NRS 430 CLC – Nursing Theory and Conceptual Model Presentation
CLC – Nursing Theory and Conceptual Model Presentation
Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efcacy in nursing practice. Explain how the theory proves the conceptual model.
- Explain how the nursing theory incorporates the four metaparadigm concepts.
- Provide three evidencebased examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.
Origin of the comfort theory
- Developed by Katherine Kolcaba
- Kolcaba serves as a registered nurse and had a Master’s degree in nursing
- Kolcaba initially analyzed the term comfort as a term that illustrates strength hence she discovered the theoretical importance of the term.
- She later developed the theory by creating a taxonomic structure.
- The theory was first published in 1994 with other modifications published in 2001 (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
This assignment is to be completed in a group, which will be assigned by your instructor. The presentation will be submitted and graded as a group assignment.
Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10‐15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:
- Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
- Explain how the nursing theory incorporates the four metaparadigm concepts.
- Provide three evidence‐based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.
Kolcaba developed the comfort theory after conducting a conceptual analysis of the term in various disciplines such as medicine, nursing, psychology, and psychiatry. The theory is a middle-range theory that focuses on placing patient comfort as the main aspect of nursing care. To Kolcaba, nurses provide comfort to patient when they engage in holistic nursing (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
- Humans respond to complex stimuli in a holistic way.
- Effective nursing care leads to holistic comfort which is a holistic outcome.
- Comfort is a human need hence humans are bound to seek it wherever possible.
- Nurses are caregivers who can easily identify comfort needs (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
Holistic comfort refers to the immediate strength that patients experience when their needs are met by nurses who are their caregivers. The comfort theory not only assumes that patients need comfort, but also that nurses have the ability to identify comfort needs and ensure that patients experience holistic comfort (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
Comfort: this is a concept that strengthens patients and is achieved using comforting actions conducted by nurses during healthcare.
Intervening variables: Factors such as social support, finances, and prognosis that do not change during healthcare and healthcare providers have no control over them. They should be considered by nurses when determining interventions that lead to patient comfort.
Healthcare needs: the needs of patients in healthcare settings.
Enhanced comfort: A desirable outcome that occurs after nurses implement appropriate interventions to meet the comfort needs of a patient.
Institutional integrity: the wholeness, values, and financial stability of healthcare organizations at national, state, regional, and local levels. When nurses engage in comfort care, they promote institutional integrity.
Best practices: these are procedures and protocols developed by healthcare institutions for specific patients after assessments. Comfort needs are patient-specific hence best practices should focus on patient-centered care.
Best policies: Overall procedures and protocols developed by healthcare institutions for use in evidence collection. They should facilitate the identification of patients’ comfort needs (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
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The comfort theory proves the conceptual model because it encourages the determination of the healthcare needs of a patient and the
use of comforting interventions to deal with these needs. In addition, the theory emphasizes on the need of considering intervening variables when providing comfort needs as a way of achieving enhanced comfort.
- Nurses have the role of identifying the comfort needs required by their patients and their families.
- Nurses develop appropriate interventions to meet the comfort needs.
- When developing interventions, it is important to consider intervening variables.
- Effective interventions lead to enhanced comfort and are called ‘comfort measures’ (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
The comfort theory describes nursing as a process that should involve the identification of the comfort needs of a patient, determining and implementing the most appropriate care plans, and conducting evaluations to determine if the plans meet the comfort needs of the patients. Intervening variables are those that are not controlled by healthcare providers but they affect the patient’s comfort such as availability of social support or finances. It is important to consider these variables before determining effective interventions (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).
Nursing Theory & Conceptual Model
- Florence Nightingale’s Environmental Theory describes that a disease can be healed by changing the patient’s environment.
- A patient needs to be viewed as an individual that is multidimensional such as considering their spiritual, psychological and biological needs.
- Altering the patient’s environment is the most important concept in this nursing theory.
- Environmental factors include: clean water, fresh air, minimal noise levels, adequate hygiene, good food supply, sanitation, sunlight.
- The foundation of concepts that are fundamental to a theory.
