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Discussion: Exploring Middle Range Theories and Framing Practice Issues

NURS 8114 Discussion

Discussion: Exploring Middle Range Theories and Framing Practice Issues

Practice Issue

My practice in oncology nursing over the past decade has afforded me several opportunities to witness the adverse effects that cancer treatment can have on patients, both short-term and long-term. After moving to an outpatient infusion role more recently, I noticed variable degrees of treatment for patients receiving Taxane medications and prevention of peripheral neuropathy. Based on the clinician’s chemotherapy teaching and the individual nurse’s knowledge of the drug and the possible side-effect determined the degree of prevention methods used. For example, if the practitioner educated the patient prior to treatment on methods to reduce peripheral neuropathy, such as cold therapies, the patient was more likely to receive this treatment. There is no identified standard of care for Taxane receiving patients and prevention of this potentially life-long side effect. 

 Nursing theory can assist in developing and supporting a standard of care for Taxane receiving patients in the outpatient infusion center. Middle range nursing theories, which can “guide nursing interventions and change conditions of a situation to enhance nursing care”, exist for development of such a practice need. (McEwin & Wills, 2019, p. 209) Specifically, Nola Pender’s Health Promotion Theory and the Theory of Unpleasant Symptoms will be discussed in relation to this practice issue here.

Discussion: Exploring Middle Range Theories and Framing Practice Issues

Middle Range Theory: Pender’s Health Promotion Theory

            Nola Pender created the Health Promotion Model of nursing theory in 1982 when working to describe the effect of nursing practice on patient health outcomes. (Gonzalo, 2021). Simplistically, the theory implies that health-promoting behaviors “result in improved overall health, enhanced functional ability, and better quality of life” (Gonzalo, 2021). In relation to the practice issue identified, utilizing the appropriate health promoting behaviors, such as cold therapy, on a consistent basis improves the quality of life for this patient population. This health promotion activity begins with patient focusing on patient education and advocacy. 

Middle Range Theory: Theory of Unpleasant Symptoms

            Adverse symptoms are generally a high influencing factor for patients to seek healthcare. The Theory of Unpleasant Symptoms

Discussion Exploring Middle Range Theories and Framing Practice Issues
Discussion Exploring Middle Range Theories and Framing Practice Issues

was created to improve understanding of the relationship between patient symptoms and their experiences to improve selected interventions. (Lee, Vincent, & Finnegan, 2017). This nursing theory can be used to assess patients in clinical settings for unpleasant symptoms, such as chemotherapy induced side-effects. It can also help nurses to understand the impact of side-effects and how the individual patient experience is affected by environment, psychological, and psychosocial influences. (Lee, Vincent, & Finnegan, 2017). There are several facets of this nursing theory that can support prevention and atreatment of peripheral neuropathy in Taxane receiving patients. 

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References:

Gonzalo, A. (2021). Nola Pender: Health Promotion Model (Nursing Theory Guide). Retrieved from https://nurseslabs.com/nola-pender-health-promotion-model/#nola_penders_health_promotion_model

Hi Katie. I would like to add that,  Nola P.developed the Health Promotion Model theory that focuses on positive motivations with the purpose of promoting wellness, prevention and healthy lifestyles (Masters, 2015) Major assumptions of the pander’s health promotion model stress that the individual is in control of shaping and sustaining their health behaviors within their environment. (Pender, N. J. ,1990). she developed the Health Promotion Model theory that focuses on positive motivations with the purpose of promoting wellness, prevention and healthy lifestyles (Masters, 2015). In order for a behavioral change to occur and be maintained it must be self-initiated (Butts & Rich, 2018)

Healthcare providers play an important role and influence in the patient’s life.  We have a chance to improve a patient’s well-being and prevent disease when health-promoting behaviors are established in the community environment.The use of Pender’s Health Promotion Model explored displays how it can positively affect and improve health behaviors.  Today the value of healthy lifestyles and behaviors holds even higher significance as health insurance becomes out of reach for many individuals due to rising costs.  Pender’s health promotion model drives the nurse to tailor their education to meet the individual and environmental needs of their patient in order to initiate a health-promoting behavioral change (Butts & Rich, 2018).

References

Butts, J. B., & Rich, K. L. (2018). Philosophies and Theories for Advanced Nursing Practice. Burlington, MA: Jones & Bartlett Learning.

Masters, K. (2015). Nursing Theories a Framework for Professional Practice (2nd ed.).

Pender, N. J. (1990). Expressing Health Through Lifestyle Patterns. Nursing Science Quarterly,

 3, 115-122.

Lee, S. E., Vincent, C., & Finnegan, L. (2017). An Analysis and Evaluation of the Theory of Unpleasant Symptoms. Advances in Nursing Science40(1), E16–E39. https://doi-org.ezp.waldenulibrary.org/10.1097/ANS.0000000000000141

McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer. 

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