Category: Dorothea Orems Theory

Concept analysis remains a powerful strategy for ensuring that readers and users of a specified theory understand and apply it accordingly. This practice is usually designed to ensure that researchers and students have a clear understanding of the intended variable. This approach conveys the desired meaning and eventually supports the formulation of the best propositions and assumptions. The selected concept for this discussion is that of self-care.

The best nursing theory that addresses it is Orems Self-Care Deficit Nursing Theory (SCDNT). The paper begins by giving an explanation of the selected concept. The second part presents a detailed literature review on the concept of self-care. It goes further to describe various attributes associated with it. The third section gives an antecedent and consequent of the selected concept. This will be followed by two empirical references of self-care. Several cases detailing the use of this concept will be presented. The final part offers a detailed theoretical application of the identified concept.

Definition and Explanation

The concept of self-care remains critical in the field of healthcare. Mills, Wand, and Fraser (2018) define self-care as a holistic and proactive approach to promoting ones wellbeing through various initiatives, such as maintaining cleanliness and taking good care of surgical sites. This practice is applicable to both patients and caregivers. Stakeholders can pursue the concept to identify existing barriers and promote enablers that will maximize personal care practices. In Orems SCDNT model, self-care is defined as the performance of various procedures and activities that people can undertake or initiatives on their behalf to maintain wellbeing, health, and life (Mills et al., 2018).

Individuals can, therefore, focus on this concept to address various barriers to positive health outcomes and engage in evidence-based strategies (Hasanpour-Dehkordi, 2016). Those with chronic conditions can consider this conception to achieve their medical aims.

Literature Review

Within the past three decades, the concept of self-care has become critical or applicable in different health settings. Although the idea revolves around patients ability to engage in health improving practices, the roles of medical professionals still remain relevant. For instance, Rutter (2015) indicates that many people usually purchase over-the-counter drugs from pharmacies. This means that practitioners in such facilities should identify enablers to self-care practices and empower individuals to record desirable results. Different stakeholders in the healthcare delivery chain should be willing to pay attention to specific factors that tend to discourage self-care practices.

Kristensen, Hølge-Hazelton, Waldorff, and Guassora (2017) go further to indicate that many general practitioners (GPs) lack adequate competencies to promote the idea of self-care in persons with various chronic conditions

Due to the complex demands of different patients, caregivers, family members, and religious can be involved to make self-care a reality. Socioeconomic issues also make it impossible for patients to take good care of their bodies (Gobeil-Lavoie, Chouinard, Danish, & Hudon, 2018). Medical professionals should introduce superior measures that can fulfil patients demands. The concept of self-care is capable of delivering positive results when health practitioners collaborate with the targeted beneficiaries (Kuehl, Abdulnour, ODell, & Kyle, 2015). Patients will receive additional instructions for managing their conditions even after being discharged from their hospitals.

Some studies have presented evidence-based strategies for introducing self-care practices to patients in different clinical settings. For instance, Abreu, Barroso, Segadães, and Teixeira (2015) indicate that nurses and supervisors should introduce self-care as a practice that individuals can carry out with reduced support. The ultimate objective is to ensure that they preserve their self-esteem, health, and life. Hospitals usually consider this argument to ensure that more people are capable of promoting the highest level of hygiene, engaging in continuous learning, and reducing the level of dependence (Riegel, Jaarsma, Lee, & Strömberg, 2019).

With the use of modern technologies, individuals can acquire advanced ideas for engaging in self-care practices. Gobeil-Lavoie et al. (2018) revealed that there was a need for medical professionals to embrace the same concept to continue providing high-quality services to their patients. Such measures will make it easier for them to reduce chances of infections and fatigue, address emerging barriers, and eventually transform the face of the healthcare sector.

Defining Attributes

Medical practitioners focus on the best practices to maximize patients outcomes. A proper understanding of the attributes associated with self-care can ensure that the intended objectives are realized. The first one is that of self-reliance and it encourage people to focus on ethics. Family members and relatives can be involved to ensure that their patients record positive outcomes (Hasanpour-Dehkordi, 2016). The second characteristic is that of education.

Hasanpour-Dehkordi (2016) supports the power of training procedures and resources that make it possible for different individuals to engage in self-care practices. This form of education will ensure that the targeted beneficiaries embrace such procedures and eventually record improved quality of life. The third attribute referenced in different researches is that of interaction. Since human beings cannot live without the support of their colleagues and relatives, it is appropriate for friends, nurses, and family members to be involved in order to ensure that self-care objectives are realized.

Antecedent and Consequence

The adoption of self-care in medical practice is usually informed by client, system, or situation-based antecedents. A good example is the involvement of health professionals in medical facilities. Hasanpour-Dehkordi (2016) indicates that practitioners can engage in evidence-based practices and educate patients about this concept. The potential outcome is that the identified individual will engage in self-care procedures. When such practices become a reality, the outstanding consequence is that the patient will achieve his or her health objectives. This is possible since self-care improves healing and delivers desirable medical results.

