This document provides an overview of Dorothea Orem's Self-Care Theory of Nursing. Some key points:
- The theory is composed of three interrelated theories: self-care, self-care deficit, and nursing systems.
- Self-care deficit occurs when self-care demands exceed a person's ability to meet them. This creates a need for nursing care.
- The nursing systems theory identifies actions nurses and clients can take to reduce or eliminate self-care deficits.
- Orem developed her theory over decades to establish a theoretical foundation for nursing practice and organize nursing knowledge.
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.
Nursing process theory ( ida jean orlando) mainly focus on patient nurse relationship and also it guide the care giver to plane a best care for patient
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.
Nursing process theory ( ida jean orlando) mainly focus on patient nurse relationship and also it guide the care giver to plane a best care for patient
Chapter 14 Self-care deficit theory of nursingVioleta A. BeEstelaJeffery653
Chapter 14: Self-care deficit theory of nursing
Violeta A. Berbiglia, Barbara Banfield*
PowerPoit by Dr. Sergio Osegueda
Dorothea E. Orem (1914–2007)
“Nursing is practical endeavor, but it is practical endeavor engaged in by persons who have specialized theoretic nursing knowledge with developed capabilities to put this knowledge to work in concrete situations of nursing practice.” (Orem, 2001)
Credentials and background of the theorist
Dorothea Elizabeth Orem was born in Baltimore, Maryland, in 1914.
She began her nursing career at Providence Hospital School of Nursing in Washington, DC, where she received a diploma of nursing in the early 1930s.
Orem received a bachelor of science degree in Nursing Education from Catholic University of America (CUA) in 1939, and she received a master’s of science degree in Nursing Education from the same university in 1946.
Background
Orem’s early nursing experiences included operating room nursing, private duty nursing (home and hospital), hospital staff nursing on pediatric and adult medical and surgical units, evening supervisor in the emergency room, and biological science teaching.
Orem held the directorship of both the nursing school and the Department of Nursing at Providence Hospital, Detroit, from 1940 to 1949. After leaving Detroit, she spent 8 years (1949–1957) in Indiana working at the Division of Hospital and Institutional Services of the Indiana State Board of Health.
In 1957, Orem moved to Washington, DC, to take a position at the Office of Education, U.S. Department of Health, Education, and Welfare, as a curriculum consultant. From 1958 to 1960, she worked on a project to upgrade practical nurse training.
That project stimulated a need to address the question: What is the subject matter of nursing? As a result, Guides for Developing Curricula for the Education of Practical Nurses was developed (Orem, 1959).
Background
In 1970, Orem left CUA and began her consulting firm. Orem’s first published book was Nursing: Concepts of Practice (Orem, 1971).
She was editor for the NDCG as they prepared and later revised Concept Formalization in Nursing: Process and Product (NDCG, 1973, 1979).
In 2004 a reprint of the second edition was produced and distributed by the International Orem Society for Nursing Science and Scholarship (IOS). Subsequent editions of Nursing: Concepts of Practice were published in 1980, 1985, 1991, 1995, and 2001. Orem retired in 1984 and continued developing the self-care deficit nursing theory (SCDNT).
Background
Georgetown University conferred the honorary degree of Doctor of Science on Orem in 1976.
She received the CUA Alumni Association Award for Nursing Theory in 1980.
Other honors included Honorary Doctor of Science, Incarnate Word College, 1980; Doctor of Humane Letters, Illinois Wesleyan University, 1988; Linda Richards Award, National League for Nursing, 1991; and Honorary Fellow of the American Academy of Nursing, 1992.
She was awa ...
Theorist : Dorothea Orem (1914-2007).
She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant.
Kufa University - College of Nursing
Appraise the component of various nursing theories; description, purpose, concepts, definition.
Discuss the application of nursing theories in nursing practice.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Orem’s Grand Theory of Nursing
Composed of three interwoven
Middle-Range Theories
Self-Care
Deficit
Nursing
Systems
Occurs when the
demand of self-care
is greater than
the individual’s
ability to
satisfactorily
attain it.
---
A deficit in self-care
brings about a need
for nursing care.
Self-Care
Activities that an
individual completes
or assists with in
order to maintain
life and/or a higher
level of well-being.
---
Humans have an
innate desire to care
for themselves.
Identifies actions
that the nurse and
client can take to
reduce or eliminate
the identified
self-care deficit.
---
Role of the
nurse and client.
