Theory Analysis Paper
Theory Analysis Paper
Sharisse T Watkins
Nursing Theory and Advanced Practice 502-B01
Liberty University
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Theory Analysis Paper
Theory Analysis Paper
Theory analysis is a, “systematic process of objectively examining the content, structure
and function of a theory” (McEwen & Wills, 2011). The nursing grand theory analyzed in this
paper is Orem’s Theory of Self-Care. In order to successfully analyze Orem’s theory, the
approach referred to as Chinn and Kramer’s Theory Description and Critical Reflection will be
utilized. This theory analysis approach is a two-phase process: theory description phase and
critical reflection. The theory description has six elements: purpose, concepts, definitions,
relationships, structure and assumptions. The second phase is a critical analysis to determine
“how well the theory serves its purpose” (McEwen & Willis, 2011). The intention of this paper
is to examine Orem’s theory by employing Peggy Chin and Maeona Kramer’s method of theory
description and critical reflection.
Theory Description
Purpose
Doctor Dorothea Orem began to form the Self-Care Nursing Deficit Theory (SCNDT) in
1971. It has changed numerous times since the original conception, but the main idea has
generally stayed the same. The SCNDT is three nested theories: Nursing System, Self-Care Deficit
and Self-Care (McEwen & Willis, 2011). This paper will focus on the smallest-nested of the
theories, self-care. The theory of Self-Care explains “why and how people care for themselves”
through conscious, learned actions that are unique to the individual (Gligor & Domnariu, 2020).
Concepts
Similar to the metaparadigm of nursing, Orem’s Self-Care Theory centers on the four key
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Theory Analysis Paper
concepts: person, health, environment and nursing. Orem added many more additional
concepts to mold her theory, such as: self-care, self-care requisites, universal self-care
requisites, developmental self-care requisites, health deviation self-care requisites, therapeutic
self-care demand, deliberate action, nursing system and product of nursing (McEwen & Willis,
2011).
Definitions
While there are a plethora of definitions of the metaparadigm components available, it
is essential to be knowledgeable how Orem defined them to understand how they fit into her
theory. All of her components will be discussed through this paper if not immediately
addressed.
Orem defined nursing as an art practiced by the nurse who gives special assistance to a
person who needs more than average assistance (McEwen & Willis, 2011). She then uses the
word human instead of person, encompassing all age spans as the “material object” of the
nurse. This could be one human or a social unit. Environment (family culture and community
included) is the physical, biological and chemical surroundings of the human or social group.
Lastly, health is “being structurally and functionally whole or sound,” but also a state where a
human or group of humans can use their health status to signify experience or communicate
with others (McEwen & Willis, 2011).
Next, are the pertinent definitions to the theory itself: self-care, self-care requisites,
universal self-care requisites, developmental self-care requisites, health deviation self-care
requisites, therapeutic self-care demand and deliberate action. Self-care is the center of the
theory and is defined as a purposeful action completed to ensure human life thrives and is
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Theory Analysis Paper
sustained. Within self-care are subcategories called, “self-care requisites." There are three self-
requisites: universal, developmental and health deviation. Universal self-care is necessary to all
humans, developmental self-care is needed to grow and health deviation self-care is a learned
behavior due to adaption caused by health care deficits (McEwen & Willis, 2011).
Therapeutic self-care demand is the action of the nurse completing self-care tasks for
the patient who is unable to do so themselves to produce a better outcome. Deliberate action is
the intentional action to complete the self-care actions (McEwen & Willis, 2011).
Relationships
The relationships in Orem’s theory appear to be easily deduced. Orem believed that
humans interacted with each other and their environment continuously to stay alive and to
thrive. Humans hold the power to make decisions based on appropriate judgment calls. Humans
need to be able to communicate or alter their environment to be able to survive, rather alone
or in groups. Orem recognized humans are complex beings and therefore continuously updated
her needs theory throughout her life (McEwen & Willis, 2011).
Structure
Again, this paper focuses on one piece of Dorothea Orem’s interconnected larger theory.
If all pieces of her theory were to be analyzed, not only would this paper be longer, it would be
much more complicated. Instead, the self-care aspect is analyzed alone. The Self-Care Theory is
the innermost circle of her theory, the foundation of it all. Orem’s Self-Care Theory begins with
a human’s self-care. When demands are not met, a self-care need is created. Orem produced a
conceptual framework that introduced conditioning factors, which influenced an individual’s
self-care (Younas, 2017). Basic conditioning examples are factors such as age, gender,
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Theory Analysis Paper
developmental state and health status. When a self-care deficit cannot be fulfilled by the self-
care agency (the ability of an individual to fulfill his/her own tasks), a nursing agency will
provide effective self-care. Nursing agencies are utilized appropriately to ensure self-care is
promoted and the deficit does not widen.
Assumptions
Dorothea Orem rendered major assumptions based on the individual human and the
nursing system. Because her over arching theory is a nested set of three theories, the
assumptions overlap. Her first assumption was that humans are all special and different but
have the same basic needs of living. The second is that all human beings have the ability to
provide self-care based on what is needed in a particular life stage. Lastly, if there are any
deviations from the standard self-care, deliberate action needs to be taken to correct the
deviation (Younas, 2017).
