Week 7 Nursing Theory Comparison Paper Final Draft
Due Apr 24 by 11:59pm Points 300 Submitting a file upload
Choose one grand nursing theory and one middle-range theory and have them approved by your instructor. Write an 8–10 page comparison paper based on your approved theories.
Based on the reading assignment ( McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory.
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
Based on the reading assignment ( McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select a middle-range theory.
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
The following should be included:
An introduction, including an overview of both selected nursing theories
Background of the theories
Philosophical underpinnings of the theories
Major assumptions, concepts, and relationships
Clinical applications/usefulness/value to extending nursing science testability
Comparison of the use of both theories in nursing practice
Specific examples of how both theories could be applied in your specific clinical setting
Parsimony
Conclusion/summary
References: Use the course text and a minimum of three additional sources, listed in APA format
The paper should be 8–10 pages long and based on instructor-approved theories. It should be typed in Times New Roman using 12-point font, and double-spaced with 1″ margins. APA format must be used, including a properly formatted cover page, in-text citations, and a reference list. The proper use of headings in APA format is also required.
Recommended: Before you begin, review the WCU Library APA guides.
Due: Sunday, 11:59 p.m. (Pacific time)
Points Possible: 300
Rubric
NURS_500_DE – Theory Comparison Paper Rubric Final Draft
NURS_500_DE – Theory Comparison Paper Rubric Final Draft
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
180 to >147.6 pts
Meets Expectations
Content is clear, thorough, and organized effectively. Main points well supported. All specific portions of the assignment have been addressed. Meets all the criteria of the written assignment
147.6 to >135.0 pts
Approaches Expectations
Content is somewhat clear, thorough, and organized effectively. Most of the specific portions of the assignment have been addressed. Some points well supported. Meets most of the criteria of the written assignment
135 to >106.2 pts
Falls Below Expectations
Content is generally unclear, not thorough, and organized ineffectively. Some of the specific portions of the assignment have been addressed. Main points not well supported. Meets only a few of the criteria of the written assignment
106.2 to >0 pts
Does Not Meet Expectations
Content is generally unclear, not thorough, and organized ineffectively. Some of the specific portions of the assignment have been addressed. Main points not well supported. Meets only a few of the criteria of the written assignment
180 pts
This criterion is linked to a Learning OutcomeWriting Style
30 to >24.6 pts
Meets Expectations
Writing is professional with no spelling or grammatical errors and has been carefully proofread. Captures and maintains reader’s interest
24.6 to >22.5 pts
Approaches Expectations
Writing follows normal conventions and has minor spelling, punctuation and grammatical errors throughout. Efforts made to capture and maintain reader’s interest
22.5 to >17.7 pts
Falls Below Expectations
Writing does not consistently follow appropriate style of format with frequent spelling, punctuation and grammatical errors. Do not capture or maintain reader’s interest
17.7 to >0 pts
Does Not Meet Expectations
Writing does not consistently follow appropriate style of format with frequent spelling, punctuation and grammatical errors. Do not capture or maintain reader’s interest
30 pts
This criterion is linked to a Learning OutcomeClarity & Coherence
45 to >36.9 pts
Meets Expectations
Writing flows smoothly from one idea to another. Writer has taken pains to assist the reader in following the logic of the ideas expressed
36.9 to >33.76 pts
Approaches Expectations
Sentences are mostly structured to communicate ideas clearly. Transitions between paragraphs make the writer’s points easy to follow
33.76 to >26.54 pts
Falls Below Expectations
Sentence structure and word choice sometimes interferes with clarity of content and distracts the reader
26.54 to >0 pts
Does Not Meet Expectations
Poor sentence structure, sentences do not make sense to the reader, no clarity evident in the paper
45 pts
This criterion is linked to a Learning OutcomeReferences
15 to >12.3 pts
Meets Expectations
References included throughout paper in APA format
12.3 to >11.26 pts
Approaches Expectations
References included throughout paper but not all are in APA format
11.26 to >8.86 pts
Falls Below Expectations
References included but unclear which references are direct quotes and which are paraphrased
8.86 to >0 pts
Does Not Meet Expectations
No references included in the body of the paper and writing indicates none were used
15 pts
This criterion is linked to a Learning OutcomeCover page & Reference Page
15 to >11.86 pts
Meets Expectations
Cover page and reference page are in APA format with appropriate number of references included
11.86 to >11.26 pts
Approaches Expectations
Cover page and reference page are in APA format with some references included
11.26 to >8.86 pts
Falls Below Expectations
Cover page and reference age are mostly in APA format with few references included
8.86 to >0 pts
Does Not Meet Expectations
Cover page and reference page are not in APA format or no cover or reference page included
15 pts