3. Concepts of Self-Care
Self-Care
“A human regulatory
function that is a
deliberate action to
supply or ensure the
supply of necessary
materials needed
for continued life,
growth, and
development
and maintenance of
human integrity”
(McEwen & Wills, 2014, p. 144)
Self-Care
Requisites
The requirements
needed to bring
about or maintain
optimal functioning
---
Universal
Developmental
Health Deviation
Self-Care
Agency
The ability to engage
in and/or perform
fulfilling self-care
activities
---
Influenced by
conditioning factors
such as development,
age, sociocultural
factors, health and
education
---
Agent provides care
Dependent agent
receives care
Therapeutic Self-
Care Demand
The combined
actions necessary to
meet the prescribed
self-care activities in a
given period in time
---
The agent utilizes
appropriate and
validated measures
identified by the
self-care requisites
4. Conceptual Model
R=relationship; <=deficit relationship, current or projected
(Alligood & Marriner-Tomey, 2002, p. 192)
Self-Care
Self-Care
Agency
Self-Care
Demands
<
Nursing
Agency
5. Sub-Concepts
Nursing – Deliberate actions that assist clients and their families in
regaining and/or maintaining optimal health.
Human being – Has developmental and universal health related needs.
Is capable of providing self-care. Is the object of nursing.
Environment – Influences self-care knowledge and behaviors.
Includes family and sociocultural factors.
Health – A dynamic state that may “impose new or different demands for
self-care on the person” (Fawcett, 2005, p. 250).
Nursing Client – Has a health related deviation and is incapable of
providing adequate self-care. Requires assistance from nursing.
Developmental self-care requisites – Occur due to a
health condition or life event. Includes disease processes,
injury, effects related to aging, etc..
Universal self-care requisites – Are common to all
human beings. Consists of basic life requirements such
as air, food, elimination, activity, etc.
Health deviation requisites – Actions necessary to
employ when a deficit in self-care exists. Procuring
medical treatment and nursing interventions.
6. Assumptions
Based on the philosophy that
“all patients wish to care for themselves”
(Paraska & Clark, 2012, p. 63).
Individuals can and should strive for optimal health and life through self-care
Individuals should care for themselves as well as their dependents
Each individual is distinct and separate from others and the environment
Nursing is deliberate and requires action as well as interaction
Achieving the universal and developmental requisites of self-care is integral
to attaining optimal health
Knowledge and the environment influences self-care behaviors and activities
The art of nursing is a therapeutic form of self-care that assists individuals in
recovery from disease and/or injury
Nursing enhances self-care behaviors and activities
7. Relationships & Influences
Nursing exists due to deficits in self-care.
Humans are self-reliant and desire to take responsibility
for self-care.
Health is a state of individual well-being that is influenced by the
nurse as well as the environment.
When a deficit or need for maintenance in self-care exists
the nurse and the environment can be modified to restore
and/or preserve the state of health.
Optimal performance of self-care requisites minimizes
the therapeutic self-care demand.
Universal, developmental and other conditioning
factors can alter the agent’s ability to complete
self-care requisites.
The nursing system is developed based upon the self-care
deficit identified by the nurse.
Self-care needs can be met by the nurse, the client or both.
8. Theory Development
1914: Born in Baltimore, Maryland
1939: BSN, Catholic University of America
1959: Experienced in many areas of nursing, including:
staffing, private duty, education, administration, and
consulting; Orem began developing her definition of nursing
practice and the concept of self-care
1971: First formal publication of Orem’s
Theory of Self-Care (Orem, 1971)
1976: Honorary Doctor of Science Degree
2001-2007: Orem refined and publish her theories
throughout the remainder of her life
Considered a “pioneer” of nursing theory
(McEwen & Wills, 2014, p. 142)
Orem developed her theory in the late 1960’s when tasked with
designing a national curriculum for practical nursing education.
Orem wished to revitalize nursing education in order to keep
it current with the healthcare needs of modern society.
9. 1960’s
The “scientific foundation for
healthcare” moved nursing
toward a more professional
role (Taylor & McLaughlin
Renpenning, 2003, p. 18)
The American Nurses
Association recommended
institutional education with
the baccalaureate degree
as the basic foundation for
nursing practice.
The U.S. Public Health
Service recommended
increasing the quality
of patient care.
The Nurse Training Act
allocated millions of dollars
in government funds to
improve and enhance
nursing schools and
education.
Nursing scholars
strived to build
their own body
of knowledge
Nurses were employed
in a variety of settings.
This increased the
number and complexity
of problems nurses
encountered.
