Dorothea Orem

Nursing Theory

Dorothea Orem
Early 1930’s - AD from Providence School of Nursing, Washington, D.C.  1939 – BSN completed  1945 - MS in nursing education  1958 - consultant to the Office of Education where she began working on her SELF-CARE THEORY

Dorothea Orem 1959 .first published her theory in “Guides for Developing Curricula for the Education of Practical Nurses” (a government publication)  1976 .honorary Doctorate of Science from Georgetown University  1999 .last edition of her theory was published  .

. or coping with their effects. in recovering from disease or injury.Orem’s Definition of Nursing  Nursing is the provision of self-care which is therapeutic in sustaining life and health. not a derivative of medicine.  Nursing promotes the goal of patient self-care.  Nursing is a service to people.

Orem’s Nursing Process Consists of 3 steps:  Step 1: determine why a patient needs care  Step 2: design a nursing system & plan the delivery of care  Step 3: management of nursing systems planning. & controlling nursing actions . initiating.

3. Self-care Deficit Theory: 5 Methods of Assistance Nursing Systems Theory . 2.Orem’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 categories 1.

Orem’s Self-care Theory  Based on the concepts of:  SELF-CARE  SELF-CARE AGENCY  SELF-CARE REQUISITES  THERAPEUTIC SELF-CARE DEMAND .

.Self-care Definition  Self-care comprises those activities performed independently by an individual to promote and maintain personal wellbeing throughout life.

person other than the individual who provides the care (such as a parent) .person who provides the self- care – Dependent Care Agent .Orem’s Self-care Agency Definition: the individual’s ability to perform self-care activities  Consists of TWO agents:  – Self-care Agent .

needs resulting from illness. injury & disease or its treatment .requisites/needs that are common to all individuals – Developmental .needs resulting from maturation or develop due to a condition or event – Health Deviation .Orem’s Self-care Requisites (also called Self-care Needs)  Definition: the actions or measures used to provide selfcare  Consists of THREE categories: – Universal .

Orem’s Self-care Deficit Theory      Is the central focus of Orem’s Grand Theory of Nursing Explains when nursing is needed Describes and explains how people can be helped through nursing Results when the Self-care Agency (patient) can’t meet her/his self-care needs or administer self-care Nursing meets these self-care needs through five methods of help .

Five Methods of Nursing Help  Acting or doing for  Guiding  Teaching  Supporting  Providing an environment to promote the patient’s ability to meet current or future demands .

.  Nursing responsibilities  Roles of the nurse and patient  Rationales for the nurse-patient relationship  Types of actions needed to meet the patient’s demands .Orem’s Nursing Systems Theory Describes..

Orem’s Nursing Systems Theory  Refers to a series of actions a nurse takes to meet a patient’s self-care needs  Is determined by the patient’s self-care needs  Is composed of THREE systems: – Wholly compensatory – Partly compensatory – Supportive-educative .

Three Nursing Systems Wholly Compensatory: a patient’s self-care agency is so limited that s/he depends on others for well-being  Partly Compensatory: a pt can meet some selfcare requisites but needs a nurse to help meet others  Supportive-educative: a pt can meet self-care requisites but needs help in decision-making. or knowledge acquisition  . behavior control.

interpret experiences.PERSON        The recipient of nursing care A being who functions biologically.Orem’s Theory & Nursing’s Metaparadigm . and perform beneficial actions Can learn to meet self-care needs (requisites) . and socially Has the potential for learning & development Is subject to the forces of nature Has a capacity for self-knowledge Can engage in deliberate actions. symbolically.

communicating.PERSON  Human beings are distinguished from other living beings by their capacity to: – Reflect upon themselves and their environment – Symbolize what they experience – Use symbolic creations (ideas. and guiding efforts to make things that are beneficial for themselves and/or for others . words) in thinking.Orem’s Theory & Nursing’s Metaparadigm .

Orem’s Theory & Nursing’s Metaparadigm .ENVIRONMENT  Environmental Conditions .promotion of personal development through motivation to establish appropriate goals & to adjust behavior to meet those goals  Can positively or negatively impact a person’s ability to provide self-care .external physical & psychosocial surroundings  Developmental Environment .

NURSING  A service geared towards helping the self and others  Is required when self-care demands exceed a patient’s self-care ability (agency)  Promotes the patient as a self-care agent  Has several components .Orem’s Theory & Nursing’s Metaparadigm .

to decide to act in a particular manner.Components of NURSING  NURSING ART: the theoretical base of nursing and other disciplines such as sciences. and/or to act  NURSING SERVICE: a helping service  NURSING AGENCY: the ability of the RN . art. humanities  NURSING PRUDENCE: the quality that enables the nurse to seek advice in new or difficult situations. to make correct judgements.

establishing & maintaining therapeutic relations.Orem’s Theory & Nursing’s Metaparadigm . growth/development. and psycho-physiologic modes of functioning . rendering assistance – Regulatory technologies . coordinating.NURSING  ROLE THEORY: the role of the nurse & patient are complementary as they work together to achieve selfcare  SPECIAL TECHNOLOGIES: – Social & Interpersonal technologies communicating.maintaining and promoting life processes.

Orem’s Theory & Nursing’s Metaparadigm .HEALTH  Supports health promotion and health maintenance  Supports the premises of holistic health in that both RN and patient promote the individual’s responsibility for self care .

. functions. self-care needs. and nursing systems based on research.Orem’s Key Contribution To Nursing  The continued evolution of original ideas to further delineate nursing practice.

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