DQ: Select one theory discussed during Topics 4 and 5

      As nursing becomes increasingly important in healthcare, some people think that for nursing to be seen as its own profession and for nurses to be recognized as a crucial part of hands-on care, there should be clear theories or models outlining the specific tasks and responsibilities of nursing in a systematic way (Dewey, 2023).

               I believe that the most suitable theory for my future role in advanced nursing practice concerning individuals, families, communities, and special populations is Orem’s self-care deficit theory. This theory focuses on the patient’s ability to take care of themselves. As a nurse, I can use this theory to evaluate and support the patient’s self-care skills in handling different aspects of their treatment and overall well-being (Dewey, 2022). Orem’s self-care deficit theory focuses on people being able to take care of themselves. It would help assist in evaluating and improving patients’ self-care abilities, and this idea applies to families, communities, and special groups, encouraging a complete view of healthcare that gives different groups the power to be actively involved in looking after their health.

               As a hemodialysis nurse, I think the theory that fits well is Peplau’s theory, which is all about the relationship between the nurse and the patient and using communication to help. This is especially crucial in hemodialysis, where it’s really important to establish trust and communicate effectively (Hagerty et al., 2017).

NUR 513 Topic 5 Discussion 2

DQ: Select one theory discussed during Topics 4 and 5

One of the theories I discussed last week was Orem’s Self-care Deficit Theory. Orem’s theory promotes the idea of patient independence over self-care with the ultimate goal of overcoming human limitations to self-care (Current Nursing, 2020). By focusing on a person’s ability to perform self-care, maintain health and overall wellbeing, this empowers the individual to take responsibility for their health or the health of others (Shah, et. al, 2013). This theory can be highly individualized from patient to patient, or patient’s families, so the application of this theory can differ greatly based on population focus. For example, this theory would be applied differently between adult and pediatric populations based on age and developmental stages. In pediatrics, this theory would likely be heavily geared towards parent support and educations in performing cares. Additionally, this theory can great vary based on specific illness or disease state. For example, I work in a pediatric cardiovascular ICU where the patient’s defect, arrhythmia, or ailment greatly determines their self-care needs. A neonate with a congenital heart defect that is not yet fully repaired may have an oxygen requirement or tube feeding support. In this case, much more teaching would be geared towards the parent’s ability to use/manipulate these new medical devices. On this same unit, I may also take care of an adolescent patient who just had a mechanical valve replacement. Initially post op, this patient may require full or partial cares, and these deficits would change as the patient status improves and once again becomes independent. This same patient may also require teaching involving anticoagulant therapy; many adolescents have the physical and mental capacity to administer their own medications, so teaching and support would be given in this case.

Ultimately, how Orem’s Self-Care Deficit Theory is applied to a population focus is highly variable from situation to situation because deficits can be adaptable and dynamic in nature.


Current Nursing. (2020, March 12). Nursing theories: Open access articles on nursing theories and models.

Shah, M., Abdullah, A., & Khan, H. (2013). Compare and contrast of grand theories: Orem’s self-care deficit theory and Roy’s adaptation model. International Journal of Science and Research.

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I agree with you Gina that Orem’s theory promotes patient independence over self-care. The theory believes that patient autonomy enables the overcoming of human limitations to self-care.  Self-care differs among patients due to their complications and personalities (Younas, 2017). Tailoring patient care based on their needs increases accuracy and service reliability. Tailoring patient services create individualized care. Therefore, Orem’s theory application differs based on the population’s character. The adult patients due to their age and nature of complication they may want unique medical care compared to the young population (Fernandes et al., 2018). Adult patients due to their age they are pre-exposed to various health problems. Orem’s theory flexibility allows nurses to adjust their nursing care based on the condition. The ultimate goal of Orem’s theory is to facilitate self-care. Successful self-care is individualized nursing care that considers patient’s needs. Teaching nurses on understanding patient’s needs is an integral activity towards integrating Orem’s theory. Creating an enabling environment allows patient to disclose their concerns improving healthcare services.


Fernandes, S., Silva, A., Barbas, L., Ferreira, R., Fonseca, C., & Fernandes, M. A. (2019, September). Theoretical contributions from Orem to self-care in Rehabilitation Nursing. In International Workshop on Gerontechnology (pp. 163-173). Springer, Cham.

Younas, A. (2017). A foundational analysis of dorothea orem’s self-care theory and evaluation of its significance for nursing practice and research. Creative Nursing23(1), 13-23.

In Topic 4, I have mentioned the Environmental theory by Florence Nightingale in one of the discussions. This theory is not based on a specific population focus. This can be applied to every individual, families, communities, with no other special populations specified. The reason for this is that the theory is concerned on a person’s health in relation to its environment and the impact of the environment upon them (Gonzalo, 2021). Every person, young or old, has a variety of environmental factors that can be detrimental to their health. However, a person’s environment may also constantly change, temporary or permanent, depending on the circumstance.

