Editing my discussion paper to make it more succint

Discuss why the authors of the Theory of Self-Care of Chronic Illness (Riegel, Jaarsma, & Stromberg, 2012) categorized their theory as middle range. Also, discuss whether you agree with this categorization and provide your rationale.

Riegel et al. (2012) inducted the Theory of Self-Care of Chronic Illness (TSCCI) while working with heart failure patients along with their self-care (practice-specific theory). They subsequently categorized TSCCI as middle-range theory (MRT) based on the scope and level of theory rather than the purpose or source/disciplines (McEwen & Wills, 2019). I agree that TSCCI fits the MRT rather than practice (specific) or grand theory (generalized). TSCCI focused on individuals specific to some degree but not narrowed the scope as their previous studies of a specific group of illness-specific while Orem’s focused on general self-care. TSCCI has a limited number of concepts while propositions are clear. It paves for testable hypotheses in different clinical practices. The MRT, grand theory, and practice specific theory are interrelated (McEwen & Wills, 2019, p. 75; Walker & Avant, 201, p.21).

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Discuss the strategy for theory development used for the development of the Theory of Self-Care of Chronic Theory, and the process (steps) used for development of this theory.

Riegel et al., (2012) utilized practice to theory approach to inductively develop TSCCI as MRT from their clinical practice challenges of self-care for heart failure patients (practice/situation-specific). The challenges the patients faced were self-care levels, and the patient’s decisions coincide with the chronic illness (Riegel et al., 2012). They did not believe Orem’s self-care was useful to describe illness-specific, but their previous study is relevant.

Researchers clearly stated the processes for their theory: 1. Concept development by clarifying and define self-care management, monitoring, and maintenance as a process then specify self-care monitoring as a bridge between self-care management and self-care maintenance with linkages and their revised model 2. Three assumptions of self-care. 3. 7 suggested Propositions to test in practice. 4. 8 affecting factors (facilitating and barriers) of self-care. 5. Presented both intended and unintended consequences/outcomes for future research.

Discuss the purpose of the Theory of Self-Care of Chronic Illness, and the context for use. Were the purpose and context explicitly stated in the article?

Authors explicitly stated the purpose and context of TSCCI are to “describe MRT of self-care that addressed the process of maintaining health with health promotion practices within the context of management required of chronic illness” (Riegel et al., (2012). Both presented in abstract, introduction, and conclusion sections. Reigel et al. (2012) did not believe Orem’s self-care was useful to describe self-care for chronic illness. Therefore, using their practice experience as a situation/practice specific theory to induct into MRT. They left possibilities for practice testing in other clinic settings.

Discuss whether the concepts in the Theory of Self-Care of Chronic Illness were theoretically and operationally defined. If so, identify the theoretical and operational definitions of the key concepts used in this theory.

TSCCI is an operational definition concept. Researchers defined and explained in-depth between the critical concepts of self-care management, monitoring and maintenance, and testable in other groups of patients with any chronic illness. They used literature and previous work models in heart failure to measure the concepts and formed a new self-care model with self-monitoring as a bridge between self-care management and self-care maintenance.

How are the concepts in this theory linked? Was there a model showing linkages of concepts?

Researcher did not think their concepts; self-care management, self-care monitoring and self-care maintenance; need to organize in any orders. They defined, evaluated, refined, and clarified how each concept has similarities, differences, and their linkage and referents for testability. They refined the concept and propositions of their previous studied model to create a new model to apply to TSCCI.

Discuss how the assumptions made by the authors contribute to the theory development.

The authors explicitly stated each of their three assumptions as true to accept the knowledge, support, and structure their testable propositions (Jacox, 1974; Powers & Knapp, 2010.  These assumptions are part of the self-care for illness-specific.

Assumption 1: Authors defined general self-care and how it is different from illness-specific.  Assumption 2: Authors brought back the decision making as a value position that someone can make a decision.

Assumption 3: Authors make a value position of how self-care with comorbidities instead of a specific illness and its complication from other providers’ advice.

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