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Dorothea Orems Groundbreaking Theory on Nursing Practice and Self-Care
Abstract
This paper discusses the self-care deficit theory by Dorothea Orem. According to this concept, people are individuals who are capable and willing to provide care for themselves and who also need to be treated. Thus, people want to preserve their life, health, and well-being. This theory requires a functional vision of the problem and a directed nursing intervention. In order to determine how to provide care and plan nursing activities based on self-care deficits. Orem notes self-care deficit as the patients dependence on others to satisfy their needs. In this situation, relatives should assume that persons self-care. However, counseling and individualized advice to patients and their family members are also essential. The application of this theory by hospice nurses is especially critical. This is because they can first provide patients and their relatives with reconditions based on their situation. Then, after the patients health deteriorates, they can give them full attention, guaranteeing that the patients will receive the proper care before they die.
Introduction
The significance and relevance of nursing theories are examined closely when their practical applicability is compromised. Without practical applicability, many theories remain idealistic creations and are rarely used in everyday life. However, this is not the case with Dorothea Orems theory of self-care deficits. The concepts of this theory can be applied to almost any nursing practice (Orem, 1985). Thus, this article will demonstrate this theorys analysis, evaluation, and application to a clinical scenario.
Analysis
Hendersons theory is the philosophical basis of Orems concept of nursing. Similarly to Henderson, Orem considers nursing as compensation for actions performed in a healthy state when the patient cannot perform them (Orem, 1985). The author emphasizes that the central goal of nursing is to aid patients to become independent in their actions to the extent that this is achievable. In Orems research, Hendersons ideas about what activities a person needs to maintain health and an active lifestyle are elaborated further (Orem, 1985). Additionally, Orem has highlighted the problems that can result from this.
Self-care deficit theory is a theory consisting of four component theories. They combine to establish and define the relationship between the provider and the care recipient. The first pillar is the self-care theory, which includes actions people have to initiate and perform for themselves. These are to obtain and maintain good health, well-being, and optimal functioning. These self-care acts include adequate food and water consumption, sufficient socialization, and avoidance of hazards (Denyes et al., 2001). Individuals should be capable of making decisions about self-care and have the ability to perform these acts.
The second component theory is the dependent care theory, which involves performing care for individuals when they can no longer handle it for themselves. The third part of the theory is the self-care deficit approach. This emphasizes that caregiving is essential when the needs of the individual caregiver exceed their capacity (Denyes et al., 2001). Hence, there is a self-care deficit, and nursing is one measure to compensate for this deficit. The nursing systems approach is Orems self-care deficit theorys fourth component theory. It described ways in which self-care requirements are addressed by the patient, the nurse, or both. This theory focuses on how the nurse provides care to patients based on assessing patients individual needs (Denyes et al., 2001). It explains the way the nurse satisfies deficits in self-care needs, depending on the patients specific self-care limitations.
Evaluation
Congruency of the Philosophical Foundation of the Theory to the Role of the Hospice Nursing
The philosophical basis for the theory is consistent with the hospice nurses role. This is because hospice care is a type of family care since patients and their families are actively involved in the planning and delivering nursing care (Orem, 1988). The nurses role is to provide these families with the best care for their sick relatives. The philosophical basis of Orems theory views nursing as acting in situations where patients need supplemental assistance (Orem, 1988). Thus, this theory corresponds to the role of hospice nurses, fostering patients independence and encouraging them to provide care to the extent possible. When patients need the appropriate care from hospital nurses, the assistants provide them with the attention and procedures they need.
Congruency of the Goals of the Theory & Goals of the Role of the Hospice Nursing
The aim of Orems theory of self-care deficiency is to enhance the condition of patients by maintaining some independence in relation to their own self-care. However, the theory also focuses on increasing the role of patients relatives in providing care for them (Orem & Taylor, 2011). The role of the hospice nurse is to address the needs not only of patients but also of their caregivers. The nurses goal is to support patients relatives and teach them how to properly provide emotional and practical assistance to the patient (Orem & Taylor, 2011). Thus, the goals of self-care deficit theory and the hospice nurse coincide.
Research Evidence to Support the Usefulness of the Theory to the Role of the Hospice Nursing
Hospice nurses verify that patients are provided with the essential factors to support their needs. For instance, individually established standards of air, water, and food intake are critical to patients life functioning (Orem & Taylor, 2011). According to self-care deficit theory, nurses determine the resources to maintain peoples health, and patients and their relatives follow recommendations. Compliance with these recommendations has enabled patients to self-care for a long time (Orem & Taylor, 2011). Accordingly, applying the theory promotes better adaptation of patients to their diseases and understanding of their personal needs.
Application of the Theory to Support Practice in the Hospice Nursing
The theory identifies some self-care deficits and formulates interventions specific to the individual patient. In hospice nursing practice, this encourages specific patients to verbalize emotions, discuss problems, and teach modified care techniques. Individualized assessments of patients capabilities will provide professional nursing care as required (Orem, 1988). In this way, the approach contributes to the practice of hospice nursing by accurately establishing individual patient needs and methods of care.
Application
Self-care deficit theory can be effectively applied to the practice of hospice nurses. For example, a hospice patient has a chronic lung disease that will result in the patients death in a short time. The family and patient know this, which is why they decided to use self-care deficit aimed at maximizing the patients independence. Hospice nurses and the patients family can collectively plan and determine the activities that the family and patient will perform independently. The nurses will periodically evaluate needs to support them in continuing to address the patients therapeutic demands for self-care (Orem, 1985). In this way, it will reduce the patients self-care and care deficits. Initially, the nurses will instruct the relatives and provide them with the care they need to maintain treatment of the symptoms.
As the patients disease progresses, gradually, the role of the relatives in the care that the patient has had will diminish. At the same time, hospice nurses will concentrate on alleviating the patients symptoms. Accordingly, the cooperation of the medical staff and the family will permit the hospice to ensure that each patient receives proper attention according to their requirements. As a consequence, the patient will be able to die with dignity and without unnecessary suffering. Thus, applying this theory will encourage the patient to help themselves rather than suffer from depression (Orem, 1985). At the same time, all individuals can receive the most care, depending on the progression of their illness.
Conclusion
Therefore, Orems generalized theory encompasses more than three particular theories. It is the theory of the impossibility of self-care, a test of nursing systems. Self-care theory includes three central concepts: self-care, need for self-care, and therapeutic self-care (Orem, 1988). The nurses role aligns with the field theory, including supporting and guiding patients and their relatives to provide help. Once patients diseases gradually begin to progress, there will be a need for more involvement of the health professions. It is essential to mention that the self-care deficit theory is particularly beneficial for nurses working in hospice care. That is because its application permits patients to manage their own health according to the recommendations presented to them. Simultaneously, the nurses provide qualified assistance when patients health conditions change (Orem, 1985). Thus, applying the theory offers an opportunity to enhance patients emotional states and prevent attention deficit.
References
Denyes, M. J., Orem, D. E., & Bekel, G. (2001). Self-care: A foundational science. Nursing Science Quarterly, 14(1), 48-54. Web.
Orem, D. E. (1985). A concept of self-care for the rehabilitation client. Rehabilitation Nursing Journal, 10(3), 33-36. Web.
Orem, D. E. (1988). The form of nursing science. Nursing Science Quarterly, 1(2), 75-79. Web.
Orem, D. E., & Taylor, S. G. (2011). Reflections on nursing practice science: The nature, the structure, and the foundation of nursing sciences. Nursing Science Quarterly, 24(1), 35-41. Web.
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