Middle Range Nursing Theory Nursing Essay Paper

Middle Range Nursing Theory Nursing Essay Paper

Middle Range Nursing Theory Nursing Essay Paper

The aim is to describe the development of a middle-range theory by using an inductive-deductive approach. A theory of well-being supporting physical environment of home-dwelling elderly is used as an example. The inductive-deductive theory development process is described through four different phases: (1) the creations of concepts were described inductively through concept synthesis, (2) relationships between the concepts were examined to set up a hypothetical model, (3) hypotheses were set up to verify the concepts and to test hypothetical models, and (4) the verification and presentation of the theory.Middle Range Nursing Theory Nursing Essay Paper

Permalink: 

Struggling to meet your deadline ?

Get assistance on

Middle Range Nursing Theory Nursing Essay Paper

done on time by medical experts. Don’t wait – ORDER NOW!

This article tries to discuss general aspects on models of nursing knowledge, basic elements for its development and practice. First, it shows the importance of the development of knowledge sustained by the practice and the expression of it by means of four knowledge models: empirical or nursing science, ethical, esthetical or nursing art, and personal.

A description of each model of knowledge takes place, beginning with the personal one. Its meaning is showed as something basic for the development of ethical and aesthetical models, as it is a condition sine qua non such models are not totally developed or expressed satisfactorily in practice.Middle Range Nursing Theory Nursing Essay Paper

It presents the discussion on evolution of epistemological questions toward philosophy and ontology. It tries to progress in the knowledge of the self or essence of what is known, to end with a summary on repercussions of knowledge models inclusion in syntax of nursing discipline.

A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing. Nursing theory is the delivery of nursing care within the nursing process and is directed by the way specific conceptual frameworks and theories define the person (patient), the environment, health and nursing. Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs1978). It should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future (Brown 1964). Theory is important because it helps us to decide what we know and what we need to know.Middle Range Nursing Theory Nursing Essay Paper

This article tries to discuss general aspects on models of nursing knowledge, basic elements for its development and practice. First, it shows the importance of the development of knowledge sustained by the practice and the expression of it by means of four knowledge models: empirical or nursing science, ethical, esthetical or nursing art, and personal.

A description of each model of knowledge takes place, beginning with the personal one. Its meaning is showed as something basic for the development of ethical and aesthetical models, as it is a condition sine qua non such models are not totally developed or expressed satisfactorily in practice.Middle Range Nursing Theory Nursing Essay Paper

It presents the discussion on evolution of epistemological questions toward philosophy and ontology. It tries to progress in the knowledge of the self or essence of what is known, to end with a summary on repercussions of knowledge models inclusion in syntax of nursing discipline.Middle Range Nursing Theory Nursing Essay Paper

Theories and different theorist has shaped the way in which we look at nursing, nursing care and how it should be delivered to individuals and their family on a daily basis. For the purpose of this paper we would be looking at two theorists’ first Nancy Roper her model is based upon activities of living, which evolved from the work of Virginia Henderson in 1966. The activities of daily living are the key to the model, which seeks to define “what living means.” And secondly Faye Glenn Abdellah’s theory deals with the topology of 21 Nursing Problems condition presented or faced by the patient or family. Problems are in 3 categories physical, social and emotional. The nurse must be a good problem solver. We looked at the different nursing approaches they identified and developed as a means of implementing nursing care through the nursing process, which includes the basic framework of assessment, diagnosis, planning, implementation and evaluation of the findings. Also during the research we identified the classification of theories which includes: The Meta theory, Grand theory, Middle range theory, Practice theory, and under which classification of the theory does Nancy Roper and Faye Glenn Abdellah’s falls under.Middle Range Nursing Theory Nursing Essay Paper

CLASSIFICATION OF NURSING THEORIES

Meta-Theory

Meta-theory is the highest level of theory. A nursing meta-theory presents the most global perspective of the nursing discipline. It deals with the processes of generating knowledge and debating broad issues related to the nature of theory, types of theory needed and suitable criteria for theory evaluation. It’s only natural that meta-theory has parts of grand theory, middle range theory and practice theory.Middle Range Nursing Theory Nursing Essay Paper

