Fundamentals of Nursing Models, Theories, and Practice discusses the theory-practice gap in detail in many chapters. As you have read throughout the course, there is ongoing discussion about the connection between theory and practice and the application in day-to-day nursing activities. This reflection is designed to illustrate that although there may be a gap, other factors play an important role in decision-making and each aspect of theory, research, and practice experience are integral to well-rounded patient care.

Access Fundamentals of Nursing Models, Theories, and Practice and review Figure 1.4 Correlation: Education, Science and Practice on page 11.

Post 2 substantive replies to classmates. Be constructive and professional.

Repsonse 1#

Patient is 64-year-old, married female presenting in her PCP’s office because her husband has concerns of her coughing – the frequency and amount. Patient has been smoking for 25 years, diagnosed with asthma 10 years ago – patient does not feel it’s necessary to renew medication for asthma because she feels as if it is not working. When asked about her general health – patient states she feels overall healthy, her husband chimes in and appears to know about her health, providing more necessary details.

Regarding the scenario, I created above, I choose to apply Dorothea Orem’s Self-Care Deficit Theory. Orem’s theory is comprised of three related parts: theory of self-care; theory of self-care deficit; and theory of nursing system (Orem’s Self-Care Deficit, 2020). Self-care pertains to the activities a patient can perform on their own regarding maintaining life, health, and well-being. Self-care deficit is when nursing care is required because the patient is either incapable or limited in providing self-care. Lastly, the nursing system is the relationship formed between the nurse and the patient – the nursing system is activated when the self-care deficits force the nurse to intervene and provide care to the patient. Orem explained that well-being is used in the sense of an individual’s ‘perceived condition of existence’ (McKenna et al., 2014). One of the main strengths with Orem’s theory is that is can be applied to that of a novice nurse all the way to an expert nurse – it is comprehensive approach to nursing. In a primary care setting – Orem’s theory allows for the provider to communicate effectively to the patient while contributing to the patient’s overall health and well-being. There are limitations with Orem’s theory just like other theories especially when applying them to different cases or settings. The case provided above does not account for “family” –the patient’s husband. Orem’s theory focuses on the individual’s ability not accounting for the individual’s support system in which some cases including the above scenario – the patient’s husband better understands and better manages the patient’s care. Another limitation is that Orem’s theory does not account for a patient’s emotional needs or explain how to handle or account for the dynamic aspect of the patient’s health and how it can be every-changing (Gonzalo, 2021a).

References

Gonzalo, A. B. (2021a, March 5). Dorothea Orem: Self-Care Deficit Theory. Nurseslabs. https://nurseslabs.com/dorothea-orems-self-care-th…

Mckenna, H., Pajnkihar, M.,& Murphy, F. (2014). Fundamentals of nursing models, theories and practice (2nd ed.) Wiley.

Orem’s Self-Care Deficit. (2020, July 19). Nursing Theory. https://nursing-theory.org/theories-and-models/ore…

Response 2#

Kathryn E. Barnard developed the Child Health Assessment Model with the aim of improving the health of infants and their families (Nurselabs, 2021) Barnard’s theory focused on the importance of the way they were treated and cared for from birth onward into their childhood. The children were evaluated in several areas, stimulation of the senses, social, emotional, and behavioral growth (Weber, B. 2015). Barnard did extensive research on premature newborns who were isolated in incubators and lacked physical touch and interaction. She developed the Isolette which rocks the baby as they are in the incubator, and the result was improved weight gain and more motor and sensory function advancement (Weber, B., 2015). The development of her theory developed a standard in care of premature babies. The consistent positive outcomes for the infants showed her theory qualified as a contribution to nursing science (McKenna, H., Pajnkihar, M., & Murphy, F., 2014).

The gaps in Barnard’s theory could be the variables such as the socioeconomic status of the family, meaning resources available for food, parenting classes, community resources and support. Another gap regarding variables is the health of the child. Children with health problems such as cerebral palsy would not be able to be compared to a healthy child in the area of senses and behavioral growth. The medical diagnosis of ‘Failure to Thrive’ is another potential gap. “Because the causes of organic and environmental weight loss in the infant are numerous, failure to thrive (FTT) is a difficult diagnosis McPeters, S. L., Bryant, P. H., & Speck, P. M. (2021).”

With the gaps that are a possibility in Barnard’s theory it is easy to appreciate that each infant is individualized and must be evaluated on a case-by-case basis. There are factors that will determine the child’s development as they grow, and these could also affect the way they develop in addition to the nurturing and care they receive as a child.