- Concepts Include:
○Nursing – Nursing Actions (applying knowledge and skill)
○Health – Defined by Person (quality and wellness of health, access to healthcare)
○Person – Recipients of Care (spiritually, culture, family/friends, socioeconomic status)
○Environment – Internal and External Factors relating to the patient
- Applying the 4 metaparadigm concepts to the nursing process is essential to provide patient care as a whole.
(Branch, Deak, Hiner, Holzwart, 2020)
An author’s client in community clinical during her undergraduate studies in 2009 was a 60-year-old lady who had recently undergone coronary artery bypass grafting. It was a four-person middle-class family living in a two-room apartment. When the author first entered the house, he noticed an awful smell throughout the house since only one window was open, resulting in a bright but poorly ventilated surroundings.
During the examination, it was discovered that the patient had been experiencing pain, itching, and redness in her stitches since the previous day, and that her body temperature had also increased. Her wound was red with purulent discharge, and her temperature was 38 degrees Celsius. The patient had an infection in her wound and needed to be taken to the hospital right away. Patient’s bed linen was discovered to be dirty and wrinkled while transporting her from bed to chair. Inquiring with her daughter-in-law, it was discovered that the bedding had not been changed in the previous week because she does not leave her bed for long enough for the bed linen to be changed.
The patient is only offered an assisted bath twice a week, and her garments are not changed on a daily basis.
To intervene, the author assisted the patient’s daughter in law in changing bedding and giving her a bath. She also taught her sponging techniques, so that if she can’t give the patient shower every day, she can give her sponge twice a day. She opened all the windows to make the building brighter and more ventilated, and she took personal and bed hygiene as a topic and provided a session to teach it.
Following the scenario above, the patient’s environment was not conducive for post operative wound healing and general well-being.
The nurse utilized the elements in Florence Nightingale theory to improve the patient’s condition which resulted in a better outcome.
In the world today, nursing is primarily a female-dominated profession, the desire to help the sick and poor has its roots in military, lay, and religious orders fulfilled by men between 300 BC to prior 1800. Most will be surprised by the simplicity of the work done by the uneducated and unrecognized groups that comprised nursing at the time. Recognizing the critical need for caregivers, on the other contrary, illustrates the commonality of caring, which exists independently, culture, and gender.
Given the strong dedication to the sick and poor, nursing as a profession was still in its childhood, considered only to be the job of the lowest classes of society. Nurse education and training were at best rudimentary, with little importance put on the care given by those in the various nursing orders.
Nursing conditions were at their worst in the first half of the nineteenth century. Nursing had become a job for society’s “undesirables,” such as the immoral, alcoholic, and illiterate. Nursing care was underpaid and frequently supplemented in any way possible. There was little organization associated with nursing and certainly no social standing. No one would enter nursing if they could earn a living in another way. Nursing gained the respect of the military and the government as a result of the work of early nursing figures, ushering in what is now known as modern nursing.
Modern nursing began as a result of the event of the Crimea war.
Following this is the event of nursing with a ceremonial cap and pin. This was referred to as Nurse’s “Muffin” Cap circa 1910.
It was customary for women to wear their hair long at the time. The nurse’s cap served the purpose of promoting hygienic conditions for the patient by containing the nurse’s hair. Earlier styles of the nurse’s cap covered the entire head and were considered unsuitable by nurses.
This gave rise to handkerchief cap circa 1940.
As the handkerchief cap replaced the muffin cap, the style of nurses’ caps evolved further. This cap was less difficult to manufacture, clean, and transport. Its design made it smaller than previous caps, covering only the top of the head knot of hair.
Senior student nurses decorated their caps with a quarter-inch black band, while graduate nurses adorned their caps with a half-inch thick band, as the style of the nursing cap began to reflect the level of academic achievement attained by the nurse. This was referred to as Graduate Nurse’s cap circa 1944.Graduate nurses wore their own Alma mater’s cap despite where they worked.
Furthermore, the American nurses association was developed to give credentials to nurses and specialization in different areas of nursing.
