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Concept analysis is an integral element in the realm of nursing theory development. It enhances an interdisciplinary conceptual understanding of the theoretical aspects of nursing. Moreover, the theoretical framework of nursing is premised on a dynamic process that stems from an analysis and development of concepts. The selected nursing concept is self-care. It has evolved from the self-care theory by Dorothea E. Orem. This theory lays emphasis on the importance of encouraging people to be self-reliant and responsible for their well-being. The paper will define the selected nursing concept, provide a literature review on the topic, and determine attributes as well as antecedent and consequence. It will also explain the relevant empirical referents, model cases and alternative cases.
Definition of Selected Nursing Concept
Self-care pertains to the ability of patients to take care of themselves in the quest of controlling symptoms such as coughs, sore throats and other minor ailments (Blum, 2014). It entails empowering individuals with confidence and relevant information that would enable them to look after their well-being. The essence is to avoid or resolve minor health complications without the help of a medical practitioner. Self-care is an integral concept in nursing because it encourages healthy behaviors through the prevention of ill-health (Clark, 2014). This leads to an increased personal responsibility that improves people’s health and well-being. It also makes it easy to manage long-term health conditions. Self-care has recently gained widespread support from health care professionals as well as key organizations. Examples of self-care strategies include eating healthy meals, exercising often and getting enough sleep. The concept plays a critical role in holistic nursing.
According to Dorothea E. Orem, the concept of self-care revolves around behaviors learned within a socio-cultural context. The theorist acknowledges that a person’s knowledge on potential health problems is vital in the promotion of self-care behaviors (Letvak, 2014). In addition, it is important for people to practice self-reliance and responsibility in regards to their own care. Self-care theory encapsulates universal, developmental and health deviation self-care requisites (Blum, 2014). The approach in question is important because it provides a comprehensive base to nursing practice and has a utility for professional nursing.
The literature on self-care lays emphasis on the significance of self-care in professional growth and personal health. However, the concept should not be constrained to patients because nurses also need to take care of their well-being. Medical practitioners are taught to care for others as it has been engrained in their life purposes. In this respect, nurses should also embrace self-care as much as they advise their patients on how to conduct their lives (Blum, 2014). This should be achieved by engaging in productive activities that match their interests. In fact, self-care can help nurses cope with the inherent stressors they face while practicing nursing. Such factors result in psychological symptoms the impact of which can be detrimental. The stressors include being unable to provide appropriate responses to patients and dealing with bio-psychosocial problems. Other aspects include surrogate decision making, staffing patterns as well as autonomy and informed consent (Blum, 2014).
The appropriate administration of self-care paves way for the maintenance of integrity as well as functionality of humans. Similarly, the participation of patients in self-care strategies and activities can help control chronic diseases such as diabetes mellitus. In fact, patients are responsible for 95% of their treatment whereas the medical practitioner plays the other part (Neta, Silva, & Silva, 2015). However, nurses still remain with the prerogative of promoting better patients’ adherence to treatment. This involves making lifestyle changes that suit the latter accordingly as well as equipping them with skills that negate the severity of health complications. For instance, patients with diabetes mellitus should consider foot care as a primary self-care aspect. This is because it can help in the detection of early signs of a minor trauma (Neta et al., 2015). Similarly, people who wear open shoes are more vulnerable to diabetes. Choosing the appropriate footwear is also an important aspect of self-care plan. Therefore, nurses should be persistent in providing self-care plans as to as to reduce mortality from complications of the disease (Neta et al., 2015).
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Nursing practice encompasses compassionate care as nurses embrace a holistic approach in addressing the needs of their patients. Empathy makes it easier to recommend self-care practices as one shows care and concern towards the well-being of the other (Mills, Wand, & Fraser, 2014). However, it is important to acknowledge that one can be compassionate to others only if he/she is compassionate to himself/herself first. Having a genuine empathy to others is a motivation factor that compels most nurses to pursue the profession. In this regard, the concept of self-care is premised on the compassion that nurses have towards their patients. Similarly, medical practitioners should also extend the compassion and care towards themselves. However, even though quality of care and nurse’s well-being are interdependent, the compassionate care towards patients has been a pressing issue (Mills et al., 2014). Self-care is, therefore, vital for nurses and patients as it fosters empathy among both parties. It should not be perceived as selfishness on the nurses’ behalf because they also have inherent health needs. Moreover, it should not be seen as narcissism as it embeds compassionate care (Mills et al., 2014).