Empirical Referents

The adoption of a specific concept in nursing is something that can be measured or determined. This analytical technique is known as empirical reference. The first one for self-care is the degree of responsibility in the targeted patients. It can be high or low depending on the willingness and desire of individuals to complete various self-care practices (Kuehl et al., 2015). The second one is the level of independence in making desirable decisions and promoting the best behaviors. This means that people can engage in such procedures freely or be demanded by other professionals. These empirical referents can guide nurses and caregivers can measure the presence of self-care objectively.

Construct Cases

The selected situation occurred when my advanced practice nursing team was required to provide high-quality care to a patient with arthritis. While in the ward, the group embraced the power of education to sensitize him about the best self-care practices. The members also interacted with him continuously until positive results were realized. He was taught how to take care of his body, engage in light exercises, eat healthy, and engage others after being discharged.

The end result was that the individual became self-reliant after going home, collaborated with family members, took medications, and eventually recorded positive health results (Rutter, 2015). These aspects show conclusively that this example is a model case.

The second scenario occurred when a nurse was providing medical support to a patient with diabetes. While in the hospital, the individual received timely instructions for engaging in self-care practices. This means that the attribute of education was evident in the situation. He also interacted with both clinicians and caregivers throughout the care delivery period. However, the patient was reluctant to engage in the outlined self-care practices after being discharged. This malpractice affected his medical outcomes. This is a good example of a border case.

The final scenario occurred when a team of health workers were required to offer evidence-based services to a HIV/AIDS patient. The individual was uninterested in the presented ideas and concepts. He slept most of the time and avoided any meaningful conversation with the clinicians. He complained about his situation and even failed to interact with others. Although he was taking the required medicine, it was hard to sensitize him about the most appropriate self-care practices (Mills et al., 2018). After being discharged, the patients health deteriorated since he did not accept any form of support from immediate family members. Consequently, his overall wellbeing and life deteriorated. This example is a clear description of a contrary case.

Theoretical Applications of the Concept

The analysis of a concept is something essential since it makes it possible for users to understand it, identify the best approaches to measure it objectively, and follow specific attributes that can make it applicable in different settings. The description can deliver a superior model for pursuing a specific model and ensuring that the intended health experiences are recorded (Riegel et al., 2019). Since different theories tend to have several concepts, it is always necessary for scholars to analyze them and understand how they can adopt them to improve nursing practice. Additionally, concept analysis is a critical procedure for developing a specific nursing theory.

The effectiveness and applicability of Orems SCDT model depends on the self-care concept. The theory identifies nursing as a process of empowering others by presenting self-care opportunities and improving the level of human functioning (Kristensen et al., 2017).

The theory presents evidence-based approaches for ensuring that people or patients are able to take good care of their bodies and eventually maintain their wellbeing. This concept, therefore, expands the four metaparadigms of nursing by introducing a new idea whereby practitioners can consider evidence-based approaches for empowering patients to perform specific activities that will eventually maintain health and life. The above attributes can also be introduced to educate and ensure that more patients are willing to engage in self-care practices.

Conclusion

The above discussion has identified self-care as a unique concept that can be considered to transform nursing practice. It focuses on the best that can empower more people to record positive health outcomes. Orems SCDNT model is founded on this concept and it presents evidence-based ideas for ensuring that more patients perform self-care initiatives. Those in the field of advanced practice nursing can consider this concept to empower their patients and ensure that they appreciate the importance of engaging in practices that will promote their wellbeing and health. Such professionals will also present training opportunities to individuals and encourage their relatives or friends to remain supportive.

They should focus on recording positive results whereby patients engage in self-care voluntarily and pursue the intended health goals. The completed analysis has equipped me with numerous ideas for engaging in personal self-care practices and empowering my patients to do so. I will go further to conduct more studies to acquire additional ideas and eventually improve my philosophy of nursing.

References

Abreu, W., Barroso, C., Segadães, M. F., & Teixeira, S. (2015). Promotion of self-care in clinical practice: Implications for clinical supervision in nursing. International Journal of Information and Education Technology, 5(1), 6-9. Web.

Gobeil-Lavoie, P., Chouinard, M., Danish, A., & Hudon, C. (2018). Characteristics of self-management among patients with complex health needs: A thematic analysis review. BMJ Global Health, 9(5), e028344. Web.

Hasanpour-Dehkordi, A. (2016). Self-care concept analysis in cancer patients: An evolutionary analysis. Indian Journal of Palliative Care, 22(4), 388-394. Web.

Kristensen, M. A. T., Hølge-Hazelton, B., Waldorff, F. B., & Guassora, A. D. (2017). How general practitioners perceive and assess self-care in patients with multiple chronic conditions: A qualitative study. BMC Family Care, 18(1), 109-118. Web.

Kuehl, B. L., Abdulnour, S., ODell, M., & Kyle, T. K. (2015). Understanding the role of the healthcare professional in patient self-management of allergic rhinitis. SAGE Open Medicine, 3, 2050312115595822. Web.

Mills, J., Wand, T., & Fraser, J. A. (2018). Exploring the meaning and practice of self-care among palliative care nurses and doctors: A qualitative study. BMC Palliative Care, 17(1), 63-74. Web.

Riegel, B., Jaarsma, T., Lee, C. S., & Strömberg, A. (2019). Integrating symptoms into the middle-range theory of self-care of chronic illness. Advances in Nursing Science, 42(3), 206-215. Web.

