Grand Theory v. Middle Range Theory - Special Academic Support

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Background of the Theories

Dorothea Orems grand theory and Nola Penders middle-range theory are some of the most popular theories in the field of nursing. These concepts are often used to define the approach that nurses should take when caring for their patients. Dorothea Orems Self-Care Theory is one of the grand theories of nursing that has gained popularity in the recent decade. It emphasized the need for patients to have the ability to embrace the concept of self-care (Younas, 2017). It holds that individuals have a responsibility to maintain a healthy life and limit the need for hospitalization. Nola Penders Health Promotion Model is a popular mid-range theory. It holds the view that health promotion enables individuals and communities to achieve full health potential when they adopt healthy behavior. It emphasizes the need for individuals to play a leading role in promoting a healthy lifestyle. Nurses are expected to empower their patients so that they can understand the role that they should play and the significance of their active involvement in managing their condition. In this paper, the focus of the researcher is to compare the two theories and determine their relevance in modern-day nursing.

Philosophical Underpinnings of the Theories

It is necessary to review the philosophical underpinnings of the two theories. Orems Self-Care Deficit Theory holds the philosophy that individuals ability to perform self-care is critical in enhancing their health. According to Whelan (1984), it embraces the belief that the activities that people initiate and perform specific actions own behalf is critical in maintaining a healthy life and well-being. As such, nurses should be keen on assisting their patients to understand the relevance of self-care and the best approach they can take when they are at it. When one is recovering from an illness, an injury, or coping with the effects of a given disease, they have to understand what is expected of them, especially when they are adults. When dealing with outpatients, a nurse may not have the capacity to direct the actions of a patient when they leave the precinct of the hospital. The best they can do is to provide the necessary guidance to them.

Penders mid-range theory holds the philosophy that health promotion is essential in empowering individuals and communities so that they can achieve full health potential. Adoption of healthy behavior is critical in enhancing the health of people within the community (Smith & Parker, 2015). For instance, lifestyle diseases such as obesity and their related health complications are becoming increasingly common in the country. However, society can help fight this health problem by taking individual responsibilities (Alligood, 2018). They can check on their intake of calories and maintain regular exercise to combat the problem.

Major Assumptions, Concepts, and Relationships

When comparing and contrasting the two theories and their application in the modern healthcare environment, it is necessary to start by outlining their major assumptions, concepts, and relationships. According to Younas (2017), one of the primary assumptions of Orems theory is that to stay alive and remain functional, humans engage in constant communication and connect among themselves and their environment. It also assumes that individuals have the power to make the right judgment. Adults experience privations exhibited in the form of individual actions in the care of self and those around them (Alligood, 2018). It also assumes that a properly structured group can act to promote the health of its members. Penders Health Promotion Models primary assumption is that individuals have the capacity to see the relevance of regulating their health. They can have knowledge about the impact of their decisions and actions on their health. Through interpersonal relationships with healthcare professionals, people can be guided on health promotion behaviors (Pender & Pender, 1980). It is evident that there is a close relationship between the two theories. They both hold the concept that individuals have the responsibility of taking care of their own health. Actions that they take directly affect their wellbeing.

Clinical Applications, Usefulness/Value to Extending Nursing Science Testability

The two theories can only be significant if they can be clinically applied and are useful in nursing science. The striking similarity of the theories is their concept of self-care when it comes to managing the condition of a patient. This concept is critical in the field of nursing. Alligood (2018) explains that whether a nurse is managing an inpatient or outpatient, the role that these individuals have to play when receiving medical care is critical. Cases, where adult patients fail to take their medication as prescribed for them, are common. Sometimes they fail to take their medicine but lie about it, making it difficult for nurses to understand why their conditions are not improving. When dealing with a patient suffering from obesity or related condition, a medical practitioner may prescribe specific drugs that the patient may need to take to help regulate their calories intake (Öztürk & Ocakç1, 2017). They may also be advised to maintain regular exercise. However, it is upon the patient to take seriously the advice that the nurse offers, especially when handling adults. They have to understand the significance of self-care for them to take seriously instructions provided to them in the hospitals. These theories are useful and valuable because they explain how patients can work closely with nurses and other practitioners to regain their health.

Comparison of the Use of Both Theories in Nursing Practice

The definition and analysis of the two theories have identified similarities and differences that they have. One of the striking similarities is that both theories emphasize the relevance of patients taking control in managing their own health. They both hold the view that success in managing a patients condition largely depends on the actions that they take. In nursing practice, both of them can be used to empower patients so that they can understand their condition, how it affects them, and what they can do improve (Alligood, 2018). Despite the striking similarities, it is important to appreciate that there are differences in the principles and practice of the theories. Orems Self-Care Theory is a grand theory while Penders Health Promotion Model is a mid-range theory. Orems theory emphasizes the need for nurses to address deficits in self-care while Penders model holds the belief that individuals understand the significance of self-care and only need some knowledge on how to manage their condition (Smith & Parker, 2015). Both theories have proven useful in nursing practice and research.

Examples of How Both Theories Could Be Applied in a Specific Clinical Setting

It is important to explain how each of the two theories can be applied in various clinical settings. Dorothea Orems Self-Care Deficit Theory can be applied when handling patients with chronic illnesses such as heart diseases. According to Öztürk and Ocakç1 (2017), patients with cardiovascular problems should maintain a specific lifestyle that involves a certain level of physical activities and limited intake of calories. Nurses can work closely with these patients and offer them guidance on what they should do while they are at home. This theory will help in empowering a patient so that they can take a leading role in enhancing their condition. Penders Health Promotion Model can be used in a clinical setting to empower nurses so that they can know how to equip their patients to be self-reliant. Nurses have to understand the fact that patients have control over their health (Alligood, 2018). As such, they need to be educated on how to behave to avoid exacerbating their condition.

Parsimony

The governments parsimony may be witnessed in the coming days as the revenue stream through taxation is affected by the outbreak of the COVID-19 pandemic. In such cases, nurses and other medical practitioners will have to learn how to operate in a financially stressful environment. It is possible that the budget for each of the governments departments may be reduced in the next financial year, including that of healthcare. However, that does not mean the demand for the services of this sector will drop. Nurses can use the concept of self-care as propagated in the two theories to offer quality healthcare services to patients at a significantly reduced cost (Öztürk & Ocakç1, 2017). When patients are responsible, cases of relapse will be reduced, which will in turn lower incidences of readmissions. It will also lower the overall expenditure of the department of health.

References

Alligood, M. R. (Ed.). (2018). Nursing theorists and their work (9^th ed.). Elsevier.

Öztürk, Ö., & Ocakç1, A. F. (2017). The effect of stress management training program on stress coping styles among the adolescents in prison in Turkey. Stress and Health, 33(1), 278-287.

Pender, N. J., & Pender, A. R. (1980). Illness prevention and health promotion services provided by nurse practitioners: Predicting potential consumers. American Journal of Public Health, 70(8), 798-803.

Smith, M. C., & Parker, M. E. (Eds.). (2015). Nursing theories & nursing practice (4^th ed.). F.A. Davis Company.

Whelan, E. G. (1984). Analysis and application of Dorothea Orems self-care practice model. Journal of Nursing Education, 23(8), 342-345.

Younas, A. (2017). A Foundational analysis of Dorothea Orems self-care theory and evaluation of its significance for nursing practice and research. Creative Nursing, 23(1), 13-21.

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