Great Significance in the Nursing Discipline - Case Study Example

Application of Borrowed Theory and Middle Range Theory to Problem Application of Borrowed Theory and Middle Range Theory to Problem A theory can be defined as a set of interrelated concepts which give a systematic view about a specific phenomenon that is explanatory and predictive in nature in nature. It is usually composed of concepts, definitions, prepositions, models which are based on various assumptions. In this regard, a nursing theory is a set of definitions, assumptions, concepts and relationships derived from nursing models or other related disciplines aimed at proposing a purposive and systematic view of phenomena by designing various interrelationships among concepts with the aim of describing, explaining, predicting and prescribing (Chinn & Kramer,2010). Nursing theories have great significance in the nursing discipline. For instance, they provide elaborate descriptions and explanations of various nursing phenomena. Nursing theories also provide a foundation for the nursing practice. In this regards, the theories help in generating further knowledge and provide a ground upon which nursing as a discipline, develops. Nursing theories are helpful as they enhance better patient care and professionalism in nursing. Also, they help in improving communication between nurses as well as providing guidance for further research and education in the nursing discipline. Development of various nursing theories perpetuates the dream of nursing having its own unique body of knowledge that is distinct from medicine. Nursing theories are also important in analyzing and explaining what nurses do. From the above discussion, it is apparent that nursing theories are necessary and a prerequisite for better nursing practice. They assist nurses in describing, explaining and predicting their day to day experiences during their practice. The theories serve as a guide assessment upon which evaluation of nursing care could be based. Also, the theories provide a rationale for collecting useful data about various health matters. Such data is essential for effective decision making in the nursing practice. In our case study for instance, application of theories proved to be helpful in many ways. Various nursing theories could be applied in assisting the patient who experiences no compliance with his care at home after being discharged. This case study involves a patient who is discharged from hospital after treatment for a congestive heart failure. There is a non-compliance tendency observed in the patient. The patient depicts this through his continued smoking habit. This habit perpetuates chest pains. Specific reference could be made from Betty Neuman’s Systems Model as well as Hildegard Peplau’s middle-range theories could be applied in this situation. Beginning with the Neuman Systems Model, which is borrowed theory, focus is placed towards coming up with a better solution for the patient. The model perceives clients as being in a state of dynamic equilibrium with the environment. The environment is considered a perceptual field that surrounds each person. Neuman focuses on the stress factors and the reaction of each person to the condition that brings about the stress. She brought forth the conviction that stress factors comprise the environment, and further argues that the disequilibrium in the body system that is caused by the stress is a tension. This tension acts as the stimuli, which has the potential of causing illness to the individual that is suffering from the stress. The environment is subdivided into two components that include the internal and external factors. The internal factors comprise of the forces that occur within an individual or intrapersonal stress factor. In our case study, the example is smoking which the patient is involved in after being discharged. The external environment consists of interpersonal stress factors that result from interaction with other individuals. This is in terms of changes in the roles that can bring about stress to an individual. The physiological issues in patient perspective involve things like the ability to see, hear and have mobility. There are other things like the ability to breath, sleeping, feeling, eating, speaking and the vital signs. This variable focuses on the physiological wellbeing of the patient. On the other hand, psychological variables involve non-verbal behaviour, attitudes, coping pattern and response to stress. These things focus on the psychological status of the patient. Therefore, by ensuring that the patient psychological status is appropriate one will be able to facilitate the things that ensure the well being of the patient is considered. There are various expectations in this variable that are recognized through evaluation of the patient’s behaviors and the way the patient handles stress. Social variable reflects much on the individual’s values and culture. This is by exploring the social and cultural functions of the individual. This can be mainly approached in terms of the way this functionality influences the life of the individual. There are certain cultural believes that affect the life of a given individual negatively in terms of undergoing the medication. This is by getting involved in things that affect their well being after the discharge from hospital. The other dimension is the developmental variable, which focuses on the process of life in an individual. This is in terms of the factors that are related to the present situation and they have an influence on the situation. The developmental dimensions in the human life make them to move from one stage in life to the other as time goes by. Therefore, the main objective of this variable is to determine how this change of development is affecting the particular patient in the problem. The other variable, which is considered significant in the life of a patient, is the spiritual variable. This focuses on the aspect of spirituality on a continuum from entire awareness of an individual. The patient may also be in a condition of denial to a consciously developed high level of spiritual understanding. There is a lot of usefulness to understand the spiritual wellbeing of the patient since it can also contribute to the provision of quality health care services that will be beneficial to them. There is a way that a client perceives a stressor. In our case, the patient is concerned about the fact that he had experienced the chest pain. This problem interfered with the way he undertook his daily activities before he was hospitalized. The patient can even find it hard to do all he wanted to do. This experience with a health problem is difficult to describe how he is planning to deal with other situation. His expectations are to carry on with his daily routine after being discharged from the hospital and recovering. It would be definitely a source of stress if he does not manage to accomplish what he intends to after the experience with the illness. There is also a way in which a nurse perceives the stressors, which is different from the perspective of the patient. The perception is through assessment of the patient by the nurse concerning the