Jean Watson’s Nursing as Caring Theory
Meaning
A description of the main ideas of the theory (assumptions)
The Jean Watson nursing theory is based on the caring relationships that characterize humanity and life experiences in general. Specifically, Jean Watson’s theory is concentrated on relationships between caregivers and patients (Lukose, 2011).
Watson model works on several assumptions, including views that care is demonstrated and practiced interpersonally; effective caregiving can satisfy some human needs and promote health and personal growth; caring has an aspect of accepting patients as they are, having in mind that they have the potential to change. Additionally, patients should be put in environments that foster development while allowing them to choose the best for themselves; caring phenomenon complements the science of curing and appreciation of the fact that caring is vital to nursing practice.
Main concepts
Watson’s theory is based on four concepts characterized by four key concepts, including human beings, nursing environment/society, health, and nursing practice.
Main relationships between the concepts
Human beings (patients) are the center of care delivery. Human health is a vital concept that caregivers should strive to achieve. Further, caregivers use the nursing practice to deliver care to human beings in their environments.
How do different concepts affect each other?
Human beings are influenced by the care provided by nurses in caring environments. Ultimately, patient/nurse relationships affect healing processes, which affect health.
Origins of the Theory
What was going on in the profession of nursing or in American society that may have influenced the theory?
During the mid-twentieth century, nursing was not perceived as a distinct profession. However, nursing practice and care delivery had distinct characteristics. As a result, nursing scholars and specialists like Watson began theorizing on the nursing discipline.
What values, theories, evidence, and/or existing knowledge did the theorist cite as support for the theory?
Watson observed that nursing has distinct values, knowledge, and practice. Additionally, she based her decisions on the view that nursing has a unique ethic and mission to society. In addition, unique language order, distinct concepts, and philosophies characterized nursing practice.
What motivated the theorist to write the theory?
Writing of Watson’s theory was influenced by the theorist’s views of nursing and studies while she was a professor at the University of Colorado. Additionally, she wrote the theory influenced by her involvement with the nursing academic curriculum.
Approach to theory development used by the theorist
Watson adopted an approach that developed a theory that is logical, simple, general, the study based, usable, and supported by theoretical frameworks. The theory developed between 1975 and 1970 during Watson’s tenure as a University of Colorado professor.
Usefulness
How useful is this theory in practice?
Watson’s theory provides useful and vital metaphysical orientation pertinent to patients’ care delivery. The concepts assist the nursing practice in attempts to find meaning and harmony in difficult times of care delivery.
Is the theory practical and helpful to nursing?
Watson’s theory is pertinent to nursing practice and can be used in all healthcare environments. Views offered through the model focus on commitment to human care, environment, and humanity, which is an integral aspect of the nursing discipline.
Contributions of the theory to understanding and predicting outcomes
Watson’s theory is vital in care delivery and plays key roles in predicting patient outcomes.
Cite an example/case study where this theory could be used
Watson’s theory can be used to give care to healthcare providers by applying Watson’s Caritas processes to their own lives since nurses oftentimes neglect themselves in attempts to give optimal care to patients (Goldin & Kautz, 2010).
Testability
How testable is this theory?
The writing and development of Watson’s theory were based on scientific and philosophical approaches. Therefore, Watson’s theory can be evaluated using research-based studies and scientific tools.
Has this theory generated research? How many and what types of studies?
Jean Watson’s theory is among the forerunners in nursing theorizing. Therefore, many studies have been generated from Watson’s theory. The majority of studies generated from Watson’s theory focus on nursing practice and care delivery.
Give one example of a study done using the theory
A study was carried out in Saudi Arabia to investigate a patient’s perceptions of caring behaviors in an environment with people of diverse cultures. It was discovered that people regarded caring behavior more relative to the number of times care was given (Suliman, Welmann, Omer, & Thomas, 2009).
What types of statements are the propositions?
Statements in Watson’s theory propositions are based on patient care delivery and nursing practice.
Overall Evaluation
Is the theory comprehensive and specific?
