Presented by Melissa Kurek , Nicholas Kurek , Kimberly Marino and Heather Nowak Dorothea Orem’s ...
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PRESENTED BY MELISSA KUREK, NICHOLAS KUREK, KIMBERLY MARINO AND HEATHER NOWAK
DOROTHEA OREM’S THEORY OF SELF CARE DEFICIT
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Born in Baltimore, Maryland in 1914
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Orem’s parents
Mother was a homemaker
Father was a construction worker
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1930- graduated from Providence Hospital School of Nursing, Washington, DC
1935- BSN from Catholic University of America
1945-MSN from Catholic University of America
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Orem’s World of Academia
1959- Dean of the School of Nursing at Catholic University of America
1976- Doctorate of Science from Georgetown University 1988- Doctor of Humane Letters from Illinois Wesleyan
University 1998- Doctor of Nursing Honoris Causae from University of
Missouri Retired in 1984
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Orem’s nursing experience
Operating room nurse
Staff nurse Private duty nurse Nurse educator Nurse
administrator Nurse consultant
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Died June 22, 2007
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The Historical Evolution of Orem’s Model
Orem worked on developing
nursing curriculum and nursing
practice
1949-1957
Worked for the Office of
Education, in the U.S. Dept. of
Health, Education and Welfare as a
curriculum consultant
1958-1960
Guidelines for Developing
Curricula for the Education of
Practical Nurses was developed
( Tomey and Alligood, 2006).
1958-1960 cont’d
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Evolution continued
Eventually served as the acting dean of
the School of Nursing at the
Catholic University of America
1960-
1970
Published Nursing: Concepts of
Practice
1971
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Metaparadigms of Orem’s Model
Person Environment Health Nursing
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Metaparadigm: Person
An individual or group of individuals who have the ability to acquire the knowledge necessary to perform tasks of self care.
Ability to integrate self-care tasks and family, community and individual needs.
Motivation to accomplish self care tasks.
Intellectual ability to cognitively perform, delegate and evaluate tasks performed.
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Metaparadigm: Health
“Promotes function and development within social groups in accordance with human potential, known human limitation, and the human desire to return to normal” (Tomey & Alligood, 2006 p. 279).
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Metaparadigm: Environment4 realms of state are encompassed in Environment:
Physical Chemical Biological Socioeconomical
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Environment continued
Environment – Physical Shelter Security- internal
and external Climate Amenities eg. Heat,
electricity, indoor plumbing, sanitation…
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Environment-Chemical
Chemical Pollutants:
Air Water
Physical Lead paints Mercury Asbestos
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Environment-Biological
Biological Molds Pollens Allergens Mites Animal waste and
its by-products
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Environment-Socioeconomic
Socioeconomic Family income Education level Occupation Social status Resources
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Metaparadigm: NursingThe skilled professional who evaluates and acknowledges a patient’s health deficit.
Nursing plans and implements care based on the actual and potential self-care deficits.
Task Performanc
e
Self-Care Promotion
DemographicsSupportive
Coordinated
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Concepts Unique to Orem’s Model
Three Nursing Theories1. The Theory of
Self Care2. The Theory of
Self-Care Deficit3. The Theory of
Nursing Systems
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Theory of Self-Care
“Self –care comprises the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interest of maintaining life, healthful functioning, continuing personal development and well-being through meeting known requisites for functional and developmental regulations”(Tomey & Alligood, 2006 p.269).
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Theory of Self-Care continued The Theory of Self-
Care has three components: universal self-care needs, developmental self-care needs and health deviation.
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Theory of Self-Care Deficit
A self-care deficit occurs when an individual cannot carry out self-care requisites.
Examples of self-care requisites are: Wound care Activities of Daily Living Bowel program Glucose monitoring
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Universal Self-Care Requisites
The 8 elements : Air Food Water Elimination/
Excretion Activity & Rest Solitude/Social
interaction Functioning/Well-
being Normalcy
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Developmental Self-Care Requisites
Composed of 3 needs Promote
development Engage in self-
development Preventing or
overcoming adverse human conditions and life situations
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Health Deviation Self-Care Requisites
When a condition permanently or temporarily alters structural, physiological or psychological function. Comatose states Autism Mental Retardation
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Theory of Nursing Systems
Total compensatory support- patient is unable to complete any self-care independently; nursing compensates for patient’s inability to perform self-care.
Partial compensatory support- patient is able to perform self-care tasks with partial or no assistance from nursing.
Educative/supportive compensatory– patient able to perform tasks independently. Nursing provides ongoing education and support.
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Clinical Practice Models for Patient AssessmentTheory applies to multiple clinical settings.
Theory applied in order to:
Home By the patient alone or
with assistance provided
Doctor’s office Education provided and
care supervised by a nurse
Hospital Needs identified,
assessed and plan of care implemented
Extended care facility
Help identify the patient’s ability for self-care deficits that need to be addressed to promote health.
Help identify support available to patient such as family and environment.
Encourage patient to develop self-care abilities
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Orem’s Theory Applied to Nursing Education
Teaches the student to encourage compensatory care in the patient population.
Conceptualize patients’ current and potential self-care deficits.
Supports the nursing process in all 3 nursing theories.
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Research Status of Orem’s Model
Model used by multiple nursing specialties due to encompassing nature of Orem’s theory.
Current research using Orem’s theory would include: Chinese Medicine Battered woman
counseling
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Orem’s Strengths
The Self Care Deficit Theory is specific to nursing.
The Theory can be used in multiple nursing specialties.
The concept of self-care and health maintenance are congruent with contemporary literature in healthcare.
The theory creates a coordinated nursing care plan that adjusts to the patient’s needs throughout recovery.
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Orem’s Limitations
Time consuming for nurses
Direct contact is necessary throughout the nursing process.
Multiple levels of the theory to consider Self care, self care deficit and self care deficit potential.
Does not address cultural needs
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Analysis and Insights
Three theories combined into one.
Cumbersome Completely
dependent on nursing to assess the patient and family’s ability to complete self-care requisites and deficits
Culturally diverse
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References
Marrier Tomey, A. & Alligood, M. (2006). Nursing theorists and their work. (6th ed.) St. Louis, MO : Mosby Elsevier.
Bruce, E., Gagnon, C., Gendron, Puteris, L., & Tamblyn, A.(2009, November 7). Dorothea Orem’s Theory of Self Care. Retrieved from http://www.nipissingu.ca/faculty/arohap/aphome/NURS3006/Resources/DorotheaOremTheory.ppt
Dorothea Orem, Nursing Theory ( 2009, November 7). Retrieved from http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps
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Like it you do.Like it you do. An A you must
give, Educated
One.