Meaning of the Theory
In the process of care delivery, there are multiple instances when patients are advised to put in their most beneficial qualities despite dealing with an illness for long periods of time. In environments where health care relies on patients being independent, Dorothea Orem’s self-care nursing theory comes into play. Developed by Orem between 1959 and 2011, the theory implies that “people have a natural ability for self-care, and nursing should focus on affecting that ability” (Simmons, 2009, p. 419). Most of the main assumptions revolve around the idea that patients should depend on themselves. For instance, Orem assumed that in care provision, patients should be self-reliant and have knowledge of possible health issues. The theory is divided into such subordinate directions as the theory of self-care, the theory of self-care deficits, and the theory of nursing systems (Simmons, 2009, p. 420). Dominant concepts include nursing (as art, technology, and services), health (as integrity and wholeness), environment (as conditions and enthronement elements), human beings (as a biological unity), nursing clients, nursing problems, nursing processes, and nursing therapeutics.
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Origins of the Theory
At the time of the theory’s development, the nursing profession of the United States has been undergoing some significant changes and developments in terms of theoretical exploration. There has been a dramatic leap in nursing education and the emerging ideas of developing the profession systematically, similar to the way engineers or surgeons were trained. Because nursing started to rely more on interactions between patients and their care providers, the creation of the self-care model is understandable. Orem’s theory heavily relies on a specific system of values that include the following:
- Establishing the optimal level of health for all people;
- Helping patients reach independence when managing their personal health care needs;
- Valuing nursing as practice makes it possible for people to achieve the conditions mentioned above.
In supporting her theory, Orem appeals to the importance of relations between people rather than individual needs. The components of the theory focus on different dimensions of care. For instance, the self-care aspect relies on the self of a person, the component of self-care deficits focuses on relations between people, while the aspect of nursing systems relies on people in communities. Thus, the key motivation behind the theory is the idea of improving patients’ abilities to care for themselves by collaborating with healthcare providers. In the development of the theory, Orem uses the causal process approach to formulate connections between dependent and independent variables.
Dorothea Orem’s self-care theory is useful because it allows professionals to understand whether their patients have enough resources to administer self-care. It can show whether self-neglect is an issue and provide a framework for overcoming it. By exploring the relationships between nurses and their patients, the theory facilitates the development of practical insights into what should be done to strengthen those connections or create those that do not exist. By doing so, nurses can predict the likely outcomes.
For instance, when dealing with multiple sclerosis (MS) patients that suffer from constant fatigue, the self-care theory can be applied to a sample group, with health outcomes being evaluated before and after the intervention. The study conducted by Afrasiabifar, Mehri, Sadat, and Ghaffarian Shirazi (2016), revealed that before the implementation of an educational intervention on Orem’s model, only 11% of patients with MS had a solid knowledge of self-care. After the one-month intervention was implemented, researchers observed a significant difference in fatigue outcomes between the intervention and the control groups (Afrasiabifar et al., 2016). This means that the self-care theory is effective at not only strengthening patients’ personal awareness about their health but also produce effective results within reasonable timeframes.
The theory is highly testable because it is easy to measure patients’ health outcomes in relation to their knowledge and self-care abilities. It has generated multiple studies on a variety of topics. For example, Hasanpour-Dehkordi, Mohammadi, and Nikbakht-Nasrabadi (2016) studied the applicability of the self-care theory for chronic hepatitis patients, while Afrasiabifar et al. (2016) tested its effectiveness for caring for patients with multiple sclerosis. In general, research on the theory implied how well patients could care for themselves in the context of dealing with different health conditions.
In general terms, it can be concluded that the theory was developed for encouraging people to overcome their limitations and become independent in caring for themselves and managing their health conditions. Dorothea Orem’s theory provides a comprehensive look at how nursing practice should benefit patients. On the one hand, the theory is useful for implementation in different settings and multiple areas as well as aligns with the changing nature of the profession, which means that it is highly generic. On the other hand, it is illness-oriented, with health being viewed as a process that does not end. In the advanced nursing practice, the theory can be used for the purpose of supporting patients’ abilities to take control of their health.
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Afrasiabifar, A., Mehri, Z., Javad Sadat, S., & Ghaffarian Shirazi, H. R. (2016). The effect of Orem’s self-care model on fatigue in patients with multiple sclerosis: A single blind randomized clinical trial study. Iranian Red Crescent Medical Journal, 18(8), 31955.
Hasanpour-Dehkordi, A., Mohammadi, N., & Nikbakht-Nasrabadi, A. (2016). Re-designing Orem’s self-care theory for patients with chronic hepatitis. Indian Journal of Palliative Care, 22(4), 395-401.
Simmons, L. (2009). Dorothea Orem’s self-care theory as related to nursing practice in hemodyalysis. Nephrology Nursing Journal, 36(4), 419-421.