Nursing Theorist Grid Dorothea Oren Theory Over the years, nursing theories have been used in defining the ways healthcare is delivered through the interaction of patients and nurses. This study presents a theoretical discussion of the self-care concept in relation to health care delivery among elderly patients. The self-care concept is popular as Self-Care Deficit Theory of Nursing by Orem. Orem's theory perceives individuals as self-care agents equipped with unique needs. The theory focuses on transactional analysis in enhancing rehabilitative roles of nursing and positively influencing self-care agency among individuals. This creates power component based on self-care behaviors. The theory was initially defined as the analysis of exchanges between people in their interactions and communications with one another. The focus also classifies, understands, predicts and alters human behavior among the well and sick individuals. The theory supports individuals treated as adults and has a higher likelihood of using Adult ego states in encouraging information processing, as well as responsible behavior. The items recognize the congruence of perceptions between nurses and patients as one of the vital factors in the provision of nursing care. The issues should focus on nursing and validation of the perceptions held by patients. It is through the theory that people work together to attain the desired healthcare goals in an effective and satisfactory manner.

In most cases, the elements of the acquisition involve the maintenance of the overall self-care behaviors. Environmental factors including power disparity and health perception are eminent in illustrating contextual perspectives that nurses and patients interact. Patients exhibit child ego state while surrendering the levels of problem-solving and decision-making abilities onto health care teams. Hardships with patients arise as the condition of patients change and move along the ego states especially when nursing fails to focus on the ego states in maintaining paired contacts (Butts & Rich, 2012). Nursing tends to apply parental interaction styles. Orem started her nursing work by focusing on the nature and uniqueness of nursing. The theory comprises of three inter-related theories namely Theory of Self-Care Deficit, and theory of Nursing Systems, Theory of Self-Care. All individuals are viewed to be self-care agents possessing capabilities of self-care agency against essential performance of self-care actions. Deliberate levels of actions are undertaken for purposes of meeting therapeutic self-care demand coming from known care needs. The variation cuts across all life and meeting demand involve allowance of self-care deficit denoting the impacts of nursing (Ranheim, 2010).

It is always appropriate to have joint decision-making process between nurses and patients. Roles of nurses include facilitating and increasing self-care abilities for individuals. Problem identification involves assessment of care demands for individual patients and the ability of patients in making independent self-care demands. The assessment is dependent on the ability of the nurse to consider the perceptions of patients in terms of own self-care agencies and health needs. This is because it influences the self-care agency (Ranheim, Karner, Rehnsfeldt & Bertero, 2010). The scope of self-care does not have reflexive or instinctive without the performance of rational response to the needs. The element is perceived as an individual's interpersonal communication and relations. Learned behavior depends on goals directed on the mind's purpose. However, people should have the perception of action as well as relationships to continued life, well-being, or health. Individual's level of education affects the process of decision-making (Finfgeld- Connet, 2008).

Factors of socio-cultural orientation affect an individual's ability to develop self-care choices as well as acquire and maintain health-promoting behaviors. People hold differentiated opinions on illness and health and may not perceive the issues of self-care on similar platforms. The definition and importance of individual's health and perceived health status are central to the conceptualization of health-promoting behavior. Further, culture, values, beliefs and the society influences the success of health care delivery. Nurses learn in the most appropriate ways of listening desires and goals of clients while recognizing their patients' practices, worldviews, and beliefs as informative resources. The theory adds that in case nurses embrace cultural and social origins of patients, they recognize social infrastructure that they provide favorable nursing care solutions. Power disparity is a factor worth consideration.

The self-care theory by Orem supports the establishment of contractual relationships among patients. Emphases are placed on the content that patients do in changing their lives. Nurses and patients have identical perceptions while working together to achieve common goals. Absence of such understanding makes patients and nurses encounter conflicts while working at cross-purposes. These metaphorical extensions of crossed transactions cause drastic non-therapeutic interactions. All forms of discrepancies are established when interpretations in self-care between patients and caregivers are put to comparison. The communication...

