Tuesday, January 29, 2019
Dothea Orem Self-Care Theory
Dorothea Orems egotism-Care Theory This page was last updated on February 4, 2012 INTRODUCTION theoretician Dorothea Orem (1914-2007) Born 1914 in Baltimore, US Earned her diploma at saving Hospital Washington, DC 1939 BSN Ed. , Catholic University of America 1945 MSN Ed. , Catholic University of America She worked as a staff nurse, private duty nurse, nurse educator and executive and nurse consultant. Received honorary Doctor of Science degree in 1976. Theory was first published in treat Concepts of Practice in 1971, second in 1980, in 1995, and 2001.MAJOR ASSUMPTIONS People should be ego-importance-importance-importance-reliant and trus 2rthy for their own armorial bearing and opposites in their family needing commission People are unadorned individuals treat is a form of action interaction between two or more individuals Successfully fulfilling universal and development egotism-importance- caution requisites is an authorised fraction of primary fright preve ntion and ill wellness A persons knowledge of potential wellness paradoxs is necessary for promoting self- accusation behaviors self care and dependent care are behaviors learned within a socio-cultural context DEFINITIONS OF DOMAIN CONCEPTSNursing is art, a helping service, and a technology Actions by design selected and transacted by nurses to help individuals or groups under their care to bear on or change conditions in themselves or their purlieus Encompasses the endurings perspective of wellness condition ,the physicians perspective , and the nurse perspective aim of nurse to render the persevering or members of his family capable of meeting the patients self care needs To maintain a deposit of wellness To regain normal or near normal differentiate of wellness in the event of ailment or injury To calm ,control ,or minimize the do of chronic poor wellness or deterrent Health wellness and healthy are terms institutionalise sessiond to line living thing s It is wbiddy they are structurally and functionally whole or sizeable wholeness or truth. .includes that which makes a person charitable,operating in community with physio analytical and psychophysiological mechanisms and a material structure and in relation to and interacting with other pitying beings Environment surroundings offices are enthronement factors, enthronement elements, conditions, and positive environment Human being has the capacity to reflect, symbolize and use symbols Conceptualized as a total being with universal, developmental needs and capable of straight self care A unity that provide function biologically, symbolically and socially Nursing client A human being who has health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in unable(p) / incomplete care. A human being is the focus of breast feeding that when a self care requisites exceeds self care capabilities N ursing problem dearths in universal, developmental, and health derived or health related conditions Nursing suffice a clay to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of care Nursing remedys deliberate, frameatic and businesslike action, OREMS GENERAL THEORY OF NURSING Orems public possible action of nursing in three related parts- Theory of self care Theory of self care deficit Theory of nursing system A. Theory of Self Care This supposition Includes Self care practice of activities that individual initiates and perform on their own behalf in maintaining look ,health and well being Self care agency is a human ability which is the ability for engaging in self care -conditioned by age developmental state, life experience sociocultural orientation health and available resources redress self care demand totality of self care actions to be performed for some(a) uration in order to meet self care requisites by using valid methods and related sets of operations and actions Self care requisites action directed towards provision of self care. 3 categories of self care requisites are- oUniversal self care requisites oDevelopmental self care requisites oHealth deviation self care requisites 1. Universal self care requisites Associated with life work outes and the sustainment of the integrity of human structure and functioning Common to all , ADL Identifies these requisites as oMaintenance of capable intake of air ,water, food Provision of care assoc with elimination process oBalance between occupation and rest, between solitude and social interaction oPrevention of hazards to human life well being and oPromotion of human functioning 2. Developmental self care requisites Associated with developmental processes/ derived from a condition. Or associated with an event oE. g. adjusting to a new job oadjusting to body changes 3. Health deviation self care Required in conditions of illness, injury, or disease . these i nclude Seeking and securing assign medical assistance Being aware of and attending to the effects and results of morbid conditions Effectively carrying out medically prescribed measures Modifying self concepts in accept oneself as being in a particular state of health and in specific forms of health care Learning to live with effects of pathologic conditions B. Theory of self care deficit Specifies when nursing is needful 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.Orem identifies 5 methods of helping oActing for and doing for others oGuiding others oSupporting another oProviding an environment promoting personal development in relation to meet future demands oTeaching another C. Theory of Nursing Systems Describes how the patients self care needs exit be met by the nurse , the patient, or both Identifies 3 classifications of nursing system to meet the self care requisite s of the patient- Wholly compensatory system Partly compensatory system Supportive educative system Design and elements of nursing system go down Scope of nursing responsibility in health care situations familiar and specific roles of nurses and patients Reasons for nurses relationship with patients and Orem recognized that specialized technologies are usually certain by members of the health profession A technology is systematized information somewhat a process or a method for affecting some desired result through deliberate practical endeavor, with or without use of materials