Rasmussen Contrast two nursing models and theories assignment
Question Description
-Answer the following question in apa format:
For this discussion, in three to four paragraphs, contrast two nursing models and theories found in your reading. Discuss how they are similar or different in the way the define/discuss health and wellness, illness, the client, the environment, and nursing. Summarize by selecting the one model or theory that aligns best with your beliefs and then describe how this would affect the way in which you would practice nursing. note:refer to the roy adaption model and the The Orem Self-Care theory for this assignment please.
use the apa citing the following book for both initial discussion posts and their responses please (discussion posts 3-4 paragraphs and responses should be at least 200 wds each:
Reference
Catalano, J. T. (2015). Nursing Now! Today’s Issues, Tomorrow’s Trends, 7th Edition.Your Rating:
According to chapter 3 of our text book, the Orem Self-Care Model of nursing was developed by Dorothea E. Orem and is based on the belief that health care is everyone’s own responsibility. The aim of this model is to help clients direct and carry out activities that maintain or improve their health (Catalano, 2015). The Roy Adaptation Model developed by Sister Callista Roy, is very closely related to the general systems theory. The main goal of this model is to allow the client to reach his or her highest level of functioning through adaptation.
Although both models see clients as a human being, there are many differences. The major difference between these two nursing models can be observed in their main goals, and the way that they define health and nursing needs. The Orem Self-Care model follows the theory that clients are self-sufficient, can live life to the fullest through self-care, and only require proper guidance to maintain their own health. Whereas the Roy Adaptation model follows the theory that clients are a dynamic system with input and output stimuli, constantly adapting based upon various stimuli that are affecting them, and nursing is a multistep process that helps the client adapt and reach the highest level of functioning. (Catalano, 2015).
I personally felt that the general systems theory most closely aligned with my beliefs and thought processes. When I can break things down into several different sub-categories (systems) that all build upon a larger item it makes more sense to my brain.
Reference
Catalano, J. T. (2015). Nursing Now! Today’s Issues, Tomorrow’s Trends, 7th Edition.
For this discussion, in three to four paragraphs, contrast two nursing models and theories found in your reading. Discuss how they are similar or different in the way the define/discuss health and wellness, illness, the client, the environment, and nursing. Summarize by selecting the one model or theory that aligns best with your beliefs and then describe how this would affect the way in which you would practice nursing.
Respond to these two postings with apa format and a reference from the book citing listed above for each discussion response:
posting number 1
Compare & Contrast
There is many times when a theory and a model are used as the same thing. Often times one is confused over the other. In nursing, it happens just as much, if not more. A theory is defined as a serious of statements that is developed through a process of continued abstractions. It is aimed towards a generalized statement that is explaining a phenomenon. Now a model, is a purposeful view of reality.
The Orem Self-Care theory is based on a a relief that health care is each individual’s own responsibility. The purpose of this model is to allow clients to maintain or improve their health through out activities. The main focus in this model is the client. Health is defined as the clients ability to live as comfortable as possible at a higher level of functioning to promote the person from entering a lower life form that that of what already exists. It is important that the individual is able to carry on one of the key health care activities. They are as follow; air, water, food, excretion of waste, activity and rest, solitude and social interactions, avoiding hazards to life and well being, and being normal mentally under universal self care. The nursing goal in this model is to help and guide the client into proper self care activities.
The Roy Adaption model allows the client to reach his or her highest level of functioning through adaption. The client has a dynamic system with input and output. Health is a continuum with the ability to adapt successfully to illness. The nursing process in the Roy Adaption model is a process that helps the client adapt and reach the highest level of function for that individual.As you can see it is very easy to get the two confused. They are both similar yet different in their own ways. Each theory and model was designed with the best interest of the client in mind. They also allow the client to feel more involved in their own recovery process.
- posting number 2 below
Your Rating:
According to chapter 3 of our text book, the Orem Self-Care Model of nursing was developed by Dorothea E. Orem and is based on the belief that health care is everyone’s own responsibility. The aim of this model is to help clients direct and carry out activities that maintain or improve their health (Catalano, 2015). The Roy Adaptation Model developed by Sister Callista Roy, is very closely related to the general systems theory. The main goal of this model is to allow the client to reach his or her highest level of functioning through adaptation.
Although both models see clients as a human being, there are many differences. The major difference between these two nursing models can be observed in their main goals, and the way that they define health and nursing needs. The Orem Self-Care model follows the theory that clients are self-sufficient, can live life to the fullest through self-care, and only require proper guidance to maintain their own health. Whereas the Roy Adaptation model follows the theory that clients are a dynamic system with input and output stimuli, constantly adapting based upon various stimuli that are affecting them, and nursing is a multistep process that helps the client adapt and reach the highest level of functioning. (Catalano, 2015).
I personally felt that the general systems theory most closely aligned with my beliefs and thought processes. When I can break things down into several different sub-categories (systems) that all build upon a larger item it makes more sense to my brain.
