Theories and conceptual models from nursing and related fields for use in advanced nursing practice.

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• Example (Grand Theory - Martha Rogers' Science of Unitary Human Beings): While highly abstract, Rogers' theory encourages an NP to view the patient as an integral, irreducible energy field continuously exchanging with their environmental energy field. This perspective moves beyond a reductionistic view of illness to consider patterns of wellness and illness as manifestations of the human-environment energy process. In practice, this might mean an NP focuses not just on a patient's hypertension, but on the rhythms of their daily life, their stress patterns, their perception of their health, and their interconnectedness with family and community, as all contribute to their overall energy field and health potential. Assessment questions would explore these broader patterns, leading to a more holistic diagnosis of human responses rather than just medical diagnoses.

 

2. Guiding Intervention and Care Planning

  Theories provide a rationale for selecting specific interventions and developing individualized care plans. They help NPs understand why certain approaches might be effective for a given patient or population.

• Example (Middle-Range Theory - Dorothea Orem's Self-Care Deficit Theory): This theory is highly applicable to NPs, especially in chronic disease management or health promotion. It posits that nursing is required when individuals are unable to meet their own self-care requisites. An NP applying Orem's theory would systematically assess a patient's self-care abilities (universal, developmental, and health deviation requisites). If a deficit is identified (e.g., an elderly patient with heart failure struggling to manage their medications and fluid intake), the NP would design interventions to support the patient's self-care agency. This could involve direct assistance, guidance, support, providing an enabling environment, or teaching. The goal is always to move the patient towards greater self-care independence, leading to better adherence and improved health outcomes.

 

Sample Answer

          Evaluating theories and conceptual models from nursing and related fields is fundamental to advanced nursing practice. As an Advanced Practice Registered Nurse (APRN), specifically a Nurse Practitioner (NP), these theoretical frameworks are not abstract academic exercises; they are essential tools that guide clinical decision-making, shape intervention strategies, inform research, and provide a unique disciplinary lens through which to understand and respond to complex patient and population health needs. Here's an evaluation of their use in advanced nursing practice:  

1. Providing a Framework for Holistic Assessment and Diagnosis

  Nursing theories and conceptual models guide the NP in conducting comprehensive assessments that go beyond mere physiological symptoms. They prompt the NP to consider the patient within