Dorothea Orem's - Encompasses the patient’s perspective

Self-Care Theory of health condition, - the physician’s

perspective, and the nursing perspective
INTRODUCTION - Goal of nursing – to render the patient or
members of his family capable of meeting
- Theorist: Dorothea Orem (1914-2007) the patient’s self-care needs
- Born in 1914 in Baltimore, US - To maintain a state of health
- Earned her diploma at Providence - To regain a normal or near-normal state
Hospital – Washington, DC of health in the event of disease or injury
- 1939 – BSN Ed., Catholic University of - To stabilize, control, or minimize the
America effects of chronic poor health or disability
- 1945 – MSN Ed., Catholic University of
America Health – health and health are terms used
- She worked as a staff nurse, private duty
to describe living things …
nurse, nurse educator and administrator and
- It is when they are structurally and
nurse consultant.
- Received honorary Doctor of Science degree functionally whole or sound … wholeness
in 1976. or integrity. .includes that which makes a
- Theory was first published in Nursing: person human,…operating in conjunction
Concepts of Practice in 1971, second in 1980, with physiological and
in 1995, and 2001. psychophysiological mechanisms and a
material structure and in relation to and
interacting with other human beings
MAJOR ASSUMPTIONS
Environment
- People should be self-reliant and - environment components are
responsible for their own care and others enthronement factors, enthronement
in their family needing care elements, conditions, and developed
- People are distinct individuals environment
- Nursing is a form of action – interaction
between two or more persons Human being – has the capacity to
- Successfully meeting universal and reflect, symbolize and use symbols
development self-care requisites is an
important component of primary care ● Conceptualized as a total being with
prevention and ill health universal, developmental needs and
capable of continuous self-care
- A person’s knowledge of potential health ● A unity that can function biologically,
problems is necessary for promoting self- symbolically and socially
care behaviours
- Self-care and dependent care are
Nursing client
behaviours learned within a sociocultural
- A human being who has "health-
context
related /health-derived limitations that
render him incapable of continuous self-
DEFINITIONS OF DOMAIN CONCEPTS
care or dependent care or limitations that
Nursing – is an art, a helping service, and a result in ineffective/incomplete care.
technology - A human being is the focus of nursing
only when a self –care requisites exceeds
- Nursing – is art, a helping service, and a self-care capabilities
technology
Nursing problem ○ Universal self-care requisites
- deficits in universal, developmental, and ○ Developmental self-care
requisites
health-derived or health-related conditions ○ Health deviation self-care
requisites
Nursing process
- a system to determine (1)why a person
is under care (2)a plan for care,(3)the 1. Universal self-care requisites
implementation of care - Associated with life processes and the
maintenance of the integrity of human
Nursing therapeutics structure and functioning
- deliberate, systematic and purposeful - Common to all, ADL
action, - Identifies these requisites as:

OREM’S GENERAL THEORY OF NURSING ● Maintenance of sufficient intake of air,

water, food
● Provision of care assoc with the
Orem’s general theory of nursing in three elimination process
related parts: ● The balance between activity and rest,
between solitude and social
interaction
- Theory of self care
● Prevention of hazards to human life
- Theory of self-care deficit well being and
- Theory of nursing system ● Promotion of human functioning

A. Theory of Self Care

2. Developmental self-care requisites
This theory Includes:
- Associated with developmental
processes/ derived from a condition…. Or
Self-care
associated with an event
– the practice of activities that individual
initiates and perform on their own behalf in ● E.g. adjusting to a new job
maintaining life, health and well being ● adjusting to body changes

