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Self-Care in Elderly as a Nursing Concern


The purpose of this paper constitutes several principal aspects. It is essential to overview the principles of research and evidence-based practice. Further, based on the identified nursing concern, it would be appropriate to develop a Population-Intervention-Comparison-Outcome-(Time) (PICOT/PICO) question that will serve as the basis for the development of the MSN project proposal. The identification of the literature research strategy, as well as the application of a theoretical framework, will also be discussed. A comprehensive conclusion will be built upon the findings of the paper.

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Overview of the Selected Evidenced-based Practice Project

Before dwelling upon the discussion of the particular nursing concern that will determine the scope of the future MSN project proposal, it is of high importance to observe general aspects related to research and evidence-based practice in nursing. It is possible to state that nursing research is the significant integral part of the evidence-based practice (EBP) (Holloway & Galvin, 2016). Nursing research and EBP are integrated parts of the scientific process that is improving the modern health care system in various ways. Nursing research is a more theoretical part that develops and observes new strategies for improving the patient’s health.

At the same time, EBP is a practical implementation of the results of theoretical research that tests and refines techniques by providing care for patients. The nursing research contributes to the EBP by retrieving useful information from various scholar studies as well as original research. Regarding the differences between the EBP and nursing research, it could be noted that the EBP covers a larger field of concern (Holloway & Galvin, 2016).

For example, the EBP also includes such aspects as the nursing expertise, principles of decision-making, along with the provision of advanced care. Therefore, it could be concluded that the nursing research is the instrument that ensures that the current EBP is in compliance with the high standards of care and that nurses are informed about the best possible practices.

Accordingly, the contribution of the EBP to professional nursing is evidently positive. As it was identified previously, the EBP represents a holistic framework of various integral components. Each of these components serves as an instrument for the overall improvement of the nursing profession. As nursing strategies are refined and improved according to patients’ needs, it allows collecting more data case by case, leading to the accumulation of knowledge in specific cases. Accordingly, the significance of the nursing research as the primary contributor of renewing the nursing knowledge is apparent.

Therefore, the scope of the future MSN project proposal should be identified. Since my MSN Program Specialty Track is the family nurse practitioner, it is logical that the practice focus, as well as the overall field of interest of the MSN project proposal, would be largely connected with problems specific for the family nursing practice. Such problems, despite the fact that their magnitude for the overall state of the public health sector might not seem to be crucial, are still highly important for numerous people, who are in need for high-quality care and support from a nursing professional.

Additionally, it is appropriate to state that the EBP has a direct impact on the promotion of change within the practice setting of a nurse practitioner. Therefore, I consider my MSN project proposal to be a significant contribution to the improvement of this area of practice.

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Identification of the Nursing Concern to Be Improved

Since the significance of conducting the nursing research as an integral part of the EBP was identified in the previous section, it is possible to dwell upon the discussion of the particular nursing concern that will be the primary scope of the future MSN project. Due to the fact that my nursing role is the family nurse practitioner, it would be appropriate to focus on the problem of self-care of the elderly population. This section aims to provide a strong rationale for the selection of this nursing concern.

The issue of self-care of the elderly is a problem that contains multiple facets. Numerous aspects are covering them, such as the ascertaining of capability for self-care among the patients, educating on the subject and so on (Dorociak, Rupert, Bryant, & Zahniser, 2017). As it is a problem that concerns those with limited capabilities for precise actions, it is essential to find those barriers and work around them, leaving the more difficult tasks to professional care. At the same time, it is crucial to assure the elderly patients that they are still independent and functional people, decreasing their psychological issues regarding their aging. Those actions should provide an improvement in the well-being of senescent people.

First of all, it is possible to state that the selected issue is chosen because it is one of the most frequently occurring problems within the area of family nursing practice. Within my specialty track setting, the lack of self-care skills among elderly patients is highly evident. Since the insufficient level of self-care affects nearly every aspect of the patient’s life, such as cooking, eating, dressing, using the bathroom, grooming, doing the laundry, and other routine tasks, it could be hardly doubted that the various problems would occur frequently.

Apparently, the primary stakeholders impacted by the identified nursing concern are elderly patients since they are directly affected by the problems related to the lack of self-care skills. The second significant group of stakeholders consists of the elderly patients’ relatives and significant ones, who often do not have the time or other resources to provide a sufficient amount of care. Additionally, family nurse practitioners could also be mentioned as the involved stakeholders since they are responsible for the health condition of their elderly patients.

Consequences of the selected nursing concern are evidently negative. First of all, it could not be argued that the inability to perform routine tasks, which were mentioned previously, seriously affects the quality of the patient’s life. Both the psychological and physiological aspects of the inability to independently conduct everyday tasks might lead to the worsening of a patient’s condition. Regarding psychology, it may incur the feelings of hopelessness and infirmity, which may lead to depression and general damage to an individual’s well-being (Liu, Wang, Huang, Cherng, & Wang, 2014).

Moreover, the lack of self-care skills also influences the patient’s ability to adhere to treatment, follow food restrictions, and communicate with family nurse practitioners on a regular basis, et cetera (Holden, Schubert, & Mickelson, 2015). In overall, the complex of these factors has a vast negative impact on the quality of life of elderly patients.

Primarily, it is argued that even though various health disparities found in elderly patients are determined by genetic factors to a considerable extent, the inability to implement self-care is largely caused by social and environmental factors (Passarino, De Rango, & Montesanto, 2016). Therefore, the proposed solution for the selected nursing concern is to investigate how social and environmental factors impact the life of elderly patients and their ability to implement self-care (Sharoni et al., 2015). Accordingly, the purpose statement of the EBP proposal could be formulated as follows: it is critical to identify to which extent social factors and environment influence the implementation of self-care in elderly patients.

