The promotion of care across the lifespan of the patient constitutes holistic nursing practice. Holism is multifaceted in the promotion of health. Nursing theories formulated play an essential role in understanding the approach to health. The holistic approach in nursing considers the client’s psychological, physiological, mental, and environmental needs. All these are unified into one to form the patient. Nursing theories, in general, formulate the interactive process which would create the integrative process. These theories support the intersystem model, which suggests that an individual is under constant interaction with the immediate environment. The client is a biopsychosocial agent in a changing world. The nursing response should be aware of these interacting elements, and the practitioner’s role is to ensure that the agent adapts to these changes.
Nevertheless, the relationship between the professions and the patients should be mutual. A common denominator in all these theories entails focusing on the patient’s recovery efforts rather than the disease or injury (Papathanasiou, 2013). Some of the theories, such as the self-care model by Dorothea Orem, empower the patient with the skills and knowledge that would be instrumental in changing the behavior. The patient has the right to make decisions that influence the outcome of care. Another essential theory that focuses on the individual is Newman’s Health Care System Model (Papathanasiou, 2013). In this model, the person is viewed as a whole system. According to the theory, the nurse’s role is to recognize the individual needs and their interaction with the environment. The person is the system linked to the parts and subparts. Good health is attainable when there is a balance between all the elements. Importantly, nursing theories have articulated the need for patient-centered care. The patient’s culture, social context, dignity, and respect should be critical in designing a care plan that observes the patient’s need requirements.
Nursing theories underscore the obligation of nurses to offer safe healthcare within the legal, ethical, and moral standards. Additionally, these theories have also been calling for healthcare policies and regulations to be made within the confines of safe, legal, ethical, and moral standards. Nursing theories have several provisions concomitant with safe, legal, ethical, and moral standards. The bare minimum requirement is the provision of care that respects the patient’s dignity, worth, and unique attributes. Additionally, nursing theories recognize that the primary concern of medical care is the patient. Collaboration between professional teams is essential in the provision of the best care. The theories also stipulate the importance of nurses in promoting, protecting, and offering the best healthcare and safety to the patient. The standards of competence are essential when creating a mutual relationship between patients and healthcare providers (Roussel, 2009). Nursing theories offer nurses an opportunity to reflect on the value of the practice, which would positively impact the quality of patient care. A vital consideration in the theoretical formulation is the authority, accountability, and the responsibility of nurses in practice. The decisions undertaken by the nurse should be planned out and well thought.
Moreover, these decisions should be implemented purposefully. The provision of nursing care within ethical and moral standards recognizes nurses’ role in the promotion of health and safety that preserve the integrity of the patient. Most nursing theories are congruent with the moral and ethical requirements. The nursing theories play an important role in describing the contextual realities that can be used to create healthcare policies. The construction of nursing knowledge using the nursing theories is instrumental in creating the multifaceted approach which instills the principles of social justice. The principles of social justice would be critical in the creation of health policy.
Evidence-based nursing holds the premise that nursing care should be grounded on research rather than belief. It is essential to realize that evidence-based practice is not synonymous with the research but rather the application of collected information. At the core of the evidence-based practice is the integration of research and theory. Nursing practice and theory are inseparable. EBP is the conscientious and judicious use of theory-based information when making clinical decisions. The increased awareness of evidence-based practice indicates the linkage between research and theory. Nursing theories can influence situation-specific research, which can be used in influencing the clinical outcome.
The legitimacy of nursing as a profession comes from the ability in generation and application of theory. The nursing theories developed in the 70s and 80s failed in bridging the gap between theory and practice. The theoretical enterprise has gained new momentum. The nursing theories are diversified since the focus on human nature and nurture. These theories have expanded further to include the side socio-environmental context. Theories such as the Systems Theory by Callista Roy associates the patient to a whole comprised of biological, psychological, and social components. She linked the components with the progression of the diseases. Nursing theorists have played an integral role in presenting a rational and comprehensive approach to the nursing process (McCrae, 2011). Nursing theories are developmental, and conceptualization of new ideologies and processes links evidence to practice. Nursing theories realizes the pragmatic nature of the discipline. The problem-solving approach is linked to personal values, experience, and current use of medical information. While applying current evidence to nursing practice is a crucial requirement, nursing theories recognize the three fundamental dualisms that define the discipline. The nursing practice, which is formalized using the conceptual framework serves as the starting point in the use of current evidence (McCrae, 2011).
Several nursing theories and models serve the crucial role of supporting health promotion and disease prevention. Nursing theories in health promotion helps in understanding and explaining health behavior while at the same time, guiding the interventions. Health promotion and disease prevention can draw from more than one theory or model (Raingruber, 2014). Some nursing theories play an important role in explaining and predicting individual changes in healthcare behaviors. In formulating the explanations, nursing theories also provide the reinforcement used to achieve the behavioral changes. Understandably, the field of health promotion is increasingly becoming complex such that one theory cannot be used in guiding best practice and research. Additional models, such as the Intervention-Based approach by Tannahill, recognize that health promotion occurs within the overlapping spheres of health education, prevention, and health protection. Ecological nursing theories and models recognize the interaction between the patient and the environment (the environment consists of the social organization, cultural systems, and the physical environment). The reciprocal influence of these interacting elements affects the patient. Health promotion and disease prevention activities should focus on these external influencing factors. The recognition of the multiple facets that influence the well-being and the social environment would be critical in identifying the organizational and behavioral leverage points that can be used in health promotion. Health changes across the lifespan have been espoused in the Life Course Health Development Model (LCHDM) and can serve health policy development. The multifactorial influences in the life of the individual can be used in targeting the best response. Nursing theories have expanded the scope to develop the planning models used in community needs assessments, planning, and implementation of health promotion strategies. An example of this theory is the Stage Planning Program Model for Health Education/Promotion developed in 2001 (Raingruber, 2014).
Raingruber, B. (2014). Health promotion theories. Contemporary health promotion in nursing practice, 53, 53-94.
Roussel, L. (2009). Concepts and theories guiding professional practice. Management and Leadership for Nurse Administrators. Sudbury, MA: Jones and Bartlett Publishers, LLC.