THEORETICAL FOUNDATIONS OF NURSING

Introduction

Nursing theories are the frameworks that have been developed by scholars to guide the practice of nursing. Most of nursing theories were developed by scholars who were nurses and had interacted for long periods with patients. Some of these theories are similar and they can be used interchangeably. This paper will cover Casey’s model of nursing theory, self care deficit nursing theory and adaptation model of nursing theories. The study will discuss the philosophies that are behind the three nursing models and also look at the background of the theories in the nursing field. It will highlight on the major contributors to the theories and their effect in the entire nursing field.

The study will elaborate on the application of the three theories in the current nursing practice. It will also look at other ways the three theories of nursing are being applied in other fields especially in medical field as a whole. The study will also explain on how each theory giving information on the major factors that form the theory and how they relate to each other. It will also look at how the three theories relate to each other and how they can be used together to achieve the best results in the nursing field. The paper will finally look at the differences among the three theories and it will state what factors make each of the three theories unique. A conclusion will be done on the entire study and the major issues will be highlighted in the conclusion.

Philosophies of the theories    

A philosophy is the knowledge behind a study and it forms the back bone of the study.

   Casey’s model of nursing

This model was developed by Anne Casey in 1988. She was a pediatric and her theory is based on children health care practice. It is made up of five concepts and the philosophy behind the theory is that “the best people to take care for a child are the family members with help from various professional staff”. This theory emphasizes on the importance of the family in the recovering process of a child (Masters, 2014). Anne Carey sees the family as the best unit of taking care of a sick child because it is in constant interaction with the child. Also the family has a close watch on a child and can easily establish when a child is unwell and initiate the healing process. The family of a sick child has to form a relationship with the nurse who helps it in caring for the sick child. Thus the healing process of a child according to Casey should be a joint effort between a nurse and a family.

Casey developed the theory after a long period of treating children in hospital. During her work she observed that children were kept in adult wards and they were strictly monitored by other staff so as to remain quiet and keep the ward tidy. They took long to heal because their mental needs were not catered for and they felt bad that they were confined in one place. Their parents were not allowed to attend to them while in the wards and they interacted with clinical workers throughout their stay in the wards. One time it occurred that a child was ill and was admitted together with as many family members as possible and it was observed that the healing process was very fast. The family members provided a lot of support to the sick child which quickened the healing process. Researchers then started to research on the topic and Casey was the one who discovered that the care given by close family members to an ailing child quickens the healing process. She came up with the partnership-in-care model which is based on the fact that both nurses and doctors work together in the process of treating a patient.

Adaptation model of nursing

This theory was advanced by Callister Roy and it is based on the view that “a person is a bio psychosocial being in constant relation with a changing environment (Catalano, 2011). She observed that people strive to maintain a balance between their bodily functions and the environment but the balance has never been perfect. People only devise ways of coping with the environment. In her model, Roy used six steps in determining the adaptation model. The first step is the assessment of the behaviour that is portrayed by a human being. The second step is the assessment of the stimuli that has caused certain behaviour while the third one is diagnosis of the medical problem by a nurse. The fourth step is setting the goal of a medication process and the fifth step is intervention of the problem. The last step is evaluation of the entire process including the medication process.

This model is called the systems model because it involves several systems of the human body. These systems are the ones that try to maintain a balance between themselves and the environment. Roy’s model is basically built from human being, adaptation and nursing concepts. She tried to relate the three by insisting that they have to exist for the nursing process to be effective. The function of the human body is to try and adapt to changes in the environment while the function of the nurse is to aid in the adaptation process by diagnosing the health problem and issuing corrective medicines.

Self- care deficit nursing theory

This theory of nursing was developed by Dorothea Orem and it is based on the philosophy “all patients wish to care for themselves”. The theory encourages the sick people to learn to do things for themselves and in that manner they will recover faster (Sagar, 2011). This theory was developed mainly for application in rehabilitation and primary care facilities. In such settings, the patients are capable of handling their own issues and they are encouraged to learn to take initiative when it comes to duties that concern them. Such duties include taking care of personal hygiene and medication follow ups.