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PICOT/PICO Question and Literature Search Process

In the context of the problem’s specificity, the qualitative approach appears to be a more suitable approach to researching the identified topic. Thus, the PICO question could be formulated in the following way: in elderly patients from 60 to 80 years old (P), does social and environment factors like motivation and family support (I), compared to genetic factors (C), associate more with self-care problems (O)? Accordingly, the expected outcome of the conducted research is the development of a comprehensive understanding of the impact of social and environmental factors on the implementation of self-care among elderly patients (Räsänen, Kanste, Elo, & Kyngäs, 2014).

The purpose of conducting the literature review for the EBP project is to provide evidence for the proposed hypothesis by researching other works in the same field. Additionally, it would be possible to avoid possible repetitions and ensure that the research is original, and its findings are substantial. Other than that, a literature review is a valuable tool to systematize the study and to trace its origins, as well as to track how the researched topic has evolved over the years. After all, previous theories often inspire the improvement of the more recent. This also allows highlighting the contribution of the new work to the scientific field.

As literature research is a vital stage in any research, it should be executed following the correct procedure. Firstly, to conduct the literature review, it is essential to employ databases such as Scopus, SAGE Publications database, and CINAHL, as they provide the access to peer-reviewed, reputable sources on the topic. The primary search terms should include self-care, elderly patients, social factors in self-care problems, environment, and genetic factors. Additional search terms might include behavior and family nurse practice. The Uniformed Nurse Practitioner Association is the organization that is highly relevant for the EBP proposal.

Theoretical Framework

It is also of high importance to identify a theoretical framework that will support the proposed EBP research. Arguably, the most suitable theory for the identified area of concern is the Dorothea Orem’s self-care deficit nursing theory (Hartweg, 2015). In general, the theory is based on the interaction between “the self-care agent (person receiving care)/dependent-care agent (family member/friend providing care)” and “the nurse (nurse agent)” (Hartweg, 2015, p. 109).

It allows researchers to have an overview of nursing practices that could be used by self-care agents or dependent-care agents to practice self-care. It also provides tools to ascertain that the patient can tend to themselves, as well as sets roles for the nursing staff and patients in order to maximize the impact of the self-care and to minimize the risks for the patients’ health.

However, to properly utilize this theoretical framework, it is necessary to investigate it through the prism of this research. The data provided by it is used to both obtain the necessary tools for research, and to correctly analyze it.

The theory that was chosen for this assignment provided additional insight into the issue, allowing both to conduct the research and to verify the result. In particular, the purpose of this theoretical framework is to ensure that the patient is able to implement self-care. The theory also emphasizes the crucial role of the patient, as the nurse should only provide guidance in the nurse-patient relationships (Hartweg, 2015). Therefore, it would be highly beneficial to apply this theoretical approach to the EBP proposal, as the Orem’s self-care theory is highly suitable for the identified area of concern.


It could be stated with certainty that the continuous research is one of the most important aspects of the discipline of nursing. Not only it is significant due to its contribution to theoretical aspects of the nursing science, but also it has a vast positive impact on the improvement of the evidence-based practice. Therefore, it is appropriate to state that this paper is an important step toward the implementation of the nursing research.

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This essay overviews the principles of conducting the nursing research and its role in the evidence-based practice. As a result, it was concluded that the nursing research is one of the crucial parts of EBP, as it allows the existing knowledge to constantly refresh. In addition to that, it was found that EBP plays a similar role in terms of the practical implementation of theoretical knowledge, as it allows to expanse the sample and to correct any individual issues.

Moreover, the paper identifies a specific area of clinical concern, develops the PICO question that will guide the future EBP project, and also discussed the literature research strategy as well as the application of the theoretical framework. As such, it could be said that this work has achieved all its goals, providing an overview of existing study formats and mechanics and discussing their importance in the scholar’s research. Thus, it could be concluded that this essay serves as a solid basis for the future development of the research on the identified topic.


Dorociak, K. E., Rupert, P. A., Bryant, F. B., & Zahniser, E. (2017). Development of the Professional Self-Care Scale. Journal of Counseling Psychology, 64(3), 325-334.

Hartweg, D. L. (2015). Dorothea Orem’s self-care deficit nursing theory. In M. C. Smith & M. E. Parker (editors), Nursing theories and nursing practice (4th ed.) (pp. 76-81). F. A. Davis Company.

Holden, R. J., Schubert, C. C., & Mickelson, R. S. (2015). The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. Applied Ergonomics, 47, 133-150.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare (4th ed.). Hoboken, NJ: Wiley-Blackwell.

Liu, M. H., Wang, C. H., Huang, Y. Y., Cherng, W. J., & Wang, K. W. (2014). A correlational study of illness knowledge, self-care behaviors, and quality of life in elderly patients with heart failure. The Journal of Nursing Research, 22(2), 136-145.

Passarino, G., De Rango, F., & Montesanto, A. (2016). Human longevity: Genetics or lifestyle? It takes two to tango. Immunity & Ageing, 13. Web.

Räsänen, P. M., Kanste, O., Elo, S., & Kyngäs, H. (2014). Factors associated with the self-care of home-dwelling older people. Journal of Nursing Education and Practice, 4(8), 90-96.

Sharoni, S. A., Shdaifat, E. A., Majid, H. M. A., Shohor, N. A., Ahmad, F., & Zakaria, Z. (2015). Social support and self-care activities among the elderly patients with diabetes in Kelantan. Malaysian Family Physician, 10(1), 34-43.

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