NURSING CONCEPT ANALYSIS 1
A concept analysisin nursing is an exercise applied in making the researcher or studentfamiliar with a concept or variable. A concept is communicationthrough the application of a language using words, terms, and phrasesrepresenting the developed idea. This concept analysis will focus onthe self-care concept of the Orem Theory of Self-Care. Orem’stheory asserts that there are times when patients need toencouragement to bring out the best in them although they may be illfor long periods. This theory is applicable in rehabilitationsettings where patients need to exercise larger degrees ofindependence after nurses and physicians have taken care of them fora long time. The concept analysis will include definition andexplanation of the selected concept, a literature review, definingattributes, antecedents and attributes, empirical referents, modelcase, alternative cases, and a conclusion.
Self-care refers tovarious activities performed or practiced by individualsindependently to sustain well-being, health, life, and quality oflife. Patients are encouraged to undertake these activities in orderto enhance the recuperation and experience a state of independence,which is critical for the healing process (Wong et al., 2015).
Self-care inhealthcare is a concept that is frequently references in both theoryand clinical practice of nursing. Self-care concept arises from theknowledge that all individuals naturally need to take care ofthemselves. However, it is important to note that whereas thisassumption is true, nurses need to intervene in some situations wherepatients refuse to achieve the maximum level of independence. In thisrespect, research indicates that there is some level of diseaseprogression, which alters patients’ self-image and some patientsbecome overly dependent on their caregivers (McEwen, 2014). This ismostly in elderly female patients who have taken care of other peoplein different situations such as ailing family members and bringing upchildren. These patients hold the belief that it is their time toreceive care from caregivers. However, when a nurse or a caregiverdirects the care toward returning control to the patients, then theycan efficiently start the self-care and healing process (Wong et al.,2015).
Orem’s theory ofself-care includes various concepts: self-care, self-care agency,therapeutic self-care demand, and self-care requisites. Self-careconcept refers to the practice of actions that patients starts andperforms on their own behalf in order to enhance the maintenance oflife, health, and wellbeing. On the other hand, self-care agency isthe ability of human beings associated with capability of beinginvolved in self-care (Green, 2014). Such aspects as availableresources, health, socio-cultural orientation, life experience,developmental state, and age condition the self-care agency.Therapeutic self-care demand refers to the totality of self-careactivities performed for a given period. These activities have theobjective of meeting self-care requisites through the application ofvalid approaches and associated sets of actions and operations. Theother concept is self-care requisites, which refers to activitiesdesigned to enhance self-care. There are three categories associatedwith self-care requisites: universal self-care requisites,developmental self-care requisites, and deviation of health self-carerequisites (Shah et al., 2015).
The theory ofself-care applies a number of assumptions. One of the assumptions isthat for people to remain functional and stay alive, they need toengage in continuous communication and make connections with theirenvironment. The other assumption is that people exercise the rightto act deliberately in an effort to identify their specific needs andmake the required judgments that will sustain life and health. Thereis also the assumption that adults go through privations, manifestedin actions of care of self and others that involves functionregulating and life sustaining activities (Montreuil & Carnevale,2016). The exercise of human agency enhances the discovery,development, and transmission to other human beings the methods andmeans of the identification of needs for in addition, contributes toself and other members of the society. Structured relationshipsbetween human groups help in clustering tasks and allocatingresponsibilities for the provision of care to members of the groups(Lindberg et al., 2014).
Definingattributes, which are similar to symptoms, are crucialcharacteristics that help to differentiate a concept from otherrelated concepts and clarify the concept’s meaning. Three majordefining attributes for the concept of self-care include:
The ability to engage in behaviors and practices geared towards improving a prevalent health condition in an effort to regain full health. Self-care is associated with independence from caregivers, nurses, and physicians to ensure that an individual is capable of engaging these behaviors and practices that will sustain life (Lindberg et al., 2014).
The ability to gather information that enhances sustenance of life used by the self and applied on others. This ability also requires that a patient can independently the available information for self-care without the intervention of a nurse or physician (Montreuil & Carnevale, 2016).
Demonstrated readiness and determination of improving the sustenance of life of the individual and groups of people with the applied behaviors and practices derived from the discovery, development, and transmission of information from other reputable sources of health information (Wong et al, 2015).
Antecedents referto the attributes or events that must be present before the concept’schange occurs. There is a need for the patient to identify theexistence and need to change a problem, event, situation, orbehavior. One of the antecedents for self-care is previous healthcare administered by a nurse or physician. Although the careadministered may be sufficient and professional, it is important forthe patient to identify the need to incorporate self-care in anindependent manner. The other antecedent is that there is theexistence of activities and behaviors independently applied by thepatient to sustain life and improve the wellbeing of the individual.It is imperative to keep in mind that for the activities andbehaviors to be applicable, there is a need for the patient torecognize that he or she did not engage in these behaviors beforewhich could have prevented the current health problem (MeEwen, 2014).