This criterion is linked to a Learning OutcomePresentation
15 to >11.86 pts
Meets Expectations
Paper is presented professionally, word –processed, double spaced, 12 point font, 1” margins on all sides
11.86 to >11.26 pts
Approaches Expectations
Paper is word- processed but contains only minimal errors in spacing, font or margins
11.26 to >8.86 pts
Falls Below Expectations
Paper is word-processed but does not appear professional with errors in two areas of spacing, font or margins
8.86 to >0 pts
Does Not Meet Expectations
Paper is word-processed but does not appear professional with errors in all area of spacing, font or margins, or it is hand-written
15 pts
Total Points: 300
Comparison of Nursing Theories
Introduction
The Roy adaptation model (RAM) explains five main nursing concepts: person, objective, health, nursing actions, and environmental patterns. When all five concepts are addressed in this way, health emerges from adaptive patterns that reflect existence and wholeness integrated with one’s self and environment in the RAM model, persons are the initial notion. According to Roy’s perspective, people realize the inmate’s unique role and develop coping methods to aid in the adaption to their environment. Roy has identified four primary concepts in which the coping mechanisms’ actions are addressed. These are what she calls adaptable modes, which are; self-concept, physiological, interdependence, and role function. Effectors are a term used to describe these adaptable modes. The experience of a big loss, discrepancy by determining how an individual’s reality differs from their ideals, and trigger events assist in the definition of the notion of chronic sorrow (Almasloukh and Stewart, 2021).
Significant loss can be a long-term event, like giving birth to a disabled child or the diagnosis of a chronic illness, or it can be a one-time event, such as the loss of a loved one. The disparity is an unresolved sorrow emanating from a loss and generates a gap between the real relationship and an anticipated one. When someone suffers a loss, it can be challenging to accept what happened, delaying the grieving process. Other variables that lead to chronic sorrow include triggering events, which are any occurrences that remind a person of their loss and exacerbate the disparity. According to Wijaya et al. (2022), the absence of closure linked with persistent discrepancy lays the foundation for chronic sorrow, characterized by a gradual loss (Wijaya et al.,2022).
History of the Theories
The Roy Adaptation Model (RAM) was first employed as the conceptual foundation for the nursing degree curriculum at the Los Angeles Mount St. Mary’s College in 1968, where Sister Callista Roy chaired the Nursing department. In 1970, the RAM was initially published. Over the years, Roy has broadened the scientific premises and created and improved philosophical assumptions of her paradigm (Jennings,2017).
The chronic sorrow idea was initially proposed. To depict how parents of children with mental illness handled and experienced grief in the 1960s. Later, the notion would shift from the consequences of parents with mentally ill or physically disabled children to the impacts of great loss. Through a succession of researchers, studies, and reviews, Eakes and other researchers finalized the notion in 1998 (Coughlin and Sethares,2017).
Philosophical Foundations
The basic notion of adaptation in the RAM pertains to a person’s effective development as someone depending on others. The virtue-directed perspective of Roy’s nursing paradigm is shown in her use of phrases like “mastery” and “integrated adaptive outcome.” The philosophical foundations of the Roy adaptation model identify the goal of each person having maximal freedom to reach their potential. The conviction that human life has a shared meaning, aim, and direction. Under adaptation, growth, mastery, purposefulness, destiny, and development, there is a defined path toward a conceivable end that benefits the individual, even if the goal is to assist an individual die with dignity and comfortably. Roy connotes the word unity in addition to the concept of truth, which he defined as the unity of oneness. Roy uses the words integrity and unity interchangeably. The interdependence modes and role function in the RAM are based on the relationality of persons in a community of others. As a result, Roy’s focus on adaptation and unity showed the RAM’s relational and teleological nature. This focus on human and social unity reflects that veritivity has similar attributes to the truth. Still, it also emphasizes human beings’ inherent relationality and development toward a shared goal (Almasloukh and Stewart, 2021).
The idea of chronic sorrow, on the other hand, contends that chronic sorrow is a natural human response to a major loss. It’s a normal and expected human reaction to loss. Chronic sorrow is a recurring occurrence that can happen during one’s life when a disparity is exposed by a trigger hence the regular experience of a sense of loss. Chronic sorrow is a lifelong experience since the substance of the loss prohibits closure or ensures that a gap will always exist. An individual’s comparison of the preferred concept of health and life processes with the actual reality is one reason for the mismatch. Another factor is the social environment in which people live. People evaluate themselves by comparing themselves to social norms. It does not incapacitate the affected because it happens between periods of enjoyment or contentment (Coughlin and Sethares,2017).
