SLLICAkL DLIICI1 NUkSING 1nLCk

I MA1kIk
1nLCkIS1 1nLCk MAICk CCNCL1S LkSCN LNVIkCNMLN1 nLAL1n NUkSING
Dorothea
Crem

O8orn ln
1914 aL
8alLlmore
Maryland

Oecelved
nurslng
dlploma
from
rovldence
PosplLal
School of
nurslng
WashlngLo
n uC ln
Lhe 1930's

Oarned
8Sn
MSn aL
1he
I Se|f
care

(lounda
Llonal
Lheory)


















O5elfcote ls a human regulaLory
funcLlon LhaL ls a dellberaLe
acLlon Lo supply or ensure Lhe
supply of necessary maLerlals
needed for conLlnued llfe
growLh developmenL and
malnLenance of human lnLegrlLy
lL carrles Lhe dual connoLaLlon of
for oneself" and glven by
oneself" lL ls learned behavlour
dellberaLe and purposeful

O5elfcote oqeocy ls Lhe human
capablllLy or power of
lndlvlduals Lo perform acLlons Lo
Lake care of Lhemselves

O5elfcote oqeot ls Lhe provlder of
selfcare whlle JepeoJeotcote
oqeot ls Lhe provlder of lnfanL
care chlld care or dependenL
care


OPumans are
deflned as
men women
and chlldren
cared for
elLher slngly or
as soclal unlLs
and are Lhe
maLerlal
ob[ecL" of
nurses and
oLhers who
provlde dlrecL
care

OConcepLuallzed
as a LoLal belng
wlLh unlversal
developmenLal
needs and
capable of
conLlnuous
selfcare

OnvlronmenL
as
encompassed
by Lwo
dlmenslons
physlcal
chemlcal and
blologlc
feaLures and
socloeconomlc
feaLures
9yslcol
cemlcol ooJ
bloloqlc
feototes
lnclude Lhlngs
such as
aLmosphere
polluLanLs
weaLher
condlLlons
peLs lnfecLlous
organlsms and
Lhe llke
O rem
supporLs
Lhe World
PealLh
rganlzaLlo
n's
deflnlLlon
of healLh as
a sLaLe of
physlcal
menLal
and soclal
wellbelng
and noL
merely Lhe
absence of
dlsease or
lnflrmlLy

O 1he sLaLe
of belng
whole or
sound"
Jole
O speclflc Lype
of human
servlce
requlred
whenever Lhe
malnLenance of
conLlnuous
selfcare
requlres Lhe
use of speclal
Lechnlques and
Lhe appllcaLlon
of sclenLlflc
knowledge ln
provldlng care
or ln deslgnlng
lL

On arL Lhrough
whlch Lhe
pracLlLloner of
nurslng glves
speclallzed
asslsLance Lo
CaLhollc
unlverslLy
of merlca

OWorked as
a sLaff
nurse ln a
varleLy of
hosplLal
cllnlcal
seLLlngs

OServed as
dlrecLor of
nurslng
servlce aL a
ueLrolL
hosplLal
(1940
1949)

OWorked ln
Lhe ulvlslon
of PosplLal
and
lnsLlLuLlona
l Servlces
of Lhe
lndlana
SLaLe 8oard
of PealLh































O5elfcote tepolsltes represenL Lhe
reason for whlch selfcare ls
underLaken Lhe goals of self
care also known as selfcare
needs 1here are Lhree Lypes of
selfcare requlslLes ldenLlfled
unlversal developmenLal and
healLhdevlaLlon

ODolvetsol selfcote tepolsltes are
requlslLes common Lo all human
belngs durlng all sLages of Lhe
llfe cycle 1hey are assoclaLed
wlLh llfe processes and general
wellbelng L|ght se|fcare
requ|s|tes common Lo all human
belngs suggesLed are
1 sufflclenL lnLake of alr
2 sufflclenL lnLake of waLer
3 sufflclenL lnLake food
4 provlslon of care assoclaLed
wlLh ellmlnaLlon
3 balance beLween acLlvlLy and
resL
6 balance beLween sollLude and
soclal lnLeracLlon
7 prevenLlon of hazards Lo
human llfe human funcLlonlng
and human wellbelng and
8 normalcy a sense LhaL whlch
ls essenLlally normal and ln

OIlewed from
Lwo
perspecLlves
as persons
and LhaL of Lhe
sLrucLural and
funcLlonal
dlfferenLlaLlons
of human
belngs (1) s
persons
humans are
movlng
Lowards
maLuraLlon
and
achlevemenL
of poLenLlal
(2) Ilews
humans
Lhrough
sclences such
as anaLomy
blophyslcs and
psychology
Powever boLh
perspecLlves
need Lo be
lnLegraLed

5ocloecooomlc
feototes of Lhe
envlronmenL
focus on Lhe
famlly and Lhe
communlLy
and lnclude
such Lhlngs as
gender and age
roles culLural
roles and
culLural
prescrlpLlons
of auLhorlLy