Reference
Catalano, J. T. (2015). Nursing Now! Today’s Issues, Tomorrow’s Trends, 7th Edition.
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Here Is reading literature to support the two models:
The Roy Adaptation Model
As developed by Sister Callista Roy, the Roy Adaptation Model of nursing is very closely related to systems theory.13 The main goal of this model is to allow the client to reach his or her highest level of functioning through adaptation.
Client
The central element in the Roy Adaptation Model is man (a generic term referring to humans in general, or the client in particular, collectively or individually). Man is viewed as a dynamic entity with both input and output. As derived from the context of the four modes in the Roy Adaptation Model, the client is defined as a biopsychosocial being who is affected by various stimuli and displays behaviors to help adapt to the stimuli. Because the client is constantly being affected by stimuli, adaptation is a continual process.13
Inputs are called stimuli and include internal stimuli that arise from within the client’s environment and stimuli coming from external environmental factors such as physical surroundings, family, and society. The output in the Roy Adaptation Model is the behavior that the client demonstrates as a result of stimuli that are affecting him or her.
Output, or behavior, is a very important element in the Roy Adaptation Model because it provides the baseline dataabout the client that the nurse obtains through assessment techniques. In this model, the output (behavior) is always modified by the client’s internal attempts to adapt to the input, or stimuli. Roy has identified four internal adaptational activities that clients use and has called them the four adaptation modes:
- 1. The physiological mode (using internal physiological process)
- 2. The self-concept mode (developed throughout life by experience)
- 3. The role function mode (dependent on the client’s relative place in society)
- 4. The interdependence mode (indicating how the client relates to others)
Table 3.2 Comparison of Selected Nursing Models
Health
In the Roy Adaptation Model, the concept of health is defined as the location of the client along a continuum between perfect health and complete illness. In this model, health is rarely an absolute. Rather, “a person’s ability to adapt to stimuli, such as injury, disease, or even psychological stress, determines the level of that person’s health status.”13 For example, a client who broke her neck in an automobile accident and was paralyzed but who eventually went back to college, obtained a law degree, and became a practicing lawyer would, in the Roy Adaptation Model, be considered to have a high degree of health because of the ability to adapt to the stimuli imposed.
Environment
The Roy Adaptation Model’s definition of environment is synonymous with the concept of stimuli. The environment consists of all those factors that influence the client’s behavior, either internally or externally. This model categorizes these environmental elements, or stimuli, into three groups: (1) focal, (2) contextual, and (3) residual.
Focal stimuli are environmental factors that most directly affect the client’s behavior and require most of his or her attention. Contextual stimuli form the general physical, social, and psychological environment from which the client emerges. Residual stimuli are factors in the client’s past, such as personality characteristics, past experiences, religious beliefs, and social norms, that have an indirect effect on the client’s health status. Residual stimuli are often very difficult to identify because they may remain hidden in the person’s memory or may be an integral part of the client’s personality.
Nursing
In the Roy Adaptation Model, nursing becomes a multistep process, similar to the nursing process, to aid and support the client’s attempt to adapt to stimuli in one or more of the four adaptive modes. To determine what type of help is required to promote adaptation, the nurse must first assess the client.
Assessment
The primary nursing assessments are of the client’s behavior (output). Basically, the nurse should try to determine whether the client’s behavior is adaptive or maladaptive in each of the four adaptational modes previously defined. Some first-level assessments of the client with pneumonia might include a temperature of 104°F, a cough productive of thick green sputum, chest pain on inspiration, and signs of weakness or physical debility, such as the inability to bring in wood for the fireplace or to visit friends.
A second-level assessment should also be made to determine what type of stimuli (input) is affecting the client’s health-care status. In the case of the pneumonia client, this might include a culture and sensitivity test of the sputum to identify the invasive bacteria, assessment of the client’s clothes to determine whether they were adequate for the weather outside, and an investigation to find out whether any neighbors could help the client upon discharge from the hospital.
Analysis
After performing the assessment, the nurse analyzes the data and arranges them in such a way as to be able to make a statement about the client’s adaptive or maladaptive behaviors—that is, the nurse identifies the problem. In current terminology, this identification of the problem is called a nursing diagnosis. The problem statement is the first part of the three-part PES (problem–etiology–signs and symptoms) formulation that completes the nursing diagnosis (Fig. 3.1).
Setting Goals
After the problem has been identified, goals for optimal adaptation are established. Ideally, these goals should be a collaborative effort between the nurse and the client. A determination of the actions needed to achieve the goals is the next step in the process. The focus should be on manipulation of the stimuli to promote optimal adaptation. Finally, an evaluation is made of the whole process to determine whether the goals have been met. If the goals have not been met, the nurse must determine why, not how, the activities should be modified to achieve the goals.11
The Orem Self-Care Model
Dorothea E. Orem’s model of nursing is based on the belief that health care is each individual’s own responsibility. The aim of this model is to help clients direct and carry out activities that maintain or improve their health.14
Client
As with most other nursing models, the central element of the Orem model is the client, who is a biological, psychological, and social being with the capacity for self-care. Self-care is defined as the practice of activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being. Self-care is a requirement for maintenance of life and for optimal functioning.
