Dothea Orem Self-Care Theory

Dorothea Orems self-importance-C be Theory This page was last updated on February 4, 2012 INTRODUCTION Theorist Dorothea Orem (1914-2007) Born 1914 in Baltimore, US Earned her diploma at Providence Hospital Washington, DC 1939 BSN Ed. , Catholic University of America 1945 MSN Ed. , Catholic University of America She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant. Received honorary Doctor of Science degree in 1976. Theory was first published in Nursing Concepts of Practice in 1971, number in 1980, in 1995, and 2001.MAJOR ASSUMPTIONS People should be ego-reliant and responsible for their own kick and others in their family needing flush People atomic number 18 distinct individuals Nursing is a form of action interaction between two or more persons Successfully meeting universal and knowledge self- business organization requisites is an important component of primary care prevention and ill health A persons knowledge of potential health problems is necessary for promoting self-care behaviors Self care and dependent care are behaviors learned in spite of appearance a socio-cultural context DEFINITIONS OF DOMAIN CONCEPTSNursing is art, a helping service, and a engineering science Actions deliberately selected and performed by nurses to help individuals or groups under their care to keep an eye on or change conditions in themselves or their environments Encompasses the unhurrieds purview of health condition ,the physicians perspective , and the nurse perspective Goal of nursing to render the patient or members of his family capable of meeting the patients self care needs To maintain a adduce of health To regain ruler or near normal narrate of health in the event of disease or injury To stabilize ,control ,or disparage the effects of chronic poor health or disability health health and healthy are terms used to describe living things It is when they are structurally and functionally whol e or sound wholeness or integrity. .includes that which makes a person human,operating in conjunction with physiological and psychophysiological mechanisms and a strong structure and in relation to and interacting with other human beings Environment environment components are enthronement factors, enthronement elements, conditions, and developed environment Human being has the condenser to reflect, symbolize and use symbols Conceptualized as a total being with universal, developmental needs and capable of continuous self care A unity that tolerate function biologically, symbolically and socially Nursing client A human being who has health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in ineffective / incomplete care. A human being is the focus of nursing that when a self care requisites exceeds self care capabilities Nursing problem deficits in universal, developmental, and health derived or health related conditions Nursing function a formation to set apart (1)why a person is under care (2)a plan for care ,(3)the implementation of care Nursing alteratives deliberate, formatic and purposeful action, OREMS full general THEORY OF NURSING Orems general surmise of nursing in three related parts- Theory of self care Theory of self care deficit Theory of nursing system A. Theory of Self apportion This theory Includes Self care practice of activities that individual initiates and perform on their own behalf in maintaining support ,health and well being Self care agency is a human ability which is the ability for engaging in self care -conditioned by age developmental state, life experience sociocultural orientation health and available resources Therapeutic self care demand centre of self care actions to be performed for some uration in order to meet self care requisites by using valid methods and related sets of operations and actions Self care requisites actio n directed towards provision of self care. 3 categories of self care requisites are- oUniversal self care requisites oDevelopmental self care requisites oHealth deviation self care requisites 1. Universal self care requisites Associated with life processes and the maintenance of the integrity of human structure and functioning Common to all , ADL Identifies these requisites as o concern of sufficient intake of pedigree ,water, food Provision of care assoc with elimination process oBalance between activity and rest, between solitude and social interaction oPrevention of hazards to human life well being and oPromotion of human functioning 2. Developmental self care requisites Associated with developmental processes/ derived from a condition. Or associated with an event oE. g. adjusting to a new job oadjusting to body changes 3. Health deviation self care Required in conditions of illness, injury, or disease . these include Seeking and securing appropriate medical assistance Being awa re of and be to the effects and results of pathologic conditions Effectively carrying out medically prescribed measures Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care Learning to live with effects of pathologic conditions B. Theory of self care deficit Specifies when nursing is mandatory Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care.Orem identifies 5 methods of helping oActing for and doing for others oGuiding others oSupporting another oProviding an environment promoting personal development in relation to meet future demands oTeaching another C. Theory of Nursing Systems Describes how the patients self care needs will be met by the nurse , the patient, or both Identifies 3 classifications of nursing system to meet the self care requisites of the patient- Wholly compensatory system Partly compensatory system Supportive educative system Design and elements of nursing system define Scope of nursing responsibility in health care situations General and specific roles of nurses and patients Reasons for nurses relationship with patients and Orem recognized that specialized technologies are usually developed by members of the health profession A technology is systematized information about a process or a method for affecting some desired result through deliberate practical endeavor, with or without use of materials or instruments. Categories of technologies 1. Social or interpersonal Communication adjusted to