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Selecting a relevant theoretical framework that can guide a study is crucial for the success of the research. Theories provide a broad understanding of concepts and relationships among them that help to predict the results of the analysis and build hypotheses (Dolan & Taylor-Piliae, 2019). Using different theories provides the researcher with an opportunity to look at the problem of interest using different lenses (Walker & Avant, 2019). The present paper provides a refined understanding of the phenomenon of dialysis prevention by defining the major concepts, explaining the relationships between them, and selecting the appropriate theoretical framework to guide future research.
Phenomenon of Interest
The phenomenon of interest is dialysis prevention, as it is of great personal and professional interest to me. I have been working as a dialysis nurse for almost 30 years, and I lost my husband, who was on dialysis for several months. I always thought that if he controlled his blood pressure and diabetes, he might have avoided being put on dialysis. Therefore, I decided to dedicate my research to understanding if patient education about preventive measures can reduce the chance of being put on dialysis.
Primary Concepts
The research will be based on four primary concepts, which are prevention, self-care, and patient education. There are numerous definitions of prevention depending on the area of use. Major definitions are provided in Table 1 below. The proposed research will define prevention as actions taken to decrease the chance of getting a disease or condition, which is the definition used by NCI (n.d.).
Table 1. Definitions of prevention
One of the best definitions of self-care was provided by Dorothea Orem in the self-care deficit theory. Orem (1991) defined self-care as “the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being” (p. 117). This definition will be sued for future research. As for patient education, the American Academy of Family Physicians (AFFP, 2000) defines the concept as “the process of influencing patient behavior and producing the changes in knowledge, attitudes, and skills necessary to maintain or improve health” (para. 1). The concept of health will be defined as being structurally, functionally, and emotionally sound, and whole (McEwen & Wills, 2019). The connections between these four concepts help to build hypotheses about the phenomenon of interest.
Relationship between the Concepts
The analysis of concepts revealed that the central concept is prevention, and both patient education and self-care are precedents of prevention, while health is its consequence. There is expected to be a strong positive one-way correlation between patient education and self-care, as more patient education leads to better adherence to self-care (Awoke et al., 2019). Self-care practices is one of the prevention methods, along with other procedures, such as vaccination and regular health check-ups. Therefore, there is expected to be a positive correlation between patient education and adherence to prevention practices (Siudak et al., 2018). By definition, prevention is expected to be positively correlated with health, as preventing diseases support being structurally, functionally, and emotionally sound. The conceptual relationships can be summarized in the conceptual map provided in Figure 1 below.
Assumptions
There are several assumptions associated with my future research. First, patient education is relevant, timely, and professional. In other words, only qualified personnel provide patient education at the appropriate time to relevant patients. Second, patients or their family members can understand the provided education and can perform the taught self-care practices. Finally, the study will assume that there are numerous factors affecting adherence to prevention practices aside from patient education.
Theory that Can Inform Future Research
The theory selected to inform my future research is Orem’s theory of self-care deficiency. The theory touches upon the defines several concepts, including nursing, humans, environment, health, self-care, and self-care agency (Orem, 1991). The central idea of the theory is that the aim of nursing is helping patients to restore their ability to practice self-care (Orem, 1991). The major strength of Orem’s theory is that it logically explains the role of the nurse in self-care agency and defines clear relationships between self-care, health, and nursing (Orem, 1991). Additionally, Orem (1991) outlines the steps of the nursing process that can help to turn the theory into practice. At the same time, there are several drawbacks associated with the theory. First, it does not clearly explain the role of the family in self-care. Second, the theory focuses more on physical health and does explain the emotional part of the issue (Orem, 1991). Finally, the definition of health as being dynamic and ever-changing with states ranging from health or non-health, wellness, or illness is different from the experience of some patients (Fitzpatrick, & Whall, 2005). Thus, the theory will need to be modified for future use.
Theory Origins and Modifications
The theory of self-care deficit emerged in the 1950s when Dorothea Orem was working on the development of a national nursing curriculum (Orem, 1991). The theory was created to improve the nursing practices in the US (Orem, 1991). The theory was meant to be used by nurses to guide patients in their self-care practices (Orem, 1991). These are two modifications to the theory that will need to be made to make it useful for my future research. First, the definition of health will include emotional or psychological health, which was not mentioned by Orem (1991). Additionally, the assumptions will include that self-care practices can be performed by either the patient or the family, which implies that patient education can be provided to either the patient or the relatives that support patients’ living.
Summary
The present paper defined the major concepts that will guide my future research about dialysis prevention and the relationships between them. The major concepts were patient education, health, self-care, and prevention. Three major assumptions were identified to understand the limitations of the research. Additionally, the theory of self-care deficit was overviewed, and its use for future research was discussed.
References
American Academy of Family Physicians. (2000). Patient education. AAFP.
Awoke, M. S., Baptiste, D. L., Davidson, P., Roberts, A., & Dennison-Himmelfarb, C. (2019). A quasi-experimental study examining a nurse-led education program to improve knowledge, self-care, and reduce readmission for individuals with heart failure. Contemporary Nurse, 55(1), 15-26.
Dolan, H., & Taylor-Piliae, R. (2019). Selecting a theoretical framework to guide a research study of older adults’ perceptions and experiences of falling in the hospital. Applied Nursing Research, 47, 38–40.
Fitzpatrick, J.J., & Whall A.L. (2005). Conceptual models of nursing, analysis, and application (4th ed.). Pearson Prentice-Hall.
McEwen, M., & Wills, E.M. (2019). Theoretical basis for nursing (5th ed.). Walters Kluwer.
National Cancer Institute. (n.d.). Prevention. Cancer.gov.
Orem, D.E. (1991). Nursing: concepts of practice (4th ed.). Mosby.
Oxford. (n.d.). Prevention. In Oxford Learner’s Dictionary.
Raken. (n.d.). Preventing equipment damage.
Safeopedia. (2019). Fire prevention.
Siudak, Z., Krawczyk-Ożóg, A., Twarda, I., Franczak, I., Rajtar-Salwa, R., Bartuś, S., & Dudek, D. (2018). “Heart without smoke” educational campaign — The role of patient education in secondary prevention of cardiovascular disease. Kardiologia Polska (Polish Heart Journal), 76(1), 125-129.
United Nations. (n.d.). Crime prevention. UNODC.
Walker, L.O., & Avant, K.C. (2019). Strategies for theory construction in nursing (6th ed.). Pearson.
Workplace Testing (n.d.). Accident prevention.
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