This document provides an overview of Dorothea Orem's Self-Care Deficit Theory of Nursing. It introduces Orem as the theorist and discusses the main concepts of her theory, including self-care, self-care agency, self-care requisites, and nursing systems. The theory posits that nursing is needed when there is a deficit between what an individual can do for self-care and what needs to be done. The document then provides an example application of Orem's theory to a case study of a patient with rheumatoid arthritis, identifying her self-care deficits, nursing diagnosis, goals, and care plan.
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. ... Nurses practice in many specialties with differing levels of prescription authority.
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. ... Nurses practice in many specialties with differing levels of prescription authority.
History of development of Nursing ProfessionsAnamika Ramawat
History of development of Nursing Professions, Characteristics, Criteria of the Nursing Profession, Perspective of Nursing Profession- National and Global Level
CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.
gud evening guys
this is descrive you that this ppt is making very simple way and i hope this will help you to understand lightky about nursing theories
Florence nightingale’s environment theoryShrooti Shah
The foundation of Nightingale’s theory is the environment- all the external conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or contribute to disease or death.
Her goal was to help the patient retain his own vitality by meeting his basic needs through control of the environment.
Trends and issues in medical surgical nursing pptseema dhiman
current trends and issues in medical surgical nursing is quite important on the basis of improvement of care based on new technologies and situation.
Trends and issues in medical-surgical nursing
What do you mean by issues?
What do you mean by trends?
INTRODUCTION- Nursing has been called the oldest of the art, and the youngest of the profession. As such, it has gone through many stages and has been an integral part of social movements. Nursing has been involved in in the existing culture, shaped by it and yet beeping to develop it. The trend analysis and future scenarios provide a basis for sound decision making through mapping of possible futures and aiming to create preferred futures.
The world health organization (who) has been considering the future and predicts that by 2000 the world experiences:
Major growth in the elderly population
Decline in birth rate, especially in western counteries
Increase in chronic illness
Continuing social unrest
AIDS a major problem
Many infectious diseases under control
Mental health a key issue
Poverty continuing to plague mach of the world
TRENDS IN NURSING: Education changes due to changes in demographics
2. Embracing of technology
3. Advancements in communication and technology
4. Working with more educated consumers
5. Increasing complexity of patient care
. Increased cost of health care
7. Changes in federal and state regulation
8. Interdisciplinary skills
9. Nurses working beyond retirement age
10. Advances in nursing and science research.
TRANSITIONS TAKING PLACE IN HEALTH CARE: Curative - Preventive approach
Specialized care - Primary health care
Medical diagnosis - Patient emphasis
Discipline stovepipes - Programme stovepipes
Professional identity - Team identity
Trial and error - Evidence based practice
Self – regulation - Questioning of professions
Focus on quality - Focus on costs
IN THE WORKPLACE: High tech - Humanistic
Competition - Cooperation
Need to supervise - Caching, mentoring
Hierarchies - Decentralized approach
IN NURSING: Continued competencies - Competencies a condition
Hospital environment - Community environment
Quality as excellence - Quality as safe
Clear role - Blurring roles
outlines are Introduction
Basic assumptions
Major concepts
Proposition of king’s theory
Nursing paradigms
Theory of Goal Attainment and Nursing Process
References
Virginia henderson's theory of nursingMandeep Gill
Virginia Henderson was born in Kansas City, Missouri in 1897, the fifth of eight children in her family. During the World War 1, Henderson developed an interest in nursing. So in 1918 she entered the Army school of Nursing in Washington D.C. Henderson graduated in 1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse Service in New York. After 2 years, in 1923, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. She has enjoyed a long career as an author and researcher. She is known as, “The Nightingale of Modern Nursing” & “The 20th century Florence Nightingale."