Grand Nursing Theory

Grand theories are the most complex and broadest in scope. They attempt to explain broad areas within a discipline and may incorporate numerous other theories. Grand theories are nonspecific and comprised of relatively abstract concepts which lack operational definition, their propositions are also abstract and are not amenable to testing generally. They are developed through thoughtful and insightful appraisal of existing ideas as opposed to empirical testing. Grand Theory provides the foundation for middle-range theory.Middle Range Nursing Theory Nursing Essay Paper

Middle-range Nursing Theory

Middle range theories are abstract, inclusive and organized with a limited scope. It carries variables that have to be proven and tested. Middle range has a stronger relationship with research and practice. It focuses on concepts of pain, symptom management, cultural issues and health promotion.Middle Range Nursing Theory Nursing Essay Paper

Nursing Practice Theory

Nursing Practice theory is the lowest of the theories. Practice theory is the practice that is most seen from nurses. In practice theory, there are four steps to follow: you have to identify and describe a phenomenon, identify and describe possible explanations, predict the occurrence and control or eliminate the cause. Ideally, nursing practice theories are interrelated with concepts from middle-range theories, or may be deduced from theories at the middle range. The day-to-day experience of nurses is a major source of nursing practice theory. The depth and complexity of nursing practice may be fully appreciated as nursing phenomena and relations among aspects of particular nursing situations are described and explained.Middle Range Nursing Theory Nursing Essay Paper

Nursing practice theory has been articulated using multiple ways of knowing through reflective practice (Johns & Freshwater, 1998). The process includes quiet reflection on practice, remembering and noting features of nursing situations, attending to one’s own feelings, re-evaluating the experience, and integrating new knowing with other experience (Gray & Forsstrom, 1991).Middle Range Nursing Theory Nursing Essay Paper

“Needs” theories

Faye Glenn Abdellah’s is a need theorist. The need theory is based around helping individuals to fulfil their physical and mental needs. Needs theories have been criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position.Middle Range Nursing Theory Nursing Essay Paper

Faye Glenn Abdellah’s Theory

“Nursing is based on an art and science that mould the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs.” – Abdellah Middle Range Nursing Theory Nursing Essay Paper

Nursing Approach of Faye Abdullah

The nursing-centered orientation to client care seems contrary to the client-centered approach that Abdellah professes to uphold. The apparent contradiction can be explained by her desire to move away from a disease-centered orientation. In her attempt to bring nursing practice to its proper relationship with restorative and preventive measures for meeting total client needs, she seems to swing the pendulum to the opposite pole, from the disease orientation to nursing orientation, while leaving the client somewhere in the middle.Middle Range Nursing Theory Nursing Essay Paper

She describe the recipients of nursing as individuals (and families), although she does not delineate her beliefs or assumptions about the nature of human beings.

Health, or the achieving of it, is the purpose of nursing services. Although Abdellah does not give a definition of health, she speaks to “total health needs” and “a healthy state of mind and body.” (Abdellah et al., 1960)Middle Range Nursing Theory Nursing Essay Paper

Health may be defined as the dynamic pattern of functioning whereby there is a continued interaction with internal and external forces that results in the optimal use of necessary resources to minimize vulnerabilities. (Abdellah & Levine, 1986; Torres & Samton, 1982).

Society is included in “planning for optimum health on local, state, and international levels.” However, as Abdellah further delineates her ideas, the focus of nursing service is clearly the individual.

Nursing Problems

The client’s health needs can be viewed as problems, which may be overt as an apparent condition, or covert as a hidden or concealed one.Middle Range Nursing Theory Nursing Essay Paper

Because covert problems can be emotional, sociological, and interpersonal in nature, they are often missed or perceived incorrectly. Yet, in many instances, solving the covert problems may solve the overt problems as well. (Abdellah, et al., 1960)Middle Range Nursing Theory Nursing Essay Paper

Problem Solving

Quality professional nursing care requires that nurses be able to identify and solve overt and covert nursing problems. These requirements can be met by the problem-solving process involves identifying the problem, selecting pertinent data, formulating hypotheses, testing hypotheses through the collection of data, and revising hypotheses when necessary on the basis of conclusions obtained from the data. (Abdellah & Levine, 1986)Middle Range Nursing Theory Nursing Essay Paper

FAYE GLENN ABDELLAH CONCEPTS OF THE NURSING CONCEPTS OF MAN, HEALTH, ENVIRONMENT & NURSING

Nursing is broadly group into twenty-one problem areas to guide care and promote use of nursing judgment. These deal with biological, psychological, and social areas of individuals.Middle Range Nursing Theory Nursing Essay Paper

