Part-1 A theoretical framework has been defined as “a basic structure developed to organize a number of concepts that are particular set of questions” (Meleis, 2011, p.28). The function of frameworks is perceived as “to provide direction for research projects” and they develop from both theory and research (Meleis, 2011, p.28)…
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Hence the framework is an evolving design that inspires and facilitates theory and gets inspired and modified by it. The major “components” of a theoretical framework have been identified and listed as given below by Fitzpatrick and Kazer, 2011): (a) concepts that are identified and defined, (b) assumptions that clarify the basic underlying truths from which and within which theoretical reasoning proceeds, (c) the context within which the theory is placed, and, (d) relationships between and among the concepts that are identified (no page number). Following the method adopted by Schmieding (2006), this researcher has adopted an “integrative nursing theoretical framework,” a framework that has the many advantages (p.463). The benefit of an integrative theoretical framework is that it can be made as comprehensive as possible through bringing in different aspects of the same topic picked up from different theories and frameworks. The benefits, according to Schmieding (2006) are that: It serves as a guide for both clinical and administrative decisions, forms the basis of the nursing philosophy, facilitates communication with patients and colleagues, helps identify congruent supporting theories and concepts, provides a basis for educational programmes, helps to differentiate nursing from non-nursing activities, and enhances nurse unity and self-esteem (p.463). My theoretical framework incorporates Callista Roy's adaptation model of nursing and the Orem self-care deficit model developed by Dorothea Orem and also a conceptual approach that nursing profession and education needs to have as their basic ethos, the values of equality and transparent communication (Masters, 2011; Hartweg, 1991). I have integrated these two theoretical frameworks because the Roy model has a patient-centered approach that anchors itself on the patient's adaptive abilities and the Orem model on the other hand focuses on the role of the nursing practitioner, by saying that it is the role of the nurse to address the self-care deficits of the patient (Masters, 2011; Hartweg, 1991). In this manner, these two frameworks together gives a comprehensive new framework that integrates the role of the patient and the nurse in nursing care. This model thus balances the possible errors involved with top down and bottom up approaches. This model also facilitates proper communication just because in the Roy model and in the Orem model, the nurses have to constantly interact with the patient to find out how the status quo is evolving and what changes in their approach is needed. The Roy model views “the person as a holistic adaptive system in constant interaction with the internal and the external environment” and observes that “the main task of the human system is to maintain integrity in the face of environmental stimuli” (as cited in Masters, 2011, p.128). The role of the nurse here is only in a supportive role and “is to foster successful adaptation” (as cited in Masters, 2011, p.128). The results of successful adaptation is understood as “optimal health and well-being, (…) quality of life, and (…) death with dignity” (as cited in Masters, 2011, p.129). This theoretical model has talked about three levels of human
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