NUR 513 Topic 4 Discussion 2
DQ Select two different nursing theories and describe how they relate to patient care
Nola Pender’s Health Promotion Model. This model looks at the patient’s characteristics and behaviors and how nursing interventions can help adapt, add, or improve the patient’s healthy behaviors. Pender believed that health is a positive dynamic state, meaning that overall health includes physical, mental, and social wellbeing, not merely the absence of illness or disease (Current Nursing, 2020). Pender’s model is foundational in public health and disease prevention and has helped outline how nursing practice can spark the patient’s healthy lifestyle changes. This theory focuses on inciting behavioral changes that promote self-care and prevention of illness by looking at biological, psychological, and sociocultural factors (Gonzalo, 2021). This is done by examining the benefits, barriers, influences, commitment, and self-efficacy of the patient’s actions.
This model can be used to prevent disease, obesity, and future spread of infection. A limitation of this model can be related to the patient’s willingness to change and the nurse’s ability to provide adequate education and reassess interventions when necessary. Increasing responsibilities at the bedside, increased charting, increased acuity, and a lack of nurse-patient ratios can significantly impact the success of this model in an acute care setting. Additionally, ethical issues can be raised in terms of the scope of public health and disease prevention and how it relates to religious beliefs. For example, sexual health promotes the use of birth control and contraceptive methods, and some religions disapprove of contraception and have procreation views. Another example of ethical issues in health promotion can be seen with the highly politicized 2020 mask mandates and the individual’s right to choose their health behaviors.
Dorothea Orem’s Self-Care Deficit Theory focuses on the idea of promoting patient independence over self-care (Current Nursing, 2020). This theory can be applied to guide nursing care, essentially individualizing plans of care where deficits lie. Orem believed that a patient could better recover if nurses worked to maintain patient independence. This can range from providing total care, assistance with using the restroom and bathing, and providing education to allow the patient to care for self. The nurse’s role is to assess the patient’s strengths, weaknesses, limitations, and needs; and then form appropriate interventions that promote patient independence (Current Nursing, 2020). I believe that having patient autonomy and independence can help institute behavioral changes within the patient.
Promoting self-care in patients can also promote health maintenance; encouraging and advocating for patient self-care can help patients make lifelong behavioral changes. A limitation of Orem’s theory is that it is very focused on self-care tasks and can often overlook the patient’s spiritual and emotional needs (Current Nursing, 2020). Additionally, this theory can be limited by the patient’s understanding of their illness, ability to understand teaching, or the family’s ability to assist with self-care needs successfully. For example, if a patient needs assistance with home wound care, the patient and family may be taught how to dress the wound appropriately, but perhaps the patient and family members don’t have the stomach for wound care. Or maybe there are barriers to learning. Ethical concerns can arise if nursing interventions go against a patient’s cultural or religious beliefs.
I find both of these models useful, but I believe as a future informatics nurse that Pender’s Health Promotion Model would help incite behavioral changes. Pender’s model essentially embodies provoking behavioral changes; keeping this in mind, future research and implementation of technologies can be used within this model’s framework to promote disease prevention and optimal health behaviors.
References
Current Nursing. (2020). Nursing theories: Open access articles on nursing theories and models. https://currentnursing.com/nursing_theory/application_self_care_deficit_theory.html
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.
Gonzalo, A. (2021, March 5). Nola Pender: Health promotion model. Nurseslabs. https://nurseslabs.com/nola-pender-health-promotion-model/
RESPOND HERE (150 WORDS, 2 REFERENCES)
Indeed Gina Nola Pender’s Health Promotion Model is suitable in inciting behavioral change. The model examines individual traits and characteristics. The patient information will determine a behavioral change introduced based on the expected outcome. Pender’s model takes a wholesome model when examining the patient. The model allows a nurse to evaluate the physical, emotional, and spiritual well-being of a patient before deciding on the right intervention (Khoshnood et al., 2018). Pender’s protocols reduce the chances of committing errors. Dorothea Orem’s Self-Care Deficit Theory is also a theory that supports behavioral adjustments. However, Dorothea believes in patient independence’s influence on behavioral change and patient recuperation. The self-care deficit theory mandates the healthcare provider with the obligation of granting patient autonomy (Hernández et al., 2017). All nursing theories are important most nurses may want to incorporate them in nursing practice. Nevertheless, Pender’s health promotion model will be preferable due to its holistic approach to patient’s behavioral assessment before initiating the transformational process.