Watson’s theory is relatively comprehensive. The theory developed over time incorporating important aspects of nursing practice.
How general is the theory?
Watson’s theory is relatively general. As such, it can be adopted in all nursing practice environments.
A Summary of the strengths and weaknesses of the theory
Watson’s theory has a number of advantages, including it is easy to be understood; easy to use in guiding and augmenting nursing practice; logical (creative factors are based on assumptions and hierarchy of human needs) and can be used to give holistic care to patients.
Additionally, Watson’s theory is based on the moral and philosophical aspects of nursing practice. Finally, Watson’s theory focuses on human health promotion, disease prevention, and reduces agonizing deaths while providing guidelines for interaction between nurses and their patients (a vital aspect of care delivery).
Nonetheless, practitioners argue that Watson’s theory does not provide clear direction concerning what to do to achieve authentic caring-healing relationships. Additionally, too much time is wasted in adopting Watson’s Caritas.
Using Watson theory in advance practice
Watson’s theory can be used in advanced nursing practice due to its scientific and philosophical bases. Watson’s theory is simple and logical and, therefore, easy to use.
Florence Nightingale’s Environmental Model
Meaning
A description of the main ideas of the theory (assumptions)
The key focus of the theory is making the patients’ environment as conducive as possible in an attempt to augment outcomes. The major aspects of the environment that can be altered include ambient and indoor air; water; food supply; drainage; patients’ hygiene; and light. All elements should be in balance to reduce patients’ stress (Zborowsky, 2014).
Florence Nightingale’s Environmental Model is a patient-care theory that is based on seven major concepts, including the view of nursing as a calling, art, and science; natural laws; the idea that people can achieve perfection; patient outcomes can be improved through environmental alterations; and nursing has basic educational and training requirements. Additionally, nursing should be perceived as a distinct discipline. Main concepts
Nightingale’s Canons include nursing room ventilation and warming; light and noise regulation; personal and environmental cleanliness; bed and bedding; giving hope and advice to patients; giving clean and healthy food; observation; variety and health of houses.
Main relationships between the concepts
The Nightingale’s Canons are interdependent. They all revolve around alteration of environments to ensure that patients’ outcomes are augmented.
Origins of the Theory
What was going on in the profession of nursing or in American society that may have influenced the theory?
Florence Nightingale was working as a nurse during the Crimean war, which leads to the killing of many soldiers (Fee & Garofalo, 2010). Crimean war victims (soldiers) were critically wounded yet they were being treated in horrifying sanitary conditions. Extremely poor conditions amplified the number of deaths and the suffering of patients. It is approximated that the rate of deaths emanating from sanitary related diseases was ten times more than wounds and injuries sustained during the war (Fee & Garofalo, 2010).
A number of scandals broke out (in American society) about the poor conditions, the soldiers were subjected.
What values, theories, evidence, and/or existing knowledge did the theorist cite as support for the theory?
Florence Nightingale was a Christian and strongly believed in giving hope and advice to patients. She included these values in canons of the theory. Additionally, she was deeply moved by extremely bad environmental conditions of war victims. The knowledge that more deaths were caused by environmental factors relative to wounds informed her decision.
It is worth noting that nurses had a poor reputation, which led to shortages of personnel.
What motivated the theorist to write the theory?
Nightingale wanted to improve the conditions of suffering soldiers. For instance, she observed that soldiers in the British base hospital in Constantinople were dying in conditions that could be altered. She was, therefore, motivated to write the theory to influence healthcare practitioners to consider environmental issues in nursing practice.
What approach to theory development did the theorist use?
Nightingale used scientific and philosophical observations to develop her theory.
Usefulness
How useful is this theory in practice?
The theory is one of the most useful in nursing practice (Selanders, 2010).
Is the theory practical and helpful to nursing?
Nightingale’s theory is pertinent to care delivery, especially on matters pertaining to sanitation.
Does it contribute to understanding and predicting outcomes?
When using Nightingale’s theory, it is possible to comprehend patients’ needs and predict outcomes.
