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Grand Nursing Theories

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Select two grand nursing theories and discuss how each theorist addresses the metaparadigm for nursing. Discuss briefly the similarities and differences of the two. The nursing metaparadigm consists of the concepts person, heath, nursing, and environment. The purpose of a metaparadigm is to “summarize the intellectual and social missions of the discipline and place boundaries on the subject matter of that discipline” (McEwen & Wills, 2014, p.41). It is essentially a domain that explains the phenomenon of nursing. The two theorist chosen to examine are Orem and Neuman. Orem’s theory focused on Self-care Deficit while Neuman focused on a Systems Model. They approached the metapradigm differently, with some similarities. Orem viewed the metapradigm concept of nursing as an art that is performed when patients are in a position where self-care is not feasible. She also noted that nursing addresses medical needs as well. The concept of humans, or persons, were described singly or in social units, and were also referred to as the “material object” for direct care nurses (McEwen & Wills, 2014, p. 143). Environment was explained as having multiple components (physical, chemical, and biological) and was also stated, similarly to the concept of persons, as including family and community.

Lastly the concept of human health was referred to as being able to reflect individually and having the capability to communicate. Health encompasses individuals and groups (McEwen & Wills, 2014). Neuman expanded the metapradigm with added concepts aside from the four generally discussed. The concept of persons was referred to as a “composite of variables” (McEwen & Wills, 2014, p. 150). By stating a composite of variables, Neuman was elaborating on her theory that multiple systems constitute human beings. Environment, according to Neuman, could be viewed as internal, external, and created rings; each affecting patients adaptation to sickness/stress. The concept of health is explained as a continuum. Wellness is at one end, while sickness is at the opposite end. When sickness penetrates this line, a state of instability occurs. Lastly nursing is viewed as assisting patients to properly adjust to maintain the ‘continuum’ and optimal health (McEwen & Wills, 2014). The similarities between these two theorists’ views are that they both viewed the environment as having multiple components.

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