Nurses can employ Orem’s Self-care Model to tackle barriers that hinder patients from attaining optimum health. By successfully applying this theory, nurses can ascertain their suitable level of impact on patient care. Correctly utilizing this model enables nurses to discern and control the patient’s progress, rendering it an essential component of nursing care.
The main aim of this paper is to show that Orem’s Theory can be successfully utilized through consistent implementation and individuals actively practicing self-care. The environment has a vital role in regulating the factors and situations that enhance an individual’s life, health, and general well-being.
The paper supports Dorothea Orem’s Self Care Model as a crucial tool for nurses to bridge the gap between patient well-being and health status. This theory aims to empower individuals and their families in maintaining control over their healthcare, continuously evolving throughout life.
The model is a complex process that takes longer than other models. It is suitable when a patient needs to be hospitalized for a long time. The model is built on four concepts that make up nursing’s metaparadigm: human beings, environment, health, and nursing (Fawcett, 2005).
In 1971, Orem defined a person as an integrated whole with physical, psychological, and social aspects and varying levels of self-care ability. According to Chinn & Kramer (2004), this theory enables nurses to determine the patient’s developmental level and anticipate the care needed to promote increased self-care. By using the Self Care Model, nursing care is tailored to the patient’s specific needs, distinguishing it from other healthcare models. This model also empowers the nursing profession by advocating for evidence-based practice in decision making.
According to Orem, the scope and boundaries of nursing, both as a field of practice and a field of knowledge, are defined by the Self Care Model and the considerations taken into account when making judgments to create a patient’s care plan. Orem refers to humans using terms such as individual, patient, multiperson unit, self-care agent, and dependent-care agent (Fawcett, 2005). In a 1996 newsletter to the International Orem Society, she poses the question: “What do nurses come across in their environments as they design and provide nursing for others?”
According to Orem’s Nursing Theory, nurses should consider the meaning of persons, things, events, conditions, and circumstances that they encounter. The theory was based on Orem’s own nursing experiences and came to her as a sudden realization. She understood that individuals could benefit from nursing because of their limitations in self-care. Orem defines a human being as a unified entity with different parts that develop and reach perfection throughout their development process.
Self-care is essential for maintaining optimal health and wellness for the patient as well as taking care of oneself and dependents. The model assists healthcare providers in conducting an initial assessment of the patient’s health and enables nurses to comprehend the client’s developmental stage. After a prolonged period, adaptation to the new activity level and potential is achieved through collaboration among all healthcare providers involved in the care plan.
According to the theory, patients experience different stages of adaptation to changes in their health condition and eventually recover their previous level of activity. For instance, consider a patient with left-side paralysis who is currently being discharged with minimal harm. When admitted, the patient relied on a compensatory system where the nurse provided full care. At that time, the patient was unable to perform any tasks independently, including basic daily activities and walking, and depended entirely on the nurse for survival.
After undergoing several months of care, the client progressed to the second system in Orem’s framework, which is the Partial Compensatory system. In this system, nurses provided assistance to the patient’s care, while the patient and their family also contributed. Thanks to treatments and physical therapy, the patient regained their previous level of activity in their right hands and began independently performing some simpler tasks. While the patient can now take care of themselves, the nurse must still monitor vital signs, oxygen saturations, assist with activities of daily living (ADLs) and walking, as well as provide educational support.
The third Orem’s system is the Educative-developmental system in which the patient has primary control over their health while healthcare providers assist with educating and promoting safe health practices. In this case, the client has cholesterol, making them fitting into this category because they need to comply with diet, exercise regimen, and medication. The nurse plays a crucial role in this situation as they need to educate the patient on how to be compliant with the regimen and how to properly maintain good health practices.
The theory emphasizes the importance of patient-nurse relationships in providing care and focuses on restoring, promoting, and maintaining health. It considers the patient as a whole and their interaction with their environment. According to Orem’s Theory, self-care is an ongoing process that requires constant evaluation throughout one’s life. Healthcare providers use evidence-based practice to make decisions and achieve desired outcomes after conducting a comprehensive assessment.
According to this theory, nurses can address multiple aspects of a patient’s well-being. These include character traits, social situation, environmental living conditions, and physical assessment from head to toe. To accomplish this, nurses utilize self-care requisites, behavioral characteristics, and past medical history. Orem’s emphasis lies in identifying the patient’s nursing care needs by uncovering their self-care deficits during the assessment process. However, due to the time-consuming nature of this procedure and staffing ratio limitations, developing a comprehensive initial care plan for short-term patients poses challenges.
It is nearly impossible for nurses to thoroughly analyze a patient according to Orem’s Self Care theory when they receive multiple admissions during their twelve-hour shifts. Familiarity with the theory’s steps is necessary. However, it takes several days to fully understand a patient, as Orem suggests. Unfortunately, when patients have short lengths of stay, time is a luxury that does not exist. The complexity and detailed nature of the theory, along with difficult wording, require healthcare providers to study the model extensively before implementing it.
