Introduction
Paradigms influence the development and progress of scientific disciplines. In this context, clarifying the fundamental thesis of metaparadigm concepts facilitates a nuanced understanding of the scope of nursing and attitudes toward nursing staff (Deliktas et al., 2019). Additionally, Fawcett proposed the conceptual framework as an aspect of the structural hierarchy to address central interests in contemporary nursing by constructing practice values and concepts (Deliktas et al., 2019; Vieira et al., 2021). One such conceptual framework that interrelates metaparadigm concepts is Orem’s self-care deficit nursing theory. Nursing education should holistically integrate nursing paradigms into practice to develop a critical understanding of patient needs and for the enhanced acquisition of key nursing values and concepts.
Orem’s Self-Care Deficit Nursing Theory
Dorothea Orem developed the self-care deficit theory to guide and improve the nursing practice. The theory interrelates the theory of self-care, the nursing system, and self-care deficit (Yip, 2021). In the theory of self-care, Orem implied that self-care constitutes the activities initiated by a person to maintain their health and well-being, but under certain conditions like experiences and developmental state (Gligor & Domnari, 2020).
Further, Orem stated that the theory of self-care constitutes three self-care requisites: universal, developmental, and health deviation self-care requisites. Rezaeean et al. (2020) highlighted life processes, functional integrity, and human structure maintenance as components of universal self-care specification. The specialized expressions of these components fall under developmental self-care requisites, which can be drawn from developmental processes like adjustments to new social settings (Rezaeean et al., 2020). On the other hand, health deviation self-care requisites include the conditions affecting health status and needed in situations of illness, injury, or disease.
Following the theory of self-care, Orem asserted that patients need nursing interventions to meet their health needs, thus, the conceptualization of the self-care deficit theory. Gligor and Domnari (2020) cited that the deficits in self-care relate to the limitations preventing individuals from attaining optimum health and well-being. The theory of the nursing system further establishes how these practices can be attained through assessment, implementation, and implementation of adequate self-care. Orem recognized wholly compensatory systems, supportive-educative, and partly compensator systems as fundamental nursing systems (Mendes & Pedro, 2020). Typically, Orem’s theory provides an approach to identifying self-care deficits and defining the roles of nurses and patients in meeting self-care demands.
Nursing Metaparadigms
Nursing metaparadigms provide a holistic approach to care based on the person, their health, environment, and the nursing practice. Person refers to the recipient of care and includes patients, their families, friends, and communities (Vieira et al., 2021).
The environment concept entails the internal and external surroundings affecting the person. Deliktas et al. (2019) concurred that the environment encompasses various factors such as life experience, genetics, socioeconomic status, and political factors. The next concept, health, involves a patient and is subjective to their perspectives. Vieira et al. (2021) provided evidence that the principle further applies in evaluating the quality of life. Thus, health depends on factors like physical, social, and psychological. Finally, the nursing practice metaparadigm particularly revolves around nursing interventions. The interrelation and interdependence of these concepts help nurses to detect changes and address new challenges in care delivery.
Metaparadigm Concepts and the Self-Care Deficit Nursing Theory
Orem provides a unique take on the nursing metaparadigm based on the self-care deficit nursing theory. The theorist defined the person concept as a human, including men, women, and children, whom nurses care for as a single or social unit and the material objects used by health professionals to provide direct care (Gligor & Domnari, 2020). Orem asserted that the person’s environment has a large impact on their health, which constitutes physical, biological, and chemical features. Additionally, family, community, and culture can potentially influence health outcomes. According to Orem, health implies being functionally and structurally sound, and thus, an individual should be able to reflect on themselves, symbolize unique experiences, and communicate their care needs with healthcare providers (Gligor & Domnari, 2020). Therefore, nurses should proactively and intelligently participate in the care a person receives from a physician.
Self-Care Deficit Nursing Theory and Advanced Nursing Roles
Orem’s self-care deficit nursing theory applies to advanced nursing practice. Nurses’ primary role as per Orem’s model, is to meet self-care deficit (Rezaeean et al., 2020). Advanced practice registered nurses (APRN), including clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwives, and nurse practitioners, must be grounded in theory to guide their clinical practice. The self-care nursing theory posits that APRNs should assist patients by guiding, supporting, acting for, and providing a safe developmental environment (Gligor & Domnari, 2020; Rezaeean et al., 2020).
Furthermore, APRNs combine the roles of advocates, educators, administrators, and providers who are caring as they are compassionate, empathetic, and committed to patient advocacy. Therefore, integrating Orem’s theory in advanced nursing can improve the discipline and offer new solutions to the increasingly complex healthcare system.
Conclusion
Nurses’ perception of conceptual frameworks and their awareness of metaparadigm concepts in nursing significantly influence their professional development. Orem’s self-care deficit nursing theory shows the interdependence and interrelation between the nursing meta paradigms: person, health, nursing, and the environment. The theory provides a distinct framework for interpreting a phenomenon, such as people involved in the care system, factors affecting their health, and the role of nurses in delivering holistic care. Therefore, the nursing metaparadigm covers the outlook that defines advanced nursing practice. APRNs, from nursing practitioners to clinical nurse specialists, must integrate theoretical knowledge into clinical experiences to cope with the complexity of their professional identity.
References
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Rezaeean, S. M., Abedian, Z., Latifnejad-Roudsari, R., Mazloum, S. R., & Abbasi, Z. (2020). The effect of prenatal self-care based on Orem’s theory on preterm birth occurrence in women at risk for preterm birth. Iranian Journal of Nursing and Midwifery Research, 25(3), 242–248. Web.
Vieira, J. V., Deodato, S., & Mendes, F. (2021). Conceptual models of nursing in critical care. Critical Care Research and Practice, 1-6. Web.
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