Nursing Theorists and Their Work

Introduction

Today we could observe significant shifts in people’s mentalities and value systems. These alterations are stipulated by the rapid development of human thought, science, and humanistic values. In such a way, the human being is considered the greatest treasure and his/her life should be protected. This belief triggered numerous processes in the coherent society and gave rise to such concerns as the quality of life, health of the nation, healthy environment, etc. Under these conditions, the healthcare sector and nursing acquire the top priority as the central institutions that can help to deliver appropriate care to patients and guarantee their well-being regarding the ideas mentioned above.

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Personal Values and Beliefs about Nursing, Clients, Health, and Environment

Thus, in my opinion, nursing should be defined broader than simply providing care to patients. It is also important to remember that nursing is a dynamic practice that should be performed by a highly qualified professional, who can keep pace with the transforming environment while preserving the best heredity of the predecessors. Quality nursing requires thorough observation, close attention to patients, profound research of theory, an accurate assessment, detailed analysis, and proper diagnosis to be successful.

Taking into consideration my beliefs regarding nursing, I can provide the following definitions of the four key domains of the nursing metaparadigm:

  1. A person is a human being that requires medical aid and should be perceived as an aggregate of a number of factors, including physiology, psychology, emotion, social status, intellect, cultural background, individual characteristics, etc. The person must be treated comprehensively and in dynamics since the change of each factor may influence the outcome.
  2. The environment is a set of contextual characteristics of the nursing experience that should be considered while providing care since they have a direct or an indirect impact on the patient. Such characteristics are not stable and may vary in time, space, and nature.
  3. Health is a state of body and mind dependent on the environment, which is proportionally comprised of wellness and diseases and is individual for each person while being unachievable in its absolute state. The person’s ability to maintain homeostasis is individual and is capable of influencing his/her behavior. Health encompasses plenty of characteristics (physical conditions, psychological stability, adequate self-esteem, moral realms, positive look into the future, etc.) and can be affected by elements of the other components of the metaparadigm.
  4. Finally, nursing is the art of identifying the patient’s unique, individual needs and providing care and education to those who cannot do this for themselves. Nursing covers critical assessment, treatment, support, education, and personal involvement in each patient’s case.

It is highly important to remember that all these domains do not exist separately and are interconnected. This implies that it is challenging to restore health without the interference of nursing, which cannot be practiced without people. I believe that in the future, nursing will become more culture- and patient-specific in all its critical aspects.

Assumptions, Values, and Beliefs of Various Nursing Models

The Health Promotion Model (HPM) is a middle-ranged predictive theory of nursing that was developed by Nola J. Pender closer to the end of the previous century (1982) in order to establish the connection between the personal perception of health, environmental drivers, and health behaviors and identify to what degree health promotion is possible for each particular individual. The model, therefore, accounts for individual experiences as predominant factors determining health-promoting conduct (Alligood, 2014). The theory particularly emphasizes behavior-specific cognitions that can be identified as perceived benefits, self-efficacy, barriers, challenges, interpersonal impact, and contextual influences (Alligood, 2014). The outcome for the patient is, therefore, predicted by his/her action plan, personal preferences, and context.

Some scholars believe that the core value of the model is in its focus on personal motivation as one of the most influential dynamics (Alligood, 2014). The idea is borrowed from the expectancy-value and cognitive theories. Despite the fact that barriers can be partially overcome by the nurse, the result still largely depends on the patient’s readiness to recover. The person is seen as a holistic entity seeking self-actualization via the path of the least resistance to achieve harmony while adapting to the environment (Alligood, 2014). Thus, the environment is a sum of barriers; the person is an independent self-regulator; health is potentially achievable well-being, and the nurse is a facilitator.