Rutter, P. (2015). Role of community pharmacists in patients self-care and self-medication. Integrated Pharmacy Research and Practice, 4, 57-65. Web.

Introduction

Orems Self-Care Deficit Theory mainly focuses on patients unique needs and the actions they initiate on their behalf to improve their quality of life. Orem also theorized that nursing practice encompasses deliberately directed actions executed by nurses to help people or groups under their care maintain an optimal state of health, change conditions in themselves or their environments or regain normal or near-usual health status in the event of illness or injury (Yip, 2021). The theory incorporates both clinicians and patients perspectives of the health situation. It comprises three interrelated concepts: self-care, self-care deficit, and nursing system theories.

The Theory of Self-Care

Self-care can maintain life functioning and promote well-being. This theory incorporates self-care agency, the acquired power (capability) to engage in self-care (Gonzalo, 2021). Nevertheless, performing self-care is influenced by gender, age, developmental state, health status, and available resources. The theory also includes therapeutic self-care demand, which is the amount of intervention needed in a given period to meet an individuals self-care requirements. Lastly, it also entails a self-care requisite, defined as an action directed towards self-care provision. There are three categories of self-care requisites, namely, health deviation self-care requisite, developmental self-care requisite, and universal self-care requisite.

Health Deviation Self-care

It is required if there is an injury or illness associated with genetic issues. It may address the problems that impede the diagnosis or treatment efforts (Gonzalo, 2021). An individual can learn to live with the consequences of pathologic conditions or seek appropriate medical assistance.

Developmental Self-care

It focuses on issues related to growth and development and life events, which can either be positive or negative. For instance, adjusting to the physical changes or a new job.

Universal Self-Care

It relates to basic activities or life processes performed to safeguard the integrity of human structure and functioning, such as sufficient water, air, and food intake, balancing between rest and activity, and promoting human function and growth through social interaction.

Theory of Self-Care Deficit

This concept specifies when nursing services are required. For instance, a professional healthcare intervention may be needed when an individual is incapable of performing their own continuous effective self-care and, thus, requires assistance (Smith & Parker, 2015). The theory provides means of assisting people in meeting self-care demands (Gonzalo, 2021). These include teaching, supporting, guiding, and acting for others and creating an environment that promotes personal development to address future care demands. In this case, a nurse needs to initiate a professional relationship with individuals, families, and groups to help coordinate care to address underlying health issues.

Theory of Nursing System

The system is required when a patients self-care needs surpass the available self-care agency and therapeutic self-care demand, leading to self-care deficits requiring effective nursing assistance. This model describes how a patients self-care demands will be addressed by a nurse, a patient, or both. The theorist identifies three categories of the nursing system; wholly compensatory system, which involves providing care to a patient who is entirely socially dependent on others. A partly compensatory system is where nurses and patients take an active role in the care process (Gonzalo, 2021). Conversely, a supportive-educative system trains patients to perform self-care through assistance from nursing staff.

Current Nursing Example Based on Orems Theory

Ms. B is a 49-year-old hypertension patient. Applying the self-care theory, the patient can engage in physical activity (at least two hours of moderate-intense exercise) to maintain a healthy weight and lower blood pressure. However, if Ms. B is incapable of performing these self-care actions independently, nursing intervention can be secured. Nurses can monitor the patients blood pressure at intervals. Additionally, if Ms. B is on antihypertensive medication, her blood pressure is assessed to determine its effectiveness and identify changes in her symptoms. Regarding the theory of the nursing system, the nurses role in the supportive educational system may be considered when the patient is ready to learn but cannot do it without assistance (Khademian et al., 2020). Ms. B can enroll in a cardiac rehabilitation program to obtain lifestyle education.

Conclusion

Orems theory plays a significant role in healthcare provision because its key concept can be applied to a wide variety of patient settings, such as home, rehabilitation, and primary care. The self-care principle encourages patients to be independent by taking action to promote normal life functioning. Through their individual efforts, they can recover quickly and holistically by performing their own self-care as much as possible. In addition, the nursing systems and self-care deficit are also vital because they specify situations when professional nursing intervention is needed to help patients cope and manage their conditions.

References

Gonzalo, A. (2021). Dorothea Orem: Self-care deficit theory. Web.

Khademian, Z., Kazemi Ara, F., & Gholamzadeh, S. (2020). The effect of self care education based on Orems nursing theory on quality of life and self-efficacy in patients with hypertension: A quasi-experimental study. International Journal of Community Based Nursing and Midwifery, 8(2), 140149. Web.

Smith, M., & Parker, M. (2015). Nursing theories and nursing practice. F. A. Davis Company.

Yip, J. (2021). Theory-based advanced nursing practice: A practice update on the application of Orems self-care deficit nursing theory. SAGE Open Nursing, 7, 23779608211011993. Web.

