Nursing Assignment Sample

Q1:

Directions: When you complete all of your coursework in the Master's in Nursing Program, you will be required to complete a final project in the NUR 622 course. There are several steps to this, and one of the first steps is to identify a topic and then to choose a theoretical model to support your project. For the Theoretical Framework Assignment, please complete this paper using the theorist that you anticipate you will use when completing your project in the NUR 622 course. An example of the Theoretical Framework Assignment is posted in the first section of the NUR 600 Canvas course.

To complete this assignment, please be sure to do the following:
Provide an introduction (begins with: The purpose of this paper is to_____, and then outlines the main points of the paper) and conclusion
Describes the nursing theorist, major concepts, definitions, assumptions and propositions found in the theory. Incorporates how the theory fits the project purpose. Uses a primary source (theorist's own writing). (The librarian can help you locate primary sources)
Primary: original, first-hand; the author of the source generated the research data they are using. Secondary Research: This is when an author of the source you are using gathers existing data, usually produced by someone else, and they then report, analyze, or interpret that other person's data
All metaparadigm concepts (person, health, environment and nursing) are defined according to the theorist and student develops their own definition (operational) for concepts
Use subheadings 
APA format should be used including a title page, and references. A running head is not needed 
Assignment should be submitted electronically as a Word document to the drop box associated with this assignment in Canvas.
Please be sure to take a look at the grading rubric as well as the instructions for writing the paper. Be sure that you have met all of the grading criteria before submitting
See the attached rubric for grading criteria. 

Rubric
Theoretical Framework

Q1:

Introduction: The objective of this exploration is to investigate and assess how Dorothea Orem's Self-Care Deficit Theory can serve as an effective framework for enhancing medication adherence among elderly individuals suffering from hypertension. The implications of this research could greatly enhance the quality of life for these individuals. Often labeled a silent killer, hypertension is responsible for millions of fatalities annually. This condition leads to serious complications such as strokes, heart disease, and renal failure. Despite the existence of antihypertensive medications, elderly patients grappling with hypertension struggle with adherence to their medication schedules due to cognitive decline, physical limitations, and the aging process. The present circumstances necessitate urgent attention and effective strategies focusing on early detection and preventive measures, given the numerous complications associated with the condition. Tackling the issues surrounding medication adherence in elderly patients with hypertension demands a structured and patient-centered methodology. This methodology, in line with the principles of Dorothea Orem's Self-Care Deficit Theory, is not only advantageous but essential. The Self-Care Deficit Theory emphasizes the capacity of individuals to fulfill their self-care requirements. The theory posits that when patients face a self-care deficit—indicating they are unable to care for themselves due to injury, illness, or age—nurses must provide support to help them regain and enhance their health. Orem categorizes nursing systems into three types according to the patient’s self-care capability. The theory consists of three interconnected components: the theory of self-care, the theory of self-care deficit, and the theory of nursing systems (Dorothea Orem). This paper presents Dorothea Orem and her theory, delineating the key concepts, definitions, assumptions, and propositions. The research then illustrates how the theory aligns with the project’s aim of enhancing medication adherence in elderly patients with hypertension. As outlined in Orem's writings, the four meta-paradigm concepts are also examined to formulate operational definitions pertinent to elderly patients living with hypertension.

Dorothea Orem and the Self-Care Deficit Theory:
Nursing Theorist:

Dorothea Elizabeth Orem (1914-2007) was a renowned American nursing theorist, educator, and author. Orem has published several works, including her book Nursing: Concepts of Practice, which is considered a foundational anchor in nursing education. She has received honorary doctorates from Georgetown University, Incarnate Word College, Illinois Wesleyan University, and the University of Missouri-Columbia. She is best known for developing the Self-Care Deficit Nursing Theory and has been awarded multiple times.
She has received the Catholic University of America Alumni Achievement Award for Nursing Theory (1980), the Linda Richards Award from the National League for Nursing (1991), was made an Honorary Fellow of the American Academy of Nursing (1992), and received the Sigma Theta Tau Edith Moore Copeland Founders Award (1997) ((Nursing Theories: The Base for Professional Nursing Practice).

