Searching and Critiquing the Evidence

Selecting a Theoretical Framework

Article Reviewed and the Theoretical Framework used to Explore the Practice Problem.

In his article, Evans (2010) explores the effectiveness of advanced practice nurse (APN)-led follow-up telephone intervention to glycemic control in patients with type 2 DM (p. 318). To ensure the effectiveness of the intervention, the study employed the interpretation of daily fasting blood glucose results. The study used the Dorothea Orem's Self-Care Deficit Theory of Nursing. The conceptual model theory has three theories expressed in it: the theory of self-care deficit, the theory of nursing systems, and theory of self-care. However, the study is based on Orem's Mid-Range Theory of Self-Care. The theory defines self-care as "a human regulatory function that people must, with deliberation, perform themselves or have performed them to maintain life, health, development, and wellbeing (p.319)". The research revealed that the bi-weekly telephone contact would help to guide individuals in the assumption of self-care and improved observance to the treatment administration.

Appropriateness of the Theoretical Framework

The framework was appropriate for the research because it provided sound guidelines to address the main purpose of the research decisively. The theory got selected for the evidence-based practice protocol (EBPP) since patients with type 2 diabetes mellitus should adhere to treatment guidelines (self-care) for them to maintain health, development, life, and well-being. Additionally, Orem's Mid-Range Theory of Self-Care is important because it is the framework which provides fundamental elements of caring. It is through periodic follow-ups that there is increased adoption of self-care among the patients which in turn ensures that they maintain their life, health, well-being, and general development (Weld, Padden, Ramsey, & Garmon Bibb, 2008). The framework is also necessary for that the nurses are able to get in touch with the patients. This is an important aspect of the nursing profession which provides an avenue for the proper administration of cure among the DM patients.

New Insights Gained

From the Orem's Mid-Range Theory of Self-Care, I could deduce several insights on the concept of self-care. The treatment process is a collaborative activity that requires collaboration between the caregivers and the patients. For chronic illness and dependent care individuals, self-care plays a central role in the treatment process. Patients should care for themselves, but the nursing intention is needed especially when there is an imbalance between self-care and self-care needs. The intervention can be in different forms. In the case of the article discussed here, the author recommends one nurse’s visit and bi-weekly follow-ups meant to ensure the patients adhere to the treatment process. The theory promotes self-care maintenance which is key in preserving well-being and maintaining physical as well as emotional stability. In everyday life, individuals maintain self-care behaviors (Plummer & Molzahn, 2009). However, the intervention of nurses is required in the event of chronic illness.

Applicability of the Theory

This theory can be applied to a practice problem in my clinical setting; I’m a critical care nurse, and I deal with patients that are in critical condition, which means that I cannot rely on them to give me information with regard to their health progress. However, in the case of Diabetes Mellitus patients, I can rely on the records made during the course of their treatment. Since the information that patients give to healthcare providers with regard to their progress is recorded, I can take a look at the records to determine the cause of the patient’s current condition. I would rely on the records of the patient’s self-care practice to assist in my decision regarding the treatment to give them.

References

Evans, M. M. (2010). Evidence-based practice protocol to improve glucose control in individuals with type 2 diabetes mellitus.MEDSURG Nursing, 19(6), 317–3 22. Retrieved from: https://search-proquest-com.ezp.waldenulibrary.org

Plummer, M., & Molzahn, A. (2009). Quality of life in contemporary nursing theory: A concept analysis. Nursing Science Quarterly, 22(2), 134–140. DOI: abs/10.1177/0894318409332807

Weld, K., Padden, D., Ramsey, G., & Garmon Bibb, S. C. (2008). A framework for guiding health literacy research in populations with universal access to healthcare. Advances in Nursing Science, 31(4), 308–318. Retrieved from: http://web.b.ebscohost.com.ezp.waldenulibrary.org