This essay examines Orem’s theory both in nursing situations and in other disciplines.
Dorothea Orem developed several interesting theories of nursing which are still current today. (Orem herself is very much alive; she lives in Savannah, Georgia.) According to one source, Orem’s inspiration for her theory came when she asked herself a simple question, “Why do people need nursing?” (Taylor, n.d., PG).
Her nursing theories arose out of a need to answer that question.
This paper discusses Orem’s self-care deficit nursing theory (SCDNT) and how it relates to some of the practical issues of nursing. It also discusses the way in which the theory might apply in non-nursing situations.
IIMajor Components of the Theory
Orem’s theory really arises out of the comparison of two other theories. First, she proposed the “theory of self-care.” In this theory, she proposed that human beings are capable of taking deliberate action to regulate their lives, health and well-being. The term she gave to this ability to take action on one’s own behalf is “self-care agency.”
The self-care deficit theory says that human beings have a set of tasks they must perform in order to insure optimal life, health and well-being. Orem termed the total of all these actions that are essential to maintaining life, health and well-being “therapeutic self-care demand.” When the actions a person can perform (self-care agency) are insufficient to fulfill all or part of the therapeutic self-care demand, a self-care deficit develops. That is, the person can no longer perform everything he/she needs to do to maintain their life, health and well-being. A “nursing system” is the term given to “the design and organization of an action plan that bridges the identified gap between self-care agency and therapeutic self-care demand.” (Whitener, 1998, PG).
... relationships between phenomena, predicting consequences or prescribing nursing care. Nursing theories are reservoirs in which are stored those ... 1991). “Self-care agency to meet individual’s needs for self-care action in order to sustain life and health, ... Thought Educational Background Philosophy of Nursing Definition of Nursing Goal/Purpose of Theory Dorthea Orem The First School of Thought: ...
It seems then that the “mechanism” we need is something to either help the person perform the needed action; substitute different actions; or find someone to assist in the performance of the actions.
IIIHow the Theory Relates to Nursing, Clients and
Whitener’s article describes the use of the theory in regard to children’s health, and is a good example of the way the theory relates to nursing. The idea described in the article is the way in which children can be presented with appropriate health messages to develop “self-care agency.” (Recall that self-care agency is the ability to take action on one’s own behalf to regulate one’s life.) The environment here was the elementary school, in particular a health fair, the “clients” are the children, and the idea was to use the theory to help children recognize good health choices amid the bombardment of advertising and media hype we live in today. The main emphasis was on the work of school nurses, who are in a perfect position to deliver appropriate messages to school age children who can then begin “to discriminate between good and bad choices that influence their personal health.” (Whitener, 1998, PG).
Children, like the rest of us, are exposed to seductive messages from the media every day; messages often delivered by much-admired celebrities and sports figures. These messages tell the children everything from “supersize your fries” to “you can’t live without a ____” (fill in the latest, absolutely have-to-have-it toy or gadget).
How much of an effect does your environment have on your mental health? Plenty. Does it mean you're doomed if your environment is supposedly negative? Not necessarily. What can we attribute the high rate of social and psychological problems in cities to? And, are urban areas predestined to be a hub for high social and psychological problems. The latter two are questions David Quinton is attempting ...
As marketers become more insistent and as corporations make their way into the classroom, it’s imperative that children have a method to make good choices in regard to their health.
At this age, however, many of the decisions and actions that are part of the self-care agency are made by others on the children’s behalf. Even so, Whitener says, SCDNT in combination with other cognitive learning theories will prepare the children for full actuation of the self-care agency.
Some of the actions students decided to take after being exposed to the positive messages at the heath fair were to eat more vegetables; eat breakfast; read more and wear their glasses. (Whitener, 1998, PG).
IVImplications of the Theory in Other Disciplines
It would seem that the theory could be applied to almost any discipline or situation. The idea is simple: finding a way to bridge the gap between what the person has to do and what he’s capable of doing with regard to those actions that he must take to maintain his life, health and well-being.
I believe though that the term “actions” is somewhat misleading, because we are actually talking about decisions that have to be made and actions that follow those decisions. It seems therefore to be important to make sound decisions first. In science, for instance, it might be necessary to run an experiment around the clock. It’s also probable that the results must be meticulously recorded. The decisions here would involve making sure that the scientists had scheduled their time so that the person recording the data was alert and correct in his observations. In other words, to maintain his well-being, the scientists wants to conduct and record an experiment, and make sure that his data is correct. His decisions about rest for himself and other members of his team, then, have a direct impact on the accuracy of his results, which in turn impacts his well-being as a professional in a demanding field. This is far afield from nursing, but the theory seems broad enough, when considered in its general terms, to encompass almost any field.
Although these numbers are slightly under the national average, they are daunting when broken down by total population of the state that figure comes out to about 4. 488. 188 people receiving Medicaid health care benefits (Kaiser State Health Facts, 2013). Harris county clinic provides care to a large Medicaid population, and the department budget for clinic has been recently cut by 15%. This ...
VApplication in Industrial (Occupational Health)
The nature of industrial and occupational nursing means that a practitioner may have to deal with things as varied as accidents, chemical spills and the flu. In this discipline, it would seem to me that the SCDNT would come into play most strongly with regard to safety in the workplace. The nurse would want the employees to make the choices that would enhance their safety, cut the accident rate, and reduce chances of injury or death on the job. The choices they would make would then be things like using a ladder, lifting heavy objects correctly, making sure cans are closed properly, and perhaps even knowing how to deal with such things as radioactive waste.
The nurse would probably only come in contact with the employees after an incident, but she could show them, at that time, ways to prevent a recurrence. Her nursing strategy, then, would be to show them the “bridge” between what he must do and what he’s capable of doing. (For example, he must lift a heavy box if he wants to retain his position; but he’s only capable of doing it without injury if he does it a certain way. The nurse can show him the proper method.)
Orem’s theory seems to me to be very practical, and does indeed encompass a wide range of ideas, starting with her very first question about people’s need for nursing. The theory is so elegantly simple it can be applied to many different disciplines and situations.
Taylor, S.G. (N.D.) The development of self-care deficit nursing theory: An historical analysis. Retrieved March 6, 2003 from the World Wide Web: http://www.muhealth.org/%7Enursing/scdnt/taylor1198.htm
Whitener, L.M., Cox, K.R. & Maglich, S.A. Use of theory to guide nurses in the design of health messages for children. Advances in Nursing Science, 20, 21-36. Retrieved March 6, 2003 from The Gale Group, San Diego Public Library, San Diego, CA at: http://web3.infotrac.galegroup.com/itw/infomark/7/904/58571653w3/purl=rc1_ITOF_0_A20426596&dyn=4!xrn_2_0_A20426596?sw_aep=sddp_main