Major Concepts:

Dorothea Orem’s Self-Care Deficit Theory is built upon the fundamental concept of self-care, which is the practice of activities that individuals initiate and perform on their behalf to maintain life, health, and well-being. The framework puts great emphasis on the role of an individual in maintaining his own life (Dorothea Orem).
Another key concept is the self-care requisites, which are the needs of the individuals that must be met to regulate their functioning and development. Orem categorized them into three groups- universal self-care requisites, developmental self-care requisites, and health deviation self-care requisites.
Another key concept of the theory is the self-care deficit, which occurs when an individual's ability to perform self-care is hampered. The nursing system is also one of the significant concepts of the theory. Orem has identified three types of nursing systems- wholly compensatory, partially compensatory, and supportive-educative (Dorothea Orem).

Definitions:

Self-care is the practice of activities that maturing and mature persons initiate and perform, within the time frames, on their behalf in the interest of maintaining life, continuing personal development, and maintaining well-being or recovering from disease or injury. According to her, self-care is the purposeful action to regulate one's functioning and development.
Self-care agency is the individual's ability to perform self-care activities, influenced by knowledge, skills, motivation, and physical capabilities. Therapeutic self-care demand, conversely, represents the totality of self-care actions required to meet known self-care requisites. These are categorized as universal, developmental, and health deviation requisites.
According to her, self-care deficit occurs when an individual's self-care agency is unable or partially able to meet the self-care needs of the individual.

Assumptions:

Dorothea Orem's Self-care Deficit Theory rests on the fundamental assumption that humans possess an inherent capacity for self-care: optimal functioning and well-being (Nursing Theories). When a self-care deficit occurs, which requires nursing interventions, it is also assumed that individuals actively participate in their health interventions and are capable enough to make informed decisions about their social and physical environments (Orem et al., 1995).
The interaction allows individuals to make judgments based on their surroundings and allows humans to engage in deliberate self-care actions. It is also assumed that care is often provided within structured social relationships.

Propositions:

The self-care deficit theory is particularly relevant to medication adherence in elderly patients with hypertension. Patients with hypertension often experience challenges with cognitive decline, physical limitations, and complex medication regimens. Such challenges can create self-care deficits.
Through the application of Dorothea Orem's theory, the study aims to measure the ability of patients to manage these interventions through targeted interventions. For instance, an elderly patient may have memory deficits, causing them to forget to take their medications (MacLaughlin et al., 2005). By applying self-care deficit theory, nurses can implement a partially compensatory system and teach patients to use specified interventions, such as pill boxes or medication reminders.

Metaparadigm concepts:

The Metaparadigm concepts of Dorothea's self-care deficit theory outline the dynamism of nursing care, specifically as applied to elderly individuals with hypertension and medication adherence challenges.

Person:

Orem views a person as a holistic being with the capacity for self-care. She highlights the concept of self-care agency, which is defined as the individual's ability to engage in self-care activities to maintain life, health, and well-being (Orem et al., 1995). The agency is influenced by knowledge, skill, motivation, and physical capabilities (Dorothea Orem).
In this context, the definition narrows the focus to a specific population: elderly patients with a chronic condition (hypertension) and a prescribed treatment (antihypertensive medication). The person may or may not exhibit adequate medication adherence. When applied to elderly patients with hypertension, the definition assesses their self-care agency related to medication management. The operational definition necessitates a nuanced assessment that extends beyond simple adherence rates. The definition necessitates a comprehensive assessment of the person's self-care agency, comprising cognitive function, physical limitations, health literacy, psychological factors, and medication beliefs. The detailed evaluation allows for a personalized self-care plan that addresses each patient's unique needs.

Health:

Orem views health as not merely the absence of the disease but a state characterized by soundness or wholeness of developed human structures and bodily and mental functioning (Dorothea Orem).In the context of elderly hypertensive patients, a state of health translates to a focus on both blood pressure control and the prevention of hypertension-related complications in elderly patients (Schutte et al., 2022).
In this context, "health" is operationalized as the patient's blood pressure control, measured by consistent readings within the target range and the absence of hypertension-related complications.
Orem's perspective requires a more comprehensive understanding of health in a broader perspective. Since Orem views health as a dynamic process and not a static endpoint, the study also includes quality of life, symptom management, monitoring laboratory values indicative of organ function, and evaluating adherence to lifestyle modifications under the umbrella of health.