problem he is experiencing. According to the nurse perspective, the patient is not able to alter the way of living after the hospitalization. This becomes the reason why the patient is still suffering from the chest pains. It is evident that the patient will be continuing with the initial habit of smoking and he is still bound to continue experiencing the pains in the chest. This is despite the fact that the individual has never coped with the same problem in the past. Therefore, the nurse perceives the stressor as being the behaviours that the patient gets involved in after the discharge from the hospital. There are short-term goals that the nurses focus on achieving in order for them to ensure that the patient has received quality health care. One of these goals is for the patient to stop suffering from this chest pains. The other goal is to make the patient to learn to live in a way that will facilitate his recovery. The next goal is to facilitate the increase of the tolerance of the patient to his daily activity. There are also some long-term goals that the nurses are focused on achieving in terms of treating the patient. These long-term goals entail the creation of an optimal degree of harmony and balance between his external and internal environment. This is in terms of smoking habit seizing, attaining the deal weight and development of a lifestyle which commensurate with a satisfying and fulfilling retirement. The nurses are also bound to prevent the invasion of stressors by providing the resources that strengthen the patients system and coping with positive functioning, together with motivating the patient and using stress as a positive intervention strategy. The nurses can also engage in mobilizing the patient’s internal and external resources focusing on the achieving stability. They can also seek to maintain the stability through educating and reorienting the patient’s system as required. The other theory applied in the case study is the middle range theories. The theories base their focus mainly on the emotional aspects such as grief, pain, guilt and hope as experienced during nurse-patient interactions. Relevant to our case study are three middle-range theories: the symptom management theory, the unpleasant symptom theory and finally, the story theory. Symptoms management theory determines the intervention strategies using a systematic approach. This could be achieved through the use of questions. The theory affects the symptoms experience as well as patient’s outcomes .Within the system management model, there is an interrelationship between the person, health state and the environment. There is also a further interrelationship between evaluation, perception and response within the symptom experience. The interrelationship can be depicted in an instance involving the patient in the case study undergoing pain. In such a situation, the patient’s perception as well as response to the symptom affects evaluation. For example, if the patient feels that the pain he veneering is not bad, he may claim that he needs no medication just yet. Even so, the ideas vindicated by the symptoms management theory regarding the interrelationship of health status, environment and the patient are only meant to offer a guidance in the nursing decisions when handling patients veneering pain. The second theory is the unpleasant symptoms theory. Unpleasant symptoms could be defined as subjectively experienced indicators the affect performance. Unpleasant symptoms are described by timing, intensity, quality and distress. They are influenced by situational, physiological and psychological factors. Consequently, the affected performance outcomes can eventually influence the symptom experience as well as the accompanying factors which affect that experience. This theory also talks about the concept of symptoms clusters. In this regard, the theory assumes that people in totally unrelated situations can experience similar symptoms. Also, the theory assumes that symptoms are individual phenomena which occur in family and community contexts. The final theory is the story theory. Here, a story is described as an active process by which a person recognizes him/herself in relation to others through deliberate nurse-patient dialogue. Such a story presents itself in the course of a purposive conversation between a patient and a nurse regarding a certain health challenge. A nurse, for instance, may prompt a patient to tell about what he/she (the patient) knows about a specified health challenge. This could be done by simply a nurse posing questions relating to that issue. This way, the nurse gets a chance to hear about all the prevailing issues about that condition from the patient’s purview. The process of story gathering is also known to cause some sort of a relief feeling. The theories may be applied in our case study. In regards to symptom management theory, the patient can be channelled through a series of questions. These questions will end up providing information upon which assessment could be made. The information gathered will also be a prerequisite in defining intervention .With specific reference to unpleasant symptoms theory, the patient can be taken through a symptoms assessment, symptom relief intervention and symptom management process. Finally, with regards to story theory, the patient can be prompted by a nurse to tell what he thinks about the chest pains. Basing on what the patient will say, the nurse gets a chance to hear about all the prevailing issues about the chest pains from the patient’s purview. This process may end up causing some sort of relief to the patient. In conclusion, the two theories Neuman’s Systems Model and middle-range theories could be applied in various health situations. It is apparent that no single theory is eminently above the others. Thus, different theories guide different actions. Each of the theories offers a distinctive and lofty viewpoint and facts through which a health matter could be evaluated and addresses. These pieces of facts could be interwoven into a rudimentary base of knowledge that could bring palpable results in a myriad of health situations. References  Aylward, P. D. (2006).  Betty Neuman: The Neuman systems model and global applications: In Parker, M.E. Nursing theories and nursing practice. (2nd ed, pp. 281-294). Philadelphia: F.A. Davis. Chinn, P. L., & Kramer, M. K. (2010). Integrated theory & knowledge development in nursing: Chinn, integrated theory and knowledge development in nursing. (8 ed.). Philadelphia: Mosby. George, J. B. (2010). Nursing theories: The base for professional nursing practice. (6 ed.). New Jersey: Prentice Hall.  Lowery, L (Ed). (1988). The Neuman systems model and nursing education : Teaching Strategies and Outcomes. Indianapolis: Sigma Theta Tau International Center for Nursing Press. Neuman, B. & Fawcett, J. (Eds.). (2002). The Neuman systems model (4th. Ed). Upper Saddle River, NJ: Prentice Hall Peterson, S., & Bredow, T. S. (2008). Middle-range theories: Application to nursing research. (2 ed.). Baltimore: Lippincott Williams & Wilkins. Smith, M. J., & Liehr, P. R. (2008). Middle range theory for nursing. New York: Springer Publishing. Read More