This document provides an overview of Dorothea Orem's Self-Care Theory. It discusses Orem's education and clinical background, the evolution and key concepts of her theory, including self-care, self-care deficits, nursing systems, and the nursing process. The document also outlines Orem's view of human beings, health, and environment, which make up the paradigm of her theory.
Orems theory ppt for M.Sc. nursing 1st yearShweta Kumar
Introduction: Orem defines self-care as a learned, goal oriented activity directed towards the self in the interest of maintaining life, health, development and well being. The goal of Orem’s theory is to help the client perform self-care.
Biography of theorist Dorothea E Orem: Dorothea E Orem was born in Baltimore, Maryland on July 15, 1914. She was a nursing theorist and creator of the ‘ Self-care deficit ’ nursing theory, also known as the Orem model of nursing.
Orem’s General Theory Of Nursing: Orem (1991) states her general theory. Orem developed the Self-Care Deficit Theory Of Nursing, which is composed of three interrelated theories: 1) Theory of self-care: Self-care, self-care agency, basic conditioning factors, the therapeutic self-care demand, self-care requisites- Universal (Activities of daily living [ADL]), Developmental, Health deviation
2) Theory of self-care deficit, 3) Theory of nursing systems: Wholly compensatory system, partly compensatory system, supportive educative system.
Orem’s theory and nursing metaparadigm:Definition of metaparadigm- “ the concept that identify the phenomenon of central interest to a discipline ; the prepositions that describe those concepts and their relationships to each other.”
Nursing metaparadigm concepts: *Nursing,* Health, *Environment, *Human being.
Orem’s theory and nursing process:
Nursing process- 1)Assessment, 2)Nursing diagnosis, 3)Plans with scientific rationale, 4)Implementation, 5)Evaluation
Orem’s nursing process- 1)Diagnosis and prescription ; determine why nursing is needed. Analyze and interpret- make judgements regarding care. 2)Design of a nursing system and plan for delivery of care. 3)Production and management of nursing systems.
Orem’s work and the characteristics of a theory:- *Theories must be logical in nature,* simple yet generalizable,*basis of hypothesis that can be tested,* assist in increasing the general body of knowledge,* practitioners to guide and improve their practice,* consistent with other validated theories , laws and principles.
Strengths of Orem’s theory:-
Limitations of Orem’s theory:-
Application of Orem's Self-Care Deficit theory: Evaluation of the application of self care deficit theory:
Summary: Orem presents her general theory of nursing, The self care deficit theory of nursing , which is composed of three interrelated theories of self care, self care deficit and nursing systems. This theory is used as basis for nursing school curriculum and base of nursing information system.
In her model of nursing, she explains that nursing is the practice of identification of a patient’s need for help through the observation of presenting behaviors and symptoms, exploration of the meaning of those symptoms with the patient, determining the cause of discomfort, and determining the patient’s ability to resolve the discomfort or if the patient has a need for help from the nurse or other health care professionals. The goal of nursing consists primarily of identifying a patient’s need for help.
The need for help is defined as “any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that affect health and wellness.” Need-for-help must be based on the individual patient’s perception of his or her own situation.
Wiedenbach’s theory identifies the patient as “any individual who is receiving help of some kind, be it care, instruction or advice from a member of the health profession or from a worker in the field of health.” A patient is any person who has entered the healthcare system and is receiving help, which means he or she does not need to be ill. A person receiving health-related education would qualify as a patient.
Orem's theory viewed nursing as an act of helping those who are self care deficit with best nursing care. She described her theory into three interrelated concepts, viz., Theory of self care , Theory of self care deficit, Theory of nursing system.
Orems theory ppt for M.Sc. nursing 1st yearShweta Kumar
Introduction: Orem defines self-care as a learned, goal oriented activity directed towards the self in the interest of maintaining life, health, development and well being. The goal of Orem’s theory is to help the client perform self-care.
Biography of theorist Dorothea E Orem: Dorothea E Orem was born in Baltimore, Maryland on July 15, 1914. She was a nursing theorist and creator of the ‘ Self-care deficit ’ nursing theory, also known as the Orem model of nursing.
