Self Care Theory - Dorothea Orem


Resulta ng larawan para sa DOROTHEA OREM
DOROTHEA OREM
            Dorothea Elizabeth Orem (July 15, 1914 – June 22, 2007) was one of America’s foremost nursing theorists who developed the Self-Care Nursing Theory, also known as the Orem Model of Nursing.
Orem was born in July 15, 1914 in Baltimore, Maryland. Her father was a construction worker and her mother is a homemaker. She was the youngest among two daughters.
In the early 1930s, she earned her nursing diploma from the Providence Hospital School of Nursing in Washington, D.C. She went on to complete her Bachelor of Science in Nursing in 1939 and her Master of Science in Nursing in 1945, both from the Catholic University of America in Washington, D.C.
Orem attended Seton High School in Baltimore and graduated in 1931. She received a diploma from the Providence Hospital School of Nursing in Washington, D.C. in 1934 and went on to the Catholic University of America to earn a B.S. in Nursing Education in 1939, and an M.S. in Nursing Education in 1945.
She had a distinguished career in nursing. She earned several Honorary Doctorate degrees. She was given Honorary Doctor of Science from both Georgetown University in 1976 and Incarnate Word College in 1980. She was given an Honorary Doctorate of Humane Letters from Illinois Wesleyan University in 1988, and a Doctorate Honoris Causae from the University of Missouri in Columbia in 1998.

PERSON
Humans are defined as “men, women, and children cared for either singly or as social units,” and are the “material object” of nurses and others who provide direct care.
ENVIRONMENT
Environment has physical, chemical and biological features. It includes the family, culture and community.
HEALTH
Health is “being structurally and functionally whole or sound.” Also, health is a state that encompasses both the health of individuals and of groups, and human health is the ability to reflect on one’s self, to symbolize experience, and to communicate with others.
NURSING
Nursing is as art through which the practitioner of nursing gives specialized assistance to persons with disabilities which makes more than ordinary assistance necessary to meet needs for self-care. The nurse also intelligently participates in the medical care the individual receives from the physician.

MODEL OF THEORY
Orem’s theory focuses on each “individual’s ability to perform self-care, defined as ‘the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being.'”
The Self-Care or Self-Care Deficit Theory of Nursing is composed of three interrelated theories: (1) the theory of self-care, (2) the self-care deficit theory, and (3) the theory of nursing systems, which is further classified into wholly compensatory, partial compensatory and supportive-educative.
According to Orem, “The condition that validates the existence of a requirement for nursing in an adult is the absence of the ability to maintain continuously that amount and quality of self-care which is therapeutic in sustaining life and health, in recovering from disease or injury, or in coping with their effects. With children, the condition is the inability of the parent (or guardian) to maintain continuously for the child the amount and quality of care that is therapeutic.”
Universal self-care requisites
Universal self-care requisites are associated with life processes and the maintenance of the integrity of human structure and functioning.
·       The maintenance of a sufficient intake of air
·       The maintenance of a sufficient intake of water
·       The maintenance of a sufficient intake of food
·       The provision of care associated with elimination process and excrements
·       The maintenance of a balance between activity and rest
·       The maintenance of a balance between solitude and social interaction
·       The prevention of hazards to human life, human functioning, and human well-being
·       The promotion of human functioning and development within social groups in accord with human potential, known human limitations, and the human desire to be normal
Normalcy is used in the sense of that which is essentially human and that which is in accord with the genetic and constitutional characteristics and the talents of individuals.
Developmental self-care requisites
Developmental self-care requisites are “either specialized expressions of universal self-care requisites that have been particularized for developmental processes or they are new requisites derived from a condition or associated with an event.”
Health deviation self-care requisites
Health deviation self-care requisites are required in conditions of illness, injury, or disease or may result from medical measures required to diagnose and correct the condition.
·       Seeking and securing appropriate medical assistance
·       Being aware of and attending to the effects and results of pathologic conditions and states
·       Effectively carrying out medically prescribed diagnostic, therapeutic, and rehabilitative measures
·       Being aware of and attending to or regulating the discomforting or deleterious effects of prescribed medical measures
·       Modifying the self-concept (and self-image) in accepting oneself as being in a particular state of health and in need of specific forms of health care
·       Learning to live with the effects of pathologic conditions and states and the effects of medical diagnostic and treatment measures in a lifestyle that promotes continued personal development
ASSUMPTIONS
The assumptions of Dorothea Orem‘s Self-Care Theory are: (1) In order to stay alive and remain functional, humans engage in constant communication and connect among themselves and their environment. (2) The power to act deliberately is exercised to identify needs and to make needed judgments. (3) Mature human beings experience privations in the form of action in care of self and others involving making life-sustaining and function-regulating actions. (4) Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify needs for, and make inputs into, self and others. (5) Groups of human beings with structured relationships cluster tasks and allocate responsibilities for providing care to group members.

APPLICATION OF SEL-CARE THEORY

Self-care and HIV/AIDS patients: nursing care systematization

This research aimed at systematizing nursing care to HIV/aids patients in view of Orem's Self-care Deficit Nursing Theory, using the convergent-care method and the Self-Care Nursing Process. Subjects were thirteen HIV/AIDS patients attended at a non-governmental organization in Fortaleza/CE, Brazil. We used interview techniques, physical examination, observation and information records, with a structured instrument, addressing requisites related to universal self-care, development and health alterations. Self-care deficits corresponded to nineteen nursing diagnoses, named according to NANDA's Taxonomy II, ten of which were based on the requisites for universal self-care, five on the requisites for self-care related to development and four on the requisites for self-care related to health deviations. In care planning, goals were established and the system and health methods were selected, prioritizing support-education actions in order to engage HIV/aids patients in self-care.

2.The Application of Orem’s Self-care model to Burn Care
Although much information can be found in the literature related to nursing theory, the lack of literature that identifies theory as a basis for delivery of care in the specialty of burn nursing is evident. Those in the field of burn nursing should begin looking for, adapting, or developing a theory for this specialty practice. Orem’s self-care model is suggested as a suitable theory to guide nursing practice and is applicable to burn care. Educating our current and future nurses in the application of a theoretical framework to guide their practice begins in our nursing programs but must be continued with renewed specificity in our practice settings.
Assumptions
The assumptions of Dorothea Orem‘s Self-Care Theory are: (1) In order to stay alive and remain functional, humans engage in constant communication and connect among themselves and their environment. (2) The power to act deliberately is exercised to identify needs and to make needed judgments. (3) Mature human beings experience privations in the form of action in care of self and others involving making life-sustaining and function-regulating actions. (4) Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify needs for, and make inputs into, self and others. (5) Groups of human beings with structured relationships cluster tasks and allocate responsibilities for providing care to group members.
                                               
ANNE MARGARETH V. SANGLAY
JAIRA MAE B. PINPIŇO

REFERENCES
Gil,W. (2014, August 11).  Dorothea E.Orem. Retrieved from https://nurseslabs.com/dorothea-orem/
Caetano,JAPagliuca,LM. (2006, May-June). Self-care and HIV/AIDS patients: nursing care systematization. Retrieved from http://www.easybib.com/reference/guide/apa/website

Wilson,J.(2009, September).The Application of Orem’s Self-care model to Burn Care. Retrieved from https://www.researchgate.net/publication/26753580_The_Application_of_Orem's_Self-Care_Model_to_Burn_Care

Gil,W. (2014, August 12). Dorothea Orem’s Self-Care Theory.Retrieved from https://nurseslabs.com/dorothea-orems-self-care-theory/

BY: Anne Margareth V. Sanglay & Jaira Mae Pinpino

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