A Middle-Range Theory of Self-Care of Chronic Illness
Tasha Hott
South University Online
Grand Range-Self-Care Theory
The self-care theory, developed by Dorothea Orem, is a widely used theory implemented by nurses to improve the quality of patient care. Generally, self-care is performed by patients while at home and in tandem with the health care providers. This paper will address Dorothey Orms Self-care deficit theory.
Dorothea Orem was born in 1914 and had many different roles-educator, administration, staff RN, director and consultant. Dorothea worked on many different nursing units during her nursing career like medical surgical units, emergency room, and the operating room. During her nursing practice, Orem was greatly involved in practice, service and education in nursing. Orem received many honorary awards and received her doctorate in 1976. Orem Developed her self-care deficit theory early in her career and refined it through her career and retirement. From 1949-1957, Orem worked for the division of the Hospital and Institutional Services of the Indiana state board of Health. This is where she encountered issues regarding the lack of substantive and structured body of nursing knowledge and where Orem discovered the greatest need to upgrade the nursing quality in the states general hospitals. Orem also made her definition of nursing practice with clear statements of the inherent distinction between the practice of nursing and medicine (CITATION)This
Theory development stems from personal experiences, intuition, and knowledge of the theorist (Burns et al., 2013). When a scholar develops a theory, it has to be tested through research. The findings of the study are then presented to experts in the area of academics and the field of practice (Burns et al., 2013). The presentation of the findings allows experts to provide constructive criticism, highlight the pros and cons of the theory, and acknowledge whether or not the theory can be accepted as a guide to practice. This theory evaluation paper will give the reader a theory description, theory analysis, and an assessment of Dorothea Orem’s self-care deficit theory of nursing (Alligood et al., 2010).
The theory focuses on the ability of a person to meet his or her own needs. Developed in the year 1970, Orem’s theory focused on the three various concepts, namely self-care, self-care deficit, and the nursing system. Self-care is a group of activities or processes that a person performs to maintain health, life, and wellbeing (Orem, 2001). For instance, self-care is being demonstrated when a chronic heart failure patient checks his or her weight daily, takes prescribes medications, and avoids salty foods. Self-care deficit happens when an individual is not able to provide effective self-care (Orem, 2011). Nurses are able to assist patients in this state by educating them with their disease condition and treatment compliance. A nursing
Nursing theories play an integral role in guiding practice, education, and research. Many different theoretical perspectives are maintained in the field of nursing due to the diversity of the field, no single theory is able to account for all nursing knowledge. The purpose of this paper is to compare and contrast two nursing theories that have produced a profound impact on nursing practice. The theories being compared are Dorothea Orem’s Self Care Deficit Nursing Theory (SCDNT) and Sister Callista Roy’s Adaptation Model (RAM). Both theorists have profoundly influenced nursing science, research, practice, and education. Similarly, both of these theories fall into the category of Grand nursing theories which are the most complex theory level and explain broad areas of the discipline, as well as being the broadest in scope (McEwen & Wills, 2014).
The nursing process does not merely treat the patient as a physical body, but rather treats the patient holistically. The central philosophy of Dorothea Orem's self-care deficit nursing theory "is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they're able" (Dorothea Orem, 2012, Nursing Theory). However, although self-care may be the core of Orem's theory, the decision to engage in self-care must be facilitated by the patient's social and physical environment, of which the family can play a critical role in shaping.
Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories. The grand nursing theories are a
Orem’s Self-Care Deficit Theory views every individual as practicing “self-care, a set of learned behaviors, to sustain life, maintain or restore functioning, and bring about a condition of well-being.” (Creasia & Friberg 2011) The nurse uses her/his abilities to assist the patient to overcome current self-care deficits and help the patient achieve her/his best level of self-care. As time passes many of the elderly need more assistance with the activities of daily living. Taking care of themselves physically becomes more difficult, sometimes there is decreased mental acuity, as well as a loss in social contact. In every one of these areas the nurse assists the patient to achieve her/his highest level of self-care. This includes diet, eating, elimination, activity, social interaction, education, awareness of obligations, and the promotion of health. Where possible the nurse will help the patient achieve self-care. Since there are no true cures to the aging process the nurse will be needed more and more
Dorothea Orem is known as one of the foremost nursing theorists. She is credited with the development of a nursing grand theory, the self-care deficit nursing theory (SCDNT). The beginning of her career can be traced back to Washington, D.C. in the mid 1930’s. Though she was a Baltimore, Maryland native, Orem pursued her nursing education at Catholic University of America (CUA) in Washington, D.C., graduating with baccalaureate and Master’s degrees in 1939 and 1945 respectively. Following her education, Orem held many job positions across multiple nursing disciplines, including working as a private nurse, nurse educator, administrator, director, and private contractor (McEwen & Wills, 2011).
