Dorothea Orem : Self Care Deficit Nursing Theory

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.

Theory is an arrangement of thoughts meant to describe something. These thoughts and ideas usually have basic principles that validate the purpose of the proposed theory. Nursing theory is a well thought out scholarly structure of concepts. These concepts are created to help guide nursing practice. They explain the fundamentals of nursing care. Multiple clinical decisions are based upon nursing theories. There are many different types of nursing theories developed primarily by nurses. Nursing theorist’s main goal is to examine nursing practice and explain the working or non-working parts

designed to guide the practice of nursing” (Medical Dictionary for the Health Professions and Nursing, 2012). Nursing theories can help patients, managers and other healthcare professionals to recognize what and how much that nurses do contribute to the healthcare field. I never did realize how important theories in nursing practice could be until I became a nursing student myself. Nurses use theories in their everyday practice, but never think about them as being

70). This definition begins a departure from the Logical Positivistic Received View, in that it does not emphasize the structure of the theory. According to Meleis (1985) this definition of theory exemplifies the multiple usageof theory, an important issue in dealing with nursing practice, research, education and administration. The definition for use here is one adapted from Meleis (1985) and states that a nursing theory is a conceptualization of phenomena and relationships in or pertaining to nursing for the purpose of describing, explaining, predicting and/or prescribing nursing care. Many of the definitions of nursing theory proposed in the 1960s and ’70s derived their definitions from psychology and the social sciences.Nursing theories, according to Meleis (1985) “evolve from extant nursing reality as seenthrough the mind of a theorist who is influenced by certain historical and philosophical processesor events” (p. 29). Theory is not only a tool for the development of research propositions but is also a goal, in which findings becomemore meaningful (Meleis, 1985). One problem in nursing has been the lack of agreement on the definition of theory. Many authors have used the term theory as interchangeable with such terms as conceptual framework, conceptual model, model, and paradigm. Fawcett (1989) clearly states that “conceptual models and theories are clearly distinguished by their

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.

quality of patient care, and can be implemented in practice, to provide solutions to nursing

The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way.

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).

As I advance my career to the doctoral level, nursing theory should define my practice. Nursing theories help professional nurses to create a unique plan of care to address unique patients’ needs. Zaccagnini and White (2014) describe five steps given by Kenney as follows:

Nursing theory is vital to the nursing profession because it provides a foundation and framework which is reflected in nurses’ caring ideals and practice (William, 2015). Theory provides an understanding of a nurse’s role within the healthcare system. The first nursing theory, formed by Nightingale, was observations of interventions that improved patient outcomes (Mackey & Bassendowski, 2016). Nurses can improve quality of care by implementing theory into their practice (Mackey & Bassendowski, 2016). This paper will discuss the importance of nursing theory, Florence Nightingale’s Notes on Nursing: What It Is and What It Is Not, and the application of this theory in the nurse

Dorthea E. Orem is a well recognized and a very well educated nursing theorist. She had a lot of experience as a nurse, and this greatly helped her provide insight into her views of nursing practice, education, and science. “The question that directed Orem’s thinking was, “What condition exists in a person when judgments are made that a nurse(s) should be brought into the situation?”” (Berbiglia & Banfield, 2014) Her biggest focus was the Self- Care Deficit Nursing Theory.

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

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.

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.