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Nurses are bound to accept the physical and emotional demands of their profession. They lay emphasis on caring for others and downplay caring for themselves. In fact, medical practitioners are more susceptible to tuberculosis and blood-borne pathogen infections than representatives of other professions (Letvak, 2014). This emphasizes the importance of self-care within the nursing practice. A healthy nurse lays stress on the creation and maintenance of a balance and synergy premised on emotional, personal and professional well-being. Nurses should thus consider self-care as a major aspect in assuring their own health (Letvak, 2014).
Self-care can also be a major indicator in the healthcare outcome of a patient. There is also a positive correlation between the patient’s quality of life and effective self-care administration (Rayyani, Malekyan, Forouzi, & Razban, 2014). This can be attributed to the fact that self-care is a reflection of capacity and intention and plays a major role in an individual’s well-being. Moreover, the correlation shows that nursing practitioners need to lay emphasis on the effectiveness of self-care programs they administer because it is a major element of the wellness of a person. In this case, medical practitioners can take the initiative of identifying haemodialysis patients and offer education interventions that address their conditions (Rayyani et al., 2014).
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It is equally important for nurses to create and enact a self-care advice that incorporates the physiological and ethical practices of a patient (Clark, 2014). The ethical aspect of the concept plays a major role in the decreasing stress for patients as well as the work environment. Moreover, self-care should facilitate the healing process as it gives them a rewarding element of their job (Clark, 2014).
The major characteristic of self-care nursing concept is its ability to exhibit compassion and caring for others. This is because it makes sense for people to be responsible for caring for their loved ones. Moreover, the promotion of self-care behaviors depends on individual’s knowledge on potential health problems (Clark, 2014). One more attribute is that self-care can be used in the healing process while it also ensures that patients attain self-actualization.
Another attribute is that the practice of self-care creates a different way of looking at a particular phenomenon. This is because it is multidimensional and has many different elements (Letvak, 2014). In his regard, it makes one realize that patients play a major role in their healing process whereas nurses play a minor role. Similarly, the former are responsible for adopting practices that will reduce their vulnerability to different types of diseases while the latter play a minor role in this.
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Antecedent and Consequence
The antecedent of self-care was an increasing number of patients who were not acquainted with information pertinent to taking care of themselves. In fact, health practitioners noted that the vast majority of patients were suffering from illnesses they could have easily avoided. For instance, most diabetes patients are not sensitized on how their lifestyles and food choices play a major role in the ailment (Neta et al., 2015). As a result, nurses considered incorporating the concept in the realm of nursing practice in the quest of promoting individuals’ well-being. The consequence of self-concept is that people can now make rational health decisions (Blum, 2014). They also embrace lifestyles that reduce their vulnerability to major diseases. Moreover, through self-care, most people are now exercising and embracing healthy diet plans which promote their overall health. In addition, nurses are also assisting patients in self-care programs that help them achieve their desired health results.
The presence of self-care can be measured by patients’ self-reports and assessing their quality of life. The two will provide the clinician with an observable phenomenon that measures the defining characteristics of self-care (Neta et al., 2015).
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Dionard is a thirty-five years old Hispanic male who works as an accountant in a busy airport. He is outgoing and loves partying with friends and workmates. His job also pays him well and gives him several allowances which allow him to take care of his younger siblings. The nature of his job makes Dionard very busy on weekdays and he finds it hard to prepare a decent meal as he is always tired from work. On his way from work, he picks burgers and fries from fast food joints. Dionard also drives to work daily and does not enroll in any gym program. His place of residence is in close proximity with his workplace, as it is only a fifteen minutes’ drive.
