Scholarly Paper: Application of GQOLE Theory in Nursing Practice

This scholarly paper examines the Register Theory of Generative Quality of Life for the Elderly (GQOLE) as a middle-range theory applicable to nursing practice. The paper begins with an introduction to the theory, emphasizing its focus on connectedness as a core concept and its six forces: metaphysically connected, spiritually connected, biologically connected, connected to others, environmentally connected, and connected to society. It then delves into the application of GQOLE in clinical settings, offering practical strategies for nursing professionals to enhance the quality of life for elderly patients. The paper highlights how nurses can implement the theory through various interventions, such as encouraging self-awareness, facilitating spiritual practices, promoting physical activity, fostering social connections, enhancing environmental engagement, and providing societal resources. The theoretical adequacy of GQOLE is discussed, with a focus on its multidimensional view of quality of life and its grounding in several frameworks. The paper concludes by emphasizing the potential of GQOLE to improve care for elderly patients, providing a framework for nursing professionals to enhance the quality of life for the elderly population. The paper uses multiple references to support the claims and evidence-based practice.

Running head: MIDDLE RANGE THEORY
REGISTER THEORY OF GQOLE
Name of the Student:
Name of the University:
Author Note:

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Introduction
The middle range theory is a theoretical approach and framework that link the nursing
practice and nursing theories. The quality of life is multidimensional that evaluates the life of
people that includes physical health, mental health, and social relationship along with the
environment (de Frias & Whyne, 2015). Nursing professionals need to provide effective care
among the elderly patient to promote the quality of life. According to Burholt et al. (2019),
elderly people find social exclusion and often leads to lack of resources. This paper will
intend to examine the middle range theory that would effectively enhance the quality of life
among older people.
Description of theory
According to Liehr & Smith (2016), the middle range nursing focuses on potential
knowledge by expanding the experience of practices in nursing professionals. Quality of life
(QOL) is a crucial aspect, especially in the elder patient. QOL in older people starts
diminishing when they strike with a disease or any social disruption. The middle range theory
would help in incorporating a few drivers that need to be implementing in the practice of
nursing professionals. According to Register & Herman (2006), register theory of Generative
Quality of Life for the Elderly (GQOLE) is a comprehensive and innovative model. It
addresses the issues that arise in the delivery of quality care to the elderly population. This
model will bridge the gap of connectedness in compare to another quality model. QOL in
elder patient can be increased with the effective practices by nursing professionals. The
general system theory comprises of multiple key ideas, such as interrelationship, goal-seeking
behavior, holism and transformation process. However, the major core belief of register
theory is connectedness. Quality of life can be achieved with six different forces and process.
The first force is metaphysically connected, that is a connection with one own esteem. This

2REGISTER THEORY OF GQOLE
connectedness requires frequent self-consciousness and nurture to generate QOL. For
illustration, it would address the value of the individual, their identity and their objectives.
The second process is spiritually connected; this involves the act of physically connected
with the divine. It can involve the purpose of life through prayer, fellowship and worship. It
brings superior QOL with a sense of satisfaction, happiness and meaning of self to the divine.
The illness influence the QOL in older people and therefore, this spiritual connection would
help in nourishing the soul to diminish the influence. The third force is biologically
connected, an activity that is promoting the benefits and maintenance of health. Elderly
people often get disconnected when they encounter with any disabilities. Therefore,
biological connected would influence or affect in such a way that elderly patients would
embrace those disabilities. Embracing the difficulties enhance the adaptive behavior to offset
the disconnections and sustain the biological connection. The fourth force of register theory is
connected to others, and the connection can be with any human, irrespective to any
individual, whether family member, friends, neighbors or any random stranger. This
interaction and connection will develop a positive loop in an elder patient to generate QOL.
The fifth force in register theory is environmentally connected, being connected
environmentally means connection within oneself and the outer environment. This outer
environment includes daily routine, personnel safety and another environmental factor like
transportation. The final and sixth factor is connected to society. Connection to society means
connection with the two parallel systems. The personal social system is the first system that
involves active participation in any social activity. The global societal system includes
connecting with the global level (Robert et al., 2017). For illustration, participating in any
global context or keeping up with the latest news or any political context. This generative
theory would deliver the role of connectedness in enhancing the QOL in elderly patients
concerning the disease.

