Draper states that medical theory is an instrument This simile, although quite crude, captures the notion of goal orientation a medical theory is said to require. Drapper focuses on two goals that a nursing theory has or must have because. First, a medical theory serves as a framework to provisionally understand some part of the medical world by determining relevant phenomena that require evaluating, and second, it recognizes a special process of medical, i. e. to postulate an excellent world of nursing. It is the combo of ideas, explanations, relations, and assumptions derived from nursing models or from other disciplines and job. Actually theory can be an idea or combination of ideas that is advised to clarify phenomena. For understanding of theory, it's important to find out about the concept, conceptual body work, and other components of the theory. Nursing theories have greater effect on today's nursing, it can help in education, nursing good care, and research. Within this paper I am speaking about the Orem theory and Roy adaption model, and will compare and contrast to conclude the better applicability than it.
Orem's theory
Every human has the capacity to perform self-care and maintain his/her health and life satisfied paradigm of the theory is individual, health, environment, and medical. Orem's theory is made up of three related theories
Theory of self-care
Theory of self-care deficit
Theory of nursing process
First is theory of self-care, Orem talks about that if person can attain all the needs have the capability for self-care. Self-care comprises those activities performed separately by a person to promote and keep maintaining personal well-being throughout life. She advised that humans are capable and responsible for taking action to adapt their health, and life. The word she provided to this capability to do something on one's own behalf is self-care company. The second is self-care deficit theory, which tells us that human beings have some need for survival, and have the capability to achieve it for health, and life. Human beings take some action to realize their needs and support life, which is called restorative self-care demand. When these activities are insufficient to satisfy all or area of the restorative self-care demand (needs), a self-care deficit advances. In this way the person is unable to perform and deal with everything she/he must maintain health, and life. Third is theory of nursing process, to build up and organize an action plan that attaches the identified difference between self-care firm and therapeutic self-care demand. " (Whitener, 1998, PG). It build-up the capabilities to meet their self-care, for example one is struggling to maintain his health. In this way the nurses can help the person to execute the needed action, or find you to definitely help out with the performance of the actions.
Nursing goal focuses to overcome individual restriction for needs and self-care. Medical process is further divided in to nursing practice and fundamental nursing science. Medical practice is dependant on observation, view and decision in medical practice. it is research based practice consciousness and critical thinking in nursing practice. Critical pondering further separate into diagnostic, prescriptive, regulatory and control analysis. Orem talks about five ways, on the basis of that nurses can help their patients in boosting self-care: operating and doing for others, guiding, promoting, promoting personal development and teaching.
Roy Medical Model
Roy developed adaptation model of medical, and establish the delivery of nursing care. Roy explain the Human beings as a set of interrelated system(psychological, biological, and interpersonal). human beings are in battle to bring equilibrium between their system and environment. Humans are facing factor (stimuli) from the surroundings, which alter the total amount between the specific and environment. Stimuli may be internal or external that assist or hinder in the process of adaptation. To create balance human beings develop coping system (tendencies) to the stressor. It is a construction between environment and human beings, and stimuli, human beings changes his functions for version. it also includes the four domain concepts of person, health, environment, and medical. In Roy's model goal for medical is to help in adaptation to boost person health, quality of life, and dying with dignity. They are four modes which she used in her model are physiological, self-concept, role function and interdependence. She used six step nursing process diagnosis of behavior, evaluation of stimuli, nursing diagnosis, goal sitting, intervention, and evaluation. It is a total process, based on which we can do evaluation and plan for intervention to receive the desire goal.
Roy's model has three basic concepts: the individual, adaptation, and medical. The individual is continually getting together with the surroundings (stimuli), and medical is the helping to bring balance and version. The individual has two major inner handling subsystems, the regulator and the cognator. " These subsystems are the mechanisms utilized by human beings to cope with stimuli from the internal and external environment. The regulator device works through the autonomic stressed system and includes chemical substance, neural, and understanding pathways. This mechanism prepares the individual for dealing with environmental stimuli. The cognator device includes emotions, understanding, control, learning, and common sense.
There are three types of stimuli focal, contextual, and residual. Important factors in all human beings version include developmental stage, family and culture. In the same way adaptation degree of the life process is described on three different levels: included, compensatory, and compromised. Adaptation is a device in which a person is coping mentally, actually, socially, spiritually and psychologically. Nursing role in adaptation process is to help you in adaptation and improve functions. Roy adaptation model has a great implication in medical care, education, and research.
Compare and comparison between the Orem and Roy medical theory
Dorothy Orem's Self-Care Deficit Theory and Sister Callista Roy's Version Model are grand nursing theories, but their applicability are the same as the middle range theory. The grand nursing theories consist of conceptual model, which find out the key point of medical investigation and keep an eye on the development of mid-range theories that will be suited to nurses and the as to other health professionals. Corresponding to Walker and Avant (2011), these ideas added in "conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives. "
Orem's HEALTHCARE Deficit Theory and Sister Callista Roy's Adaptation Model are likened and analyzed for their importance in nursing. The main target and reason for the nursing ideas is to provide medical care and attention to the human beings. Orem and Roy medical theories based on the interrelating framework, which focus on the nursing practice. Therefore these theories promote better patient good care, improve the position of nursing occupation, and help in communication between the nurses, and offer guidance to the researches and education. in both theories the medical process will be the same, first we do analysis, identify the issues, plan goal, treatment, and evaluation. They used the various word for medical but the process and strategy will be the same.
Orem and Roy used the same paradigms system which is related to nursing-person, health, environment, and nursing-are basic and important to nursing practice, however the main target is health insurance and improvement of life. Today the main focus of medical researchers is prevent disease, give medication, and implementation. These paradigm have better relation with each other, help in every treatment of medical as well as the other specialists.