Faye Abdellah proposed a classificatory framework for identifying nursing problems, based on her idea that nursing is basically oriented to meeting an individual total health needs. Her major effort was to differentiate nursing from medicine and disease orientation. Her patient-centred approach to nursing was developed inductively from her practice and is considered a human needs theory; with its relevance for nursing care in community settings. She promotes the image of the nurse not only as kind and caring, but also intelligent, competent, and technically well prepared to provide service to the patient.Middle Range Nursing Theory Nursing Essay Paper

Typology of 21 Nursing Problems

Basic to all patient needs

1. To maintain good hygiene and physical comfort..

2. To promote optimal activity: exercise, rest, and sleep.

3. To promote safety through prevention of accident, injury, or other trauma and through the prevention of the spread of infection.

4. To maintain good body mechanics and prevent and correct deformity.Middle Range Nursing Theory Nursing Essay Paper

SUSTENAL CARE NEEDS

5. To facilitate the maintenance of a supply of oxygen to all body cells.

6. To facilitate the maintenance of nutrition of all body cells.

7. To facilitate the maintenance of elimination.

8. To facilitate the maintenance of fluid and electrolyte balance.Middle Range Nursing Theory Nursing Essay Paper

9. To recognize the physiological responses of the body to disease conditions—pathological, physiological, and compensatory.

10. To facilitate the maintenance of regulatory mechanisms and functions.

11. To facilitate the maintenance of sensory function.

REMEDIAL CARE NEEDS

12. To identify and accept positive and negative expressions, feelings, and reactions.Middle Range Nursing Theory Nursing Essay Paper

13. To identify and accept interrelatedness of emotions and organic illness.

14. To facilitate the maintenance of effective verbal and nonverbal communication.

15. To promote the development of productive interpersonal relationships.

16. To facilitate progress toward achievement of personal spiritual goals

17. To create and/or maintain a therapeutic environment.

18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs.Middle Range Nursing Theory Nursing Essay Paper

RESTORATIVE CARE NEEDS

19. To accept the optimum possible goals in the light of limitations, physical, and emotional.

20. To use community resources as an aid in resolving problems arising from illness.

21. To understand the role of social problems as influencing factors in the cause of illness.Middle Range Nursing Theory Nursing Essay Paper

Theoretical Assertions

The nursing problem and nursing treatment typologies are the principles of nursing practice and constitute the unique body of knowledge that is nursing.

Correct identification of the nursing problem influences the nurse’s judgment in selecting steps in solving the patients’ problem.

The core of nursing is patient/client problems that focus on the patient and their problems

Abdellah’s main goal was the advancement of education for nurses; she believed that as the education of nurses improves, nursing practice improves as well. She categorized nursing problems based on the individual’s needs and developed a typology of nursing treatment and nursing goals which served as a basis for determining and organizing nursing care.Middle Range Nursing Theory Nursing Essay Paper

Her twenty-one nursing problems made nurses look at patients’ problems and came up with nursing plan of care in a through and organized way. He client centered care emphasizes the principle that the nurses’ goal should be geared towards treating the patient and not just the illness. Her problem-solving process of identifying the problem, selecting pertinent data, formulate hypotheses through collection of data, and revising hypotheses on the basis of conclusions obtained from the data that parallels the steps of the nursing process of assessment, diagnosis, planning, implementation and evaluation ( Abdellah and Levine, 1986; George, 1995). If the nurse assists the client in meeting the goals stated in the nursing problem, then the client will be moved toward good, optimum health. The theory helps the practicing nurse organize the administration of care, nursing strategies and provides a scientific basis for making decisions.Middle Range Nursing Theory Nursing Essay Paper

Her Typology gave birth to more nursing research and studies. The concepts are precise and straight forward, making it simple and applicable. Patient are categorized with similar client needs, than by their medical diagnosis and diseases, it helped the nurse to provide better patient care and improved critical thinking skills.

ABDELLAH’S TYPOLOGY AND THE FOUR CONCEPTS OF THE NURSING METAPARADIGM

MAN/PERSON Middle Range Nursing Theory Nursing Essay Paper

Abdellah describes people as having physical, emotional and sociology needs.

These needs may overt, consisting of largely physical needs, or convert, such as emotional, sociology and interpersonal needs – which often missed and perceived incorrectly.

