Orem's self care theory presentatiom

1. OREM’S
THEORY
Self care, Self care deficit
&
Nursing systems
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2. OBJECTIVES
• Brief biography and historical overview of Dorethea Orem
• Metaparadigms of Orem's theory
• Explanation of three interrelated self care theories
• Explanation of concepts of the theories
• Case study
• Application of theory
• Criticism
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3. BIOGRAPHY
• Born 1914 in Baltimore, USA
• 1934-Received her diploma at Providence Hospital –
Washington, DC
• 1939 – BSN Ed. And Master of science in nursing education
(1945) from Catholic University of America, Washington D.C.
honorary Doctoral Degree Georgetown University(1976)
• Awards; several national and international awards including
Sigma theta Tau 1997 9/22/2018Group 9 3

4. BIOGRAPHY CONT.’
• Clinical field: staff nurse in operating room,ER, pedis and med/surg
• Teaching field she taught biological sciences, and later was a service
director of the SON at providence hospital Michigan
• Last 25 years as an author and consultant. Concept of nursing as
provision of self care 1959,‘Nursing; concepts of practice’(1971).
Subsequent editions in 1980, 1985, 1991, 1995 and 2001
Died at 92 on June 22,2007
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5. INTRODUCTION
• Orem's goal was to upgrade the quality of nursing in general hospitals
throughout the state. During her time she developed the self care theory
to answer the question
‘what is the phenomena of nursing practice?’
• Orem’s concept of nursing as the provision of self- care was first
published in 1959 The theory is a grand theory with three related parts
namely; Self care, Self care deficit and Nursing systems 1/23/2019Group 9 5

6. PHILOSOPHY
• Patient wish to care for themselves. Recovery
is quick if they are allowed to perform their
own self care activities to the best of their
ability or at least incorporated in taking care
of themselves.
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7. METAPARADIGMS
• PERSON
• Orem defines a person as the patient who is with the capacity of self
knowledge and can perform actions deliberately, interprets experiences
and perform beneficial actions to health.
• Health
• A state of wholeness or integrity of the individual human beings, his parts,
and his modes of functioning. A healthy person is likely to have sufficient
self care abilities to meet his or her universal self care needs.1/23/2019 Slide 6
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7

8. METAPARADIGM CONT.
Environment
Orem defines an environment as a external element to man but consider as a sub
system of man. The environment may include the physical and developmental aspects.
Physical(air, water, light etc.) Developmental environment may include opportunities to
be helped; being with other people; companionship; trust; belief.
Nursing
Nursing is an action deliberately selected and performed by nurses to help individuals or
groups under their care to maintain, or change conditions in themselves. Nursing renders
the patient or his family capable of meeting the patient’s self care needs.
8

9. THEORIES AND CONCEPTS
• The three major theories are
• Major concepts
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SELF CARE SELF CARE DEFICIT NURSING SYSTEMS
SELF
CARE
SELF
CARE
AGENCY
THERAPE
UTIC
SELF
CARE
DEMAND
S
SELF
CARE
REQUISIT
E

10. THEORY OF SELF CARE
• These are the activities that the individuals initiate
and perform on their own in order to maintain
health and wellbeing.
• It helps to maintain structural integrity, human
functioning and contributes to human
development.
• Self care is learned through
interpersonal relations and
communication.
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10

11. SELF CARE AGENCY & THERAPEUTIC SELF
CARE DEMAND
• Self care is the ability to perform self care
activities and it influenced by conditions like age,
gender,developmental state, health state, family
factors etc.
• Therapeutic self care demand is the total care
activities needed at a point in time or over a
period of time to meet a person’s requirements for
self care
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12. SELF CARE REQUISITES
• These are the reasons why self-care activities occur.
They are categorized into three
• Universal self-care requisite
• Developmental self care requisites
• Health deviation self care requisites
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13. Universal
Sufficient intake of
air, water ,food.
elimination,
protection against
hazard
Developmental
developmental
processes and events
in life cycle. birth,
neonatal, infancy,
adult, childhood etc.
Health Deviation
Changes affecting
normalcy, being aware
and attending, carryin
out medically prescribe
activities
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14. THEORY OF SELF CARE DEFICIT
This is the basic element of the general theory of self care
which tells when nursing care is required.
Nursing is required when adult (or in the case of a
dependent, the patient or guardians) are incapable of or
limited in their ability to provide continues effective self
care.
When there are more demands than abilities,
nursing is needed. 1/23/2019Group 9 14
SELF
CARE
DEMAN
D
SELF
CARE
AGENC
Y

15. THEORY OF NURSING SYSTEMS
• This describes how the patient’s self care needs will be met by the nurse, the
patient, or both.
• Orem identifies 3 classifications of nursing system to meet the self care
requisites.
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Supportive
education
partial wholly

16. Types of Nursing
Systems
Definitions Example
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Wholly
Compensatory
Is represented by the situation in
which the individual is unable to
carry
out needed self-care actions at all.
Patients under coma,
anesthesia, with
fractures ,
etc
Partly
Compensatory
Is represented by a situation in
which the patient and nurse are
both physically active in meeting
the patient’s self-care needs and
either may perform the majority
of the needed actions.
Patients with major
surgeries, temporary
limitation of activities
due
to cast application etc
Supportive-
Educative
Is represented by the
capability of a person to
perform self-care activities
independently or needs to
learn to how to meet self care
Clients wishing to
know about
contraceptive
methods, adolescent
seeking information

