Evaluating Research for Evidence-Based Nursing Practice, Article Critique Example

Abstract

The paper discusses a scholarly article from a nursing journal that uses a nursing theory. The article involves the use of Orem’s self-care deficit theory. The article includes a research component. The goal is to provide a critique of the article. The identification of the theory is included. The paper provides a brief evaluation of the theory itself and its relevance for the discussed research article. The inconsistencies and limitations of the article are evaluated and discussed.

Introduction

Diabetes is fairly regarded as one of the most serious chronic health conditions. 20 million of people have been diagnosed of diabetes in the United States, with one million likely to be diagnosed each year (Kumar, 2007). Long-term complications of diabetes are extremely costly, and pharmacological interventions alone cannot reduce the negative impact of diabetes on the individual health outcomes (Kumar, 2007). Self-management is of vital importance for health and wellbeing of every patient with diabetes.

In her article, Kumar (2007) discusses the relevance and importance of self-management in diabetes patients. The case of Stella C., an obese 49-year-old patient with type 2 diabetes is used to illustrate the benefits and limitations of self-management techniques (Kumar, 2007). Stella reported having numbness and pain in her lower extremities, but the vascular surgeon ruled out peripheral vascular disease and Stella was referred to the CNS diabetes educator for diabetes education and self-management skills (Kumar, 2007). For the purpose of her analysis, Kumar (2007) uses Orem’s self-care deficit theory. Orem’s idea of self-care serves the fundamental aspect of the conceptual framework for Kumar (2007). Orem’s theory of self-care covers and includes the four basic client-related concepts – self-care, self-care agency, self-care deficit and therapeutic self-care demand (Kumar, 2007). Orem’s theory treats self-care as the practice and activities that are initiated voluntarily by adults, to maintain their health, life, and wellbeing (Kumar, 2007). Orem grounds her theory on the assumption that healthcare professionals alone cannot know what is best for their patients and clients, whereas habits and family patterns produce significant influence on how individual patients comply with their therapeutic regiments (Kumar, 2007). Placement in individual family constellation affects individuals’ abilities for self-care (Kumar, 2007).

Orem treats the concept of self-care agency as the power of individuals to engage in self-care (Kumar, 2007). As a result, the person who engages in self-care is a self-care agent (Kumar, 2007). Therapeutic self-care demands are the actions the individual has to perform to engage in self-care and maintain his life, health and wellbeing (Kumar, 2007). Here, self-care deficit means the difference between the self-care agency and self-care demand. Kumar (2007) writes that self-care deficit is needed to make nursing care legitimate (Kumar, 2007). Kumar (2007) describes Stella as an individual in a state of self-care deficit, who requires guided assessment and the identification of the required health outcomes related to her management of diabetes. Kumar (2007) finds out that theory-based nursing care enhances patients’ ability to self-manage diabetes. Nursing theory enhances communication between clients and nurses and supports the patient’s ability to self-manage chronic illness (Kumar, 2007).

That nursing theories play a vital role in the development of effective nursing interventions cannot be denied. Actually, nursing theories lay the foundation for the creation and implementation of enhanced nursing solutions, which are particularly important for patients with chronic health conditions. Unfortunately, the multitude of nursing theories makes it difficult to choose the best theoretical framework. Moreover, Orem’s theory itself reveals several essential inconsistencies, which may turn into a serious barrier in the nurses’ way to using the theory in practical nursing environments. For example, the term “self-care” lacks clarity and consistency; nurses can interpret this term in a variety of ways. These complexities can negatively affect the reliability and validity of the discussed research findings. That the patient’s clinical outcomes improved proves that Orem’s self-care deficit theory may serve an effective source of nursing interventions for patients with diabetes. However, it is possible that the factors other than the nursing theory were responsible for the success of self-management interventions in Kumar’s (2007) article.

The future research needs to clarify the applicability and effectiveness of Orem’s nursing theory for patients with other chronic health conditions. The links between different concepts within Orem’s theoretical framework must be clarified. Additional analysis is required, to determine what nursing theories, terminologies, and conceptual frameworks can be used to add value to Orem’s concept of self-care in practical nursing environments.

References

Kumar, C.P. (2007). Application of Orem’s self-care deficit theory and standardized nursing languages in a case study of a woman with diabetes. International Journal of Nursing Terminologies and Classifications, 18, 3, 103-110.