The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories.
The grand nursing theories are a conceptual model, which identifies the focal point of nursing inquiry and guide the development of mid-range theories that will become useful to nurses and also to other health professionals. According to Walker and Avant (2011), these theories contributed in “conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives.” In this essay, Orem’s Health Care Deficit Theory and Sister Callista Roy’s Adaptation Model are compared and analyzed for their importance in nursing. Orem’s Self-Care Deficit Theory
Orem’s Self-Care Deficit Theory is one of three grand theories written by Dorothea E. Orem. According to Orem, nursing becomes necessary when an individual can no longer care for him or herself. Nursing provides care through acting, guiding, supporting, teaching, and environmental manipulation promoting personal development. Orem developed this theory from her experience and personal connection with the Vincentian-Louisiana nursing tradition of the Daughters of Charity (Libster, 2008.)
Roy’s Adaptation Model
Roy’s Adaptation Model provides the framework for nurses by viewing the adaptability of patients to internal and external stimuli in their environments (Alligood & Tomey, 2006.) Reponses to these stimuli can be either adaptive, which promote the goals of “human survival, growth, reproduction and mastery,” or non-adaptive (“Roy’s Adaptation,” 2011.)
The metaparadigm for nursing is the concepts that define the nursing practice. Since 1970s, person, nursing, health, and environment are considered as the core concepts of nursing theories by many nursing theorists.
According to Orem, a person is made of a physical, psychological, and social character with variable degrees of self-care ability (“Dorothea Orem’s Self,” 2011.) Roy views a person as “an adaptive system that responds to internal and external stimuli in their environments” (Alligood & Tomey, 2006.)
Orem and Roy have the different attitude toward the concept of nursing. Orem sees nursing as an intervention to meet the daily needs for self-care and medical-care patients need (“Dorothea Orem’s Self,” 2011.) Roy believes nursing as a key player to help patients to develop coping mechanism and positive outcome from the constant stimuli exposure. Roy’s goal is for the patient to achieve adaptation leading to optimum health, well-being, quality of life, death with dignity, and finding in life by participating in their own care (Roy & Andrews, 1999.)
Orem defines health as “physical, mental and social well being” (“Dorothea Orem’s Self,” 2011.) Roy views health as a method used by patients to obtain their utmost possible health regardless of the presence or absence of disease.
Orem and Roy both state the individual exists in an environment. Orem sees the environment in two dimensions, the physical, chemical, biologic features and socioeconomic features, which influence the self-care requirements of the individual (“Dorothea Orem’s Self,” 2011.) According to Roy, the environment consists of stimuli including conditions, circumstances, and influences surrounding an individual, whether focal, contextual, or residual.
Orem’s Self-Care Deficit Theory and Roy’s Adaptation Model can be applied to groups or individuals, and used at any nursing settings. However, Orem’s Self-Care Deficit Theory is more recommended for the acute-care setting, where a patient receives active but short-term treatment for a severe injury or episode of illness. Orem focuses on finding the self-care deficit of the patient and providing the necessary care to promote his or her well-being. Whereas, Roy is concerned with the different stimuli that forces adaptation in order to achieve optimal health. Roy’s Adaptation Model views the person as an adaptive system which includes the four adaptive modes. These adaptive modes are: physiological-physical mode, self-concept-group identity mode, role function mode, and interdependence mode. Although first two modes can be identified immediately, the assessment of role function mode and interdependence mode is time consuming. Therefore, Roy’s Adaptation Model is not suitable for acute-care setting.
Having defined nursing theories promotes better patient care, improve the status of nursing profession, and improve the communication between the nurses. In addition to guiding the nurses to provide the best care to the patients, nursing theories are used to promote and guide baccalaureate programs, administration and nursing research. Many organizations now exist to support the advancement of nursing profession. Sigma Theta Tau International, the Honor Society of Nursing, is created to “support the learning, knowledge and professional development of nurses committed to making a difference in health worldwide” (“STTI Organizational,” 2011.) International Orem Society “promote the advancement of nursing science and provide scholarship in the area of Orem’s Theory of Self-Care Deficit Nursing to lead to further advancement of knowledge for the discipline of nursing” (“International Orem,” 2011.) The Roy Adaptation Association (RAA) is a society of nursing scholars who want to “advance nursing practice by developing basic and clinical nursing knowledge based on the Roy Adaptation Model” (“Roy Adaptation,” 2011.) These organizations along with progression of the nursing theories will promote the advancement of nursing science and enhance the nursing profession.
Alligood, M., & Tomey, A. (2006). Nursing Theory: Utilization & Application (3rd ed.). St. Louis, MO: Mosby. Dorothea Orem’s Self-Care Theory. (2011, October 14). Retrieved November 6, 2011, from Nursing Theories Web site:
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html International Orem Society for Nursing Science and Scholarship. (2011). Retrieved November 6, 2011, from http://www.orem-society.com/ Keefe, S. (2011). About Nursing Theory. Retrieved October 22, 2011, from eHow.com Web site: http://www.ehow.com/about_5471364_nursing-theory.html Libster, M. (2008). Perspectives on the History of Self-Care. Self-Care and Dependent-care Nursing the Official Journal of the International Orem Society, 16(2), 8. Roy Adaptation Association. (2011, October 27). Retrieved November 6, 2011, from http://www.bc.edu/content/bc/schools/son/faculty/featured/theorist/Roy_Adaptation_Association.html Roy, C., & Andrews, H. (1999). The Roy Adaptation Model (2nd ed.). Stanford, CT: Appleton and Lange. Roy’s Adaptation Model. (2011, April 22). Retrieved November 5, 2011, from Nursing Theories Web site: http://currentnursing.com/nursing_theory/Roy_adaptation_model.html STTI Organizational Fact Sheet: Mission and Vision. (2011). Retrieved November 5, 2011, from http://www.nursingsociety.org/aboutus/mission/Pages/factsheet.aspx Walker, L. O., & Avant, K. C. (2011). Strategies For Theory Construction in Nursing (5th ed.). Upper Saddle River, NJ: Pearson Health Science.
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