The main objective of the empirical study was to measure the effects of Dorothea Orem’s self-care model on fatigue and its self-management in patients with multiple sclerosis (MS). As such, fatigue is defined as a subjective MS symptom yet it is one of the most prevalent in patients with this disease. The term refers to a sense of reduced psychological and/or physical functionality and, therefore, adversely affects individuals’ performance of various activities.
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A decisive evidence-based treatment for this problem currently does not exist, but the researchers argued that Orem’s self-care model provides opportunities for the improvement of patients’ quality of life by enabling them to decrease fatigue.
As the authors of the study indicate, the main purpose of Orem’s theory is to empower patients and endow them with the necessary resources to engage in self-care independently. The major concepts used in the article are self-care, self-care needs, self-care agency, self-care deficit, and nursing system design. The researchers did not provide an explicit description of these concepts yet utilized them during the design of research measures and tools in their original meanings.
In the article, the term “self-care” refers to individuals’ behaviors aimed at the promotion and maintenance of their own health and well-being. Self-care needs imply basic necessities that a person must satisfy and the resources they need to get to ensure their good health. These needs include rest/physical activity, food, air, medical assistance, adherence to recommended healthcare interventions, and so forth.
As for the concept of self-care agency, it is used in the study as one’s overall capability to engage in self-care behaviors. This ability is defined not only by the skills and healthcare status of a patient but also their access to essential resources, including finances and knowledge. At the same time, when one is incapable of performing self-care tasks or lacks certain resources, it means they have a self-care deficit.
Lastly, the authors of the study developed their own concept of nursing system design based on Orem’s theoretical principle of methods of helping that clarifies which particular tools and techniques nurses should implement in order to help patients to enhance their self-care agency. A few of the examples of those methods include guiding and teaching, providing an environment, and support. Some of the ways through which these methods can be implemented are education about the disease and non-medical treatment principles, assistance in the planning of daily activities, and so forth.
The described concepts are applied in the study to assess self-care agency and deficit levels in a sample of 32 MS patients and 31 control group members. The researchers developed an evaluation tool to measure their universal and disease-specific self-care needs, including water, food, and learning to live with the negative impacts of MS. In addition, they analyzed participants’ ability to meet those needs by marking their self-care agency levels as either adequate or inadequate. Besides, the researchers identified specific self-care deficits of each patient, such as grooming, drug complications, and so forth, and linked them to particular methods of helping and interventions.
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The study findings revealed that by implementing self-care interventions, which were prescribed to patients with MS-related fatigue based on the outcomes of the abovementioned assessment, it was possible to reduce this symptom in them. The results showed that those interventions allowed to improve individuals’ self-concepts, as well as their perceptions of health status and quality of life. It means that the use of Orem’s model in order to develop persons’ self-care agency and reduce their self-care deficits, it is possible to attain more favorable health outcomes and gain more opportunities for the overall success of chronic disease treatment.
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), e31955.