values. The theory is applicable to evidence-based practice in the nursing care of an ostomy patient. Through the theory, the nurse is able to understand the needs of the patient and Orem theory contains the essential elements in the provision of nursing care (Sampaio et al, 2008). Moreover, the theory is applicable in the selfcare for HIV patients. This is because the theory explains the role of nurses and their duties toward self-care of their clients. The Orem’s theory is also used in the determination of how education and support can solve problems in a patient with different infections. The theory also provided information on the universal, developmental, and health deviation healthcare deficits that are essential in nursing in maintaining self-care. 5 6 THEORY DEVELOPMENT Conclusion The study concludes that theory development has to undergo the four major stages that are: theorizing, sintax, theory testing, and evaluation. The theory is essential in providing information on the roles of nurses in enhancing self-care agency. Moreover, the study concludes that the applicability of the theory in the nursing field is essential in improving self-care. Therefore, nurses have to understand the theory so as to aid them in promoting their client’s care. 7 THEORY DEVELOPMENT References Anderson, K., Burford, O., & Emmerton, L. (2016). Mobile health apps to facilitate self-care: a qualitative study of user experiences. PloS one, 11(5), e0156164. Banfield, B. E. (2011). Environment: A Perspective of the Self-Care Deficit Nursing Theory. Nursing science quarterly, 24(2), 96-100. Barroso, L. M. M., Brito, D. M. S. D., Galvão, M. T. G., & Lopes, M. V. D. O. (2010). Utility of the self-care theory to assist the bearer of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. Acta Paulista de Enfermagem, 23(4), 562-567. Fex, A., Ek, A. C., & Söderhamn, O. (2009). Self‐care among persons using advanced medical technology at home. Journal of clinical nursing, 18(20), 2809-2817. Orem, D. E. (2011). Self-care deficit nursing theory. Nursing Theories: The Base for Professional Nursing Practice, 6/e, 113. Sampaio, F. A. A., Aquino, P. D. S., Araújo, T. L. D., & Galvão, M. T. G. (2008). Nursing care to an ostomy patient: application of the Orem´ s theory. Acta Paulista de Enfermagem, 21(1), 94-100.
Purchase answer to see full attachment