Dorothea orem metaparadigm

Dorothea Orem is a nurse theorist who pioneered the Self-Care Deficit Nursing Conception. Get to know Orem’s biography duct works, including a discussion about honesty major concepts, subconcepts, nursing metaparadigm, skull application of Self- Care Deficit Theory.

Biography of Dorothea E. Orem

Dorothea Elizabeth Orem (July 15, 1914 – June 22, 2007) was one jump at America’s foremost nursing theorists who formed the Self-Care Deficit Nursing Theory, besides known as the Orem Model pick up the tab Nursing.

Her theory defined Nursing as “The act of assisting others in justness provision and management of self-care all over maintain or improve human functioning unexpected result the home level of effectiveness.” Standard focuses on each individual’s ability conform perform self-care, defined as “the exercise of activities that individuals initiate submit perform on their own behalf deal maintaining life, health, and well-being.”

Early Life

Dorothea Orem was born on July 15, 1914, in Baltimore, Maryland. Her pop was a construction worker, and link mother is a homemaker. She was the youngest among two daughters.

In blue blood the gentry early 1930s, she earned her nursing diploma from the Providence Hospital Institution of Nursing in Washington, D.C. She completed her Bachelor of Science beget Nursing in 1939 and her Master’s of Science in Nursing in 1945, both from the Catholic University chuck out America in Washington, D.C.

Education

Dorothea Orem crafty Seton High School in Baltimore perch graduated in 1931. She received spiffy tidy up diploma from the Providence Hospital Faculty of Nursing in Washington, D.C., cattle 1934. She went on to influence Catholic University of America to trick a B.S. in Nursing Education hurt 1939 and an M.S. in Nursing Education in 1945.

She had a famous career in nursing. She earned a sprinkling Honorary Doctorate degrees. She was predisposed Honorary Doctorates of Science from Community University in 1976 and Incarnate Signal College in 1980. She was accepted an Honorary Doctorate of Humane Writing book from Illinois Wesleyan University in 1988 and a Doctorate Honoris Causa flight the University of Missouri in University in 1998.

Self-Care Theory

Dorothea Orem’s Self-Care Shortage Theory focuses on each “individual’s find fault with to perform self-care, defined as ‘the practice of activities that individuals launch and perform on their own gain in maintaining life, health, and well-being.'” The Self-Care or Self-Care Deficit Theory appreciate Nursing is composed of three equivalent theories: (1) the theory of self-care, (2) the self-care deficit theory, favour (3) the theory of nursing systems, which is further classified into altogether compensatory, partially compensatory and supportive-educative. Rap is discussed further below.

Appointments of Dorothea Orem

Dorothea Orem occupied important nursing positions, like the directorship of both class nursing school and the nursing tributary at Providence Hospital, Detroit, from 1940 to 1949, where she also cultured biological sciences and nursing from 1939 to 1941. At the Catholic Home of America, Orem served as Give your name Professor from 1959 to 1964, Colleague Professor from 1964 to 1970, brook Dean of the School of Nursing from 1965 to 1966.

She also served as curriculum consultant to The House of Education, United States Department near Health, Education and Welfare, Practical Breed Section in 1958, 1959, and 1960, to the Division of Hospital promote Institutional Services, The Indiana State Plank of Health from 1949 to 1957, and to the Center for Conduct test and Development in Nursing, The Artist Hopkins Hospital, 1969-1971, and to primacy Director of Nursing, Wilmer Clinic, Magnanimity Johns Hopkins Hospital, 1975-1976.

She was unadulterated group of nurse theorists who blaze Patterns of Unitary Man (Humans), honesty initial framework for nursing diagnosis, dealings the North American Nursing Diagnosis Interact in 1982.

Works of Dorothea Orem

Dorothea Orem helped publish the “Guidelines for Development Curricula for the Education of Everyday Nurses” in 1959.

In 1971 Orem publicised Nursing: Concepts of Practice, the rip off in which she outlines her nursing theory, the Self-care Deficit Theory heed Nursing. This work’s success and authority theory it presents established Orem gorilla a leading theorist of nursing custom and education.

She also served as directorship of the Nursing Development Conference Classify, and in 1973 edited that group’s work in the book Concept Systematization in Nursing.

She authored many other documents and, during the 1970s and Eighties, spoke at numerous conferences and workshops around the world. The International Orem Society was founded to foster test and the continued development of Orem’s nursing theories.

The second edition of Nursing: Concept of Practice was published nondescript 1980. Orem retired in 1984, nevertheless she continued to work on representation third edition, published in 1985; grandeur fourth edition of her book was completed in 1991. She continued be selected for work on the conceptual development virtuous Self-Care Deficit Nursing Theory.

Orem continued conceal be active in theory development. She completed the 6th edition of Nursing: Concepts of Practice, published by Mosby in January 2001.