Dionard was diagnosed with diabetes. In fact, his case was serious because the condition was complicated and was leading to peripheral neuropathy. He was immediately enrolled to the medication program and his condition required him to visit a healthcare facility at least three days a week. During the frequent hospital visits, medical practitioner practiced self-care and advised Dionard how he could try to change his lifestyle to deal with his situation. After the diagnosis, Dionard became more self-conscious of his lifestyle and started practicing self-care so as to manage his condition. He also learned more about the disease and its complications. Additionally, Dionard subscribed to a gym membership program and got a professional personal trainer who helps him attain his fitness goals as prescribed by the doctor.
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Now Dionard prefers to walk to work and leaves his car in the driveway. On weekends, when he is not working, he has reduced his hangouts and takes a two hour jog every morning. Dionard also hired a house manager who would prepare his meals and he no longer relies on fast foods. His doctor is using self-care to help him acquire sole responsibility of his condition. Dionard has been monitoring his blood glucose levels and regulates his insulin intake himself. His diabetes control has been commendable so far because his glycosylated haemoglobin level does not exceed 8%. Moreover, Dionard has tested negative for any diseases related to diabetes complications. He uses his experience to advise his younger siblings how they can be responsible for their lives through changing their lifestyles and habits. Dionard’s ability to change his lifestyle to manage his condition gave him a new perspective and acknowledged that an individual himself plays the biggest role in his healing process.
Dionard has demonstrated all three attributes of self-caring concept because the health-care practitioner used self-care in his healing process. This has improved his condition and prevented further complications pertinent to diabetes. Dionard also uses his experience to care for his younger siblings by sensitizing them on how lifestyle changes can affect their health. He also followed doctors’ advice through his self-care and realized he actually played a big role in regulating his condition. This gave him a new perspective. The model exhibits antecedent and consequence because initially, Dionard led an unhealthy lifestyle without considering the vulnerability to various diseases. The consequence is that he now uses self-care to make better health-care decisions. The empirical referent in the model case is self-report and quality of life. This is because in Dionard’s check-ups, the doctor relies on his reports to determine his condition. The physician also reviews his quality of life which is reflected in his blood sugar levels and glycosylated haemoglobin level.
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Border Line Case
Mrs. Brown is a twenty-six year old lady who works as a housewife. She was diagnosed with type 1diabetes four months ago. The doctor advised her on how to take care of herself to manage her condition. She also undertook a diabetes educational program where people suffering from diabetes could share information on how to regulate their condition. However, Mrs. Brown does not adhere to her diet, exercises or monitoring her blood glucose. Even though she administers insulin on herself, she does not adjust the dosage to commensurate with the blood glucose levels.
Mrs. Brown partially demonstrates the attributes of self-care because she does not use it regulate her condition and facilitate the healing process. In addition, it does not give her a different perspective as she believes a doctor should play the biggest role in regulating her condition. However, she exhibits the attribute of caring for others as she shares information on diabetes regulation in her educational program.
Budden is a 32 year old man who works as a school driver. Six months ago, he was diagnosed with coronary artery disease. Budden underwent a surgery because the narrowing of his left coronary artery was greater than 70% during catheterization. The doctor advised him to go for regular check-ups to receive nutritional education and perform dressing changes. However, Budden did not go for any check-up and was not consistent with medication. He also turned down hospitalization program that would quicken his recuperation. Budden’s condition is now deteriorating and he is having major breathing difficulties. The case is completely opposite to self-care as it lacks any attribute. Budden does not incorporate self-care in his healing process and fails to demonstrate caring for others. Moreover, he does not gain any new perspective as he believes the doctor plays the biggest role in his healing process.
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The significance of self-care in the nursing practice should not be downplayed as it encourages individuals to maintain their health and well-being. It also provides a comprehensive base to nursing and promotes health maintenance. The concept stems from self-care nursing theory by Dorothea Orem. The theory encapsulates universal, developmental and health-deviation self-care requisites. An analysis of self-care concepts reveals that a patient plays a major role in his/her healing process. Moreover, the concept should not be constrained to the patient only but to nurses as well because they should also address their health needs. The application of nursing theory to a professional issue of concern is important because it helps generate further nursing knowledge. It also provides principles that underpin practice. Moreover, the application of nursing theory gives nurses a sense of identity.
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