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chapter_13.pptxSelf-Care Deficit Theory of Nursing: Dorothea Orem
Chapter 13
Overview of Orem’s Self-Care Deficit Theory of Nursing
Three theories in relationship constitute Orem’s self-care deficit theory of nursing each of which has as its focus a specific dimension of the person
Theory of self-care focuses on the self
Theory of self-care deficit focuses on you and me
Theory of nursing system focuses on we, persons in community
Theory of Self-Care
Self-care agency has three dimensions
Development
Operability
Adequacy
Therapeutic self-care demand consists of the summation of care measures necessary to meet all of an individual’s known self-care requisites
Theory of Self-Care
Three types of self-care requisites are integrated into the theory of self-care and provide the basis for self-care
universal self-care
developmental self-care
health-deviation self-care
Universal Self-Care Requisites
Maintenance of sufficient intake of air
Maintenance of sufficient intake of water
Maintenance of sufficient intake of food
Provision of care associated with elimination processes and excrements
Maintenance of a balance of activity and rest
Universal Self-Care Requisites
Maintenance of a balance between solitude and social interaction
Prevention of hazards to human life, human functioning, and human well-being
Promotion of human functioning and development within social groups in accordance with human potential, known limitations, and the human desire to be normal
Developmental Self-Care Requisites
Bringing about and maintenance of living conditions that support life processes and promote the processes of development
Provision of care either to prevent the occurrence of deleterious effects of conditions that can affect human development or to mitigate or overcome effects from various conditions
Health-Deviation Self-Care Requisites
Seeking and securing appropriate medical assistance
Being aware of and attending to the effects and results of illness states
Effectively carrying out medically prescribed treatments
Health-Deviation Self-Care Requisites
Being aware of and attending to side effects of treatment
Modifying self-concept in accepting oneself in a particular state of health
Learning to live with the effects of illness and medical treatment
Theory of Self-Care Deficit
Five methods to help meet self-care needs of patients:
Acting for or doing for another
Guiding and directing
Providing physical or psychological support
Providing and maintaining an environment that supports personal development
Teaching
Theory of Nursing Systems
Three systems can be used to meet the
self-requisites of the patient:
wholly compensatory system
partially compensatory system
supportive-educative system
Major Concepts of Nursing According to Orem
Person under the care of a nurse; a total being with universal, developmental, and health deviation needs and capable of self care
Environmental: physical, chemical, biologic, and social contexts within which human beings exits
Major Concepts of Nursing According to Orem
Health: state characterized by soundness or wholeness of developed human structures and of bodily and mental functioning
Nursing: therapeutic self-care is designed to supplement self-care requisites. Nursing actions fall into one of three categories: wholly compensatory, partly compensatory, or supportive educative system
Explicit Assumptions of Orem’s Self-Care Deficit Nursing Theory
Nursing is a deliberate, purposeful helping service performed by nurses
Persons are capable and willing to perform self-care for self and for dependent family members
Self-care is part of life that is necessary for health, human development, and well-being
Education and culture influence individuals
Explicit Assumptions of Orem’s Self-Care Deficit Nursing Theory
Self-care is learned through human interaction and communication
Self-care includes deliberate and systematic actions to meet a known need for care
Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify needs
Persons possesses powers, capabilities, personal dispositions, talents, interests, and values
Implicit assumptions of Orem’s Self-Care Deficit Nursing Theory
People should be self-reliant and responsible for their own care needs as well as others in the family who are not able to care for themselves
People are individuals who are distinct from others and from their environment
Propositions of Orem’s Self-Care Deficit Nursing Theory
Human beings have capabilities to provide their own self-care or care for dependents to meet universal, developmental, and health-deviation self-care requisites
Self-care abilities are influenced by age, developmental state, experiences, and sociocultural background
Propositions of Orem’s Self-Care Deficit Nursing Theory
Self-care deficits should balance self-care demands and self-care capabilities
Self-care or dependent care is mediated by age, developmental stage, life experiences, sociocultural orientation, health, and resources
Therapeutic self-care includes actions of nurses, patients, and others who regulate self-care capabilities and meet self-care needs
Propositions of Orem’s Self-Care Deficit Nursing Theory
Nurses assess the abilities of patients to meet their self-care needs and their potential of not performing their self-care
Nurses engage in selecting valid and reliable processes, technologies, or actions for meeting self-care needs
Brief Critique of Orem’s Self-Care Deficit Nursing Theory
Concepts defined precisely and used consistently across the three theories
Concepts developed with sufficient depth to give the theory level of complexity necessary to describe and understand nursing, yet theory remains simple
Possesses the characteristics of generality and empirical precision
Brief Critique of Orem’s Self-Care Deficit Nursing Theory
Clearly differentiates focus of nursing from other disciplines and provides nursing a unique focus
Provides a structure for the organization of existing nursing knowledge and the generation of new knowledge
Orem’s Self-Care Deficit Nursing Theory as a Framework for Practice
Orem designed a version of the nursing process that is known as the “practice methodology” for the self-care framework
Methodology defined in terms of four operations
diagnostic operations
prescriptive operations
regulatory operations
control operations