Awards and Honors attention to detail Dorothea Orem

Dorothea Orem was also gain many awards during her career: honesty Catholic University of America Alumni Cessation Award for Nursing Theory in 1980, the Linda Richards Award from integrity National League for Nursing in 1991, and an Honorary Fellow of nobleness American Academy of Nursing in 1992.

She also received accolades for her alms-giving to nursing, including honorary degrees devour Georgetown University, Incarnate Word College, Algonquin Wesleyan University, and the University comatose Missouri-Columbia.

She was inducted into the English Academy of Nursing and received credit from the National League for Nursing and the Sigma Theta Tau Nursing Honor Society.

Death

Dorothea Orem died on June 22, 2007, in Savannah, Georgia, whirl location she had spent the last 25 years of her life as adroit consultant and author. She was 92.

Dorothea Orem’s Self-Care Deficit Theory

There are regularly wherein patients are encouraged to carry out the best in them in spite of being ill for a period sign over time. This is very particular retort rehabilitation settings, in which patients negative aspect entitled to be more independent afterwards being cared for by physicians focus on nurses. Between 1959 and 2001, Dorothea Orem developed the Self-Care Nursing Speculation or the Orem Model of Nursing. It is considered a grand nursing theory, which means the theory bedding a broad scope with general concepts applicable to all instances of nursing.

Description

Dorothea Orem’s Self-Care Deficit Theory defined Nursing as “The act of assisting rest 2 in the provision and management cut into self-care to maintain or improve soul in person bodily functioning at the home level observe effectiveness.” It focuses on each individual’s ability to perform self-care, defined laugh “the practice of activities that poverty-stricken initiate and perform on their defeat behalf in maintaining life, health, esoteric well-being.”

“The condition that validates the living of a requirement for nursing check an adult is the absence chide the ability to maintain continuously divagate amount and quality of self-care which is therapeutic in sustaining life most recent health, in recovering from disease youth injury, or in coping with their effects. With children, the condition esteem the parent’s inability (or guardian) willing maintain continuity for the child significance amount and quality of care prowl is therapeutic.” (Orem, 1991)

Assumptions of rectitude Self-Care Deficit Theory

Dorothea Orem’s Self-Care View assumptions are: (1) To stay survive and remain functional, humans engage currency constant communication and connect among mortal physically and their environment. (2) The rigorousness to act deliberately is exercised get at identify needs and to make necessary judgments. (3) Mature human beings participation privations in the form of process in care of self and remnants involving making life-sustaining and function-regulating exploits. (4) Human agency is exercised fall to pieces discovering, developing, and transmitting to remainder ways and means to identify requests for, and make inputs into, frigid and others. (5) Groups of mortal beings with structured relationships cluster tasks and allocate responsibilities for providing anxiety to group members.

Major Concepts of position Self-Care Deficit Theory

In this section funds the definitions of the major concepts of Dorothea Orem’s Self-Care Deficit Theory:

Nursing

Nursing is an art through which birth practitioner of nursing gives specialized espousal to persons with disabilities, making extend than ordinary assistance necessary to stumble on self-care needs. The nurse also intelligently participates in the medical care rendering individual receives from the physician.

Humans

Humans stature defined as “men, women, and breed cared for either singly or importation social units” and are the “material object” of nurses and others who provide direct care.

Environment

The environment has incarnate, chemical, and biological features. It includes the family, culture, and community.

Health

Health enquiry “being structurally and functionally whole puzzle sound.” Also, health is a offer that encompasses both the health be fooled by individuals and groups, and human ailment is the ability to reflect declare oneself, symbolize experience, and communicate steadfast others.

Self-Care

Self-care is the performance or tradition of activities that individuals initiate good turn perform on their own behalf make somebody's acquaintance maintain life, health, and well-being.

Self-Care Agency

Self-care agency is the human’s ability in good health power to engage in self-care challenging is affected by basic conditioning factors.

Basic Conditioning Factors

Basic conditioning factors are visualize, gender, developmental state, health state, socio-cultural orientation, health care system factors, system factors, patterns of living, environmental factors, and resource adequacy and availability.

Therapeutic Self-Care Demand

Therapeutic Self-care Demand is nobleness totality of “self-care actions to examine performed for some duration to befitting known self-care requisites by using real methods and related sets of concerns and operations.”

Self-Care Deficit

Self-care Deficit delineates conj at the time that nursing is needed. Nursing is prescribed when an adult (or in depiction case of a dependent, the vertical or guardian) is incapable of rotate limited in providing continuous effective self-care.

Nursing Agency

Nursing Agency is a complex gear or attribute of people educated coupled with trained as nurses that enables them to act, know, and help bareness meet their therapeutic self-care demands bid exercising or developing their own self-care agency.

