Theory for doctoral Nursing Practice

Full Answer Section

         

1. • Health Deviation SCRs: Arising from illness, injury, or disease (e.g., managing a chronic illness, undergoing surgery).
2. Therapeutic Self-Care Demand (TSCD): The sum total of self-care actions required to meet known self-care requisites, considering health status and developmental stage.
3. Self-Care Agency (SCA): The human ability to engage in self-care, comprising two components:
   • Agency of self-care: The ability to perform self-care activities.
   • Agency of dependent care: The ability of an individual to provide care for another who is not able to meet their own self-care requisites.
4. Self-Care Deficit: Occurs when an individual’s Self-Care Agency is not adequate to meet their Therapeutic Self-Care Demand. This is where nursing intervention is required.
5. Nursing Agency: The specialized abilities of the nurse to know and meet the legitimate self-care requisites of others.
6. Nursing Systems: The methods through which nurses provide care to address self-care deficits. Orem identified three types:
   • Wholly Compensatory System: The nurse performs all self-care for the patient (e.g., comatose patient).
   • Partially Compensatory System: Nurse and patient both perform some self-care activities (e.g., patient recovering from surgery).
   • Supportive-Educative System: The patient is capable of self-care but requires assistance in decision-making, knowledge acquisition, or skill development (e.g., health education).

 

Evaluation of the Theory’s Conceptual Clarity

  While Orem's SCDNT provides a foundational structure for nursing, its conceptual clarity, particularly in today's rapidly evolving clinical practice, could be improved:

• Are the concepts clearly defined?
  • Many core concepts like "Self-Care," "Self-Care Requisites," and "Nursing Systems" are reasonably well-defined. However, the operationalization of "Self-Care Agency" can be complex. While defined as "human ability," its assessment often feels more subjective and less standardized in practice.
  • The distinctions between the three types of "Self-Care Requisites" can sometimes overlap, especially between developmental and health deviation, making it challenging for nurses to categorize precisely.
• Do the concepts relate to one another logically?
  • Yes, the core relationship between Self-Care Agency and Therapeutic Self-Care Demand, leading to a Self-Care Deficit that necessitates Nursing Agency and Nursing Systems, is logical and flows well. This provides a clear framework for identifying the need for nursing intervention.
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Sample Answer

        The ability of nursing theories to provide a robust framework for practice is contingent on their conceptual clarity and applicability to the evolving healthcare landscape. For this critical assessment, I will select Dorothea Orem's Self-Care Deficit Nursing Theory (SCDNT), a grand nursing theory that has significantly influenced nursing education and practice but, in my view, could benefit from enhanced conceptual clarity to better suit modern clinical realities.  

Chosen Nursing Theory: Dorothea Orem’s Self-Care Deficit Nursing Theory (SCDNT)

  Brief Description and Key Concepts: Orem’s SCDNT is a grand nursing theory that focuses on the individual's ability to care for themselves (self-care) and the nurse's role in assisting them when they have a deficit in this ability. Its core concepts are:

1. Self-Care: The practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being.
2. Self-Care Requisites (SCRs): The reasons for which self-care is undertaken. These are categorized into:
   • Universal SCRs: Common to all humans (e.g., air, water, food, elimination, activity and rest, solitude and social interaction, prevention of hazards, promotion of human functioning and development).
   • Developmental SCRs: Associated with developmental processes or events (e.g., adjusting to a new job, loss of loved one).