This paper examines Dorothea Orem's Self-Care Model as a framework for professional nursing practice. It explores Orem's definition of health as wholeness of human structure and functioning, and her central premise that individuals have the inherent capacity to regulate their own health. The paper discusses how nurses facilitate patient competence in self-care through education, guidance, and instruction, emphasizing that nursing extends beyond institutional care to support self-directed living. It also addresses Orem's concept of the self-care deficit — the condition that arises when an individual can no longer maintain the quality of self-care necessary to sustain life and health — and its implications for nursing intervention.
The paper demonstrates effective use of theoretical synthesis: it draws on multiple secondary sources (Caley, Coleman, Johnston, Fawcett, Taylor) alongside a primary source (Orem) to build a coherent picture of one theoretical model. Rather than summarizing each source independently, the paper weaves them together to support a unified argument about the role of self-care in nursing.
The paper opens with a definition of nursing theory and introduces Orem's model. It then establishes the personal and professional significance of self-care, defines the concept formally, and explains how nurses operationalize it through education and guidance. The argument expands outward — from individual self-care to care of dependents — before concluding with Orem's concept of the self-care deficit, which anchors the nurse's interventional role.
Nursing theory is an organized and systematic articulation of a set of statements related to questions in the discipline of nursing (Caley, p. 302, 1980). The model presented by Dorothea Orem is based on the idea that, as human beings, we are engaged in self-care activities that allow us to maintain a state of good health. Orem defines health as "a state of a person that is characterized by soundness or wholeness of developed human structures and of bodily and mental functioning" (Coleman, p. 325, 1980). Utilization of Orem's concepts allows the nurse the freedom to develop their own style of practice to best meet the self-care needs of any patient.
Nurses have always recognized the rights of clients of all ages to be both informed and active participants in care, but the idea of self-care has not always been apparent in the delineation of care. This theory of self-care is of great interest because, in the past, it was easy to assume the medical profession bears responsibility for patient care from start to finish — and to regard self-care as having nothing to do with nursing at all. It is important to establish at the outset that the role of the professional nurse is to promote and maintain healthy systems (Coleman, p. 327, 1980), which includes, of course, the incorporation of self-care.
"Self-care is a universal requirement for sustaining and enhancing life and health" (Johnston, pp. 56–60, 1982). Competence in self-care determines quality of life and has an impact on longevity; this is true in sickness and in health. Nurses assist clients to achieve competence in self-care through health education, instruction, and guidance. As one formulation puts it, "Health education is an example of self-care — one that informs, motivates, and helps people adopt healthful lifestyles."
Self-care is defined as action directed by individuals toward themselves or their environments to regulate their own functioning and development in the interest of sustaining life, maintaining or restoring integrated functioning under stable or changing environmental conditions, and maintaining or bringing about a condition of well-being (Taylor, p. 25, 1985).
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6. Taylor, S.G. (1985). Curriculum development in preservice programs using Orem's theory of nursing. In J. Riehl-Sisca (Ed.), The science and art of self-care (pp. 25–32). Norwalk, CT: Appleton-Century-Crofts.
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