OqulvalenL Lo
SocleLy where
adulLs are
expecLed Lo be
selfrellanL and
responslble for
Lhe wellbelng
of Lhelr
dependenLs
1hus boLh self
help and help
Lo oLhers are
valued by
socleLy as
deslrable
acLlvlLles
means LhaL
noLhlng has
been
omlLLed
lgnored or
lessened
5oooJ
means
possesslon
of full vlgor
and
sLrengLh
and Lhe
absence of
slgns of
dlsease and
morbldlLy
persons wlLh
dlsablllLles of
such a characLer
LhaL greaLer
Lhan ordlnary
asslsLance ls
necessary Lo
meeL dally
needs for self
care and Lo
lnLelllgenLly
parLlclpaLe ln
Lhe medlcal
care Lhey
are recelvlng
from Lhe
physlclan
where her
goal was Lo
upgrade
Lhe quallLy
of nurslng
ln general
hosplLals
LhroughouL
Lhe sLaLe
(1949
1937)

OeLurned
Lo
WashlngLo
n (1937)
and served
as
consulLanL
ln Lhe
fflce of
ducaLlon
uS
ueparLmen
L of PealLh
and
became an
asslsLanL
professor
aL 1he
CaLhollc































accord wlLh Lhe geneLlc and
consLlLuLlonal characLerlsLlcs
and LalenLs of lndlvlduals

Oevelopmeotol selfcote
tepolsltes are relaLed Lo Lhe
dlfferenL sLages LhaL human
belngs undergo such as
adolescence pregnancy and
aglng 1wo types ldenLlfled are
(1) maLuraLlonal brlnglng abouL
and malnLalnlng condlLlons LhaL
supporL llfe processes of
developmenL LhaL ls human
progress Loward hlgher levels of
Lhe organlzaLlon of human
sLrucLures and Loward
maLuraLlon and (2) slLuaLlonal
provlslon of care assoclaLed wlLh
effecLs of condlLlons LhaL can
adversely affecL human
developmenL

Oeoltevlotloo selfcote
tepolsltes exlsL for persons who
are lll or ln[ured have speclflc
forms of paLhology lncludlng
defecLs and dlsablllLles and who
are under medlcal dlagnosls and
LreaLmenL lLs s|x categor|es
are
OPuman belngs
are
dlsLlngulshed
from oLher
llvlng Lhlngs by
Lhelr capaclLy
(1) Lo reflecL
upon
Lhemselves
and Lhelr
envlronmenL
(2) Lo
symbollze
whaL Lhey
experlence
and (3) Lo use
symbollc
creaLlons
(ldeas words)
ln Lhlnklng ln
communlcaLlng
and ln guldlng
efforLs Lo do
and Lo make
Lhlngs LhaL are
beneflclal for
Lhemselves
and oLhers
unlverslLy
of merlca
where she
recelved
Lhree
honorary
docLoraLes
and an
lumnl
chleveme
nL ward
for nurslng
1heory ln
1980

Oecognlzed
a need Lo
look for Lhe
unlqueness
of nurslng


O eflecLlng
upon her
own
nurslng
experlence
s rem
says Lhe
answer
came Lo































(1) seeklng and securlng
approprlaLe medlcal asslsLance
ln Lhe evenL of exposure Lo
speclflc physlcal or blologlc
agenLs or envlronmenLal
condlLlons assoclaLed wlLh
human paLhologlc evenLs and
sLaLes or when Lhere ls evldence
of geneLlc physlologlc or
psychologlc condlLlons known Lo
produce or be assoclaLed wlLh
human paLhology
(2) belng aware of and
aLLendlng Lo Lhe effecLs and
resulLs of paLhologlc condlLlons
and sLaLes
(3) effecLlvely carrylng ouL
medlcally descrlbed dlagnosLlc
LherapeuLlc and rehablllLaLlve
measures dlrecLed Lo Lhe
prevenLlon of speclflc Lypes of
paLhology Lo Lhe paLhology
lLself Lo Lhe resoluLlon of human
lnLegraLed funcLlonlng Lo Lhe
correcLlon of deformlLles or
abnormallLles or Lo
compensaLlon for dlsablllLles
(4) belng aware of and aLLendlng
Lo or regulaLlng Lhe
dlscomforLlng or deleLerlous
effecLs of medlcal care measures
her as a
flash of
lnslghL an
undersLand
lng LhaL Lhe
reason why
lndlvlduals
could
beneflL from
nurslng
was Lhe
exlsLence
of self care
llmlLaLlons"

Oldeas were
furLher
formallzed
afLer
parLlclpaLlo
n ln Lhe
nurslng
uevelopme
nL
Conference
Croup
(nuCC)