age, health status Maintaining interpersonal, intra group or inter group relations for coordination of efforts Maintaining therapeutic relationship in light of psychosocial modes of functioning in health and disease Giving human assistance adapted to human needs ,action abilities and limitations 2. Regulatory technologies Maintaining and promoting life processes Regulating psycho physiological modes of functioning in health and disease Promoting human growth and development Regulating position and movement in quad OREMS THEORY AND NURSING PROCESS Nursing process presents a method to determine the self care deficits and hen to define the roles of person or nurse to meet the self care demands. The steps within the approach are considered to be the technical component of the nursing process. Orem emphasizes that the technological component must be coordinated with interpersonal and social processes within nursing situations. Nursing Process Orems Nursing Process Assessment Diagnosis and prescription determine why nursing is needed. analyze and interpret make judgment regarding care Design of a nursing system and plan for delivery of care action and management of nursing systemsStep 1-collect data in six areas- The persons health status The physicians perspective of the persons health status The persons perspective of his or her health The health goals withi n the context of life history ,life style, and health status The persons requirements for self care The persons capacity to perform self care Nursing diagnosis Plans with scientific rationaleStep 2 carry designs a system that is wholly or partly compensatory or supportive-educative. The 2 actions are- Bringing out a good organization of the components of patients therapeutic self care demands plectron of combination of ways of helping that will be effective and efficient in compensating for/ overcoming patients self care deficits Implementation evaluationStep 3 Nurse assists the patient or family in self care matters to achieve identified and described health and health related results. collecting evidence in evaluating results achieved against results contract in the nursing system design Actions are directed by etiology component of nursing diagnosis evaluationApplication of Orems theory to nursing process Therapeutic self care demandAdequacy of self care agencyNursing diagnosi sMethods of helping Air Maintain effective respiration Water No problem Food maintain sufficient intakeInadequate Adequate InadequatePotential for impaired respiratory status P F fluid imbalance tangible nutritional deficit r/t nauseaGuiding & direct Teaching Providing physical support Hazards Prevent spouse abuse Promotion of normalcyInadequate InadequateP/F injury A/d in environment Shared housingPersonal development Guiding & directing Guiding & directingMaintain developmental environment Support ed normalcy in environment Prevent /manage dev threatInadequate InadequateActual delay in normal dev. R/T early parenthood Level of education Dev deficit r/t qualifying of reproductive organsGuiding & directing Providing psy support Providing physical, psy support Maintenance of health status Management of disease process Inadequate InadequateP/F contd. alterations in health status P/F UTIGuiding & directing, pedagogics Guiding & directing, teaching Adherence to med regimen Awareness of potential problemsInadequate InadequateP/F ? dherence in self catheterization & OPD RT Actual deficit in awareness of advisability of HRT & RT effectsteaching teaching Adjust to loss of reproductive ability & dev healthy view of illness Adjust life style to cope with change Inadequate InadequateActual threat to self image Actual self deficit in planning for future needs Providing psy support Guiding & directing OREMS WORK AND THE CHARACTERISTICS OF A THEORY Orems theory ointerrelate concepts in such a way as to create a different way of looking at a particular phenomenon ois logical in nature. ois comparatively simple yet generalizable ois basis for hypothesis that can be tested contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them ocan be used by the practitioners to guide and improve their practice omust be consistent with other pass theories ,laws and principles Strengths Provides a compre hensive base to nursing practice It has utility for nonrecreational nursing in the areas of nursing practice nursing curricula ,nursing education administration ,and nursing research Specifies when nursing is needed Her self-care approach is contemporary with the concepts of health promotion and health maintenance Limitations In general system theory a system is viewed as a single whole thing while Orem defines a system as a single whole, thing. Health is often viewed as fighting(a) and ever changing. The theory is illness oriented. RESEARCH ON OREMS THEORY 1. Self-care requirements for activity and rest an Orem nursing focus 2. Nursing diagnoses in patients after heart catheterization voice of Orem 3. Self-carethe contribution of nursing sciences to health care 4. Self-care a foundational science 5. Orems self-care deficit nursing theory its philosophic foundation and the state of the science 6. Dorothea E. Orem thoughts on her theory . Orems theory in practice. Hospice nursing c are 8. Solving the Orem mystery an educational strategy 9. Orems family evaluation REFERENCES Orem, D. E. (1991). Nursing Concepts of practice (4th ed. ). St. Louis, MO Mosby-Year Book Inc. Taylor, S. G. (2006). Dorthea E. Orem Self-care deficit theory of nursing. In A. M. Tomey, A. & Alligood, M. (2002). Significance of theory for nursing as a discipline and profession. Nursing Theorists and their work. Mosby, St. Louis, Missouri, United States of America. Whelan, E. G. (1984). Analysis and application of Dorothea Orems Self-care Practuce Model.Retrieved October 31, 2006. George B. Julia , Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange. Wills M. Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins. Meleis Ibrahim Afaf (1997) , Theoretical Nursing Development & Progress 3rd ed. Philadelphia, Lippincott. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philade lphia, Lippincott. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing Concepts Process & Practice 3rd ed. London Mosby Year Book.