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The Self-Care Theory by Dorothea Orem

Abstract

The theoretical models continually guide nursing practice, and the nurses follow and learn them intuitively. This paper examines the self-care theory of Dorothea Orem in psychiatric mental health practice. Orem has used a philosophical foundation to define the role of individuals and nurses in maintaining self-care, which she called the self-care framework theory. Orem has explained the importance of independence and autonomy in health interventions as the full dose to enhance self-care in patients. She has employed major components and different concepts, which are explained briefly. She uses these aspects to apply the role of nursing in various settings of nursing practice. The paper also examines the relationship between the self-care theory framework and psychiatric health by examining the framework’s philosophical foundations and goals. It also surveys the applicability of the self-care framework in mental health issues and the solutions of mitigating and treating these problems using the theoretical concepts and principles obtained from the self-care framework.

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Introduction

Nursing theories are crucial components of nursing practice and education. They provide a useful matrix for understanding the role of nurses in attaining harmonized healthcare outcomes for patients. Currently, there are numerous theories used in various nursing practice areas, and the self-care framework is not an exception. It serves to outline the important ties between nurses and patients while establishing key principles of health promotion. The self-care framework was developed by Dorothea Orem and has become one of the most popular theories in nursing practice and education. The main principle presented in this theory is that all patients want to exercise care for themselves and their families, and the goal of the nurses is to help them obtain maximum autonomy and effectiveness in their condition (Younas, 2017). This paper seeks to analyze and evaluate Orem’s theory of self-care as well as outline the main ideas of its application and use in psychiatric mental health practice.

Analysis of the Self-Care Framework Theory

The self-care framework is a theory-practice that explains the activities of individuals for their own benefits while pursuing to maintain good health and wellbeing. This approach is rooted in the philosophy that all patients perform care for themselves. Which illuminates that patients can holistically recover when dedicated to their health interventions. In keeping with Orem (1985), patients are expected to be responsible and rely on themselves when addressing their care and their families. The potential knowledge of a person’s healthcare problems is crucial for promoting dynamic behavior of self-care.

Additionally, the theory conjures that dependent care and self-care signifies practices obtained from the socio-cultural context. Within the self-care theory, nursing is reflected as an art, science, or technology. Health is considered a condition where something is anatomically and functionally complete. Environment signifies the combination of various enthronement elements, factors, and conditions. Nursing problem mirrors deficit in universal and developmental health-related conditions. Thus, self-care is crucial as a nursing practice to maintain the life and general wellbeing of humans.

The theory has various components, such as, self-care which is a framework of actions and activities performed by individuals to maintain life, health, and wellbeing (Younas, 2017). Self-care agency, an individual’s ability to undertake self-care, preconditioned by health status, life experience, resources, age, and socio-cultural orientation. Demand for therapeutic self-care, covering a matrix of care actions done for achieving the requisites of self-care by employing valid activities, methods, and related operations (Younas, 2017). Self-care requisites are a set of methods, divided into three categories of universal, developmental, and health deviation, directed towards the provision of self-care.

Evaluation of the Self-Care Framework Theory

Congruency of the Philosophical Foundations of the Theory to the Role of the PMHNP

The foundation of the self-care theory plays an important role in educating patients to have adequate autonomy and independence in managing health conditions. Like in mental health practice, the framework offers free will and a set of actions on individuals to sustain life and wellbeing. The Orem self-care practice advocates for an individual’s independence which is a crucial tool in psychiatry. Individuals’ own dedication to the health interventions enables them to have more involvement and control over their condition. Thus psychiatrists can use this framework to assess the condition and wellbeing of their patients.

Congruency of the Goals of the Theory & Goals of the Role of the PMHNP

The goal of a psychiatric mental health nurse practitioner is to assist in supporting and influencing patient’s recovery by enabling them to have total involvement and control over their health conditions. Similarly, the self-care theory framework focuses on individuals’ activities performed on their behalf, which are actions to maintain life and correct a health deviation condition (Younas, 2017). Thus, the two paradigms are directly related because both aim at correct patient’s health conditions to maintain life and functioning.

