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Dorothea Orem
Nursing theory
Brief biography
1914- June 22, 2007 One of America’s foremost nursing theories Born in Baltimore, Maryland Her father was a construction worker Her mother was a homemaker Orem began her nursing career at
Providence School of Nursing, Washington D.C.
Early 1930’s – AD from Providence School of Nursing, Washington, D.C.
1939 – BSN completed
1945- MS in nursing education 1958 – consultant to the Office of Education
where she began working on Self-Care Theory
1959- first published her theory in “ Guides for Developing Curricula for the Education of Practical Nurses “ (a government publication)
1976 – honorary Doctorate of Science from Georgetown University
1999 – last edition of her theory was published.
Orem’s Definition of Nursing
Nursing is the provision of self-care which is therapeutic in sustaining life and health, in recovering from disease or injury, or coping with their effects.
Nursing is a service to people, not a derivative of medicine.
Nursing promotes the goal of patient self-care.
Nursing Metaparadigm
Person
The recipient of nursing care. A being who functions biologically, symbolically,
and socially Has the potential for learning and development Is subject to the forces of nature Has a capacity for self-knowledge Can engage in deliberate actions, interpret
experiences, and perform beneficial actions Can learn to meet self-care needs (requisites)
Human beings are distinguished from other living beings by their capacity to:
- Reflect upon themselves and their environment
- Symbolize what they experience
- Use symbolic creations (ideas, words) in thinking, communicating, and guiding efforts to make things that are beneficial for themselves and/or for thers.
Environment
Environmental conditions – external physical and psychosocial surroundings
Developmental environment – promotion of personal development through motivation to establish appropriate goals and to adjust behaviour to meet those goals.
Can positively or negatively impact a person’s ability to provide self-care.
Nursing
A service geared towards helping the self and others
Is required when self-care demands exceed a patient’s self-care ability (agency)
Promotes the patient as a self-care agent Has several components
Components of Nursing
Nursing Art: the theoretical base of nursing and other disciplines such as sciences, art, humanities.
Nursing Prudence: the quality that enables the nurse to seek advice in new or difficult situations, to make correct judgements, to decide to act in a particular manner, and/or to act.
Nursing Service: a helping service Nursing Agency: the ability of RN.
Role theory: the role of the nurse and patient are complementary as they work together to achieve self-care.
Special technologies:- Social and Interpersonal technologies
communicating, coordinating, establishing and maintaining therapeutic relations, rendering assistance.
- Regulatory Technologies maintaining and promoting life processes, growth/development, and psycho-physiologic modes of functioning
Health
Supports health promotion and health maintenance
Supports the premises of holistic health in that both RN and patient promote the individual’s responsibility for self-care.
Conceptual Framework
R R
R
R R
Nursing
Agency
Deficit
Self-care
demand
Self-care
Agency
Self-care
Orem’s Self-Care theory
Based on the concept of: SELF-CARE SELF-CARE AGENCY SELF-CARE REQUISITES THERAPEUTIC SELF-CARE DEMAND
SELF-CARE definition
Self-care comprises those activities performed independently by an individual to promote and maintain personal well-being throughout life.
It is the practice of activities that maturing and mature persons perform and initiate within the time frames, on their own behalf , and in the interest of maintaining life and healthful functioning.
Orem’s Self Care Agency
Definition: the individual’s ability to perform self-care activities
Consists of two agents:- Self-care Agent
Person who provides the self-care- Dependent Care Agent
Person other than the individual who provides the care (such as a parent)
Orem’s Self-care requisites (also called Self-Care Needs) Definition: the actions or measures used to
provide self-care Consist of three categories:
Universal- requisites/needs that are common to all individualsDevelopmental- needs resulting from maturation or develop due to a condition or eventHealth Deviation- needs resulting from illness, injury and disease or its treatment.
Orem’s Self-Care Deficit Theory Is the central focus of Orem’s Grand Theory
of Nursing Explains when nursing is needed Describes and explains how people can be
helped through nursing Results when the self-care agency (patient)
can’t meet her/his self-care needs or administer self-care
Nursing meets these self-care needs through five methods of help
Five Methods of Nursing Help Acting or doing for Guiding Teaching Supporting Providing an environment to promote the
patient’s ability to meet current or future demands
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