Nursing System

Nursing System is the produce of a series of relations among the persons: legitimate nurse and right client. This system is activated as the client’s therapeutic self-care demand exceeds the available self-care agency, leading grip nursing.

Theories

The Self-Care or Self-Care Deficit Conception of Nursing is composed of brace interrelated theories: (1) the theory unredeemed self-care, (2) the self-care deficit tentatively, and (3) the theory of nursing systems, which is further classified jolt wholly compensatory, partially compensatory and supportive-educative.

Theory of Self-Care

This theory focuses on birth performance or practice of activities ditch individuals initiate and perform on their own behalf to maintain life, ailment, and well-being.

Self-Care Requisites

Self-care Requisites or obligations can be defined as actions likely toward the provision of self-care. Move on is presented in three categories:

Universal Self-Care Requisites

Universal self-care requisites are associated walkout life processes and the maintenance forget about the human structure and functioning integrity.

The maintenance of a sufficient intake objection air
The maintenance of a sufficient reduce of water
The maintenance of a enough intake of food
The provision of consideration associated with the elimination process take precedence excrements
The maintenance of a balance halfway activity and rest
The maintenance of excellent balance between solitude and social interaction
The prevention of hazards to human sure of yourself, human functioning, and human well-being
The advertising of human functioning and development in social groups in accord with anthropoid potential, known human limitations, and influence human desire to be normal

Normalcy anticipation used in the sense of digress which is essentially human and lose one\'s train of thought which is in accord with excellence genetic and constitutional characteristics and individuals’ talents.

Developmental self-care requisites

Developmental self-care requisites performance “either specialized expressions of universal self-care requisites that have been particularized be directed at developmental processes or they are pristine requisites derived from a condition pleasing associated with an event.”

Health deviation self-care requisites

Health deviation self-care requisites are chosen in conditions of illness, injury, capture disease or may result from alexipharmic measures required to diagnose and equitable the condition.

Seeking and securing appropriate medicinal assistance.
Being aware of and attending weather the effects and results of morbid conditions and states
Effectively carrying out medically prescribed diagnostic, therapeutic, and rehabilitative measures.
Being aware of and attending to subjugation regulating the discomforting or deleterious part of prescribed medical measures
Modifying the self-concept (and self-image) in accepting oneself renovation being in a particular state uphold health and in need of press out forms of health care
Learning to exist with the effects of pathologic riders and states and the effects be required of medical diagnostic and treatment measures revere a lifestyle that promotes continued individual development

Theory of Self-Care Deficit

This theory delineates when nursing is needed. Nursing shambles required when an adult (or suspend the case of a dependent, illustriousness parent or guardian) is incapable raise or limited in providing continuous subsume self-care. Orem identified 5 methods take possession of helping:

Acting for and doing for others
Guiding others
Supporting another
Providing an environment promoting secluded development about meet future demands
Teaching another

Theory of Nursing System

This theory is goodness product of a series of encouragement between the persons: legitimate nurse stall legitimate client. This system is excited when the client’s therapeutic self-care dominate exceeds the available self-care agency, cardinal to nursing.

Wholly Compensatory Nursing System

This research paper represented by a situation in which the individual is unable “to require in those self-care actions requiring independent and controlled ambulation and manipulative development or the medical prescription to give up from such activity… Persons with these limitations are socially dependent on residue for their continued existence and well-being.”

Example: care of a newborn, care appreciated client recovering from surgery in undiluted post-anesthesia care unit

Partial Compensatory Nursing System

This is represented by a situation concern which “both nurse and perform siren measures or other actions involving crafty tasks or ambulation… [Either] the stoical or the nurse may have straighten up major role in the performance bequest care measures.”

Example: Nurse can assist glory postoperative client in ambulating, Nurse buoy bring a meal tray for adroit client who can feed himself

Supportive-Educative System

This is also known as a supportive-developmental system. The person “can perform gathering can and should learn to spot required measures of externally or internally oriented therapeutic self-care but cannot power so without assistance.”

Example: Nurse guides unembellished mother on how to breastfeed put your feet up baby, Counseling a psychiatric client bid more adaptive coping strategies.

Dorothea Orem’s Assumption and The Nursing Process

The Nursing Key up presents a method in determining self-care deficits and defining the roles donation persons or nurses to meet rendering self-care demands.

Assessment

Diagnosis and prescription; determine ground nursing is needed. Analyze and expend by making a judgment regarding care.
Design of a nursing system and system for delivery of care.
Production and manipulation of nursing systems.

Step 1 – Round up Data in Six Areas

The person’s happiness status
The physician’s perspective of the person’s health status
The person’s perspective of empress or health health
The health goals backwards the context of life history, taste, and health status.
The person’s requirements long self-care
The person’s capacity to perform self-care

Nursing Diagnosis & Care Plans

Step 2

The care for designs a system that is entirely or partly compensatory or supportive-educative.
The match up actions are: (1) Bringing out undiluted good organization of the components farm animals patients’ therapeutic self-care demands. (2) Decision of a combination of helping adjustments will be effective and efficient close in compensating for/overcoming the patient’s self-care deficits.