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References
Hernández, Y. N., Pacheco, J. A. C., & Larreynaga, M. R. (2017). The self-care deficit nursing theory: Dorothea Elizabeth Orem. Gaceta Médica Espirituana, 19(3).
Khoshnood, Z., Rayyani, M., & Tirgari, B. (2018). Theory analysis for Pender’s health promotion model (HPM) by Barnum’s criteria: a critical perspective. International journal of adolescent medicine and health, 1(ahead-of-print).
Many nursing models have come into practice since the early 1950’s (DeNisco & Barker, 2016). May of these theories focus on a patient as a individual and therefore focus their behavioral modifications and goals on an individual’s unique circumstances (DeNisco & Barker, 2016). While this path is incredibly important, it is also pivotal to understand that many of our patients belong to a family unit and this will directly impact their care (DeNisco & Barker, 2016). This discussion will focus on the Calgary family assessment Model and the Modeling and Role Modeling theory.
The Calgary Assessment Model is a framework that is multidimensional and focuses on assessing a family with the aim and focus of resolving issues within the family environment (All Answers Ltd, 2018). This model focuses on assessing based on three categories, structural, developmental and functional (All Answers Ltd, 2018). The structural component focuses on the how the familial unit is structured based on three key concepts, internal structure, external structure and context (All Answers Ltd, 2018). This model can be applicable to nursing practice by understanding that all patients are part of a larger family unit that can directly impact their health care. In my practice this is incredibly true for patients who have had strokes. In order to change behaviors in the patients it’s incredibly important to include families in post stroke education.
The Modeling and Role Modeling theory was developed in 1983 by Helen Erickson, Evelyn Tomlin and Mary Swain (“Model and Role Modeling Theory”, n.d.). This theory focuses on the nurse’s ability to care for each patient and enables them to identify the uniqueness of the patient (“Model and Role Modeling Theory”, n.d ).This theory is built on foundational principles of many other theorist including Maslow, Piagets and Erikson (“Model and Role Modeling Theory”, n.d). This theory identifies commonalties with all patients, these are holism or the belief that people are the more than a sum of their parts, basic needs that drive all patients, affiliation, attachment, psychological stages and, cognitive stages (“Model and Role Modeling Theory”, n.d). The differences that exist between patients are unique to an individual and they focus on genetics, view of the world, adaption, stress and self-care process (“Model and Role Modeling Theory”, n.d). Understanding that each patient is unique and has specific behaviors, genetics and self-care practices that make them uniquely them helps to tailor a care plan that is specific to each patient.
Both of these models do not present ethical dilemmas in the way they are integrated into care. They should be a platform to build care that aims to be of quality and safe.
References
All Answers Ltd. (November 2018). Calgary Family Assessment Model | Case Study. Retrieved from https://nursinganswers.net/essays/calgary-family-assessment-model-study-7564.php?vref=1
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.
Model and Role Modeling Theory. (n.d.). Nursing Theories. https://currentnursing.com/theory/Model_and-Role-modeling_theory.html.
I concur with you that since the early 1950s many nursing models have been generated due to the increase in nursing research. Many nursing models have increased the range of choice among nurses. However, most nursing models focus on a patient as an individual with behaviors that must change to facilitate recovery from most health complications. Calgary family assessment Model and the Modeling and Role Modeling theory are examples of nursing theories. Calgary family assessment model focuses on the family environment. The assessment model allows a nurse to examine the family and find out issues that require intervention (Tucci & Oliveira, 2019). Resolving family issues will automatically lead to family and family members’ recuperation. The Modeling and Role Modeling theory allows nurses to determine similarities among patients. The commonalities allow the nurse to develop a framework that will consider the similarities (Matouš et al., 2017). Calgary family assessment Model and the Modeling and Role Modeling theory can all be applied in nursing practice. The models do not create an ethical dilemma that will compromise their suitability.
References
Matouš, K., Geers, M. G., Kouznetsova, V. G., & Gillman, A. (2017). A review of predictive nonlinear theories for multiscale modeling of heterogeneous materials. Journal of Computational Physics, 330, 192-220.
Tucci, B. F. M., & Oliveira, M. D. (2019). Alcoholic beverage users: structural and functional aspects based on the Calgary Model. Revista da Rede de Enfermagem do Nordeste, 20, 1-8.