The development of nursing training and degree programs that adhered to nursing associations’ quality of practice and regulations, as well as nurse licensure, bolstered the nursing profession. The first conference of the Nurses Affiliated Alumnae of the United States and Canada, which subsequently became the American Nurses Connection in 1911, was attended by fewer than twenty nurses in 1896.
Over a century later, the American Nurses Association has grown in membership, expanded its services, published a vast collection of material on nursing practice and the profession, founded a code of professional nursing, developed and instituted the means for registered nurses to be credentialed in areas of specialization, and most notably, become legislatively involved to advance the nursing practice so that the responsibilities, obligations, and clinical settings of nursing are acknowledged.
Nurses wear different uniforms through their formation and transition over the years. The nursing outfit reflects not only the vital role of attire dressed by nurses, but also the honorable work of nursing as a crucial component of health care delivery.
Another noticeable aspect of change is in the aspect of technological advancement.
As both the demands of patient populations are becoming more challenging, so does the technology used to diagnose, monitor, and treat disease. Consider how far we have come as a society in the short time that medical science has been applied.
The nursing profession has changed over the years through training and education, Responsibility,specialization with safety and quality practice.
Formalized education is one notable change in the evolution of the nursing profession. In the late nineteenth century, the first training programs were established in hospitals. In exchange for patient care, student nurses received clinical training. During this training period, nurses assisted hospitals in making significant improvements in safety and quality, as well as humanizing medical care. Nursing education is changing in response to patient needs, and the emphasis on comprehensive education has never been greater. The Institute of Medicine (IOM) issued a firm recommendation in 2010. By 2020, at least 80% of registered nurses should have a bachelor’s degree in order to manage increasingly complex patient conditions.
Emphasis is stressed on academic progression for a better patient’s care and outcome.
This is a significant advancement in the evolution of the nursing profession. Nurses now have a broad range of responsibilities. Nursing is no longer regarded solely as a form of care-giving. Modern nursing, according to the International Council of Nurses, is a combination of knowledge, judgment, and skill.
The current approach to education and training has overburdened nurses. Over 3 million nurses in the country are qualified to provide patient care, serve as patient advocates, lead care delivery teams, and conduct work to enhance care.
Unexpectedly, more Americans sought medical attention. To meet the demand, some nurses partnered with doctors to acquire extra training. As a result, the nursing profession grew, and nurse practitioners were able to assist physicians in diagnosing and treating common illnesses.
Due to medical advancements and changing patient needs, nurses can now practice in a wide range of specializations. Dermatology, emergency care, and rehabilitation are just a few of the options available. However, some of the most sought-after specialties are found in advanced practice registered nursing.
Advanced training Registered nurses have a master’s degree or higher and work as nurse practitioners, nurse anesthetists, nurse midwives, or clinical nurse specialists. The U.S. Bureau of Labor Statistics predicts that employment of nurse practitioners, nurse anesthetists, and nurse midwives will increase by 26% by 2028. That is nearly six times the national average across all occupations.
Nurse practitioners can specialize in a variety of fields. The family nurse practitioner (FNP) is the most comprehensive specialty, seeing patients of all ages. They are concerned with health promotion, disease prevention, and the treatment of various diseases that fall under the scope of primary care. Almost 67 percent of nurse practitioners in the United States are certified family nurse practitioners.
Safety and Quality
Nurses have always been an important part of patient care. Today, however, that role is even more visible. Nurses, according to the United States Department of Health and Human Services, spend more time with patients than doctors. They also have regular interactions with every member of the patient’s health care team. In addition to essential clinical work, these factors enable nurses to ensure that health care teams provide high-quality care.
A large body of evidence links excellent nursing to positive patient outcomes, particularly among nurse practitioners. According to the American Association of Nurse Practitioners, research shows that nurse practitioners provide safe, effective, and patient-centered care. Furthermore, when compared to doctor patients, nurse practitioner patients are more satisfied, have fewer unnecessary hospital re-admissions, and have fewer potentially avoidable hospitalizations.
