theory week 4

MC17

CH08.ppt

Home >Nursing homework help >theory week 4

Chapter 8

Dorothea Orem’s Self-Care Deficit Theory

Developed by S. Gordon and C. Kain (2010)

Updated by D. Gullett (2014)

On completion of this chapter, students will be able to:

Describe Orem’s Theory of Self-Care Deficit.

Identify the proper object of nursing identified in Orem’s Theory of Self-Care Deficit.

List the abilities of humans to affect their health as identified by Orem.

Compare and contrast self-care agency and dependent-care agency.

Identify and describe major constructs of the Self-Care Deficit Nursing Theory.

Describe the theoretical linkages between the Theory of Self-Care, Theory of Dependent Care, Theory of Self-Care Deficit, and Theory of Nursing Systems.

Chapter Purpose

Discuss the integration of views of humankind within views of nursing
Discuss the differentiate individual and generally held nurse-specific views of human beings as part of developing viable nursing science
Provide insight into model building and theory development using exemplars from the Self-Care Deficit Nursing Theory

Nursing is Commonly Viewed as:

Human health service
Implies two categories of human beings:
Those who need nursing service
Those who produce nursing service

Nursing as a Human Health Service

Service implies nursing is a helpful activity
Health indicates that the thrust of the service is the structural and functional integrity of persons served

General Theories of Nursing

Gives names and roles to the two categories of human beings
Attributes distinct potential and actual human powers, properties and actions of each human
Identifies the interactions among the types of human beings and their powers, properties and actions
Specifies the broad structural features of the processes that produce nursing

Integration of Views of Human Beings

General views
You can study and think about human beings and their situations without thinking about nursing.
Nurse-specific views
You cannot study and think about nursing without incorporating nursing-specific views of human beings.

Nursing Science

Knowing and seeking to extend and deepen knowing by:
Understanding both the structure of the processes of nursing
Understanding the internal structure, constitution, powers, properties, and nature of those who require nursing

Comprehensive General Nursing Theories Address

What nurses do
Why they do it
Who does what
How they do it

Valid General Nursing Theories

Set forth nursing’s professional-technical features specific to the production of nursing
Provides articulation with interpersonal features of nursing and sets standards for safe effective interpersonal systems
Point to the legitimacy of, or the need for change in, societal-contractual systems

Model Building and Theory Development

Nursing-specific views of human beings are necessary for understanding and identifying
(1) When and why individuals need and can be helped through nursing
(2) The structure of the processes through which the nursing help needed is determined and produced

Self-Care Deficit Nursing Theory (SCDNT)

Began with formulations about the reasons why individuals (the patient)
Need nursing and
Can be helped through nursing

Central Idea

Mature human beings have learned and continue to learn to meet some or all components of their own TSCDs and the TSCDs of their dependents (those for whom the dependent care agent assumes or has responsibility for meeting TSCDs).
Self-care and dependent care (i.e., care delivered by someone other than the individual for the individual) are time-specific entities produced by individuals.

Self-Care Deficit Nursing Theory

Human properties and powers:
Individuals have a continuing demand for self-care
Therapeutic Self-Care Demand (TSCD)
Care for self that must be learned and deliberately performed

Theory of Self-Care

Individuals have the human power to develop and exercise capabilities to know and meet Therapeutic Self-Care Demands using
Self-Care Agency (SCA)
First, investigate or identify what can or should to be done.
Second, decide what can be done.
Third, produce the care.

Theory of Dependent Care

Assumptions relate to the nature of interpersonal action systems and social dependency.

Nursing Is Needed:

When Therapeutic Self-Care Demands exceed an individual’s Self-Care Agency because of health state or health-care–related conditions
Self-Care Deficit (SCD)
TSCD > SCA = SCD = Nursing Required

TSCD and SCA

Vary qualitatively and quantitatively over time
Identified as patient variables
Real or potential existence of a health-related care deficit relationship between care demand and the power of agency is the reason nursing is required

Nurse Agency

Critical power operative in nursing
The power of nurses to think about, design and produce nursing care for others
Investigation of Nurse Agency and the capabilities and conditions for its exercise are critical components of nursing science

Nurses Must Have Knowledge and Skills

Investigating and calculating individual’s TSCD
Determining degrees and development of SCA
Estimating potential for regulation of the exercise or development of SCA
Identify, perform, and support an individual’s SCD when indicated

Nursing Triad of Interrelated Action Systems

Professional-Technical
Necessary for the production of nursing–dependent on the interpersonal system
Interpersonal
Interaction and communication necessary for design and production of nursing
Societal
Established by the specifying contracting parties and their legitimate relationships
Societal-contractual system

Broader Views of Human Beings

Nurse-specific views of human beings fit within broader views of human beings.
Orem identifies five broad views of human beings that support the development of the constructs of Self-Care Deficit Nursing Theory.
Broader views come into play when nurses think about and produce nursing.

View of Person

Human beings are:
Embodied with inherent rights
At once a self and a person
Person-as-agent
Central to understanding and integrating the other views of human beings
Subsumes all other views
Essential to understanding nursing as a triad of systems

View of User of Symbols

Individual human beings are persons who use symbols to:
Stand for things
Attach meaning to them
Formulate and express ideas
Communicate ideas and information to others
Essential to understanding the nursing interpersonal system
Necessary for nurse-patient communication

View of Organism

Individuals viewed as unitary living beings who grow and develop biological characteristics of homo sapiens during known stages of the human life cycle.
Requires knowledge of biology, psychology, human physiology, environmental physiology, pathology, and other sciences.

View of Object

Human beings are viewed as having the status of object subject to physical forces whenever they act to protect themselves against such forces.
Requirement for protective nursing care.
Taken when nurses provide care for infants, young children, or adults unable to control their positions and movements in space and contend with environmental physical forces.

Conclusion

Nursing-specific views of human beings are differentiated from general views of human beings.
General views (human beings as energy fields, living health, or culture-oriented or as caring beings) are helpful in understanding humankind but do not and cannot support viable nursing science.