Lydia Hall’s theory centers around the concepts of core, care, and cure. The core is the patient who needs nursing care that is nurturing providing comfort. The nurse provides care directed at biological functions, educating the patient, and providing help in activities that the patient is unable to perform. The cure is attention from the health care team including nursing that assists in the healing process of the core (Care, Core, and Cure: the Three Cs of Lydia Hall, 2021). Subrata (2019) discusses the use of Lydia Hall’s theory to treat pressure ulcers in the community. The nurse would provide teaching, nursing care, and collaborate with an interdisciplinary team to treat decubiti. Another interesting theory is that of Katherine Kolcaba. This theory is centered around comfort described as relief, ease, and transcendence. A holistic approach is used to achieve comfort through the physical, psychospiritual, social, and environmental areas (Comfort Theory by Katharine Kolcaba, 2021). Comfort or relief can be achieved through physical means in the form of catheterizing a patient who has urinary retention. the removal of urine eases the discomfort of a full bladder.
Transcendence is then achieved as the patient can see beyond their biological issues. Both theories could be utilized to encourage change through education (Hall’s theory) and showing the patient-specific actions that can lead to their comfort (Kolcaba’s theory). Both theories could be applied to practice as they deal with direct care of the patient. Hall’s theory focuses on the care and cure of the core or patient. This is the essential part of nursing. Care is provided to patients in a manner that can lead to healing. Kolcaba’s theory suggests that patient care should come from a desire to create a state of comfort for the patient. This is a desirous situation for nursing for all patients. These two theories describe one particular perspective of nursing. While they are descriptive of nursing, they are not all-encompassing and do not cater to an individual patient. Patient care should be individualized. These theories are an important aspect of care that can be taught to future nurses. From an ethical point of view, individualized care for each patient is important in order to develop a rapport that can assist the patient in their health care needs. Since no two individuals are alike, it is important to include the patient in an individualized plan.
Nursing theories integrated into nursing practice shape many of the clinical guidelines that many nurses practice by. The two nursing theories that will be discussed are Martha Roger’s Theory of Unitary Human Beings and Hildegard Peplau’s Interpersonal Relations Theory.
Integration and reliability to patient care is important when thinking about how theories can influence one’s future professional practice as an advanced practice nurse. Both Roger’s and Peplau’s theory relate to patient care by looking at the patient as an individual and considering the effects that all intrinsic and external factors can have on overall well-being. Peplau’s Interpersonal Relations Theory focuses on the importance of building a nurse-client relationship to form a partnership that is more than just passively acting out doctors orders and receiving care (Wayne, 2023). Roger’s Theory of Unitary Human Being focuses on combining what is seen as the science of nursing and the art of nursing that views the unitary human-being seen as one with their environment (Wayne, 2023). Understanding all aspects of the patient and their environment to create therapeutic interventions the patient can achieve is a number one goal for most nurses that provide patient care. Both theories allow for the nurse to have a deep understanding of the person they are providing care to. This allows the nurse to implement nursing interventions that will incite behavioral changes. The therapeutic interactions that incorporate these theories allow for both parties to gain respect for one another and allow both to learn about each other which in turn allows the nurse to offer interventions that are individualized instead of just valued by the nurse (Wayne, 2023).
This does not mean that integrating these two theories into one’s nursing practices does not come with some cons. Roger’s Theory of Unitary Human Being is very abstract in nature and believes the patient can not be separated from their environment when addressing one’s health and treatment (Wayne, 2023). Ethical issues could arise from this if the patient’s environment is deemed to be a direct catalyst for the patient’s illness. Peplau’s Interpersonal Relations Theory biggest limitation is it can only be implemented on patients who are willing to converse and participate in the process. This means one could not integrate this theory when caring for an unconscious and paralyzed patient, one who is withdrawn from care, or mentally incapable of actively participating in forming the nurse- client relationship (Wayne, 2023). This could cause an ethical issue if care is delayed due to a patient’s inability to mutually participate in four phases discussed in this theory.
Nursing theories are an important part of nursing practice and will be something I look forward to learning more about and understanding their importance to improving clinical outcomes and progression of the nursing profession.
Wayne, Gil. (2023). Nursing Theories and Theorists: The Definitive Guide for Nurses. Nurseslabs. Nursing Theories & Theorists: The Definitive Guide for Nurses – Nurseslabs