In summary, nursing has evolved over the years with many historical events. However, education, increased responsibilities, medical advancement, specialization with safety and quality contributed to what nursing has become in the 21st century.
Texas woman’s university(2019). How the evolution of the Nursing profession Benefits Nurses and patients alike.
Grand Canyon University. Nursing Timeline
Academic progression in Nursing(2010). Future of Nursing IOM report
US Bureau of Labor Statistics (2018). Employment and outlook
Nurses constitute a critical part of the healthcare system. As practitioners, they leverage various theories to offer care. These models allow the to use various approaches to patient care and community health. Nursing theories offer a systematic way of executing nursing practice to achieve quality outcomes. These theories include various components of healthcare and the setting that influence care delivery (Younas, 2019). The theories focus on four nursing metaparadigm comprising of person, health, nursing, and the environment (Deliktas et al., 2019). The aim of this presentation is to describe Dorothea Orem’s self0care theory and its conceptual model. The presentation illustrates how the policy can be applied in nursing settings.
The presentation’s objectives entail providing an overview of Dorothea Orem’s self-care theory, and evidence to support its efficacy in nursing practice. The presentation also explains and demonstrates the theory’s conceptual model. It also explains the integration of the four metaparadigm concepts into the theory. The presentation also shows three evidence-based illustrations of self-care model’s support for the nursing practice based on rationales.
Dorothea Orem made important and long-term impact in nursing through her self-care theory. Born in 1914, Orem worked in different parts in the country to advance the nursing profession before her demise in 2007 (Younas, 2019). Orem developed her nursing model in 1971 and was vital in assisting to shape the holistic approach nurses use towards patient care. Using the theory, nurses can determine the aspects of care they should emphasize. Self-care model also emphasizes the critical role played by patients play in maintenance of autonomy over the nursing processes.
The theory explains that nurses should intervene in patient care by helping them to make independent decisions based on their autonomy. The theory advances that all people have the ability to care for themselves if given right information and incentive. The model comprises of self-care, self-deficits and theory of nursing system.
According to Orem, Self-care emanates from actions that individuals freely and deliberately start and execute on their own to maintain life, health and wellness based on their environment. deficit occurs when one requires nursing due to incapacitation in providing self-care (Wills, 2019). The nursing system focuses on the interactions between nurses and patients as well as the wholly or partial compensatory nursing system and supportive-educative model that occurs in healthcare settings.
The efficacy of self-care theory is buoyed by diverse study findings which illustrates that health professionals leverage the model to lower costs, develop quality care interventions and allows faculty members to reduce the gap between theoretical aspects and practice for nursing students (Maslakpak et al., 2019). The model helps in enhancing patient outcomes and as it can be used to evaluate appropriate interventions for better results and maintenance of autonomy for patients.
The self-care model focuses on patient care and assists nurse practitioners to think and interact well with patients and colleagues. The framework is vital in development of nursing school curriculum and improving quality of nursing care for patients in different settings by leveraging interventions which are self-sustaining and initiated by patients or individuals in need of care. The self-care model’s primary objective is to ensure that an individual returns and maintains their former state of health and this allows providers to customize care interventions based on patients and their practice settings (Wills, 2019).
The Model’s Conceptual Framework includes three areas: Self-care, self-care deficits and Nursing Agency. Self care contains two aspects that comprise of self-care agency and self-care demands. The self-care agency advances that an individual can care for themselves based on their age, life experience, and sociocultural orientation health and accessible resources (Wazni & Gifford, 2017). The second concept is the therapeutic self-care demand which denotes to the totality of self-care where one performs actions to meet the self-care needs or requisites using acceptable approaches. The self-care requisites are things needed by individuals at al stages of life to care for themselves.
The universal self-requisites affect all people and are linked to life processes and maintenance of integrity of human structure and optimal functionality (Wazni & Gifford, 2017). These comprise of daily activities in life aimed at sustenance of sufficient intake of air, water, food, and having elimination processes. It also entails creating a balance among a host of activities that include rest, solitude and social interactions as well as hazards’ prevention to attain wellness and promote optimal human functioning.
