Self-care deficit nursing theory
Self-care deficit nursing theory, developed by nursing theorist Dorothea Orem, emphasizes the importance of individuals' ability to engage in self-care to maintain their health. The theory posits that when individuals cannot perform self-care activities, they experience a "self-care deficit" and require nursing assistance. This model encourages the promotion of patient independence, particularly in contexts like surgical recovery and geriatric care, where patients are taught to manage their health effectively.
Orem's theory comprises three interrelated components: the theory of self-care, the theory of self-care deficit, and the nursing system theory. It guides nurses in assessing patients' needs, formulating care plans, and evaluating outcomes based on a holistic understanding of the patient, including their personal background and available resources. The theory highlights the role of the nurse as a facilitator who can support, educate, and guide patients towards achieving self-care capabilities.
While the self-care deficit nursing theory has been influential since its inception in the mid-20th century and continues to inform nursing practice today, critics argue that its framework may be too rigid and not fully responsive to the complexities of health and illness in modern contexts. Overall, Orem's theory presents a structured approach to nursing care that seeks to empower patients in their health management.
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Self-care deficit nursing theory
The self-care deficit nursing theory is a large-scale theory that can be used to benefit patients' lives. The theory centers on a person's ability to execute self-care, or to act on their own behalf in ways that help them remain healthy.
Dorothea Elizabeth Orem, who developed the theory, believed that if a person could not execute self-care, the individual was self-care deficit. In such cases, health care experts were required to help put a plan in place to help patients reach a level at which they could execute self-care, and to help patients acquire the tools and the education they need so they are able to practice their own self-care. The purpose of her theory is twofold: to see the patient as a complete person, and to use nursing knowledge to revive and uphold the patient's health. Even though the theory was developed in the mid-twentieth century, it provides information that nurses and nursing educators continue to use. Her work helped to form the science of nursing, the practice of nursing, and the education of nurses.
Background
Dorothea Elizabeth Orem was an American nursing theorist who created the self-care deficit nursing theory. The theory is also known as the Orem Model of Nursing. Orem obtained her nursing diploma from the Providence Hospital School of Nursing in Washington, DC, in the early 1930s. She obtained both her bachelor of science in nursing and her master of science in nursing from the Catholic University of America in Washington, DC, in 1939 and 1945, respectively. Orem held various influential nursing posts, serving as director of both the nursing school and the department of nursing at Providence Hospital in Detroit from 1940 to 1949. Not only was Orem a nurse, but she was also an educator. She moved from assistant professor to an associate professor at the Catholic University of America in 1964 and continued teaching there until 1970.
One of Orem's first books is Guidelines for Developing Curricula for the Education of Practical Nurses. The 1959 work addresses nursing practices and self-care. In it she develops the self-care deficit nursing theory. After the book was published, she continued to develop nursing concepts. Over the next thirty-five years, she worked on creating and refining the self-care deficit nursing theory. Many experts helped her work on the theory, but she maintained control.
Overview
Orem's self-care deficit theory is a combination of three theories that define when a person needs nursing care, which Orem describes as a nursing system. The three theories are the theory of self-care, the theory of self-care deficit, and the theory of nursing system. The objectives of the combined theories are to assess a patient's condition, identify the needs of the patient, communicate with the patient, create a plan for the patient to get healthy, and finally to evaluate and reflect on the plan after the patient is well.
The theory of self-care is the idea that a person who is healthy is able to take care of oneself. The self-care-ready person is able to do very basic things that keep the human body alive, such as obtain food, air, and water. It also entails being able to eliminate waste properly. When people are able to practice self-care, they are also mentally and emotionally healthy. They are able to strike a healthy balance between solitude and social interactions.
When people cannot practice self-care, according to Orem's theory, they are self-care deficit and in need of nursing care. The self-care deficit theory outlines that a nurse must decide if the patient cannot perform self-care actions. Nursing is required when an adult cannot perform self-care actions. Orem's theory explains than nurses can help patients in five ways: Nurses can act for and do for others, guide patients, support patients, provide an environment that promotes personal development, and teach patients.
Once the nurse identifies that nursing is in need, he or she moves into the third part of Orem's model, the nursing system theory. Nurses make a plan for care that includes goals for the patient. The nursing system or plan may be wholly compensatory, partially compensatory, or a supportive and educational plan. Orem's nursing system theory also takes into account personal information about the patients to help make the plans. The nurse making a plan should take into account the patient's age, gender, socioeconomic status, family system, and the resources the patient has available to help him or her. Oftentimes the plans include patient education portions, so a person can learn the self-cares that the individual needs to function.
The plan that a nurse lays out also includes what technologies the patient will need to eventually be able to perform one's own self-cares. Orem defines a technology as information about a process that gets a desired result, with or without the use of materials or instruments. Orem's nursing system theory maintains that technology includes two categories. The first category of technology is social or interpersonal, which includes the ideas of maintaining a therapeutic relationship and giving human assistance when needed. The secondary category of technology is regulatory technologies, which includes the idea of maintaining and promoting life processes and promoting human growth and development.
After the care is provided, the way the patient was nursed and the nursing systems that were chosen to help the patient are to be evaluated. This analysis helps determine whether the mutually planned goals were met or if improvements could be made.
Many nursing experts believe Orem's plan is ideal because it provides a thorough base to nursing practices. The theory clearly states when nursing is needed. Its logical nature makes the theory relevant in modern nursing. Critics of the theory, however, believe that health is too dynamic and changing for the theory to work and that the theory is simply illness-oriented.
Bibliography
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