The Concept Of A Nursing Theory

Theory can be defined as the explanation of an event in which constructs and concepts are identified, relationships are proposed and predictions are made; it is a set of interpretative assumptions, principals or propositions that help explain or guide action. (McEwen & Wills, 2014, p521) Concepts occur in three steps; originating as a thought which are abstract or concrete in nature, progressing to a stage in which words and meaning are given to the concept, and lastly it is operationalized becoming a variable to be used tested during research. (McEwen & Wills, 2014, p50) According to McEwen, & Wills, (2014), a concept analysis identifies, clarifies and explores the meaning of concepts in order to promote understanding which aids in the development of conceptual frameworks, theories and research studies. (p55) Concepts relative to nursing include quality of life, blood pressure, hope, job satisfaction and pain.

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

Three connecting theories developed by Dorothea Orem are the theory of self- care, the theory of self-care deficit and the theory of the nurse system (George, 2011). Self-care theory is offering an

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

The metaparadigm of nursing consists of four parts comprised by Jacqueline Fawcett, in 1984, in her seminal work (Alligood, 2014). The metaparadigm she developed served to provide direction and guidance for the nursing framework already in use and became an organization tool for theories already in use (Alligood, 2014). The four parts being person, health, environment, and nursing. The four components of the metaparadigm concept of nursing is important to nursing theory because they are the key areas of focus of patient care, and the metaparadigm is designed to differentiate nursing from other specialties (Alligood, 2014). It is this use of theories that makes nursing a profession and guides professional nursing practice, research, and education (Alligood, 2014).

Dorothea Orem’s Self Care Model states, “Nursing care is required when an adult is unable to perform self-care sufficiently to sustain life, maintain health, recover from disease or injury, or cope with the effects of disease or injury” (Orem, 1991). Orem also takes into account that caregivers also need nursing care. Six concepts:

Dorothea Orem’s Self Care Model states, “Nursing care is required when an adult is unable to perform self-care sufficiently to sustain life, maintain health, recover from disease or injury, or cope with the effects of disease or injury” (Orem, 1991). Orem also takes into account that caregivers also need nursing care. Six concepts:

The second component of the Orem’s theory, Self-care deficit, is the inability for individual or parent to care themselves or provide care to maintain well being or health and is the situation when nursing is needed. In these circumstances, Orem indicates that nursing care and interventions are needed when the patient is in the self-care deficit. This is accomplished by offering physical and psychological support, teaching, and providing an environment to promote personal development to meet the patient needs. Nursing care will provide aid if the patient is not able to shave or wash themselves, or a guide if patient needs support when using their walking aid. Patient may also need emotional support, training and education to provide self-care if they are able but lack the skills. Nurses must assess the type of self-care deficits and provide nursing intervention as needed.

Dorothea Orem’s idea of health is categorized by completeness of recognized human structures, physical, and mental functioning. This theory states that individuals should be self-reliant and responsible for their care as well as others. The development of self-care is an important part of primary care prevention and optimal health. When an individual becomes aware of their potential health issues their need for self-care behaviors become more evident. Self-care and dependent care are behaviors learned with sociocultural setting. Orem’s theory is compromised of three related parts: theory of self care; theory of self care deficit and theory of nursing system.

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 E. Orem devoted her life to defining nursing and the nurse’s role in improving the patient’s overall health, which she coined the Self-Care Deficit Theory. Orem’s theory is quite a complex one, which can be simplified by identifying that it is three theories in one: self-care theory, self-care deficit theory and nursing systems theory. In 1959, as Orem first began the evolution of the Self-Care Deficit Theory, she defined the nurse’s role as another self. This nursing theory is the foundation for nursing as it actually defines the art of nursing, the actions that drive the nurse and the nurse’s provision of care through the nursing systems theory. To place in simplistic terms, Orem assumes that all humans desire to care for self. In the self-care theory, she states that individuals are meant to care for themselves and their basic needs by promoting life, health, development and well-being (Banfield, 2011). When something happens that does not allow the human to care for self, a deficit occurs. This deficit drives the need for specialized nursing care to restore the human’s health so they can resume self-care.

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).

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.