Introduction
Dorothea Orem developed her self-care deficit nursing theory in order to improve the quality of nursing care in her state. Her theory is rooted in three sub-theories, which are the theory of self-care, the theory of self-care deficit and the theory of nursing system. Put together, they describe an approach to nursing where nurses work within a system to help patients to help themselves, as a means of improving the overall quality of care delivered (Petiprin, 2016).
Theory Description
There are three constituent parts to Orem’s self-care deficit theory. The first part is the self-care theory. This part of the theory is based on the idea that people are responsible for their own care, in order to optimize their health. Within this is the idea that people should be empowered with knowledge that can help them to monitor their health better, and to manage it. If someone is incapable of managing their own health care, then family members should be responsible for the care of that individual. Orem’s theory places emphasis on personal responsibility, such as for eating well, exercise, taking one’s medications and avoiding substance abuse.
The second component of Orem’s theory is the self-care deficit part. In this part of the theory, health issues are often the result of one’s failure to attend to one’s own health. People get sick because they are not taking care of themselves. This viewpoint may not hold in all instances, of course, but it does in many, and Orem’s theory is rooted in the idea that the role of nurses is mainly to empower people to look after themselves, both proactively and once they get sick as well.
The role of nurses is the third component of the Orem Self-Care Deficit Theory. Nursing is required “when an adult is incapable or limited in the provision of continuous, effective self-care” (Petiprin, 2016). At the heart of this philosophy is the idea that if nursing practice is designed around the principles of self-care, and nurse intervention is mainly in situations when self-care has failed, then overall health care outcomes are going to be better. There has been little study to actually test the hypotheses that underlie Orem’s self-care deficit theory (Taylor et al, 2000).
Purpose
The purpose of Orem’s theory is to align the role of nursing with what, in her view, is something that would help most people. Thus, the theory starts with a diagnosis of what’s wrong with most people (self-care deficit) and then prescribes a nursing action in light of that diagnosis. An example of the theory in action is nursing intervention to educate low-income mothers about immuniziations for their children (Wilson et al, 2007). The children are unable to make medical decisions for themselves, and in order for mothers to administer appropriate care, nurses need to provide them with the education...…explanatory factor. Science, where actual causal factors for illnesses and conditions are identified, makes more sense than Orem’s theory. But for preventative medicine, there is a lot to like about the underlying logic of Orem’s theory because nurses can play an important role in coaching people, educating them and teaching them the right behaviors to maximize their chances at being as healthy as possible for as long as possible.
Assumptions
The core assumptions of the theory have been discussed at length elsewhere in this report – people’s health is related to self-care, and a lack of health relates to a self-care deficit. Thus, nurses can help people by teaching them to help themselves, and that this is the area where nurses can do the most good for people.
Usefulness
As noted, Orem’s theory can be quite useful in examining the role of nurses in educating and coaching people on preventative medicine, or even in helping them to take care of themselves once they do have a condition. But the underlying logic that people are responsible for their own health care, and that their having a condition is related to their own failings in that regard, is a bit on the harsh side and not supported by science. In light of this, it is important for nurses to understand when and where Orem’s theory can be logically applied for best value.
References
Petiprin, A. (2016) Self…
References
Petiprin, A. (2016) Self care deficit theory. Nursing Theory.org. Retrieved March 27, 2019 from http://www.nursing-theory.org/theories-and-models/orem-self-care-deficit-theory.php
Taylor, S., Geden, E., Isaramalai, S., & Wongvatunyu, S. (2000). Orem’s self-care deficit nursing theory: Its philosophical foundation and the state of the science. Nursing Science Quarterly. Vol. 13 (2) 104-110.
Timmins, F. & Horan, P. (2007) A critical analysis of the potential contribution of Orem’s self care deficit nursing theory to contemporary coronary care nursing practice. European Journal of Cardiovascular Nursing. https://doi.org/10.1016/j.ejcnurse.2006.03.006
Wilson, F., Baker, L., Nordstrom, C., Legwand, C. (2007) Using the teach-back and Orem’s self care deficit nursing theory to increase childhood immunization communication among low-income mothers. Issues in Contemporary Pediatric Nursing. Vol. 31 (1) 7-22.
Wilson, F., Wood, D., Risk, J. & Kershaw, T. (2003) Evaluation of education materials using Orem’s self-care deficit theory. Nursing Science Quarterly. Vol. 16 (1) 68-76.
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