RESPONSE DISCUSSION

The purpose of evaluating theories and their accompanying frameworks is to determine the applicability to practice and benefit for research (Gray et al., 2017). Critically appraising theory and frameworks will not generate new information outside of the theory but does help to provide insight on the usefulness and logical adequacy to nursing practice (McEwen & Wills, 2018). An article by Johnson et. al uses the self-determination theory as a framework to address hypertension self-management in young adults (2019).

The self-determination theory (SDT) is a broad theory focused on human motivation and personality (Center for Self-Determination Theory [CSDT], 2020). In the MyHEART study, the SDT is used to support self-management of hypertension and lifestyle modification. The article describes the principles of the SDT by identifying internal motivation, relatedness, and perceived self-competence and self-efficacy, and applies these concepts to the study to achieve adoption and maintenance of lifestyle modification behaviors (Johnson et al., 2019). Their framework is solidly based in the aspects of the SDT, and the key concepts and constructs are logically utilized throughout their research agenda. The study’s methodology for self-management and lifestyle modification is guided by the concepts of the SDT and tailored to fit their participants. This study is currently ongoing, and it will be interesting to see how the findings connect to the existing framework for the research.

The self-care theory by Evans to improve glucose control in type 2 diabetics boasts many similarities to the self-determination theory, as well as the health promotion model theory (2010). From analyzing the self-determination theory in terms of it use to promote health behaviors in hypertensive patients, I have gained insight on the multitude of paths a theory can guide research on, on the same subject matter. Of course, each theory leads to differing intended methods, but the ultimate outcome of improved patient health remains a constant.

In a previous week, I have identified Pender’s Health Promotion Model (HPM) as an effective theory for use in hypertension management. This is a familiar clinical practice problem in the realm of family practice medicine. The SDT can also be effectively applied to the growing concern of hypertension management through lifestyle modification behaviors. The HPM focuses congruently on internal and external motivations versus the more internal motivational focus of the SDT (Petiprin, 2016). Hypertension is a multifaceted and complex practice problem, which requires acknowledgement of both internal and external motivations to increase the positive effects research can have on lifestyle modification. For this reason, the HPM might be better suited to this clinical concern.

References

Center for Self-Determination Theory. (2020). Theory. Self-Determination Theory. https://selfdeterminationtheory.org/theory/

Evans, M. M. (2010). Evidence-based practice protocol to improve glucose control in individuals with type 2 diabetes mellitus. Medsurg Nursing, 19(6), 317–322. https://doi.org/https://search-proquest-com.ezp.waldenulibrary.org/docview/821544342?accountid=14872

Gray, J. R., Grove, S. K., & Sutherland, S. (2017). Burns & grove's the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Saunders Elsevier.

Johnson, H. M., Sullivan-Vedder, L., Kim, K., McBride, P. E., Smith, M. A., LaMantia, J. N., Fink, J. T., Knutson Sinaise, M. R., Zeller, L. M., & Lauver, D. R. (2019). Rationale and study design of the myheart study: A young adult hypertension self-management randomized controlled trial. Contemporary Clinical Trials, 78, 88–100.https://doi.org/10.1016/j.cct.2019.01.010

McEwen, M., & Wills, E. M. (2018). Theoretical basis for nursing (5th ed.). Wolters Kluwer.

Petiprin, A. (2016). Pender’s health promotion model. Nursing Theory. https://nursing-theory.org/theories-and-models/pender-health-promotion-model.php