Dorothea Orem
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DOROTHEA OREM’SGENERAL THEORY OF NURSING
“ Individuals,families, groups and communities need to be taught self care.”
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DOROTHEA OREM1914-2007
•One of foremost nursing theorists.•Born 1914 in Baltimore.•Earned her diploma at Providence Hospital – Washington, DC•1939 – BSN Ed., Catholic University of America•1945 – MSN Ed., Catholic University of America•Involved in nursing practice, nursing service, and nursing education•During her professional career, she worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant•Received honorary Doctor of Science degree in 1976•Published first formal articulation of her ideas in Nursing: Concepts of Practice in 1971, second in 1980, and in 1995.
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GENERAL THEORY OF NURSINGDorothea Orem’s theory is composed of three related parts which are self-care, self-care deficit and nursing systems.
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SELF-CARE THEORY
WHY and HOW people care for themselves.
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Self-Care Agency
It consists of two agents:
• Self-care Agent - person who provides the self-care
• Dependent Care Agent - person other than the individual who provides the care (such as a parent)
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Self- Care Requisites It is composed of the following categories:
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Similar to Maslow's heirarchy of needs. Important for sustaing life. Common to all people.
UNIVERSAL
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Conditions that support life processes and promote specific developmental stages.
a. Intra-uterine life and birthb. Neonatal lifec. Infancyd. Childhoode. Adolescencef. Adulthoodg. Pregnancy
DEVELOPMENTAL
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HEALTH-DEVIATION
Categories:
1. Seeking and securing appropriate medical assistance
2. Being aware of and attending to the effects and results of pathologic conditions and states
3. Effectively carrying out medically prescribed diagnostic, therapeutic and rehabilitative measures
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4. Being aware of and attending to or regulating the discomforting or deleterious effects of prescribed medical care measures
5. Modifying the self – concept in accepting oneself as being in a particular state of health and in need of specific forms of health care
6. Learning to live with the effects of pathologic conditions and states of medical diagnostic and treatment measures in a life-style that promotes continued personal development
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SELF-CARE DEFICIT THEORY
WHY people can be helped through nursing
Self- Care Deficit: demand to care for oneself is greater than the individual’s capacity or ability to meet it.
Nursing is required when the client is incapable of continuous and effective self-care. It determines the need for nursing care.
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Five Methods of Assistance- 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
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THEORY OF NURSING SYSTEMS
describes and explains RELATIONSHIPS that must be made and maintained for nursing to be produced
It specifies how the client’s self-care needs will be met by the nurse, client or both. With this theory, the nurse determines whether there is a legitimate need for nursing care and if a self-care deficit exists. It is also the time when a nurse plans care and identifies what should be done and who should do it. In addition, it establishes 3 classifications of nursing system to meet the self-care requisite of the client.
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3 Classification of Nursing Systems
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Orem’s General Theory of Nursing
Self care
Nursing
Agency
Deficit
R R
R
R R
Con
ditio
ning
fa
ctor
sC
ondi
tioni
ng
fact
ors
Conditioning
factors
Therapeutic Self care
demands
Self Care / Dep. Care
Agency
R indicates a relationship between components; < indicates current or potential deficit where nursing would be required.
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CORE COMPETENCIESOut of the 11 core competencies listed, few applies to Dorothea Orem’s General Theory of Nursing. One main competency that can be practiced using Orem’s theory is the SAFE QUALITY CARE. To illustrate, the nurse can diagnose self-care needs and deficit of his/her patient. Once, the patient’s self-care need/deficit is identified, the nurse then formulates a nursing care plan in which COLLABORATION and COMMUNICATION competency comes in. In order to formulate a nursing care plan, the nurse will have to communicate with his/her patient. She would also have to collaborate with his/her client and others so that they can help apply the plan she developed.
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If people cannot care for themselves, they
sure need help. This is when nurses come in to provide assistance.
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THAT’S ALL!