Grand and Middle Range Theory
Nursing theories have been grouped into various categories that enhance the nursing practice in health organizations. Most of these theories were developed by theorists many years ago, thus instituting major concepts and other nursing components that have improved quality care and patient outcomes. This study reviews and compares a grand theory; Dorothea Orem’s Self-Care Deficit and middle range theory; Patricia Benner’s Novice to Expert Theory.
Grand theories are broad and essential in organizing knowledge for studies, thus more applicable in nursing practice (Hjørland, 2017). Dorothea Orem’s Self-care deficit theory is comprehensive enough to help understand the concepts of self-care among patients. Dorothea’s nursing theory consists of three elements; self-care theory, self-care deficit, and theory of nursing system. Her self-care deficit theory was mainly developed to help nurses recognize those activities that help patients care for themselves and maintain good health (McEwen & Wills, 2017). It is a grand theory due to its broad information that has been applied in educating patients to be independent in sustaining their lives and wellbeing.
Middle range theories focus on a specific scope thus are narrower and can be easily tested for variables. They specify specific concepts to develop theoretical frameworks. Patricia’s Benner’s Novice to expert theory is considered a middle range theory because of its specification in developing the concepts, terminologies, and other components (McEwen & Wills, 2017). She applied the Dreyfus model and developed five stages of nursing skill acquisition; novice, expert, competent, advanced beginner, and proficient in elaborating her theory to the nursing profession.
Background
Dorothea Orem was born in Baltimore, Maryland, in 1914. She attained her diploma and degree in nursing in two Universities in 1939. Later, in 1945 Dorothea attained her Master’s Degree from Catholic University. Due to her experience, she held different positions in the nursing profession like; hospital staff nurse, private duty, and educator. Her work did not stop at the three positions mentioned above. She later became an acting dean of Catholic University in 1959, after assuming the faculty member’s role in the same University. Her interest in nursing theory emerged when she and her colleagues were assigned a role in choosing a curriculum in practical nursing for the department of health, wellbeing, and education in Washington DC. This motivated her to write her first nursing theory book in 1971. She continued developing her self-care and nursing concepts until her demise in 2007 due to complications with health. Her theory proposes that patients can sustain and function well in recovery when independent of their self-care because they can maintain life health and wellbeing independently. It is therapeutic in supporting life, health, recuperating from an illness, and dealing with the outcomes.
Patricia Benner was born in 1942 in Hampton, Virginia, in the United States. She attained her degree in nursing in 1964, then later received a Master of Science in Medical-Surgical Nursing in 1970 and a Ph.D. in 1982. She has worked in the nursing field in various departments of different hospitals, such as a head nurse and an intensive care staff nurse. She has also been a research associate based at the University of California in the nursing school from 1971-1975. She is currently a professor emerita in the Department of Physiological Nursing at the University of California, teaching and researching her nursing theory. She wrote nine books, the likes of ‘Novice to Experts and Nursing Pathways for Patient Safety, and many articles. She has dedicated her life to educating nurses, specializing in clinical nursing, writing nursing articles to help nurses understand the concepts of gaining nursing knowledge and the importance of clinical experiences in their practice. She advocates for well-structured research on nursing with evidence-based practices to help nurses compare with their current level of knowledge. Her theory has diverted the meaning of being an expert in nursing. It gives an insight into nurses’ position levels and the quality of work achieved (McEwen & Wills, 2017).
Philosophical Underpinnings
Dorothea Orem’s nursing theory is considered one of the most used grand theories in nursing practice. Her model is fundamental considering it has three other theories; theory of self-care, self-care deficit, and nursing system that helps understand the importance of self-care in improving health. Orem’s theory derives its major works on the aspect that a person is an agent and requires
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