Health
In the Orem Self-Care Model, health is defined as the person’s ability to live fully within a particular physical, biological, and social environment, achieving a higher level of functioning that distinguishes the person from lower life-forms.
Quality of life is an extremely important element in this model of nursing. A person who is healthy is living life to the fullest and has the capacity to continue that life through self-care. An unhealthy person is an individual who has a self-care deficit. This group of unhealthy individuals also includes adults with diseases and injuries, young and dependent children, elderly people, and disabled people. This deficit is indicated by the inability to carry out one or more of the key health-care activities. These activities have been categorized into six groups:
- • Air, water, and food
- • Excretion of waste
- • Activity and rest
- • Solitude and social interactions
- • Avoiding hazards to life and well-being
- • Being normal mentally under universal self-care
Self-Care
In the Orem model, self-care is a two-part concept. The first type of self-care is called universal self-care and includes those elements commonly found in everyday life that support and encourage normal human growth, development, and functioning. Individuals who are healthy, according to the Orem model, carry out the activities listed in order to maintain a state of health. To some degree, all of these elements are necessary activities in maintaining health through self-care.15
The second type of self-care comes into play when the individual is unable to conduct one or more of the six self-careactivities. This second type of self-care is called health deviation self-care. Health deviation self-care includes those activities carried out by individuals who have diseases, injuries, physiological or psychological stress, or other health-care concerns. Activities such as seeking health care at an emergency department or clinic, entering a drug rehabilitationunit, joining a health club or weight-control program, or going to a physician’s office fall into this category.
Environment
Environment, in the self-care model, is the medium through which clients move as they conduct their daily activities. Although less emphasized in this model, the environment is generally viewed as a negative factor in a person’s health status because many environmental factors detract from the ability to provide self-care. Environment includes social interactions with others, situations that must be resolved, and physical elements that affect health.
Nursing
The primary goal of nursing in the Orem model is to help the client conduct self-care activities in such a way as to reach the highest level of human functioning. Because there is a range of levels of self-care ability, three distinct levels, or systems, of nursing care are delineated, based on the individual’s ability to undertake self-care activities. As clients become less able to care for themselves, their nursing care needs increase.
Wholly Compensated Care
A person who is able to carry out few or no self-care activities falls into the wholly compensated nursing care category, in which the nurse must provide for most or all of the client’s self-care needs. Examples of clients who require this level of care include comatose and ventilator-dependent clients in an intensive care unit, clients in surgery and the immediate recovery period, women in the labor and delivery phases of childbirth, and clients with emotional and psychological problems so severe as to render them unable to conduct normal activities of daily living (ADLs).
“The primary goal of nursing in the Orem model is to help the client conduct self-care activities in such a way as to reach the highest level of human functioning.”
Partially Compensated Care
Clients in the partially compensated category of nursing care can meet some to most of their self-care needs but still have certain self-care deficits that require nursing intervention. The nurse’s role becomes one of identifying these needs and carrying out activities to meet them until the client reaches a state of health and is able to meet the needs personally. Examples of this level of nursing care include postoperative clients who can feed themselves and do basic ADLs but are unable to care for a catheter and dressing, and clients with newly diagnosed diabetes who have not yet learned the technique of self-administered insulin injections.
Supportive Developmental Care
Clients who are able to meet all of their basic self-care needs require very few or no nursing interventions. These clients fall in the supportive developmental category of nursing care, in which the nurse’s main functions are to teach the client how to maintain or improve health and to offer guidance in self-care activities and provide emotional support and encouragement.
What Do You Think?
Based on your experiences with the health-care system, write your own definition of client (patient). What factors led you to this definition?
Also, the nurse may adjust the environment to support the client’s growth and development toward self-care or may identify community resources to help in the self-care process.15 Conducting prenatal classes, arranging for discharge planning, providing child screening programs through a community health agency, and organizing aerobic exercise classes for postcoronary clients all are nursing actions that belong in the supportive developmental category of care.
A Three-Step Process
In the Orem model, nursing care is carried out through a three-step process. Step 1 determines whether nursing care is necessary. This step includes a basic assessment of the client and identification of self-care problems and needs. Step 2 determines the appropriate nursing care system category and plans nursing care according to that category. Step 3 provides the indicated nursing care or actions to meet the client’s self-care needs.
Step 3—the provision of nursing care (implementation phase)—is carried out by helping the client through one or a combination of five nursing methods:12
- • Acting for or doing for another person
- • Guiding another person
- • Supporting another person (physically or psychologically)
- • Providing an environment that promotes personal development
- • Teaching another person
Orem, by focusing on the individual’s ability to perform self-care, was many years ahead of her time. Current trends in health care reinforce her belief that individuals can take responsibility for care of themselves and others. The capacity for self-care is a key premise of the ACA and the more than 8000 apps that are available that deal with self-care. It might even be referred to as “Digital Orem.”
