Self Care in Nursing: Application of Orem's Theory

This paper delves into Dorothea Orem's self-care theory, a framework emphasizing patient self-care activities for physical and spiritual well-being. It examines the theory's components: self-care, self-care agency, and self-care requisites. The paper provides a literature review supporting the theory and its assumptions. Key attributes of Orem's model are discussed, alongside antecedent and consequent factors. Empirical referents, such as patient functional status and satisfaction, are explored. The paper presents model, borderline, and contrary cases to illustrate the theory's application. Theoretical applications highlight the model's relevance in various nursing scenarios. The conclusion emphasizes the positive impact of Orem's theory on patients with manageable chronic diseases, promoting health maintenance and comprehensive nursing practice. This paper is a valuable resource for students, showcasing how the theory is applied in real-world nursing situations. The paper also includes a list of references for further reading.

Running head: SELF CARE IN NURSING
SELF CARE IN NURSING
Name of the Student
Name of the university
Author’s note

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Introduction
Self care can be defined as the activity that a patient takes up for his or her own physical and
spiritual well being. This paper aims to discuss about the theories of Dorothea Orem related to
self care (Orem, 2012). The paper will provide an insight regarding the attributes of the self care
model supported by specific case studies. A literature review has also been provided to support
the assumptions and the concept analysis of the theory.
Definition of Dorothea Orem’s theory
Dorothea Orem's theory of self care includes three related parts, which are as follows-
 Theory of self care
 Theory of the system of nursing
 Theory of self deficit care
Orem's theory also includes Self care, which are the activities performed by an individual for his
or her own well being (Orem, 2012).
Self care agency- this is the human ability to engage in self care, which is conditioned by the age
developmental states.
Self care requisites, includes the developmental self care requisites, universal care requisites and
health division self care requisites.
Literature review
According to the author Berbiglia & Banfield, (2013), nursing is an art, which a
practitioner uses to provide appropriate care to the patients. A nurse participates in the treatment
regimen that a physician decides from patient. As proposed by (Dobrina, Tenze & Palese, 2014),

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each individual has got the right and the ability to perform self care and are responsible for their
own physical as well as mental well being.
Orem's initial theory of nursing refers to the fact that man requires self care and
management on a continuous basis for sustaining the life and the health of her own, for
recovering from injury and adjusting with their effects. As proposed by Ghafourifard &
Ebrahimi, (2015), Orem’s self care model proposes a structure where the nurses helps the
patient by maintaining an ample level of self care. The interventions of the nursing should be
dependent upon the level up to which the patient is able to meet the needs of self care. According
to Baumann & Dang, (2012) the universal self care requisites involves air, water, food,
elimination, rest and activity, social communication and isolation.
The developmental self care requisites involve the social interaction such as the marriage,
college, retirement, maintenance of good health (Dobrina, Tenze & Palese, 2014).
According to Altay & Çavuşoğlu, (2013), the major assumptions of the Orem's self care deficits
theory can be stated as -
People should be responsible for their care and self reliant. Nursing is a kind of an action,
which involves interaction between two people. A person should be aquainted to his health
problems for adopting self care behaviors (Orem, 2012).
The three theories of the Orem's model are interrelated. The theory of self care
demarcates the demands of self care that a person requires in order to stay healthy.
Defining attributes
The attributes of Dorothea Orem's theory are as follows:-

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1. It interrelates the concept in a certain way to create a different perceptive of looking at
the phenomenon.
2. It is logical
3. Orem's theory is simple yet generalizable
Antecedent and consequent
Antecedent - The amount of self care depends on the degree to which the patient will be able to
take care of his or her own. In case of chronic diseases such self care can bring about better
outcomes (Berbiglia & Banfield, 2013).
Consequent- Data from nursing care units suggests that nurses practicing the Orem's self care
methods have seen better outcomes in patients suffering from some chronic diseases like asthma,
diabetes. In case of some chronic diseases the self esteem may be compromised. Orem's care
model has resulted in fruitful outcomes on the self esteem of the patients (Berbiglia & Banfield,
2013).
Empirical Referents
1. The presence of the selected nursing concept has been estimated by conducting
interviews with the nurses and asking them about the methods and the evidences based
researches that they have conducted.
2. The patients who have been imparted the knowledge regarding self care can be assessed
or interviewed in order to understand the nursing concept of self care that has been
applied on the patients.

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The different attributes such as the functional status of the patients (improved or
deteriorated), Patient safety (Protected or harmed) and patient satisfaction (Patient’s
feedback) are helpful empirical referents of a nursing concept (Orem, 2012).
Cases
Model case:
A home care nurse goes to the house of an elderly patient who remains isolated and alone
and is bed ridden due to osteoarthritis. As the conversation with the patient follows, the nurse
found that the patient feels low esteemed and depressed owing to his disabilities. The nursing
priorities in this case study includes the managements of pain, after which the patient will be able
to do the simplest tasks by himself. Developing self care requisites, like the patient also have to
adjust himself with the changing condition of his body (O'shaughnessy, 2014). As far as the
universal self requisites are concerned the patient will be able to perform his daily activities
without being dependant on somebody else.
Border line case:
Patient A suffered from type 2 diabetes, the nurse in charge of the patient provided him
with the necessary medications and taught him about the ways to manage his diabetes, like
managing diets and exercises. The patient was an elderly lady and was suffering from depression
and incontinence. The nurse did not provide her with spiritual support and help her to manage
her incontinence. In this case it can be seen that the developmental self care requisites of the
patient had been addressed as per the Orem’s self care model, but it left the patient unaware of
the self care regimens.
Contrary case:

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Patient X is an elderly patient of 75 years, suffering from Asthma, who is being assessed
by the community nurse. The community nurse jotted down his vital signs and prescribed him
with the medications as per the consultation with the doctors. The doctors also prescribed the use
of the nebulizers. The nursing assessment took place for two to three minutes. The nurse did not
attempt to impart any information to the patient regarding his disease nor did she teach the
patient regarding the use of the bronchodilators. This case study shows that the nurse had not
followed any concept related to self care.
Theoretical Applications of the Concept
Orem’s theory is applicable to a large number of nursing cases that requires self care
activities. Concept analysis is necessary in nursing practice and educations it brings about clarity
in a typical model. A concept analysis involves determining of the concept and determining the
purpose of the analysis (O'shaughnessy, 2014).
Orem has defined self care as when an individual initiates his or her own activities to maintain
life and well being of his own and self care deficit includes not meeting adequate self care
requisites (Orem, 2012).
Conclusion
A conclusion can be drawn that application of Orem’s theory can bring about better outcomes in
patients suffering from some manageable chronic diseases. Self care can help an individual to
maintain a healthy life and meet their social, psychological and emotional needs of life. Orem's
theory provides a comprehensive base to the practice of nursing. Her approach of self care is
contemporary with the ideas of health maintenance and promotion.

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References
Altay, N., & Çavuşoğlu, H. (2013). Using Orem's self‐care model for asthmatic
adolescents. Journal for Specialists in Pediatric Nursing, 18(3), 233-242.
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Baumann, L. C., & Dang, T. T. N. (2012). Helping patients with chronic conditions overcome
barriers to self-care. The Nurse Practitioner, 37(3), 32-38.
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Berbiglia, V. A., & Banfield, B. (2013). Self-care deficit theory of nursing. Nursing Theorists
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