Theory/Author Name and Background
Known as one of the people that broke new grounds in the realm of nursing, Dorothea Orem reinvented how patients’ needs were addressed in healthcare (Wong, Choi, & Lam, 2015). Her Self-Care Deficit Nursing Theory (SCDNT) allowed viewing patients and their participation in the process of recovery from an entirely different perspective. No longer were target demographics viewed as passive recipients of care; instead, they were given the agency to take part in the management of their needs (Wong et al., 2015). As a result, the process of administering nursing services, as well as the speed and overall rates of recovery, was enhanced greatly (Wong et al., 2015).
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Dorothea Orem was the chairman of the Department of Nursing in Detroit, as well as the head of a local nursing school. As a result, her innovative ideas were deployed in the healthcare environment successfully (Snowden, Donnell, & Duffy, 2014). Furthermore, being the curriculum consultant in Detroit, she helped shape the process of education in nursing to teach the active communication between a nurse and a patient as an important part of the curriculum (Snowden et al., 2014).
Current nursing theories borrow heavily from Orem’s concept of self-care promotion (Wong et al., 2015). For example, a recent study has shown that SCDNT can be utilized successfully as the platform for addressing the needs of patients with STD, particularly, with Hepatitis (Hasanpour-Dehkordi, Mohammadi, & Nikbakht-Nasrabadi, 2016). The reasons for the issue to retain its weight include the uniqueness of each patient and their response to diseases and disorders, the increasingly high levels of diversity in communities, and the need to provide patients with new information about threats to their well-being (Hasanpour-Dehkordi et al., 2016).
In Nursing: Concepts of Practice, Dorothea Orem provided an exhaustive description of SCDNT and its main provisions (Wong et al., 2015). Furthermore, Orem’s theory has been supported by a range of studies that prove the efficacy of the concept of self-care (Hasanpour-Dehkordi et al., 2016). For instance, Hashemi et al. (2014) state explicitly that SCDNT can be used to manage the needs of burn patients (Hashemi et al., 2014). Similarly, the needs of patients with diabetes II can be met more efficiently once Orem’s approach is deployed, according to the research carried out by Pelicand, Fournier, Rhun, and Aujou (2015).
The philosophy that Orem built and promoted as an innovative method of catering to the needs of diverse populations implied assisting patients in learning to perform self-care (Barrett, Wilson, & Woollands, 2014). The reason for emphasizing the significance of patients’ role in a treatment process was justified by the fact that nursing primarily implies an interaction between a nurse and a patient. Therefore, the role of the latter must not be underestimated when designing an intervention strategy or performing any steps for managing patients’ immediate needs (Barrett et al., 2014).
The theory uses inductive reasoning to showcase the importance of enhancing patient education and maintaining communication between a patient and a nurse consistent (Barrett et al., 2014). For example, Orem provided direct examples from her professional experiences to support her argument about the need to engage a patient in self-directed education (Barrett et al., 2014). However, Orem also supported her statement about the need to increase patient health literacy by conducting a profound analysis of relevant studies (Barrett et al., 2014). The necessity to build the theoretical framer for SCDNT based on the tenets and provisions of existing theories and philosophies was stressed heavily by Orem as one of the principal steps toward making SCDNT efficient. Therefore, a reproductive approach was also incorporated into the set of techniques that Orem chose to provide a foundation for her theory. Finally, deductive reasoning is employed to connect theory and practice (Barrett et al., 2014).
The major concepts of the theory include the Theory of Self-Care, the Theory of Self-Care Deficit, and the Theory of Nursing Systems. According to the provisions of the Theory of Self-Care, self-care requisites can be defined as universal, developmental, and health-deviation-related ones (Hasanpour-Dehkordi et al., 2016). In other words, the ones that are intrinsic to people’s nature and biology, universal ones that can be acquired by training, and ones that are developed based on health issues observed in an individual (Hasanpour-Dehkordi et al., 2016).
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Remarkably, none of the components listed above exist in a vacuum; instead, all of them are connected, thus, making patient education and independence possible. For instance, the Theory of Self-Care offers an insight into the idea of providing patients with a certain amount of independence to help them identify a threat to their health, take the necessary measures to avert or slow down its effect, and locate available healthcare services. The Theory of Self-Care Deficit, in turn, sheds light on the dangers of failing to allow patients to learn more about their health, as well as helps identify the point at which nursing services must be provided. The Theory of Nursing Systems, in turn, serves as the unifying framework that solidifies SCDNT’s place among the rest of nursing frameworks, thus, giving it legitimacy and weight.
The assumption regarding the necessity to recognize patients’ agency as individuals that are capable of learning and participating in the process of nursing must be recognized as the revolutionary statement that propelled Orem’s theory to the top of frameworks used to improve the quality of nursing services (Mills, Wand, & Fraser, 2015). The theory is based on the idea that patients should be regarded as important and active agents of nursing. nurses used to treat patients like passive recipients of nursing services. However, with the enhancement of Orem’s theory, nurses started considering target populations as individuals who can develop the skills required to sustain health by recognizing existing threats, taking based measures for addressing their health concerns, differentiating between factual and false information about health-related issues, and addressing health services whenever needed (Mills et al., 2015).