3. Health deviation self-care

Self-care agency
- Required in conditions of illness, injury,
– is a human ability which is "the ability
or disease .these include:--
for engaging in self-care" -conditioned by
- Seeking and securing appropriate
age developmental state, life experience
medical assistance
sociocultural orientation health and
- Being aware of and attending to the
available resources
effects and results of pathologic conditions
- Effectively carrying out medically
Therapeutic self-care demand
prescribed measures
– "totality of self-care actions to be
- Modifying self concepts in accepting
performed for some duration in order to
oneself as being in a particular state of
meet self-care requisites by using valid
health and in specific forms of health care
methods and related sets of operations
- Modifying self concepts in accepting
and actions"
oneself as being in a particular state of
health and in specific forms of health care
Self-care requisites
- action directed towards the provision of
self-care. 3 categories of self-care B. Theory of self-care deficit
requisites are- - Specifies when nursing is needed
- Nursing is required when an adult (or in ● Maintaining interpersonal, intra group
the case of a dependent, the parent) is or inter-group relations for
coordination of efforts
incapable or limited in the provision of ● Maintaining a therapeutic relationship
continuous effective self-care. Orem in light of psychosocial modes of
identifies 5 methods of helping: functioning in health and disease
● Giving human assistance adapted to
● Acting for and doing for others human needs , acting abilities and
● Guiding others limitations
● Supporting another
● Providing an environment promoting 2. Regulatory technologies
personal development in relation to
● Maintaining and promoting life
meeting future demands
processes
● Teaching another
● Regulating psycho physiological
C. Theory of Nursing Systems modes of functioning in health and
disease
● Describes how the patient’s self-care ● Promoting human growth and
needs will be met by the nurse, the development
patient, or both ● Regulating position and movement in
● Identifies 3 classifications of the space
nursing system to meet the self-care
requisites of the patient:- OREM’S THEORY AND NURSING
● Wholly compensatory system PROCESS
● Partly compensatory system
- The nursing process presents a method to
● Supportive – educative system
determine the self-care deficits and then to
● Design and elements of the nursing
define the roles of the person or nurse to meet
system define
the self-care demands.
● Scope of nursing responsibility in
healthcare situations - The steps within the approach are
● General and specific roles of nurses considered to be the technical component of
and patients the nursing process.
● Reasons for nurses’ relationship with
patients and - Orem emphasizes that the technological
● Orem recognized that specialized component "must be coordinated with
technologies are usually developed by interpersonal and social processes within
members of the health profession nursing situations.
● Technology is systematized
information about a process or a Nursing Process
method for affecting some desired
result through deliberate practical Assessment
endeavour, with or without the use of
materials or instruments. ● Diagnosis and prescription; determine
why nursing is needed. analyze and
interpret –make judgment regarding
care
● Design of a nursing system and plan
for delivery of care
● Production and management of
nursing systems

Step 1-collect data in six areas:-

● The person’s health status

Categories of technologies ● The physician’s perspective of the
person’s health status
1. Social or interpersonal
● The person’s perspective of his or her
● Communication adjusted to age, health
health status ● The health goals within the context of
life history, lifestyle, and health status
 ● The person’s requirements for self- research implemented to
care validate them
● The person’s capacity to perform self- ○ can be used by the
care practitioners to guide and
improve their practice
○ must be consistent with other
validated theories,laws and
Nursing Diagnosis principles
Plans with scientific rational

Step 2
Strengths
● Nurse designs a system that is wholly
● Provides a comprehensive base to
or partly compensatory or supportive-
nursing practice
educative.
● It has utility for professional nursing in
● The 2 actions are:-
the areas of nursing practice nursing
● Bringing out a good organization of
curricula, nursing education
the components of patients’
administration, and nursing research
therapeutic self-care demands
● Specifies when nursing is needed
● Selection of a combination of ways of
● Her self-care approach is
helping that will be effective and
contemporary
efficient in compensating for/
overcoming patient’s self-care deficits Limitations

● In general system theory a system is

viewed as a single whole thing while
Implementation
Orem defines a system as a single
evaluation whole, thing.
● Health is often viewed as dynamic and
Step 3 ever-changing.
● The theory is illness oriented.
● Nurse assists the patient or family in
self-care matters to achieve identified
and described health and health-
related results. collecting evidence in
evaluating results achieved against
results specified in the nursing system
design
● Actions are directed by aetiology
component of nursing diagnosis
● evaluation

of OREM’S WORK AND THE

CHARACTERISTICS OF A THEORY

● Orem's theory
○ interrelate concepts in such a
way as to create a different
way of looking at a particular
phenomenon
○ is logical in nature.
○ is relatively simple yet
generalizable
○ is basis for hypothesis that
can be tested
○ contribute to and assist in
increasing the general body of
knowledge within the
discipline through the