17. MAJOR ASSUPTIONS
• People should be self-reliant, and responsible for their care, as well as others in their
family who need care.
• People are distinct individuals.
• Nursing is a form of action. It is an interaction between two or more people.
• Successfully meeting universal and development self-care requisites is an important
component of primary care ,prevention of diseases and ill health.
• A person's knowledge of potential health problems is needed for promoting self-care
behaviors.
• Self-care and dependent care are behaviors learned within a socio-cultural context.
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18. 1/23/2019Group 9 18

19. CASE STUDY
• Ms. O.A an immunocompromised patient with pulmonary TB and diarrhea. She is in
her early adulthood stage and enjoys family support from parents. Student Nurse
Obenu identifies Ms. O.A self care deficits by thorough assessment using areas
Orem's universal self care requisite
• Ineffective pain control related to lack of utilization of pain relief measures
• Identified deficits included
• Inability to maintain the ideal nutrition related to insufficient intake and knowledge
deficit
• Self care deficit ;dressing and toileting related to restricted movement secondary to
edema at the foot
• Risk for impaired skin related to edema at the feet,
• Deficient knowledge on medications and disease process
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20. • STN. Obenu educated Ms. O.A on the need to maintain optimum nutrition and also patient was
educated on immune boosting foods. Patient understood the importance nutrition and also started
taking fruits after meals
• Patient was helped to dress by putting dressing articles near her, advising her on use of loose
clothing to making dressing easier. Patient was also helped in using the commode for elimination
purposes. Patient could dress up and also eliminated freely with the commode
• Patient was taught non pharmacological means of relieving pain like diversion. STN Obenu also
administered Tab diclofenac as prescribed. Patients pain was relieved as evidenced by patient
verbalizing it and also patient took to reading her Bible to create diversion when she's in pain
• Patients edema and skin was regularly assessed. Pillows were used as pressure relieving device for
pt. and to elevate the legs. Patient was advised to report increase in size of the edema. Patient skin
remained free of impaired integrity and patient identified the need to put the feet on pillows.
• The theory help identify the deficits of Ms. O.A and also helped in providing comprehensive care.
The application of this theory revealed how nursing system could be used in solving problems of Ms.
O.A,
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21. IMPORTANCE IN CLINICAL USE
• Orem's theory helps identify the need for nursing care.
• It emphasize on various interactions that should occur between a nurse and a patient.
• The theory is tied with nursing goals, clinical practice and research.
• Orem’s theory is used as a theoretical framework and hypotheses in research works.eg
Application of Orem Self Care Deficit Theory on Psychiatric Patient by Bibi Hahira Irshad Ali
• It guides in identifying self care requisite and self care behavior in clinical population during
research.
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22. CRITICISM
INTERNAL CRITICISMS (POSITIVE)
Clarity; Precisely defined terms and simple language
Consistency; Concepts are consistent throughout with no excessive exchange of words
Logical development; All conclusion set forth in the theory logically follows the preceded
reasoning.
EXTERNAL CRITICISMS (POSITIVE)
Reality convergence; The basic premises of the theory is accepted.
Utility; The theory is very useful in most departments of nursing.
Significance; The theory addresses a lot of essential issues in nursing.
Discrimination; Orem theory has helped differentiate nursing from other health professionals
by identifying what nursing actions are 1/23/2019 22

23. CRITICIMS CONT..
• The circle of contagiousness; Orem's theory has widely spread
geographically
• Scope of theory; The theory widely covers a lot of specialties in nursing.
• Complex; The theory is very complex but practical.
CRITICISMS (NEGETIVE)
Adequacy; The theory does not cover all aspect of nursing. The theory is
rather physical oriented or illness oriented
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24. CONCLUSION
• Orem identifies patients as people
who wish to care for themselves
however due to condition factors the
may not have adequate ability to do
so.
• Nursing is an action and interaction
focused on enabling patients to meet
their self care deficits
• Thank you
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25. REFERENCES
Application of Orems Self Care Deficit Theory, retrieved from
http://currentnursing.com/nursing_theory/application_self_care_deficit_theory.
html retrieved on 04/09/18
Hagran, A. & Fakharany, E. (2015). Critique of Orem's Theory. J. Middle East
North Afr. sci, 1(5), 12-17]. (p-ISSN 2412- 9763) - (e-ISSN 2412-8937).
http://www.jomenas.org. Retrieved on 23/09/18
Parker, E.P. (2005) Nursing Theories and nursing practice (2nd Ed).
Philidelphia.F.A. Davis Company
Petiprin ,A .(2016). Self Care Deficit. Retrieved 28th September, 2018. from
www.nursing-theory.org retrieved on 29/09/18
Trikhatrin C. (2016) Dorothea Elizabeth Orem’s Self Care Theory (powerpoint
slides retrieved from www.slideshare.com retrieved on 29/09/18
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26. GROUP MEMBERS
• GROUP MEMBERS
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Kyerewaa Theresa
Tetteh-Mensah Sarah Melissa
Amoako-Mensah Deborah
Kwantwi Barimah Sammy Jr.
Aboagyewaa Millicent
Agyemang-Adu Priscilla
Osei Kofi Junior Stephanopoulos
Obenu Nadjokie Deborah
Nurse Abigail
Akwa Peace Sylvia