The difference that would be observed in this theory would depend on the environmental factors affecting that population focus. An example is when I volunteered for a medical mission before and performed health assessments on families who lived near a mangrove, many of them reported GI symptoms or have history of gastrointestinal-related illnesses (e.g., diarrhea, vomiting, stomach pain). It was reported that the water from the mangrove had somehow entered through a leaked pipe, causing them to consume unclean water. It affected both children and adults. On the other hand, another family that I conducted health assessments on that did not live near the mangrove, exhibited no symptoms, and were all perfectly healthy. The idea here is that these families had different environmental conditions, which led to two different outcomes.

In order for APNs to incorporate this theory into practice, as Nightingale described it, the nursing process should include gathering of information and assessing the information on its relevancy (Tourville & Ingalls, 2003). Also, it is essential that nurses in an inpatient setting be able to provide an environment that fosters healing. Though some of the environmental factors can not be controlled, it is imperative for nurses to take the initiative in configuring the environmental settings appropriate for the gradual restoration of the patient’s health (Gonzalo, 2021). In my future practice, with emphasis in healthcare quality, one of my major goals is to ensure that I implement policies and procedures that promote environmental safety.


Tourville, C., & Ingalls, K. (2003). The living tree of nursing theories. Nursing Forum, 38(3), 21-30, 36. doi:


Gonzalo, A. (2021). Florence nightingale: Environmental theory. Nurselabs.

Maria, I agree with you that environmental factors impact people regardless of their age.  Nurses attend to different patients with different medical needs.  Environment affects the medical intervention. The environmental theory insists that healthcare facilities should be clean and suitable to facilitate patient’s recovery (Fernandes & Silva, 2020).  Unfortunately, the environment might change due to various environmental occurrences. A clean environment, water, and proper lighting are environmental factors that facilitate smooth patient’s recovery. Some patients may not prioritize clean water since they are used to drinking untreated water. Therefore, these patients may want other environmental factors that will enable them to be comfortable. Prioritizing environmental factors when attending to patients (Sayani, 2017). Nightingale’s theory dictates that the APNs should gather crucial environmental information before integrating the environmental theory. Obtaining the information allows healthcare providers to understand patients’ environmental needs.  The inability to understand the patient and the environment that enable the patient’s recovery paralyzes the nurses’ efforts to improve healthcare quality.

In my future role as an Advanced Practice Registered Nurse (APRN), I consider the theory of cultural humility very applicable. My perspective is in line with cultural and spiritual humility, which emphasizes the value of treating people with respect regardless of their background. These ideas transfer to APRNs giving patients tailored care that takes their spiritual and cultural needs into account. As an advanced nursing professional, the current practice involves dealing with a diverse patient population. For that reason, my approach to delivering nursing care is informed and influenced by philosophies of the cultural humility theory.

I need to embrace cultural humility as an essential aspect my advanced nursing career. As demonstrated by Foronda (2020), the cultural humility theory should be considered as a lifetime commitment. For that reason, the theory advocates for self-reflection, respectful inquiry, and empathy in the nursing practice. From that point of view, cultural humility goes beyond simple cultural competency. In order to apply the theory, I will embrace the broader aspect of culture influence on professional practice which is in line with the holistic care. I can adjust to the ever-changing cultural landscape by integrating cultural humility in my professional practice. For instance, this can be crucial in understanding my patients’ preferences and enhance cross-cultural literacy. Then again, cultural humility plays a major role in creating personalized care plans that facilitate better relationships with patients from a different of backgrounds (Hughes et al., 2020).

Nolan et al. (2021) advocate for ideology of inclusivity and respect in interprofessional relationships in the nursing field as a major pillar in cultural humility. I will employ the ideology in my advanced nursing practice to align with the philosophy of cultural humility. This way, the philosophy will help me develop a work atmosphere that promotes diversity and inclusion. Furthermore, I believe that cultural humility encourages behavioral change and adherence to treatment plans. From my point of view, behavioral change is part of personal and professional development in the advanced nursing practice.




Foronda, C. (2020). A theory of cultural humility. Journal of Transcultural Nursing, 31(1), 7-12.
Hughes, V., Delva, S., Nkimbeng, M., Spaulding, E. M., Turkson‐Ocran, R., Cudjoe, J., Sherman, A. D. F., Rushton, C. H., D’Aoust, R., & Han, H. R. (2020). Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. Journal of Professional Nursing, 36(1), 28–33.
Nolan, T. S., Alston, A., Choto, R., & Moss, K. O. (2021). Cultural humility: Retraining and retooling nurses to provide equitable cancer care. Clinical Journal of Oncology Nursing, 25(5), 3.