Environment

Orem views the environment as all the external factors that influence a person's ability to engage in self-care. According to her, the environment includes the physical, chemical, biological, and social contexts in which humans exist (Dorothea Orem).
For the project, "environment" is contextualized as a patient's home setting, social support network, and access to healthcare resources. Operationally, the study defines environment as encompassing all these factors, which can influence their ability to adhere to medication regimens. The facts identify the need to assess the safety and suitability of the home environment for medication storage and administration, evaluate the availability of social support to assist with medication management and ensure access to healthcare providers and pharmacies (Denyes et al., 2001).
Orem's theory outlines that environmental changes can positively or negatively impact self-care agency. For instance, limited financial resources or cultural beliefs can significantly impact medication adherence. In such cases, nurses are required to address these factors within their interventions. 

Nursing:

Orem observes nursing as assisting individuals with self-care needs when they exhibit deficit patterns. According to Orem, a nurse must intervene and assist individuals in meeting their self-care needs when they cannot do so themselves (Dorothea Orem).
Within the scope of the study, "nursing" involves assessing the elderly patient's self-care agency, identifying self-care deficit patterns, and defining necessary interventions to promote medication adherence in elderly patients with hypertension. Operationally, nursing involves a systematic process of assessment, diagnosis, and intervention measures required to support patient self-care behaviors. Nurses utilize Orem's wholly compensatory, partially compensatory, or supportive-educative nursing systems to tailor interventions to the patient's needs (Nursing Theories).
Orem's theory also views nurses as facilitators who empower individuals to regain or maintain their self-care agency. By applying Orem's Self-Care Deficit Theory, nurses can provide comprehensive and effective care to elderly individuals with hypertension, promoting medication adherence and improving their health outcomes.

Conclusion and Analysis:

The Self-care deficit theory offers a systematic framework for assisting elderly patients suffering from hypertension. The theory addresses medication adherence challenges by recognizing patients' inherent capacity for self-care and acknowledging the limitations that arise due to aging, cognitive decline, and the complex medication schedule. By applying the identified theory, the study enables nurses to implement customized interventions for the identified patient group that support their patient autonomy and health maintenance.
The theory follows a structured approach to identify self-care deficits and categorize nursing interventions into three systems: wholly compensatory, partially compensatory, and supportive-educative. Each of these interventions is defined to cater to different stages of self-care deficit in patients, ranging from direct assistance in medication administration to patient education through reminder tools or the creation of personalized medication management plans.
A key strength of Orem's theory in this context is its comprehensive integration of four meta-paradigm concepts- person, health, environment, and nursing. In analyzing the application of self-care deficit theory to medication adherence, it is evident that a personalized, patient-centric approach is required. Elderly hypertensive patients face multiple barriers to medication adherence, which requires individual interventions based on their specific deficits and capabilities.
Furthermore, the study highlights the need for continuous assessment and adaptation of nursing strategies to ensure sustained adherence. As the patient’s adherence to the self-care behaviors involved, so should the designed interventions to support them. Orem’s theory offers a dynamic model to accommodate the varying self-care needs of patients, allowing nurses to deliver targeted and patient-centric care.

References

Denyes, M. J., Orem, D. E., & Bekel, G. (2001). Self-Care: A Foundational Science. Nursing Science Quarterly, 14(1), 48–54. https://doi.org/10.1177/089431840101400113
Dorothea Orem. (2025). Google Books. https://books.google.com/books?hl=en&lr=&id=jFMiCgAAQBAJ&oi=fnd&pg=PP1&dq=self+care+deficit+theory&ots=i-7c0n3blQ&sig=aMYXDpJ0eg0_OEMk2_bn6y5VChM
MacLaughlin, E. J., Raehl, C. L., Treadway, A. K., Sterling, T. L., Zoller, D. P., & Bond, C. A. (2005). Assessing Medication Adherence in the Elderly. Drugs & Aging, 22(3), 231–255. https://doi.org/10.2165/00002512-200522030-00005
Nursing Theories. (2025). Google Books. https://books.google.com/books?hl=en&lr=&id=sd0-BAAAQBAJ&oi=fnd&pg=PA153&dq=self+care+deficit+theory&ots=4qFzr7_WH-&sig=XQFG2onbmSNjsWhm3PH-dGdJaoY
Nursing Theories: The Base for Professional Nursing Practice, 6/e. (2025). Google Books. https://books.google.com/books?hl=en&lr=&id=ENFbsUFcGrMC&oi=fnd&pg=PA113&dq=She+has+received+the+Catholic+University+of+America+Alumni+Achievement+Award+for+Nursing+Theory+(1980)