Dorothea Orem's Self-Care Deficit Theory PDF

Nursing Philosophies Martha Rogers Dorothea Orem Imogene King Myra Levine Martha Rogers Dorothea Orem Imogene King Myra Le...

Nursing Philosophies Martha Rogers Dorothea Orem Imogene King Myra Levine Martha Rogers Dorothea Orem Imogene King Myra Levine Unitary Human Beings Self-Care De Goal Attainment Theory Conservation Theory f Dorothea Orem Self-Care De icit Theory — Bachelor of Science degree in Nursing Education & Master’s of Science degree in Nursing Education from Catholic University of America (CUA) — Nursing experiences: operating room nursing, private duty nursing (home and hospital), hospital sta nursing on pediatric and adult medical and surgical units, evening supervisor in the emergency room, and biological science teaching. f ff Self-Care De icit Theory Dorothea Orem's Self-Care De icit Theory proposes that patients have the innate ability and responsibility to care for themselves. A nurse's role goes beyond tending to patients' physical needs; it involves supporting them on their journey to regain independence. f f  The self-care de icit theory is a general theory composed of the following 4 related theories: 1. The theory of self-care — why and how people care for themselves 2. The theory of dependent-care — how family members and/or friends provide dependent-care for a person who is socially dependent 3. The theory of self-care de icit — which describes and explains why people can be helped through nursing 4. The theory of nursing systems —which describes and explains relationships that must be brought about and maintained for nursing to be produced f f MAJOR CONCEPTS & DEFINITION Self-care comprises the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interest of maintaining life, healthful Self-care functioning, continuing personal development, and well-being by meeting known requisites for functional and developmental regulations. Dependent-Care Care that is provided to a person who, because of age or related factors, is unable to perform the self-care needed to maintain life, healthful functioning, continuing personal development, and well-being.  MAJOR CONCEPTS & DEFINITION Actions to be performed that are known to be necessary in the regulation Self-Care Requisites of an aspect of human functioning and development. Universal Self-Care Requisites Developmental Self-Care Requisites Health Deviation Self-Care Requisites 8 Self-Care Requisites: — supporting growth & development throughout life Health deviation self-care requisites exist for 1. Air Three sets of DSCRs have been identi ied: persons who are ill or injured, who have speci ic 2. Food 1. Provision of conditions that promote development forms of pathological conditions or disorders, 3. Water 2. Engagement in self-development including defects and disabilities, and who are 4. Elimination processes and excrements 3. Prevention of or overcoming e ects of human under medical diagnosis and treatment. 5. Balance between activity and rest conditions and life situations that can adversely 6. Balance between solitude and social a ect human development interaction 7. Prevention of hazards to human life 8. Promotion of human functioning and development within social groups and the human desire to be normal Family creating a nurturing and stable home environment for a child. ff ff f f MAJOR CONCEPTS & DEFINITION Therapeutic Self-Care Demand Therapeutic self-care demand consists of the summation of care measures necessary at speci ic times or over a duration of time to meet all of an individual’s known self- care requisites. Therapeutic Self-Care Demand is performed by the individual (self-care agent). Dependent-Care Demand Dependent-care demand is the summation of care measures at a speci ic point in time or over a duration of time for meeting the dependent’s therapeutic self- care demand when his or her self-care agency is not adequate or operational. Dependent-Care Demand is performed by a caregiver (dependent-care agent) for someone who cannot do it themselves. f f MAJOR CONCEPTS & DEFINITION Self-Care Agency — is the human’s ability or power to engage in self-care and is affected by basic conditioning factors. Dependent-Care Agency — refers to the acquired ability of a person to know and meet the therapeutic self-care demand of the dependent person and/or regulate the development and exercise of the dependent’s self- care agency. MAJOR CONCEPTS & DEFINITION Self-Care De icit The individual cannot meet their own self-care needs due to physical or mental limitations and requires external support or nursing care. A 62-year-old patient has su ered a stroke, which has left them with limited mobility on the left side of their body and di iculty speaking (aphasia). As a result, they are unable to perform many basic self-care activities. Dependent-Care De icit