Theory of self-care

1. Dorothea Orem • 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 • (Current Nursing, 2012) Lori Steffes-Chouinard Carol Rajala Toya Ozark Theory of self-care

2. According to Fawcettin her Scholarly dialogue, The nurse theorists: 21st-century updates -- Dorothea E. Orem Dorothea Orem was greatly influenced during “…a period of intensive exposure to nurses and their endeavors from 1949 to 1957, during her tenure as a nursing consultant in the Division of Hospital and Institutional Services of the Indiana State Board of Health. Her observations led to the idea that “nursing involved both a mode of thinking and a mode of communication” (Orem & Taylor, 1986,p. 41). Orem’s “interest in and insights about the domain and boundaries of nursing” (Orem, 1991, p. 60) progressed from a global focus on “preventive health care” (p. 60) to a formal search “to know nursing in a way that would enlarge and deepen its meaning” (Orem & Taylor,1986, p. 39) and to identify a proper nursing focus.” (Fawcett, J., 2001) Theory Origins

3. “She focused on the questions “What is nursing?” and “When do people need nursing care?” and from this she derived that people need nursing when they are unable to care for themselves. In 1971, she presented the self-care deficit theory of nursing (S-CDTN) in the book Nursing Concepts of Practice and has continually revised and updated her theory.” (Nursing Theory, 2011) Theory Origins

4. “Orem's theory incorporates the medical model rather than rejects it, centers on the individual, is problem oriented, and is easily adaptable in varied clinical situations. As a grand theory, the S-CDTN has three interconnecting theories: theory of self-care, theory of self-care deficit, and theory of nursing systems” (Nursing Theory, 2011) Theory Origins continued

5. 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” (Current Nursing, 2012) Self-Care Theory

6. Theory Assumptions • “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” (Current Nursing, 2012) Self-Care Theory

7. Human being – Self-Care, according to Nursing Theory, is a learned behavior performed by mature & maturing individuals. • Environment – Although Orem did not focus on “defining health and the environment” (Nursing Theory, 2011). I feel that an individuals response to Self-Care are actions that result from learned behavior and the circumstances dictated by ones individual environment, resources and motivation to be a healthy individual. • Health - Although Orem did not focus on “defining health and the environment” (Nursing Theory, 2011). I feel that when looking at Orem’s theory of self-care an individuals concept of health is going to be defined by their learned behavior and motivation to move towards being healthier. • Nursing – Dorothea Orem’s Self-Care Deficit defines when self-care is absent and assistance (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” (Current Nursing, 2012) Information & Concepts

8. Dorothea Orem herself said it best during an interview with Fawcett; “…The self-care deficit theory of nursing will fit into any nursing situation, because it is a general theory, that is, an explanation of what is common to all nursing situations, not just an explanation of an individual situation…” (Fawcett, J., 2001) Information & Concepts

9. Current Nursing. (Feb. 4, 2012) Nursing Theories; Dorothea Orem’s Self-Care Theory. Retrieved from http://currentnursing.com/nursing_theory/self_care_deficit_theory.html Nursing Theory. (2011). In S. C. DeLaune (Ed.), Fundamentals of Nursing: Standards and Practice. (4th ed.). Clifton Park, NY: Delmar, Cengage Learning. Retrieved February 24, 2013, from Nursing Resource Center via Gale: http://0-find.galegroup.com.libcat.ferris.edu/nrcx/start.do?prodId=NRC Fawcett, J. (2001). Scholarly dialogue. The nurse theorists: 21st-century updates -- Dorothea E. Orem. Nursing Science Quarterly, 14(1), 34-38. references

10. Learning Theory group presentation grading rubric