Discussion Theory 2
SamanthaJa
dorothea_orems__theory_of_self_care_deficit.pptxPresented by Melissa Kurek, Nicholas Kurek, Kimberly Marino and Heather Nowak Dorothea Orem’s Theory of Self Care Deficit
Born in Baltimore, Maryland in 1914
Orem’s parents
Mother was a homemaker
Father was a construction worker
1930- graduated from Providence Hospital School of Nursing, Washington, DC
1935- BSN from Catholic University of America
1945-MSN from Catholic University of America
Orem’s World of Academia
1959- Dean of the School of Nursing at Catholic University of America
1976- Doctorate of Science from Georgetown University
1988- Doctor of Humane Letters from Illinois Wesleyan University
1998- Doctor of Nursing Honoris Causae from University of Missouri
Retired in 1984
Orem’s nursing experience
Operating room nurse
Staff nurse
Private duty nurse
Nurse educator
Nurse administrator
Nurse consultant
Died June 22, 2007
The Historical Evolution of Orem’s Model
1949-1957
Orem worked on developing nursing curriculum and nursing practice
1958-1960
Worked for the Office of Education, in the U.S. Dept. of Health, Education and Welfare as a curriculum consultant
1958-1960 cont’d
Guidelines for Developing Curricula for the Education of Practical Nurses was developed ( Tomey and Alligood, 2006).
Evolution continued
1960-1970
1971
Published Nursing: Concepts of Practice
Eventually served as the acting dean of the School of Nursing at the Catholic University of America
Metaparadigms of Orem’s Model
Person
Environment
Health
Nursing
Metaparadigm: Person
An individual or group of individuals who have the ability to acquire the knowledge necessary to perform tasks of self care.
Ability to integrate self-care tasks and family, community and individual needs.
Motivation to accomplish self care tasks.
Intellectual ability to cognitively perform, delegate and evaluate tasks performed.
Metaparadigm: Health
“Promotes function and development within social groups in accordance with human potential, known human limitation, and the human desire to return to normal” (Tomey & Alligood, 2006 p. 279).
Metaparadigm: Environment
4 realms of state are encompassed in Environment:
Physical
Chemical
Biological
Socioeconomical
Environment
Environment – Physical
Shelter
Security- internal and external
Climate
Amenities eg. Heat, electricity, indoor plumbing, sanitation…
Environment-Chemical
Chemical
Pollutants:
Air
Water
Physical
Lead paints
Mercury
Asbestos
Environment-Biological
Biological
Molds
Pollens
Allergens
Mites
Animal waste and its by-products
Environment-Socioeconomic
Socioeconomic
Family income
Education level
Occupation
Social status
Resources
Metaparadigm: Nursing
The skilled professional who evaluates and acknowledges a patient’s health deficit.
Nursing plans and implements care based on the actual and potential self-care deficits.
Task Performance
Self-Care Promotion
Demographics
Supportive
Coordinated
Concepts Unique to Orem’s Model
Three Nursing Theories
The Theory of Self Care
The Theory of Self-Care Deficit
The Theory of Nursing Systems
Theory of Self-Care
“Self –care comprises the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interest of maintaining life, healthful functioning, continuing personal development and well-being through meeting known requisites for functional and developmental regulations”(Tomey & Alligood, 2006 p.269).
Theory of Self-Care
The Theory of Self-Care has three components: universal self-care needs, developmental self-care needs and health deviation.
Theory of Self-Care Deficit
A self-care deficit occurs when an individual cannot carry out self-care requisites.
Examples of self-care requisites are:
Wound care
Activities of Daily Living
Bowel program
Glucose monitoring
Universal Self-Care Requisites
The 8 elements :
Air
Food
Water
Elimination/Excretion
Activity & Rest
Solitude/Social interaction
Functioning/Well-being
Normalcy
Developmental Self-Care Requisites
Composed of 3 needs
Promote development
Engage in self-development
Preventing or overcoming adverse human conditions and life situations
Health Deviation Self-Care Requisites
When a condition permanently or temporarily alters structural, physiological or psychological function.
Comatose states
Autism
Mental Retardation
Theory of Nursing Systems
Total compensatory support- patient is unable to complete any self-care independently; nursing compensates for patient’s inability to perform self-care.
Partial compensatory support- patient is able to perform self-care tasks with partial or no assistance from nursing.
Educative/supportive compensatory– patient able to perform tasks independently. Nursing provides ongoing education and support.
Clinical Practice Models for Patient Assessment
Theory applies to multiple clinical settings.
Theory applied in order to:
Home
By the patient alone or with assistance provided
Doctor’s office
Education provided and care supervised by a nurse
Hospital
Needs identified, assessed and plan of care implemented
Extended care facility
Help identify the patient’s ability for self-care deficits that need to be addressed to promote health.
Help identify support available to patient such as family and environment.
Encourage patient to develop self-care abilities
Orem’s Theory Applied to Nursing Education
Teaches the student to encourage compensatory care in the patient population.
Conceptualize patients’ current and potential self-care deficits.
Supports the nursing process in all 3 nursing theories.
Research Status of Orem’s Model
Model used by multiple nursing specialties due to encompassing nature of Orem’s theory.
Current research using Orem’s theory would include:
Chinese Medicine
Battered woman counseling
Orem’s Strengths
The Self Care Deficit Theory is specific to nursing.
The Theory can be used in multiple nursing specialties.
The concept of self-care and health maintenance are congruent with contemporary literature in healthcare.
The theory creates a coordinated nursing care plan that adjusts to the patient’s needs throughout recovery.
Orem’s Limitations
Time consuming for nurses
Direct contact is necessary throughout the nursing process.
Multiple levels of the theory to consider Self care, self care deficit and self care deficit potential.
Does not address cultural needs
Analysis and Insights
Three theories combined into one.
Cumbersome
Completely dependent on nursing to assess the patient and family’s ability to complete self-care requisites and deficits
Culturally diverse
References
Marrier Tomey, A. & Alligood, M. (2006). Nursing theorists and their work. (6th ed.) St. Louis, MO : Mosby Elsevier.
Bruce, E., Gagnon, C., Gendron, Puteris, L., & Tamblyn, A.(2009, November 7). Dorothea Orem’s Theory of Self Care. Retrieved from http://www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resources/DorotheaOremTheory.ppt
Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps
