Dorothea Orem's Theory Of Self-Care Deficit Nursing Theory

When identifying uses and meanings of ‘self-care’, I first looked in a dictionary. The concept was defined in the Shorter Oxford dicitonary as, “Self-care (noun) taking care of one-self; self-interested behavior.” I searched the internet to get a generalized view of how the concept was being used and it was defined on Wikipedia as, “Self-care refers to actions and attitudes which contribute to the maintenance of well-being, personal health, and promotion of human developent.” I searched data bases for scholary peer reviewed articlew and retrieved limited amount of English articles on self-care. Key word searches consisted of self-care, self-care maintenance, and self-management. The definitions and uses of the concept were fairly broad. I narrowed the search to post-op patients and self-care. The two uses for the concept in the post op patient would be self-care of the post op patient and also supportive care to promote self-care of the post-op patient. The supportive care could be from a nursing system or a family member.

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.

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

Nursing goes beyond caring for a patient during their illness and managing their disease process. Nursing includes adapting to a patient’s and their family’s physical, social, spiritual, environmental and psychological needs. I believe in treating the whole patient and being supportive of the family’s needs as well. Shelly & Miller (2006) asserts “while critical thinking, decision-making, and leadership skills are extremely important, the characteristics nurses need most are compassion, competence, faith, integrity and responsibility” (p. 291).

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.

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,

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).

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.