Today, Nursing theories have a great impact when it comes to the nursing profession. With that being said, two nursing theories’ that stood out to me where Orem self- care theory and Roy adaptive model.
Orem’s concpets, assumptions and implications
Orem’s theory focuses on each individual’s ability to perform self-care. Orem’s theory has four key concepts, which include health, environment, person, and nursing. She defines self- care as “the practice of activities that individuals’ initiate and perform on their own behalf in maintaining life, health and well-being” (Wayne, 2014). The person is viewed from a biological and social aspect. Orem’s defines three concepts in her self-care deficit theory, which include self- care, self-care deficit and the nursing system. Her assumptions based on this theory is that in order to maintain ones’ well-being, an individual must be involved with the community and environment to remain alive and to function. Also, to act purposefully in making judgments, and knowledge of health issues is essential in fostering self-care activities (McEwen; Wills, 2014). Moreover, Orem developed a three-step nursing process that is similar to the nursing process we have today. Orem’s theory implies that nurses must provide care until the patient is able to restore their own self-care. The core of Orem’s model is a nurse-patient relationship. Although some patients may take longer depending on their ability to function due to a physical deficit.
Sister Callista Roy’s concpets, assumptions and implications
In Sister Callista Roy’s Adaptation model, is a deductive theory based on nursing practice developed for education, research and practice settings (McEwen; Wills, 2014). Roy focuses on the notion of adaption of man. Her four key concepts of nursing, person, health, and environment all connect, yet differ from Orem’s definitions. She defines the human adaptive system as “a whole with parts that function as a unity for some purpose” (McEwen& Wills, 2014). Her assumptions based on this theory is being identified as philosophical, scientific and cultural. Some of her assumptions incorporate that an individual is accountable for the development and changing they make within their life, the way one thinks and feels lead to human action, and one’s culture may lead to changes when it comes to nursing practice and assessment (Gonzalo, 2011). Her theory implies the adaption only occurs when the patient responds to the environmental changes in a positive manner. Also, it promotes the integrity of the person; thus, leading to ones well- being and health. However, if one does not effectively respond to stimuli, it can stoppage the integrity of the individual.
Compare and Contrast Roy and Orems theories
To compare and contrast, Roy and Orem both use the meta-paradigm of nursing four concepts. However, Roy perception of the person component mainly is in a psychological aspect and focuses on adaption to one’s environment to promote a person’s well-being. On the other hand, Orem emphases the physiological and social aspects of the individual and does not view the importance of mental health. For example, a patient with a mental or psych issue may not acknowledge or admit that he needs help regarding his self-care and basic ADLs. Therefore, making it hard to apply Orem’s theory to this scenario. Furthermore, some of Roys assumptions are based on culture and philosophical manner that include God. On the contrary, Orem model does not mention culture. Both theories imply the nurse as a helper. Roys model is to aid the patient to changes during illness; while Orem’s model the nurse helps self- care abilities. Roy and Orem share the idea of a holistic approach when it comes to the nursing component; even though, they have different definitions of the four concepts of nursing. They both primarily focus on the patients’ outcomes.
Application
Both of these models guide nurses to us an individualized assessment of their patients. the theoretical framework guides our nursing practice. Orem’s theory is applied to our decision-making process within a clinical setting (Wayne, 2014). For example, Orem developed a three-step nursing process, which is based off what our five-step nursing process is today. In addition, Orem’s theory can be related to a patient who is on chronic dialysis, and need to modify their diet, be on a fluid restriction and continue on medication. As a nurse, we need to keep educating our patient to promote self- care. Compared to a patient who is new to dialysis and experiences self- deficit due to lack of knowledge.
When it comes to Roys adaptation model, there was a research conducted. During this research, 597 adults who presented with various chronic illnesses were studied over seven years. The purpose was to determine and identify predictors of adaptation to chronic illness (Pollock, 1993). The patients were reinforced with health promotion activities. They also considered physiological and psychosocial adaption in all groups. The result showed a significant difference in the physiological adaption, but no significant difference in psychosocial (Pollock, 1993). The outcomes support the value of using Roys nursing model to guide nursing practice.
Resources
Gonzalo, A. G. (2011). Sister Callista Roy. In Theoretical Foundation of Nursing. Retrieved from http://nursingtheories.weebly.com/sister-callista-roy.html
McEwen, M., & Wills, E. (2014). Theoretical basis of nursing. (4th ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
Pollock, S. E. (1993, April 1). Adaptation to Chronic Illness: A Program of Research for Testing Nursing Theory. Sage Journal, 6(2).
Wayne, G. (2014, August 12). Dorothea Orem’s Self-Care Theory. In Nurses Lab. Retrieved from https://nurseslabs.com/dorothea-orems-self-care-theory/
