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Criticisms of Mischel's uncertainty in illness theory
Disparities in healthcare causes a lack in
+factors that contrubute to healthcare disparities
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continuous and efficient self-care (Orem, 1991). This part is essential for current POI since it talks about requisite conditions to be considered when analyzing disparity of health care. The theory recognized five techniques of support, such as helping, acting for, directing others, setting an environment that enhances personal improvement in correlation with subsequent demands, and training of others (Berbiglia, 2011).
The third part of Orem’s theory is about the concept of a nursing process that is relevant to understanding how health care disparity can be understood through advanced nursing practice. Therefore, the three parts of Orem’s theory are essential guiding constructs applicable in assessing the current POI since they tackle all
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There are many types of these theories, but their applicability narrows down to nursing interventions for health care resolutions. For this study, “Mishel’s 1984 Uncertainty of Illness Theory” was identified as the most appropriate middle range theory since the current POI talks about disparity health care and metabolic syndrome. Newcomer (2012) explains that Metabolic Syndrome is a phenomenon defined by various collections of symptoms, instead of a clear differential diagnosis. This condition necessitates usage of Orem’s Grand nursing theory but also requires a differential theory with specific …show more content…
The theory elucidates how persons cognitively articulate sickness-related inducements and construct implications and perspectives of these events. Uncertainty is observed as the incapability to edifice connotation and create the person’s mental meaning, as illustrated a “cognitive schema for illness events” (Mishel, 1988, p. 225). The initial recapitulation of this theoretical framework explains the ideas of stimuli frame, cognitive capacities, and structure providers that are associated with uncertainty. The first concept is about symptom pattern, phenomenon congruency event familiarity; the second concept is about mental concepts; and the third concept is about credible authority, social support, education. These three components of this theory correlate with Orem’s three components and the four-elements of Fawcett’s nursing meta-paradigms. However, this theory concentrates on the cognitive uncertainty that can be directly linked to psychiatric patients. In this theory, the other concepts include opportunity, assessment, implication, illusion, and, coping procedures that lead to adaptation. Later, the procedure of philosophy derivation was implemented to modernize and review the philosophy to handle concepts associated with long-lasting uncertainty (Mishel,
The majority of our society holds the notion that nurses are no more than trained professionals, working for a doctor, who simply provide medical care for the sick and informed. However, what nursing means to me goes deeper than that belief. Nursing is a profession in which individuals are responsible for not only the care of the sick and infirmed but are also responsible for being a support system and an educator, as well as an advocate for the promotion of optimal care. In today’s society, nurses are an important part of any medical facility’s investment. This paper will address the many different aspects of nursing in which nurse’s act as not only caregivers but also act as, counselors and educators.
Marriner-Tomey, A., & Alligood, M. R. (2006). Nursing theorists and their work. St. Louis, Mo: Mosby/Elsevier.
A diverse range of elements affects patient experiences in relation to the quality of nursing care. However, nurses often have to reconcile systemic biases with their desire to provide nursing care that 's based on patient needs and preferences. Establishing autonomy over their own practice in order to improve patient experiences is considered optimal.
Mishel’s Uncertainty of Illness Theory is a middle-range theory indicating the theory is not overly broad or narrow (Black, 2014). The theory was developed from studying men with prostate cancer who were watchfully waiting for the advancing signs of their disease (Black, 2014). The theory has three main components, which incorporate: the antecedents of uncertainty, impaired cognitive appraisal, and coping with uncertainty in illness (Neville, 2003). The antecedents of Mishel’s theory are the stimulus frame, cognitive capacities and event congruence (Neville, 2003). The stimulus frame concerns three parts including: symptom pattern, event familiarity and event congruency (Neville, 2003). Symptom pattern may be when symptoms of illness present with consistency to form a pattern (Elphee, 2008). Event familiarity refers to the repetitive nature of the healthcare environment and not necessarily the physical characteristics of the disease (Elphee, 2008). Elphee also defines event congruence as the cor...
Does the theory have broad application or is the application only confined within a narrow focus? This theory can be applied to all areas of nursing because all patients experience a form of uncertainty when health is not
... M.A. (2006). Applications of Dorthea Orem's self care deficit nursing theory. In M.E. Parker (Ed.) (2006). Nursing theory and nursing practice (2nd ed., pp. 149-155). Philadelphia: EA. Davis Company.
The best way to look at nursing theories is like the foundational block. Nursing theories are important set the tone of how a nurse will practice. A nurse will use intuition, practice, past expertise and events, and couple with learned theories to work every day in order to give the best patient care. it is all the more important to appreciate what first advanced nursing beyond mechanisms of practice to becoming a knowledge-based force in healthcare: That force is nursing theory and the theoretical thinking and research that generate theory. The complexity and depth of nursing are reflected in its structure of knowledge, which includes discipline-specific components such as philosophies, theories, and research and practice methodologies”( Reed, 2006). Patient care is a wide topic, but a key role in a patient’s care is the patient themselves, an educated patient is vital to their well being and higher level of care.
