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Self-Care Problems in Elderly Patients

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 a significant integral part of evidence-based practice (EBP) (Holloway & Galvin, 2016). Nursing research contributes to the EBP by retrieving useful information from various scholarly 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 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 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. Accordingly, the significance of nursing research as the primary contributor to renewing 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 to the family nursing practice.

Such problems, even though 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 need 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.

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. Because 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.

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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.

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.

The consequences of the selected nursing concern are 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. Moreover, the lack of self-care skills also influences the patient’s ability to adhere to treatment, follow food restrictions, communicate with family nurse practitioners regularly, et cetera (Holden, Schubert, & Mickelson, 2015). Overall, the complexity of these factors has a vastly 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.

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 (P),
  • does social and environment factors (I),
  • compared to genetic ones (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. 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.

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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 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).

In particular, the purpose of this theoretical framework is to ensure that the patient can implement self-care. The theory also emphasizes the crucial role of the patient, as the nurse should only guide the nurse-patient relationships (Hartweg, 2015). Therefore, it would be highly beneficial to apply this theoretical approach to the EBP proposal, as Orem’s self-care theory is highly suitable for the identified area of concern.


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

This essay overviews the principles of conducting nursing research and its role in evidence-based practice. 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. Thus, it could be concluded that this essay serves as a solid basis for the future development of the research on the identified topic.


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.

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

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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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