Discussion Problem:
MadHo
Discussion Post Reply #1
Grand, Mid-Range, and Situation-Specific Theory
Grand nursing theories provide broad, abstract concepts guiding nursing practice, research, and education. Mid-range theories focus on more specific nursing concerns and application to practice. Situation-specific theories are highly focused and address particular patient populations or specific health conditions of a patient. Dorothea Orem's Self-Care Deficit Nursing Theory, considered a grand theory or a situation-specific theory, and emphasizes the need for nursing interventions when an individual cannot meet their own self-care needs. In Calvin's case, his difficulty managing his asthma and his lack of adherence to allergy medications suggest a self-care deficit requiring nursing intervention (Khademian et al., 2020).
Calvin is experiencing poorly controlled asthma with possible allergic triggers and tobacco use as exacerbating factors. His inconsistent medication use and exposure to allergens suggest a need for improved asthma self-management. A suitable mid-range theory is The Theory of Chronic Illness Trajectory by Corbin and Strauss, which describes how individuals adapt to chronic conditions (Cooley, 1999). This theory is relevant because asthma requires long-term management, including lifestyle modifications and medication adherence. The theory emphasizes phases of illness, including periods of stability and exacerbation, aligning with Calvin's experience of worsening symptoms and emergency room visits. Looking for Assignment Help?
Research Article Supporting the Theory
A study by Corbin and Strauss (1991), titled "A Nursing Model for Chronic Illness Management", applies the Chronic Illness Theory to conditions like asthma (Corbin & Strauss, 1991). The study highlights that effective chronic disease management involves three key components. The first is illness work by managing symptoms, medications, and treatments. Everyday life work by adjusting routines, diet, and habits to accommodate the illness. Biographical work by redefining one's self-identity with the chronic condition. Calvin's inconsistent medication adherence and continued smoking suggest difficulties in "illness work" and "everyday life work," reinforcing the need for structured nursing interventions grounded in Chronic Illness Theory (Corbin & Strauss, 1991). Based on the Chronic Illness Trajectory Theory improving adherence to asthma medication, reducing emergency room visits, and enhancing patient education on triggers are critical. This research aligns with Calvin's needs, reinforcing the importance of patient education, smoking cessation support, and consistent medication use.
Most Useful Theory Level for Advanced Practice
For advanced nursing practice in the 21st century, situation-specific theories are the most useful because they offer a balance between conceptual frameworks and practical, evidence based applications. Situation-specific theories provide guidance for specific patient populations, conditions, and interventions, making them particularly effective in clinical decision-making. For instance, using The Theory of Chronic Illness Trajectory, an advanced practice nurse (APN) can develop personalized asthma management plans, improve patient education, and facilitate long-term behavioral changes to reduce hospitalizations and improve quality of life (Cooley, 1999).
KriJo
Discussion Post Reply #2
A grand theory is a broad explanation of a large-scale phenomenon. Examples of generalization and universal inclusion are human behavior or society as a whole. Grand theories are highly abstract, meaning they focus on very general concepts and principles. Grand theories in nursing would include broad topics such as the "nature, mission, and goals of nursing" (Meleis, 2018).
The simplest way to define mid-range theory is that it fits between broad and highly specific explanations. Mid-range theories have specific concepts or behaviors within a particular domain and are more easily observed and tested (Meleis, 2018). Mid-range theories give more specific guidance to nursing practice by focusing on substantive context that is easier to observe and access that can lead to new practice approaches that can influence positive outcomes desired in nursing (Chinn & Kramer, 2011).
The scope of situation-specific theories include specific nursing phenomena in specific populations or in a specific field. Situation-specific theories are not universal or generalized, but they do respect diversities (Meleis, 2018). These theories address unique needs of a particular group of people in a specific context. Evidence-based practice benefits from situation-specific theories since the content is most easily tested and researched (Chinn and Kramer, 2011).
In the case scenario, Calvin reports trouble breathing, chest tightness, and wheezing. Calvin is mindful of the cats at his grandmother's, but he continues to smoke. Dorothea Orem's self-care deficit theory is a theory that describes how nurses can educate patients to improve their health.
Calvin has asthma but still smokes. Calvin needs to take the necessary medication and adapt his lifestyle to prevent exacerbations of his symptoms. The theory will educate Calvin that he is responsible for controllable actions that affect his health, and that his own self-management will directly affect his health and wellbeing (Uslu & Canbolat, 2022).
Mid-range theories are the most useful because they address particular areas of care including pain management, chronic diseases, and patient education just to name a few. Mid-range theories have significant amount of research for the APRN to ensure best practice and evidence-based practice.