Cite an example/case study where this theory could be used
Nightingale’s theory can be used in the alteration of nursing environments with the aim of augmenting outcomes.
How testable is this theory?
Nightingale’s theory can be tested using scientific and empirical studies.
Has this theory generated research? How many and what types of studies?
Nightingale’s theory has generated a considerable number of studies, especially on the alteration of environments.
Give one example of a study done using the theory
A study was carried out in Kenya to link environmental factors to TB patients. It is imperative to note that TB spreading and patients’ outcomes are highly dependent on the environment. The study concluded that the spread of TB could be minimized if environments are altered. Additionally, TB patients could have augmented outcomes when in areas with high levels of sanitation (Kamau, Rotich, Chemutai, & Chepketer, 2015).
What types of statements are the propositions?
Statements on Nightingale’s theory are based on views of altering environments aimed at augmenting patient outcomes.
Overall Evaluation
Is the theory comprehensive and specific?
Nightingale’s theory is relatively comprehensive since it comprises the major aspects and concepts of the nursing paradigm. The theory is specific to nursing and healthcare delivery.
How general is the theory?
Nightingale’s theory is relatively general and can be used in varied nursing settings.
Summarize the strengths and weaknesses of the theory.
Nightingale’s theory has a number of advantages, including using precise, logical, and elegant language; it gives a clear relationship between the environment and patients’ outcomes and having broad applicability to nursing practice.
However, Nightingale’s theory has limitations that include the insufficient information provided concerning psychosocial environments and uncertainty pertaining applicability of some of her concepts.
Using theory in advanced nursing practice
Sanitation plays key roles in human health. The care delivery environment should be as clean as possible. Nightingale’s theory can be used in advanced nursing practice since it is scientific and is based on empirical inferences.
Ida Jean Orlando’s Nursing Process
Meaning
A description of the main ideas of the theory (assumptions)
In nursing practice, it is generally agreed that seeking mutual understanding between caregivers and patients is paramount. Precisely, it is unprofessional for nurses to make interventions before getting patients’ consent.
Therefore, Ida Jean Orlando’s theory is based on reciprocal relationships and interactions between caregivers and their clients (Faust, 2002). As such, Orlando’s theory emphasizes the view that patients should be active in nursing practice rather than being objectified. Patients should actively participate in nursing practice and care delivery.
Orlando’s theory emphasizes the role of nursing in healthcare delivery, considering the nursing practice as a distinct profession and a separate discipline that should not be confused with medicine. As such, nurses are independent of physicians and consequently should not get orders from physicians.
According to Orlando, patients comprehend and interpret situations in their own ways and caregivers should authenticate their conclusions with patient interpretation for comprehensive and accurate decisions.
Orlando’s theory works under a number of assumptions, including the views that patients become helpless when they cannot meet their needs; nursing should be geared to reducing patients’ anxieties; patients are unique and respond to situations differently; nursing to patients is likened to motherhood to children; and nursing practice encompasses dealing with human beings, environments, and health.
In addition, patients should be given assistance to communicate their needs; patients can share or hide their needs, thoughts, and feelings; both care providers and patients are responsible for intrapersonal interactions; people may comprehend situations that are not apparent to others; medicine links patients to nursing, and nurses should establish healthy rapports for patients to effectively communicate their distress.
Finally, caregivers should make use of all observations made from their patients in ascertaining/catering for patients’ needs, and nurses should be concerned with needs that patients cannot meet on their own.
Main concepts
Orlando used three concepts in her theory, including person, health, and nursing.
What are the main relationships between the concepts?
According to Orlando, human beings are a key focus of nursing practice. Nursing is initiated by states of helplessness that result from being unhealthy. Individuals who feel helpless, therefore, need nursing to retain their health. It is imperative to note that Orlando did not pay attention to the environment as a concept in her theory.
How do different concepts affect each other?
The three concepts in Orlando’s theory influence each other. Human beings are affected by their health status. As such, human beings feel helpless whenever they become unhealthy. Nursing as a practice is affected by human health. Nursing is necessitated by the ill health of a person that results in helplessness. Therefore, nursing practice is dependent on human health.
