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