Orem Universal Self-Care Requisites and Developmental Self-Care Requisites

¶ … Universal and Development Self-Requisites in the Context Of a Nursing Practice Scenario

Orem's Theory of Self-Care

Self-care is the key concept in Orem's nursing model (1991). It is defined as the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interests of maintaining life, healthful functioning, continuing personal development, and well-being A self-care deficit occurs when an individual is unable to engage in self-care Orem's self-care model has, throughout the years, provided the basis for training and support programs for groups of patients with both chronic and acute diseases, e g diabetic patients (Allison 1973, Fitzgerald 1980), employees with rheumatoid arthritis (Dear & Keen 1982), renal transplant patients (Hoffart 1982), stroke patients (Anna et al. 1978, Faucett et al. 1990), bone marrow transplant patients (Mack 1992) and patients with cancer (Dodd & Dibble 1993).

The universal self-care requisites are 1)sufficient intake of air, water and food; 2) the provision of elimination and excrements care; 3)maintaining balance between activities and rest; 4)maintaining balance between solitude and social interaction; 5) preventing situation which are hazardous to human life, human functioning, and human well beings; and 6)maintaining "Normalcy" in promotion of human functioning, human development within social groups. The Developmental Self-Care Requisites refers to coping with situational changes, that is actions that are needed in meeting the change of condition that could adversely affect human development. (Orem, 1991). Individuals who fail to meet their self-care requisites are in danger of hospitalization. This paper will discuss universal and development self-requisites in the context of a nursing practice scenario.

Universal and Development Self-Requisites: Practical applications

Primary antibody deficiencies are chronic conditions and the patients usually need lifelong replacement therapy with gammaglobulin to prevent or reduce infections. Oftentimes, patients administered these infusions to themselves in a home setting. Home therapy with intravenous self-infusions gammaglobulin is considered convenient for the patients, resulting in a minimum of time lost from school or work and leading to a better compliance with the treatment, as the patients feel more in control of the disease and the situation It has been shown that the gammaglobulin can be given safely as subcutaneous infusions, instead of intramuscular injections or intravenous infusions regime Subcutaneous self-infusions are being increasingly used at home, as this administration form has been found a) to be safe (l e no severe, adverse systemic reactions) Gardulf et al. 1991, Remvig et al. 1991, Gardulf et al. 1995), (b) to improve the quality of life for antibody deficient adults (Gardulf et al. 1993), (c) to result in serum IgG levels v*nthm the normal range of healthy individuals Waniewski et al. 1994), and (d) to be less costly, as compared vwth the intravenous therapy (Long et al. 1987, Remvig et al. 1991, Gardulf et al. 1995) The patients were found to have a strongly positive attitude towards receiving the replacement therapy as subcutaneous infusions, perceived the method as effective in preventing infections and wished to retain the treatment. However, the younger patients found the subcutaneous infusions more uncomfortable and were less determined to continue with the therapy as compared with the older individuals.