Dorthea Orem based her nursing theory on a holistic approach. She believed that emotional, mental and physical balance were three parts of a whole in which individuals and healthcare providers needed to focus on in order to provide the best quality of life possible. Orem described much of her theory by defining self-care, self-care deficit, self-care requisites, and agency. Self-care is the care taken by an individual in order to meet his or her self-care demands. Agency refers to a person’s ability to care for their self (Hood, 2014). In Orem’s theory, there is a deficit when the agency cannot perform the necessary actions to sustain their self-care demands, which are, “all self-care activities required to meet existing self-care requisites” (Berman & Snyder, 2014, p. 44). There are three categories of self-care requisites; universal, developmental, and health deviation. Universal self-care requisites are the basic needs of every human being. Some examples of these are oxygen, nutrients, environmental safety, and the ability to eliminate wastes. Another self-care requisite is developmental. “Developmental requisites result from maturation or are associated with conditions or events, such as adjusting to a change in body image or to the loss of a spouse” (Berman & Snyder, 2014, p. 44). Lastly, are health deviation requisites which, “result from illness, injury, or disease or its treatment.” (Berman & Snyder, 2014, p. 44). In Dorthea Orem’s self-care theory, there are three
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.
For centuries the development of nursing knowledge has been influenced by numerous theorists and their respective theories. These theories have influenced, and continue to influence, nursing education, practice and research. (Johnson & Webber, 2005)
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 philosophy in nursing is consistent with my own personal philosophy. Knowing your own capability and limits predicts almost always the final result. One must
Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of
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.
Holistic assessments in nursing provide a unique quality of care to the individual patient. Holism in the provision of care includes assessments obtaining data about the physiological, psychological, sociological, spiritual, developmental, cultural and environmental aspects. It is imperative that the nurse conducting these assessments adopts methods in the nursing process that reflects the standards outlined in Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse to ensure the health and wellbeing of the patient is maximized and maintained throughout the time health care is received. Nursing processes are directed at restoring overall harmony for the patient therefore an understanding of the
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
The theory of self-care is basically explaining how people care for themselves. In other words, what they do to maintain a healthy life-style and survive.
The theory sees a person as a system in which its parts interrelate with each other to form a whole to perform its functions. These interrelated and interdependent parts are called subsystem which is analyzed and described in term of structural and functional requirement. There are seven subsystems – attachment, attachment-affiliation, aggressive-protective, dependency, ingestive, eliminative, and sexual with each of them interrelated with the others and its environment for three functional requirements – protection, nurturance, and stimulation. The four structural elements of the subsystem include the following: drive (the ultimate cause of behavior), set (a tendency or predisposition to act in a certain way), choice (behavior to use in a certain situation) and action (behavior of an individual). These requirements must be met through a person’s efforts or with the outside assistance of the nurse to maintain the integrity of the behavioral system.
Clinical situations viewed through Orem self care deficit theory. My clinical problem is risk for fall due to arthritis. My goal is for the patient to be free of injury and this can be achieve through the following: the first step is nursing assessment of patient’s gait, activities including the use of assistive device, medication use (since some medication can cause dizziness or loss of consciousness) mental status for any confusion or disorientation.
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).
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.