Concept Analysis on Self-care: Orem´s Theory on Nursing

The purpose of this paper will be to explain the components of Dorothea Orem’s self-care deficit theory, the current significance of the theory, and the application of this particular nursing theory. A nursing theory is an explanation of a division of nursing that “describes, explains, predicts, or prescribes” that particular division. (Perry, Potter, Stockert, & Hall, 2013, p. 41). Orem developed her personal theory, the self-care deficit theory, to assess a patient’s ability to perform vital daily tasks and how it affected the patient’s. (Hartweg & Pickens, 2016). This theory is a grand theory, which means it can be used in almost all areas of nursing. There are five components or methods that compose this theory that nurses will practice when working with a patient who needs to reach the self-care deficit. (Edney, Jaime, & Young, 2016). It is used today and has been included in several studies that have proven it to be effective in shortening hospital visits when used on critically ill patients. (Hohdorf, 2010). This particular theory has helped advance nursing practice since Orem’s first publication.

Dorthea E. Orem’s self-care model emphasizes both a patient 's ability and responsibility to care for themselves. Self-care as defined by Orem as “the practice of activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being” (Catalano, 2015, p. 58). Since individuals function at varying levels, Orem has identified three levels of nursing care: wholly compensated care, partially compensated care, and supportive developmental care. This theories goal is to help each individual reach his or her maximum level of function and to take responsibility for his or her health (Catalano, 2015). Self-reliance is also core value in my own personal life. I believe that a person who is capable of performing any part of their own self-care should be encouraged to do so because it will help them become independent, improve their psychosocial status, and promote self worth at a time when they rely so heavily on other people for their care. Orem’s theory matches my own belief of the importance of independence and self-reliance because the main goal is to help patients become as self-reliant as possible in their healthcare. This theory emphasizes the important role of education in nursing in order to enable them to take control of their own health. Because of health deficits, some individuals may require more assistance from care providers. However, even these patients should be encouraged and allowed to do whatever they are able to do for

Dorothea Orem’s theory accepts and describes the premise of self-directed personal care (Alligood et al., 2010). Orem’s theory also explains and predicts when the nurse will be needed once the illness has challenged an individual's functional capacity. The purpose of the theory is to focus on individual’s being able to care for themselves on their own, identify when nurses are needed to help individuals progress to better health. Besides, self-health care is put in place to acknowledge that nurses can aid individuals to get back to their functional baseline abilities on time. (Alligood et al.,

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

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.

The profession of nursing requires a capacity and joy for caring and healing others both mentally and physically. Nurses spend their careers caring for patients and their families often in the worst and most frightening periods of their lives. Nursing responsibilities can be lengthy, stressful and physically and emotionally demanding. The demands of the nursing profession coupled with the nursing shortage and longer work hours put even more stress on nurses. Despite these extreme demands, many nurses do not fully appreciate the importance self-care. Yet without proper care for themselves, nurses are not able to provide the best care for their patients.

Self care is essential to the nursing profession because it is a reflection on the quality of health care nurses provide to their patients, it portrays an image to the patients on what’s necessary towards healthy living and can help nurses battle with stress and personal health. Self care can be expressed as taking care of ones self’s health and overall wellbeing. This can be shown through eating healthy, exercising daily, getting enough sleep and completing weekly activities to reduce stress. Improving your overall health can benefit nurses from overworking themselves and help minimize the affects certain stressors can have on them. By doing so, the overall atmosphere in the workplace and the quality of healthcare provided to the patients will be greatly improved.

The Self-Care Deficit Theory of Nursing impacts modern health as well as nursing more so than expected during its creation and evolution. The Institute of Medicine (IOM, 2001) demanded the need for health care to shift from acute care setting to management of disease. Consequently, today’s health care is in the midst of a paradigm shift, as it redirects its attention towards patient centered care, disease prevention and wellness promotion. The Affordable Care Act implemented regulations, enforced by financial reimbursement to ensure that hospitals have shorter lengths of stay, lower readmission rates and strategies to enhance health promotion, disease prevention and improved quality of life (Taylor, 2012). The government has placed incredible demands on the health care system as baby boomers are aging and chronic diseases are becoming more complex requiring increased use of technology and nursing support. In order to meet the legislative requirements, administrators and educators must transition to the structure and concepts provided by the Self-Care Deficit Nursing Theory, for it is in this theory, nurses are empowered to better care for the patients as they present with complex self-care needs requiring specialized assistance from highly advanced, educated nurses who prepare these patients to return home better equipped for self-care despite their chronic conditions.

The concept should be clear and distinct, unambiguously defined and well differentiated from other concepts, and should be applicable to the world and appropriate in context. Concept analysis is applied for the refinement and definition of concepts originating from nursing practice, nursing research and nursing theory (Maputle & Donavon, 2013), which helps to differentiate between similar and dissimilar concepts. Walker and Avant assert that concept analysis and development are fundamental processes required by nurse researchers who are attempting to measure the metaphysical phenomena of nursing, or in this study the midwifery practice.

The model is concerned with the provision and management of self-care. A requirement for nursing exists when a person is unable to maintain for him/herself self-care action which is therapeutic in sustaining life and health, recovering from disease and injury or coping with their effects. Meet own needs through nutrition, fitness, hygiene, rest and relaxation, interpersonal relationships, meaningful work, spiritual practices, prevention and health promotion practices

Dorothea Orem’s self-care nursing philosophy encourages patient autonomy and gives patients a voice. Consequently, it increases patient responsibility and participation in their care. It provides nurses with a solid foundation to give patients’ self-sufficiency and control in caring for themselves. The self-care model is achieved when patients transform from dependent, unreceptive patients to active, engaged

Theory is a cluster of concept or ideas that propose a view concerning a phenomenon to guide nursing practice (Chitty, 2005). The four concepts basic to nursing that are incorporated in this paper are nursing, person, health, and environment (Cherry & Jacob, 2005). The goal of this paper is to describe the core concept of nursing shared amongst Dorothea Orem and Virginia Henderson’s theories. The comparison and analysis of concept definitions between these two theories will also examined. Finally Henderson’s theory of concept statement, metaparadigm and her philosophy will be explored.

Dorothea Orem created the self-care theory in 1959 and continued to build upon her theory until 2001. The purpose of Orem’s theory was to define nursing, discuss the relationship among the nurse and the patient, and to promote a clear understanding of the scope of nursing (Taylor, Self-Care Deficit Theory of Nursing, 2006). Today, Orem’s theory is widely known and is utilized in nursing curriculum, as well as continuing education topics for healthcare providers.

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,

Dorothea Orem’s self-care deficit theory’s nursing goal is to assist individuals to meet all their self-care needs by teaching them with skillful healthy habits (Hood, 2014, p. 137). In order for nurses to provide the support needed by an individual, they must assess all their patients’ self-care requisites. As explained by Moore (2015), “Orem uses the self-care requisites as a basis for assessment [in] the nursing process.” These self-requisites are universal needs that arise due to illness and/or changes in developmental stages (Hood, 2014). Dennis (1997) described in detail Orem’s basic conditioning factors that must be assessed to gather sufficient information about the individual and about their ongoing and emerging self-care requisites. Orem’s basic conditioning factors include: age, gender, developmental state, health state, health care system, sociocultural/spiritual orientation, family systems, patterns of living, environment, and available resources (Dennis, 1997).