History of development of Nursing ProfessionsAnamika Ramawat
History of development of Nursing Professions, Characteristics, Criteria of the Nursing Profession, Perspective of Nursing Profession- National and Global Level
CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.
gud evening guys
this is descrive you that this ppt is making very simple way and i hope this will help you to understand lightky about nursing theories
Florence nightingale’s environment theoryShrooti Shah
The foundation of Nightingale’s theory is the environment- all the external conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or contribute to disease or death.
Her goal was to help the patient retain his own vitality by meeting his basic needs through control of the environment.
Trends and issues in medical surgical nursing pptseema dhiman
current trends and issues in medical surgical nursing is quite important on the basis of improvement of care based on new technologies and situation.
Trends and issues in medical-surgical nursing
What do you mean by issues?
What do you mean by trends?
INTRODUCTION- Nursing has been called the oldest of the art, and the youngest of the profession. As such, it has gone through many stages and has been an integral part of social movements. Nursing has been involved in in the existing culture, shaped by it and yet beeping to develop it. The trend analysis and future scenarios provide a basis for sound decision making through mapping of possible futures and aiming to create preferred futures.
The world health organization (who) has been considering the future and predicts that by 2000 the world experiences:
Major growth in the elderly population
Decline in birth rate, especially in western counteries
Increase in chronic illness
Continuing social unrest
AIDS a major problem
Many infectious diseases under control
Mental health a key issue
Poverty continuing to plague mach of the world
TRENDS IN NURSING: Education changes due to changes in demographics
2. Embracing of technology
3. Advancements in communication and technology
4. Working with more educated consumers
5. Increasing complexity of patient care
. Increased cost of health care
7. Changes in federal and state regulation
8. Interdisciplinary skills
9. Nurses working beyond retirement age
10. Advances in nursing and science research.
TRANSITIONS TAKING PLACE IN HEALTH CARE: Curative - Preventive approach
Specialized care - Primary health care
Medical diagnosis - Patient emphasis
Discipline stovepipes - Programme stovepipes
Professional identity - Team identity
Trial and error - Evidence based practice
Self – regulation - Questioning of professions
Focus on quality - Focus on costs
IN THE WORKPLACE: High tech - Humanistic
Competition - Cooperation
Need to supervise - Caching, mentoring
Hierarchies - Decentralized approach
IN NURSING: Continued competencies - Competencies a condition
Hospital environment - Community environment
Quality as excellence - Quality as safe
Clear role - Blurring roles
outlines are Introduction
Basic assumptions
Major concepts
Proposition of king’s theory
Nursing paradigms
Theory of Goal Attainment and Nursing Process
References
Virginia henderson's theory of nursingMandeep Gill
Virginia Henderson was born in Kansas City, Missouri in 1897, the fifth of eight children in her family. During the World War 1, Henderson developed an interest in nursing. So in 1918 she entered the Army school of Nursing in Washington D.C. Henderson graduated in 1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse Service in New York. After 2 years, in 1923, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. She has enjoyed a long career as an author and researcher. She is known as, “The Nightingale of Modern Nursing” & “The 20th century Florence Nightingale."
Making Great User Experiences, Pittsburgh Scrum MeetUp, Oct 17, 2017Carol Smith
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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.
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.
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.
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Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
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Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
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1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
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3. Introduction to the theorist
•Theorist : Dorothea Orem (1914-2007)
•Born 1914 in Baltimore, US
•Received her diploma at Providence Hospital,
Washington, DC in 1934
•1939 – BSN Ed. And Master of science in nursing
education (1945) from Catholic University of
America, Washington D.C.
4. Introduction cont…
• Her clinical practice included staff nurse in the
operating room, paediatrics and adult medical
surgical units.
• She also did private-duty nursing in private homes
and the hospital and was an emergency room
supervisor.
• She taught biological sciences and later served as
director of nursing service and director of the
school of nursing at Providence Hospital,
Michigan.
• Received several honorary degrees.
5. Introduction cont…
• Orem’s concept of nursing as the provision of
self- care was first published in 1959.
