• NURS 600 Assignment 6.1

LA has identified that nursing focuses on understanding cultural aspects in an attempt to minimize health differences in Indigenous and other disadvantaged populations. In line with Lowe et al. (2024), Lowe’s Self-Reliance model, when situated in Indigenous youth substance use prevention and ‘cultural’ and ‘safe’ healing, provides nurses with the skills and understanding to support individuals on their health and healing pathways.

This model aligns Meleis’ theory building and theory application in the construction of the Self-Reliance theory and in describing/ presenting the significant elements, strengths and weaknesses of the theory, including the prospective use of the theory.

Theory Description

The Theory of Self-Reliance, proposed by John Lowe, a Cherokee nurse and academic, provides one perspective that helps explain the health inequities and injustices experienced by Indigenous people. Lowe’s theory helps explain some of the health issues experienced by the Native American population, as well as the reasons for their community’s engagement in treatment and management of issues associated with the use of substances (Lowe, Kelley & Wimbish-Tompkins, 2024).

From the Indigenous perspective on healing, one can be considered healed only when there is a sense of balance and harmony that includes the physical, emotional, and spiritual, as well as the community, and more. In the quest for the ultimate goal of achieving health, preventing self-harm, and restoring one’s culture and identity, self-reliance is what is most important. Unlike many nursing models, Lowe’s Indigenous nursing model seeks to fill some of the existing gaps within the conventional nursing models.

Theory Analysis

Healing and transformation intrinsically encompass individual culture and spirituality. In this sense, the theory challenges Western medicine. Western medicine looks at pathology and little else. This theory presupposes the individual can be self-sufficient, and while this may be the case, it may be the case because of the impact of modern history and marginalization on that individual’s ability. While Lowe’s theory incorporates some other elements that might be novel to some nurses, it is still self-consistent. The theory holds that culture is a key determinant of the discourses on health.

The theory offers a critical view of health discourse oriented toward diverse epistemologies. It might be a challenge for those who are not familiar with Indigenous peoples’ cultures, but adequate training will improve the application of the theory in practice and in the field. Although the theory has been created within the Native American peoples, it has equally the potential to address other resilient and colonized and systematically marginalized communities.

Theory Evaluation

Lowe’s theory provides a starting point for developing a culturally sensitive nursing theory. Meleis (2018) recognizes that culture is integral to the formation of nursing theory. Hence, Lowe’s theory contains culture (Meleis, 2018). In the different branches of nursing, encompassing community, mental, and addiction nursing, Lowe’s theory is applicable because of the positive and generative results of belonging and identity. This is also the case for nursing practice models of social justice and decolonization. The theory is applicable to people, communities, and to policies.

However, because of its long-term focus on spirituality and behavior, this theory is not applicable to acute care and other high-order specialized health care services. While the theory does not directly address the outcomes of the Indigenous population in terms of equity, the theory’s primary goal is to enhance the health status of this population. Using this theory as a basis for practice, nursing would uphold the Indigenous population’s rights to self-determination and equity to receive safe, dignified, and restorative care while advocating for restorative services for the Indigenous population.

Theory Development

Self-reliance theory is backed by evidence and has been included in many programs, especially the CIRCLE initiative for substance abuse prevention (Lowe et al., 2024). There has been a growing interest in self-reliance and the development of both qualitative and quantitative self-reliance indicators. Most of the literature endorses the Culturally Responsive Care and Indigenous Nursing frameworks.

Therefore, it is likely that the self-reliance theory will be used in Indigenous contexts to explain and support the justification of Culturally Sensitive frameworks. Furthermore, it is likely that the self-reliance theory within different contexts, healthcare, and systems will be extended to include trauma-informed care. Finally, self-reliance, in conjunction with social justice and nursing practice, will address the positive social determinants of health and inequities within health social justice.

Conclusion

John Lowe’s self-reliance theory is a culturally and socially responsive theory that explains the nursing issues of Indigenous and marginalized communities. Compared with other theories, it has a unique perspective regarding health and focuses on the healing journey of the self, community, and spirit. Although the theory is against the mainstream biomedical paradigm, using the theory will require cultural humility from the nurse; it is the most helpful theory to explain the strengths of the marginalized communities. Considering the recent developments of the theory and the expansion of the theory for different contexts, it has the most potential to explain the future of nursing.

References

Lowe, J., Kelley, M., Longoria, K., Nnaka, T., & Wimbish-Tompkins, R. (2024). A rural native American community experiences related to emotional and mental health well-being during the COVID-19 pandemic. PubMed, 5(1). https://doi.org/10.31038/ijnm.2024511

Lowe, J., Kelley, M., & Wimbish-Tompkins, R. (2024). Sustainability of an intervention for the prevention of substance use within Native American communities. Archives of Psychiatric Nursing, 51(1), 287–292. https://doi.org/10.1016/j.apnu.2024.06.013

Meleis, A. I. (2018). Theoretical nursing development and progress. Bnd.iau.ir. https://bnd.iau.ir/file/download/page/1731751305-67386d89941ff-meleis-theoretical-nursing.pdf