The patient is describes as the only justification for the existence of nursing. The individuals (and families) are the recipients of nursing, and health, or achieving of it, is the purpose of nursing services.Middle Range Nursing Theory Nursing Essay Paper

Environment/ SOCIETY

The environment is implicitly defined by Abdellah as the home or community from which patient comes.

Society is included in planning for optimum health on local, state, national and international levels.

Abdellah further delineated her ideas; the focus of nursing service is clearly the individual. Society is integrated when she discusses the implementation.Middle Range Nursing Theory Nursing Essay Paper

HEALTH

Abdellah describes health as a state mutually exclusive of illness. Emphasis should be placed upon prevention and rehabilitation with wellness as a lifetime goal.

Holistic approach must be taken by the nurse to help the client achieve state of health.

The nurse must accurately identify the lacks or deficits regarding health that the client is experiencing. These lacks or deficits are the client’s health needs.Middle Range Nursing Theory Nursing Essay Paper

NURSING

Abdellah view nursing as a helping profession.

Is a comprehensive service that combines art and science.

Does something to or for a client or provides information that helps meet the client’s needs, increase or restores self-help ability, or alleviates impairment.

Uses the nursing process, a problem-solving approach.

Can use the 21 nursing problems as a guide for nursing care.Middle Range Nursing Theory Nursing Essay Paper

 

Nancy Roper

The model is based upon activities of living, which evolved from the work of Virginia Henderson in 1966. The activities of daily living are the key to the model, which seeks to define “what living means.” The discoveries about what living means are categorized into the activities of living to promote maximum independence through complete assessment, which leads to interventions that further support independence in areas that may be difficult or impossible for the patient on his or her own. The model assesses the patient’s level of independence in relation to the activities of living, which then helps the nurse and health care team to develop a nursing care plan based on the patient’s individual abilities and levels of independence. To be most effective, the patient should be assessed upon admission, as well as evaluated throughout care. That way, changes can be made to the care plan, if needed. The activities of living listed in the model are:Middle Range Nursing Theory Nursing Essay Paper

• Maintaining a safe environment

• Communication

• Breathing

• Eating and drinking

• Elimination

• Washing and dressing

• Temperature control

• Mobilization

• Working and playing

• Expressing sexuality

• Sleeping

• Death and dying  Middle Range Nursing Theory Nursing Essay Paper

Factors that sway activities of living are biological, psychological, sociocultural, environmental, and politico economic. These factors create the model holistic, and if they are not involved in assessment, it will be both unfinished and flawed. The biological factor is the impact of the overall health; the psychological factor is the impact of emotion, cognition, spiritual beliefs, and the ability to understand; the sociocultural factor is the impact of society and culture experienced by the individual; the environmental factor considers the impact of the environment on the patient, as well as the patient’s impact on the environment; and the politico economic factor is the impact of the government, politics, and economy on the activities of daily living.Middle Range Nursing Theory Nursing Essay Paper

NANCY ROPERS METAPARADIGM IS CONSIDERED AS ACTIVITIES OF LIVING

The Roper-Logan-Tierney Model for Nursing is a theory of nursing care based on activities of daily living, which are often abbreviated ADLs or ALs.

According to the model, there are five factors that influence the activities of living. The incorporation of these factors into the theory of nursing makes it a holistic model. If they aren’t considered, the resulting assessment is incomplete and flawed. The factors are used to determine the individual patient’s relative independence in regards to the activities of daily living.Middle Range Nursing Theory Nursing Essay Paper

They are: biological, psychological, sociocultural, environmental, and politico economic.

The biological factor addresses the impact of the overall health, of current injury and illness, and the scope of the patient’s anatomy and physiology.

The psychological factor addresses the impact of emotion, cognition, spiritual beliefs, and the ability to understand. According to Roper, this is about “knowing, thinking, hoping, feeling and believing.”Middle Range Nursing Theory Nursing Essay Paper

The sociocultural factor is the impact of society and culture as experienced by the individual patient. This includes expectations and values based on class and status, and culture within the sociocultural factor relates to the beliefs, expectations, and values held by the individual patient for him or herself, as well as by others pertaining to independence in and ability to carry out the activities of daily living.

The environmental factor in Roper’s theory of nursing makes it a “green” model. The theory takes into consideration the impact of the environment on the activities of daily living, but also examines the impact of the activities of daily living on the environment.

