THEORY ASSIGNMENT

· Theorist : Dorothea Orem (1914-2007)

· Born 1914 in Baltimore, US

· Earned her diploma at Providence Hospital – Washington, DC

· 1939 – BSN Ed., Catholic University of America

· 1945 – MSN Ed., Catholic University of America

· She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant.

· Received honorary Doctor of Science degree in 1976.

· Theory was first published in Nursing: Concepts of Practice in 1971, second in 1980, in 1995, and 2001.

MAJOR ASSUMPTIONS

· People should be self-reliant and responsible for their own care and others in their family needing care

· People are distinct individuals

· Nursing is a form of action – interaction between two or more persons

· Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health

· A person’s knowledge of potential health problems is necessary for promoting self-care behaviors

· Self care and dependent care are behaviors learned within a socio-cultural context

DEFINITIONS OF DOMAIN CONCEPTS THEORY ASSIGNMENT

Nursing – is art, a helping service, and a technology

· Actions deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments

· Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective

THEORY ASSIGNMENT

· Goal of nursing – to render the patient or members of his family capable of meeting the patient’s self care needs

· To maintain a state of health

· To regain normal or near normal state of health in the event of disease or injury

· To stabilize ,control ,or minimize the effects of chronic poor health or disability

Health – health and healthy are terms used to describe living things …

· It is when they are structurally and functionally whole or sound … wholeness or integrity. .includes that which makes a person human,…operating in conjunction with physiological and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beings

Environment

· environment components are enthronement factors, enthronement elements, conditions, and developed environment

Human being – has the capacity to reflect, symbolize and use symbols

· Conceptualized as a total being with universal, developmental needs and capable of continuous self care

· A unity that can function biologically, symbolically and socially

Nursing client

· A human being who has “health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in ineffective / incomplete care.

· A human being is the focus of nursing only when a self –care requisites exceeds self care capabilities

Nursing problem

· deficits in universal, developmental, and health derived or health related conditions

Nursing process

· a system to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of care

Nursing therapeutics

· deliberate,  systematic and purposeful action,

OREM’S GENERAL THEORY OF NURSING

Orem’s general theory of nursing in three related parts:-

· Theory of self care

· Theory of self care deficit

· Theory of nursing system

A. Theory of Self Care

This theory Includes:

· Self care – practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being

· Self care agency – is a human ability which is “the ability for engaging in self care” -conditioned by age developmental state, life experience sociocultural orientation health and available resources

· Therapeutic self care demand – “totality of self care actions to be performed for some duration in order to meet self care requisites by using valid methods and related sets of operations and actions”

· Self care requisites – action directed towards provision of self care. 3 categories of self care requisites are-

· Universal self care requisites

· Developmental self care requisites

· Health deviation self care requisites

THEORY ASSIGNMENT

1. Universal self care requisites

· Associated with life processes and the maintenance of the integrity of human structure and functioning

· Common to all , ADL

· Identifies these requisites as:

· Maintenance of sufficient intake of air ,water, food

· Provision of care assoc with elimination process

· Balance between activity and rest, between solitude and social interaction

· Prevention of hazards to human life well being and

· Promotion of human functioning

2. Developmental self care requisites

· Associated with developmental processes/ derived from a condition…. Or associated with an event

· E.g. adjusting to a new job

· adjusting to body changes

3. Health deviation self care

· Required in conditions of illness, injury, or disease .these include:–

· Seeking and securing appropriate medical assistance

· Being aware of and attending to the effects and results of pathologic conditions

· Effectively carrying out medically prescribed measures

· Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care

· Learning to live with effects of pathologic conditions

B. Theory of self care deficit

· Specifies when nursing is needed

· Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care. Orem identifies 5 methods of helping:

· Acting for and doing for others

· Guiding others

· Supporting another

· Providing an environment promoting personal development in relation to meet future demands

· Teaching another

C. Theory of Nursing Systems

· Describes how the patient’s self care needs will be met by the nurse , the patient, or both

· Identifies 3 classifications of nursing system to meet the self care requisites of the patient:-

· Wholly compensatory system

· Partly compensatory system

· Supportive – educative system

· Design and elements of nursing system define

· Scope of nursing responsibility in health care situations

· General and specific roles of nurses and patients

· Reasons for nurses’ relationship with patients and

· Orem recognized that specialized technologies are usually developed by members of the health profession

· A technology is systematized information about a process or a method for affecting some desired result through deliberate practical endeavor, with or without use of materials or instruments.

Categories of technologies

1. Social or interpersonal

· Communication adjusted to age, health status

· Maintaining interpersonal, intra group or inter group relations for coordination of efforts

· Maintaining therapeutic relationship in light of psychosocial modes of functioning in health and disease

· Giving human assistance adapted to human needs ,action abilities and limitations

2. Regulatory technologies

· Maintaining and promoting life processes

· Regulating psycho physiological modes of functioning in health and disease

· Promoting human growth and development

· Regulating position and movement in space

OREM’S THEORY AND NURSING PROCESS

· Nursing process presents a method to determine the self care deficits and then to define the roles of person or nurse to meet the self care demands.

· The steps within the approach are considered to be the technical component of the nursing process.

· Orem emphasizes that the technological component “must be coordinated with interpersonal and social processes within nursing situations.