Functional Assessment in the Older Adult

Dorothea Orem's Theory of Nursing

About Dorothea Orem:

Born: 1914 in Baltimore, Maryland
Earned her diploma at Providence Hospital - Washington DC
1939 - Earned BSN
1945 - Earned MSN
Worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant
Received honorary Doctorate of Science in 1976

Major Assumptions of her theory:

People should be self-reliant and responsible for their own care and other in their family needing care
People are distinct individuals
Nursing is a form of action - interaction between two or more people
Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health
A person's knowledge of potential health problems is necessary for promoting self-care behaviors
Self care and dependent care are behaviors learned within a socio-cultural context

Orem's theory specifics:

Theory of self care

Self care - practice of activities that individuals initiates and performs by themselves.
Self care agency- the ability to engage in the act of self care
Therapeutic self care demands - the overall actions of self care to be performed for a duration in order to meet self care requisites
Self care requisites - actions directs towards provision of self care, universal self care requisites, developmental self care requisites, health deviation self care requisites

1. Universal self care requisite -

2. Developmental self care requisite -

Associated with development process such as adjustment to new job or body changes

3. Health deviation self care

Theory of self care deficit

specifies when nursing is needed
Nursing is required when an adult is incapable or limited in continuous effective self care
Five methods of helping: acting for and doing for others, guiding, supporting, teaching, and providing an environment promoting development of future needs

Theory of nursing system

Describes how patient's self care needs will be met by the nurse and patient
Identifies three classifications of nursing system to meet self care requisites of the patient: Wholly compensatory system, partly compensatory system, and supportive - educative system
Scope of nursing responsibility in health care situations
general and specific roles of nurses and patients
Reasons for nurses' relationships with patients
Technology

Orem's Theory and the Nursing Process

Nursing process presents a method to determine self care deficits and defines the roles of the nurse or staff to meet the patients self care needs
A technical approach to the nursing process
Must coordinated with interpersonal and social processes within a nursing situation

1. Assessment -

2. Nursing Diagnosis and Plan -

Nurse designs a system that is wholly or partly compensatory or supportive-educative
Create an organized plan of care that is therapeutically self care focused
Selection of interventions that will effectively and efficiently compensate and help patient overcome self care deficits

3. Implementation and Evaluation -

Nurse assists the patient and family in self care interventions to achieve identified and described health related objectives
Collect evidence in evaluating results achieved against results specified in the nursing system design.
Action are directed by nursing diagnosis
Evaluation of process and reassessment

Strengths of theory -

Provides a comprehensive bases to nursing practice
Specifies when nursing is needed
It utility for professional nursing in the are of nursing practice, nursing curriculum, nursing education and administration, and nursing research
contemporary self care approach including health promotion and health maintenance.

Limitations of theory -

Dorothea Orem's Self Care Theory

Dorothea Orem Self Care Theory Application