Major Concepts, Assumptions, and Relationships
Person, environment, health, and nursing are the four major premises of the RAM. The Roy Adaptation Model considers a person as biopsychosocial in continued interaction with their surroundings. Additionally, it considers focused, contextual, and residual stimuli in the environment. The confrontation with one’s internal and external world is a focused stimulation. The individual promptly resists these internal and external influences. The focal stimulus should be managed first, followed by the contextual stimuli. Stimuli that influence the current situation are referred to as contextual stimuli. The residual stimuli are elements that have close effects on the current situation. These are personal experiences, attitudes, and habits. They are rooted in the past and have an impact on treatment outcomes. Health is an anticipated aspect of human life that represents a continuum of health and disease. Roy described health as the state of being and growing into a whole person. Roy’s nursing model characterized nursing as a science and applied scientific knowledge to nursing practice. The goal of nursing, according to RAM, is to ensure adaption. Increasing adaptability throughout health and disease increases the interaction between human systems and the environment, improving health, quality of life, and end-of-life care (Almasloukh and. Stewart 2021). The three primary relationships, in theory, are discussed below.
Physiologic-physical Mode. Chemical and physical processes are engaged in the function and activity of living creatures; the basic requirement is physiologic integrity, as evidenced by the level of completeness attained by adaptability to changing needs. This is how human systems adapt to fundamental operational resources in groups (Jennings,2017).
Self-Concept-Group Identification Model. It emphasizes spiritual and psychological integrity and a sense of cosmic unity, meaning, and purpose (Jennings,2017).
Role Function Mode. It relates to the roles people play in society to meet the demand for social integrity; it’s about perceiving who one is in relation to others (Jennings, 2017).
Interdependence Mode. The purpose, structure, and growth of individual and group relationships and the ability of these relationships to adapt (Jennings,2017).
According to Almasloukh and Stewart (2021), Ray’s adaption model is based on the following scientific assumptions:
Higher levels of intricate self-organization are reached by matter and energy systems.
Integration of person and environment requires consciousness and meaning.
Persons and environments are made up of systems of matter and energy that advance to higher levels of intricate self-organization, consciousness, and meaning. Integration, or awareness of oneself and one’s surroundings, is founded on one’s thoughts and feelings.
The integration of creative processes is dependent on human decisions.
Human activity is mediated by thinking and sensation.
Acceptance, protection, and encouraging interdependence are all aspects of system interactions.
People and the earth have recurring traits and are inextricably linked.
Human consciousness creates changes in people and the environment.
Adaptation is the result of the combination of human and environmental meanings.
On the other hand, chronic grief, loss, disparity, antecedents’ triggers, and internal and external management approaches are concepts in the chronic sorrow hypothesis. The following concepts are described according to definitions offered by Wijaya et al. (2022).
Chronic Sorrow. It is regularly the reoccurrence of pervasive grief or other anguish sensations after a great loss.
Disparity. It refers to the discrepancy between the desired and the real situation due to some form of loss.
Loss. It is a feeling of extreme grief that may be recurring, or a one-time event is referred to as a loss.
Two antecedents Explained by the Model. When a single event of a living loss occurs, such as the commencement or time of diagnosis of chronic illness, the first antecedent is triggered. The unresolved discrepancy resulting from the loss is the second antecedent of chronic grief.
Triggers. Occurrences cause one to notice an unfavorable disparity in losing a loved one or a loss that makes one sad again.
Internal Management Methods. The individual suffering chronic sorrow initiates individualized coping measures. Other words in the theory that are relevant are:
Person: a human being with an idealized view of life and health who compares their own experiences to the ideal and to those of interactions that exist within the social setting, such as those that occur in the healthcare, work, family, and social environments,
Health. It is a state of normal functioning, with a person’s health being determined by their ability to adapt to loss-related differences.
Nurses’ Key Responsibilities. They include being an empathic presence, a teacher-expert, and compassionate and skilled care.
Coping. It entails confronting challenges and taking steps to overcome them. Its premises are that a person who has had a single loss or a series of losses will sense a gap between the idealized and reality.
Disparity. The disparity between the actual and the idealized causes sentiments of sadness and grief to pervade the mind. The proposed notions’ links are clear and rational.
