Orem’s Self-Care Deficit Nursing Theory, Research Paper Example
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Orem’s self-care deficit nursing theory (SCDNT) views health in terms of self-care, and nursing as the practice of redressing any imbalance between self-care needs and self agency. SCDNT is a powerful theory of nursing, and it offers a compelling conceptual model of nursing systems that focuses on understanding patients’ needs, and how to meet them. By utilizing SCDNT, nurses can better ascertain the character of patients’ needs, and design effective systems of nursing to rectify the imbalance between patient agency and needs.
From the perspective of Orem’s self-care deficit nursing theory (SCDNT), the purpose of nursing is to provide care for individuals experiencing a “self-care deficit”, a lack of capacity or functionality to provide for their own care (Orem, 2004, p. 6). Such a deficit in self-care capacity is, as Orem herself explained, an indication that the individual’s own agency of self-care does not encompass the knowledge and/or functionality to meet their own needs (p. 6). In order to meet these self-care deficits, it is important to understand self-care requisites: needs, such as air, water, and food, that are essential for proper health (pp. 7-8). Other needs include elimination, a healthy balance between activity and rest, avoiding hazards, engaging in social behavior and participating in relationships, etc. (Berbiglia & Banfield, 2010, pp. 269-270).
Ordinarily, healthy people exercise self-agency in meeting their needs: thus, nurses must understand those circumstances in which self-agency is not sufficient to meet these self-care needs, and what kind(s) of assistance to provide to rectify the gap (Orem, 2004, pp. 7-8). A key point here is that SCDNT views human beings as persons, capable of exercising agency through deliberate action (Berbiglia & Banfield, 2010, pp. 267-268). Tying self-care and self-care deficits together is the theory of nursing systems: all nursing systems entail the use of nurses’ agency to bridge the gap between the patient variables of “therapeutic self-care demands and self-care agency” (Orem, 2004, p. 7). Nursing systems are concerned with how to construct the relationship between nurse and patient in order to ensure successful nursing: nursing actions constitute this relationship, which utilizes “the operations of diagnosis, prescription, and regulation” (Berbiglia & Banfield, 2010, pp. 271-273).
Implementing this theory in practice requires that the nurse answer four basic questions: “When and why do persons need nursing?”; whether people vary in their needs for assistance, and how; what kinds of assistance are valid in light of patients’ needs, and how to constitute the “form, the structure, and the content elements of nursing assistance?” (Orem, 2004, p. 7). In the case of a patient with a fractured tibia, the nurse would need to recognize the patient’s needs in terms of therapeutic self-care demands: the patient needs the bone set properly, because it interferes with their own functionality and they cannot reset it on their own. They need the bone set and a cast, but they might also need a prescription for the pain. And throughout the entire experience, the patient will need the reassurance of the nurse’s professionalism and empathy. A nursing system for such a patient would take all of these therapeutic self-care demands into account, and exercise nursing agency through the use of helping methods in order to meet these needs. This basic conception is readily applicable to an entire hospital full of patients: they too have therapeutic self-care demands that they are unable to meet with their own agency. By understanding these needs, nurses can exercise their own agency to redress the imbalance and better secure the patients’ well-being.
Redressing, compensating, or overcoming the systemic imbalance between patients’ therapeutic self-care demands and their own agency is the foundation of the SCDNT. Application of the theory requires asking the right questions about when and why patients require nursing care, in order to better understand their problems and devise solutions. By so doing, nurses can design more efficacious nursing systems to improve patient well-being.
Berbiglia, V. A., & Banfield, B. (2010). Dorothea E. Orem (1914-2007): Self-Care Deficit Theory of Nursing. In M. R. Alligood & A. Marriner-Tomey (Eds.), Nursing theorists and their work (pp. 265-279). St. Louis, MO: Mosby.
Orem, D. E. (2004). Reflections on nursing practice science: The nature, the structure and the foundation of nursing sciences. Self-Care, Dependent-Care & Nursing, 12(3), pp. 4-11. Retrieved from: http://www.search.ebscohost.com/
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