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Application in clinical practice
The implication of research theory in nursing professional practice would enhance the
QOL of elderly patients. It would formulate and develop a patient-centric model of care.
Nursing professionals play an important role in providing care and influence their health.
Adapting or application of register theory in clinical practice would establish a unique
framework. The first driver or force in the register theory is metaphysically connected. This
connection is about the connection to self and analyzing self-importance. Nursing
professionals can adapt this practice by guiding their medical report such as imaging and by
conducting any camping or seminar that would focus on their health. Such a practice would
generate awareness and would encourage the factor of self-determination. The second force is
spiritually connected, where elder patients may develop their faith in understanding the
purpose of life. Nursing professionals can involve the elder patient in some activities like
referring faith-based group. They can also help in assessing the elderly patients to the church
with the help of weekly service of transportation. According to Soriano et al. (2016), by
maintain a peaceful environment; nursing professionals can assist them in meditating for
increasing the QOL. The third force is biological connected, that would affect the health of
the elder patient. Nursing professionals can conduct activities such as group exercise, healthy
shopping outing for specific elder patient having diabetes. Few more activities can be letting
the elderly people participating in any of the health fair or any related activity. All these
activities would optimize along with developing the biological connectedness. The next force
of generative theory is connected to others. Nursing professionals can adapt the force by
employing telephone therapy. Encouraging elderly people to connect with their family
member or old friends would increase the connectedness to others. This connectedness can
also be achieved with the help of comfort touch. It involves skin to skin touch that generates
positive feelings and enhances their wellbeing. Environment connected is another force of

4REGISTER THEORY OF GQOLE
generative theory that can be practice in nursing professionals. Simply assisting the elderly
people out to watch children play and listening to birds would enhance the environment
connected. For illustration, the ambulatory elderly patient should encourage to walk around,
actively go out for fishing or any such activity that would connect nature. The last force of
register theory is connected to society. Nursing professionals, especially community health
nurse or public health nurse, are mainly involved in practicing such activities. Elderly people
achieve this connection with the help of knowing or gaining knowledge about Medicare or
any other program that is targeted for the elderly population. Nursing professionals can
provide such information and also information regarding community-based initiatives.
Nursing professionals can also assist elderly people in completing the bills or income tax
forms, and they also help in formulating contingency plan.
Theoretical Adequacy
According to Hammer (2007), the register theory of GQOLE brings a new framework
in quality of life and the structure of quality model has been evolved. The QOL is defined in
multiple prospective by multiple researchers. However, the major is quality of life-related to
health and quality, including the whole multidimensional view. Register Theory of
Generative Quality of Life for the Elderly describes the QOL as a whole multidimensional
view. The quality cannot be specific and therefore, necessary to implement considering
multiple forces that affect the QOL of elderly people. The register theory providing the
quality of life (QOL) in elderly people is an important factor in enhancing their health and in
bringing a positive outcome. It focuses on the general concept and general situation that
would impact effectively on the elderly patient. The register theory has evolved from four
major frameworks that deliver the QOL. According to Estoque et al. (2018), a global
framework, disease-specific framework, deficit-based framework and health promotion
framework are the major frameworks that incorporated in delivering the QOL in the elderly

5REGISTER THEORY OF GQOLE
patients. The global framework develops a holistic view in delivering quality among elderly
people. It focuses not only on a specific context. However, it includes the complete nature of
QOL. The disease-specific framework includes a particular disease that the patient is
suffering. Any specific condition results in the disease-specific frameworks. The final
framework is a health promotion framework. The activities under health promotion result in
the developing of QOL among elderly patients. This promotion builds positive perspective as
its influence and embraces the activity for promoting health. Therefore, this register theory is
developed in a clear picture of providing effective care. It is very much important to
implement this theory in the clinical practice of nursing professionals as it develops multiple
approaches towards the quality care among the elderly patient.
The register theory is built on multiple forces that would improve the QOL among
elderly people. The theory was formulated with the consideration of multiple frameworks that
has a direct effect on the quality of life. However, the implication of register theory of
GQOLE in clinical practice can effect on the reliability of the practice. Nursing professionals
need to interpret the data provided by the patient for developing the patient-centric model.
The theory can be easily implemented in the clinical practice with extra efforts towards the
care. The drivers consider under this theory is a broader concept and may consume time to
implement in the nursing professionals. The time can be constraint only to nursing
professionals who need to attend multiple patients within the limited timeframe.
Conclusion
Elderly patients face multiple struggles to improve their QOL. Nursing professionals
assist them in increasing the QOL with the help of existing clinical practice. However, the
clinical practice can be more beneficial with the adoption of middle-range theory. The
register theory of GQOLE offers another opportunity by a potentially generative approach to

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QOL. This theory identifies the connectedness as a central unifying theme. Connectedness
can be done with six different forces that would enhance the QOL among elderly people.
Nursing professionals can effectively result in developing QOL with a promising framework
register theory among elderly people.

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