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A PERSONAL PERSPECTIVE ON THE FOUR CONCEPTS OF THE NURSING METAPARADIGM
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Subject: The Evolution of Theoretical Knowledge A PERSONAL PERSPECTIVE ON THE FOUR CONCEPTS OF THE NURSING METAPARADIGM Introduction The four concepts of the nursing metaparadigm as described in Orem’s theory are: Person Environment Health Nursing My perspective of the four concepts has changed somewhat after studying Orem’s theory. My thoughts of the “Person” have become more focussed on to one that is the recipient of nursing care only when they cannot administer self-care. My view of the “Environment” now includes a developmental environment. My previous understanding of “Health” did not include such emphasis on health promotion and health maintenance. My view of “Nursing” now includes the understanding of the importance of nursing theory as applied to practice settings and in the development of nursing as a profession. Person Orem describes the person as a patient; an individual functioning biologically, socially and symbolically. She describes the person as having the capacity to learn and develop, has the capacity for self-knowledge and is capable of engaging in deliberate actions to meet their self- care requirements for the maintenance of health. She also states that if the individual is incapable of taking care of him / herself, then others must provide the care. The others in this case can be the nurse or a family member. She states that individuals are subject to the forces of nature. Orem through her theory self care deficit has put forth the idea that people can benefit from nursing because they are subject to health related limitations that render them incapable of continuous self-care. Wesley (1992). In other words when the individual’s health breaks down for whatever reason, the nurse is there to come to the rescue by doing what is in her power to help the health related problem either on her own or with the collaboration with other health care professionals. Orem’s definitions have crystallized my own thoughts on treating patients as intelligent people who are much more capable of learning about how to deal with their illness than often given credit for by health care professionals. It emphasizes the need for communication and patient education with regard to administering self care and that receiving hospital help is a supplement to the patient’s own self-care efforts. In the past when people entered hospital they were treated as passive recipients of care. Orem’s theory supports the shift in emphasis to the “Person” and self-empowerment towards self-care. Environment Orem’s concept for the “Environment” not only covers the actual physical surroundings and social or psychosocial elements but also addresses developmental aspects.
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