Introduction
The vulnerability of certain groups, including in the U. S. total population, implies that they are exposed to a range of additional risk factors, compared to the groups which are not vulnerable. Considering the mentioned aspect, it is essential to implement theoretical frameworks for practice in order to achieve more efficient caregiving. The purpose of this paper is to discuss the selected vulnerable group and its current health and social issues and then to analyze the application of several middle-range theories to the mentioned issues.
Overview of the Problem
Selection of a Vulnerable Population
For this paper, it was decided to continue the investigation of the vulnerable group which was selected in the previous study. As it was mentioned previously, a vast number of people experience homelessness every year in the United States. They are exposed to a wide range of health problems alongside social inequalities, which hurt their health condition. The next section will discuss the most common disparities related to the homeless population.
Health and Social Issues of the Selected Population
Despite that it is not possible to mention all the health issues of the selected population, observation of more distinct and principal disparities could be made. First of all, HIV appears to be one of the prevalent chronic diseases that adversely affect the selected vulnerable group (Mignone et al., 2015). Secondly, it is important to mention hypertension and type-2 diabetes as chronic conditions which are significantly more stressful to handle for the homeless population due to their limited access to healthcare (Pesantes et al., 2015). The problems, which were mentioned in the previous paper (including visual and hearing impairments, foot problems, non-adherence to proper medication for chronic diseases), also have a negative influence. Therefore, it is essential to discuss the implementation of middle-range theories for the practice of caregiving for the homeless population.
Application of Middle-Range Theories to Practice
Self-Efficacy
To profoundly understand the problem of vulnerability and to propose solutions to it, it is essential to begin the investigation from the individual level. One of the middle-range theories, which could be applied to this level, is the theory of self-efficacy. The core assumption of this method is that “individuals have the cognitive ability to exercise behavioral control and create evaluation criteria to judge their abilities” (De Chesnay & Anderson, 2016, p. 118). According to the theory, four self-efficacy sources mutually influence each other: enactive attainment, vicarious experience, verbal persuasion, and physiological feedback (De Chesnay & Anderson, 2016). Several studies show that the application of these sources by nurses can have a positive impact on the health outcomes of the homeless population (Mignone et al., 2015; Pesantes et al., 2015).
Social Support
Further, it is essential to observe the issue under consideration in the context of social relationships, which include family members, friends, co-workers, and the community as a whole. Implementing the middle-range theory of social support is possible. This method argues that engagement in social relationships has a significant impact on an individual’s health status and his or her ability to cope with various diseases (De Chesnay & Anderson, 2016). Contemporary models distinguish between four primary varieties of support: emotional (comforting a person to relieve anxiety or depression), instrumental (providing goods or services), structural (involves help from the community and social networks), and functional, which is assisting with information (De Chesnay & Anderson, 2016). The implementation of that theory is significant due to the considerable deficiency of social support in the case of the homeless population (Lorvick, Comfort, Krebs, & Kral, 2015; O’Toole, Johnson, Aiello, Kane, & Pape, 2016).
Quality of Life and Resilience
Finally, it is important to discuss integrative middle-range concepts, which aim to incorporate individual and social aspects of vulnerability along with community and government support. For this study, two theories were chosen: health-related quality of life approach and resilience method.
Concerning the first theory, it is important to mention that the definition of the quality of life is significantly broad. However, the contemporary model comprises five principal aspects: “(1) biological factors, (2) symptoms experienced, (3) functional status, (4) general perceptions of health status, and (5) overall quality of life” (De Chesnay & Anderson, 2016, p. 129). Studies suggest that the improved quality of life positively affects the homeless population (Mignone et al., 2015; Haskett, Armstrong, & Tisdale, 2016).
Secondly, the theory of resilience suggests that the ability of an individual to adapt to various adversity or risk is significantly important for positive health outcomes. Resilience combines both individual protective factors, such as coping ability, competence, social connectedness, level of education, and sociocultural protective factors, including relationships with family and community support (De Chesnay & Anderson, 2016). This method can be efficiently employed to cope with exhaustion and distress, which are experienced by the selected vulnerable population (Pesantes et al., 2015).
Conclusion
In conclusion, it is possible to observe that the implementation of the middle-range theories to the nursing practice is significantly efficient. Since the homeless population is exposed to a considerably broader range of risk factors, it is essential that their needs for social support were met by the healthcare system. Additionally, the improvement of self-efficacy, quality of life, and resilience is also of high importance.
References
De Chesnay, M., & Anderson, B. (Eds.). (2016). Caring for the vulnerable: Perspectives in nursing theory, practice and research (4th ed.). Jones & Bartlett Learning, LLC.
Haskett, M. E., Armstrong, J. M., & Tisdale, J. (2016). Developmental status and social–emotional functioning of young children experiencing homelessness. Early Childhood Education Journal, 44(2), 119-125.
Lorvick, J., Comfort, M. L., Krebs, C. P., & Kral, A. H. (2015). Health service use and social vulnerability in a community-based sample of women on probation and parole, 2011–2013. Health & Justice, 3(1), 13.
Mignone, J., Migliardi, P., Harvey, C., Davis, J., Madariaga-Vignudo, L., & Pindera, C. (2015). HIV as chronic illness: Caregiving and social networks in a vulnerable population. Journal of the Association of Nurses in AIDS Care, 26(3), 235-245.
O’Toole, T. P., Johnson, E. E., Aiello, R., Kane, V., & Pape, L. (2016). Tailoring care to vulnerable populations by incorporating social determinants of health: The Veterans Health Administration’s “homeless patient aligned care team” program. Preventing Chronic Disease, 13, 1-12. Web.
Pesantes, M. A., Lazo-Porras, M., Dabrh, A. M. A., Ávila-Ramírez, J. R., Caycho, M., Villamonte, G. Y.,… & Miranda, J. J. (2015). Resilience in vulnerable populations with type 2 diabetes mellitus and hypertension: A systematic review and meta-analysis. Canadian Journal of Cardiology, 31(9), 1180-1188.