Dorothea Orem was born in1914 in Baltimore, Maryland. She earned her nursing diploma from the Providence Hospital School of Nursing in Washington, D.C., in 1930, before she went on to complete her Bachelor of Science in Nursing and Master of Science in Nursing at Catholic University of America in Washington, D.C., in 1939 and 1945 respectively. Orem occupied numerous high profile nursing positions during her lifetime. She was director of nursing in various institutions and was a member of group of nursing theorists who formulated the framework for North American Nursing Diagnosis Association. She proposed Self-Care Deficit Theory of Nursing, which is made up of
Orem’s Theory has helped lay the ground work for modern nursing. In 1971 her theory was first published and includes three related concepts: self-care, self-care deficit and nursing systems. Orem’s theory has given direction to many nurses, inspiring them to seek better ways to develop and express the knowledge base of nursing. The purpose of her theory is to help patients and their families maintain control of their health during their lifetime. The theory consists of three parts the nursing system, self-care and self-care deficit. Care is the primary focus and the ultimate goal is health restoration. Patients are allowed to have primary control over their health and letting healthcare providers educate, promote and encourage healthy
The core concept of ‘The role of nursing’ was used in both Dorothea Orem’s self care model and in Virginia Henderson’s nursing care model. Dorothea
Dorothea Orem's self-care deficit theory was born while Dorothea Orem (1917-2007) was working in the Department of Health Education and Welfare (HEW) as a curriculum consultant. At this time in the history of the profession, nursing was just emerging as a unique academic discipline. Orem's theory was designed to answer the fundamental question: What is nursing? Orem defined nursing as a way of realizing every patient's desire to engage in self-care in a manner to "sustain life and health, recover from disease or injury and cope" with the consequences of major health events and daily life (El-Kader n.d.). Major assumptions of the theory include that "people should be self-reliant and responsible for their own care and others in their family needing care" (Dorothea Orem's self-care deficit theory, 2012, Current Nursing). Fundamentally, nursing and the nursing process is designed to enhance self-care and to address deficits in self-care.
The application of the Chinn and Kramer model to my selected theory, brought into view that even though this theory was developed in 1959, it will continue to remain a theory that will stand the test of time and of importance to the nursing profession. I feel that Orem’s self-care theory will stand the test of time, due to providing a clear understanding of the scope of nursing, and the theory helps define goals for
The Self-Care Deficit Theory of Nursing impacts modern health as well as nursing more than expected during the theory’s creation and evolution. The Institute of Medicine (IOM, 2001) demanded the need for health care to shift from acute care setting management of disease. Consequently,
Like any scientific discipline, the nursing profession has evolved over time. Nurses, once regarded as housemaids and lower class citizens, now hold positions of authority and stature in our modern society. These changes in the profession are attributed to the many nurse theorists who devoted their lives to the improvement of patient care. Through their theoretical advancements, the public perception of nursing has gone from dismissive to reverential. Today, our culture considers the nursing profession to be one of the most rewarding and respected career paths an individual can pursue. Through a review of one such patient theorist, Dorothea Orem, one can witness this change in the perception of the nursing profession. As a first semester student in a professional nursing course of study, Orem has already influenced my personal nursing philosophy.
Nursing Science continued to transform in the 70’s.Dorothea Orem was one of the most prominent nursing personalities that thrived in improving the standards of nursing through self-care deficit theory in 1971. The main objective of care is the self and thus catering every needs that revolve around it to perform self-care. Orem’s work had become so significant today that her Assessment for Care Evaluation method is the standard for evaluating health conditions.