Concept Identification, Analysis, Middle Range Theory Development, and Clinical Application

Concept Identification, Analysis, Middle Range Theory Development, and Clinical Application

Patient caring is the hallmark feature of modern healthcare. In the pursuit of community health, patient caring recognizes the apparent diversity in the healthcare landscape and maintains cultural sensitivity and humility during care processes. Nursing and other caregivers’ excellence in providing high-quality and effective care is pegged considerably on how well they integrate diverse nursing and healthcare concepts to optimize the clinical and health outcomes of their patients. In this paper, we will review the “Breathing Lessons: The Life of Mark O’Brien” film, pinpoint nursing concepts emanating from the film, and analyze some of the identified concepts through the Lens of the Purnell model.

The “Breathing Lessons: The Life of Mark O’Brien” Film

“Breathing Lessons: The Life of Mark O’Brien is a documentary film exploring the spiritual struggles of Mark O’Brien spiritual struggle to cope with his disability. He contracted polio in his early childhood and spent his lifetime in an iron lung due to post-polio syndrome. The film highlights the struggles he goes through while coping with his situation. It displays O’Brien’s fight against his illness, his conflicting perception of his disability, and reflections on the social concepts of sex, work, God, and death ¹. Despite his suffering and challenges, Mark O’Brien was able to champion the recognition of the disabled and even author several books

Identified Concepts from the Film

Nursing and healthcare-related thematic concerns of disability, respiratory problems, gait disturbances, patient rights, patient communication, physical disparity, environment, love, patient-caregiver relationships, and sleep disturbances are evident in the film. These concepts border on patient caring, nursing care, and disease processes. Disability, patient communications, environment, physical disparities, and love and nursing care-related concepts. Likewise, respiratory problems and gait disturbances are healthcare-related concerns that are also related to nursing.

The Select Concepts

The concepts of environment, disability, gait disturbance, and patient relationships are some of the thematic concerns identified from the case and related to Purnel’s postulates on nursing practice. The environment defines the patient’s surroundings. It entails all factors that may influence the clinical and healthcare outcomes of the patients including the patient’s interactions with the caregivers ². Disability is defined as functional impairment and limitations in the activities of daily living ³. Gait disturbance, on the other hand, is defined as deviation or disruption in normative walking ³. Patient caregiver relationship is defined as the interindividual engagements and interactions between a patient and a healthcare professional, in which both parties are impacted positively by the other parties’ attitudes and behaviors ⁴.

Middle Range Theory

The identified concepts are related to the theory of culturally competent healthcare.  To begin with, the concept of environment is related to Purnel’s postulates on the healthcare practice, specifically, the provisions on the responsibility for health. Maintaining a healing, enabling, and peaceful environment for diverse patients is crucial in healthcare. A positive healthcare environment fosters physical and mental healing of the patients ². In this case, O’Briene’s ability to live for over 40 years with his disability may be attributed, in part, to the environment he lived in.

Disability is another concept that is related directly to the domain of healthcare practice. It is defined as functional impairment and limitations in the activities of daily living. Disability is a global health concern and a predisposing factor to suffering. As evident in the case, O’Brien’s disability was the root cause of his suffering and divergent social dilemmas and perceptions of life and death. Disability, in general, is a demonstration of functional impairment and limitations in the activities of daily living. Per Purnel’s provisions, disability may be a reason for assuming the sick role and a barrier to physical and mental health ³.

Gait disturbance is also related to the health domain. It is defined as a deviation in normative walking. It also predisposes individuals to diverse health concerns and may hinder their healthcare-seeking ³. Patient caregiver relationship is another concept related to Purnel’s domains of communication, healthcare practitioners, and healthcare practice. Patient caregiver relationship is defined as the interindividual engagements and interactions between a patient and a healthcare professional, in which both parties are impacted positively by the other parties’ attitudes and behaviors ⁴. A healthy positive caregiver relationship fosters healthcare collaborations that allow greater patient involvement in the care process.

