Table of Contents
Nursing practice, as a professional discipline focused on the promotion of human health, derives from a broad pool of knowledge that comprises a plethora of theories, principles, and pieces of research evidence. In fact, theories and models drive the practice of nursing and substantially affect it. Theories significantly vary in degrees of their focus and applicability to certain situations. According to Masters (2015), “the theory that is broad in scope and highly abstract conceptually may be referred to as a grand theory, whereas the theory that has a narrow scope and is more concrete and practical may be referred to as a middle-range theory” (p. 7). Considering these differences, the present paper will have a purpose to examine how grand and middle-range theories may be applied in research, focusing on the discussion of two empirical studies that used Dorothea Orem’s Self-Care Theory and Katharine Kolcaba’s Comfort Theory. As a result of the review, it will be possible to identify the value and utility of the selected theories, as well as their impacts on nursing.
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In their study, Saeedifar, Memarian, Fatahi, and Ghelichkhani (2018) utilized Orem’s Self-Care Theory to design an educational intervention program aimed to improve self-care capacities of patients with rheumatoid arthritis. The researchers focused on the ability of the selected model to contribute to the reduction of pain – one of the main disease symptoms. Saeedifar et al. (2018) argued that since traditional methods and medications used to treat chronic pain are associated with significant side effects and high costs, self-care promotion can become a safe and effective alternative tool for pain control.
With this in mind, the researchers conducted a randomized clinical trial in which they examined the effectiveness of care systems developed based on such concepts of Self-Care Theory as a self-care deficit and nursing agency. Overall, these concepts suggest that when a person lacks abilities to engage in self-care activities in daily life, their dependence on nursing systems increases (Saeedifar et al., 2018). In other words, in the context of a self-care deficit, there is a need to implement nursing systems that would help patients maintain health and improve their self-care agency. Thus, after examining study participants’ needs (knowledge, attitudes, skills, family support, and others), Saeedifar et al. (2018) created and implemented three different types of care systems – wholly compensatory, partly compensatory, and supportive-educative – that differed in terms of content, intensity, and care duration. As a result, it was revealed that the implementation of the Self-Care Theory increases patients’ perceptions of self-efficacy and engagement in independent disease management. Therefore, it is valid to conclude that the use of Orem’s model for intervention of health-related behaviors, as well as reduction of pain in rheumatoid arthritis, can lead to positive outcomes.
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