Orem's General Theory of Nursing
Outline:-
(1)An introduction to nursing theory
(2)the self-care theory
Ø Self-care
Ø self-care agency
Ø self-care request
(3)the self-care deficit theory
(4)the theory of nursing systems
Ø Wholly Compensatory Nursing System
Ø Partial Compensatory Nursing System
Ø Supportive-Educative System
(5) Orem’s Basic concepts:-
Ø Health
Ø Nursing
Ø Patient\human being
Ø Environment
(6)references
introduction to nursing theories
Nursing theories are organized bodies of knowledge to define what nursing is, what nurses do, and why do they do it. Nursing theories provide a way to define nursing as a unique discipline that is separate from other disciplines (e.g., medicine). It is a framework of level
The first nursing theories appeared in the late 1800s when a strong emphasis was placed on nursing education.
concepts and purposes intended to guide the practice of nursing at a more concrete and specific In 1860, Florence Nightingale defined nursing in her “Environmental Theory” as “the act of utilizing the environment of the patient to assist him in his recovery.”
Needs-Based Theories. The needs theorists were the first group of nurses who thought of giving nursing care a conceptual order. Theories under this group are based on helping individuals to fulfill their physical and mental needs. Theories of Orem, Henderson, and Abdella are categorized under this group. Need theories are criticized for relying too much on the medical model of health and placing the patient in an overtly dependent position
Orem Model of Nursing
Introduction
Dorothea Elizabeth Orem (July 15, 1914 – June 22, 2007) was one of America’s foremost nursing theorists who developed the Self-Care Nursing Theory, also known as the Orem Model of Nursing.
The Self-Care Deficit Theory developed as a result of Dorothea E. Orem working toward her goal of improving the quality of nursing in general hospitals in her state. The model interrelates concepts in such a way as to create a different way of looking at a particular phenomenon. The theory is relatively simple, but generalizable to apply to a wide variety of patients. It can be used by nurses to guide and improve practice, but it must be consistent with other validated theories, laws and principles
v The Self-Care Theory of Nursing is composed of three interrelated theories:
(7) the theory of self-care
(2) the self-care deficit theory
(3) the theory of nursing systems
Theory of Self-Care
It describes and explains Self-care. It is based on the l of Self-care, Self-care agency, Self-care requisites
Ø Self-care: Comprises those activities performed independently by an individual to promote and maintain personal well-being throughout life.
Ø Self-care agency: is the individual's ability to perform Self-care activities. Consists of two agents:
Self-careagent: person who provides the self care.
Dependent care agent: person other than the individual who provides the care, such as a parent who cares for a child.
Ø Self-care requisites:
Are the actions or measures used to provide Self- care; also called Self- care needs.
Consist of three categories:
Universal: requisites that are common to all individuals, such as maintaining air, water, and food intake and elimination; balancing activity, rest, solitude, and social interaction; and preventing hazards and promoting normalcy.
Developmental requisites that result from maturation or new requisites that develop as a result of a condition or event, such as adjusting to a change in body image.
Health deviation: requisites that result from illness, injury, or disease or its treatment; they include such actions as
o seeking medical assistance,
o carrying out a prescribed treatment,
o and learning to live with the effects of illness or treatment.
Theory of Self-Care Deficit
This theory explain when nursing is needed. Nursing is required when an adult (or in the case of a dependent, the parent or guardian) is incapable of or limited in the provision of continuous effective self-care
Orem identified 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
Theory of Nursing System
Refers to series of actions a nurse takes to meet a patient's Self-care requisites It is determined by the patient's Self-care requisites and Self-care agency. It is composed of three systems:
Ø Wholly Compensatory Nursing System
This is represented by a situation in which the individual is unable “to engage in those self-care actions requiring self-directed and controlled ambulation and manipulative movement or the medical prescription to refrain from such activity… Persons with these limitations are socially dependent on others for their continued existence and well-being.”
Example: care of a newborn, care of client recovering from surgery in a post-anesthesia care unit
Ø Partial Compensatory Nursing System
This is represented by a situation in which “both nurse and perform care measures or other actions involving manipulative tasks or ambulation… [Either] the patient or the nurse may have a major role in the performance of care measures.”
Example: Nurse can assist postoperative client to ambulate, Nurse can bring a meal tray for client who can feed himself
Ø Supportive-Educative System
This is also known as supportive-developmental system, the person “is able to perform or can and should learn to perform required measures of externally or internally oriented therapeutic self-care but cannot do so without assistance.”
Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies.
Orem’s Basic concepts
A. Health:
i. Is described by Orem as a state characterized by wholeness of bodily structure and function
ii. Consists of physical, Psychological, interpersonal, and social aspects; according to Orem, these aspects are inseparable.
iii. Includes promotion and maintenance of health, treatment of illness and prevention of complications.
B. Nursing:
i. Is viewed by Orem as a service geared toward helping the self and others.
ii. Is required when therapeutic self-care demands needed to meet self-care requisites exceed a patient's self-care agency.
iii. Has several components: nursing art, nursing prudence, nursing service, role theory, and special technologies.
iv. Consists of three steps:
1. Determining why a patient needs care.
2. Designing a nursing system and planning the delivery of care.
3. Initiating conditioning and controlling nursing actions.
C. Patient \ human being
i. Is defined by Orem as the patient (the recipient of nursing care)- a being who function biologically, symbolically, and socially and who has the potential for learning and development.
ii. Is an individual subject to the forces of nature, with a capacity for self knowledge, who can engage in deliberate action, interpret experiences, and perform beneficial actions.
iii. Is an individual who can learn to meet Self-care requisites if for some reason the person cannot learn Self-care measures others must provide the care.
D. Environment:
i. Can positively or negatively affect a person's ability to provide Self-care.
ii. Consists of (environmental factors, environmental elements) not defined by Orem, environmental conditions(external physical and psychosocial surroundings), and developmental environment(promotion of personal development through motivation to establish appropriate goals and to adjust behavior to meet these goals includes formation of or change in attitudes and values, creativity, self-concept, and physical development).
References:
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