The caregiver cannot adequately meet the self-care needs of a dependent person and requires assistance, training, or resources to provide proper care. An 8-year-old child with cerebral palsy (CP) is dependent on their parents for daily care. The child has limited motor function and cannot walk, feed, or dress themselves independently. ff f ff f MAJOR CONCEPTS & DEFINITION Nursing Agency — Nursing agency comprises developed capabilities of persons educated as nurses. — To help persons meet their therapeutic self- care demands. — Nursing agency also incorporates the capabilities of nurses to assist persons who provide dependent-care to regulate the development or exercise of their dependent-care agency. MAJOR CONCEPTS & DEFINITION Nursing Design — Refers to the plan or framework that nurses develop to guide their care for patients with self-care de icits. — The purpose of nursing design is to provide guides for achieving needed and foreseen results in the production of nursing toward the achievement of nursing goals; these units taken together constitute the pattern that guides the production of nursing. f MAJOR CONCEPTS & DEFINITION Helping Methods — Sequential series of actions that will overcome or compensate for the health-associated limitations of individuals Acting for or doing for another Guiding and directing Providing physical or psychological support Providing and maintaining an environment that supports personal development Teaching MAJOR CONCEPTS & DEFINITION Basic Conditioning Factors Basic conditioning factors condition or a ect the value of the therapeutic self-care demand and/or the self-care agency of an individual at particular times and under speci ic circumstances. Age Gender Developmental state Health state Pattern of living Health care system factors Family system factors Sociocultural factors Availability of resources External environmental factors ff f  The Three Basic Nursing Systems The wholly compensatory nursing system — the individual is unable “to engage in those self-care actions requiring self- directed and controlled ambulation…” Persons with these limitations are socially dependent on others for their continued existence and well-being. The partly compensatory nursing system —“both nurse and patient perform care measures or other actions involving manipulative tasks or ambulation… [Either] the patient or the nurse may have the major role in the performance of care measures.” The supportive-educative system — also known as supportive-developmental system —the person “is able to perform or can and should learn to perform required measures of externally or internally oriented therapeutic self-care but cannot do so without assistance.” Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies. 1. Wholly Compensatory ◦ Feeding a patient who is unconscious. ◦ Turning and repositioning a bedridden. ◦ Performing all hygiene care (bathing & oral care) for a patient with advanced paralysis. ◦ Ventilator management for a patient with respiratory failure. 2. Partially Compensatory ◦ Assisting a post-operative patient in walking while they regain strength. ◦ Helping a patient with limited mobility to dress or bathe. ◦ Providing set-up assistance for meals to a patient who can feed themselves. ◦ Guiding a patient with mild dementia to remember daily hygiene routines. 3. Supportive-Educative ◦ Teaching a diabetic patient how to monitor blood glucose levels and administer insulin. ◦ Educating a patient about wound care and infection prevention. ◦ Providing dietary counseling to a patient with hypertension. ◦ Supporting a patient with asthma by teaching them how to use an inhaler correctly. ◦ Teaching lifestyle changes to promote long-term heart health.  Self-Care - all activities that individual’s initiate and perform to maintaining life, health and well being. Self-Care Agency: The individual's ability to perform self-care. This is Therapeutic Self-Care in luenced by factors like Demand is performed by age, developmental state, the individual (self-care health, and environmental agent). conditions. f  CLARITY The terms Orem used are de ined precisely. Orem’s theory is expressed in a limited number of terms. These terms are SIMPLICITY de ined and used consistently in the expression of the theory. GENERALITY A review of the research and other literature attests to the generality of the theory. As a general theory, the SCDNT provides a descriptive explanation of why persons ACCESIBILITY require nursing and what processes are needed for the production of required nursing care. The signi icance of Orem’s work extends far beyond the development of the SCDNT. In her IMPORTANCE works, she provided expression of the form of nursing science as practical science, along with a structure for ongoing development of nursing knowledge in the stages of theory development. f f f