or instruments. Categories of technologies 1. Social or interpersonal Communication adjusted to age, health view obligeing interpersonal, intra group or inter group relations for coordination of efforts Maintaining healing(predicate) relationship in light of psychosocial modes of functioning in health and disease Giving human assistance adapted to human needs ,action abilities and limitations 2. regu lative technologies Maintaining and promoting life processes Regulating psycho physiological modes of functioning in health and disease Promoting human growth and development Regulating position and act in space OREMS THEORY AND NURSING PROCESS Nursing process presents a method to determine the self care deficits and hen to define the roles of person or nurse to meet the self care demands. The steps within the approach are considered to be the technical component of the nursing process. Orem emphasizes that the technological component must be coordinated with interpersonal and social processes within nursing situations. Nursing Process Orems Nursing Process Assessment 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 solicitude of nursing systemsStep 1-collect data in six areas- The persons health status The physicians perspective of the persons heal th status The persons perspective of his or her health The health goals within the context of life history ,life behavior, and health status The persons requirements for self care The persons capacity to perform self care Nursing diagnosis Plans with scientific rationaleStep 2 defy designs a system that is wholly or partly compensatory or clog upive-educative. The 2 actions are- Bringing out a good organization of the components of patients therapeutic self care demands Selection of combination of ways of helping that will be effective and efficient in compensating for/ overcoming patients self care deficits Implementation evaluationStep 3 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 etiology component of nursing diagnosis evaluationApplication of Orems theory to nursing process Therapeutic self care demandAdequacy of self care agencyNursing diagnosisMethods of helping Air Maintain effective respiration Water No problem Food maintain sufficient intakeInadequate Adequate InadequatePotential for impaired respiratory status P F fluid imbalance existent nutritional deficit r/t nauseaGuiding &038 directing Teaching Providing physical support Hazards Prevent spouse cry out Promotion of normalcyInadequate InadequateP/F injury A/d in environment Shared housingPersonal development Guiding &038 directing Guiding &038 directingMaintain developmental environment Support ed normalcy in environment Prevent / act dev threatInadequate InadequateActual delay in normal dev. R/T early pedigree Level of education Dev deficit r/t loss of generative organsGuiding &038 directing Providing psy support Providing physical, psy support Maintenance of health status concern of disease process Inadequate InadequateP/F contd. alterations in health status P/F UTIGuiding &038 directing, teaching Guiding &038 directing, teaching Adherence to med food Awareness of potential problemsInadequate InadequateP/F ? dherence in self catheterization &038 OPD RT Actual deficit in awareness of advisability of HRT &038 RT effectsteaching teaching Adjust to loss of procreative ability &038 dev healthy view of illness Adjust life style to cope with change Inadequate InadequateActual threat to self image Actual self deficit in planning for future needs Providing psy support Guiding &038 directing OREMS WORK AND THE CHARACTERISTICS OF A THEORY Orems theory ointerrelate concepts in such a way as to create a different way of looking at a particular phenomenon ois logical in nature. ois relatively simple yet generalizable ois basis for hypothesis that can be tested contribute to and assist in increasing the general body of knowledge within the discipline through the research use to validate them ocan be used by the practitioners to guide and improve their practice omust b e consistent with other validated theories ,laws and principles Strengths Provides a comprehensive secondary to nursing practice It has utility for professional nursing in the areas of nursing practice nursing curricula ,nursing education administration ,and nursing research Specifies when nursing is needed Her self-care approach is contemporary with the concepts of health promotion and health maintenance Limitations In general system theory a system is viewed as a single whole thing while Orem defines a system as a single whole, thing. Health is often viewed as fighting(a) and ever changing. The theory is illness oriented. RESEARCH ON OREMS THEORY 1. Self-care requirements for activity and rest an Orem nursing focus 2. Nursing diagnoses in patients after feeling catheterizationcontribution of Orem 3. Self-carethe contribution of nursing cognizances to health care 4. Self-care a foundational perception 5. Orems self-care deficit nursing theory its philosophic foundation and the state of the science 6. Dorothea E. Orem thoughts on her theory . Orems theory in practice. Hospice nursing care 8. resoluteness the Orem mystery an educational strategy 9. Orems family evaluation REFERENCES Orem, D. E. (1991). Nursing Concepts of practice (4th ed. ). St. Louis, MO Mosby-Year Book Inc. Taylor, S. G. (2006). Dorthea E. Orem Self-care deficit theory of nursing. In A. M. Tomey, A. &038 Alligood, M. (2002). Significance of theory for nursing as a discipline and profession. Nursing Theorists and their work. Mosby, St. Louis, Missouri, United States of America. Whelan, E. G. (1984). Analysis and performance of Dorothea Orems Self-care Practuce Model.Retrieved October 31, 2006. George B. Julia , Nursing Theories- The base for professional Nursing Practice, third ed. Norwalk, Appleton &038 Lange. Wills M. Evelyn, McEwen Melanie (2002). theory-based Basis for Nursing Philadelphia. Lippincott Williams&038 wilkins. Meleis Ibrahim Afaf (1997) , Theoretical Nursing Developm ent &038 Progress third ed. Philadelphia, Lippincott. Taylor Carol,Lillis Carol (2001)The Art &038 Science Of Nursing Care 4th ed. Philadelphia, Lippincott. muck around A Patricia, Perry G Anne (1992) Fundamentals Of Nursing Concepts Process &038 Practice 3rd ed. London Mosby Year Book.