Testability and Clinical Applications
The Roy Adaptation Theory could be utilized to aid in building and evaluating a hospital-based program that helps to meet healthcare professionals’ needs. Theoretically directed nurse care programs may aid in demonstrating the validity and efficiency of these programs, which are urgently needed given the present worldwide pandemic and the added emotional stress jeopardizing the nurse’s well-being. The RAM Model is built on a system that examines how a person or a group interacts with and responds to environmental inputs. Nurses can use care program facilitators to help them mediate adaptive reactions to the events they encounter while meeting patient and family needs. Considering that it is based on several research investigations and a thorough literature assessment, the hypothesis is correct (Jennings,2017).
Individual responses to chronic sickness, caregiving obligations, loss of the “ideal” child, or grieving have all been studied using the chronic sorrow hypothesis. Nurses must recognize chronic grief as a natural reaction to loss and, whenever it occurs, offer assistance by encouraging positive coping techniques and taking on roles that improve consolation. Nurses can create interventions that identify persistent grief as a normal emotion, facilitate healthy adaptability, and provide empathic support through the theory’s help. The hypothesis was created through several research investigations and a thorough literature assessment, indicating that it has been empirically tested. The Burke CCRS questionnaire is a ten-question interview guide that delves deeper into the theory principle. The use of the theory for women who were abused as children, sorrow for families with epileptic children, cancer patients, mental health patients, sorrow for families with children with neural tube problems, and coping strategies for patients with multiple sclerosis are some of the research areas covered by the questionnaire. All of these are areas where the idea can be used and other chronic illnesses (Wijaya et al.,2022).
Theory Comparison
The RAM hypothesis was applied to construct a nursing approach for patients, resulting in a high-quality diagnosis and a speedy recovery. The physiologic physical mode, the self-concept mode, where the caregiver examines the physical and personal self, role performance mode, interdependence mode, and contextual and residual stimuli are the guiding principles for the patient assessment. The idea has also been utilized to evaluate a care facility program designed to meet the healthcare team’s needs, such as stress, burnout, and compassion fatigue (Almasloukh and Stewart,2021).
On the other hand, chronic sorrow theory is utilized to aid patients with chronic diseases, their families, and those who have lost loved ones. It guarantees that nurse practitioners are compassionate, caring caretakers who act as teachers and experts (Coughlin and Sethares, 2017).
Specific Examples
The construction of the Tea for the Soul Care (TFS) Model for caregivers is an example of the RAM model in action. TFS therapists are well abled and positioned to help nurses cope with the overwhelming magnitude of stimuli they face in today’s complex healthcare environment (Jennings,2017). The other example is how I would evaluate a diabetic patient using the RAM model; I give a single result for each, although assessment findings might be multiple.
Psychological, physical mode; there is no aberrant heart sounds in the
Nutrition; on a diabetic diet (1500Kcal)
Elimination; normal bladder pattern; elimination
Rest and activity; obtaining enough sleep
Protection; left foot amputated, no discharge, and no other evidence of infection
Senses; there is no pain in the wound feet.
Fluids and electrolytes; daily water consumption is around 2000ml.
Conscious and focused neurological function
Endocrine function; under Insulin treatment
In the self-concept mode, we have the physical self under this concept. In this case, the patient conceptualized is aware of changes in his bodily image.
Personal self; low self-esteem as a result of the financial burdens
Role performance mode; he was the family’s breadwinner, and his role has not been taken yet; the son has no job yet.
Interdependence mode; has solid relationships with his neighbors, acquaintances, and family, whom he feels may be unable to assist him owing to current financial restraints.
Focus Stimulus; Four-week non-healing wound after amputation in his left leg between his greater and second toe.
Contextual stimulation; diabetic for the past ten years.
Residual stimulus; has had tuberculosis in the previous ten years, but it was treated.
A partnership between a healthcare team and parents of children with sickle cell anemia in a specific institution is an example of the chronic grief theory in practice. The nurse supports them in their ability to care for the children by motivating them to keep coping and adjusting. They also give them information on what to expect as the condition progresses, allowing them to cope more effectively in the long run. This helps alleviate the effects of increased stressors that have accumulated over time.
Parsimony
The parsimony criterion evaluates the substance of the theory and demands that the theory’s phenomena be explained with fewer propositions and concepts. This means that the information must be presented clearly and concisely. The RAM model is not sparse because it contains several key ideas, sub-concepts, structures, and other multiple relational claims. It is extensive and tries to clarify the clients’ realities to tailor nursing treatments to their requirements (Jennings, 2017).
The chronic Sorrow theory might be called frugal because its essential notions are well explained and easily understood. Grief demands and the sense of loss are addressed specifically by theory experts (Coughlin and Sethares, 2017).
