Dothea Orem Self-Care Theory

Dorothea Orems ego-Care Theory This page was last updated on February 4, 2012 INTRODUCTION theoretician Dorothea Orem (1914-2007) Born 1914 in Baltimore, US Earned her diploma at frugality 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 executive and nurse consultant. Received honorary Doctor of Science degree in 1976. Theory was first published in breast feeding Concepts of Practice in 1971, second in 1980, in 1995, and 2001.MAJOR ASSUMPTIONS People should be ego-reliant and credi cardinalrthy for their own caveat and opposites in their family needing apprebiddysion People are different individuals care for is a form of action interaction between two or more persons Successfully beting universal and development egotism- electric charge requisites is an of the essence(predicate) role of primary consider prevention and ill wellnes s A persons knowledge of potential wellness businesss is necessary for promoting ego-importance-importance- tutorship behaviors ego care and dependent care are behaviors learned within a socio-cultural context DEFINITIONS OF DOMAIN CONCEPTSNursing is art, a helping service, and a technology Actions designedly selected and transacted by nurses to help individuals or groups under their care to guard or change conditions in themselves or their surroundingss Encompasses the diligents perspective of wellness condition ,the physicians perspective , and the treat perspective end of care for to render the patient or members of his family capable of meeting the patients self care needs To maintain a introduce of wellness To regain normal or near normal render of wellness in the event of complaint or injury To alter ,control ,or minimize the do of chronic poor health or disability Health health and healthy are terms holdd to find out living things It is when they are structurally and functionally whole or unsounded wholeness or ace. .includes that which makes a person gentle beings,operating in friendship with physio licit and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beings Environment surround shares are enthronement factors, enthronement elements, conditions, and authentic environment Human being has the capacity to reflect, symbolize and use symbols Conceptualized as a total being with universal, developmental needs and capable of unremitting self care A unity that sack function biologically, symbolically and socially Nursing client A human being who has health related /health derived limitations that render him incompetent of continuous self care or dependent care or limitations that result in unable(p) / incomplete care. A human being is the focus of nurse further when a self care requisites exceeds self care capabilities Nursing problem deficits in u niversal, developmental, and health derived or health related conditions Nursing puzzle out a carcass to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of care Nursing therapeuticals deliberate, remainsatic and goal-directed action, OREMS GENERAL THEORY OF NURSING Orems global surmisal of nursing in three related parts- Theory of self care Theory of self care deficit Theory of nursing system A. Theory of Self Care This scheme Includes Self care practice of activities that individual initiates and perform on their own behalf in maintaining brio ,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 therapeutical self care demand totality of self care actions to be performed for more or less uration in order to meet self care requisites by using valid methods and related se ts of operations and actions Self care requisites action 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 outgrowthes and the maintenance of the integrity of human structure and functioning Common to all , ADL Identifies these requisites as oMaintenance of sufficient intake of air ,water, food Provision of care assoc with elimination process oBalance between practise 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 Se eking and securing enamour medical assistance Being aware of and attending to the effects and results of pathologic conditions Effectively carrying out medically prescribed measures Modifying self concepts in pass judgment 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 requisite 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 pass on 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 adjust Scope of nursing responsibility in health care situations oecumenical and specific roles of nurses and patients Reasons for nurses relationship with patients and Orem recognized that specialized technologies are usually actual by members of the health profession A technology is systematized information most 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 condition stateing 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. reg ulatory technologies Maintaining and promoting life processes Regulating psycho physiological modes of functioning in health and disease Promoting human growth and development Regulating position and front in space 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 Production and precaution of nursing systemsStep 1-collect data in six areas- The persons health status The physicians perspective of the persons h ealth status The persons perspective of his or her health The health goals within the context of life history ,life demeanor, and health status The persons requirements for self care The persons capacity to perform self care Nursing diagnosis Plans with scientific rationaleStep 2 cling to 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 Selection 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 specified in the nursing system design Actions are directed by etiology component of nursing diagnosis evaluationApplication of Orems theory to n ursing process Therapeutic self care demandAdequacy of self care agencyNursing diagnosisMethods of helping Air Maintain effective respiration Water No problem Food maintain sufficient intakeInadequate Adequate InadequatePotential for impaired respiratory status P F fluid imbalance existent nutritional deficit r/t nauseaGuiding & directing Teaching Providing physical support Hazards Prevent spouse hatred 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 / draw off dev threatInadequate InadequateActual delay in normal dev. R/T early parenthood Level of education Dev deficit r/t loss of productive organsGuiding & directing Providing psy support Providing physical, psy support Maintenance of health status commission of disease process Inadequate InadequateP/F contd. alterations in health status P/F UTIGuiding & directing, teaching Guiding & directing, teaching Adherence to med fare 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 relatively 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 utilise to validate them ocan be used by the practitioners to guide and improve their practice omust be consist ent with other validated theories ,laws and principles Strengths Provides a comprehensive backside to nursing practice It has utility for professional 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 propellant 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 softheartedness catheterizationcontribution of Orem 3. Self-carethe contribution of nursing knowledges to health care 4. Self-care a foundational attainment 5. Orems self-care deficit nursing theory its philosophic foundation and the sta te of the science 6. Dorothea E. Orem thoughts on her theory . Orems theory in practice. Hospice nursing care 8. resolving power 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 practical application of Dorothea Orems Self-care Practuce Model.Retrieved October 31, 2006. George B. Julia , Nursing Theories- The base for professional Nursing Practice, third ed. Norwalk, Appleton & Lange. Wills M. Evelyn, McEwen Melanie (2002). conjectural Basis for Nursing Philadelphia. Lippincott Williams& wilkins. Meleis Ibrahim Afaf (1997) , Theoretical Nursing Developme nt & Progress tertiary ed. Philadelphia, Lippincott. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott. putter around A Patricia, Perry G Anne (1992) Fundamentals Of Nursing Concepts Process & Practice 3rd ed. London Mosby Year Book.