• Orem continued to develop her nursing concepts
and her self-care deficit theory of nursing. In 1971
she published Nursing: Concepts of practice.
• The 2nd
, 3rd
, 4th
, 5th
and 6th
editions of this book were
published in 1980, 1985, 1991, 1995 and 2001
respectively
6. Orem’s general theory of nursing
Its related parts:-
• Theory of self care
• Theory of self care deficit
• Theory of nursing system
7. 1. Theory of self care
Based on the concepts of:
– SELF-CARE
– SELF-CARE AGENCY
– SELF-CARE REQUISITES
– THERAPEUTIC SELF-CARE DEMAND
9. Self-Care Agency
• Definition: the individual’s ability to perform self-care
activities.
Consists of 2 agents:
– Self-care Agent - person who provides the self-care
– Dependent Care Agent - person other than the
individual who provides the care (such as a parent)
• Affected by basic conditioning factors
10. Self-Care Requisites
Definition: reasons for which self-care is done; these
express the intended or desired results
• Consists of 3 categories:
– Universal - requisites/needs that are common to all
individuals (e.g. air, water, food, elimination, rest,
activity, etc.)
– Developmental - needs resulting from maturation or
develop due to a condition or event (e.g. adjustment to
new job, puberty)
– Health Deviation - needs resulting from illness,
injury & disease or its treatment (e.g. learning to
walk with crutches after a leg fracture)
11. Therapeutic Self-Care Demand
• Definition: the totality of “care measures”
necessary at specific times or over a duration of
time for meeting an individuals self-care
requisites by using appropriate methods and
related sets and actions.”
12. 2. Theory of self care deficit
• It is the central focus of Orem’s general theory of
nursing.
• It describes how people can be helped through
nursing.
13.
14. Theory of self-care deficit
• ROLE OF THE NURSE
Acting (or) doing for another
Guiding and directing
Providing physical (or) Psychological support
Providing and maintaining environment that
support personal development
Teaching another
15. Theory of self-care deficit
• Coordinating nursing care
• Establishing the kind and amount of immediate
and continuing care needed
• Coordinating the care with other services, such as
other health care, social, or educational services,
needed or being received.
• Discharging patients from nursing care when they
have regained their abilities to perform their own
self-care needs
16. 3. Theory of Nursing Systems
It describes how the patient’s 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 what the individual can do
(self-care agency) and what needs to be done to
maintain optimum functioning (therapeutic self-
care demand)- nursing is required.
17. Classification of nursing system
It identifies 3 classifications of nursing system to
meet the self care requisites of the patient:-
• Wholly compensatory system
• Partly compensatory system
• Supportive – educative system
19. Partly compensatory system
NURSE
ACTION
PERFORMS SOME SELF CARE
LIMITAIONS OF PATIENT’S
COMPENSATES FOR SELF
CARE LIMITATIONS OF
PATIENT
ASSIST PATIENT’S AS REQUIRED
PREFORMS SOME SELF CARE
MEASURES
REGULATES SELF CARE
AGENCY
ACCEPTS CARE AND
ASSISTANCE FROM NURSE
PATIEN
T
ACTION
20. Supportive – educative system
NURSE
ACTION
ACCOMPLISHES
SELF CARE
REGULATES THE
EXERCISE AND
DEVELOPMENT OF
SELF CARE
AGENCY
PATIENT’S
ACTION
21. Major Assumptions
• All patients wish to care for themselves.
• Humans are capable and willing to engage in self-care and
care for dependent members of the family.
• Self-care and dependent care are learned behaviors
through human communication and interaction with each
other.
• Nursing is a deliberate helping actions performed by
nurses for the benefits of others over a certain period of
22. Continues…
• Humans are supposed to be self-reliant and
responsible for their self-care needs and care
needs for dependent members of the family.