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Research Evidence to Support the Usefulness of the Theory to the Role of the PMHNP

There are pieces of evidence that show conceptual frameworks drawn from Orem’s self-care theory used in assessing mental health. For example, Khatiban et al. (2018) used a conceptual framework from Orem’s theory to measure the self-capacity of patients with chronic mental illness. Also, research shows that Orem’s model of self-care can be helpful to a schizophrenic patient with difficulties in maintaining self-care.

Application of the Theory to Support Practice as a PMHNP

The role theories give benefits of social interaction that nurses can use to understand the patients and their roles in the family and the society. Mental health nurses can use Orem’s theory to assess the condition of the patients, identify their problems and needs, solve their issues, and evaluate the effectiveness of the process. Following a patient’s needs, psychiatric nurses can assume different roles, including compensatory, educative, or supportive roles in the treatment practice. For instance, if the patient’s condition is not in a severe stage but can be prevented, Orem’s framework advocates for education instead of compensatory treatment.

Application of the Self-Care Framework Theory to PMHNP

The variety of practical examples to the debate of Orem’s theory is prominently stretched. Due to the wider application of the framework in many backgrounds, self-care theory can be applied in a range of nursing practices (Ali, 2018). For example, in patients with arterial hypertension, the psychiatrist must examine the associated risk factors such as heredity, gender, age, high sodium and fat diet, alcohol, sedentary life, contraceptives, and anxiety. This is to attest to self-care deficit to scrutinize the outcomes according to the background of the self-care theory (Ali, 2018). According to Orem’s self-care theory, patients diagnosed with such risk factors have a self-care deficit present in them (Orem, 1985). In this problem, the individual’s lifestyle is the most prevalent diagnosis based on the universal requirement. On the other hand, the sedentary lifestyle and high sodium and fat diet signal ineffective control of therapeutic regimen. The identification of imbalanced nutrition requires more than consultation and therefore needs compensatory treatment.

The self-care practice should constantly contemplate a person’s choice since it is the attitude of each individual (Orem, 1985). Regardless of the information about the disease, people may decide to keep their lifestyle, a situation that can affect the treatment of the disease, causing persistent self-care deficit in these individuals. Because of the chronic nature of arterial hypertension and its inability to exacerbate physical changes, there is a need for constant counseling for the patients to understand and carry out the necessary orientation for its treatment. Such attitudes oblige some cognitive facets for the patient to easily understand and accept the treatment orientations. Therefore, educating the patients would contribute to a faster understanding of the required cognitive aspects.

Conclusion

In conclusion, the self-care framework is a unifying and sensible model that can be employed to conceptualize the entirety of self-care and its related dimensions. Both the psychiatrist and physicians can use it as a lens to identify, apply, study, view, and evaluate self-care elements in the intervention of a patient’s wellbeing. The middle-level descriptions showing the correlation among the four components of the self-care matrix render this framework widely applicable in various healthcare systems. This theory, therefore, indicates different thinking of the self-care framework and that many stakeholders can use this new perspective as a common ground for advancing the practice, study, and evaluation of various self-care actions in the modern world.

References

Ali, B. H. I. (2018). Application of Orem self-care deficit theory on a psychiatric patient. Annals of Nursing and Practice, 5(1), 1-3. Web.

Khatiban, M., Shirani, F., Oshvandi, K., Soltanian, A. R., & Ebrahimian, R. (2018). Orem’s self-care model with trauma patients: a quasi-experimental study. Nursing science quarterly, 31(3), 272-278. Web.

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Orem, D. E. (1985). A concept of self-care for the rehabilitation client. Rehabilitation Nursing Journal, 10(3), 33-36. Web.

Younas, A. (2017). A foundational analysis of Dorothea Orem’s self-care theory and evaluation of its significance for nursing practice and research. Creative Nursing, 23(1), 13-23. Web.

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