Dorothea Orem 's Self Care Deficit 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.

I chose to do a concept analysis on ‘Self-Care.’ The nursing theory that uses this concept is Orem’s theory of nursing. This theory is a grand theory and consists of three minor interrelated theories; self-care,

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.

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).

Many different factors can affect these abilities and must be considered by nurses when providing comprehensive care. She referred to this new thought process as the Self-care Deficit Theory of Nursing, which also is known as the Orem Model of Nursing. Orem published the basis for this theory in her book Nursing: Concepts of Practice in 1971. The Self-care Deficit Theory of Nursing earned Orem much acclaim and respect within the medical world. She became a lead theorist in nursing education and practice for the rest of her career. Her book, Nursing: Concepts of Practice, is still widely read today as it enters into its sixth edition. Wayne,

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

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

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.

Orem’s Self-Care Theory lays the foundation to measure self-care maintenance, management, and confidence. The framework of Orem’s theory contributes an optimistic patient view to their own personal healthcare and the goal of nurses, and the independent function of their patients. The identification of nursing as a science and an art are identified as well as its boundaries, and serve as unique contributions to nursing. The research that Orem completed was designed to measure self-care deficits and the quality of life to help determine the correlation between both (Seed & Torkelson, 2012).

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.