Dorothea Orem’s Self-Care deficit: Its influence on nursing practice among

nursing students

Bedecir, Shanice Shaira

Cunada, Bea Alexandria
Marin, Alyssa Nicole
Toledo, Kim Heather
Nuevaespana, Jayne Angelie
Daniel, Erika Jane
Catalan, Minitte
Arboleda, Dinese
Funa, Pamela
Garcia, Kim Jude
 Introduction

When an individual is unable to meet their own self-care requisites, a "self-

care deficit" occurs. It is the job of the Nurse to determine these deficits, and define
a support modality. However, recent studies show reports of neglect from
patients. Patient neglect is found to have two aspects. First, procedure neglect,
which refers to failures of nurses to achieve objective standards of care. Second,
caring neglect, which refers to behaviours that lead patients and observers to
believe that nurses have uncaring attitudes (Reader and Gillespie, 2013). Nurses
on the other hand, who work shifts also have acknowledged falling asleep when
working. Another study indicated almost one-fifth of nurses working the permanent
night shift indicated they struggled to stay awake while taking care of a patient at
least once during the previous month, (Brent, 2018) thus some of this night shift
nurses does not live much attention in attending the patients need for self-care.
The nursing theory of Dorothea Orem is based upon the philosophy that all
"patients wish to care for themselves". They can recover more quickly and
holistically if they are allowed to perform their own self-cares to the best of their
ability. Orem's self-care deficit nursing theory emphasized on establishing the
nursing perspectives regarding human and practice.
Orem’s self-care deficit theory suggests patients are better able to recover
when they maintain some independence over their own self-care. Nurses use the
term activities of daily living to refer to the aspects of self-care that patients are
having trouble with. When nurses find that patients are showing signs of self-care
deficit, they look for ways to help them while allowing for individual autonomy. How
do nurses determine whether a patient is facing a self-care deficit? Orem’s theory
includes three steps. First, a nurse gathers information about the patient. This
includes the patient’s health, needs, goals, and capacity, from the perspective of
both the patient and the attending physician. Next, the nurse strategizes ways to
help the patient with his or her self-care deficit. Next, the nurse works directly with
the patient to meet these needs.
 Orem’s contribution to the field of nursing is substantial. Every day, nurses
diagnose self-care deficits, and this allows them to craft solutions for their patients
while staying mindful of their need to be independent and feel like they have control
over their rehabilitation and treatment.
Orem’s theory is very practical and is very much applicable not only in the
hospital setting but also at home. This theory, not only, helped to move nursing
from occupation to profession, it is one of the most commonly used in practice. It
helps nurses to develop their own style to develop efficient high quality nursing
care. The role of the nurse is not only limited to covering up the deficit but it also
extends to educating the individual about the disease process.
This hospital received complaints about nurses’ poor attitudes and poor
standards of nursing care. Nurses’ attitudes needed to be explored so that
strategies could be patients
The researcher of this term paper believe that nurses plays a very critical
role in supporting and promoting independence in patient care and we must give
to the patients the best nursing care to create positive patient outcome. Nowadays
hospitals received complaints about nurses’ poor attitudes and poor standards
of nursing care and this term paper served as a gateway to assess the nurses
attitudes needed to be explored so that strategies could be implemented to
improve the quality of care and address problems experienced by patients.
The objectives of this study is to determine the influence of Dorothea Orem’s Self-
Care deficit on nursing practice among nursing students.
(1) Determine the level of the influence of Dorothea Orem’s Self-Care
deficit on nursing practice among nursing students.
(2) Determine the significant relationship on the level of influence of
Dorothea Orem’s Self-Care deficit on nursing practice among nursing students
when they are grouped according to age, gender, and year level.

In view of the aforementioned problems, the following hypotheses were

advanced:
 1. There are no significant difference on the level of influence of Dorothea
self-care deficit on nursing practice among nursing students when they are
grouped according to age, gender, and year level.
2. There are no significant relationship on the level of influence of Dorothea
self-care deficit on nursing practice among nursing students when they are
grouped according to age, gender and year level.