Passage of the
Civil Rights Act
Medicaid and Medicare
provided government-
funded healthcare to
millions of Americans.
Vietnam War
Women’s movement
focused on equality in
pay and employment
10. Theory Origin & Support
Orem’s theory was developed and revised over the course of four decades.
The combination of practice, experience, education and collegiate
collaboration influenced values and theory development.
Orem’s Values: Optimal health for every individual, independence in caring
for the self, the art of nursing is valuable to society
Orem refers to but has never directly credited an author or work as the
foundational basis for her theory.
Significant influential nurses referred to by Orem include: Rogers, Roy,
Nightingale, Henderson, Abdullah & Orlando.
Theoretical influences: Aristotle & Thomas Aquinas. Action Theory. An area
of philosophy concerned with “agent-causal” relationships. (O’Connor &
Sandis, 2010, p. 7).
11. Motivation
While employed as a nursing
consultant, Orem began to question
the reality of nursing.
Orem was motivated by the ability
to perform yet not communicate
nursing services.
Orem wished to create a framework
that organized nursing knowledge
What is
Nursing?
“What is the human
condition that occasions
requirements for nursing?”
(Orem, 2001)
Why do some individual’s
need nursing care and
others not?
What is the subject
matter of the discipline
of nursing?
Orem asked…
12. Development Strategy
Incorporates both inductive &
Deductive reasoning processes
Concepts were identified and
conceptualized based on
experience in practice
Worldview of reciprocal interaction
A Human Needs Theory
Orem utilized a developmental
model to conceptualize her theory
The theory can also be regarded
as an interaction model
13. Usefulness
Useful in everyday practice settings
Applicable across the lifespan
Contributes to nursing’s body of knowledge
Research findings can be applied to practice
Can guide interventions to enhance outcomes
Generate research & research instruments
Utilized by schools of nursing
as a base for curriculum
Generates testable hypothesis
for use in a multitude of settings
Identifies the focus of nursing
14. Practicality in Practice
Orem’s theory provides a practical means to guide and enhance
nursing practice.
The theory can be utilized to positively influence the motivation
that drives the deliberate actions of self-care.
Patient outcomes can be enhanced through easily identifiable
requisites and interventions.
The self-care requisites within the theory encompass practical
concepts that can be developed to assist in daily practice.
Universal requisites are common to all humans; Eliminative functions of
self-care can be addressed by encouraging the patient to bathe daily.
Developmental requisites occur with growth and development; Proper
growth and development can be facilitated through skill and knowledge
enhancement.
Health Deviations occur due to internal and external forces; Primary,
secondary and tertiary interventions can be employed to maintain
and/or restore function.
15. Contribution to Care
Nurses make judgments for recommendations and adjustments in nurse-patient roles
and interventions.
Theory that uncovers self-care needs, requisites and demands as well as the
interventions to meet these requirements contribute to nursing’s body of knowledge.
Orem thoroughly describes each concept within the theory of self-care and predicts
relationships between them. This aids in determining outcomes.
Identification of inadequacies in the self-care
agency and within self-care requisites aids in
predicting the degree of disability and the
need for nursing activities.
Determines the effect and outcomes
of self-care activities
Identifies the needs of the patient
Evaluates the success of interventions
Identifies need for modification of interventions
16. Example in Practice
The theory of self-care can provide a theory-based
approach to assist nurses and patients in hospital burn units
Burn units significantly lack theory in care interventions
Wilson and Gramling suggest utilizing Orem’s Self-Care Model “as a valid basis for
delivering care and increasing the level of professionalism in this specialty area”
(Wilson & Gramling, 2009, p. 852). The authors also suggest that the application of
the theory in the practice of burn care units will provide a unique way to view this
phenomenon. Many theories present gaps in care due to lack of comprehensiveness.
Additional theories such as Roy’s Adaptation Model
can complement matters not addressed by Orem in
this specialty area of care. Orem’s theory however,
“is the most applicable to burn care and provides a
beginning point for theory usage in burn nursing
care” (Wilson & Gramlin, 2009, p. 852).
17. Theory Testing
Despite the popularity and feasibility of the theory of self-care, a 1993 review
noted only 4 of 31 related research studies met the criteria for making
“‘adequate use’ of Orem’s theory” in testing (Spearman, Duldt & Brown, 1993, p. 1629).
Orem did not believe that “nursing research should be focused on testing her theory as much as on
developing knowledge related to the different components” of her theories (Meleis, 2011, p. 220).