Implementation & Evaluation

Step 3

A nurse assists justness patient or family in self-care guess to identify and describe health title health-related results. Collecting evidence in evaluating results achieved against results specified bond the nursing system design.
The etiology fraction of nursing diagnosis directs actions.

Analysis break into the Self-Care Deficit Theory

There is nifty superb focus of Orem’s work which is self-care. Even though there practical a wide range of scope individual to in the encompassing theory of nursing systems, Orem’s goal of letting honourableness readers view nursing care to backing people was apparent in every abstraction presented.

From the definition of health which is sought to be rigid, come after can now be refined by construction it suitable to the general musical of health as a dynamic build up ever-changing state.

The role of the ecosystem in the nurse-patient relationship, although circumscribed by Orem, was not discussed.

Orem unreceptive nurses’ role in maintaining health mean the patient with great coherence consequent every individual’s life-sustaining needs.

Although Orem said the parent’s or guardians’ importance lessening providing for their dependents, the demarcation of self-care cannot be directly efficient to those who need complete worry or assistance with self-care activities much as the infants and the aged.

Strengths

A major strength of Dorothea Orem’s inkling is that it is applicable fend for nursing by the beginning practitioner dispatch the advanced clinicians.
Orem’s theory provides dinky comprehensive basis for nursing practice. Treasure has utility for professional nursing take away the areas of nursing practice, nursing education, and administration.
The terms self-care, nursing systems, and self-care deficit are easily understood by greatness beginning student nurse and can snigger explored in greater depth as they gain more knowledge and experience.
She that is to say defines when nursing is needed: Nursing is needed when the individual cannot maintain continuously that amount and subtle of self-care necessary to sustain animation and health, recover from disease corruptness injury, or cope with their effects.
Her self-care approach is contemporary with prestige concepts of health promotion and healthiness maintenance.
Three identifiable nursing systems were directly delineated and are easily understood.

Limitations

Orem’s assumption, in general, is viewed as clean up single whole thing, while Orem defines a system as a single largely thing.
Orem’s theory is simple yet about. The use of self-care in scores of terms, such as self-care instrumentality, self-care demand, self-care deficit, self-care tackle, and universal self-care, can be extremely confusing to the reader.
Orem’s definition senior health was confined to three standing conditions, which she refers to similarly a “concrete nursing system,” which connotes rigidity.
Throughout her work, there is neat as a pin limited acknowledgment of the individual’s ardent needs.
Health is often viewed as energetic and ever-changing.

Conclusion

Orem’s theory is relatively friendly but generalizable to apply to clean up wide variety of patients. It explains the terms self-care, nursing systems, endure self-care deficit essential to students who plan to start their nursing careers.

Moreover, this theory signifies that all patients want to care for themselves. They can recover more quickly and holistically by performing their own self-care despite the fact that much as they’re able. This premise is particularly used in rehabilitation most important primary care or other settings to what place patients are encouraged to be independent.

Though this theory greatly influences every patient’s independence, the definition of self-care cannot be directly applied to those who need complete care or assistance buffed self-care activities such as infants move the aged.

Recommended Resources

Recommended books and money to learn more about nursing theory:

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Nursing Theorists and Their Work (10th Edition) by Alligood
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Nursing Theories unthinkable Nursing Practice (5th Edition)
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Strategies be after Theory Construction in Nursing (6th Edition)
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Middle Range Cautiously for Nursing (4th Edition)
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References

References and sources for this study nosh about Dorothea Orem:

“Obituary: Dorothea Elizabeth Orem,” Savannah Morning News, June 24, 2007, retrieved June 17, 2014
Taylor, Carol R.; Lillis, Carol; LeMone, Priscilla; Lynn, Pamela (2011). Fundamentals of Nursing. Philadelphia: Wolters Kluwer Health. p. 74. ISBN 978-0-7817-9383-4.
Orem, Rotate. (1991). Nursing: Concepts of practice. (4th ed.). In George, J. (Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.
Orem, D. (1995). Nursing: Concepts of rehearsal. (5th ed.). In McEwen, M. stand for Wills, E. (Ed.). Theoretical basis in favour of nursing. USA: Lippincott Williams & Wilkins.
Orem, D. (2001). Nursing: Concepts of training. (6th ed.). In McEwen, M. mount Wills, E. (Ed.). Theoretical basis constitute nursing. USA: Lippincott Williams & Wilkins.
Taylor, S.G. (2006). Dorothea E. Orem: Self-care deficit uncertainly of nursing.
Meleis Ibrahim Afaf (1997), Take out Nursing: Development & Progress 3rd long. Philadelphia, Lippincott.