- Based on the Case Study of Ms G. (presented below) and your readings in Smith (2020) and/or Peterson and Bredow (2020), or theories from other health related disciplines, such as:
- Lazarus & Folkman Stress & Coping McCubbin’s Family Resiliency Model Fishbein’s Theory of Reasoned Action
- Ajzen’s Theory of Planned Behavior
- Health Belief Model
- Olson’s Circumplex Model (Family) Belsky’s Parenting Model
- Locus of Control
- Selye’s Stress Model
- Theory of Learned Resourcefulness Bandura’s Self-Efficacy Theory
- Family Life Cycle
- Aguilera & Messick’s Crisis Intervention Theory
SELECT ONE Middle Range Theory that you believe would be appropriate to guide the nursing care of Ms. G.
- Based on the Selected Middle Range Theory Discuss the Following:
- Theory Development
- Purpose
- Assumptions
- Key Concepts
- Propositions of the Theory
- Based on the Middle Range Theory:
- Identify Three Nursing Assessment Questions
- Identify Three Nursing Actions (Interventions)
- Write one research question based on the middle range theory and the care of Ms G.
- Discuss how knowledge of a middle range theory has informed or guided your nursing practice in the care of Ms G.
Case Study of Ms. G
Demographic Information: 42-year old Hispanic female
Primary Care Clinic Visit: Appointment made in primary care clinic for recurrent vaginal infections and follow-up for atypical cells on pap smear.
Initial complaint: “I am having bleeding between my periods. I have pain in my abdomen and back. I have been feeling lousy for weeks.”
Diagnosis: Stage III Cervical Cancer
History of Present Illness
- Current admission to the medical-surgical unit for a total abdominal hysterectomy
- Post-operative day 3: Patient reporting abdominal pain (7/10 in intensity), intermittent nausea with vomiting, chills and sweats, anxious mood, generalized weakness and insomnia. No frequency on urination or urinary burning. Reports slight red vaginal discharge.
- Emotional Outlook: Crying: States “I knew something bad was going to happen to me. Am I going to die? God is angry with me.”
Past Medical and Surgical History
- History of constipation since childhood. Takes Metamucil daily to promote regularity
- History of asthma
- Termination of pregnancy six months before her divorce since her husband did not want any more children and unstable relationship
Psychiatric History
- Post-partum depression after each pregnancy. Treated with anti-depressants and counseling.
Social History
- No history of substance use
- Reports two to three glasses of wine with dinner every night
- Limited social network since divorce
- Unable to work at present- income $31,000 per year
Cultural/Spiritual History
- Family originally from Puerto Rico.
- Faith-Catholic though has not attended church recently.
Sexual and Reproductive History
- Menarche age 12; sexual abuse age 14 by family friend
- Two Cesarean sections (Patient’s age 24 and age 29)
- Used birth control pills
- Has new sexual partner who she met at work
Family History
- Sons have been delinquent at school; participation in gang activity
- Unavailability of support of parents due to their own chronic illness (Father-prostate cancer; Mother- depression)
Activities of Daily Living
- Limited energy to perform IADLs or ADLs.
GRADING RUBRIC
Components of Assignment # 3
Points
Middle Range Theory
- Theory Development
- Purpose
- Assumptions
- Key Concepts
- Propositions of the Theory
9 points
Middle Range Theory:
Three Nursing Assessment Questions
3 points
Middle Range Theory:
Three Nursing Actions (Interventions)
3 points
Develop ONE Research question to test the Middle Range Theory
2 points
Discuss how knowledge of this middle range theory informs your nursing practice
3 points
Total
20 points