To comprehensively comprehend the interconnection of all elements, nurses must extensively examine the patient. Evaluations should be performed through direct interaction with the nurse, client, and family. The patient is a person with both physical and emotional requirements for self-growth and welfare. The patient’s living environment can influence their capacity to engage in self-care tasks. The individual’s health determines their overall well-being and serves as the foundation for an individualized care strategy (Orem 1991).
Orem’s theory defines the self care patient as someone who can take part in activities and meet personal needs to maintain their overall health and well-being. This theory emphasizes that self care is a behavior that can be influenced by factors like the individual, environment, health, and nursing.
When in the hospital, there are three components that may be impacted: universal self care needs, developmental self care needs, and health deviation.
Orem’s theory of self-care applies all these components to patients that are in at least 3 months recovery time. The nursing care plan is one essential tool used to manage the balance between illness and self-care. The area of self-care deficit applies to the diagnosis area of the nursing care process and is a concept that provides a guideline for the selection of methods when nurses help and understand the patient roles in self-care. The supportive-educative role indicates that the client is participating in most of their self-care, and the nurse’s role is simply to monitor and regulate the client’s self-care.
When a newly diagnosed diabetic patient is receiving diabetic care teaching in the hospital, the model can be utilized to identify the personalized plan of care and assist the patient in adapting the regimen to their specific needs. If the patient’s visits module indicates highly fluctuating blood sugar or chemstrip readings, the healthcare provider may suspect that the patient is executing the procedure incorrectly. The model suggests employing an assessment tool to determine the cause of the issue.
After the nurse warns the patient about cutting strips and the potential consequences of inaccurate readings due to exposed chemicals, the nurse also observes that the patient’s wife, who cooks for the family, did not receive any nutritional education during the patient’s hospitalization. To address this, the nurse initiates nutritional counseling and gives a referral to the nutritional services department. The Universal self care requisites include air, water, food, elimination, activity and rest, solitude and social interaction, hazard prevention, and promotion of normality.
Developmental self care requisites can be categorized as maturational, which relates to the progress towards higher levels of maturation, and situational, which involves the prevention of deleterious effects related to development. On the other hand, health deviation requisites refer to the needs that arise as a result of a patient’s condition (Fawcett, 2005). The final stage of this model emphasizes the importance for nurses to provide a supportive-educative role to clients and assist them in actively participating in their self-care. Additionally, healthcare providers should continue to monitor and regulate the client’s self-care after they have regained part of their previous health level.
This model enables nurses to evaluate a patient’s overall wellness comprehensively. It covers various aspects such as character traits, social situation, living conditions, physical assessment from head to toe using self-care requisites, behavioral characteristics, and past medical history. The model proves advantageous for both long-term patients with terminal illnesses or bedridden patients and short-term patients in need of post-hospitalization follow-up care.
It is essential to comprehend and implement the stages promptly. The health objectives of patients depend on their life history, lifestyle, and self-care capabilities. Nurses need to assist clients and their families with regards to self-care in order to enhance or sustain the determined health level. By gathering evidence throughout the continuous process, the Model proves highly efficient in evaluating and specifying the design of the nursing system.
In my conclusion, the Self Care Model has an understanding of clients’ beliefs and maintains boundaries in the professional relationship. This can ultimately enhance the trust between healthcare providers and patients. The theory provides guidelines for healthcare providers to adapt to changes in patient health and promote compliance with treatment regimens, thereby improving the quality of care. The Self Care Theory is linked to life processes that aid in preserving the integrity of human structure and functioning in patients.
Orem’s Self Care Theory states that nurses can assist patients in improving their ability to carry out daily activities, ensuring they have enough air, water, and food, and finding a balance between rest and activity as well as solitude and social interaction. The theory also highlights the significance of preventing harm to human well-being and promoting optimal functioning. The objective is to maintain or enhance the patient’s current health status.
The primary emphasis of Orem’s nursing theory is to improve a patient’s self-care capabilities. Nurses can apply this theory to identify the sensations, perceptions, evaluations, and motivations of each individual patient. This aids in establishing a foundation for the patient’s ability to care for themselves.
References
- Chinn, P. L. , & Kramer, M. K. (2004). Integrated knowledge development in nursing (6th ed. ). St. Louis: Mosby.
- Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories 2nd ed. . Philadelphia: F. A. Davis.
- Gomez, J. , & Walks, L. Dorothea Orem’s self-care deficit theory. Retrieved September 30, 2005, from Northern Arizona University Web site: http://dana. ucc. nau. edu/~jmg8/image_of_nursing. htm.
- Hartweg, D. L. (1991). Dorothea Orem self-care deficit theory: Notes on nursing theories (pp. 1- 63). London: Sage.
- Hartweg, D. L. (1995). Dorothea Orem self care deficit theory. In C. M. McQuiston & A. A. Webb (Eds. ), Foundations of nursing theory. Thousand Oaks, CA: Sage.