Nursing Assessment Questions

The concepts identified in the film include disability, gait disturbances, patient-caregiver relationships, and environment. Nurses play a vital role in patient interactions and can also be involved in the direct management of patients with health care concerns such as gait disturbance and disability ³. When assessing disability, nurses may ask whether the client is open to and able to discuss their disability, what their access needs are, and their self-identity ³. The nursing assessment questions bordering on gait disturbance include whether they are open to discussing their gait disturbances, whether they are able to participate in and communicate aspects of their physical and health history, and whether they recognize factors that may predispose them to illness. The nursing assessment questions for the client’s environment include asking about how they cope with their illnesses, the people they interact with socially, and the factors within their environment that predispose them to illnesses ². The nursing assessment questions bordering their interaction with the caregivers include how frequently they communicate with the caregivers, their perception of caregivers, and how they approach communication processes between them and their caregivers ⁴.

My Middle Range Theory and How It Guides Practice

The identified concepts of disability, gait disturbances, environment, and patient-caregiver relationships are a projection of pertinent issues affecting diverse groups of patients in modern healthcare. A middle-range theory that encapsulates these concepts is the theory of self-care. This theory grants patients greater responsibility in taking care of themselves ⁵. Nurses and other healthcare professionals can leverage patient-caregiver relationships and a positive care environment to educate clients with gait disturbance and other forms of disabilities on diverse aspects of self-care. Through healthy patient-caregiver relationships, nurses and other healthcare professionals can educate persons with disabilities and gait disturbances on the prerequisite self-care skills that may enhance their ability to promote and preserve their health. This theory is aligned with the healthcare practices domain of Purnel’s theoretical postulates. It provides a means of health preservation by ensuring that patients, traditionally predisposed to various illnesses, such as those with disabilities have the skills to take care of themselves.

Conceptual map

 Why Advanced Nurses are Nurse Theorists

Nurse theorists utilize nursing ideas, knowledge, and expertise to formulate theoretical frameworks that support aspects of nursing care. Advanced Nurses possess unique nursing skills, expansive nursing knowledge, and expertise that allow them to make informed judgments on aspects of nursing care by utilizing their knowledge, expertise, and skills to formulate theoretical frameworks that have a positive impact on their patients. This makes them nurse theorists.

 References

Jessica, Y. (1996). Breathing Lessons: The Life and Work of Mark O’Brien. Inscrutable Films.

Hesselink G, Smits M, Doedens M, et al. Environmental needs, barriers, and facilitators for optimal healing in the postoperative process: A qualitative study of patients’ lived experiences and perceptions. HERD: Health Environments Research & Design Journal. 2020;13(3):125-139. doi:10.1177/1937586719900885

Noel Lorenzo Villalba, Santiago Díaz Nicolas, Maria Belen Alonso Ortiz, Zaida Cordoba Sosa, Saturnino Suárez Ortega, Abrar-Ahmad Zulfiqar. Intellectual disability, Falls and gait disturbances: A misdiagnosis. European Journal of Case Reports in Internal Medicine. 2020;(Vol 7 No 3). doi:10.12890/2020_001488

Wu Q, Qian S, Deng C, Yu P. Understanding interactions between caregivers and care recipients in person-centered dementia care: A rapid review. Clinical Interventions in Aging. 2020;Volume 15:1637-1647. doi:10.2147/cia.s255454

Hellqvist C. Promoting self-care in nursing encounters with persons affected by long-term conditions—a proposed model to guide clinical care. International Journal of Environmental Research and Public Health. 2021;18(5):2223. doi:10.3390/

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Points 25Introduction: This assignment is a strategy to assist students in incorporating concept identification, theory utilization, and middle-range theory development in informing the care of patient populations, including those of differing cultures.

Concept Identification, Analysis, Middle Range Theory Development, and Clinical Application