Orem’s General Theory Of Nursing: Orem (1991) states her general theory. Orem developed the Self-Care Deficit Theory Of Nursing, which is composed of three interrelated theories: 1) Theory of self-care: Self-care, self-care agency, basic conditioning factors, the therapeutic self-care demand, self-care requisites- Universal (Activities of daily living [ADL]), Developmental, Health deviation
2) Theory of self-care deficit, 3) Theory of nursing systems: Wholly compensatory system, partly compensatory system, supportive educative system.
Orem’s theory and nursing metaparadigm:Definition of metaparadigm- “ the concept that identify the phenomenon of central interest to a discipline ; the prepositions that describe those concepts and their relationships to each other.”
Nursing metaparadigm concepts: *Nursing,* Health, *Environment, *Human being.
Orem’s theory and nursing process:
Nursing process- 1)Assessment, 2)Nursing diagnosis, 3)Plans with scientific rationale, 4)Implementation, 5)Evaluation
Orem’s nursing process- 1)Diagnosis and prescription ; determine why nursing is needed. Analyze and interpret- make judgements regarding care. 2)Design of a nursing system and plan for delivery of care. 3)Production and management of nursing systems.
Orem’s work and the characteristics of a theory:- *Theories must be logical in nature,* simple yet generalizable,*basis of hypothesis that can be tested,* assist in increasing the general body of knowledge,* practitioners to guide and improve their practice,* consistent with other validated theories , laws and principles.
Strengths of Orem’s theory:-
Limitations of Orem’s theory:-
Application of Orem's Self-Care Deficit theory: Evaluation of the application of self care deficit theory:
Summary: Orem presents her general theory of nursing, The self care deficit theory of nursing , which is composed of three interrelated theories of self care, self care deficit and nursing systems. This theory is used as basis for nursing school curriculum and base of nursing information system.
In her model of nursing, she explains that nursing is the practice of identification of a patient’s need for help through the observation of presenting behaviors and symptoms, exploration of the meaning of those symptoms with the patient, determining the cause of discomfort, and determining the patient’s ability to resolve the discomfort or if the patient has a need for help from the nurse or other health care professionals. The goal of nursing consists primarily of identifying a patient’s need for help.
The need for help is defined as “any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that affect health and wellness.” Need-for-help must be based on the individual patient’s perception of his or her own situation.
Wiedenbach’s theory identifies the patient as “any individual who is receiving help of some kind, be it care, instruction or advice from a member of the health profession or from a worker in the field of health.” A patient is any person who has entered the healthcare system and is receiving help, which means he or she does not need to be ill. A person receiving health-related education would qualify as a patient.
Orem's theory viewed nursing as an act of helping those who are self care deficit with best nursing care. She described her theory into three interrelated concepts, viz., Theory of self care , Theory of self care deficit, Theory of nursing system.
1. To be able to differentiate, apply and identify the various models of nursing theories and approaches in all phases of life.
2. To know the essential value of formal nursing conceptual models and understand the provision of a shared view of the metaparadigm concepts (person, environment, health and nursing).
3. Be able to focus on nursing's role: to work with patients to manage their health problems/life processes.
outlines are Introduction
Basic assumptions
Major concepts
Proposition of king’s theory
Nursing paradigms
Theory of Goal Attainment and Nursing Process
References
Theory of self care includes of self-care, self-care agency, self-care requisites and therapeutic self-care demand. This theory promotes the goal of self-care
Self-Care: Activities performed independently by an individual to promote and maintain personal well-being throughout life.
1. To be able to differentiate, apply and identify the various models of nursing theories and approaches in all phases of life.
2. To know the essential value of formal nursing conceptual models and understand the provision of a shared view of the metaparadigm concepts (person, environment, health and nursing).
3. Be able to focus on nursing's role: to work with patients to manage their health problems/life processes.
outlines are Introduction
Basic assumptions
Major concepts
Proposition of king’s theory
Nursing paradigms
Theory of Goal Attainment and Nursing Process
References
Theory of self care includes of self-care, self-care agency, self-care requisites and therapeutic self-care demand. This theory promotes the goal of self-care
Self-Care: Activities performed independently by an individual to promote and maintain personal well-being throughout life.
There are various theories proposed by nursing theorist. among those, Orem is one who gave self care deficit theory. She proposed three interrelated concepts viz. theory of self care, theory of self care deficit , and theory of nursing system.
