Introduction
In this paper I will be discussing Orem’s self care theory. The motive for the theories development and main idea of the theory will be stated. The concept of person, environment, health and nursing will be examined using Orem’s self care theory. The practice of nursing is often influenced by nursing theories. Various nursing theory suggests different design and pathway for caring for clients. These theories give context to the practice of nursing in daily life by advancing health.
Orem’s self care deficit theory has been popular in the nursing community. It is applicable to the practice of nursing, nursing education and nursing research. The valve of nursing and the constant change and development in the nursing field gives rise to various nursing theorist and orem’s theory is one of them. Different perspective and priorities are is used in other help meet client’s needs. Actions that improve health is the focus of orem’s theory.
Dorothea Orem formulated the self care deficit theory earlier in her career although she continued to work on perfecting it throughout her career. She was born in Baltimore in 1914. Her highest level of education is masters in nursing education, although she received a honorary doctor of science degree. In 1956, she defined nursing practice when she worked at Indiana state general. When Orem worked for the division of hospital and institutional services in Indiana state, she noticed the need to better the quality of nursing in Indiana state general hospital. She published in 1956, 1971, 1980, 1985, 1991, 1995, and 2001. Orem as worked as a staff nurse, private nurse, nurse educator, nurse administrator and nurse consultant.
Orem defines nursing as helping individual overcome human difficulties and challenges. Orem’s theory says self care is required when client and their family is not capable of providing care for the individual. Nurses can help individuals meet this need by providing adequate care. Different client need different needs depending on how much the client can do for themselves. This individuality is an important consideration when discussing Orem’s self care theory.
Main concepts of Orem’s self care theory
Orem constructed her theory on the assumption that individuals have a natural capability, right and obligation to care for their selves. A construct of individual development and growth is accompanied by autonomy which is having independence or freedom of will and action and supporting other people to do the same. The ability of client to care for themselves is the focus of this theory. Caring for one’s self is developed through performing actions that advance health, human life and well being. Care is viewed from the client’s view and different levels of help needed from the nurse. Orem bases her theory on the basis that every one can take charge of their health and health of the people around them. In other words every individual can care for themselves and people that depend on them. Individuals have the capability to care for themselves and are accountable for their health and the health of the people that depend on them. Individuals maintain a healthy lifestyle by performing practices that lead to maintenance of life and health.
Orem’s theory consist of three parts and it includes
- Theory of self care,
- Theory of self care deficit
- Theory of nursing system.
Self care requirement are things that are done to meet the self care needs. There are also three categories of self care requirements or requisites and theses requirements includes universal, Developmental and health deviation. The universal requisites aspect of self care includes basic human needs like air, food, water, rest and safety. These are things that are common to all humans and includes activities of daily living. Inadequate intake of food, water and air need to be maintained. Adequate ways of elimination of body waste needs to be provided. Activity and rest must be at equilibrium. The prevention of client form harm and maintenance of safety must be fulfilled. Individuals must be supported to provide for optimal functioning to the best of their capacity.
The developmental requisites aspect of self care includes various stages of growth and developmental process. This can also include important events in someone’s life. Example would be getting married, losing a job or having a baby. During this period of extreme life changing situations, clients are very vulnerable and they require a lot of support.
The health deviation aspect concerns with illness, disease and injury. Encouraging people to seek and secure medical help that is appropriate for their illness is vital to improving the quality of life. Also individuals must effectively carry out activities that are prescribed for their conditions. Attaining information and understanding the impact of disease on the quality of life is important. Individuals must change their thinking and accept the limitations attributed with certain diseases.
Theory of self care deficit involves providing care to those in need of it that are incapable of providing this care for themselves. According to orem nurses can help clients in different ways. Nursing provides a means for solving this problem. Nurses can help client meet self care deficits by proving support, directing and guiding them through decision making process. Nurse can do for client what they can’t do for themselves, giving client an environment suitable for growth and providing teaching and education to clients. The ways in which needs of client’s are met by the nurse is the focus of the theory of nursing system. The nurse assess the client capability and provides care based on this assessment.
According to Orem nurses can use three systems to meet the needs of the client. These systems are wholly compensatory, partially compensatory and supportive educative. Wholly compensatory can be put to use when the client is not able to carry out most of care and the nurse performs this care. Partially compensatory can be use when the client can perform some of his/her care and the nurse helps by assisting the client. Lastly supportive educative can be used client is quite to perform his/ her own care and the role of the nurse is to support and educate the client.
Person, environment, health and nursing
Orem defines the person as a functioning unity capable of self care who is socially, biologically and symbolically viewed and possesses certain needs. A person is the individual that receives nursing care. A person consist of a physical psychological and social attributes which changes depending on the ability of the individual to carry out self care. She see a person as a self care operator who possesses a beneficial self care demands consisting of universal, development and health deviation self care requirements.
The environment gives a circumstance in which the client exists and the nurse is capable of changing the environment to meet the need of the client. Humans exists in an environment and the effect of the environment can affect individuals in a negative or positive way with regards to the ability to perform self care. The interaction between humans and their environment is constantly changing, therefore the environment needs to be constantly assessed. Orem recognizes the environment as an important factor in the development and survival of humans because it provides basic human needs for survival.
According to Orem, Health is described by soundness or wholeness of individual compositions and meant functions. This depends on the environment and can change if the environment changes. Health is also viewed as physical, mental and social well being. The health of a person depends on receiving care needed to attain and maintain health. These activities can be accompanied by the individual himself/ herself, family members or the nurse. Orem gives an holistic approach to attain healthy health with the nurse and client working together towards a common goal. Health promotion and maintenance is very important.
Nursing consists of thing the nurse does to help the patient. All these concept are interrelated for Orem and the focus of nursing care is the client. She sees nursing as an intervention performed to help client meet their self care need. According to Orem nursing is defined as things done choosing and done by nurses solely for the purpose of helping their clients maintain or change conditions in themselves or the environment. The need for nursing support depends only on self care deficit to improve self care abilities.
References
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