In both of the models age group, past experiences, developmental, and sociocultural environment influences the individuals. These factors are straight and indirectly influence the person for self-care and version with the internal and external environment. Nurses, patients, other family members, and environment are involved to improve capabilities, possibilities to attain necessary must maintain life and progress Furthermore, Zarkowska and Clements (1994) talk about Orem's (1991) concept of the strong interplay between sociable, physical, environmental and emotional issues in relation to the adjustment of personal actions. They claim that it is through the manipulation of environmentally friendly settings, triggers, human being actions and reactions that an individual can be encouraged to adapt personal action. In both models the nurses determine patients' potential and features to attain their needs, nurse choose the most appropriate and effective process and take actions success and health.
Orem and Roy model are preventive and rehabilitative medical models. In the Orem nursing theory, she concentrate on the needs that happen to be required for sustaining life, growth and development. It can be used for rehabilitation so that as a primary health care, in which the individual is urged to be 3rd party. The main purpose of this theory is to assess the average person at different level and offer care accordingly to the needs. Roy style of version is also a rehabilitative and preventive model, relating to her medical is a service to the culture. Human beings possess the capabilities to improve the stimuli or conform the stimuli to promote health and life. Adaptation is a positive response to the surrounding environment and changes; it is the response from the individual and choice to bring equilibrium between personal and environment. Prior to the stimuli to damage the individual, individual responded to the stimuli to make adaptation. The purpose of adaptation is build coping device to achieve success, development and learning to the stimuli.
Orem's and Roy's medical theories, tackled each theory with regards to the four meta-paradigms of nursing, and finally likened the one meta-paradigm of health across both ideas. This analysis shows that Orem's theory is more occupied with activities that promote health, while Roy's theory is more worried about where in fact the patient stands on the health-illness continuum and how he can be taken to greater wholeness. It is argued that Orem nursing theory is obviously applicable; it is only a theoretical model.
Orem model only focus the individual, that all individual gets the capabilities to perform self-care. Every person will perform activities for his/ her needs to survive, maintain progress, health, and life. (Polit & Henderson p. 103). The essential basic principle of the model is that each will take responsibility for his/ her health and the fitness of other; it is the key drawback in her theory. in Roy model the there are four adaptive methods for success, physiological, role function, self-concept, and interdependence method. this means that Roy adaptive model give attention to different point of view of the patient. "In Roy's Version Model, humans are bios psychosocial adaptive systems who handle environmental change through the process of version. " (Polit & Henderson, p. 104).
Orem theory has one restriction i. e. it doesn't not consist of all areas of attention and needs of a particular customer. Therefore some dilemma and miss conception has been found with Orem theory, having unclear explanation of family, community, nurse population relationship, and general public education area. However the family, community and environment are considered in self-care action, the emphasis is mainly on the individual (Balabagno, et. al, 2006). Roy model clarify the definition of family, community, environment and nurse modern culture relationship it is the nurse role to improve capabilities in situation of health and illness and also to improve the involvement of individual systems with the surroundings, and promote survival (Roy &Andrew, 1999, p. 55)
The most notable limitation of Orem theory is that in her theory, she didn't explain well the individual psychological needs. She targets physical care and provides limited stress to subconscious care. Roy nursing model points out it very well at length, but at the same time it needs time and deep knowledge for understanding. .
Orem's theory of self-care is more suitable to acute good care configurations, whereas Roy's adaptation model is more useful in the persistent care environment as elaborated by Alligood and Tommy (2010). The diagnosis process in version model calls for longer time and frequently happens to be a repeated process for various components of evaluation. So, in acute care setting up like in crisis good care and in ICU, a less need to adaptation to stimuli is less pronounced. However, self-care model is more suitable in acute health care settings. Additionally, Self-care model combine concepts of medical process as produced by American Nursing Connection (ANA) that are espoused by North American Nursing
Application in nursing
Every theory has its implications and importance in nursing, both the theories have greater impact on today's medical, it help in education, nursing care and attention, and research. Dorothy Orem's Self-Care Deficit Theory and Sister Callista Roy's Adaptation Model are employing as a grand nursing ideas, but their applicability are the same as the center range theory. Orem and Roy medical theories predicated on the interrelating construction, which emphasis on the medical practice. These theories follow the same approaches, both the ideas help in curriculum development, and nursing health care to prioritize the nursing needs. After discourse I conclude that Orem medical theory is most effective in the scientific practice. Orem nursing theory is more suitable in hospital create and community, and predicated on the evidence starting critical decision. The self-care theory affiliates the individual assessments with medical medical diagnosis, expected patient end result, release planning, quality guarantee, medical research, and external agency information. Many studies has been done on the Orem medical theory application in various region of health. it does apply acute care items, ambulatory clinics, community, nursing homes, hospice, and treatment center. Orem theory does apply to a number of patients, specific diseases, long-term disease, alcoholic, brain and neck surgery, arthritis, and cardiac condition (Conway, McMillan, & Solman, 2006). This theory is also suitable to different age groups, children, and mother with newborns.
Conclusion
All the medical theories have their significances; nursing ideas create new methods, and method to nursing practice. Theories challenge the existing knowledge and practice, and change the framework of laws and principle. The primary reason for theory is to improve medical practice, and the target is guide the medical practice. Our company is familiar that medical techniques are totally predicated on theories. We are using these theories straight and indirectly in our practice, but it that variety of meanings and concepts make clear in nursing ideas does not predict anything. It cannot be applied to the scientific practice and have a little effect on nursing practice. All of the concepts, paradigm, and structure work guide and provide rationale for practice, but scheduled to improvement in techniques the incorporation become problematic.
