Nursing practice can be based on empirical evidence from the past or nursing theories describing an integrated approach to nursing. For this critique, an article by Yip has been selected in which an advanced nurse used practice based on Orem’s general self-care deficit patient care theory (SCDNT) (2021). The author explains the choice of this theory by the fact that previously only certain aspects of this theory were studied, but not its complex application. This fact can be singled out as a research problem.
The study aimed to find out the global understanding of the philosophy of this theory and how the theory is applied to patient management in practice. The literature review of this article confirms the positive impact of selected aspects of SCDNT on patients with migraines and multiple sclerosis (Yip, 2021). In addition, these experiments create a theoretical foundation for this study to obtain practical recommendations based on positive dynamics. Using the example of an asthma patient and a nurse using SCDNT, questions are raised about using the strengths of this theory, monitoring patient compliance with all prescriptions, and presenting the patient as a representative of the wider family and society.
The nursing framework is reflected in the nurse’s many years of experience dealing with similar conditions. The variables were taken as indicators of the four primary operations of this approach: diagnosis, prescription, treatment, or regulation, and case management (Yip, 2021). In addition, the patient had to monitor his health indicators with particular devices, such as a peak flow meter, and administer the dosing of the inhaler.
The account also includes the social aspects of the case, for example, the patient’s dependence on his own family, which is not described in detail in Orem’s original theory (Yip, 2021). Consequently, the relevance and validity of this study are supported by a review of the literature, which has proven the usefulness of this approach in the management of patients with chronic lifestyle-related diseases. Efficiency is achieved by an integrated approach, partly expanding this theory. The nurse showed more responsibility, was able to find an approach to the patient that began to look after herself better – the issue was resolved.
The legal and ethical issue of this study is not addressed directly in the article. The involvement of the patient’s wife paid off. Preliminary and subsequent negotiations made it possible to arrange the use of the patient’s wife’s time and energy in advance. As representatives of the same family, their mutual concern is not discussing rights and obligations since this is their own business, and they are not strangers to each other. The nurse’s competence can be noted in the fact that she found the necessary lever of pressure on the patient through his social dependence, which is fully justified by the results of treatment. The cultural aspect of the study also lies in the complex consideration of each case from the point of view of the sociology and psychology of the patient.
The sample patient with asthma was initially unable to answer the essential questions of self-esteem and recognition of the disease. Nurse procedures aimed to transfer relevant knowledge and skills of health control to the patient, while dialogues developed the patient’s own management decisions (Yip, 2021). Finally, the involvement of a wife allowed for the creation of a coordinated care system. The results showed that the patient successfully applied the acquired skills and improved his health indicators.
For nursing practice, these research results bear a confirming nature of the positive influence of this theory. In addition, this case reveals one of the needs of patients, which is not spelled out in the original text of Orem. Given the growing concern about the increase in chronic disease, this kind of humanistic, holistic care will implications for future practice. Such research allows students to take a fresh look at practice, allowing them to consider the social aspects that improve the positive results of the theory.
Reference
Yip, J. Y. C. (2021). Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem’s Self-Care Deficit Nursing Theory. SAGE Open Nursing, 7. Web.