Orem identified the self care deficits that should be used by a nurse to establish the type of care to be given to a patient. In some cases the patient is able to meet his or her self care requisites and it becomes possible for the nurse to issue guidelines that should be followed by the patient for a quick recovery. In a case where the patient is unable to meet his/her self care requisites, and then the nurse should assess the patient’s situation and define the type of medication to be offered to the patient.

Application of the theories to practice

The three theories are used together in the health care sector in the following ways:

•    Quality improvement

By applying the mentioned theories, the health care sector has been able to improve the quality of health care given to many patients. Casey’s theory of nursing is used to enhance the quality of health care given to children because it advocates for a partnership care program of children where the families of children are involved because they offer emotional support which quickens the healing process. The adaptation model of nursing helps to improve the quality of health care because it guides the nurses in determining the type of care to give to patients by examining a patient’s systems and comparing them with the environment. The self care deficit nursing theory has helped in the improvement of the health care given to people in rehabilitation centres because it has helped nurses determine what duties a patient can perform for himself so as to quicken the healing process.

•    Easing the nursing practice

The theories above have made the nursing practice easy because they offer them guidelines on how to handle patients (Melesis, 2011). Nurses are faced with many situations and theories act as a back bone for them during their daily routines. The Casey’s theory of nursing is good to nurses because it offers them guidelines on how to handle children. It reminds them of the importance of their families and hence the nurses are able to make informed decisions when deciding of a medication program for a child. The adaptation model of nursing makes it easy for nurses to determine the required equilibrium of the body processes and hence make it easy for them to correct the processes. The self care deficit model has eased the nursing practice by making it easy for nurses to measure the level of self care deficits that a patient has and hence know what type of health care is best for a patient.

•    Aiding in provision of patient centred care

The main aim of the nursing practice is to provide quality health care for patients and the existence of theories of nursing has made it possible for nurses to offer patient centred health care (Aligood, 2014). These theories focus mostly on the patient and this has helped nurses to always focus their care on the patient too. The Casey’s theory focuses on the child whose care should be offered in collaboration with families. The adaptation model of nursing focuses on the processes of the patient who becomes the centre of interest during a nursing exercise because his/her system is tested to establish the balance. The self care deficit model focuses on people in rehabilitation centres who need a lot of attention to correct their behaviours. This theory has made it possible for the nurses to only focus on the affected with the aim of determining what they require to regain their health.

Similarities and differences among the theories

•    The three theories are patient centred

These theories have been developed with the patient as the centre of interest. In Casey’s theory the child is the centre of the theory and in adaptation theory of nursing the patient is also the centre of interest while in the self care deficit model the interest is directed to people in rehabilitation centres.

•    They focus on different classes of patients

The three theories focus on different types of patients who might be found in a health care facility. Casey’s model focuses on children, adaptation model focuses on adults while self care deficit model focuses on people in rehabilitation centres both adults and children.

Conclusion

The theories of nursing are many and they have been developed with the aim of improving the nursing practice. From the above discussed theories, it is evident that the patient is the most important person in the health care sector and nurses should strive to understand the situation of a patient and offer the best services that will lead to a quick recovery. The theories have improved the act of nursing and many patients have found satisfaction in the nursing exercise in the recent times as compared to the olden times when nursing was only a practice which was not aimed at satisfying the patient. Future developments will be aimed at making the nursing profession better for the nurses and the patients so that both parties can exist in harmony.

References

Melesis.A. (2011). Theoretical Nursing. Lippincott Williams& Wilkins

Alligood.M.(2014).Nursing Theorists and Their Work. Elsevier Health Sciences

Catalano.J.(2011). Nursing Now. F.A Davis

Masters.K.(2014).Nursing Theories: A framework for professional practice. Jones & Bartlett Publishers

Sagar.P.(2011). Transcultural Nursing Theory and Models. Springer Publishing Company.




 

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