OefL Cu
and began
her own
consulLlng































performed or prescrlbed by Lhe
physlclan
(3) modlfylng Lhe selfconcepL
(and selflmage) ln accepLlng
oneself as belng ln a parLlcular
sLaLe of healLh and ln need of
speclflc forms of healLh care
and
(6) learnlng Lo llve wlLh Lhe
effecLs of paLhologlc condlLlons
and sLaLes and Lhe effecLs of
medlcal dlagnosLlc and
LreaLmenL measures ln a llfe
sLyle LhaL promoLes conLlnued
personal developmenL

O@etopeotlc selfcote JemooJ ls
Lhe LoLallLy of all acLlons Lo be
performed Lo meeL Lhe selfcare
requlslLes

Ooslc cooJltlooloq loctots are
facLors lnLernal or exLernal Lo
lndlvlduals LhaL affecL Lhelr
ablllLles Lo engage ln selfcare
1en factors ldenLlfled are
1 ge
2 Cender
3 uevelopmenLal sLaLe Lhe
physlcal funcLlonal
cognlLlve and psychosoclal
flrm (1970)
resldlng ln
Savannah
Ceorgla


Oassed
away lasL
!une 22
2007

OPer self
care deflclL
Lheory a
general
Lheory of
nurslng ls
one of Lhe
mosL
wldely
used
models ln
nurslng
Loday


































level
4 PealLh sLaLe
3 SocloculLural orlenLaLlon
Lhe mulLlple complex
lnLerrelaLed sysLem of Lhe
person's soclal envlronmenL
splrlLual bellef sysLem and
soclal relaLlonshlps
6 PealLh care sysLem facLors
7 lamlly sysLem facLors
8 aLLern of llvlng lncludlng
acLlvlLles regularly engaged
ln
9 nvlronmenLal facLors and
10esource avallablllLy and
adequacy
















ll
Se|fcare
Def|c|t

(ssenLlal
consLlLu
enL
Lheory)
























O5elfcote eflclt ls Lhe
relaLlonshlp beLween Lhe acLlon
capablllLles of an lndlvldual and
Lhe demands for selfcare

O1here ls a deflclL when Lhe self
care agency ls noL adequaLe Lo
meeL some or all componenLs of
Lhe LherapeuLlc selfcare
demand

OSC1SCu Lhen SCu exlsLs

















lll
Nurs|ng
Systems

(rganl
zlng com
ponenL)





O-otsloq 5ystems are acLlon
sysLems formed (deslgned and
produced) by nurses Lhrough Lhe
exerclse of Lhelr nurslng agency
for persons wlLh healLh
assoclaLed llmlLaLlons 1he Lhree
nurslng sysLems are Wholly
compensaLory sysLem arLly
compensaLory sysLem and
SupporLlveeducaLlve sysLem


O-otsloq oqeocy ls Lhe developed
capablllLy of nurses Lo acL know
and help persons meeL Lhelr
LherapeuLlc selfcare demands
and Lo regulaLe Lhe
developmenL of Lhelr selfcare
agency wlLhln Lhe frame of a
leglLlmaLe lnLerpersonal
relaLlonshlp

Onurslng goal ls Lhe developmenL
of selfcare agency by uslng
helplng meLhods LhaL encourage
learnlng lncrease feellngs of
wellbelng and sLlmulaLe
lnLeresL ln selfcare


O elploq MetoJ ls a sequenLlal
serles of acLlons whlch lf
performed wlll overcome or
compensaLe for Lhe healLh
assoclaLed llmlLaLlons of persons
Lo engage ln acLlons Lo regulaLe
Lhelr own funcLlonlng or LhaL of
Lhelr dependenLs 1he f|ve
he|p|ng methods are
1 acLlng for or dolng for
anoLher
2 guldlng and dlrecLlng
3 provldlng physlcal or
psychologlcal supporL
4 provldlng and malnLalnlng an
envlronmenL LhaL supporLs
personal developmenL and
3 Leachlng


OJolly compeosototy system ls a
nurslng sysLem used for paLlenLs
unable Lo engage ln Lhose self
care acLlons requlrlng self
dlrecLed and conLrolled
ambulaLlon and manlpulaLlve
movemenL or Lhe medlcal
prescrlpLlon Lo refraln from such
acLlvlLy xamples are paLlenLs
who are comaLose quadrlpleglc
and newborns

O9ottly compeosototy system ls a

nurslng sysLem for slLuaLlons
where boLh nurse and paLlenL
perform care measures or oLher
acLlons lnvolvlng manlpulaLlve
Lasks or ambulaLlon xamples
are posLoperaLlve cllenLs who
need asslsLance Lo ambulaLe
and brlnglng Lhe food Lray Lo a
cllenL who can feed hlmself

O5oppottlveeJocotlve system ls a
nurslng sysLem for slLuaLlons
where Lhe paLlenL ls able Lo
perform or can and should learn
Lo perform requlred measures of
LherapeuLlc selfcare buL cannoL
do so wlLhouL asslsLance
xample ls Leachlng a moLher
how Lo breasLfeed properly