Origins of the Theory
What was going on in the profession of nursing or in American society that may have influenced the theory?
Orlando’s theory was written at a time when the nursing practice had no defined roles. As such, there were uncertainties in care delivery (Gregory, 2015).
What values, theories, evidence, and/or existing knowledge did the theorist cite as support for the theory?
To Orlando, it was apparent that patients play major roles in their own care delivery. Additionally, she considered making nursing interventions without patients’ consent as unprofessional.
What motivated the theorist to write the theory?
Orlando had a view that patients play a key role in their own care delivery and they should be actively involved.
What approach to theory development did the theorist use?
Orlando used scientific and philosophical approaches in the writing and development of her theory.
Usefulness
Orlando’s theory is one of the most useful theories in nursing. Reciprocal relationships between nurses and patients are vital in care delivery.
Does it contribute to understanding and predicting outcomes?
Orlando’s theory is based on scientific and philosophical foundations that are crucial in understanding and predicting patients’ outcomes.
Cite an example/case study where this theory could be used.
Orlando’s theory can be used in a case where the patient’s input during care delivery is vital.
How testable is this theory?
Orlando’s theory can be tested using empirical and scientific studies.
Has this theory generated research? How many and what types of studies?
Orlando’s theory has generated a number of studies in nursing practice.
Give one example of a study done using the theory
A study was carried out using nursing students pertaining to patients’ needs in relation to Orlando’s theory. Many of the nursing students responded to the patient’s needs regardless of clients’ abilities in decision-making. The study concluded that it is imperative to change nursing students’ views on patients. As such, nurses should involve patients during care delivery (Abdoli & Safavi, 2010).
Overall Evaluation
Is the theory comprehensive and specific?
Orlando’s theory is specific to nursing and relatively comprehensive.
How general is the theory?
Orlando’s theory can be used in varied and general nursing environments.
A summary of the advantages and disadvantages of the theory
Orlando’s theory has a number of advantages, including guaranteeing treatment of patients as individuals; allowing patients to be active in their own care; asserting that nursing is an independent discipline; guiding nurses in the evaluation of care in terms of objectively noticeable patient results.
Nevertheless, Orlando’s theory has some shortcomings. First, Orlando’s theory lacks proper operational definitions of environment/society limiting the development of research propositions. In addition, Orlando’s theory overemphasizes short-term care.
Using theory in advanced practice
Orlando’s theory can be adopted in advanced practice since it is simple and logical.
Callista Roy’s Adaptation Model
Meaning
A description of the main ideas of the theory (assumptions)
Callista Roy’s adaptation model focuses on human beings’ adaptive capacities to acclimatize to constantly changing circumstances. The model allows the shaping of patients’ skills to activate defense mechanisms to respond to stimuli. Consequently, patients are able to take the necessary steps that lead to individual adaptation, which is dependent on stimuli.
Roy portrays a human being as a combination of interlinked and interconnected systems that constantly attempt to keep a balance between several environmental stimuli.
Roy’s model works under scientific and philosophical assumptions. Scientific assumptions include the views that human actions are mediated by thoughts and feelings; human beings and planet earth have common patterns and essential relationships; integrating human beings to environments will result in adaptation; human consciousness plays a key role in the transformation of persons and their environments; and human beings should accept their situations, protect themselves while fostering independence. In addition, thoughts and feelings of human beings result in both self and environmental awareness; persons are responsible for the integration of creative processes, and human consciousness and meanings are derived from environmental integration.
Philosophical assumptions, on the other hand, include the worldviews that God is revealed in His creation and He is the common destiny of the earth; human beings have mutual relationships with a supreme being (God); enlightenment, awareness, and faith are key aspects of humanity; and human being are responsible for sustaining and transforming the earth.
Main Concepts
Roy’s model encompasses four concepts, including environment, health, nursing, and person.
Main relationships between the concepts
In Roy’s model, there are apparent relationships between the four major concepts. Humanity is given the highest emphasis amongst all concepts. Human beings strive to attain states of being integrated and whole (attain health). While striving to attain health, human beings exist in surroundings that influence their behavior (environment). Nursing practice plays a key role in the processes of attaining human health.