Introduction

Nursing theories have been developed for describing, predicting, and explaining the process of nursing for those in the field. They offer a foundation for the nursing practice as well as help to generate further knowledge to indicate the direction in which the discipline should be developed in the future. Comparing and contrasting existing nursing theories can contribute to the enhanced understanding of approaches associated with caring for patients. The current paper will focus on comparing two nursing theories, Orems Self-Care Theory and Neumans system model. Dorothea Orems self-care deficit theory is based on the premise that human beings can adapt to their environments and thus become independent during their rehabilitation and the management of chronic conditions. Neumans systems model represents a nursing theory that is based on the relationship between patients and stress. The central principle of the model is associated with energy resources, such as average temperature, organ strength, response patterns, which are surrounded by several resistance lines. These lines represent internal factors that help patients cope with stressors.

While the nursing theories approach the principle of care from different perspectives, the critical similarity between the two of them is attributed to the need to consider unique patient needs and build care on the basis of their requirements and environments. To compare and contrast the two nursing approaches, it is imperative to elaborate on their background, their philosophical underpinnings, assumptions and concepts, the value to nursing practice, parsimony, and application in practice with examples.

Background of the Theories

The self-care deficit nursing theory was developed in the course of forty years by Dorothea Elizabeth Orem. She was born in 1914 in Baltimore, Maryland, in the family of a homemaker and a construction worker. The theorist received a diploma from Providence Hospital School of Nursing in Washington as well as receive honorary doctoral degrees from Wesleyan University, Georgetown University, and Incarnate Word College. The self-care theory was first explained in Orems book Nursing: Concepts and Practice (first published in 1971). Orems contribution to the nursing theory is undisputable as she wanted to educate professionals about the need to ensure that patients can be effective ins self-care and practice activities that would be beneficial to improving their health. According to the theorist, the condition that validates the existence of a requirement for nursing in an adult is the absence of the ability to maintain continuously that amount and quality of self-care which is therapeutic in sustaining life and death (Sitzman & Eichelberger, 2015, p. 89). When speaking of care for children, Orem mentioned that parents inability to maintain the health of their children to the extent that is both high-quality and therapeutic. Therefore, the theory applies to a variety of healthcare contexts and diverse patients.

The Systems Model was created by Betty Newman, an Ohio native, who obtained a bachelors degree in nursing and a masters in Mental Health Public health consultation, and a Ph. D. in clinical psychology from UCLA. In 1947, Neuman graduated from Peoples Hospital School of Nursing in Akron. Between the years 1992 and 1998, the theorist was awarded two distinct honorary doctorates for the achievements in the nursing study. The systems model was first presented in the theorists work Conceptual Models for Nursing Practice in 1974. Betty Newman developed the Systems Model due to the need to enhance the education and professional experiences of nurses who deal with patients on a regular basis. The background of the model is linked to the practical perspective as it can be used as a dynamic roadmap employed by nurses around the world. The script of the model underlines the concept of individuality by considering the unique conditions and backgrounds.

Philosophical Underpinnings of Theories

Dorothea Orems approach to care is grounded on the philosophy that parents wish to care for themselves, which means that they can recover holistically when being dedicated to their own health interventions (Orem, 2001). Thus, it can be suggested that Orems theory portrays the idea that nursing is an extraordinary ability to care for another person and to guide them toward achieving autonomy and effectiveness in caring for themselves. This corresponds to the philosophy of care to achieve the optimal level of health. The three support modalities of nurses roles that include complete or partial compensation and educative (supportive) purposes also contribute to the philosophical approach of the model, suggesting that no individual can independently resolve his or her health problems. Thus, the role of nurses in various support modalities is essential.

In regards to Neumans philosophy, the models underpinnings are directly related to de Chardins and Cornus approach to the wholeness in systems (Lowry, 2012). The concept of wholism is used for referencing both philosophical and biological concepts implying relationships and processes arising from wholeness, dynamic freedom, and creativity in adjusting to stressors in the internal and external environments (Neuman & Fawcett, 2011, p. 10). Therefore, patients may deal with barriers and stressors differently, which refers to the particular philosophy of the nursing approach  each individual is unique; thus, ways of improving their well-being should also be distinguished.

Major Assumptions, Concepts, and Relationships

According to Orem, patients are expected to be self-reliant and responsible for addressing their own care as well as others in their family who need it. A persons knowledge of potential problems in their health is necessary for promoting effective behaviors of self-care. Another critical assumption of the theory is that self-care and dependent care represent practices learned from a socio-cultural context. Within Orems theory, nursing is considered an art, service, and technology. Health is described as a state in which something is structurally and functionally whole or sound. Environment represents a combination of enthronement factors, elements, and conditions. A nursing problem refers to the deficit in universal, developmental, and other health-related conditions. Thus, self-care is needed as a practice and activities initiated for performing on individuals own behalf for maintaining, life, and general well-being.

Neumans system model assumes that each patient is unique in his or her characteristics and factors within a basic structure of responses. Several known, unknown, and universal stressors can influence the well-being of clients. Each of the stressors had an influence on the degree to which a person is protected by the Line of Defense (LOD). When such a protective mechanism is not available to maintain the well-being of patients, it is expected that a stressor would break through the desired state of system stability. Primary prevention is associated with the applied client assessment and a subsequent intervention targeted at the reduction of possible risk factors.