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3. OBJECTIVE
At the of presentation learner will be able to,
• History of Orem
• Evolution of theory
• General theory of nursing
• Concept used bye orems
• Theory of nursing system
• Paradigm of Orems theory
• Orem's on nursing process
• Orems work and charateristics of theory
4. INTRODUCTION
EDUCATION
• Theorist:Dorothea Orem(1914-2007)
• Born 1914 in baltimore,Maryland US
• father was construction worker(fishing)
• Mother was a homeworker(reading)
• youngest of 2 daughter
• Diploma at providence hospital.washington,D.C. in 1934
• 1939-BSN Ed. and 1945 Master of science in nursing
education from catholic university of America, Washington
D.C.
5. Cont...
CLINICAL PRACTICE
• staff nurse in operating room, peadiatric and adult medical
surgical units
• private duties in private rooms .hospitals and supervisor
of emergency room
• 1940-taught biological sciences,later served as director of
nursing services and school of nursing at providence
Hospital,Michigan and detorit
• orems spent 7 years in indiana working in the div. of
hospital
6. Cont...
• 1976-honoray degrees
• concept of nursing as the provision of self care was 1st
published in 1959.
• continue to develop thoery of selfcare,1971-develop
concept of practice was published
• 2nd,3rd ,4th, 5th and 6th editions were published in
1980,1991,1995 and 2001
• continous work of orems with colleagues on the continued
conceptual development of the theory SCDNT
7. EVOLUTION OF THE THEORY
• no nursing leader directed for work
• working with nurses ronided many learning experience
• viewed her work with graduate students and collaborative
work with collagues as valuable andeavours
• mention no one contribution but appericiate
Henderson,Orlando,Nightangle,Abdellah,Paplau,King ,
Johnson etc ,other disciplinary were also inculded
• 1958-insight need of nursing for indivisdual
8. AWGENERAL THEORY OF NURSING
Its related parts,
Theory of
selfcare
Theory self
care deficit
Theory of
nursing
System
9. THEORY OF SELF-CARE
Based on concept of ;
Self-care
Selfcare
agency
Selfcare
requisites
Theraputic
selfcare
demand
10. Cont...
• SELFCARE;
the performance of activities that indiviual initiates and
perform on their behalf to maintain life health and wellbeing
11. Cont...
• SELF-CARE AGENCIES:
the individual activity to perform selfcare activites
• 2 AGENTS:
1. SELF-CARE AGENT;peron who provide the self care
2. DEPENDENT CARE AGENT:person other than the
individual who provides the care (parents etc)
• Affected by basic conditioning factor
12. cont...
• SELFCARE REQUISITES:
reason for where selfcare is done ;these express intended
or desired result
3 CATAGORIES;
1. UNIVERSAL;needs that are common to all indivisual (air
,water ,food rest etc)
13. cont...
• DEVELOPMENTAL;needs resulting from maturation or
develop due to a condition or event(adjusment to new job
etc)
• HEALTH DEVIATION; needs resulting from illness, injury
and disease or its treatment (learning to walk with cruthes
after a leg fracture)
14. THERAPUTIC SELCARE DEMAND
• The totallity of “CARE MEASURES” necessary at specific
time or over a duration of time for meeting an individual's
self care requitses by using appropriate methods and
related sets and actions
THERAP
UTIC
SELF-
CARE
CARE
MEASU-
RES
CARE-
MEASUR
-E
15. THEORY OF SELF CARE DEFICIT
• It is the centarl focus of orems general theory of nursing
• it describes how people can be helpful through nursing
16.
17. THEORY OF SELF-CARE DEFICIT
ROLE OF THE NURSE
• Acting and doing for other
• Guiding and directing
• Providing physical and psychological support
• Providing and maintaing enviornment that support
personal development
• Teaching others
18. Cont...
• coordinating nursing care
• establishing the kind and amount of immidiate and
continue care needed
• coordinating the care with other services ,such as other
health care ,social ,or educational services,needed or
being recieved
• discahrging patient from nursing care when they have
regained their abilities to paerform their own self-care
needs
19. THEORY OF NURSING SYSTEM
• It describes how the patients self care needs will be met
by the nurse ,the patient , or both.
• if there is a self care deficit-that is ,if there is a difference
between waht the indivisaul can do (self care - agencies )
• and waht need to be done to maintain optimum
functioning (theraputic self care demand )-nursing is
required
21. WHOLLY COMPENSIATED NURSING SYSTEM
• “Nurse should be compensiating for a patient's total
inability for (or prescription against ) engaging in self care
activities that require ambulation and manipulation
movements.”
