There are situations when patients are encouraged to bring out the best in themselves despite falling sick for some time in health care. This is especially prominent in a rehabilitation setting…in which a patient is expected to be self-reliant after being taken care of by nurses and physicians.
Between 1959 and 2001, Dorothea Orem developed the Self-Care Deficit Theory to better the quality of nursing in general hospitals in her state. It’s considered a noble nursing theory, containing a broad range and general concepts applicable to all cases of nursing.
Dorothea Orem’s Self-Care Deficit Theory describes nursing as the act of helping others within the provision and management of self-care to take care of or improve human working at the house level of effectiveness.
It focuses on each person’s ability to perform self-care. Orem defines self-care as the execution of activities that people trigger and act on in maintaining life, health, and well-being.
The circumstances that authenticate the existence of a requirement for nursing in adults is the absence of the power to take care of that quantity and quality of self-care continuously.
This care is therapeutic in sustaining health and life, recuperating from illness or injury, or dealing with their outcomes. With children, the condition is that the parent cannot take care of and provide therapeutic care in the same quantity and quality.
The assumptions in the Self-Care Deficit Theory include:
The major concepts of the Self-Care Deficit Theory include:
Nursing is the art through which a nurse gives specialized assistance to a patient for self-care. The goal…is to provide a better quality of life while helping the patient become more responsible and active in managing their health care at home.
It’s about nourishing, encouraging, protecting, compensating, and promoting recovery from illness and injury. The nurse also intelligently participates in the patient’s care.
Humans refer to men, women, and children being given care either as single or social units. They are nurses’ “material object” and the subject of the environment that nurses will act upon by providing direct care. It’s through their actions that inputs are given to them, and they receive output.
The environment refers to the physical, social, cultural, economic, political, and historical surroundings in which nursing activities are implemented.
It’s where human agencies give nurses opportunities to influence or be influenced by what is happening there. The environment also includes the family, community, and culture.
Health is the ability to perform optimally as a human being. It’s defined as the absence of disease and infirmity, total physical and mental well-being, and functioning optimally in an environment.
Health also includes the well-being of an individual and a group and encompasses the ability to reflect on oneself, symbolize one’s experience, and communicate with others.
Self-care is an ability possessed by humans to meet the physical and psychosocial demands that sustain life. According to Orem, self-care is the practice of activities people initiate and partake in on their own to maintain their life, health, and well-being.
Self-care agency is the power to act deliberately in meeting one’s own needs. The inherent trait in humans makes them able to make choices and make judgments on their behalf. Self-care agency is influenced by essential conditioning factors.
Basic conditioning factors are those that affect self-care agency from birth to adulthood. These include the state of health, environmental conditions, health care systems, social interactions, mental ability, and maturity.
They also include resource adequacy and availability and biological factors such as body strength, senses, coordination skills, agility, and pain threshold.
Therapeutic self-care demand is the need to participate actively in meeting one’s health care needs. It’s the totality of self-care actions and activities needed to maintain and promote optimum health and well-being.
It’s determined by assessing one’s entire situation. This demand is affected by social, cultural, political, psychological, and biological factors.
Self-care deficit is the lack of self-care activities or the manner in which self-care actions are performed. It delineates the need for nursing.
Nursing is only required when the parent, guardian, or dependent isn’t capable of or is limited in providing continuous effective self-care.
The nursing agency is the attributes of nurses that enable them to act, know, and feel in a manner that helps them meet the self-care needs of their patients by exercising and developing their self-care agency.
The nursing system is the network of all the relations between the people involved; legitimate nurse and legitimate client. It’s activated when the client’s therapeutic self-care demand cannot be met or is limited, leading to nursing.
Dorothea Orem’s Self-Care Theory is composed of three intertwined theories.
This theory focuses on the patient’s individuality and self-care abilities. The theory states that individuals can meet their own needs, but only under certain conditions.
These include the state of health, environmental conditions, health care services, social interactions, economic resources, the environment or community setting in which one lives or functions, and biological factors.
The theory of self-care includes three self-care requisites:
Universal self-care specifications are associated with life cases and the maintenance of the human structure and its functional integrity. They include:
Developmental self-care requisites become apparent when the adult’s social interactions are judged. They can either be specialized expressions of universal self-care necessities detailed for developmental processes…..or new needs drawn from a condition or connected with an event.
They include:
Health deviations are conditions that affect health status and require more than usual self-care efforts. They are needed in situations of disease, illness, or injury.
They can also result from medical measures necessary for diagnosing and correcting the situation. They include:
The self-care deficit is based on the premise that clients and patients cannot meet their own essential needs; thus, they require nursing intervention.
The cause of this deficit in meeting self-care is related to limitations or barriers that prevent individuals from meeting their requirements for health, well-being, growth, and development. Orem identified five methods of helping:
This theory is about providing for individuals who are unable to provide for themselves. It is based on the belief that an individual will not meet basic needs.
The focus of this theory lies in assessment, planning, implementation, and evaluation so that adequate self-care can be attained. It’s divided into three:
This system is employed when there are physical barriers to self-care. It focuses on providing for needs that the client cannot meet.
Persons with these needs are socially dependent on others since they cannot meet their own requirements, for example, newborns, after-surgery patients, etc.
The focus is on providing physical care that includes:
This system is employed when barriers affect the individual’s ability to perform some self-care activities. They can meet their own essential needs but with assistance.
The focus of this system is on meeting physical care needs that include:
This system is used when individuals can meet their own needs but cannot understand, learn, or perform them due to environmental barriers.
Individuals having the needs are socially competent enough to meet their needs but need to be taught how. The focus of this system is on meeting mental care needs that include:
The Self-Care Deficit Theory focuses on assessment through the use of the nursing process. Nurses assess the individual’s ability to meet self-care needs and barriers to meeting self-care needs.
They then establish an individualized plan to facilitate successful knowledge or skill acquisition for self-care.
Collect Data in Six Areas
The nurse formulates a plan that is either wholly compensatory, partially compensatory, or supportive-educative.
The two actions are:
The nurse assists the patient or family in self-care matters to identify and describe health and health-related results.
Orem’s theory applies to the practice of nursing and has shaped how nurses view their roles. The role of the nurse in Orem’s theory is to meet self-care deficits.
The goal is to provide client participation in meeting self-care requirements. For example, an individual’s ability or inability to adequately take care of themselves may determine whether a nurse needs to assist them with their needs like bathing, feeding, etc.
If someone needs assistance with these activities because they lack the capacity or skills, then an assessor like a nurse or social worker may help that individual find the services they need to stay in their home.
Let’s take the case of inadequate air intake…it poses a potential risk for impaired respiratory status. Orem’s Self-Care Deficit theoretical framework directs the nurse to assess the individual’s ability to care for themselves regarding their air intake.
Based on the assessment, the nurse guides and directs the patient accordingly. If they need help, the nurse helps them with it.
If they don’t, the nurse might suggest some exercises that they can do independently to avoid becoming a problem later on. In this way, the nurse’s intervention is supportive instead of compensatory.
Orem’s self-care deficit theory has been criticized in regards to its limitations. Some of these include:
Orem’s contribution to nursing is substantial. Every day, nurses assess, diagnose and plan interventions for their patients while being mindful of their need to be independent.
By so doing, they can assist the patient in meeting their needs and maintaining health. If this rewarding aspect of nursing interests you, Nursing.com offers online nursing programs to help nurses learn how to assess self-care practices and the deficits of their patients.
This allows you to gain skills and market-relevant expertise while still pursuing an advanced degree. Sign up today, and let’s dive in.