Orem's Self-Care Theory and Therapeutic Communication

Introduction to Orem's Self-Care Deficit Theory

Dorothea E. Orem's Self-Care Deficit Nursing Theory focuses on the need for all patients to develop self-reliance, particularly after traumatic injuries or in cases of disability. A self-care deficit exists when patients lack the ability to care for themselves — such as by feeding themselves, performing personal hygiene, or avoiding behaviors that might be harmful to self or others. Nurses are defined as self-care "agents" within the Orem theoretical construct, as nurses are uniquely trained to provide evidence-based interventions that help patients achieve the goal of self-caring. To help patients reach their goals, the nurse must understand the health assessment process within the Self-Care Deficit Theory.

Health Assessment Within the Self-Care Framework

The Self-Care Deficit Theory — also referred to more simply as the Self-Care Theory — conforms to the fundamental tenets of healthcare assessment, including the design of a plan of care. Data is collected on the patient's health history and current health status, followed by input from the healthcare team, including the physician. Subsequently, the nurse collects information related to the patient's perception of health and the patient's healthcare goals. Finally, attitudes toward self-care and self-care behaviors are specifically assessed, which is what distinguishes Orem's theory from similar nursing theories that stress patient independence.

During the assessment process, the nurse must also analyze the need for interventions, being open and honest about the role the nurse intends to play in the process (Wayne, n.d.). The nurse can then develop a coherent system of care, including a plan for care delivery (Wayne, n.d.). Finally, Orem's theory connects with systems theories showing that both assessments and interventions reflect overarching systemic issues.

Therapeutic Communication in Nursing

Therapeutic communication refers to the communication that takes place within the therapeutic context between patient and nurse. As Kourkouta and Papathanasiou (2014) point out, "good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient," and good communication itself entails "courtesy, kindness and sincerity" (p. 65). Therapeutic communication also requires the nurse to possess "self-awareness, self-understanding, and a philosophical belief about life, death, and the overall human condition for effective therapeutic use of self" ("Therapeutic Communication in Psychiatric Nursing," n.d.). Because communication is vital throughout the therapeutic process, the concept of therapeutic communication has become central to nurse education and ongoing professional development.

References

"Dorothea Orem's Self-Care Theory." (n.d.). Nursing Theories. Retrieved from http://currentnursing.com/nursing_theory/self_care_deficit_theory.html

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia Sociomedica, 26(1), 65–67.

"Therapeutic Communication in Psychiatric Nursing." (n.d.). Nursing Planet. Retrieved from

Wayne, G. (n.d.). Dorothea Orem's self-care theory. Nurse Labs. Retrieved from http://nurseslabs.com/dorothea-orems-self-care-theory/