Introduction
Contemporary nursing education and practice are grounded on diverse nursing theories that are widely applied. Their primary goals include specifying, predicting, and defining the phenomenon of nursing. Self-Care Deficit Nursing Theory was developed by Dorothea E. Orem, one of the prominent American nursing theorists. At present, it is among the most significant theories of nursing. It describes the issue of self-care deficit, its major determinants, and the ways it can be managed. Orem was focused on the increase in the quality of nursing in general hospitals (Alligood, 2014). The theorist, having nursing education herself, was able to treat it through the prism of practical experience and research work (Parker & Smith, 2015). Orem attempted to define nursing and came up with a description of its subject. According to Orem (as cited in Parker & Smith, 2015, p.122): “The condition is the inability of persons to provide continuously for themselves the amount and quality of required self-care because of situations of personal health.” Thus, it can be stated that it made her contribution to the contemporary theory and practice of nursing.
Analysis of Basic Concepts and Major Relationships in the Theory
The theory developed by Orem discloses the problem of low self-care culture. People tend to rely on medical science that can help in case of necessity and do not pay enough attention to the issue of self-care despite the fact that it can reduce the risk of health problems. Another issue related to the self-care problem centers around the people who cannot take care of themselves appropriately due to a disease. Moreover, people frequently do not have enough knowledge to act properly in situations when self-care is necessary. All those factors condition the deficit of self-care. The Self-Care Deficit Nursing Theory focuses on educational interventions that can teach nurses and the people how to take care of patients in different situations.
There are six central concepts in Orem’s theory. They are “(1) self-care, (2) self-care requisites, (3) self-care and dependent-care agency, (4) therapeutic self-care demand, (5) self-care deficit, and (6) nursing agency” (Seed & Torkelson, 2012, p. 395). Self-care is an intentional, learned action carried out by an individual who is able to regulate his or her own functions to improve and preserve personal well-being. Self-care requisites are “insights framed by individuals about the kind and course of actions that are necessary for regulation of aspects of their own functioning, development, or well-being (Seed & Torkelson, 2012, p. 396).
These requisites can be common such as the need for air, water or food, developmental requisites that usually change as the person grows and develops, and health-deviation requisites that are connected with the needs of a person’s physical and mental health. Self-care and dependent-care agency are related to people who provide self-care or dependent care to support “human functioning, development, and well-being” (Seed & Torkelson, 2012, p. 396). Therapeutic self-care demand proves that the individual possesses the knowledge and experience of interventions necessary to provide self-care and provide the regulation of human function. Self-care deficit appears in case of a discrepancy between the self-care needs and the ability to satisfy them.
Finally, the nursing agency includes an individual educated as a nurse who “has the power within a frame of a legitimate interpersonal relationship to act, educate, and help a person in such a relationship meet their therapeutic self-care demands” and can be helpful in determining self-care requisites and providing their own self-care agency (Seed & Torkelson, 2012, p. 396). There is also the seventh peripheral concept, known as basic conditioning factors. It is connected with the three major concepts (Parker & Smith, 2015). On the whole, basic conditioning factors are connected with the patient concepts such as self-care agency and therapeutic self-care demand and a nurse concept, i.e. nursing agency. These conditioning factors include the properties that influence the constructs, for example, “age, gender, developmental state, health state, sociocultural orientation, health care system factors, family system factors, the pattern of living, environmental factors, resource availability, and adequacy” (Parker & Smith, 2015, p. 128).
The concepts of the theory are closely related. These concepts are connected in a logical way and create a model. Figure 1 represents the connections within the theory.
The model reflects the relations of the concepts. Thus, self-care is connected with self-care agency and self-care demands. At the same time, the later ones determine the functioning of the nursing agency that influences deficit (Alligood, 2014).
The Relevance of the Self-Care Deficit Theory
The relevance of the self-care deficit theory is revealed in three aspects, such as personal relevance, relevance to healthcare, and relevance to research and practice. First of all, the theory was relevant to the theorist. Orem dedicated her research work to improve the work of nurses and provide care to those people who cannot take care of themselves due to some reasons.
Secondly, the theory is relevant to healthcare. It can be used to develop educational interventions for people who have to struggle the consequences of some diseases that deprive them of the opportunity to provide self-care. For example, Mohammadpour, Sharghi, Khosravan, Alami, and Akhond (2015) present some supportive educational interventions based on the self-care theory. Their research proves that such interventions can contribute to self-care ability of non-hospitalized patients and positively influence their health outcomes.
Finally, the theory is significant both for nursing research and practice. Thus, Seed and Torkelson (2012) apply the concepts of the theory in acute psychiatric care and develop a recovery model. Moreover, Wong, Ip, Choi, and Lam (2015) use the model for the examination of self-care behaviors of adolescent girls with dysmenorrhea. As a rule, the use of the model for the research results in some practical implications.
Summary: Strengths and Limitations of the Theory
Generally speaking, the self-care deficit model suggested by Orem is among those that are frequently applied in research and practice. Its strengths make it applicable not only to nursing education but also to practical work. One of the strengths of the theory is its simplicity. It makes it universal for both beginners and experienced healthcare professionals. All concepts of the theory are clearly defined and presented in relation to each other. Moreover, the theory describes one of the major tasks of a nurse, to help those who are in need and cannot provide self-care.
Still, despite the evident strengths, the theory has some limitations. First of all, despite the simplicity of the concepts, the theory is rather complicated. In fact, it comprises three theories in one that can be embarrassing for an inexperienced person. Moreover, the theory does not provide enough attention to the issue of emotional needs of the person that are crucial for general health and well-being. On the whole, it can be concluded that the self-care deficit nursing theory is a valuable resource of theoretical knowledge and a guide to efficient nursing care.
References
Alligood, M.R. (2014). Nursing theorists and their work (8th ed.). St. Luis, MS: Elsevies Mosby.
Mohammadpour, A., Sharghi, N., Khosravan, S., Alami, A., & Akhond, M. (2015). The effect of a supportive educational intervention developed based on the Orem’s self-care theory on the self-care ability of patients with myocardial infarction: A randomised controlled trial. Journal of Clinical Nursing, 24(11-12), 1686-1692. Web.
Parker, M.E., & Smith, M.C. (2015). Nursing theories. Nursing practice (4th ed.). Philadelphia, PA: F.A. Denis Company
Seed, M., & Torkelson, D. (2012). Beginning the recovery journey in acute psychiatric care: Using concepts from Orem’s self-care deficit nursing theory. Issues in Mental Health, 33, 394-398.
Wong, C., Ip, W., Choi, K., & Lam, L. (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.