Nursing is a practice or field that must be based on nursing theories, which contributes to the consideration of nursing discipline as a profession. The significance of nursing theories in the practice is attributed to their provision of direction and guidance for arranging professional nursing education, research, and practice. Nursing theories also distinguishes the focus of this discipline from other professions since they provide directions regarding evaluation, assessment, and intervention of nursing care. Nursing theories also provide the basis for gathering reliable and valid data about clients' health status that is crucial for effective decision making and implementation. Notably, these theories are based on certain concepts that are essential for guiding nursing practice. While nursing theorists have developed different theories and models, these theories or models are based on some common core concepts.
Core Concept in Two Contemporary Nursing Theories
The understanding of nursing theories first requires the definition of a conceptual model, concept, and conceptual frameworks. This is primarily because concepts act as the building block of the theory as well as mental images or abstract ideas of phenomena (Cruz, n.d.). In addition, a conceptual framework provides a general outlook or orientation to focus thoughts since it is a collection of related concepts. On the other hand, a conceptual framework is a diagram or graphic representation of a conceptual framework. There are four basic concepts in nursing, which are commonly referred to as nursing metaparadigms. The four basic concepts in nursing are the individual, environment, health, and nursing.
An example of a core concept across two contemporary nursing theories i.e. Dorothea Orem's Self-care Deficit Nursing Theory and Virginia Henderson's Need Theory is nursing. Nursing is a core concept or metaparadigm that describes the process of caring for the health of individuals and helping them meet their needs while providing education of the basics of caring for themselves. Generally, nursing is a profession or discipline that focuses on promoting good health and healing, preventing diseases as much as possible, and relieving suffering of patients who are dying. Nursing metaparadigm goes beyond the boundaries of the health care facility or organization to cover the community and society in its entirety. This is largely because the concept considers individual health and the environment as factors that are closely related. Therefore, the concept is defined as care that is designed based on the health needs of individuals and provided in way that is effective and efficient (Lake, n.d.). Orem's Self-care Deficit Nursing Theory and Henderson's Need Theory have nursing as the common basic concept or metaparadigm that their models are based on.
Comparison and Analysis of the Concept
Dorothea Orem's Self-care Deficit Nursing Theory is based on three interconnected theories or models i.e. The theories of self-care, self-care deficit, and nursing systems (Wanchai, Armer & Stewart, 2010, p.8). This theory postulates that individuals learn and carry out actions that assist them to safeguard human functioning and integrity. This is geared towards the promotion of normal life and well-being as well as controlling, preventing, and recompensing for injuries and disease that affect a person's life. The theorist argues that every individual has the capability or power to participate in self-care through a process known as self-care agency. Self-care agency is a process that can be influenced by some basic conditioning issues like health state, age, socio-cultural factors, gender, health care system, and state of development. Furthermore, self-care agency is also affected by the ability to control body positioning, ability to make decisions regarding self-care, ability to combine self-care operations, and ability to obtain, retain and utilize technical knowledge.
The Need Theory by Virginia Henderson focuses on the significance of patient autonomy in order for the patient to continue progressing upon release from hospital. In this case, the theorist describes the role of the nurse as complementary, substitutive, and supplementary. Complementary role involves working with the patient perform a certain function or role while substitutive involves doing something for the patient and supplementary role involves assisting the patient to perform something. These varying roles ultimately enable the patient to become as independent as possible once he/she has been released from the health care facility. Her emphasis on these roles was based on her belief that the distinctive function of nurse practitioners is to assist patients in carrying out activities that result in improve health or recovery of health (Henderson, 1991, p.16).
In her theory, Virginia Henderson classified nursing activities into more than ten components that are based on human needs. These components included physiological, psychological, and sociological components that are associated with various factors on human needs. Notably, the theory incorporates the four basic concepts or metaparadigms of nursing because it addresses various stages of the nursing process.
As previously mentioned, Orem's Self-care Deficit Nursing Theory and Henderson's Need Theory have one common core concept i.e. nursing. The commonality between these different nursing theories is their efforts in defining the role of nursing across health practices. While Henderson "s theory provides a definition of nursing, Orem's theory was developed based on her experience and intention towards enhancing the quality of nursing in general health care facilities in her state. This implies that these nursing theorists created concepts and/or models that endeavored to define the nursing discipline as a profession. The focus on nursing practice and discipline is the core foundation for the formulation of these theories and the promise within which their concepts and models are established.
Despite focusing on the same metaparadigm or basic concept, the two theories differ on various issues related to the concept. An analysis of their definitions and focus on nursing shows differences in how nurses should intervene in the care process, the definition of a patient in need, and when nursing should provide support to the patient. In relation to the definition of a patient in need, Henderson argues that a patient in need emerges when a person is either healthy or sick. On the contrary, Orem does not necessarily focus on defining a patient in need but suggests that such an individual can be identified based on determination of self-care deficits.
Secondly, Orem's Self-care Deficit Nursing Theory suggests that a patient should have a deficit for nursing support. This implies that the nursing process would involve a method to identify the self-care deficits before the roles of the individual or nurse in meeting these demands are defined or determined. The nursing process involves assessment, diagnosis, planning through scientific grounds, implementation, and evaluation. In contrast, Henderson's classifies the roles of nurses into three categories i.e. substitutive, complementary, and supplementary as previously discussed. These categories are identified based on the physiological, psychological, and sociological human needs. Given the difference of the goals or objectives of the concepts, the theories or models are applicable in different nursing settings.
Nursing Theory and Its Applicability
Virginia Henderson's Need Theory is a nursing concept or model that is applicable in different nursing settings. The theory was formulated on the basis that a patient should have the ability to take care of himself/herself upon release from hospital as the patient receives treatment and recover. While nurses should care for the patient, they should also focus on assisting the patient to become autonomous in order to achieve their goals and landmarks on the recovery path towards optimal health. The concept deals with this issue and assists nurses to help patients toward caring for themselves upon release from the health care facility.
The concept statement of this theory is that it clearly distinguishes nursing from medicine by focusing on the need for patients to be independent in taking care for themselves after being released from the health care facility. Actually, the model is based on the exceptional function of the nurse to help the person in performance of care activities that contribute to improved health and recovery. The patient should be encouraged to carry out such activities in a similar manner as he/she would do without any assistance if he/she had the necessary strength. This will in turn enable the patient to have fewer setbacks in the recovery process and smoother transition into self-care ("Virginia Henderson -- Nursing Theorist," n.d.).
As previously indicated, Virginia Henderson's Need Theory incorporates the four metaparadigms in nursing. In relation to the individual or client, the theory states that mind and body are interconnected and cannot be separated and presents the patient as the sum of all biopsychosocial needs. The concept also examines the sociological, biological, spiritual, and psychological components of health based on basic human needs.
With regards to the environment, the theory states that basic nursing care entails offering conditions or situations through which the patient can carry out various activities related to the fourteen components based on human needs. However, Henderson's concept minimally examines the effect of the society on the patient and family. Therefore, it relatively ignores the external situations and influences that have significant effect on life and development. The basic nursing care provided based on the theory takes place in settings in…