Critical Reflection
Sematic Clarity and Consistency
Dorothea Orem clearly defined her concepts for her SCNDT. Each concept is linked and
dependent on one another. Therefore, it is imperative a nurse knows and understands each
defined concept in order to utilize the theory effectively in practice. As described earlier, since
the SCNDT is a nested theory, many of its aspects overlap and the concepts are no exception
(McEwen & Willis, 2011). A prime example is in Dorothea Orem’s personal writing, she writes
nurses should have the knowledge of “concrete actions” that ultimately replace the self-care of
the individual. “They must know not only patients’ usual self-care systems but also the self-care
measures that are equal to the effective meeting of particularized self-care prerequisites,”
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Theory Analysis Paper
(Orem, Renpenning & Taylor, 2003). This signifies that in order to apply the theory in its entirety
in practice, a nurse has to grasp the meaning of each individual concept mentioned throughout.
Consequently, the theory exemplifies the consistency component. However, because Orem’s
theory slightly changes the wording and definitions of the metaparadigm, the semantic clarity is
slightly lessened (Younas, 2017).
Structural Clarity and Consistency
The SCNDT is structurally sound concept wise in both clarity and consistency. The
relationships that are formed between the nursing metaparadigm, self-care agencies and
conditioning factors are all connected with each other and showcased in the diagram (McEwen
& Willis, 2011). Although the Self-Care Theory’s illustrative structure gives impression to be
overly simplified, one must remember it is just one part of a whole interwebbed theory. All of
the concepts are related to self-care or lack thereof, therefore consistent throughout the entire
theory.
Complexity
Needs theories in general are complex due to our ever-evolving environments such as
the use of technology and pursuit of knowledge (McEwen & Willis, 2011). However, while the
nursing agency of complex care within Orem’s Self-Care Deficit Theory is difficult to grasp, the
concept of the Self-Care Theory itself is not complex. As a comprehensive whole, Orem’s SCNDT
can become overwhelming due to each theory having its own formulated assumptions,
definitions and revisions (Gligor & Domnariu, 2020).
Generality
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Theory Analysis Paper
The entire SCDNT is applicable to every living human because it focuses on self-care
needs that are essential to survival. It addresses not only a singular human’s needs but a group’s
as well. Self-care needs are continually progressing based on individual or group’s conditioning
factors. All of the concepts can be applied to all aspects of both the self-care and nursing
agencies.
Accessibility
Self-Care is the framework for both the patient and nurse across all fields of nursing. It
becomes of even more importance when the patient is diagnosed with medical conditions that
become debilitating (Gligor & Domnariu, 2020). Orem’s theory is both beneficial for guiding
front-line operational care and empirical theory testing. However, the main goal of Orem’s
entire theory is to ensure all basic human survival needs are met and the individual is capable
within reason and their own ability to fulfill it themselves.
Importance
“Orem’s theory is considered more useful in practice than in research,” but it is
important because, “-- (it) provides nurses with a perspective to understand that patient’s
situation and a way to organize information into the patient daily care,” (Gligor & Domnariu,
2020). The theory has also proved important to graduate students because it is completely
realistic in day-to-day nursing practice (McEwen & Willis, 2011). Although it made not lead the
way in terms of research, this grand nursing theory has given birth to numerous middle-range
theories (Younas, 2017). This theory has been repetitively applied and referred to, to guide
nursing practice of both novice and experienced nurses.
Conclusion
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Theory Analysis Paper
This paper analyzed the Self-Care Theory, innermost circle of Dorothea Orem’s grand
theory, the Self-Care Nursing Deficit Theory by applying Chinn and Kramer’s theory description
and critical reflection. The theory’s purpose was summarized and the concepts were
appropriately defined. In the critical reflection area of this paper, the Self-Care Theory’s
structure, usefulness and importance were examined. Conclusively, this paper determined
Orem’s Self-Care Theory to be a solid, inclusive framework able to be applied to daily human life
in all populations.
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Theory Analysis Paper
References
Gligor, L., & Domnariu, C. (2020). Patient Care Approach Using Nursing Theories - Comparative
Analysis of Orem’s Self-Care Deficit Theory and Henderson’s Model. Acta Medica
Transilvanica. 25(2), 11–14. https://doi.org/10.2478/amtsb- 2020- 0019
McEwen, M., & Wills, E. M. (2011). Theoretical basis for nursing.
Philadelphia: Wolters Kluwer/Lippincott. Williams & Wilkins.
Orem, D., Renpenning, K., & Taylor, S. (2003). Self-care theory in nursing selected papers of
Dorothea Orem. Springer Pub.
Younas, Ahtisham. (2017). A foundational analysis of Dorothea Orem’s self-care theory and
evaluation of its significance for nursing practice and research. Creative Nursing, 23(1), 13-23
doi:http://dx.doi.org.ezproxy.liberty.edu/10.1891/1078- 4535.23.1.13
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