Review and comment or make additional comments based on current evidence-based literature on TWO classmates in the “Discussion Board” section of blackboard using research evidence to support your source of the information.

Review and comment or make additional comments based on current evidence-based literature on TWO classmates in the “Discussion Board” section of blackboard using research evidence to support your source of the information.

#1 DOC Middle Age Concept of Nursing Goal

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The future of healthcare has given rise to much uncertainty about care delivery to clients who need it directly and indirectly. With the unending growth of overhead costs spiraling upwards, nurses are finding themselves caught between administrative decisions about staffing and decisions about care delivery, all the while offering quality patient care. So, where does nursing model fit in nursing’s future, and what is the most important theoretical concept that professional nurses can apply to this changing healthcare market? It seems that in recent years, health care practitioners have given little attention to middle age nursing concepts and their importance in nursing practice.

Nursing practice in the 21st century highlights the importance of middle-range theories (MRTs) in cementing a professional nurse’s knowledge base. Smith and Parker (2014), contend that nursing remains on the sideline of the specialized disciplines and faces the risk of being ignored or consumed if adequate attention is not given to the exclusivity of nursing’s research and practice. The progress of MRTs marked the growth of knowledge development. Besides, nursing’s continued evolution has translated to professional specialization, and theories have moved closer to the bedside, allowing nurses to expand their practice knowledge in their specialties.

One of the most essential middle age concepts in nursing is Ida Jean Orlando’s theory of deliberative nursing process. As Chinn and Kramer (2010) explain, this theory holds that a nurse’s role is to identify and meet the patient’s current need for assistance. In this concept, the patient’s presenting behavior may be a plea for help. Nonetheless, the support wanted may not be what it seems; consequently, a nurse needs to use his or her observation, thoughts about the observation or feeling caused by their thoughts to discover with patients the connotation of the patient’s actions. Through this course, a nurse can identify the nature of suffering plus the patient’s needed help.

Orlando’s theory can be linked with the uncertainty in illness theory (UIT) developed by Merle Mishel (Smith & Parker, 2014). In this theory, Mishel addresses uncertainty when diagnosing and treating illnesses with a determined downward trajectory. Since the original theory’s development, the concept of uncertainty was used in nursing and other medical fields with different meanings, extensions, and applications. The relationship between Orlando’s and Mishel’s theories highlights nurses’ imperative to try and find out patients’ concerns and needs. These theories and subsequent provisions form part of the primary goal of the nursing profession.

Nursing’s primary goal encompasses improving patients’ quality of life by taking care of them both physically and psychologically. Nurses usually accomplish this in several ways, including the provision of medications and treatments as per physicians’ orders and in a timely and efficient fashion; this underlines the need to improve patients’ conditions and cure the roots of their illnesses. Also, nurses understand the imperative for patient comfort and safety by checking on them, prevention of complications, and maintaining awareness of any incipient complication. Moreover, nurses try to relieve patients’ anxiety through the provision of education, explanations, and listening to them as part of alleviating their concerns.

In brief, middle-age concepts have proven effective in leading the way for specific situations and nursing phenomena. A plethora of research literature has highlighted the importance of MRTs like Orlando’s theory of the deliberative nursing process in guiding nursing practice and nursing actions to manage health conditions effectively. These aims underpin the overall objective of modern nursing science that incorporates fundamental concepts that include health promotion, illness, and stress.





Chinn, P.L. & Kramer, M.K. (2010). Integrated theory and knowledge development in nursing (8th Ed.). Philadelphia, PA: Elsevier.

Smith, M. & Parker, M.E. (2014). Nursing theories and nursing practice (4th Ed.). Philadelphia, PA: FA Davis.

#2 DOC: Middle-Range Concept

An important middle-range concept, called the self-concept mode, is derived from the Roy Adaptation model. Self-concept is defined by developing self, the perceiving self, and the focusing self (Smith & Parker, 2020). Explained further, self-concept mode means for one to have purposefulness in the universe, as well as feelings that the person holds about them self at a given time (Roy, 2014). The self-concept mode begins by gathering data about behavior of a person, or group, and then identifying the internal and external factors that influence adaptative behaviors (Smith & Parker, 2020). The next step of the Roy Adaptation model is to understand how coping is a crucial concept in understanding how people or groups adapt to changing situations of health and illness (Smith and Parker, 2020). Roy goes on to explain that “Coping and adaptation processing is defined as the person’s ability to respond to changes in their environment by developing strategies and new coping styles to adapt effectively” (Roy, 2014, p. 219). The overall outcome, or desired nursing goal, within the Roy Adaptation model is “the promotion of adaptation for individuals and groups … thus contributing to health, quality of life, and dying with dignity” (Smith & Parker, 2020, p. 154). With this information, to develop a middle-range concept within the Roy Adaptation model, one must identify the patient’s level of self-concept, relate it to the coping concept, and then arrive at their nursing goal. One such example could be to examine disturbed body image, which is an internal factor that influences behavior. A viable coping strategy would be maintaining a positive attitude and outlook, which would lead to the nursing goal of achieving a higher self-esteem for my patient. This coping concept can, however, be structured in various ways. Another example would be a patient with a disturbed body image, who receives emotional support, would lead to a nursing goal of enhanced body image. The middle-range concepts I have provided in my examples are abstract, as they are not directly measurable, but this abstract concept can be related to a certain group of people, therefore, providing guidelines for the level of abstraction (Chinn & Kramer, 2018). The middle-range concept of disturbed body image can apply to any gender, age range, culture or race, meaning that this concept is neither too broad or too narrow.



Kramer, M. K., & Chinn, P. L. (2018). Knowledge development in nursing: Theory and process (10th ed.). Elsevier.

Roy, C. (2014). Generating Middle Range Theory: From Evidence to Practice. Springer Pub.

Smith, M. C., & Parker, M. E. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis Company.

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