• Humans are unique individuals that are
separated from each other and from their
environment
24. Person
• Person is defined by Orem as the patient (a
recipient of nursing care)- a being who functions
biologically, symbolically, and socially and who has
the potential for learning and development.
• Person is an individual, who is with the capacity
for self knowledge, who can engage in deliberate
action, interpret experiences, and perform beneficial
actions
25. Health
• A state characterized by soundness or wholeness of
bodily structure and function; illness is its opposite.
• It consists of physical, psychological, interpersonal
and social aspects; these aspects are inseparable.
• Health includes promotion and maintenance of
health, treatment of illness, and prevention of
complications
26. Environment
• Environment consists of environmental factors,
environment elements, environmental conditions
(external physical and psychological surrounding),
and developmental environment.
27. Nursing
• Orem defines the art of nursing as an intellectual
quality of the individual nurse; this quality is
related to creativity as well as analysis and
synthesis of information, all of which contribute to
development of nursing systems to assist
individuals or multiperson units.
29. Orem’s work and characteristics of theory
•Theories can interrelate concepts in such a way as
to create a difference
•Orem’s theoretical constructs of self-care, self-
care deficits and nursing systems are interrelated in
her general comprehensive theory of nursing which
is unique phenomena.
•Orem’s theory follows a logical thought process.
She states her general theory, that presents the
central idea of each of the three interrelated
theories.
30. • Statements that describe a concept or explain and
predict relationship between two concept.
• The theory can be applied to all individual patients
and with further adaptation, to multiperson units.
• Theories can be used by practitioner to guide and
improve their practice
• Theory focuses on nursing a helping art that
assists an individual to meet self-care needs and
that is the foundation for nursing practice.
• Adds nursing’s body of knowledge
31. • Theories can be the bases for the hypothesis that
can be tested or for theory to be explained
• Theories must be consistent with other validated
theories, laws, principles but leave unanswered
questions that need to be investigated.
• Consistent with role theory, need theory, field
theory and health promotional concepts
33. Strengths
• Provides a comprehensive base to nursing practice
• It has utility for professional nursing in the areas of nursing
practice, curricula, education, administration, and research
• Specifies when nursing is needed
• Her self-care approach is contemporary with the concepts
of health promotion and health maintenance
• Expanded her focus of individual self-care to include
multiperson units
34. Limitations
• In general system theory, a system is viewed as
a single whole thing while Orem defines a
system as a single whole thing.
• Appears that the theory is illness oriented
rather with no indication of its use in wellness
settings.
36. Baseline data
Areas Patient details
Name
Age
Sex
Education
Occupation
Marital status
Religion
Diagnosis
Theory applied
Mrs. X
56 years
Female
No formal education
House hold
Married
Hindu
Rheumatoid arthritis
Orem’s theory of self care
deficit.
37. Case history
For Mrs. X….
She came to the hospital with complaints of pain over
all the joints, stiffness which is more in the morning and
reduces by the activities.
She has these complaints since 5 years and has taken
treatment from local hospital.
The symptoms were not reducing and came to Hospital
for further management.
Patient was able to do the ADL by herself but the way
she performed and the posture she used was making her
prone to develop the complications of the disease.
She also was malnourished and was not having
awareness about the deficiencies and effects.
38. BASIC CONDITIONING FACTORS
Age 56 year
Gender Female
Health state Disability due to health condition,
therapeutic self care demand
Development state Ego integrity vs despair
Sociocultural orientation No formal education, Hindu
Health care system Institutional health care
Family system Married, husband working
Patterns of living At home with partner
Environment Rural area, items for ADL not in easy
reach, no special precautions to prevent
injuries
Resources Husband, daughter, sister’s son
39. UNIVERSAL SELF-CARE REQUISITES
Air Breaths without difficulty, no pallor cyanosis
Water Fluid intake is sufficient. Edema present over ankles.
Turgor normal for the age
Food Hb – 9.6gm%, BMI = 14.Food intake is not adequate or the diet is
not nutritious.