Methods

The participants of the study were the twenty (20) students’ random
selected of Filamer Christian University who were having their duty and RLE in
Capiz Emmanuel Hospital during the first semester of academic year 2019-2020.
Random Sampling was used in this study.
To gather the data needed for this study, a researcher - made questionnaire
was used. This was divided into 3 parts composing 15 questions. The first part of
the questionnaire was designed to identify / measure the knowledge of student
nurses in assisting their patients in self-care. The second part aims to identify the
competence and performance of student nurses in meeting the self-care
requirements of their patients. The third part of the questionnaire was designed to
identify the attitude of the nurses on how they handle their patient who is unable
to meet their own self-care requisites. The questions were presented to the expert
for validation.

Results

Table 1 shows the evaluation of Dorothea Orem’s Self-Care deficit: Its

influence on nursing practice among nursing students by the twenty (20)
evaluators prior to nursing practice of Dorothea Orem’s Self-Care deficit. Result
show that Dorothea Orem’s self-care deficit is highly evident on the nursing
practice among nursing students with the mean of 4.40 and standard deviation of
0.359.

Mean Description SD

Level of influence 4.40 Highly Evident 0.359.

The result was highly evident in the influence of Dorothea Orem’s Self Care
Deficit on nursing practice among nursing students which is shown in table 1. It
was very high because nursing students applies the theory of Orem’s when it
comes in dealing patients with confidence in their skills, good attitude towards
approaching their patients and the have the knowledge with the nursing care plan
that they will give to their patients.

Table 1 also talks about Orem’s Self Care Deficit Theory is an effective
theory in relation to nurses’ performance with regards to the health care provision.
The result also showed that the nursing students can perform well with less
supervision of their instructors and has a good communication with the patient and
to determine the needs in regards with the self-care. This implies that nursing
students were well prepared and trained by their instructors who gives emphasis
about the theory of Dorothea Orem’s Self Care Deficit in incorporating it in the
academic scenario inside the classroom in terms of procedure, practice and
foundation of the school.

According to Hagbaghery and Copeland, theory with lecture demonstration

enables the students to acquire the skills and to work confidently when giving care
to the patients. Pointed out that competence and self-confidence are the most
important factors in allowing students to make appropriate decision in patient care.
This could be related to nursing students since self-care is very vital in clinical
practice, giving emphasis on this theory will lead to better quality of care provision
by the nursing students.
 Table 2 shows the mutual relationship or connection among nursing
students when they are grouped according to age, sex and year level. A Levine’s
Independent samples t-test was conducted to determine the influence of
Dorothea self-care deficit on nursing practice.

The result was there is no significant difference in the level of influence of

Dorothea self-care deficit on nursing practice among nursing students with ages
19-21 (M=4.35, SD=.355) and nursing students with ages 21-23
(M=4.69, SD= .268)

Group Statistics

Age N Mean Std. Deviation Std. Error Mean

Level of Influence 19-21

17 4.35 .355 .086

21-23
3 4.69 .268 .155

The result indicates that there is no significant difference in the degree of

influence of Dorothea's Self Care Deficit on clinical practice between nursing
students aged 19-21 and nursing students aged 21-23. This ensures that nursing
students can do the job, regardless of their age, in delivering the care needed by
the patient.

The influence of Dorothea Orem's self-care deficit in nursing students

aged 19-21 and nursing students aged 21-23 is evident. The subsequent age is
not relevant when dealing with patients with self-care problems because they are
taught in school of the things they have to do before their exposure to the
hospital and the number one priority of a nurse is to help the patient meet their
independency and being an instrument in helping patients get healthy comes
with no age. This implies that regardless of age of the care provider, self-care is
the priority of a nurse. As a Filipinos we are always compassionate towards our
fellowmen. Regardless of age, we are expected to act at all times with humility
and courtesy and respect especially in dealing with our patient who are in needs
as a care provider.

This result is supported by the study of (Thomas, Stefanie, 2014) which

states that any phase of life offers opportunities for the attainment of wisdom
related strengths as long as an individual is willing and able to actively engage in
life’s ongoing challenges.

The result was there is no significant difference in the level of influence of

Dorothea self-care deficit on nursing practice among male nursing students
(M=4.10, SD=.279) and female nursing students (M=4.53, SD= .315)

Group Statistics

Sex N Mean Std. Deviation Std. Error Mean

Level of Influence Male 6 4.10 .279 .114

Female 14 4.53 .315 .084

The findings indicates that the level of influence of Dorothea’s Self Care
Deficit on nursing practice among female nursing students does not differ from
male nursing students. This implies that male and female are both trained well in
terms of providing the best nursing care for their patients.

