DQ 1: Describe a recent or current ethical issue you have faced in nursing practice or which has attained national attention

DQ 1: Describe a recent or current ethical issue you have faced in nursing practice or which has attained national attention

Nursing in hypertension care comprises counseling about lifestyle changes, blood pressure measurement, and being a translator for the physician. My literature search in CINAHL using the terms middle range theory and nursing resulted in many articles from which I chose an article written by Drevenhorn, E. (2018) on A Proposed Middle-Range Theory of Nursing in Hypertension Care. This study aimed to determine the effectiveness of a nurse’s caring relationship according to Watson’s Caring Model of blood pressure and quality of life and Orem’s self-care deficit theory. According to Drevenhorn, E. (2018), there are not many guidelines available to nursing; therefore, the development of a middle-range theory of nursing in hypertension care was developed to guide nurses in their practice, improve the nursing of patients, and design studies for investigating nursing in hypertension care. Patients’ attitudes and beliefs toward health and sickness, autonomy, personality and traits, level of perceived vulnerability, hardiness, sense of coherence, locus of control, self-efficacy, and access to social support and network were presented. Use of counseling skills, patient advocacy, empowerment, professional knowledge, health education, and support of patients was discussed as the nursing application of theories and models for behavioral change.  Orem’s nursing theory was integrated with the concepts of consultation, including communication, shared decision-making, concordance, coping, adherence, and self-care Drevenhorn, E. (2018). The results support the middle-range hypothesis of self-care for chronic illness. Strategies and education to improve self-efficacy, health motivation and knowledge must be incorporated when designing self-care programs. Patients can participate in nursing interventions with their family members might facilitate improving self-care. Self-care was significantly correlated with learning, health motivation, self-efficacy, social support, and access to care. The studies showed that self-efficacy, health motivation, and knowledge influenced blood pressure. For patients, changing their lifestyle includes performing activities of daily living, including performing self-care.

Drevenhorn, E. (2018). A Proposed Middle-Range Theory of Nursing in Hypertension Care. International Journal of Hypertension, 1–11. https://doi-org.lopes.idm.oclc.org/10.1155/2018/2858253

Using the middle range theory and nursing search in CINAHL, I found an article about hypertension care. A middle-range theory in hypertension care was developed to pilot and mentor nurses in their practice to improve patient care. The concepts of self-care, coping, adherence, communication, and shared decision-making are interlaced with Orem’s theory of nursing. Nursing in hypertension care involves measuring and monitoring blood pressure, lifestyle changes, patient counseling, and the provider’s translator. Medication compliance and lifestyle modification express self-care.

A middle-range theory is developed from practice and research, and other theories can also be incorporated. The development process includes a comprehensive review and literature search to look for concepts reflecting lifestyle change counseling and taking medications to assist an individual in self-care, including citing original literature. Self-care is an act of individuals who has the capability to take care of themselves in their environmental situations (Drevenhorn, 2018). Self-care for health promotion requires that individuals have the ability to take care, sustain and improve their own’s health. Orem’s self-care deficit theory of nursing is incorporated as a natural component in the proposed middle-range theory, and it arises when the capabilities of self-care are not meeting the demands due to existing limitations. The nursing supportive-educative system agencies help patients regain their self-care.

Drevenhorn, E. (2018). A Proposed Middle-Range Theory of Nursing in Hypertension Care. International Journal of Hypertension, 1–11. https://doi-org.lopes.idm.oclc.org/10.1155/2018/2858253