Clinical Applications and the Value to Nursing Science

When applied in practice, Orems self-care theory can be used to assess patient conditions, identify their needs, ensure effective communication, solve the identified problems, and evaluate the extent to which the process was effective (Drevenhorn, 2018). Based on the needs of patients, a nurse can assume compensatory, partially compensatory, or supportive and educative roles. For example, if a patients health is not significantly compromised, but preventive methods are necessary, Orems theory suggests that a nurse should support and educate instead of assuming a compensatory care model.

The application of Neumans System Model in practice implies the discovery of stressors that influence the poor well-being of patients. These include lifestyle choices and patterns, the quality of social connections and relationships, socioeconomic status, and many others. Based on the framework of stressors that influence the well-being of patients, a nurse recommends a course of action that will improve the general well-being. A nurse is responsible for considering patients psycho-social, physical, developmental, spiritual, and interpersonal factors when eliminating the adverse impact of stress factors on patients (Admadi & Sadeghi, 2017). This means that the model offers a comprehensive look at the range of stressors that should be addressed during treatment.

Comparison

Orems theory encourages patients to be independent in addressing their health. This distinguishes the approach from the Neuman systems model, which focuses on nurses as primary actors in alleviating the burden of disease. The self-care theory approach is recognized as a tool for education and practice in a variety of settings and as applied to a diverse set of patients and conditions. As self-care refers to the set of actions implemented deliberately and freely to maintain life and health, this aspect of the theoretical approach is what sets it apart from others.

In comparison to Dorothea Orems theory of self-care, Neuman underlines the role of various factors in shaping the approach to care. This distinction between the two approaches is essential to consider in the healthcare setting because the systems model is applied through evaluating the barriers that prevent patients from getting the desired level of care. Therefore, both theories underline the role of nurses in the process of healthcare. Similar to Orems approach, Neuman suggests that practitioners should consider the unique needs of their patients.

Parsimony

As applied to the discussion of nursing theories, the principle of parsimony, also referred to as the Occams razor suggests that an approach should offer the easiest and the most viable explanation for a particular phenomenon. Also, some may indicate that a good nursing theory shows both natural beauty and aesthetic quality. When considering parsimony as a principle applied to Dorothea Orems argument, it is essential to mention that the approach is logical and straightforward when explaining nursing care as a process. The suggestion that care can be enhanced when patients possess enough education and resources to manage their health with minimum supervision. Patients autonomy and independence are both accessible and viable components of care that make Orems theory exceedingly valuable within modern practice.

Neumans nursing theory also approaches the process of care with simplicity and viability because it is logical to suggest that there are stressors that would be preventing patients from reaching the desired health barriers. Such stressors may be associated with the financial situation of individuals or their emotional well-being since every patient is unique and has distinct sets of issues. It is also easy to understand that nurses should understand that in different patients, the resistance to various stressors and care barriers is on various levels. This means that each patient should be approached individually.

Examples

The range of examples applicable to the discussion of Dorothea Orems theory is greatly extended. Due to the simplicity and the broad application of the model in various contexts, there is a range of nursing situations in which the model can be applied. For example, when providing care to a patient with an autoimmune condition, a nurse will use the self-care theory to educate patients on the most effective management strategies. A patient who has been diagnosed with an autoimmune condition requires a roadmap that he or she can use to keep health under control. Nurses assume educational and supportive roles in such cases to provide guidance and make sure that their patients have enough autonomy and independence when managing their health.

When applying the systems model in practice, nurses will evaluate barriers (factors) or stressors that prevent the patient from reaching desired health outcomes. For instance, the care for a patient with liver problems that have an alcohol addiction can be approached from the perspective of the systems model. Alcohol addiction is a complex healthcare challenge that exasperates through the influence of numerous stressors, such as psychological, socioeconomic, or personal issues. In such a case, a nurse should be prepared not only to assess the situation but also to address healthcare challenges as related to these stressors. For example, referring the patient to a psychotherapist is expected to resolve the underlying problems that contribute to alcohol addiction.

Conclusion

In summary, it should be mentioned that nursing theories are all targeted at enhancing the quality of care and improving patient outcomes. Both models have been created on the basis of nurses experiences as well as the holistic approach of care delivery. The exploration of Orems theory and Neumans model showed that approaches to nursing practice could be different; however, the aim is the same. The two theories can be used in combination with each other to approach the practice of nursing from a multi-dimensional perspective. While Orem encouraged nurses to promote autonomy and self-care among their patients, Neuman suggested eliminating stress-related factors that prevent patients from reaching positive health outcomes.

An important takeaway from the comparison of theories is that each patient is unique and should be treated differently by healthcare providers. Instead of viewing patients as combinations of illnesses or conditions, healthcare professionals should study the specific barriers that prevent the maintenance of positive health outcomes. When interacting with their patients, nurses should explore the personal history, socioeconomic status, mental health state, as well as the range of other stressors that limit well-being. Within a holistic health model, both Neumans and Orems nursing theories point to the importance of considering patients unique circumstances and needs when developing care strategies and educating them on positive self-care practices.

References

Ahmadi, Z., & Sadeghi, T. (2017). Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis. Multiple Sclerosis Journal  Experimental, Translational and Clinical, 3(3), 205.

