NRS 430 CLC Nursing Theory Conceptual Model

NRS 430 CLC Nursing Theory Conceptual Model

Nursing Theory & Conceptual Model

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. (Alex Cortes)

  • 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.
  • Setting appropriate environmental factors have always been important in providing excellent patient care that promote healing and relieving pain.
  • Environmental factors influence a person’s mental and physical status.
  • For example, if a patient has a fever, they require a cooling environment with hydration and limited stimulation. If this same patient has a fever and is in a hot environment, without water and heavy stimulation, the fever will increase and there will not be a good outcome.
  • This theory proves the conceptual model by illustrating how all these environmental factors truly impact the patient’s mind, body and soul.

Explain how the nursing theory incorporates the four metaparadigm concepts.



  • 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)

Applying the Four Metaparadigm Concepts to

Florence Nightingale’s Environmental Theory

  • Nursing-
  • Health-
  • Person-
  • Environment-

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Provide three evidence‐based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each. (CASSIDY WRIGHT)

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.

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Introduction to the Presentation

Nurses are an essential part of the overall healthcare provision and system. These practitioners leverage existing models or theories to provide care as they help them apply different approaches to patient care and community health (Younas, 2019). The essence of nursing theories is to offer a systematic way of implementing nursing practice to attain expected outcome. These theories entail different aspects of healthcare and the environment that impact care delivery. These models focus on four nursing metaparadigms that include person, health, nursing and the environment (Deliktas et al., 2019). The purpose of this presentation is to describe Orem’s self-care model as a nursing theory and its conceptual model. The presentation demonstrates the application of the model in nursing practice based on highlighted objectives.

Objectives of the Presentation

The presentation’s objectives include providing an overview of Dorothea Orem’s self-care theory, and evidence that supports its efficacy in nursing practice. The presentation also explains and demonstrates the theory’s proof of the conceptual model. It also explains how the theory integrates the four metaparadigm concepts. In its final part, the presentation offers three evidence-based illustrations of how self-care model supports nursing practice. These illustrations are supported by rationales.

Overview of Self-Care Deficit Theory

Dorothea Orem mad significant and lasting impact in nursing through her self-care theory. Born in 1914, Orem worked in different areas in the country to shape the nursing profession before her death in 2007 (Younas, 2019). Orem developed her nursing theory in 1971 and was instrumental in assisting to shape the holistic approach nurses use towards patient care. through the model, nurses can determine the aspects of care they should emphasize. The model also emphasizes the critical role that patients play in maintenance of autonomy over self-care processes.

Self-Care Deficit Theory

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.

Evidence of Efficacy of the Model in Nursing

The efficacy of Orem’s self-care model is supported by numerous study findings which demonstrates that health professionals leverage the theory to reduce costs, develop quality care interventions and allows faculty members to bridge the gap between theoretical models 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 does not only focus on patient care but also helps nurse to think and interact well with patients and colleagues. The framework is essential 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 (Wills, 2019). The self-care model’s main goal 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.

Self-Care Requisites: Universal Requisites

The Universal self-requisites apply to all individuals and are associated with life processes and maintaining the integrity of human structure and optimal functioning (Wazni & Gifford, 2017). These include daily living activities focused on maintenance of enough intake of air, water and food, having elimination processes and establishing a balance among rest and activity, solitude and social interaction and prevention of hazards to attain wellness and promotion of effective human functioning.

Self-Care Deficit & Nursing System

Self-deficit means that an individual cannot provide care for themselves due to different reasons. The deficit model highlights the relationship between the self-care agency and the ability to conduct aspects self-care based on the expected requisites (Wills, 2019). The therapeutic self-care demands may not be met when the agency lacks the ability to initiate and carry out the respective interventions.

Nursing system consists of three aspects that include wholly compensating model where one attain 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.

Person and Environment Paradigms

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 and Nursing Metaparadigms

Health metaparadigm entails attainment of wellness and improved quality of life. The paradigm implores individuals to make necessary interventions to meet changes in self-care needs(Deliktas et al., 2019). Under self-care model, one should restore their health to the original or former optimal levels. Therefore, health as a paradigm requires nurses to help the patient come back to their former optimal state through self-care interventions (Bender, 2018). On its part, the nursing concept requires 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 applying all the four concepts in care provision.

Evidence-Based Examples on Self Care Model in Diabetic Patients

Individuals with diabetes may lack knowledge on how to control their conditions and live optimal lives. These individuals can use self-care model to get knowledge from nurses. In this case, nurses can offer information about evidence-based practice interventions like insulin based diets, attainment of low glycemic levels and diet rich in carbohydrates and starch. However, they should avoid high impact outdoor activities. The second EBP example is having a minor patient suffering from diabetes and requires nutrition to recover and be restored to optimal functioning. The patient 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.

Third Example: Education to General Population

Health populations; especially communities and individuals with elevated risk for diabetes, should get general education that allows them to enhance self-care and prevent diabetes. These include knowing symptoms associated with the condition, knowledge on how they can do insulin administration in events of an attack. The public should get information on aspects like glucose monitoring to ensure that a patient is well positioned to meet care interventions. The education should also allow the public to understand other issues like not massaging an individual with the condition and how to locate positions to administer the insulin. Therefore, Orem’s theory is critical in attainment of better outcomes among diabetic patients and at risk individuals and populations.


Nursing models like Orem’s self-care deficit theory are essential for nurses as they offer 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,

38(2), 165-172.

Younas, A. (2017). A foundational analysis of Dorothea Orem’s self-

care theory and evaluation of its significance for nursing

practice and research. Creative Nursing, 23(1), 13-23.

Wazni, L., & Gifford, W. (2017). Addressing Physical Health Needs of

Individuals With Schizophrenia Using Orem’s Theory. Journal

   of Holistic Nursing, 35(3), 271-279.

Wills, E. M. (2019). Overview of grand nursing theories. Theoretical

  Basis for Nursing. 5th ed. China: Wolters Kluwer, 116-158.