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.

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

According to Petiprin (2015), Dorothea Orem’s theory is used to encourage a person to become more independent. Petiprin (2015) further states that it is true of rehabilitation settings, (Such as,)for example HealthSouth Sunrise Rehabilitation Hospital in which patients are transitioning out of being cared for by physicians and nurses and to exclusive self-care at home. According to George (2011), Dorothea Orem has developed three connecting theories: the theory of self-care, the theory of self-care deficit and the theory of the nurse system. George defines the term metaparadigm as the core content of a discipline (2011). George further states that the metaparadigm of the discipline of nursing comprises of four major concepts: person, health, environment and nursing (2011). At HealthSouth Sunrise Rehabilitation Hospital, the mission of our operations is the delivery of quality healthcare in the most appropriate, safe, patient-centered environment (HealthSouth, 2015). The purpose of this paper is to discuss Dorothea Orem theory, metaparadigm and how it relates to nursing practice at HealthSouth Sunrise Rehabilitation Hospital.

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.

In a nutshell, Orem uses her Self-Care Theory to view health as a state composed of developed mental and bodily functioning and human structures. This is because it includes psychological, social, physical, and interpersonal aspects (Caruso, Cisar & Pipe, 2008). Basically, major assumptions of Orem's self-care theory include the fact that people should be responsible and self-reliant in relation to their own care and that of others, especially family members. Orem argued that

Dorothea E. Orem is a nurse from the United States who greatly contributed to nursing theory in the modern medical world. Her newly established theory was known as the Orem Model of nursing or the self-care deficit nursing theory. The Orem Model of nursing emphasizes the importance of self-care as a basic human need and how self-care can be provided or managed to allow patients to recover more effectively.

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 SCDNT is a general theory. It started out as three theories. The theory of nursing systems, the theory of self-care deficits, and the theory of self-care were the first three theories. The theory of dependent care was added later and goes a long with the theory of self-care. Part foundation of the SCDNT was believed to be the moderate realism position, even though she never specifically mentioned it. A lot of the things that would talk about, or take a stance on, reflected this position. “According to the moderate realism position, there is a world that exists independent of the thoughts of the knower. Although the nature of the world is not determined by the thoughts of the knower, it is possible to obtain knowledge about the world.” (Berbiglia & Banfield, 2014) This means that humans make their own decisions and their actions are deliberate.

In order to find the patients baseline an assessment of functionality is needed for comparison. When assessing a patient it is important to pay attention to the abilities of activities of daily living regularly. An assumption of Orem’s Self-Care Deficit Theory is that a person’s knowledge of potential health problems is needed for promoting self- care behaviors (Nursingtheory.org, 2013).

Orem’s theory of self care deficit specifies when nursing is needed. “Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care” (Current Nursing, 2010, para. 16). Orem’s created five methods of helping; which are acting for and doing for others, guiding others, supporting one another, providing an environment that promotes personal development, and teaching one another.

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