How do different concepts affect each other?
Environments in which people live affect their health and individuals can adapt to diverse environments.
Origins of the Theory
What was going on in the profession of nursing or in American society that may have influenced the theory?
Rising cases of chronic illnesses necessitated a care model that will include adaptation.
What values, theories, evidence, and/or existing knowledge did the theorist cite as support for the theory?
Human beings have the capability of adapting to diverse environments.
What motivated the theorist to write the theory?
Callista Roy wrote the adaptation theory in 1976 with great influence from Dorothy E. Johnson. Working with Johnson made Roy realize that nursing practice is a key aspect and it involves providing service to society. As a result, Roy began developing her model aiming at highlighting the goal of nursing as a tool for adaptation.
What approach to theory development did the theorist use?
Roy organized her theory in a manner that she could use in the teaching and development of the nursing curriculum. As such, she adopted a scientific and study based approach.
Usefulness
How useful is this theory in practice?
Roy’s model is useful in nursing since it aids both patients and caregivers in adaptation processes. It is imperative to note that the model is easy and simple for nursing practice.
Is the theory practical and helpful to nursing?
Roy’s model is useful and adaptable to nursing due to its attributes, which include scientific knowledge of practice; research-based; ability to guide nurses and organizing nursing education; and giving clinical assessment and interventions.
Does it contribute to understanding and predicting outcomes?
Roy’s theory adapts scientific inference and, therefore, it is pertinent to understanding and predicting patient outcomes.
Cite an example/case study where this theory could be used.
Roy’s theory is applicable, especially to patients with chronic illnesses. Caregivers can apply Roy’s model when taking care of chronically ill persons. As such, nurses can follow Callista Roy’s model since it allows recognition and identification of patients’ needs while aiding in adaptation to situations associated with chronic diseases.
For instance, nurses can use Roy’s model of care to help patients adapt to situations associated with MS, which is a chronic and lifetime disease. Roy’s model is tailored in a manner that focuses on sustaining patients’ welfare and allowing all-inclusive personal development.
Testability
How testable is this theory?
RAM can be tested scientifically using empirical studies.
Has this theory generated research? How many and what types of studies?
RAM has generated considerable numbers of studies, especially for patients with chronic illnesses (Frederickson, 2011).
Give one example of a study done using the theory
Roy’s model has been used in many studies, especially studies that involved chronically ill persons. For instance, a study was carried out involving Multiple sclerosis (MS) patients aged 69. It is imperative to note that MS is a chronic illness with unidentified etiology development and it is associated with unpredictable clinical scenarios. MS is also associated with high levels of clinical uncertainties since patients are unaware of the occurrence of relapses.
The patient had lost her husband and was living alone. MS’s first symptoms were noticed when she was 36 years after giving birth to her first child.
After the first symptoms, the patient lived for a considerable period without experiencing relapses. However, the death of her husband rekindled relapses. When her husband died, the patient experienced a relapse that was followed by remission resulting in a paresis. She experienced another relapse when her son died.
During the study, the patient was complaining of extreme body discomforts and MS symptoms were apparent. (Rosińczuk, Kołtuniuk, Górska, & Uchmanowicz, 2015).
The study concluded that Callista Roy’s adaptation model is pertinent to care delivery for patients with chronic diseases. Therefore, nurses should consider Roy’s model due to its desirability and efficacy, especially in long-term care.
What types of statements are the propositions?
RAM proposition statements pertain to making a patient adapt to changing environments.
Overall Evaluation
Is the theory comprehensive and specific?
RAM is specific to nursing practice and it is relatively comprehensive.
How general is the theory?
RAM is relatively general and can be used in diverse nursing environments.
Summarize the strengths and weaknesses of the theory.
Callista Roy’s model has a number of advantages, including simplicity in the mentioning of major concepts; applicability of concepts in varied nursing settings; guiding nurses during patient observation and interviewing. Additionally, the concepts adapt a logical sequencing since each is operationally and sufficiently defined.
