Conceptual-Theoretical-Empirical Structure (CTE) Evaluation
Abstracts and general concepts centered on a field of interest are used to create conceptual models. A conceptual model is a framework for developing mid-range theories. Middle-range theories are founded on specific phenomena, which can then be empirically tested via research design, data collection, and data analysis. The goal of this paper is to investigate how the CTE structure translates into nursing practice using the middle-range theory Self-Care of Chronic Illness, which was developed from Dorothea Orem’s Self-Care Deficit Theory. It will assess the theory based on CTE connections, empirical indicators, research findings, and its utility.
Theory of Chronic Illness Self-Care
Dorothea Orem’s Self-Care Deficit Theory assumes that people are distinct individuals who should be self-sufficient and accountable for their own care. Orem’s theory is comprehensive and can be used to improve nursing practice. To address key components of self-care in chronic conditions, Riegel et al. (2012) developed the middle-range theory of self-care for Chronic Illness based on Orem’s conceptual theory. Self-care monitoring, management, and maintenance are critical components. The individual is expected to monitor themselves for physical and mental changes during self-care monitoring. Hypertensive patients, for example, should regularly monitor their blood pressure, diabetics should monitor their blood glucose levels, heart failure patients should monitor their weight, and mentally ill patients should monitor changes in their emotions and behaviors.
Self-care management is the idea that individuals can assess changes and decide whether or not to take action. If a heart failure patient gains more than five pounds in 24 hours, their next course of action may be to take a diuretic to reduce water retention. The third concept of self-care maintenance is the preservation, improvement, and maintenance of well-being. Overweight, diabetic patients would focus on losing weight through lifestyle changes in order to improve their blood glucose levels.
CTE Connections
The chronic illnesses of hypertension and diabetes can be used to describe CTE linkages between Orem’s Self-Care Deficit Theory and the middle-range theory of Self-Care of Chronic Illness. The middle-range theory focuses on specific acts of self-care, whereas Orem’s Self-Care Deficit assumes that individuals are distinct, self-reliant, and responsible for their own self-care. Gil and Oh (2018) applied the Self-Care for Chronic Illness middle-range theory to Korean adult patients with severe hypertension. They discovered statistically significant improvements in blood pressure control as a result of self-motivation, self-efficacy, access to care, and social support. Ausili et al. (2017) created a theory-based tool to assess self-care in diabetic patients and discovered significant relationships between self-care and hemoglobin A1c, as well as self-care monitoring and diabetic complications. Both of these studies demonstrate the connection between Orem’s theory and the middle-range theory of self-care.
Indicators based on empirical data
The real-world application of the middle-range theory is empirical indicators. The middle-range theory of Self-Care for Chronic Illness has many applications in medicine. As previously stated, when this middle-range theory is put into practice, there are positive outcomes in people with hypertension and diabetes. Individuals suffering from COPD, asthma, heart disease, seizures, and a variety of other chronic illnesses can benefit from the self-care model. An asthmatic patient, for example, can follow their asthma plan to ensure self-care maintenance (avoiding asthma triggers), monitoring (symptom evaluation), and management (putting asthma plan into action when needed).
Findings from the Research
According to the research findings, there are only a few studies that use the Self-Care of Chronic Illness theory. The few research studies that have been conducted have demonstrated success in treating chronic Illness. More research into other chronic illnesses, such as COPD, asthma, heart failure, and heart disease, would help pave the way for practice change. The idea of patients being in charge of their own self-care has the potential to improve chronic illnesses, save lives, and reduce costs.
Utility and dependability
The Self-Care for Chronic Illness is both practical and logical in its utility and soundness. A provider can use this middle-range theory in primary care to reduce obesity rates, improve hemoglobin A1c levels, and maintain well-controlled blood pressure. Ausili et al. (2017) discovered a link between self-care and A1c levels. Those who were motivated and routinely monitored had better control. Changing behaviors to reduce or eliminate alcohol consumption, avoid tobacco use, perform hand hygiene, and receive scheduled vaccinations demonstrated that those who were able to perform these behaviors had greater success in managing their chronic illnesses. Using the middle-range theory, Gil and Oh (2018) were able to demonstrate a 45.3% improvement in hypertension among 224 participants.
Conclusion
The CTE structure is a path from broad concepts to a specific discipline that can then be empirically evaluated. Assessment of the Middle-Range Theory Self-Care of Chronic Illness demonstrates a connection to Orem’s Self-Care Deficit Theory, as well as its applicability to real-world scenarios and utility in improving patient outcomes. The concepts of self-care monitoring, maintenance, and management enable patients to take control of their health and value healthy choices. More research is needed to demonstrate how effective these simple concepts can be in improving one’s quality of life. Self-care in chronically ill people should not be confused with self-care in healthy people. Self-care for the healthy includes things like brushing their teeth, going for a daily walk, showering, and so on. Self-care in chronically ill patients aims to change poor choice behaviors, identify symptoms, and know when to act on mental or physical change to prevent exacerbation. Self-Care for Chronic Illness is a middle-range theory that encourages people to take an active role in their own health.
References
Ausili, D., Barbaranelli, C., Rossi, E., Rebora, P., Fabrizi, D., Coghi, C., Luciani, M., Vellone, E., Di Mauro, S., & Riegel, B. (2017). Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: the Self-Care of Diabetes Inventory. BMC Endocrine Disorders, 17: 1– 12. https://doi-org.lopes.idm.oclc.org/10.1186/s12902-017-0218-y
Gil, E., & Oh, H. (2018). [Testing a middle-range theory of self-care of chronic Illness: A validation for Korean adult patients with severe hypertension]. Journal of Korean Academy of Nursing, 48(5): 521-533 https://doi-org.lopes.idm.oclc.org/10.4040/jkan.2018.48.5. 521
Riegel, B., Jaarsma, T., & Stromberg, A. (2012). A middle-range theory of self-care of chronic Illness. Advances in Nursing Science, 35(3): 194-204. Retrieved from file:///C:/Users/VHAPRELobueL/Downloads/A%20Middle-Range%20Theory%20of%20 Chronic%20Illness.pdf
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Question 
Use the theory that you developed in week two. Improve it by using the information you have obtained in the intervening weeks. Use the Conceptual – Theoretical – Empirical Model (CTE) to link the operational definitions with the empirical indicators with the theoretical concepts and the conceptual model components. Post your revised theory and explain how you would measure the concepts and propositions in a research study.
Conceptual-Theoretical-Empirical Structure (CTE) Evaluation
Expectations
Initial Post:
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years