Drevenhorn E. (2018). A Proposed middle-range theory of nursing in hypertension care. International Journal of Hypertension, 2018, 2858253.

Lowry, L. (2012). A qualitative descriptive study of spirituality guided by the Neuman systems model. Nursing Science Quarterly, 25(4), 356-361.

Neuman, B., & Fawcett, J. (2011). The Neuman systems model (5th ed.). Upper Saddle River, NJ: Pearson Education.

Orem, D. (2011). Nursing: Concepts of practice. Maryland Heights, MO: Mosby.

Sitzman, K., & Eichelberger, L. (2015). Understanding the work of nurse theorists: A creative beginning. Burlington, MA: Jones & Bartlett Learning.

Introduction

Nursing theories dictate the nature and quality of medical services available to different patients. A nursing theory is a general assumption informed by different concepts and definitions with the aim of improving care delivery. Practitioners use specific theories to explain emerging phenomena and offer adequate health support. Such models merge concepts, metaparadigms, and ideas in an attempt to describe and predict health outcomes. This discussion gives a detailed analysis of Dorothea Orems Self-Care Theory and explains how it can be applied in nursing practice. Nurse practitioners can embrace the theory to meet the diverse needs of patients who are in need of critical care and support. The paper begins by describing the importance of nursing theory and its relevance in healthcare. A summary of Orems theory of nursing will also be presented. The next part of the paper will present a discussion of how Orems Self-Care Theory can be utilized by nurse practitioners to deliver commendable care to their patients. The conclusion will summarize the paper and offer self-reflection regarding the lessons gained from the exercise.

Discussion

Nursing theory gives a detailed guideline that can be utilized by different stakeholders in healthcare to maximize patients outcomes. Professionals who use various theories address medical problems much faster and achieve meaningful results in areas such as nursing leadership, education, and practice (Karnick, 2014). When different models are applied efficiently, it becomes possible to meet the changing health needs of diverse populations. That being the case, nursing theory is a field that must be included in a masters program. The targeted learners require appropriate competencies in order to deliver high-quality care. Nursing theory is, therefore, a necessary tool that ensures every objective in the profession is met. Nurses who understand various theories will apply them efficiently in different settings to maximize patients outcomes. Every program should be characterized by the study of nursing theory.

Similarly, nursing theory is meaningful to the nursing profession because it provides the best framework for addressing emerging medical needs. Competent practitioners in the field will identify and implement the right theories depending on the nature of the existing situation. Nurses who use such theories will develop superior philosophies and transform their patients experiences (White, 2016). Nursing theory can also be used to separate the profession from other healthcare fields. For instance, nursing theory becomes an exemplar through which personalized, evidence-based, and culturally competent services are delivered to diverse populations. A competent nurse understands how different assumptions and metaparadigms are applied depending on the patients condition (Karnick, 2014). This means that other healthcare professions do no depend on nursing theory to offer personalized care. Instead, such fields focus on convergent concepts aimed at transforming various healthcare practices. The use of theory ensures that the profession resonates with the changing health needs of every individual, thereby differentiating nursing from every other field.

Unfortunately, there are specific concerns regarding the application of nursing theory within the profession. The outstanding issue is that nursing theories are defined by specific concepts, notions, and assumptions that will be interpreted differently by practitioners. Consequently, different professionals might not agree on the best approach to utilize a given theory (White, 2016). This issue explains why nurses must develop adequate personal philosophies and reduce any form of bias throughout the healthcare delivery process.

Summary of Selected Nursing Theory

The Self-Care Theory was developed by Dorothea Orem in 1971 (Afrasiabifar, Mehri, Sadat, & Shirazi, 2016). The grand theory was originally published in the book Nursing: Concepts of Practice. The model was revised in 1980, 1995, and 2001. The latest edition of the theory indicates that nursing is a system aimed at providing self-care and re-patterning patients experiences. The theory contains various concepts that guide nurses to empower their followers and patients. The first one is that of nursing. This concept is defined as an art, a technology, and a helping process (Mills, Wand, & Fraser, 2015). The ultimate goal of nursing, according to Orem, is to meet the self-care needs of both family members and patients. Health is a state of being whereby living things are functionally and structurally sound. The environment consists of enthronement elements, conditions, and factors. A nursing problem refers to any deficit in development or universal health (Mills et al., 2015). Nursing process is a concept focusing on these three elements: why a patient is receiving medical care, the best plan for care delivery, and implementation of the plan. Nursing therapeutics refers to a purposeful and deliberate action to deliver exemplary care.

Orems theory gives a detailed description of each of the four metaparadigms of nursing. The metaparadigm of person is defined as a unit capable of functioning socially, symbolically, and biologically. The unit is capable of reflecting and using symbols. The environment focuses on components such as enthronement factors and conditions. This metaparadigm guides practitioners to understand the emerging or changing needs of patients. Health is used to describe the ability of living things to function in a sound manner (Mills et al., 2015). Nursing in an art or technology performed to ensure patients meet their self-care need needs and eventually regain their normal health states.

