2Dorothea OremEarly 1930’s - AD from Providence School of Nursing, Washington, D.C.1939 – BSN completedMS in nursing educationconsultant to the Office of Education where she began working on her SELF-CARE THEORY
3Dorothea Oremfirst published her theory in “Guides for Developing Curricula for the Education of Practical Nurses” (a government publication)honorary Doctorate of Science from Georgetown Universitylast edition of her theory was published
4Orem’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.
5Orem’s Nursing Process Consists of 3 steps:Step 1: determine why a patient needs careStep 2: design a nursing system & plan the delivery of careStep 3: management of nursing systems - planning, initiating, & controlling nursing actions
6Orem’s General Theory of Nursing Consists of three related theories collectively referred to as “Orem’s General Theory of Nursing”:Self-care Theory: 3 types of self-care requisites (needs) or categoriesSelf-care Deficit Theory: 5 Methods of AssistanceNursing Systems Theory
7Orem’s Self-care Theory Based on the concepts of:SELF-CARESELF-CARE AGENCYSELF-CARE REQUISITESTHERAPEUTIC SELF-CARE DEMAND
8Self-care DefinitionSelf-care comprises those activities performed independently by an individual to promote and maintain personal well-being throughout life.
9Orem’s Self-care Agency Definition: the individual’s ability to perform self-care activitiesConsists of TWO agents:Self-care Agent - person who provides the self-careDependent Care Agent - person other than the individual who provides the care (such as a parent)
10Orem’s Self-care Requisites (also called Self-care Needs) Definition: the actions or measures used to provide self-careConsists 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 & disease or its treatment
11Orem’s Self-care Deficit Theory Is the central focus of Orem’s Grand Theory of NursingExplains when nursing is neededDescribes and explains how people can be helped through nursingResults when the Self-care Agency (patient) can’t meet her/his self-care needs or administer self-careNursing meets these self-care needs through five methods of help
12Five Methods of Nursing Help Acting or doing forGuidingTeachingSupportingProviding an environment to promote the patient’s ability to meet current or future demands
13Orem’s Nursing Systems Theory Describes... Nursing responsibilitiesRoles of the nurse and patientRationales for the nurse-patient relationshipTypes of actions needed to meet the patient’s demands
14Orem’s Nursing Systems Theory Refers to a series of actions a nurse takes to meet a patient’s self-care needsIs determined by the patient’s self-care needsIs composed of THREE systems:Wholly compensatoryPartly compensatorySupportive-educative
15Three Nursing SystemsWholly Compensatory: a patient’s self-care agency is so limited that s/he depends on others for well-beingPartly Compensatory: a pt can meet some self-care requisites but needs a nurse to help meet othersSupportive-educative: a pt can meet self-care requisites but needs help in decision-making, behavior control, or knowledge acquisition
16Orem’s Theory & Nursing’s Metaparadigm - PERSON The recipient of nursing careA being who functions biologically, symbolically, and sociallyHas the potential for learning & developmentIs subject to the forces of natureHas a capacity for self-knowledgeCan engage in deliberate actions, interpret experiences, and perform beneficial actionsCan learn to meet self-care needs (requisites)
17Orem’s Theory & Nursing’s Metaparadigm - PERSON Human beings are distinguished from other living beings by their capacity to:Reflect upon themselves and their environmentSymbolize what they experienceUse symbolic creations (ideas, words) in thinking, communicating, and guiding efforts to make things that are beneficial for themselves and/or for others
18Orem’s Theory & Nursing’s Metaparadigm - ENVIRONMENT Environmental Conditions - external physical & psychosocial surroundingsDevelopmental Environment - promotion of personal development through motivation to establish appropriate goals & to adjust behavior to meet those goalsCan positively or negatively impact a person’s ability to provide self-care
19Orem’s Theory & Nursing’s Metaparadigm - NURSING A service geared towards helping the self and othersIs required when self-care demands exceed a patient’s self-care ability (agency)Promotes the patient as a self-care agentHas several components
20Components of NURSINGNURSING ART: the theoretical base of nursing and other disciplines such as sciences, art, humanitiesNURSING 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 actNURSING SERVICE: a helping serviceNURSING AGENCY: the ability of the RN
21Orem’s Theory & Nursing’s Metaparadigm - NURSING ROLE THEORY: the role of the nurse & patient are complementary as they work together to achieve self-careSPECIAL TECHNOLOGIES:Social & Interpersonal technologies - communicating, coordinating, establishing & maintaining therapeutic relations, rendering assistanceRegulatory technologies - maintaining and promoting life processes, growth/development, and psycho-physiologic modes of functioning
22Orem’s Theory & Nursing’s Metaparadigm - HEALTH Supports health promotion and health maintenanceSupports the premises of holistic health in that both RN and patient promote the individual’s responsibility for self care
23Orem’s Key Contribution To Nursing The continued evolution of original ideas to further delineate nursing practice, functions, self-care needs, and nursing systems based on research.