• indivisdual is unable to engage in selfcare actions
reqiured;
1. self direction
2. controlled ambulation
3. manipulative movements
4. med.prescription to refrain such activity
22. cont...
• indivisual is socially dependent for existance
subtypes of wholly compensiatory for people
unable to perform in
any form of delibrate
action e.g coma pt.
aware and intact
insighted pt. but
unable to perform
amulation e.g person
wth c2-c4 fracture
unable to attend them,
unintact insights bt can
perform ambulation
and movements
e.gmentally retarted
23. PARTIALLY COMPENSIATED SYSTEM
• System consist of both nurse and perform care measure
or other actions involving manipulative task or ambulation.
• represents by situation in which pt an nurse have a major
role in nursing care measures
• for example,
pt. with abdominal surgery might be able to wash
face but unable to ambulate hence need nursing assistance
24. SUPPORTIVE-EDUCATIVE NURSING SYSTEM
• “For situation where the pt. is able to perform or can and
should learn to perform required measures of externally or
internally oriented theraputic selfcare but cannot do so
without assisttance.”
• supportive-developmental system
• pt do all self care but require care in
1. decision making
2. behaviour control
3. acquiring knowledge and skill
25. cont...
“above three systems can be applied to a one type of
pt. for example women in labour --when required a
cessarian delivery care is wholly,if normal delivery
partialy required ,after canal birth del. progress to
partially comensiatory when she recovers from
anesthesia later requires supportive and educative
when she prepares to go home”
27. cont...
• HUMAN BEINGS ; identifies five assumptions underlying
the theory of nursing
• require cont.delibrate input to themselves and
enviornment to remain alive and function in accord with
natural human endowments.
• human agency ,the power to act delibrately is exercised in
the form of care self and other in identifying needs for and
in making needed inputs
28. cont...
• mature human beings experience privations in the form of
limitions for actions in care of self and others involving the
making of life sustsining and function regulating inputs
• Human agencies is exercised in discovering developing
and transmiiting to other ways and means to identify
needs for and make inputs to self and others
29. cont...
• groups pf human beings with structured realtionships
cluster task and allocated responsibiltites for providing
care to grp.members who experience privation for making
delibrate inputs to self and others
• Orems belived that indivisuals have the potentials for
learning and developing.the way indivisual meet self
care needs is not intinctical but is a learned
behaviour
30. cont...
HEALTH:
• Orems (1991) supports the definition of health as the
state of physical,mental,and social well being and not
merely the absence of disease or infirmity (WHO)
• Physical,phychological ,interpersonal and social aspects
of health are inseprable in the indivisual
• concept based on preventive health care which includes
promotion and maintaince oh health (primary prevention )
31. cont...
ENVIORNMENT:
• The nurse and patient's role define the expected
behaviours for each in the specific nursing situation.
• factors infleunce the expected role behaviour are
culture,enviornment,age,sex,the helth setting and finance
• role of nurse and pt is complementary to eachother to
accomplish goal
• Orem's also focuses on nursing technologies to promotes
quality professional nursing
32. NURSING PROCESS
• 1991-proposed three step nursing process which she
labels the tecnologic process operation of nursing
STEP-1
• Nursing diagnosis and
perscription(determine
why nursing needed
• Analysis and
interpretation (making
judgment regarding care
• includes assessment
and nursing diagnosis
STEP-2
• Designing nursing
system
• planning step of present
nrsing process
STEP-3
• Production and
management of nursing
system also labelled
planning and controled
• includes implementation
and evaluation phase
33. OREM'S WORK AND CHARACTERISTICS
• Orems theoratical constructs of selfcare,self-care deficit
and nursing system are interrelated in her general
comprehensive theory of nursing
• Follows a logical thought process
• Used in both nursing educaton and practice
• Used to generate testable hypothesis in various setting
• focus on nursing as an helping art assisst pt. to meet
selfcare
•
34. cont...
• Orems theory used by nurses in
1. rehabilitation
2. heamodialysis
3. nursing
4. bone marrow transplant
5. psychiatric care
6. public and community health
• Consistent with role theory,need theory,field theory and
promotional concepts