Elimination Voids and eliminates bowel without difficulty.
Activity/ rest Frequent rest is required due to pain.
Pain not completely relieved,
Activity level ha s come down.
Deformity of the joint secondary to the disease process and use of
the joints.
Social
interaction
Communicates well with neighbors and calls the daughter by
phone Need for medical care is communicated to the daughter.
Prevention of
hazards
Need instruction on care of joints and prevention of falls. Need
instruction on improvement of nutritional status. Prefer to walk bare
foot.
Promotion of
normalcy
Has good relation with daughter
40. DEVELOPMENTAL SELF-CARE
REQUISITES
Maintenance of
developmental environment
Able to feed self , Difficult to
perform the dressing, toileting
etc
Prevention/management of the
conditions threatening the
normal development
Feels that the problems are
due to her own behaviors and
discusses the problems with
husband and daughter.
41. HEALTH DEVIATION SELF CARE
REQUISITES
Adherence to medical regimen Reports the problems to the physician when in
the hospital. Cooperates with the medication,
Not much aware about the use and side
effects of medicines
Awareness of potential problem
associated with the regimen
Not aware about the actual disease process.
Not compliant with the diet and prevention of
hazards. Not aware about the side effects of
the medications
Modification of self image to
incorporates changes in health
status
Has adapted to limitation in mobility.
The adoption of new ways for activities leads
to deformities and progression of the
disease.
Adjustment of lifestyle to
accommodate changes in the
health status and medical regimen.
Adjusted with the deformities.
Pain tolerance not achieved
42. MEDICAL PROBLEM AND PLAN
Physician’s perspective of the condition:
Diagnosed with rheumatoid arthritis and is on the following
medications:
T. Valus SR OD
T. Pan 40 mg OD
T. Tramazac 50 mg OD
T. Recofix Forte BD
T. Shelcal BD
Syp. Heamup 2tsp TID
Medical Diagnosis: Rheumatoid arthritis
Medical Treatment: Medication and physical therapy.
44. Area of Inadequacy!!!!
Air Breaths without difficulty, no pallor cyanosis
Water Fluid intake is sufficient. Edema present over ankles.
Turgor normal for the age
Food Hb – 9.6gm%, BMI = 14.Food intake is not adequate or the diet is not nutritious.
Elimination Voids and eliminates bowel without difficulty.
Activity/ rest Frequent rest is required due to pain.
Pain not completely relieved,
Activity level ha s come down.
Deformity of the joint secondary to the disease process and use of the joints.
Social
interaction
Communicates well with neighbors and calls the daughter by phone Need for
medical care is communicated to the daughter.
Prevention
of hazards
Need instruction on care of joints and prevention of falls. Need instruction on
improvement of nutritional status. Prefer to walk bare foot.
Promotion
of normalcy
Has good relation with daughter
45. NURSING CARE PLAN
• Therapeutic self care
demand: Deficient area:
food
• Adequacy of self care
agency: Inadequate
47. OUTCOMES AND PLAN
Outcome:
improved nutrition
Maintenance of a balanced diet with adequate iron
supplementation.
Nursing Goals and objectives
Goal: to achieve optimal levels of nutrition.
Objectives: Mrs. X will:
state the importance of maintaining a balanced diet.
List the food items rich in iron , that are available in the locality.
Design of the nursing system:
supportive educative
Method of helping:
guidance
Support
Teaching
Providing developmental environment
48. IMPLEMENTATION
• Mutually planned and identified the objectives
and the patient were made to understand about
the required changes in the behavior to have the
requisites met.
49. EVALUATION
• Mrs. X understood the importance of maintaining
an optimum nutrition.
• She verbalized that she will select the iron rich
diet for her food.
• She listed the foods that are rich in iron and that
are locally available.
• The self care deficit in terms of food is decreased
with the initiation of the nutritional intake.
• The supportive educative system was useful for
Mrs. X .