Consequences referto the incidents or events that happen because of occurrence of theconcept and that can often lead to the development of new ideas forresearch related to certain concepts. Possible consequences of theself-care concept include a patient’s return to a healthierlifestyle, which subsequently leads to improved quality of life. Thepatient may also change his or her psychological perspective ofhealth and illness, which eventually results in improved healthrelated practices and behaviors. Another consequence is thepossibility of patients attaining the ability of moving beyond healthsituations towards a more satisfactory and healthier future. Thisyields positive outcomes derived from positive process (Shah et al.,2015).
Empirical referentsare ways of measuring the demonstration of the concept’soccurrence. There are available measures of self-care although theyare associated with other constructs that help in quantifying theprocess of self-care and its outcomes. The constructs are associatedwith self-efficacy, hope, and resilience among patients who practiceself-care. The first measures need to evaluate the process in amanner that points to the degree of responsibility (low to high). Thesecond measure is concerned with specific attributes to a particularhealth condition and discusses activities that occur daily inrelation to the health condition. The third measure is associatedwith ownership of the activities of self-care that reflects onindependence in terms of both behaviors and practices (Green, 2014).
Jennifer isan 18 years old female suffering from type 1 diabetes and seeksmedical care from a diabetes clinic. Over the years, Angie hasmatured into an independent adult in all aspects of life andincreasing her independence on her health care. When asked about herindependence development, she responded that she has taken theresponsibility of her healthcare as a daily activity includingchecking her glucose, adjusting insulin dose, and follow a meal plan.She also points out that this has happened gradually and she hasbecome more independent than she was when she was under 18 years old.She has also developed a responsibility of deciding when to checkglucose levels, insulin dose injected, and the kind of food she eats.She states that the first independent thing she did was to checkglucose level at home and the recent thing she has independently donewas to adjust her insulin dose after various activities. She isdetermined to have full responsibility for her health condition andnot relying on any reminders.
John is a 17 yearsold suffering from hypoglycemia and uses the services of a privateclinic. His control of the condition and follows the treatmentregimen precisely. There is a regular daily check on his glucoselevels and adjustment of his insulin dose. Tim exactly follows whathis parents inform him to do. However, he does not make anyindependent adjustments and whenever he is involved in a physicalactivity, his parents must meet him to give him the appropriate snackand check the glucose levels. His parents call him regularly toremind him to check the glucose levels. His parents are alsoresponsible for adjusting the insulin dose. However, the parents tellhim that his time to take care of his condition is when he goes tocollege.
Martin is a 15years old diabetic who seeks medical care from a private clinic. Hisglycemic control is good. However, he cannot follow the treatmentregime without assistance from his mother. His mother is responsiblefor checking his glucose levels, which is required four or five timesa day. He cannot follow a meal plan without the help of his motherand cannot make any insulin dose adjustment on his own.
Orem theory ofself-care highlights how a patient should be independent in choosingthe behaviors and activities that can help in sustaining life,wellbeing, and health. In this respect, it is imperative to note thatthe nurse has the responsibility of ensuring that the patient isapproaching this independence in a constructive manner. The caregiveris responsible for enhancing the patient’s independence throughvarious interventions. This helps the patients to achieve a level ofindependence in their care and start to engage in activities andbehaviors that will enhance the healing process.
Green, A. C. (2014, July). A Concept Analysis of Self-ManagementBehavior and its Implications in Research and Policy. In SigmaTheta Tau International`s 25th International Nursing ResearchCongress. STTI.
Lindberg, C., Fagerström, C., Sivberg, B., & Willman, A. (2014).Concept analysis: patient autonomy in a caring context. Journal ofadvanced nursing, 70(10), 2208-2221.
McEwen, M. (2014). Theoretical frameworks for research. NursingResearch: Methods and Critical Appraisal for Evidence-Based Practice,75.
Montreuil, M., & Carnevale, F. A. (2016). A concept analysis ofchildren’s agency within the health literature. Journal of ChildHealth Care, 20(4), 503-511.
Shah, M., Abdullah, A., & Khan, H. (2015). Compare and Contrastof Grand Theories: Orem’s Self-Care Deficit Theory and Roy’sAdaptation Model. INTERNATIONAL JOURNAL OF NURSING, 5(1).
Wong, C. L., Ip, W. Y., Choi, K. C., & Lam, L. W. (2015).Examining Self‐CareBehaviors and Their Associated Factors Among Adolescent Girls WithDysmenorrhea: An Application of Orem`s Self‐CareDeficit Nursing Theory. Journal of Nursing Scholarship, 47(3),219-227.