Finally, Roy’s adaptation model clearly brings out possibilities of multiple causes of circumstances and, therefore, the model is pertinent to dealing with multi-faceted persons.
Nonetheless, Roy’s model has shortcomings, including the considerable input of time, efforts, and resources required in applying the model; and the complexity due to diverse elements, systems, and many concepts.
Using RAM in practice
Roy’s model of adaptation is useful since it can integrate multiple adaptive modes of human beings in diverse environments (Shah, 2015).
Dorothea Orem’s Self-Care Deficit Theory
Meaning
Describe the main ideas of the theory (should include the assumptions under which the theory operates).
Orem’s theory is based on the view that nursing is an act of providing services to humanity. The major focus of Orem’s theory is individuality in self-care delivery (Simmons, 2009). As such, the nursing practice involves individualized and own initiated strives for maintenance of health and wellbeing.
Orem’s theory works on assumptions that constant communication is vital for survival and existing of humanity; deliberated action is key in identification and meeting of human needs; rational and mature persons experience privations in self-care and when caring for others; and people strive to discover, develop, and transmit ways of needs identification.
Additionally, societies with structured interrelationships provide care for group members; culture and education highly influence individual behavior; each human being has interest capabilities and personal dispositions, and humanity is separate from environments.
Main concepts
Orem’s theory is based on five concepts, including nursing, humans, environment, health, and self-care.
What are the main relationships between the concepts?
Humans are the key emphasis on nursing care. According to Orem’s theory, persons’ environments influence their health. People who are in stable states of health are able to practice self-care. On the other hand, people with ill health are not able to complete comprehensive self-care requirements. Consequently, nursing care is necessitated to aid ill people in completing self-care prerequisites. As such, it is imperative for nurses to assess patients’ abilities to provide self-care and environmental context.
How do different concepts affect each other?
According to Orem, environments play key roles in human health. The nursing practice affects human health by making interventions when people cannot provide self-care.
Origins of the Theory
What was going on in the profession of nursing or in American society that may have influenced the theory?
Nursing scholars were theorizing the role of nurses in care delivery. Orem viewed nursing as a tool to provide care to society.
What values, theories, evidence, and/or existing knowledge did the theorist cite as support for the theory?
Orem observed that people are able to deliver self-care, unless in circumstances where they are unhealthy.
What motivated the theorist to write the theory?
Oftentimes, people are encouraged to bring out the best of themselves even in extremely difficult circumstances. Orem was influenced by the abilities of patients giving self-care at some points of their illnesses.
What approach to theory development did the theorist use?
Orem’s theory developed between 1959 and 2001 covering a broad scope while incorporating general concepts of the paradigm of nursing theories. As such, Orem’s theory developed to a grand theory usable in nursing practices in all environments.
Usefulness
How useful is this theory in practice?
Orem’s theory is vital in nursing practice. The model provides clear steps to be followed during care delivery. Orem’s theory steps, if used effectively, can augment outcomes in care delivery (Altay & Çavuşoğlu, 2013).
Is the theory practical and helpful to nursing?
Orem’s theory is pertinent to healthcare delivery since it gives guidelines in nursing practice.
Does it contribute to understanding and predicting outcomes?
Orem’s model has some scientific aspects, which can be used to make predictions of outcomes.
Cite an example/case study where this theory could be used.
Orem’s theory can be used in a case where there are people who are healthy and people with ill health.
Testability
How testable is this theory?
Orem’s model can be tested using scientific and empirical studies (Shah, 2015).
Has this theory generated research? How many and what types of studies?
Orem’s model has generated a number of studies that pertain to self-care delivery.
Give one example of a study done using the theory
A study was done on burn patients and positive outcomes were more apparent to patients under Orem’s model relative to the control group. The study recommended the adoption of Orem’s model in care delivery (Hashemi, et al., 2014 ).