Conclusion
The RAM model is more general and does not narrow down to a specific application, as with the chronic sorrow theory. Both theories are, however, significant in nursing practice. The RAM model helps structure effective broad perspective patient assessments that ensure that all underlying factors are unearthed, thus providing quality care for a speedy recovery. The Model also aids in the structuring of the TFS initiative to help caregivers address stress, burnout, and compassion fatigue hence becoming better service providers. On the other hand, the chronic sorrow theory can be used for patients with chronic diseases and their families to help them cope with the reoccurring episodes of chronic grief.
References
Almasloukh K. B. and P. Stewart Fahs (2021). The Roy adaption model is used to assess the quality of life. Nursing science quarterly, vol. 34, no. 1, pp. 67-73.
Coughlin M. B. and K. A. Sethares (2017). An integrative literature review on chronic grief in parents of children with a chronic disease or impairment. 108-116 in Journal of Pediatric Nursing.
Jennings, K. M. (2017). The Roy adaption model is a theoretical paradigm for nurses caring for anorexia nervosa patients. Advances in nursing science, vol. 40, no. 4, p. 370.
Wijaya, N. Yudhawati, S. Andriana, and Ilmy (2022). Georgene Gaskill Eakes presents Middle Range Theory: Understanding Perspective Theory of Chronic Sorrow Nursing.
DRAFT RUBRIC FEEDBACK
73.8 to >67.5 pts
CONTENT
Approaches Expectations
Content is somewhat clear, thorough, and organized effectively. Most of the specific portions of the assignment have been addressed. Some points well supported. Meets most of the criteria of the written assignment
Comments
You have some great information related to your theories. Make sure to list your theory by title so readers can understand what theory you are referring to.
WRITING STYLE
12.3 to >11.25 pts
Approaches Expectations
Writing follows normal conventions and has minor spelling, punctuation and grammatical errors throughout. Efforts made to capture and maintain reader’s interest
CLARITY AND COHERENCE
18.45 to >16.88 pts
Approaches Expectations
Sentences are mostly structured to communicate ideas clearly. Transitions between paragraphs make the writer’s points easy to follow
Comments
Due to the over-use of bullet points, the paper does not flow from one section to the next.
REFERENCE
5.63 to >4.43 pts
Falls Below Expectations
References included but unclear which references are direct quotes and which are paraphrased
Comments
There are large sections of your paper where citations have not been used.
Cover page & Reference Page
5.63 to >4.43 pts
Falls Below Expectations
Cover page and reference age are mostly in APA format with few references included
4.43 to >0 pts
Comments
Your text book should be a reference. Please review the use of italics and links in your references.
DRAFT FEEDBACK
Tammy Anderson
In the introduction, outline what you are going to be writing about in the paper. Think of is as a way to grab your reader’s interest to read your entire paper. Safe the concepts and specifics for those sections of your paper.
Higher levels of intricate self-organization are reached by matter and energy systems.
Integration of person and environment requires consciousness and meaning.
Persons and environments are made up of systems of matter and energy that advance
to higher levels of intricate self-organization, consciousness, and meaning.
Integration, or awareness of oneself and one’s surroundings, is founded on one’s
thoughts and feelings.
The integration of creative processes is dependent on human decisions.
Human activity is mediated by thinking and sensation.
Tammy Anderson
This should be narrative, not listing bullet points.
On the other hand, chronic grief, loss, disparity, antecedents’ triggers, and internal
and external management approaches are concepts in the chronic sorrow hypothesis. The
following concepts are described according to definitions offered by Wijaya et al. (2022).
Chronic Sorrow. It is regularly the reoccurrence of pervasive grief or other anguish
sensations after a great loss.
Disparity. It refers to the discrepancy between the desired and the real situation due to
some form of loss.
Loss. It is a feeling of extreme grief that may be recurring, or a one-time event is
referred to as a loss.
Two antecedents Explained by the Model. When a single event of a living loss
occurs, such as the commencement or time of diagnosis of chronic illness, the first antecedent
is triggered. The unresolved discrepancy resulting from the loss is the second antecedent of
chronic grief.
Triggers. Occurrences cause one to notice an unfavorable disparity in losing a loved
one or a loss that makes one sad again.
Internal Management Methods. The individual suffering chronic sorrow initiates
individualized coping measures. Other words in the theory that are relevant are:
Person: a human being with an idealized view of life and health who compares their own
experiences to the ideal and to those of interactions that exist within the social setting, such as
those that occur in the healthcare, work, family, and social environments,
Tammy Anderson
You will need to put this in a narrative form. Your use of headings is not correct.