NursingTheories and Problem Solving

NursingTheories and Problem Solving

Thenursing models of Roy and Orem have greatly shaped the nursingcareer. The incorporation of these two theories is not justapplicable in nursing practice but as well as in clinical education,research, and administration. These nursing models guide nursingpractitioners to use interviewing and observation skills inconducting an individualized analysis of each individual (Alligood,2014). The theoretical frameworks of nursing serve in great ways asthe guides for recording, reporting, and articulating nursing actionand thought. This paper will explore, compare and contrast the twonursing theories, which were presented by renowned nursing theoristsin the nursing practice field. These models include Orem’sSelf-care and Roy’s Adaptation models.

Nursingis a growing subject in science development that is, in professionalpractice and research and theory. There is a rich thought historyfrom the likes of Florence Nightingale to contemporary nurseresearchers, clinicians, ad theorists. Furthermore, nursingprofessional practice entails knowledge incorporation from the broadmodels’ conceptualizations to the extent of nursing practice theory(Jones, 2007). As mentioned above, the theoretical frameworks ofnursing serve in dominant ways as controllers for recording,articulating, and reporting nursing action and thought. Therefore,nurses have to understand what they are performing, why they areperforming, what might be the array of nursing outcomes, and theindicators for estimating nursing impact.

BiographicalSketch of the Nursing Theorists

Bornin Baltimore, Dorothea Orem acquired her diploma (Nursing) fromProvidence Hospital in Washington, DC. In addition, she received herbaccalaureate (Nursing) in 1939 from Catholic University, as well asa master`s degree from that same university in 1945. Orem decided tocreate her theory after her colleagues, and herself was given a taskof developing a curriculum of nursing for applied nursing for theHealth, Education, &amp Welfare Department in Washington, DC(Alligood, 2014). Between the 1975 and 1995 versions, there have beena few alterations in the theory of Orem, notably in an individual’sconcept and the notion of the nursing structure. Orem explains threetheories namely self-care, nursing system, and self-care deficit.

SisterCallista Roy acquired a bachelor’s degree (Nursing) from Mt SaintMary’s College in 1963 and a master’s degree (pediatric nursing)in 1966. In addition, she received a master`s degree (sociology) in1975 from University of California, as well as a doctorate(sociology) in 1977 from the same university. She first proposed hernursing model when studying for the master`s degree, in which DorothyJohnson challenged her to create conceptual nursing models.Therefore, the creation of the adaptation model has been inspired bythe professional and personal background of Roy (AmericanPsychological Association. 2010). Throughout her experience as apediatric staff nurse, she primarily noticed the kids and theircapacity to adapt in reaction to the major psychological and physicalchanges.

Focusof the Models and applying them in Nursing Practice

Themodel of Roy was created for education, but it continued working inthe practice and research settings. The model of Roy focuses on thenotion of man`s adaptation. Her conceptions of nursing, health,person, environment and health are all interconnected to this primaryconcept (Walker &amp Avant, 2008). As stated by her model, peoplereceive stimuli or inputs from both the self and the environment.Adaptation takes place when a person reacts positively to the changesof the environment. Such an adaptive reaction facilitates theperson’s integrity, which results in health. Futile responses tothe stimuli result in disruption of the person’s integrity.

DorothyOrem presented the self-care nursing model in 1970. The model’sfocus is self-care, nursing agency, nursing system, self-care demand,self-care agency, and self-care deficit. Self-care refers to arequisite of every individual, woman, child, and man. It is seen asthe capability and function of a person, which implies that thethings a person can perform and is capable of doing (Alligood, 2014).If self-care were not sustained, death, disease or illness wouldoccur. The requirements of self-care lead to the regulation offunctional and structural integrity, as well as human growth.Self-care requisites exist in three main categories namely healthdeviation, universal, and developmental self-care requisites. Asstated by Orem, different basic conditioning aspects can affect theself-care requisites’ categories. The principle of this model isexclusively the nurse-patient connection.


  1. Health

Asstated by Roy, health refers to a state as well as the process ofbecoming a whole and integrated individual. Similarly, Orem viewshealth like ideal if living organisms are functionally andstructurally complete. Health may be seen as an adaptive system ofhumans within a varying environment (Rosdahl &amp Kowalski, 2012). Alack of incorporation exemplifies health deficit. Adaptation refersto the process of encouraging this incorporation that is, maintainingpsychological, social, and physiological integrity. Equally, Oremsees health condition as the fundamental factor of conditioning,which also encompasses social, physiological, and psychologicalimbalances that most probably influence the adult self-care behaviorsand abilities.