Theory Applications:
Descriptive studies related to self-care practices
Assesses needs of clients
Development of interventions
To generate research instruments
To identify categories of self-care needs in specific
populations
The self-care agency has been used to focus on the
development of research tools capable of measuring
aspects of self-care
To form a basis for the testing of a hypothesis
To identify relationships between the concept of the
self-care agent and other influencing concepts in a
variety of populations
Usage:
Easily tested with a variety of
methods and in various settings
and populations.
Has generated numerous dialogues
and stimulating thinking across
disciplines
Broad clinical utility
The theoretical concepts of the
grand theory has been applied as a
whole and independently as well as
in coordination with other theories
to complement research studies
18. Research Examples
Computer-assisted reinforcement of instruction: effects on adherence in adult atopic
asthmatics. A randomized pretest-posttest experimental design to determine effects of an
intervention on adherence to dust mite avoidance in adults with atopic asthmatics (Huss, Salerno,
Huss, R., 1991).
Health and illness self-care in adolescents with IDDM: a test of Orem's theory.
Differentiates and proposes hypotheses related to adolescent diabetics and the various types of
self-care identified by Orem (Frey & Denyes, 1989, p. 67-75).
Orem's model used for health promotion: directions from research. Utilized Orem's theory
to test propositions associated to general health and health promotion (Denyes, 1988, p. 13-21).
Self-care agency as a function of patient-environmental factors among nursing home
residents. Examined the relationships of environmental and personal factors on the ability of
residents in nursing homes to provide self-care (Jirovec & Kasno, 1990, p. 303-309).
The effect of Orem's self-care model on nursing care in a nursing home setting.
Determine patient perspectives and outcomes of nursing staff utilizing Orem’s theory of self-care
compared to nursing staff employing other methods of assessments and goals (Faucett, Ellis,
Underwood, Naqvi & Wilson, 1990, p. 659-666).
Influence of selected factors and self-care behavior on abdominal distention in patients
with abdominal surgery. A descriptive and prospective study to explore self-care factors that
influence abdominal distention in patients with recent abdominal surgery (Wattanawech,
Srimoragot, Kasemkitwattana, Kimpee, 2003, p. 19-32).
19. Validity…
Strengths Weaknesses
Provides a general foundation for
the nursing discipline
Can be utilized to formulate
nursing curriculum
Can enhance the development of
nursing education, research and
administration
Identifies when nursing is required
Contemporary with nursing trends
in health promotion and
maintenance
Promotes independence
Repetitive terms can be confusing
(self-care
agency/requisites/deficit, etc..)
Psychological/emotional needs not
well developed within the theory
Assumes “all” are capable of self-
care activities and does not
address infants or the frail elderly
Oriented more toward illness than
wellness
20. Example: Case Study
A case study was performed to identify “facilitators and inhibitors
to clinical application of Orem’s theory of self-care” (Clark, 1986, p. 127).
Facilitators were described as factors that aided the utilization of self-care theory
while inhibitors deterred its use.
Subjects: Gerontological Patients
Setting: Community health nursing
Premise of theory: Individuals desire the ability and responsibility of self-care.
The nurse’s role is to identify self-care deficits and provide assistance with self-care activities to
enhance health and well-being.
Design: Following the nursing assessment, the individual’s ability to engage in identified self-care
requisites was evaluated. A nursing plan of care was implemented to achieve therapeutic self-care
demands. Contributing and inhibiting factors to the outcomes were communicated and evaluated.
Findings:
Facilitators:
Patient desire, attitude and beliefs
Positive nurse-patient relationship
Patient education, values, collaboration, communication
Nurse, knowledge, collaboration, advocacy, communication
Nursing plan of care
Inhibitors:
Managing large numbers of concepts within the theory
Lack of additional case studies and research to guide the study
Considerations: The study revealed numerous areas with potential for furthering nursing research.
(Clark, 1986, p. 127-135)
21. Research Methodologies
Descriptive studies - Focus on the comprehension, number and type of self-
care behaviors. Proposition: The nurse must assess and identify the client’s
ability and potential to complete self-care activities.
Correlational studies - Examine the relationships between self-care
variables. Proposition: The ability to perform self-care activities is influenced
by the self-care agency, requisites and demands.
Quasi-Experimental studies - Identifies causal relationships as well as the
significance of those relationships. They are necessary to determine the
effectiveness in fulfilling therapeutic self-care demands. Proposition: Self-care
deficits are balanced between therapeutic self-care demands and the ability of
the self-care agency to meet those demands. The inability to achieve optimal
self-care indicates a degree of dependency.
