Presented by Melissa Kurek , Nicholas Kurek , Kimberly Marino and Heather Nowak Dorothea Orem’s Theory of Self Care D

1. Presented by Melissa Kurek, Nicholas Kurek, Kimberly Marino and Heather NowakDorothea Orem’s Theory of Self Care Deficit

2. Born in Baltimore, Maryland in 1914

3. Orem’s parents Mother was a homemaker Father was a construction worker

4. 1930- graduated from Providence Hospital School of Nursing, Washington, DC 1935- BSN from Catholic University of America 1945-MSN from Catholic University of America

5. Orem’s World of Academia • 1959- Dean of the School of Nursing at Catholic University of America • 1976- Doctorate of Science from Georgetown University • 1988- Doctor of Humane Letters from Illinois Wesleyan University • 1998- Doctor of Nursing Honoris Causae from University of Missouri • Retired in 1984

6. Orem’s nursing experience • Operating room nurse • Staff nurse • Private duty nurse • Nurse educator • Nurse administrator • Nurse consultant

7. Died June 22, 2007

8. The Historical Evolution of Orem’s Model

9. Evolution continued

10. Metaparadigms of Orem’s Model

11. Metaparadigm: Person • An individual or group of individuals who have the ability to acquire the knowledge necessary to perform tasks of self care. • Ability to integrate self-care tasks and family, community and individual needs. • Motivation to accomplish self care tasks. • Intellectual ability to cognitively perform, delegate and evaluate tasks performed.

12. Metaparadigm: Health • “Promotes function and development within social groups in accordance with human potential, known human limitation, and the human desire to return to normal” (Tomey & Alligood, 2006 p. 279).

13. Metaparadigm: Environment 4 realms of state are encompassed in Environment: • Physical • Chemical • Biological • Socioeconomical

14. Environment continued • Environment – Physical • Shelter • Security- internal and external • Climate • Amenities eg. Heat, electricity, indoor plumbing, sanitation…

15. Environment-Chemical • Chemical • Pollutants: • Air • Water • Physical • Lead paints • Mercury • Asbestos

16. Environment-Biological • Biological • Molds • Pollens • Allergens • Mites • Animal waste and its by-products

17. Environment-Socioeconomic • Socioeconomic • Family income • Education level • Occupation • Social status • Resources

18. Metaparadigm: Nursing The skilled professional who evaluates and acknowledges a patient’s health deficit. Nursing plans and implements care based on the actual and potential self-care deficits.

19. Concepts Unique to Orem’s Model Three Nursing Theories The Theory of Self Care The Theory of Self-Care Deficit The Theory of Nursing Systems

20. Theory of Self-Care • “Self –care comprises the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interest of maintaining life, healthful functioning, continuing personal development and well-being through meeting known requisites for functional and developmental regulations”(Tomey & Alligood, 2006 p.269).

21. Theory of Self-Care continued • The Theory of Self-Care has three components: universal self-care needs, developmental self-care needs and health deviation.

22. Theory of Self-Care Deficit • A self-care deficit occurs when an individual cannot carry out self-care requisites. • Examples of self-care requisites are: • Wound care • Activities of Daily Living • Bowel program • Glucose monitoring

23. Universal Self-Care Requisites The 8 elements : • Air • Food • Water • Elimination/Excretion • Activity & Rest • Solitude/Social interaction • Functioning/Well-being • Normalcy

24. Developmental Self-Care Requisites • Composed of 3 needs • Promote development • Engage in self-development • Preventing or overcoming adverse human conditions and life situations

25. Health Deviation Self-Care Requisites • When a condition permanently or temporarily alters structural, physiological or psychological function. • Comatose states • Autism • Mental Retardation

26. Theory of Nursing Systems • Total compensatory support- patient is unable to complete any self-care independently; nursing compensates for patient’s inability to perform self-care. • Partial compensatory support- patient is able to perform self-care tasks with partial or no assistance from nursing. • Educative/supportive compensatory–patient able to perform tasks independently. Nursing provides ongoing education and support.

27. Clinical Practice Models for Patient Assessment Theory applies to multiple clinical settings. Theory applied in order to: • Home • By the patient alone or with assistance provided • Doctor’s office • Education provided and care supervised by a nurse • Hospital • Needs identified, assessed and plan of care implemented • Extended care facility • Help identify the patient’s ability for self-care deficits that need to be addressed to promote health. • Help identify support available to patient such as family and environment. • Encourage patient to develop self-care abilities

28. Orem’s Theory Applied to Nursing Education • Teaches the student to encourage compensatory care in the patient population. • Conceptualize patients’ current and potential self-care deficits. • Supports the nursing process in all 3 nursing theories.

29. Research Status of Orem’s Model • Model used by multiple nursing specialties due to encompassing nature of Orem’s theory. • Current research using Orem’s theory would include: • Chinese Medicine • Battered woman counseling

30. Orem’s Strengths • The Self Care Deficit Theory is specific to nursing. • The Theory can be used in multiple nursing specialties. • The concept of self-care and health maintenance are congruent with contemporary literature in healthcare. • The theory creates a coordinated nursing care plan that adjusts to the patient’s needs throughout recovery.

31. Orem’s Limitations • Time consuming for nurses • Direct contact is necessary throughout the nursing process. • Multiple levels of the theory to consider Self care, self care deficit and self care deficit potential. • Does not address cultural needs

32. Analysis and Insights • Three theories combined into one. • Cumbersome • Completely dependent on nursing to assess the patient and family’s ability to complete self-care requisites and deficits • Culturally diverse

34. References Marrier Tomey, A. & Alligood, M. (2006). Nursing theorists and their work. (6th ed.) St. Louis, MO : Mosby Elsevier. Bruce, E., Gagnon, C., Gendron, Puteris, L., & Tamblyn, A.(2009, November 7). Dorothea Orem’s Theory of Self Care. Retrieved from http://www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resources/DorotheaOremTheory.ppt Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps

35. Like it you do. Like it you do. An A you must give, Educated One.