  1. The Individual

Roydefined the individual in terms of adaptation and the system.According to her, the person is a bio-psychosocial creature incontinual interaction with the changing environment. Roy describes anindividual as the nursing care recipient, as an adaptive structurewith interior processes (the regulator and cognator), as the livingcomplex acting to uphold adaptation in the main adaptive modes:Self-concept (psychological), interdependence (social), physiological(biologic), and role function (Alligood, 2014). Conversely, Oremarticulated that the individual is the focus within the framework.People are rational creatures who assess situations, understand andreflect them. In comparison to the model of Roy, Orem indicated thatempowering people help in coping with the effects and causes thatultimately continue to an individual`s positive adaptation.

  1. Environment

Asstated by Roy, the surrounding is all the circumstances, conditions,which affect the behavior and growth of groups or persons.Environment refers to the input in the individual as an adaptivestructure that involves both external and internal aspects. Allenvironmental changes demand increasing energies for adapting to theconditions (Rosdahl &amp Kowalski, 2012). Factors within theenvironment, which influence the individual, are grouped as residual,focal, and contextual stimuli. Orem recognizes self-care requirementsto have their roots in humans and the environmental elements,conditions, and factors, among others.

  1. Nursing

Thegoal of Roy of nursing is to assist people to adapt to the changes intheir psychological needs, independent relations, role function, andself-concept during illness and health. Nursing seals a uniquefunction as an adaptation facilitator by analyzing behavior in allthe four adaptive modes as well as intervening through managing thedominant stimuli. Equally, Orem describes the nursing practice as asocial or human service (Alligood, 2014). Nevertheless, the aim ofnursing within both the models is to beat the limitation of thepatient whether it is physiological or psychological needs.


Identifyingthe underlying presumptions is essential to external an internalassessment of the theory that deals with congruence, logic, andconsistency with the real world. The conceptions of health,environment, person, and nursing are all well described, though thereare a few differences and similarities between Roy and Orem’smodels (Walker &amp Avant, 2008).

First,the model of Roy concentrates on a person’s psychological aspect.She explains a man’s adaptation and focuses on the adaptationmethods and coping systems while Orem’s theory emphasizes thesociological and physiological aspects of an individual it lacks thepsychological aspects (Jones, 2007). Orem discusses individualism,self-reliance, self-directed, and autonomy. In addition, the theoryof Orem is accorded to the sociological and physiological well-beingof the individual, weakening the relevance of mental health.

Secondly,the nursing management theory of Roy highlights that manipulating thestimuli is distinct from manipulating the individuals, though thequestion remains whether it is possible manipulating internal stimuliwithout causing manipulation of the person. It appears that theconnections of adaptation to health, nursing, and person are clear,but the person-environment relationship is not clear (Alligood,2014). In comparison, Orem just proposed that the alteration withinthe person-environment mechanism would ultimately alter the wholesystem of self-care. Both theories mention similar aspects, thoughthe aims of both theorists vary.

Thirdly,these two theories mainly focus on individualism. Not any of the twomodels takes the standpoint of family, community, or society as anentirety. Nevertheless, with some modification, these theories asviewed as empirically tested on different age groups like among theelderly, student’s community, and various illness specific groups,among others (Jones, 2007). Roy views a person like a livingcreature, adaptive system aiming to uphold adaptation within the fouradaptive models, while Orem sees a person as a rational creaturehaving mastery on their destiny.

Lastly,Orem’s theory is somewhat culturally inclined. Withinscientifically advanced cultures, people think that illness is due tonatural reasons. Nevertheless, certain cultures believe on folk andtraditional premises. Thus, such thoughts still fail to recognizedifferent health-linked cultural practices and beliefs. Orem’smodel does not elucidate the folk and traditional health beliefs. Incontrast, Roy’s model discusses the relationship of the person withGod and the universe on philosophical premises (AmericanPsychological Association. 2010). People use human creativecapabilities of enlightenment, faith, and awareness.


Thetwo theories have influenced the nursing profession greatly. Theincorporation of both theories is not just applicable in nursingpractice but as well as in clinical education, research, andadministration. These models direct nurses in using interviewing andobservation skills to perform individualized evaluation on everyperson. As such, it is an important guide in the assessment of nursesand in the formulation of nursing diagnoses (Alligood, 2014). Nurseshave an exceptional role in promoting health in various settingsthrough using these models. Such settings include community settings,acute healthcare settings, palliative care, and rehabilitationnursing, to mention just a few.


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AmericanPsychological Association. (2010). Publication Manual of the AmericanPsychological Association (6th ed.). Washington, DC.: AmericanPsychological Association. ISBN: 9781433805615

Jones,R. A. P. (2007). Nursing leadership and management: Theories,processes, and practice. Philadelphia, PA: F.A. Davis Co.

Rosdahl,C. B., &amp Kowalski, M. T. (2012). Textbook of basic nursing.Philadelphia: Wolters Kluwer Health/Lippincott Williams &ampWilkins.

Walker,L.O. &amp Avant, K.C. (2008). Strategies for theory construction innursing, (5th ed.). NewJersey: Pearson/Prentice Hall ISBN0-13-215688-1.