Experimental studies – Explore client outcomes related to the application of
interventions. Proposition: Nurses are tasked with identifying valid and reliable
interventions required to meet self-care needs.
The intertwined concepts of self-care, self-care requisites, the self-care
agency and therapeutic self-care demands must function in harmony for
optimal health and well-being to be realized.
22. Evaluation
Orem’s generalized theory of nursing consists of three interrelated
theoretical constructs.
Self-Care
Self-Care Deficits
Nursing Systems
The self-care component of the general theory is “common
to the health professions and to all members of social groups.”
(Basavanthappa, 2007, p. 85)
It identifies broad, comprehensive activities that
are required by the individual to maintain health.
It can be applied across the lifespan and within
a variety of settings yet focus is on the ill.
The scope is more specific when applied to
administration, education and research.
The concepts are simple and easy to understand.
Simple * Logical * Organized
23. Theory in Practice
As a provider I will utilize this theory to identify
appropriate and validated measures required by
self-care requisites.
Professional nursing practice is based on the
assumption that patient’s desire and need the
self-care agency. The ability to engage in
self-care activities is innate as well as learned.
As a provider, I will assist patients in learning as
well as performing self-care activities.
My role is to facility the self-care agency of the patient. Utilizing the
theory of self-care, along with the theories of self-care deficit and
nursing systems, I will be able to identify self-care deficits and the
degree and competency of the patient’s self-care requisites and abilities.
With this data, the appropriate nursing system of action with
interventions can be implemented.
This theory will assist me in identifying and encouraging appropriate self-
care activities across the lifespan.
25. References
Alligood, A., & Marriner-Tomey, A., (2002). Nursing Theorists and Their Work. (5th Ed.). St. Louis: Mosby.
Allison, S. (2007). Self-care requirements for activity and rest: an Orem nursing focus. Nursing Science Quarterly, 20(1), 68-76.
Basavanthappa, BT. (2007). Nursing Theories. New Delhi: Jaypee Brothers Publishers.
Clark, M. (1986). Application of Orem's theory of self-care: a case study. Journal of Community Health Nursing, 3(3), 127-135.
Denyes, M. (1988). Orem's model used for health promotion: directions from research. Advances In Nursing Science, 11(1), 13-21.
Fawcett, J. (2005). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories (2nd ed.). Philadelphia, PA: F. A. Davis
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Journal Of Advanced Nursing, 15(6), 659-666.
Frey, M., & Denyes, M. (1989). Health and illness self-care in adolescents with IDDM: a test of Orem's theory. Advances In Nursing Science, 12(1), 67-75.
Huss, K., Salerno, M., & Huss, R. (1991). Computer-assisted reinforcement of instruction: effects on adherence in adult atopic asthmatics. Research In
Nursing & Health, 14(4), 259-267.
Jirovec, M., & Kasno, J. (1990). Self-care agency as a function of patient-environmental factors among nursing home residents. Research In Nursing &
Health, 13(5), 303-309.
McEwen, M. & Wills, E. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia: Wolters Kluwer. Lippincott Williams & Wilkins.
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Wilkins.
O’Conner, T., & Sandis, C. (2010). A companion to the philosophy of action. Oxford, Wiley-Blackwell.
Orem, D.E. (1971). Nursing: Concepts of Practice. McGraw-Hill, New York.
Paraska, K., & Clark, C. (2012). Health promotion in nursing practice. Burlington, MA: Jones & Bartlett Publisher.
Simmons, L. (2009). Dorthea Orem's self-care theory as related to nursing practice in hemodialysis. Nephrology Nursing Journal, 36(4), 419-421.
Spearman, S., & Duldt, B., & Brown, S. (1993). Research testing theory: a selective review of Orem's self-care theory, 1987-1991. Journal Of Advanced
Nursing, 18(10), 1626-1631.
Taylor, S., & McLaughlin Renpenning, K. (2003). Self-Care Theory in Nursing: Selected Papers of Dorothea Orem (p. 18). New York: Springer Pub.
Wattanawech, T., Srimoragot, P., Kasemkitwattana, S., & Kimpee, S. (2003). Influence of selected factors and self-care behavior on abdominal distention
in patients with abdominal surgery. Self-Care, Dependent-Care & Nursing, 11(3), 19-32.
Wilson, J., & Gramling, L. (2009). The application of Orem's Self-Care Model to burn care. Journal Of Burn Care & Research, 30(5), 852-858.