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"In the inability of the client to do the universal, developmental or health deviationselfcare requisites, the nurse provides wholly or partially compensatory or supportive-educative Dorothea Elizabeth assistance." Orem
Who is she?
She was born in Baltimore, Maryland on 1914. Her father was a construction worker and her mother is a maker. home She studied Diploma in Nursing in early 1930s at the Providence Hospital School of Nursing In Washington D.C., In 1939 and 1945 she finished B.S. Nursing Education ( BSN Ed.) and MSN Ed in Catholic University of America, successively In 1976 She become Honorary Doctorates: Doctors Washington D.C. of Science from Georgetown University and Incarnate word college in San Antonio in Texas in 1980. In 1988 she finished Doctor of Humane Letters from Illinois Wesleyan University in Bloomington, Illinois. 1988 She graduated from University of Missouri in Columbia, Doctor Honoris Causae.
NURSING CAREER
Occupied important nursing positions, like the directorship of both the nursing school and the department of nursing at Providence Hospital, (1940 to 1949). Detroit Spent seven years at the Division of Hospital and Institutional Services of the Indiana State Board of Health (1949-1957), developed her definition of nursing practice Joined the Catholic University of America first as Assistant Professor, then later became Assistant Dean and Associate Professor of the School of Nursing. Her theory was first published inNursing: Concepts of Practicein 1971, second in 1980, in 1995, and 2001 She received the Catholic University of America Alumni Association Award for Nursing Theory in 1980. The second edition of Nursing: Concept of Practice was published (1980)
Person
Client is an integrated whole; a unity functioning biologically, symbolically and socially. Client is self-reliant and responsible for self-care and wellbeing of his or her dependents and self-care is a requisite for all. Client has capacity to reflect on their own experience and the environment and they use of symbols, ideas and words that distinguished them from other species A client is a holistic individual who is in need of assistance in meeting specific health-care demands because of lack of knowledge, skills, motivation, or orientation
Health
A healthy person is likely to have sufficient selfcare abilities to meet their universal self-care needs. The client is in a state of wholeness or integrity of the individual human beings, his parts, and his modes of functioning. Balance
Self care abilities
Universal Self Care needs
Nursing
As a service
Nursing is a service of deliberately selected and performed actions to assist individuals or groups to maintain self-care, including structural integrity, functioning, and development. Requirements for nursing are modified and eventually eliminated when there is progressive favorable change in the state of health of the individual, or when he learns to be self-directing daily self-care.
Theory of Self-Care
Self-Care
According to Orem self-care is the performance or practice of activities that individuals initiate and perform on their own behalf to maintain life, health and well-being. When self-care is effectively performed, it helps to maintain structural integrity and human functioning, and it contributes to human development (Orem, 1991)
Self-Care This is the humans ability or power to engage in Agency self-care. The individuals ability to engage in
self-care is affected by basic conditioning factors. Basic conditioning factors are age, gender, developmental state, health state, sociocultural orientation, health care system factors, family system factors, patterns of living, environmental factors, and
Theory of Self-Care
Self-Care Agency
Agents
1. Self-care agent: person who provides the selfcare 2. Dependent Care Agent - person other than the individual who provides the care
Self-Care These are the actions or measures used to provide requisites self-care.
1. Universal requisites or needs that are common to all individuals 2. Developmental - needs resulting from maturation or develop due to a condition or event 3. Health Deviation - needs resulting from illness, injury & disease or its treatment
Theory of Self-Care Deficit The core of Orem's grand theory is the Self-Care Deficit
Theory because it delineates when nursing is needed. Nursing is required when a client is incapable of or limited in the provision of continuous effective self-care (George 1995). The term "deficit" refers to a particular relationship between self-care agency and self-care demand that is said to exist when capabilities for engaging in self-care are less than the demand for selfcare (Parker, 2005, p. 149). A D A D
Self-Care
D: Demand for self care A: Ability to meet demand for self care
Self-Care Deficit
Orem identifies 6 methods of helping: 1. Doing for or acting for another 2. Guiding or directing another 3. Providing physical support 4. Providing psychological support 5. Providing an environment supportive of development 6. Teaching another
Assumptions
Human beings require continuous deliberate inputs to themselves and their environments to remain alive and functions in accord with natural human endowments. Human agency, the power to act deliberately, is exercised in the form of care of self and others in identifying needs for and in making needed inputs. Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify needs for and make inputs to self and others. Groups of human beings with structures relationships cluster tasks and allocate responsibilities for providing care to group members who experience privation for making required deliberate input to self and others
Strengths
The Orem theory is as applicable for nursing by the beginning practitioner as much as the advanced clinician(George JB., 1995) The major strength of Orems theory is its advocacy for the use of the Nursing Process (Balabagno, et.al, 2006). Orem specifically identified the steps of this process. She also mentioned that the nursing process involves intellectual and practical phases
Limitations
Orems theory dont have an unclear definition of family, the nurse-society relationship and public education areas. These issues are essential in the management and treatment plan in caring for patients. Although the family, community and environment are considered in self care action, the focus is primarily on the individual (Balabagno, 2006) et.al, One of the most obvious limitations of Orems theory is that throughout her work, it can be said that a limited recognition of an individuals emotional needs is present within the theory (George JB., 1995). It focuses more on physical care and gives lesser emphasis to psychological care.
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References
1. Henderson v: The Nature of Nursing: A Definition and Its Implications, Practice, Research, and Education. Macmillan Company, New York, 1966. (Pages 16-17) 2. http://currentnursing.com/nursing_theory/Henderson.html 3. http://en.wikipedia.org/wiki/Virginia_Henderson 4. http://www.angelfire.com/ut/virginiahenderson/concepts.ht ml 5. http://www.nytimes.com/1996/03/22/arts/virginiahenderson-98-teacher-of-nurses-dies.html 6. www.youtube.com/watch?v=AbuNz7RLHS8 7. www.youtube.com/watch?v=t89beHi7Xxw
8. Henderson v: The Nature of Nursing: A Definition and Its Implications, Practice, Research, and Education. Macmillan Company, New York, 1966. (Pages 16-17) 9. Nursing theorists and their work By Ann Marriner-Tomey, Martha Raile Alligood pp. 54-57 10. Henderson v: The Nature of Nursing: A Definition and Its Implications, Practice, Research, and Education. Macmillan Company, New York, 1966. (Pages 16-17) 11. http://nursing-theory.org/nursing-theorists/VirginiaHenderson.php