The influence of Dorothea Orem’s Self Care Deficit among males and
females is evident. Both male and female nursing students perform any task that
is assigned to them effectively and with no hesitations when it comes in dealing
patients with Self Care Deficit because the job of the nurse is to provide effective,
efficient, and holistic care to the patients.
 This result is supported by the study of (Evans 1997) which states that the
social construction of what it means to be a nurse has typically meant a caring,
hard working. Roles like nurturing, caring, dependency, submission given to her
are opposite from the ones that are attributed to men in society.

The result was there is no significant difference in the level of influence of

Dorothea self-care deficit on nursing practice among 2nd year nursing students
(M=4.23, SD=.311) and 4th year nursing students (M=4.57, SD= .340)

Group Statistics

Year Level N Mean Std. Deviation Std. Error Mean

Level of Influence 2nd 10 4.23 .311 .098

4th 10 4.57 .340 .107

The finding indicates that the level of influence of Dorothea Orem’s Self
Care Deficit on nursing practice among 2nd year nursing students does not differ
with 4th year nursing students. This implies that nursing students is prepared and
trained by their clinical instructors before they have their exposure in the hospital.
This is why they can manage what the nurses should do in regards of dealing
with the patients.

The influence of Dorothea Orem’s Self Care Deficit on nursing practice is

evident. They can attain the goal in giving specialized assistance to persons with
disabilities which makes more than ordinary assistance necessary to meet needs
for self-care and the dependency of the patients.

This result is supported by the Study of (Usana S. Saleh 2018) which

states that effective nursing practice requires the application of knowledge, skills
caring, and art to care for patients in an effective, efficient, and considerate way.
This could be related to nursing students to improve the practice by positively
influence the health and quality of life of the patients.
 Analysis

Conclusions

With the findings of the paper, the following conclusions were formed:

1. With knowledge, there is an influence on nursing practice among nursing

students. Based from the data, it is highly evident that a health provider should
have a knowledge in making the patient comfortable by his or her good assistance.
Based from the article stated by Jennifer Turcotte, RN, BSN, OCN (2017), patients
have different diseases and illnesses inside the hospital, the nurse should provide
good care in the patients and give his/her comfortable assistance to make the
patient feel ease at all costs. As a nurse, we must give to the patients the best
nursing care and take good care of them when we come to work each and every
day. It is important to make sure we’re always providing our best assistance to our
patients. Based on Nursing Times (2005), nursing knowledge is the means by
which the whole purpose of caring for patients is achieved because it underpins
what we actually do.

2. With skills, there is also an influence on nursing practice among nursing

students. Based from the data, it is highly evident that a nursing student can
perform a morning self-care to the patient with less supervision of the staff. Based
on The Balance Careers (2019), Nurses also need some soft skills, nurses should
have to be patient and empathetic towards both patients and patients’ families.

3. With attitude, there are two influences on nursing practice among nursing
students. Based from the data, a nursing student accept supervision and direction:
seek clarification and; have the patience to provide care and assistance for those
chronically ill patients who cannot perform self-care. Based on Nursing Standard
(2015), attitudes helps to understand how people perceive issues and processes in
care and determine what’s deem important, good, relevant and appropriate. Nurses
should understand attitudes of the people to provide collaborative, patient-centered
care.
 Recommendations

Based on the findings and conclusions, the following recommendations are

advanced:

Health Care Provider. It is recommended to have knowledge in

making the patient comfortable by his or her good assistance and to attend training
on the updates regarding Orem’s theory.

Head Nurse. It is recommended to check and remind the nurses to give the
best nursing care, good assistance to the patients and treat them properly with all
their might.

Nursing Students. It is recommended to have knowledge in dealing the

patients with best care and good assistance, for them to be able to practice and
understand the best patient care to have a better outcome for the health of their
patients.

Future Researchers. It is recommended to prioritize in nursing education

the knowledge in nursing care to give the very good assistance to the patient. This
is to enhance the ability of the nurses in taking care of their patients and to develop
their skills in doing it.