The identified approach has its benefits and disadvantages. On the one hand, it resolves some of the issues that have been blocking the [provision of high-quality nursing services to patients, such as the necessity to reduce and control patients’ exposure to extraneous threats to their health outside of a hospital environment (Mills et al., 2015). On the other hand, giving patients too much independence may result in serious ethical implications. For instance, there might be a chance of nurses considering the specified innovation as a means of shifting a substantial part of their responsibilities such as controlling patients’ well-being to the recipients of care. To avoid the specified misinterpretation of the provisions of Orem’s theory, one should reinforce the significance of the ethical standards deployed in a nursing facility. Thus, nurses will view patients’ needs as their priority (Mills et al., 2015).
The four concepts of the nursing meta paradigms are also present in SCDNT (Barrett et al., 2014). From the perspective of Orem’s theory, patients are deemed as independent and self-reliant, health is regarded as a natural state of living, an environment is seen as a combination of factors affecting one’s health, and nursing is defined as the process involving the identification of a health concern, its further management, and the active involvement of a patient in the process (Hasanpour-Dehkordi et al., 2016). Even though Orem pioneered in determining the phenomenon of self-care, she used key terms consistently and made them very clear to target demographics. Therefore, key concepts are defined not only explicitly but also both theoretically and operationally.
Each of the components is linked to the rest of the items closely. For instance, the phenomenon of a patient’s health is placed in the context of their environment (Barrett et al., 2014). As a result, nursing is interpreted as a set of strategies for restoring the natural state of patients’ being. Thus, the nursing meta paradigms of Orem’s framework can be characterized by a strong and evident connection between its elements (Hasanpour-Dehkordi et al., 2016).
SCDNT should also be given credit for its lucidness and consistency. The framework is quite simple, yet it can be connected to other nursing theories and philosophies rather easily (Hasanpour-Dehkordi et al., 2016). Because of the close connection between its elements and the link to other theories, SCDNT gives a chance to make the process of providing patients with knowledge and skills necessary to manage their health concerns reciprocal by enabling a nurse to establish a dialogue with members of multicultural communities. Thus, nurses will be given the impetus to develop the skills that will help them identify the needs of people from different backgrounds within a relatively short amount of time.
SCDNT allows creating an individualized plan of care that will help make the recovery process significantly faster and much more efficient. Because of expected improvements in the quality of communication between a patient and a nurse, a range of issues regarding possible misinterpretation of data, failure to recognize patients’ culture-specific needs, etc., will be prevented successfully. The subsequent rise in the quality of communication between a nurse and a patient, in turn, will serve as the platform for making patient education consistent. It is also expected that the adoption of SCDNT will have a tangibly positive effect on patients’ well-being in the global community. Particularly, the issues such as the lack of health literacy and the presence of numerous harmful myths associated with health are expected to be addressed during the introduction of SCDNT principles into the realm of modern nursing and healthcare (Barrett et al., 2014). SCDNT will inform nurses’ actions in the context of a multicultural community, thus, improving the quality of care.
The theory under analysis can be deployed successfully in Health Education. As explained above, because of the necessity to engage in the process of patient education, learning becomes reciprocal, i.e., nurses gain an increasingly large amount of information about the needs of multicultural communities regularly. Thus, SCDNT can be incorporated into the set of tools used for improving the education process among nurses and fostering the development of positive attitudes toward patients among them. Apart from helping nurses to recognize the importance of a patient-centered approach, the said framework serves as the platform for building the philosophy of lifelong learning as the means of tending to the needs of an increasingly diverse community among nurses (Barrett et al., 2014).
At this point, one must mention that, even though the theory implies providing patients with an impressive degree of independence, it does not allow nurses to shift responsibilities to the recipients of care. Quite the contrary, the approach suggests that the process of managing patients’ needs be improved by enhancing care and improving communication between a nurse and a patient (Barrett et al., 2014). It is essential to make the management of patients’ health issues even more efficient and ensuring their safety after a patient is released from a hospital.
Thus, the framework suggests giving target demographics the information that will enable them to identify a health threat or concern, i.e., recognize symptoms of a disease or locate the factors that may expose a patient to a health risk. Furthermore, the model allows making the communication process between a nurse and a patient more productive. The adoption of Orem’s framework in the context of the contemporary healthcare environment may involve the active use of IT innovations as the means of making the nurse-patient communication consistent (Barrett et al., 2014). For instance, the incorporation of social media into the existing nursing strategies for maintaining the levels of awareness among target populations high should be recognized as an important change in the quality and efficacy of nursing services.
SCDNT was one of the theories that created a platform for taking the relationships between a patient and a nurse to an entirely new level, where target demographics are recognized as smart and active participants of a nursing process. The approach must be recognized for its unique perspective, as well as the fact that it allows incorporating innovative strategies and technologies into the strategies used to meet the needs of target populations. Being ahead of its time, the theory made it possible for new patient-centered approaches to emerging, thus, heralding a new era in nursing and becoming a key to the successful management of diverse patients’ needs.
Barrett, D., Wilson, B., & Woollands, A. (2014). Care planning: A guide for nurses. New York, NY: Routledge.
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. 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.
Pelicand, J., Fournier, C., Rhun, A. L., & Aujoulat, I. (2015). Self‐care support in paediatric patients with type 1 diabetes: Bridging the gap between patient education and health promotion? A review. Health Expectations, 18(3), 303-311. Web.
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Snowden, A., Donnell, A., & Duffy, T. (2014). Pioneering theories in nursing. London, UK: Andrews UK.
Wong, C. L., Ip, W. Y., Choi, K. C., & Lam, L. W. (2015). Examining self‐care behaviors and their associated factors among adolescent girls with dysmenorrhea: An application of Orem’s self‐care deficit nursing theory. Journal of Nursing Scholarship, 47(3), 219-227. Web.