Self-Care Deficit Theory In Nursing

Orem focuses on nursing as a deliberate human action and notes that all individuals can benefit from nursing when they have health-derived or health-related limitations for engaging in self-care or the care of dependent others (Gunther, 2016). The nurse chooses deliberate actions from nursing systems to bring about desirable conditions in persons. The goal of nursing is to move a patient toward responsible self care or to meet existing healthcare needs of those who have health care deficits (Gunther, 2016). Orem expects people to be responsible for themselves and to seek help when they cannot maintain therapeutic self-care or dependent-care (Fawcett, 2003).

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 essence, the role played by the nurse is to increase and facilitate the self-care abilities and level of the individual patient (Smith & Parker, 2015). As such, self-care is neither reflexive nor instinctive. Instead, it is either performed rationally or intentionally in response to an already known need. Based on this Orem's theory, rational response is learned through communication and interpersonal relations. Orem asserts that self-care agency can also be defined as the power to take action (Caruso, Cisar & Pipe, 2008). It is a complex capability developed to enable maturing adolescents and adults to recognize, identify, and understand various factors to be managed or controlled so as to decide about, develop, and perform realistic care measures. The capability discussed above is strongly dependent on culture-related values and lifelong experiences.

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.

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 purpose of this paper is to define the concept of caring, provide a literature review and state why this concept is important to nursing and advanced practice nursing as well as in non- nursing theories, such as the Care Theory. We will also look at the critical attributes of the concept of caring, as well as how caring is recognized, assess and used in practice and research. Finally we will explain how caring is addressed in Dorothea Orem’s Self Care and Self Care Deficit Theory.

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.

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.

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.

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).

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.

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

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.

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