The politico economic factor is the impact of the government, politics, and economy on the activities of daily living. This factor addresses issues such as funding, government policies and programs, war or conflict, availability to benefits, political reforms, interest rates, and availability of public and private funding, among others.Middle Range Nursing Theory Nursing Essay Paper

The impressions of the usefulness of each theory to the practice of nursing.

The development and use of theories were meant to establish clear standards and boundaries for quality nursing care within this profession as such we being with this quote;

“Theory without practice is sterile and practice without theory is blind.”

— Karl Marx Middle Range Nursing Theory Nursing Essay Paper

The theories of Abdellah and that of Roper are the models that bring together the one centred on human needs. Though these theories were carved out of Virginia Henderson’s concept of doing for another person what he or she lacks the strength, will, or knowledge to do, (George) pg577, they also added new dimensions to the nursing practice. Besides returning that person to independence as soon as possible, they also seek to identify the patient and not just the disease being treated. Nursing care which is client- centred and involves or addresses the activities of daily living could only lead to the road of personal rehabilitation once practiced. Therefore the usefulness of both the model of nursing and the client – centred approach once explored should lead to only that of a positive.

Abdellah believed the focus of theory should be on the delivery of nursing care to the whole person. This holistic look included the physical, emotional, intellectual, social, and spiritual needs of the client and of their family. The main concepts behind this holistic theme being addressed are health, nursing problems, and problem solving. In the practice of nursing performing preventative and rehabilitative measures with wellness being a focal goal, would only help the nurse achieve a level of health for her client. Identifying the patient’s loop holes or gaps in their health when they are admitted through initial assessments, and doing this accurately would serve as guides in addressing the patient’s health needs.

In relation to nursing problems, yes they can be overt or covert in nature, but using this holistic approach making the client the centre of the care being afforded to him these problems can be identified and dealt with using nursing functions. Abdellah defines nursing as, the use of the problem- solving approach with key nursing problems related to the health needs of people. pg173. Out of this nursing diagnoses and outcomes can come into view still remaining patient oriented. The problem solving process which when looked at is parallel to our use of the nursing process to direct personalised nursing care to the client. Therefore it can only add to the accuracy in identifying and dealing with a client’s state of wellness.

Looking at the Roper- Logan- Tierney model for nursing its usefulness can be seen not only in the nursing arena but in other spheres. Ideally its use should be the thread used to link and assess planned care during the length of a patient’s care. This model which looks at the activities of daily living when coupled with the five factors that influence such activities; such as the biological, psychological, sociocultural, environment and politico-economic factors, this model would indeed benefit the one being assessed. Presently this assessment model is used to identify changes in a patient’ life due to some form of illness basically as a checklist which wasn’t its first modus operandi. Roper’s vision for using the Model of Nursing just as her counterpart Abdellah’s vision, was to accurately identify problems and solve them using this tool to plan nursing care. Roper’s stated

“The patient is the patient, they are not a different patient because they are in a different clinical area. Their needs are the same it’s who will meet those needs that changes.”

To the question of these theories and their usefulness indeed they would aid in the practice of nursing through their exposure of the covert and overt aspects of the patient’s life. Use of these two tools would aid in identifying the nursing problems the client faces and hence allow for the planned care to address these problems through the problem- solving technique. This should ultimately lead to the achievement of the nursing goal of restoration and prevention of good health.

The use of nursing theories to guide the practice of nursing is still evolving on daily basis with the movement of nursing from intuition, guess work and trial and error to the use of research and a more evidence based approach to the delivery and understanding of individualized nursing care.

Nurses then need to understand that theory should provide the foundations of nursing practice, help to generate further knowledge and indicate in which direction nursing should develop in the future. Theory is important because it helps us to decide what we know and what we need to know.

It helps to distinguish what should form the basis of practice by explicitly describing nursing. The benefits of having a defined body of theory in nursing include better patient care, enhanced professional status for nurses, improved communication between nurses, and guidance for research and education.

Struggling to meet your deadline ?

Get assistance on

Middle Range Nursing Theory Nursing Essay Paper

done on time by medical experts. Don’t wait – ORDER NOW!

Open chat
WhatsApp chat +1 908-954-5454
We are online
Our papers are plagiarism-free, and our service is private and confidential. Do you need any writing help?