OREMS SELF CARE DEFICIT NURSING THEORY
It is widely used in nursing literature and has displayed improved quality of care based on results from various randomized controlled trials (RCTs) in the nursing discipline. It is particularly used in rehabilitation and primary care settings, where the patient is encouraged to be as independent as possible. The self-care deficit theory developed as a result of Dorothea E. Orem working towards her goal of improving the quality of nursing in general hospitals in her estate. The theory interrelates concepts in such a way as to create a different way of looking at a particular phenomenon, the theory is relatively simple, but generalizable to apply to a wide variety of patients. Nurses are encouraged to rate their patient's dependencies or each of the self-care deficits on the following scale: • Total Compensation • Partial Compensation • Educative/Supportive This theory delineates when nursing is needed.
Nursing is required when an adult (or in the case of a dependent, the parent or guardian) is incapable of or limited in the provision of continuous effective self-care. Orem identified 5 methods of helping: Acting for and doing for others, guiding others, supporting another, providing an environment promoting personal development in relation to meet future demands and teaching another. Major Concepts and Their Application in Nursing Care Nursing is as art through which the practitioner of nursing gives specialized assistance to persons with disabilities which makes more than ordinary assistance necessary to meet needs for self-care. The nurse also intelligently participates in the medical care the individuals receive from the physicians. Nursing is required when an adult (or in the case of a dependent, the parent or guardian) is incapable of or limited in the provision of continuous effective self-care.
Nursing agency is a complex property or attribute of people educated and trained as nurses that enables them to act, to know and to help others meet their therapeutic self-care demands by exercising or developing their own self-care agency. Nursing System is the product of a series of relations between the persons: legitimate nurse and legitimate client. This system is activated when the client’s therapeutic self-care demand exceeds available self-care agency, leading to the need for nursing. Self-care requisites or requirements can be defined as actions directed towards the provision of self-care. Although, she has a Medicare part A and small social security income. Mrs. Green’s vision is failing and she is 80 pounds overweight making her unsteady on her feet.
The family lives on a second floor apartment and to make matters worse, there is no handrail on the stairs outside the apartment. Mrs. Green’s health status, Mrs. Green’s perspective of her own health status, the health goals within the context of life history, lifestyle and health status, Mrs. Green’s requirements for self-care and finally, Mrs. Green’s capacity to perform self-care. b) Nursing diagnoses/ problem list I would design a partly compensatory and supportive-educative systems for Mrs. e) Expected outcomes The client (Mrs. Green) is the central focus of nursing care. Her health state is mediated by her environment. For now she is capable of self-care. When the illness deteriorates nursing care will be needed to assist her in completing her self-care.
Green’s self-care demands and assist where she can’t manage to self-care. APPENDIX Case Study # 1 Alice Green is a 70 year old African American woman who has been referred for community health nursing services following her discharge from the hospital. She was hospitalized after being found unconscious in her room by her 50 year old daughter. A diagnosis of diabetes mellitus was made, and Mrs. Green was placed on 15 units of NPH insulin daily. She hears well but is 80 pounds overweight, so is unsteady on her feet. The family lives in a second floor apartment, and there is no handrail on the stairs outside the apartment. Mrs. Green tries to help out around the house because her daughter works. She says she does not want to be a burden to her daughter and her son-in-law.
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