Borrowed Theory on Orem’s Self-Care Theory

Borrowed Theory on Orem’s Self-Care Theory

In the contemporary medical world especially in the nursing profession, the use of borrowed theories is slowly becoming a mainstay for studies targeting issues affecting nursing. Such reliance on borrowed theories necessitates an in-depth analysis for the establishment of their contribution to evidence-based practice. According to () borrowed theories in nursing are theories originating from disciplines other than nursing that contribute to the development of the body of knowledge of the management of patient’s medical conditions. Their use in nursing is concurrent with proven nursing theories such as Orem’s self-care model. Self-care model has been particularly influential in the management of bedsores in recent times. As such, a scrutiny of ways to improve its returns on this healthcare issue is of utmost significance. A case in point of a measure that will result in the betterment of the outcomes yielded by Orem’s self-care model is the use of borrowed theory.

In essence, this paper devotes its attention to the identification of a borrowed theory that can complement Orem’s self-care model in managing pressure ulcers. Notwithstanding, the discussion seeks to analyze the identified borrowed theory to its practical details for the determination of its origin, previous application and suitability in the management of decubitus ulcers. By so doing, a new understanding of the efficacy of utilizing borrowed theories for the improvement of nursing outcomes is inevitable.

Summary of the Problem and Middle Range Theory (Self-care Theory)

Currently, bedsores remain a significant threat to the provision of high-quality care in most of the USA hospitals. Central to this evaluation is the healthcare burden, which is an aftermath of this undesirable healthcare problem. For instance, Pickham, Ballew, Ebong, Shinn, Lough, and Mayer, (2016) reported that 2.5 million individuals are victims of bedsores every year. Additionally, the high cost of treatment for patients with this condition also depicts the magnitude of this problem. For instance, 11 billion US dollars is the estimated cost that the USA government has to pay every year for the treatment of pressure ulcers. Going by this current situation, the healthcare sector is in dire need of addressing this problem.

At the heart of the efforts aimed at addressing this challenge is the use of proven nursing theories like Orem’s self-care model. In this model, one should help a patient up to the level that he/she cannot accomplish his/her activities of daily living. In essence, this theory is consistent with the prevention of pressure ulcers. As such, this theory is suitable for handling such healthcare problems.

Borrowed Theory and Its Appropriateness to Pressure Ulcers Management

A befitting example of a borrowed theory that scholars have cited to as a good complimentary to the self-care model is the theory of pressure ulcer causation. It identifies pressure as the most important factor for the development of pressure ulcers. Central to this theoretical framework is the idea that constant pressure on the pressure zones of the body like the sacrum results in ischemia, which subsequently causes necrosis of the tissue and eventually to bedsore. The pioneers of this theory of pressure ulcer causation acknowledge that constant pressure deprives oxygen the skin surface of bony prominences causing cell death, which in essence is descriptive of pressure sores (Agrawal&Chauhan, 2012).

Inconsistent to the ideology of the pressure ulcer causation is Charcot’s neurotrophic theory. In his theory, Charcot asserts that injury to the central nervous system (CNS) plays a role in the development of ulcers. Fundamental to his assertion is the argument that an injury to the CNS leads to a secretion of an intrinsic neurotrophic factor necessary for the control of nutrition. Consequently, the tolerance of the skin tissue to pressure reduces causing an ulcer (Agrawal&Chauhan, 2012). Regardless of the differences in how ulcer develops, the two viewpoints hold that pressure is vital for the development of bedsores. Based on these explanations, it is beyond doubt that pressure is indispensable in the decubitus ulcers development.

That said, the theory of pressure ulcer causation is a suitable borrowed theory for the application in management pressure sores. Central to this conclusion is the value it adds to the contemporary knowledge of bedsores’ etiology. By coming to terms with such importance, nursing is open to the generation of new preventive strategies targeting to eliminate or reduce this challenge at the least. As such, it is logical if nurses incorporate this theory into their practice.

Previous Application of Borrowed Theory

Going by the previous use, the theory of pressure ulcer causation has significantly contributed to the establishment of risk assessment tools that are particularly necessary for bedsores prevention. Additionally, this model has also resulted in the development of preventive measures of pressure sores. For instance, Agrawal and Chauhan, (2012) observes that theory of pressure ulcer causation is the sole reason for the continual use of pressure relievers for the risk reduction of developing bed ulcers in immobile patients. Clearly, based on these illustrations, it is beyond doubt that this theory has contributed significantly to the management of pressure sores.

Application of Borrowed Theory and Practice Change

Currently, the borrowed theory of preference is also applicable in a variety of ways that are mention. A case in point a nurse can utilize this theory to predict the chances of an individual to develop decubitus ulcers. That is for sure because a nurse bearing this knowledge can appreciate the need for risk assessment for the at-risk patients such as comatose patients. Consequently, the prevention of this healthcare problem becomes inevitable. Notwithstanding, through this theory, individuals can develop measures for pressure relief as a means of preventing decubitus. That is the case because it is apparent that pressure plays a significant role in the development of bedsores. Finally, the pressure theory is also important to modern nursing practice because, through regular risk assessment, a concept of this theory, staging of pressure ulcers is possible (Registered Nurses’ Association of Ontario, 2011).

Precisely, with such application of this theory, change in nursing practice is inevitable. That is the fact because a nurse relies solely on risk assessment for the institution of preventive measures that will reduce the chances of developing ulcers. Besides, the nurses become independent as they utilize their knowledge to rationalize the planned care instituted. A typical example demonstrating this change is a nurse initiating a prevention plan for pressure sores without waiting for the physician’s approval (Registered Nurses’ Association of Ontario, 2011). With such instances, it is beyond doubt that the theory will significantly change nursing practice.

Application of both Borrowed and Middle-Range Theory

Without a doubt, an integration of the theory of pressure ulcer causation with Orem’s self-care model will result in the best solution to this healthcare problem. That is a fact due to the dual advantages yield of this integrated approach. Primarily, the self-care model will have the nurse take care of the at-risk individuals in a nursing system approach, which is beneficial in the halting of pressure ulcers development (Meleis, 2011). On the contrary, the pressure theory will equip the nurses with the knowledge of what they can do to avoid the same. Relieving of pressure is a befitting example of what nurses stand to gain from the pressure theory. Evidently, the concurrent use of these two models will result in synergistic action that is necessary for the circumventing of this healthcare challenge.


Concisely, this paper aimed at identifying a borrowed theory that can complement Orem’s self-care model in managing pressure ulcers. Also, the discussion focused on analyzing the identified theory to its practical details. Indeed, this analysis has achieved these goals largely. An implication drawn for nursing practice is the need for more utilization of middle-range and borrowed theories. Central to this deduction is the efficacy of this approach in obliterating pressure ulcers as highlighted in this paper. As such, going into the future, nurses must learn from this perfect example simultaneous use of middle-range and borrowed theories if their practice is to change for the better. In the absence of such, a future blighted with challenges such like decubitus ulcers is inevitable.



Agrawal, K. &Chauhan, N. (2012).Pressure ulcers: Back to the basics.Indian Journal Of Plastic Surgery, 45(2), 244.

Meleis, A. I. (2011). Theoretical nursing: Development and progress.Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Pickham, D., Ballew, B., Ebong, K., Shinn, J., Lough, M., & Mayer, B. (2016). Evaluating optimal patient-turning procedures for reducing hospital-acquired pressure ulcers (LS-HAPU): study protocol for a randomized controlled trial. Trials17(1).

Registered Nurses’ Association of Ontario.(2011). Risk assessment & prevention of pressure ulcers. Toronto, Ont: Registered Nurses’ Association of Ontario.




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