Self Care Theory - 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
Caetano,JA, Pagliuca,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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