Using Orem S Self Care Theory in Clinical Practice

Dorothea Orem Self-Care Theory What is state of nursing during Dorothea Orem's time? Dorothea Orem is one of the foremost theorists in the field of nursing in the United States who developed the self-care theory between 1949 and 1957. Orem developed this theory at a time when nursing was characterized by deficits in the training of practical nurses (Basavanthappa, 2007, p.72). During this period, there was a huge need to upgrade practical nursing training and determine the subject of nursing as a profession and practice.

Nurses not only knew how to talk about nursing but also struggled with the practical aspects of this profession. As a result, the quality of nursing in general hospitals was relatively low and need significant upgrade. What are her motivating factors for her theory? Orem was motivated by various factors to develop her theory including the state of nursing during that period. Due to the state of nursing, Orem developed the theory in order to upgrade the quality of nursing in general hospitals across the state (Alligood, 2013, p.241).

The other motivating factor the theory was her experience in the nursing field that incorporated private duty nursing, teaching, and hospital staff nursing. Third, Orem was motivated to develop the theory by working on a project that focused on enhancing practical nursing training and developing her concept of this profession and practice. Theory Development Orem's theory development included definition of metaparadigm concepts and creation of a new concept of nursing to address the deficiencies in practical nursing training.

She defined nursing as an art or helping service instead of technology while health is when an individual is whole or sound both structurally and functionally ("Dorothea Orem's Self-Care Theory," 2012). Orem defined environment as enthronement factors, elements and conditions as well as the developing external environment. She defined human being as a person with the ability to reason and use symbols as well as a unit that functions biologically, socially, and symbolically.

Orem's Self-Care Theory is valuable because it provided the basis for creation of a body of knowledge for nursing education and delivery of nursing care in real situations in the nursing field (Alligood, 2013, p.243). Overview of Theory Dorothea Orem's Self-Care Theory is based on several concepts including the concept of self-care, the concept of self-care deficit, and the concept of nursing system. The concept of self-care refers to activities that a person initiates and conducts personally to maintain health and well-being.

The concept of self-care deficit specifies situations when nursing is needed i.e. when an adult is limited or unable to provide ongoing effective self-care. The concept of nursing systems describes how nurses and patients work collaboratively to meet the patient's self-care needs through technologies and processes developed by professionals in the healthcare field. The strengths of this theory include its provision of a comprehensive framework for nursing practice, specification of situations when nursing intervention is necessary, and alignment with health promotion and maintenance.

The weaknesses include its focus on illness, consideration of health as dynamic and changing, and defining the system as a single whole thing. My definition and approach to nursing is as a practice that focuses on a person's health needs, desires, and goals and using these characteristics as the basis of nursing process and care.

Orem's theory is congruent with my definition and approach to nursing since it defines who an individual is and specifies when nursing is required to promote the health and well-being of an adult who is limited or unable to provide constant effective self-care. How has the theory been used in research? Dorothea Orem's Self-Care Theory has been used in different nursing settings and research as evident in literature. Coleen P.

Kumar conducted a study on the application of this theory and uniform nursing languages in a case of a woman suffering from diabetes. The study was carried out through examining the patient's situation and determining projected health outcomes before applying the various concepts in the theory to identify suitable nursing intervention. The researcher conducted as assessment of the patient and her family and developed a plan of care based on the four client-related concepts in Orem's theory i.e. self-care, self-care agency, therapeutic self-care demand, and self-care deficit (Kumar, 2007, p.104).

The result of the study was that application of theory-based nursing care and uniform nursing language improves the capability of the patient to self-manage chronic illness. Rebecca Green conducted a study on the use of this theory to provide care for children in special needs in the school setting. The study involved examining two children i.e. one with chronic asthma while the other with mild to severe cognitive developmental disability to demonstrate the wide range of disability that school nurses handle in the school setting (Green, 2012, p.37).

Orem's theory was applied through using her recommended nursing actions to assist patients and their families to assume ongoing self-care and promoting patient independence through teaching and implementing a schedule for self-care. The study found that the theory is useful in preparing and caring for such children since it provides the framework for detecting problems and fostering independence. How can the theory be used in clinical practice? As previously mentioned, Orem's theory can be used in different nursing settings when providing care to patients.

An example of a clinical situation where this theory can be used is in Mrs. John's situation. John is a 56-year-old individual who has been suffering from rheumatoid arthritis in the past five years and complained of pain in all joints. Based on the application of Orem's theory, John's health state requires therapeutic self-care demand and inadequate self-care agency. The design of nursing intervention for John's situation through the application of this theory is supportive educative nursing system that includes guidance, support, teaching, and offering developmental environment.