Development of a shared theory in palliative care to enhance nursing competence

Abstract

This discussion article focuses on the theoretical development of a shared theory in the field of palliative care nursing through a process of comparison between Bandura's social cognitive theory and Orem's conceptual model. In many countries, nurses are little prepared to provide care to patients with life-limiting illness. Bandura's theory provides an appropriate framework for evaluating the impact of training programmes aimed at improving nursing competence in palliative care. However, this borrowed psychological theory is not specific to nursing contexts. Orem's self-care deficit theory seems to be an appropriate nursing model to guide the use of Bandura's theory in palliative care nursing situations. A review of the literature published between 1987 and 2011 was conducted to evaluate how Bandura's social cognitive theory and Orem's conceptual model have been linked at a theoretical level in the past. Bandura's theory has been linked with Orem's model essentially at the patient level. A new shared theory that combines Bandura's social cognitive theory and Orem's conceptual model at the nursing level is thus proposed. Palliative care nursing self-competence is hypothesized to influence the quality of nursing interventions in palliative care situations. To further demonstrate the relevance of this proposed shared theory in palliative care nursing contexts, empirical studies are recommended. This shared theory has the potential to provide a solid theoretical framework for evaluating nursing training programmes and, eventually, to improve quality of care and quality of life for patients with life-limiting illness.