Self-deficit implies that one cannot provide care for themselves due to various reasons. The deficit model illustrates the interaction between the self-care agency and the capability to conduct aspects self-care based on the expected requisites (Wills, 2019). The therapeutic self-care demands may not be satisfied when the agency dos not have the ability to initiate and carry out the respective interventions.
Nursing system comprise of three aspects that include wholly compensating model where an individual attains total care by care provision of the nurse, partly compensating where patients can care for themselves with support from nurses, and the supportive-educative where the nursing system focuses on providing education to individuals to enhance self-care (Bender, 2018). The implication is that the self-care model meets the conceptual framework as it shows that nurses should focus on assisting individuals attain better outcomes based on their abilities’ levels.
The four Metaparadigm model comprises Person, Environment, Health and Nursing.
The metaparadigm on person and environment requires providers to assess individual abilities of the patient and the influence of their environment in care provision. The person entails the individual getting nursing care. The self-care model incorporates person metaparadigm as it focuses on holistic approach to care. The model implores one to use learned behavior and instincts to meet their needs (Bender, 2018). The model also encourages learning about one’s self-care needs for effective care delivery.
The environment metaparadigm advances that environment influences one’s health care and the interventions they can take to attain better outcomes. The self-care model emphasizes the need for one to be in appropriate environment and understand their external and internal systems to attain better care. The self-care model is categorical that external environment is essential as it meets the universal requisites like access to water, and food among other aspects.
Health metaparadigm involves attainment of wellness and better quality of life. The paradigm encourages individuals to make necessary interventions to satisfy changes in self-care requirements (Deliktas et al., 2019). An individual should restore their health to the original or former optimal state. Therefore, health as a paradigm implores nurses to assist the patient go back to their former optimal state through self-care approaches (Bender, 2018). The nursing concept needs nurses and other healthcare providers to offer optimal care aimed at meeting individual self-care needs. Nurses should leverage their skills and knowledge to attain this concept. They should also leverage care by using all the four concepts.
Diabetic persons may not have knowledge on how to control their situations and live optimal lives. These persons can use self-care model to get knowledge from providers. In this case, nurses provide information about evidence-based practice interventions like insulin based diets, attainment of low glycemic levels and carbohydrate rich diets and starch. They should also avoid high impact outdoor activities. The second EBP example is having a juvenile individual with diabetes and needs nutrition to recover and be restored to optimal functioning. The minor can have either total parental nutrition or intravenous nutrition. The intravenous nutrition should consists of all elements that include vitamins and minerals, fats and carbohydrates as well as electrolytes. Total parental nutrition requires provision of all nutrients alongside monitoring of blood sugar levels.
Health populations; particularly communities and individuals who have elevated risk for diabetes, should have general education to enhance self-care and prevent diabetes. These include knowledge on symptoms associated with the condition, and knowledge on insulin administration in events of an attack. The public should have information on aspects like glucose monitoring to position patient better to meet care interventions. The education should also enable the public to understand other aspects like not massaging an individual with the condition and locating positions to administer the insulin. Therefore, Orem’s theory is important in attaining better outcomes among diabetic patients and at risk individuals and populations.
Orem’s self-care deficit theory is essential for nurses as it offers a systematic way for dealing with patients and providing appropriate interventions. Evidence shows that the model is effective in nursing practice and supports the four metaparadigms of nursing. The illustrative examples show that the model is critical in evidence-based practice interventions in nursing
Bender, M. (2018). Re‐conceptualizing the nursing metaparadigm:
Articulating the philosophical ontology of the nursing discipline
that orients inquiry and practice. Nursing inquiry, 25(3), e12243.
Deliktas, A., Korukcu, O., Aydin, R., & Kabukcuoglu, K. (2019). Nursing
students’ perceptions of nursing metaparadigms: A
phenomenological study. The Journal of Nursing Research, 27(5),
Maslakpak, M. H., Shahbaz, A., Parizad, N., & Ghafourifard, M. (2018).
Preventing and managing diabetic foot ulcers: application of Orem’s
self-care model. International Journal of Diabetes in Developing Countries,