THE SELF-CARE DEFICIT THEORY BY DOROTHEA OREM 1

THE SELF-CARE DEFICIT THEORY BY DOROTHEA OREM

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Einführung

Nursing theory is an integral component of nursing practice. Currently, numerous

applicable nursing theories are used in various practice settings. The importance of nursing

theories is to provide effective frameworks for conceptualizing the nurse’s role in attaining

better health outcomes for patients by stipulating the core relationships between health

professionals, nurses, and patients while also establishing key tenets of promoting health

(Shah, 2015). The purpose of this paper is to present and illuminate Dorothea Orem’s theory

of self-care as well as outline the underlying principles engulfing its application in practice

situations.

The Self-Care Theory

The self-care theory also referred to as the self-care deficit theory (SCDT), was

coined by Dorothea Orem in 2001. It has garnered acclamation across contemporary nursing

practices and tutelage. The proponent defined the grand theory as “the act of assisting others

in providing and managing self-care to maintain or improve human functioning at home level

of effectiveness” (Orem et al., 2001). The SCDT elucidates how nursing professionals can

and ought to intervene to assist clients to uphold autonomy. A self-care deficit can be

understood as the incapability to undertake certain daily functions associated with well-being

and health, such as bathing, feeding, toileting, dressing, or speech deficits. Self-care deficit

can be attributed to mental or physical impairments, like depression, recovery, or age-linked

mobility problems.

The role of nurses in addressing self-care deficits is crucial as they can assess and

intervene in such situations. As for assessments, a nurse should be aware of the patient’s

environment, strengths, weaknesses, and situational needs. Interventions can comprise of but

are not limited to spurring motivation, assisting with activities of daily living, aiding patients

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to construct short-term objectives, and creating occasions for independence. The SCDT posits

that patients are better placed to recover if they are in control of their self-care.

The metaparadigm of Nursing

Metaparadigm concepts are described as the central theories or ideas providing

structure for the functioning of a discipline. According to Nikfarid et al. (2018), the nursing

discipline has four central concepts: environment, health, person, and nursing. While nursing

theories are expansive, the four fundamental nursing metaparadigms suggest a holistic view

entailing care wherein an individual’s health and well-being are connected to four interacting

components.

The person component points to the recipient of care. In addition, it also includes

family and other elemental groups to the patient. The structure of care emphasizes the

individual’s social and spiritual needs and the need for health care. The resulting health

outcome is pointed to a person’s interaction with these social and physical interactions.

The environment component relates to the patient’s surrounding that affects their

health outcome. The environment aspect comprises internal and external factors, postulating

that a person’s interaction with their surroundings determines their wellness and health.

Family and friends’ interactions are aspects of the environment, in conjunction with social

and economic factors like culture, geographic locations, economic conditions, and

technology.

The health aspect refers to the patient’s extent of access to wellness and health care.

These comprise of the patient’s genetic makeup, lifespan, intellectual, emotional, spiritual,

social, and physical well-being and how these are integrated into health care for optimal

health outcomes (Nikfarid et al, 2018).

The nursing aspect relates to the delivery of optimal health results for the client

through a mutually beneficial relationship in a caring and safe environment. The applicable

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principles in the nursing component relate to skills, knowledge, technology, professional

judgment, collaborations, and communication to perform duties and responsibilities to

achieve the best possible health outcomes for the patient in a given scenario.

The use of metaparadigm concepts in the Self-care Deficit Theory

Orem views a person as a social, physical, and psychological character with

inconsistent potential for learning and thus can learn how to meet self-care needs. Human

beings, unlike other creatures, are capable of reflecting upon themselves and their

environment, as well as use their creative words and ideas to think, communicate, and make

efforts that improve things that benefit them and others (Shah et al., 2015).

Orem views health as a significant metaparadigm and interprets it as social, mental,

and physical wellness (Orem et al., 2001). SCDT perceives its crucial goal to be the integrity

of the human form. In her theory, Orem delineates the limitations of meeting the requirements

for self-care and how they affect health. The fundamental principle of her theory is

developing a concise plan that enhances and maintains the patient’s health. As such, she

emphasizes the focus of nursing to be the discovery of concepts that uphold the quality of

life.

As for the environment metaparadigm, Orem (2001) presented various environmental

features, classifying them into four categories: chemical, physical, social, and biological.

These concepts of the environment are broadly related and determine the person’s ability for

self-care. The environment is viewed as the immediate surrounding and concentrates on the

patient’s adaptive capabilities irrespective of the affective political, economic, and social

forces.

In respect to the nursing component, Orem presented it as a unique field of knowledge

and action system, which is a professional practice. She viewed it as a professional practice

for meeting the requisite need for self-care and need for patient’s medical care needs. Nursing

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system and nursing agency were Orem’s proposals for illustrating nursing. The nursing

agency is the person that has received training as a nurse for providing care whereas the

nursing system relates to the patient-nurse relationship that comprises of the actions in the

patient’s interests to accomplish the essential self-care (Shah et al., 2015).

The use of the Self-care Deficit Theory in Advanced Nursing

The SCDT defines and explains a nurse’s roles and responsibilities and

simultaneously offers a clear objective of nursing care: assisting patients to achieve and

maintain appropriate self-care levels (Matney et al., 2016). For instance, nurse who care for

the elderly are obliged to apply their knowledge to figure out the self-care activities that such

patients are required to undertake bearing in mind that these patients are incapable of

undertaking particular tasks. As such, the nurse should do these tasks for such patients.

Orem’s theory has also been extensively used in acute care whereby nurses in such

units should establish the self-care deficit affecting the individual and finding the most

suitable way of fulfilling this deficit. Therefore, say, if a person has an injury, the nurse’s

responsibility is offering them information that will help them manage the injury so that they

recover faster and facilitate normal functioning as quickly as possible.

Fazit

Overall, nursing theories are importance to in educating and nursing practice because

it assists in the definition and understanding of a nurse’s role in caring for patients. according

to SCDT, the nurse’s key goal is restoring the patient’s capacity for self-care. The theory

offers comprehensive view of nursing in practice settings that can be applied to varying cases

and circumstances. Examining Orem’s theory was important, as it has offered a knowledge

base that will be useful in future working as a nurse practitioner.

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Reference

Matney, S. A., Avant, K., & Staggers, N. (2016). Toward an understanding of wisdom in

nursing. The Online Journal of Issues in Nursing, 21(2).

Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm

concepts in human caring theory and Persian mysticism: a comparative study. Journal

of medical ethics and history of medicine, 11.

Orem, D. E., Taylor, S. G., & Renpenning, K. M. L. (2001). Nursing: Concepts of practice.

St. Louis: Mosby.

Shah, M. (2015). Compare and contrast of grand theories: Orem’s self-care deficit theory and

Roy’s adaptation model. International Journal of Nursing Didactics, 5(1), pp. 39-42.

Shah, M., Abdullah, A., & Khan, H. (2015). Compare and contrast of grand theories: Orem’s

self-care deficit theory and roy’s adaptation model. Int J Nurs Didac, 5(1).

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