Medical practitioners can use Orems theory to address the health needs of their patients. The theory guides professionals to understand why specific individuals require quality care and design the best approaches to achieve positive results. This understanding explains why the theory has been selected for this paper. The concepts and attributes of the theory explain why the theory is appropriate for the selected Masters track. Nurse practitioners are trained to offer exemplary services to patients from diverse backgrounds (Afrasiabifar et al., 2016). The framework offers meaningful insights for analyzing patients needs, developing superior models, and ensuring that they regain their health states.

Application of Orems Theory: Nurse Practitioner

Nurse practitioners complete numerous roles that are aimed at meeting the health needs of diverse populations. Such responsibilities include providing primary patient care, guiding individuals to address their needs, engaging in nursing research, and developing the profession. Orems Self-Care Theory is capable of empowering nurse practitioners to ensure their patients maintain the best health conditions (Apay, Capik, Nazik, & Ozdemir, 2015). The model can guide them to perform various operations and activities with the aim of maintaining the integrity of human functioning and structure. This discussion reveals that the theory defines and expands the roles of a nurse practitioner by proposing appropriate action plans that can support patients self-care needs. Practitioners who embrace the ideas associated with the theory will achieve their goals much faster.

Several examples can be used to illustrate the above information. The first one is that the theory defines the area of nursing practice. Apay et al. (2015) indicate that nurses should come up with appropriate philosophies in order to offer personalized care to every patient. Orems theory views nursing as an art whereby practitioners scan the surrounding environment and develop appropriate models to meet the needs of every individual. The ultimate goal is to re-pattern the experiences of their patients and eventually restore their wellbeing (Afrasiabifar et al., 2016). Similarly, nurse practitioners are equipped with the best theoretical notions that guide them to achieve similar goals.

The second example can be obtained from my personal experience. As a student of nursing, I have identified specific approaches, practices, and concepts that can support my objectives. I have realized that patients are unique and require personalized care. This is true because they come from different environments and religious backgrounds. Nurses should, therefore, be in a position to develop efficient nursing models that resonate with the needs of their respective patients (Afrasiabifar et al., 2016). The objective must be to ensure the individuals take care of themselves. Nurses can also collaborate to deliver quality and efficient care.

Conclusion

The promotion and maintenance of normal human functioning is the ultimate aim of nursing practice. Orems Self-Care Theory guides nurse practitioners to analyze the changing health needs of their patients, develop personalized care delivery models, and empower them to engage in self-care. The theory becomes a powerful model for developing better philosophies and upgrading them depending on the changing demands of every patient. Orem asserts that nursing should be a process for establishing the self-care deficits of patients and developing appropriate roles to meet their demands. Practitioners can ensure their practices are coordinated to re-pattern the health statuses of their patients. This analysis has equipped me with new ideas regarding the relevance of theory in the field of nursing. I have known how to utilize various theories depending on the existing settings to achieve my goals as a nurse practitioner. The exercise has revealed that care delivery should be informed by patients unique needs. This knowledge will empower me to deliver culturally competent, evidence-based, and quality care to more patients.

References

Afrasiabifar, A., Mehri, Z., Sadat, S. J., & Shirazi, H. R. (2016). The effect of Orems Self-Care Model on fatigue in patients with multiple sclerosis: A single blind randomized clinical trial study. Iranian Red Crescent Medical Journal, 18(8), 1-9. Web.

Apay, S. E., Capik, A., Nazik, E., & Ozdemir, F. (2015). The effect of the care given using Orems Self-Care Model on the postpartum self- evaluation. International Journal of Caring Sciences, 8(2), 393-403.

Karnick, P. M. (2014). A case for nursing theory in practice. Nursing Science Quarterly, 27(2), 117. Web.

Mills, J., Wand, T., & Fraser, J. A. (2015). On self-compassion and self-care in nursing: Selfish or essential for compassionate care? International Journal of Nursing Studies, 52(4), 791-793. Web.

White, M. L. (2016). Spirituality self-care practices as a mediator between quality of life and depression. Religions, 7(54), 1-10. Web.

Theory Statement

Orem model of nursing, also known as self-care deficit nursing theory (SCDNT), is a grand nursing theory, which was developed by Dorothea Orem between 1971 and 2001, and it emphasizes the role of self-care for patients after interacting with healthcare providers.

Concepts

The major concepts of SCDNT include nursing, humans, environment, health, self-care, self-care agency, basic conditioning factors, therapeutic self-care demand, self-care deficit, nursing agency, and nursing system (Petiprin, 2016). The following section discusses these concepts.

Nursing

In Orems theory, nursing is the art through which healthcare practitioners in the nursing profession offer specialized assistance to people suffering from different disabilities to facilitate self-care in the end. Moreover, nurses are involved in the medical care that the patient gets from a physician.

Humans

Humans are defined as men, women, and children cared for either singly or as social units (Petiprin, 2016, para. 4). Humans are also termed as the material objects of nurses and all other healthcare providers who offer direct care.

Environment

The environment is a complex set-up with biological, chemical, and physical features together with community, culture, and family components that surround a patient.

Health

Health is defined as the state of being functionally and structurally whole, and it covers both individuals and groups of people. Other components of human health include the ability to communicate with fellow people, symbolize experience, and reflect on ones self.

