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DOROTHEA OREM’S SELF- CARE DEFICIT NURSING THEORY
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DOROTHEA OREM’S SELF-CARE DEFICIT NURSING THEORY
What is Dorothea Orem’s major assumption about nursing care?
Orem’s concept of nursing and self care was published in 1971 and had six editions.
OREM’S GENERAL THEORY OF NURSING Orem (2001) states her general theory as
follows: The condition that validates the existence of a
requirement of nursing in an adult is the health-associated absence of the ability to maintain continuously that amount and quality of self-care that is therapeutic in sustaining life and health, in recovering from disease or injury, or in coping with their effects. With children, the condition is the inability of the parent or (guardian) associated with the child’s health state to maintain continuously for the child the amount and quality of life that is therapeutic.
The Relationship of Orem’s Concepts to the Three TheoriesTHEORY OF SELF CARE
HTEORY OF SELF-CARE DEFICIT
THEORY OF NURSING SYSTEMS
Self-care When therapeutic self-care demand exceeds self-care agency, a self-deficit exists and nursing is needed
Nursing agency
Self-care agency Nursing systems• Wholly compensatory• Partly compensatory• Supportive-educative
Self-care requisites• Universal• Developmental• Health deviation
Therapeutic self-care demand
------------------------------Basic Conditioning Factors------------------------------
THE THEORY OF SELF-CARE
Self-care Is the performance or practice of
activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being.
Self-care agency The human’s required ability or power to
engage in self-care
THE THEORY OF SELF-CARE
Basic conditioning factors: Age, gender, developmental state, health
state, sociocultural factors, health care system factors, family system factors, environmental factors, patterns of living, and resource adequacy and availability.
Therapeutic self-care demand Is the totality of “care measures necessary at
specific times or over a duration of time for meeting an individuals self-care requisites by using appropriate methods and related sets of operations and actions.”
THE THEORY OF SELF-CARE
Self-care requisites “The reason for which self-care is
undertaken; they express the intended or desired results.” Has 3 categories:
Universal self-care requisites Developmental self-care requisites Health deviation requisites
THE THEORY OF SELF-CARE
Self-care requisites: UNIVERSAL REQUISITES:
Air Water Food Elimination Activity and Rest Solitude and Social Interaction Hazard Prevention Promotion of Normality
THE THEORY OF SELF-CARE
Self-care requisites: Developmental self care requisites:
Associated with human growth and developmental processes and with conditions and events occurring during various stages of the life-cycle and events that can adversely affect development.
Health deviation self-care requisites: Are related to “genetic and constitutional
defects and human and structural and functional deviations.”
THE THEORY OF SELF-CARE
Self-care requisites: Health deviation self-care requisites:
Ex: Seeking and securing appropriate medical
assistance Being aware of and attending to the effects
and results of pathologic conditions and states
Effectively carrying out medically prescribed diagnostic, therapeutic, and rehabilitative measures
THE THEORY OF SELF-CARE DEFICIT
THE THEORY OF SELF-CARE DEFICIT Delineates when nursing care is needed States that nursing care may be provided if
“the care activities are less than those required for meeting a known-self-care demand”
Nursing may be needed when individuals need “to incorporate newly prescribed, complex self-care measures into their self-care systems or;
When the individual needs help in recovery from disease or injury, or in coping with their effects
THE THEORY OF SELF-CARE DEFICIT FIVE METHODS FOR OR DOING FOR
ANOTHER: Acting for or doing for another Guiding and directing Providing physical or psychological
support Providing and maintaining an
environment that supports personal development
Teaching
THE THEORY OF NURSING SYSTEMS
THE THEORY OF NURSING SYSTEMS Based on the assessment of an
individual’s self-care needs and on the assessment of the abilities of the patient to perform self-care activities.
THE THEORY OF NURSING SYSTEMS Nursing agency is a complex
property or attribute of people educated and trained as nurses that enables them to act, to know, and to help others meet their therapeutic self-care demands by exercising or developing their own self-care agency.
NURSING AGENCY VS. SELF-CARE AGENCY?
THE THEORY OF NURSING SYSTEMS THREE CLASSIFICATIONS OF
NURSING SYSTEMS: 1. Wholly-compensatory 2. Partly-compensatory 3. Supportive-educative system
THE THEORY OF NURSING SYSTEMS 1. Wholly-compensatory nursing
system: Represented by a situation in which the
individual is unable to engage in self-care
Client is socially dependent
THE THEORY OF NURSING SYSTEMS 2. Partly compensatory Nursing
System Is represented by a situation in which
“both the nurse and the patient perform care measures or other actions involving manipulative tasks or ambulation.”
Either the patient or the nurse may have the major role
THE THEORY OF NURSING SYSTEMS 3. Supportive-educative nursing
system: The person “is able to perform or can
and should learn to perform required measures of externally a or internally oriented therapeutic self-care but cannot do so without assistance.”
The patient is doing all of the self-care The nurse’s role is to promote the
patient as a self-care agent.
OREM’S THEORY AND NURSING’S METAPARADIGM
Orem has four major concepts in her work: Human beings Health Society Nursing
OREM’S THEORY AND NURSING’S METAPARADIGM
1. Human beings: Are distinguished from other living
things by their capacity: To reflect To symbolize what they experience To use symbolic creations
Have the potential for learning and developing
OREM’S THEORY AND NURSING’S METAPARADIGM
2. Health: Orem supports the WHO’s definition of
health Orem also presents health based on the
concept of preventive health care
OREM’S THEORY AND NURSING’S METAPARADIGM
3. Nursing: Orem speaks to several factors related
to the concept of nursing: Nursing as service Role theory related to nursing Technologies in nursing
Human service
OREM’S THEORY AND NURSING’S METAPARADIGM
OREM’S THEORY AND THE NURSING PROCESS
OREM’S THEORY AND THE NURSING PROCESS According to Orem, “Nursing process is a
term used to refer to nurses’ performance of the professional-technologic operations of nursing practice.”
Orem discusses a three-step nursing process: Nursing diagnosis and prescription Designing the nursing system and planning for
the delivery of care The production and management of nursing
systems
