There are many situations in the case study of Juan Duran that can be compared to the related theories in which were presented this week. The two theories in which will be most useful in meeting the needs for the patient Juan Duran are Dorothea Orem’s Model in which will look at self care as well as Betty Neuman’s Theory in which will present with the stressors in life and their effects. Mr. Duran has many obstacles to overcome including poor vision, loss of a daughter, wife not able to speak fluent English, and a chronic disease of diabetes to manage. In order to manage all of the many stress and obstacles Mr. Duran is currently facing the two theories mentioned will help in planning care and assisting the family.
Presented in the case study is Mr. Juan Duran a Mexican American from Chula Vista, California. The patient is married and a navy veteran who has been diagnosed with diabetes. Due to his limited eye sight, Mr. Duran has had a difficult time performing self-care by injecting insulin himself. After meeting with the doctor, Mr. Duran was assigned a diabetic counselor at the VA (Veterans Affair Medical Building) to learn how to give himself the medication. His wife was not present in the case study in which would be necessary if she were going to be the person injecting the medication. Also at home Mr. and Mrs. Duran speak Spanish due to Mrs. Duran’s limited English. If the patient and wife were present and the counselor spoke Spanish or had a medical translator available, this would relieve some of the stress and help the patient and family learn about the disease and the medications needs to control diabetes.
Dorothea Orem’s self care deficit theory in nursing encompasses “three nested theories: theories of self-care, self-care deficit, and nursing systems” (McEwen 2014, p. 143). According to the case study Mr. Duran does not like to ask questions and keeps to himself so he may be reluctant to ask for help with his vision or taking his medication. The scenario did not mention how long Mr. Duran has been without medication because he did not ask for help initially. This hesitation incorporates a psychosocial theory in which will be addressed by the nurse, doctors and counselor. Encouraging self-care as mentioned in Orem’s theory will help the patient in wanting to maintain health and improve quality of life.
According to Orem’s theory nursing care should entail wholly compensatory (doing for the patient), partly compensatory (helping the patient do for himself or herself), and supportive- educative (helping patient to learn self care and emphasizing on the importance of nurses’ role.) The supportive education the patient is receiving is the diabetic counselor as well as the information being relayed from the nurse to the medical team to plan care and teach the family about self-care.
Besides the limited eye sight and stress of trying to learn how to give himself injections and test blood sugar, his daughter had just passed away a few weeks prior after being murdered. Now the responsibility of raising her daughter falls on the Duran’s. Neuman’s Theory outlines the role of stress and how stress plays a major role on the five interacting variables in which are necessary for overall wellbeing. The five variables include: physiologic, psychological, sociocultural, developmental and spiritual. Neuman’s model looks at the patient as a whole and how to prevent such stressors. According to McEwen, “Neumans’ model uses a systematic approach that is focused on the human needs of protection or relief from stress”(McEwen 2014 p.150). The two models outlined include Neuman’s model and Orem’s model. Both together will ultimately look at the whole patient and understand the best way to treat the patient internally and externally. The patient Mr. Duran has many obstacles in which are addressed with each of these theories. These early theories are the backbone of current nursing principles and standards and have helped in defining, explaining and describing nursing and its concepts in systematic way.

References
McEwen, M. & Wills, E. (2014). Theoretical basis for nursing (4th ed.). Philadelphia, PA:
Wolter Kluer Health/ Lippincott Williams & Wilkins.