Another model was developed by Callista Roy and is called the Adaptation Model. The major assumption of it is that each person is challenged with the ever-changing conditions of the environment, making him/her seek ways to adapt to them (Alligood, 2014). The author of the theory believes that the person is a bio-psycho-social being; the environment is a sum of dynamic factors; health is the result of adaptation; and the nurse is the main figure helping patients adapt (Alligood, 2014). The model specifically emphasizes the fact that adaptation requires not only inborn but also acquired mechanisms. Each individual is believed to have four major modes of adaptation: physiologic, role-performing, self-perceptive, and social (helping adapt to inter-dependence needs) (Zaccagnini & White, 2017). The ultimate goal of nursing is to help patients achieve health as a result of using these mechanisms.

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Models Congruent with my Beliefs

One of the models congruent to my understanding of nursing is the Self-Care Model developed by Dorothea Orem since it allows for a different perception of care. Since the theory is rather simple, it can be applied to improve the nursing practice in a wide range of situations and patients. The author states that patients should be more responsible and self-reliant in matters of health (Alligood, 2014). They are distinct individuals who cannot be perceived as passive objects of care. Nursing is viewed as a form of action and interaction between the care provider and the patient (Alligood, 2014). The environment is understood as a number of factors challenging personal well-being. Health is seen as the result of the person’s actions aimed at meeting development and universal self-care requirements, his/her knowledge of potential problems, and initiative (Alligood, 2014). The model also takes into account the fact that some factors (such as age, life experience, available resources, etc.) may influence this willingness (Zaccagnini & White, 2017). The task of the nurse is to assist those who have self-care deficits and make them as independent as possible.

The second model, the assumptions of which I share, is Betty Neuman’s Systems Model, which provides a system-based, holistic approach to care. The approach relies on the assumption that the environment is a sum of stressors and the person is the one who has a normal line of defense to provide an adequate response to these stressors and stay healthy (Alligood, 2014). Health is viewed as the absence of deviations caused by known, unknown, and universal stressors. The nurse is the major agent that helps the patient attain and maintain wellness even in the most challenging conditions. Each patient’s system is perceived as unique since it is composed of characteristics that patients do not share (although some system factors are universal) (Alligood, 2014). Inter-relationships of these characteristics affect not only health but also the patient’s ability to stand against stressors.

Comparison of the Two Models

If compare the key features of the two models, it is evident that they are similar in their comprehensive character and flexibility. In both cases, health is viewed as a dynamic composite of numerous variables that exist in the state of stability. Another significant similarity is that both models give decision-making freedom to patients in all health issues unless they have a self-care deficit (according to the first model) or a weak resistance line (the second model). These are the cases when nursing actions are required. The client outcome is the state of wellness and independence, according to both theories (Alligood, 2014). However, while the first model stresses the patient’s self-awareness and health-promoting behavior, the second is focused on environmental factors and nursing prevention that allows maintaining the patient’s health. Unlike the second theory, the first model does not perceive the environment as a collection of aggressive factors.

Application of Models

All nursing models have their benefits and drawbacks and, therefore, should be applied depending on the patient’s need. For instance, geriatric patients suffering from chronic conditions will benefit from the implementation of Kolcaba’s Theory of Comfort, which sees comfort as the immediate desired outcome of care. The idea is that if the patient’s condition cannot be considerably altered for the better, it is highly important to achieve the maximum level of comfort needs satisfaction.

Conclusion

Altogether, I believe that nursing is not just a sphere of activity focused on the provision of appropriate care to individuals. However, it is a unique philosophy that encompasses four interconnected meta paradigms related to every individual. They demonstrate the outstanding importance of this science and its role in improving the health of patients. Therefore, there are such models like Self-Care or Betty Neuman’s Systems Model that are congruent with these meta paradigms and can be applied to enhance the quality of care.

References

Alligood, M. R. (2014). Nursing theorists and their work (8th ed.). Amsterdam, Netherlands: Elsevier Health Sciences.

Zaccagnini, M., & White, K. (2017). The doctor of nursing practice essentials (3d ed.). Burlington, MA: Jones & Bartlett Learning.

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