Types of statements are the propositions
Orem’s theory has clearly defined propositions, including views that self-care is influenced by factors such as age, experience, sociocultural settings; people can learn and recall capabilities to provide self-care, and individuals strive to balance self-care capabilities and self-care deficits.
Additionally, caregiving stakeholders include nurses, patients, and societies; nurses should assess patients’ capabilities to provide self-care before making interventions, and caregivers should employ reliable and valid tools to facilitate self-care.
Overall Evaluation
Is the theory comprehensive and specific?
Orem’s model is comprehensive and specific to nursing and healthcare delivery.
How general is the theory?
The theory is relatively general and can be used in a number of nursing environments.
Summarize the strengths and weaknesses of the theory.
Orem’s model has a number of advantages, including providing a comprehensive basis for nursing practice, especially on nursing education and nursing administration; contemporary in nature and with pertinent concepts of health maintenance; and giving guidelines to nursing, especially in the determination of when nursing is needed.
Nonetheless, Orem’s theory has limitations, including the insufficient definition of systems; perceiving health issues as dynamic phenomena; and overemphasizing illness.
Use of Orem’s theory in advanced practice
Orem’s model, as a framework, is usable due to its simplicity and logical nature (Shah, 2015).
References
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Altay, N., & Çavuşoğlu, H. (2013). Using Orem’s Self-care Model for Asthmatic Adolescents. Journal for Specialists in Pediatric Nursing, 18(3), 233-242. doi: 10.1111/jspn.12032.
Faust, C. (2002). Orlando’s Deliberative Nursing Process Theory: a practice application in an extended care facility. Journal of Gerontological Nursing, 28(7), 14-8.
Fee, E., & Garofalo, M. E. (2010). Florence Nightingale and the Crimean War. American Journal of Public Health, 100(9), 1591. doi: 10.2105/AJPH.2009.188607.
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Hashemi, F., Dolatabad, F. R., Yektatalab, S., Ayaz, M., Zare, N., & Mansouri, P. (2014 ). Effect of Orem Self-Care Program on the Life Quality of Burn Patients Referred to Ghotb-al-Din-e-Shirazi Burn Center, Shiraz, Iran: A Randomized Controlled Trial. International Journal of Community Based Nursing and Midwifery, 2(1), 40–50.
Kamau, S., Rotich, R., Chemutai, C. B., & Chepketer, N. L. (2015). Application of Florence Nightingale’s Model of Nursing and the Environment in the management of Multiple Drug Resistant Tuberculosis Infected Patients in the Kenyan Setting. Open Acess Library Journal ,. doi;10.13140/RG.2.1.2227.6963.
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Rosińczuk, J., Kołtuniuk, A., Górska, M., & Uchmanowicz, I. (2015). The Application of Callista Roy Adaptation Model in the Care of Patients with Multiple Sclerosis – Case Report. The Journal of Neurological and Neurosurgical Nursing, 4(3), 121-129. doi: 10.15225/PNN.2015.4.3.5.
Selanders, L. C. (2010). The Power of Environmental Adaptation. Journal of Holistic Nursing, 28(1), 81-88. doi: 10.1177/0898010109360257.
Shah, M. (2015). Compare and Contrast of Grand Theories: Orem’s Self-Care Deficit Theory and Roy’s Adaptation Model. International Journal Of Nursing Didactics, 5(1), 38-41. doi: 10.15520/ijnd.2015.vol5.iss01.28.39-42.
Simmons, L. (2009). Dorthea Orem’s Self Sare Theory as Related to Nursing Practice in Hemodialysis. Nephrology Nursing journal : Journal of the American Nephrology Nurses’ Association, 36(4), 419.
Suliman, W. A., Welmann, E., Omer, T., & Thomas, L. (2009). Applying Watson’s Nursing Theory to Assess Patient Perceptions of Being Cared for in a Multicultural Environment. The Journal of Nursing Research, 2009, 17(4), 293- 300.
Zborowsky, T. (2014). The Legacy of Florence Nightingale’s Environmental Theory: Nursing Research Focusing on the Impact of Healthcare Environments. HERD : Health Environments Research & Design Journal, 7(4).