This is an opportunity of mutually setting goals achieved through analysis of quality of communication and an instrumental component of achieving well being. Validation of perceptions offers reinforcement on belief that patients are active participants. Patient involvement in decision-making enhances the recovery process in comparison to patients who have not been involved (Ranheim, 2010).
Nurses accepting the self-care concept as a practice basis other than telling patients options for possible courses and do things on their behalf, work to enable patients make decisions by themselves. The excepted areas are when the times are impossible. Promotion of the self-care concept among the elderly as well as functional ability of institutionalized elderly is attracting more attention. Patients are admitting to the rehabilitation of units with higher probability of returning home for significant periods of official discharge. The instruments that are designed for measuring self-care include Self-care Agency Appraisal scales that test clinical studies among elderly individuals. This concerns the ability of nursing the home residents while providing sufficient self-care (Butts & Rich, 2012). Living patterns, financial resources, and level of education are associated with the operability, adequacy, and development of the self-care agency. Mostly, elderly patients with a marked deteriorated health status and lower incomes have diminished functional abilities. Such people, especially women practice health prevention strategies as compared to younger people despite the tendencies of using limited primary care services.

However, ageist attitudes are noted among future and present health care professionals who have negative impacts on future elderly care for negative attitudes resulting from ageism. Knowledge of such factors equips nurses with the ability to make judgments regarding the ability of patients in engaging in dedicated self-care actions. The motivation of individual and stimulus quality in the environment is categorized in major influence areas that are researched through available mechanisms (Ranheim, 2010). Motivation comes from the intrinsic aspects of personality among individuals against behavior. When the motivational problems are established, appropriate interventions including goal setting and verbal encouragement are included within active care plans. Patients, as well as nurses, act in togetherness for purposes of achieving self-care.

Nurses facilitate therapeutic relationships where patients achieve optimum levels of independence. Elderly persons need satisfaction and involvement in the care process instead of dependent care recipients. The adults have the freedoms and right of other adults, and it is important to shift the attitudes to include paternalistic through over-protection of risks and acknowledgment of rights to self-determination. Training facilitates the effective analysis of ego states presented along personal interactions while working towards changing the patterns. Emphasis on rehabilitation gives necessary physical care and influences the behavior of patients (Ranheim, Karner, Rehnsfeldt & Bertero, 2010).

Nurses must always appreciate the influential behaviors among their patients. Mutual approaches to decision-making and goal setting between patients and nurses are established along shared perceptions for self-care health and agency in patient management. The team approach allows patients and nurses to determine the self-care measures needed in performing excellent care services. Focus towards nursing systems involves patients and nursing collaboration with the aim of achieving self-care. While perception becomes congruent with the achievements, patients and nurses work towards achieving common self-care goals.

Despite the controls of functioning formal organization, as well as hierarchical authority structures based on the functioning of the main interpersonal influence. Nurses facilitate their personal development and growth if there is success in communicating and formulating effective adult-to-Adult interactions on the patients. This allows patients to develop confidence as well as space for a gradual assumption of responsibility for each them. Communication remains a critical factor in the facilitation of rehabilitation and empowerment. Communication and caring the inseparably links nurses to effective communication with patients to achieve optimum nursing care. Caring on an effective basis among patients allows nurses to understand themselves into self-awareness. The essence of partnership across patients and nurses is a critical aspect of new nursing dimensions (Finfgeld- Connet, 2008). Individuals present differences in self-care needs and autonomous skills satisfy the needs and offer support within situations of the transition without proper adaptation relating to their personal issues. The capability of acquiring or restoring self-care through independent and helps third parties address occurrences in the dependent phases. Self-care capability is recognized as the individual as an enabler in performing self-care activity while maintaining, restoring or improving well-being and health. The view brings on the…