I chose to do a concept analysis on ‘Self-Care.’ The nursing theory that uses this concept is Orem’s theory of nursing. This theory is a grand theory and consists of three minor interrelated theories; self-care, self-care deficit, and nursing systems. (Parker & Smith 2010). Orem defines self-care as when an individual initiates activities and performs to maintain life, health and well-being on their own and self-care deficit as not meeting adequate self-care requisites which include “limitations for knowing, deciding and producing care to self or dependent. (Parker & Smith, 2010)
The grand theory to be analyzed in this paper is Orem’s Self-Care Deficit Nursing Theory (SCDNT). The method used to analyze Dorothea Orem’s theory is Walker and Avant Theory Analysis (WAT). Theory analysis is a process of evaluating a nursing theory. The WAT is comprised of seven steps. The steps are defining the origins, meaning, logic, usefulness, details, structure and testability of the theory (McEwen & Wills, 2011). “Critical reflection of a theory determines how well the theory serves its purpose” (McEwen & Wills, 2011, p.95). Therefore, a critical reflection will be applied to the SCDNT. The purpose of this paper is to analyze and critique the SCDNT using the WAT method of theory analysis.
Dr. Merle Mishel is an American, nursing theorist who is accredited with the creation of the uncertainty in illness theory and measurement scale. She holds both a master 's degree in psychiatric nursing and a PhD in social psychology. She has accrued many distinguished awards and honors for her works showcasing her expertise in dealing with psychosocial responses to cancer and chronic illness and also the best interventions to manage the hardship and stress that can accompany uncertainty when it comes to illness. Dr. Mishel, currently she holds a position at University of North Carolina at Chapel Hill School of Nursing as a Kenan Professor of Nursing, where she continues her teachings, research and advocating of cancer patients and those with
Self awareness in nursing refers to how glowing nurses comprehend themselves, their strengths, weaknesses, attitude and ethics in order to better transact with their patients. Self- awareness includes review of self, together with self confidence. Self -regulation express beyond one`s emotion and being trustworthy. For nurses to be able to empathize with their patients and treat them with compassion, they have to be self aware. When nurses are self aware, they are capable to adapt to, or certainly change their attitudes and deed in order to understand how unusual people take care of them hence improving the nurse- patient relationship. Nurses must reflect carefully on whether they can sustain in dependence in caring for a client and whether the relationship interferes with gathering the client’s needs. It is also essential to be sure that providing care to family and friends does not interfere with the care of other clients or with the dynamics of the health care group. Before making the conclusion, the nurse may possibly wish to discuss the situation with colleagues and the employer.
Because these theory are known to have direct linkages to research and practice Most of these theory are developed from research, observation and experiences I do believe that Most nurses will agree with me if I say that the evidence based practice is a main engine for health well-being .Middle range theory signifies a growth of knowledge development in Nursing. Middle range theories offer valuable organizing frameworks for phenomena being researched by interdisciplinary terms. These theories are useful to nurses and persons from other discipline in framing phenomena of shared concern. (Archive, 2015).Middle-range theories are useful in addressing the problems of nursing, especially among vulnerable populations. Although middle-range theories address specific phenomena within nursing practice, the theories are broad enough to be applied to a variety of patient populations, and across many practice settings (Mareno, 2015). The language of middle –range theories is that used in nursing practice to deal with patient care phenomena such as pain ,unpleasant symptoms, empathy, uncertainty, comfort, change, lifestyle health promotion, relationships ,and deliberative planning for
Health psychology is a relatively new concept rapidly growing and could be defined as the biological and psychological influences affect ones behaviour also bringing in social influences of health and illness (MacDonald, 2013). Biological determinants consider genetic and biological factors of an illness whereas psychological determinants focus on the psychological factors such as why people behave the way they do when dealing with issues such as anxiety and stress. Models such as the Health Belief Model and Locus of Control were developed in attempt to try and explain psychological issues around a chronic illness such as breast cancer (Ogden, 2012). Sociological factors can cause an enormous amount of pressure for one to behave in a certain way for example gender roles in society and religious considerations when dealing with health beliefs. Health Beliefs can be defined as one’s own perception to their own personal health and illness and health behaviours (Ogden, 2012). There are also theories and models used to explain pain and coping with diagnosis such as Moos and Schaefer (1984) Crisis theory and Shontz (1975) cycle of grief people go through when being diagnosed with a serious illness.
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).
Nursing entails self- directed and cooperative health care for the society at large in all contexts. It includes the promotion of appropriate practices to enhance health, prevention of diseases,