Self-care

Self-care covers all the activities or practices that persons initiate and carry out independently as a way of ensuring health, well-being, and life.

Self-care Agency

Self-care agency is an individuals capability to get involved in self-care. This ability is subject to different conditioning factors.

Basic Conditioning Factors

Basic conditioning factors include gender, age, patterns of living, the availability and adequacy of resources, environmental factors, family and healthcare systems, socio-cultural preferences, developmental state, and health state.

Therapeutic Self-care Demand

Therapeutic self-care demand is the totality of self-care actions to be performed for some duration to meet known self-care requisites by using valid methods and related sets of actions and operations (Petiprin, 2016, para. 6).

Self-care Deficit

Self-care deficit describes the scenario where nursing care intervention is required. In such cases, patients are not in a position to get sufficient and continuous self-care from themselves (if adults are involved) or parents/guardians (if dependents are involved).

Nursing Agency

The nursing agency is the complex of different people trained and educated as nursing professionals that allows them to help patients attain their therapeutic needs by exercising or developing personal self-care agency.

Nursing System

The nursing system is the resulting product that arises when nurses engage and relate with clients or patients. This system becomes active only after a patients care demands surpass the available self-care agency, hence the need for nursing intervention.

Relationship between Concepts

The concepts of the Orem model of nursing relate through three constructs, which include theories of self-care, nursing system, and self-care deficit. The theory of self-care covers different concepts, such as self-care, self-care agency, and therapeutic self-care demand. These concepts interact with one another based on the care needs of a patient. For instance, in cases where the concept of self-care deficit emerges, other concepts like the nursing agency and nursing system are initiated to address that problem.

As noted earlier, the self-care deficit is experienced when a patient is unable to provide enough and continuous self-care, thus necessitating the need for nursing intervention (Malekzadeh, Amouzeshi, & Mazlom, 2018). In such a scenario, the nursing intervention is described under the concept of nursing agency. Therefore, these two concepts are related as they are required for proper care provision to a patient.

Ultimately, all the concepts are related as they seek to create an enabling environment where self-care deficits are identified and the roles of patients and nurses are defined to meet the available self-care demands. Similarly, the theory of nursing systems underscores the different actions and steps that nurses and patients take to ensure that self-care needs are met. As such, all the concepts related to each other depending on the level of self-care needs thus allowing patients to take care of themselves autonomously.

Structure and Organization

The structure and organization of the Orem model of nursing are formed around the premise that people are self-reliant, and they can care for themselves as their human rights. Therefore, nursing intervention is needed in cases of self-care deficit (Abotalebidariasari, Memarian, Vanaki, Kazemnejad, & Naderi, 2016). As such, the basic structure and organization of this theory is the concept of self-care. At this level, an adult patient is expected to be able to take care of himself or herself through self-care agency.

In cases where dependents are involved, parents or guardians provide this form of self-care. However, if self-care deficit emerges, the concepts of the nursing agency and nursing system are required to offer help to restore the lost self-care capability.

This form of organization facilitates the nursing process through three steps. The first one is the assessment where data is collected to determine the underlying problem. In the second step, diagnosis is carried out together with the creation of a nursing care plan. Finally, the nursing process is implemented and evaluated. Nurses then initiate the health care plan to meet the patients goals. Finally, the care plan is evaluated by interpreting results obtained from the implementation process.

Precision and Testability

According to Cramer (2013), precision and testability demands that a good theory consists of constructs that are clearly defined, tightly interrelated, and readily open to reliable and valid measurement through falsifiable hypotheses (p. 10). In light of this understanding, it suffices to state that the Orem model of nursing meets the requirements of precision and testability. The constructs or concepts are clearly defined and each can be understood independently as discussed earlier in this paper. Additionally, the concepts are tightly interrelated as they depend on each other to ensure a patients self-care capability.

Theory Application

The nursing profession is shifting from the traditional way of delivering care to patient-centeredness. In this model, patients form an integral part of care provision and they receive services aligned to their experiences, lifestyle, and backgrounds. Patient-centered care converges with the Orem model of nursing where patients are required to be actively involved in the care process. As an interventional radiology nurse, one of my duties is to prepare patients on ways to ensure self-care through ongoing education. For instance, IR nurses are expected to engage patients and family members in discharge planning even during the pre-procedure phases. This aspect ensures that patients and family members are in a position to ensure self-care after discharge, which is in line with Orem model of nursing.

References

Abotalebidariasari, G., Memarian, R., Vanaki, Z., Kazemnejad, A., & Naderi, N. (2016). Self-care motivation among patients with heart failure: A qualitative study based on Orems theory. Research and Theory Nursing Practice, 30(4), 320-332.

Cramer, K. M. (2013). Six criteria of a viable theory: Putting reversal theory to the test. Journal of Motivation, Emotion, and Personality, 1(1), 9-16.

Malekzadeh, J., Amouzeshi, Z., & Mazlom, S. R. (2018). A quasiexperimental study of the effect of teaching Orems selfcare model on nursing students clinical performance and patient satisfaction. Nursing Open, 5(3), 370-375.

Petiprin, A. (2016). Self-care deficit theory. Web.