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Metaparadigm theories of nursing
A Foundational Analysis of Dorothea Orem's Self-Care Theory and Evaluation of Its Significance for Nursing Practice and Research
Metaparadigm theories of nursing
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According to McEwen and Wills (2014), decades before Dorothea Orem developed the Self-Care Deficit Nursing Theory (SCDNT) in 1971, the identity of nursing as an independent field of study was not clearly defined. Several theories from Medicine and the Social sciences were the basis of earlier Nursing theories written between the 1950s and the 1970s. For example, Abraham Maslow’s work in Psychology, Hierarchy of Needs Theory, influenced earlier Nursing theories based on human needs. Orem, however, did not specify any theorist who provided the basis for the SCDNT. Instead, she cited Parson’s structure of social action and von Bertalanffy’s general systems theory – a sociologist and biologist respectively. In addition, Orem defined the metaparadigm
Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of nursing specialization, their definition of nursing and their philosophies of nursing.
The theory being presented is Dorothea Orem’s self-care deficit nursing theory. Theory utilization in nursing is extremely important, theory helps to guide nursing research and nursing practice. There is a close and concrete circular relationship between theory, research, and practice that has been in existence since the beginning stages of nursing practice as a profession (Im & Chang, 2012). Theory utilization continues and will continue in the future to help guide nursing practice and research. Im and Chang (2012) state, “with evolutions and changes in nursing environments, theoretical thoughts in nursing have been developed, refined, and evolved in nursing history” (p. 156). Nursing theories and borrowed theories have been a foundation in nursing since the nursing discipline began to identify as a profession (Im & Chang, 2012). Over the years amazing
In the elderly population, there are several healthcare deficits noted, the issue is when these patients are abandon by nurses due to work environment issues such as staff shortage, assignment acuity disagreements, and etc. As stated, health care deficits most often affect the elderly population, but it can affect anyone that have a debilitating disease or trauma. I have over three years of nursing experience working in a nursing home, so I am very familiar with self- care deficits in the elderly population. When dealing with the elderly population I integrate the Dorothea Orem’s Self –Care Deficit Theory into my practice to address the issue at hand. What is the Dorothea Orem’s Self-Care Deficit Theory? Dorothea Orem’s Self-Care Deficit Theory is a grand
The metaparadigm encompasses the major philosophical orientations of a discipline, the models and theories that guide research, and the empirical indicators that operationalize theoretical concepts. The purpose or function of the metaparadigm is to summarize the intellectual and social mission of the nursing discipline and place boundaries on the subject matter of that discipline (McEwen & Wills, 2014). The four metaparadigm of the discipline of nursing are person or client, environment, health, and nursing (Parker, 2001). A person or client is the recipient of nursing care. The environment is the internal or external surroundings that affect the client. Health is the degree of wellness or well-being that the client experiences. The nursing concept refers to the attributes and actions
In a line of many nursing theorists, Dorothea E. Orem has made a significant contribution to the definition and application of nursing. She was born on June 15, 1914 in Baltimore, Maryland (Alligood & Tomey, 2010, p. 265). Beginning in the 1930s, Orem earned her first diploma in Washington, D.C., while working at Providence Hospital School of Nursing. She would go on to earn a bachelors and masters of science degree in Nursing Education at The Catholic University of America (Alligood & Tomey, 2010, p. 265). While working for the Indiana State Board of Health, her personal theory of nursing care was established and eventually published in her book, Nursing: Concepts of Practice, in 1971. Finally, in 1976 Georgetown University awarded her an
Dorothea Orem, a Baltimore native, was one of America’s foremost nursing theorists with a wide variety of nursing experiences that influenced her development of the Self-Care Deficit Nursing Theory (SCDNT). Introduced as a general theory of nursing, the SCDNT is expressed in three theories which guide practice, education, and research. In addition, Orem’s conceptualizations are in continual development to improve clarity, simplicity, generality, and empirical precision.
Born in 1914 in Baltimore, Maryland, Dorothea Orem has come to be one of the well-known theorists who continue to influence nursing in todays practice. She received her nursing diploma from Providence Hospital School of Nursing in Washington, D.C. in the year 1934. In 1939 she received her Bachelors of Science in Nursing Education, and in 1945 she finished her Masters of Science in Nursing Education. Through Orem’s personal life experience as well as expertise in the subject of SCDNT, she was able to create this theory of self-care agency,
A metaparadigm is an overarching framework that provides a comprehensive perspective of a discipline. In nursing, this framework serves to distinguish the profession intellectually, comprising of four concepts which provide a foundation to the content and context of nursing theory and scope of practice (Lee & Fawcett, 2013; Masters, 2014; Schim, Benkert, Bell, Walker, & Danford, 2007). Namely, these foundational concepts are: person, environment, health, and nursing. Hence, the intent of this essay is to describe the four main concepts that make up nursing’s metaparadigm and discuss how they are used in practice, education and research.
The hospital will provide nursing care and teaching based off of Dorothea Orem’s theory. Nurses will be taught to assess patients based off of this theory, and to help with the deficits they face. Nurses will assess the needs of their patients. They will look at the three different types of needs, universal, developmental, and health deviation self-care requisites. Nurses then will be able to identify which areas the patient is in most need. It will be the end goal for the nurses to restore patients to the best they can, and to make them as self-sufficient as
Watson, J. (1985). Nursing: Human Science and Human. Norwalk; CT: Appleton – Century – Crofts.
King, I. M. (1971). Toward a theory for nursing; general concepts of human behavior. New York: Wiley.
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).
Four Metaparadigms of Nursing A metaparadigm is the shared communication, general set of concepts, perception of these concepts, a collective belief and the view of a discipline by a group of scholars within the specialty (Wagner, 1986). A metaparadigm is the foundation for the nursing profession, which can be used as a guide by nurses like me in making clinical judgment. There are four metaparadigms that are relevant to nursing practice- person, environment, health and nursing. Person The person component of the metaparadigm describes the individual, family, or community in need of health care. It also lays emphasis on the patient’s social, spiritual and physical demands.
Orem defines “nursing” through structured nursing knowledge. In the 1950s, Orem originated the idea of “self-care” from reflecting of her work experience on searching for the meaning of nursing, and over the next four decades, she continued to develop this ground
In my ADN program, I feel as though we focused mostly on scientific information and only scraped the surface of nursing theory. When I started my first job fresh out of nursing school, I was thrown into nursing and expected to be a nurse and do what a nurse does. Though, I gained nursing skills, most of nursing is what I was going to learn in a hands-on manner. I never understood the importance of theory or nursing as a profession. Researching Dorothy Johnson’s Behavioral System Model of Nursing has changed my view of what nursing really consists of. I have learned that nursing theory is what developed nursing practice today. My job has helped me grasp Johnson’s theory more clearly. I see how much her theory has guided current nursing practice and I feel as though I can relate at this point in my professional life. Therefore, I will focus on the details of this theory and how it has shaped the nursing profession and my career.