Dorothea Orem’s Theory of Nursing. .pptx

Dorothea Orem’s Theory of Nursing. .pptx

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  Dorothea Orem’s Theory PresentedBy: Mr.Veeresh Demashetti MSc (N) Community HealthNursing
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  Learning objectives Introduction Definition About theorist Conceptsof OREM’S Theory Defintions of DomainConcepts OREM’S General Theoryof Nursing OREM’S Theory and Nursing Process Conclusion or Summary
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  Introduction Theories are composedof concepts, definitions, models, propositions and are based on assumptions. They are derived through two basic principle methods. 1. Deductive reasoning and 2. Inductive reasoning
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  Nursing theory Nursing theoryis a set of concepts ,definitions, relationship and assumptions or proportions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing inner relationships among concepts for a purposes of describing, explaining and predicting or prescribing.
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  About Theorist:  DorotheaOrem  One of America’s foremost nursing theorists.  Dorothea Orem earned her Bachelor of science in nursing education in 1939 and Master of science in nursing in 1945  During her professional career ,she worked as a staff nurse ,private duty nurse ,nurse educator and administrator and nurse consultant  Received honorary Doctor of Science degree in 1976  Dorothea Orem as a member of a curriculum subcommittee at Catholic University, recognized the need to continue in developing a conceptualization of nursing.  Published first formal articulation of her ideas in Nursing: Concepts of Practice in 1971.second in 1980,and finally in 1995
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  Development of Theory 1949-1957Orem worked for the Division of Hospital and Institutional Services of the Indiana State Board of Health. Her goal was to upgrade the quality of nursing in general hospitals throughout the state. During this time she developed her definition of nursing practice. 1958-1960 US Department of Health, Education and Welfare where she help publish "Guidelines for Developing Curricula for the Education of Practical Nurses" in 1959. 1959 Orem subsequently served as acting dean of the school of Nursing and as an assistant professor of nursing education at CUA. She continued to develop her concept of nursing and self care during this time. Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980,1985, 1991, 1995, and 2001. Continues to develop her theory after her retirement in 1984
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  E n v i r o n m e n t Self care requisites Health Self care agencies Selfcare Nurse patient relationship Nursing system Self care deficit S o c i e t y Limited Unmet CONCEPTS OF OREM’S THEORY
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  Nursing – isart, a helping service, and a technology  Goal of nursing – to render the patient or members of his family capable of meeting the patient’s self care needs  To maintain a state of health  To regain normal or near normal state of health in the event of disease or injury  To stabilize ,control ,or minimize the effects of chronic poor health or disability  Health – health and healthy are terms used to describe living things … it is when they are structurally and functionally whole or sound … wholeness or integrity. .includes that which makes a person human,…operating in conjunction with physiological and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beings  Environment – environment components are environmental factors ,environmental elements, conditions ,and developmental environment  Human being – has the capacity to reflect ,symbolize and use symbols  Conceptualized as a total being with universal ,developmental needs and capable of continuous self care  A unity that can function biologically, symbolically and socially  Nursing client- a human being who has "health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in ineffective / incomplete care.  A human being is the focus of nursing only when a self –care requisites exceeds self care capabilities  Definitions of domain concepts
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   Nursing problem– deficits in universal, developmental, and health derived or health related conditions  Nursing process- a system to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of care  Nursing therapeutics– deliberate ,systematic and purposeful action
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  OREM’S GENERALTHEORYOF NURSING Orem’sgeneral theory of nursing in three related parts:-
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  Theory of SelfCare It Includes :--  Self care – practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being  Self care agency – is a human ability which is "the ability for engaging in self care"  -- Conditioned by age developmental state, life experience sociocultural orientation health and available resources  Therapeutic self care demand – "totality of self care actions to be performed for some duration in order to meet self care requisites by using valid methods and related sets of operations and actions"  Self care requisites-action directed towards provision of self care  3 categories of self care requisites are:--  Universal  Developmental  Health deviation
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  Universal self carerequisites  Associated with life processes and the maintenance of the integrity of human structure and functioning  Common to all , ADL  Identifies these requisites as:  Maintenance of sufficient intake of air ,water, food  Provision of care assoc with elimination process  Balance between activity and rest, between solitude and social interaction  Prevention of hazards to human life well being and  Promotion of human functioning Developmental self care requisites  Associated with developmental processes/ derived from a condition…. Or associated with an event E.g. adjusting to a new job adjusting to body changes
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  Health deviation selfcare  Required in conditions of illness ,injury, or disease .these include:--  Seeking and securing appropriate medical assistance  Being aware of and attending to the effects and results of pathologic conditions  Effectively carrying out medically prescribed measures  Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care  Learning to live with effects of pathologic conditions
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  Theory of selfcare deficit Specifies when nursing is needed  Nursing is required when an adult (or in the case of a dependent ,the parent) is incapable or limited in the provision of continuous effective self care Orem identifies 5 methods of helping:--  Acting for and doing for others  Guiding others  Supporting another  Providing an environment promoting personal development in relation to meet future demands  Teaching another
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  Theory of NursingSystems Describes how the patient’s self care needs will be met by the nurse , the patient, or both Identifies 3 classifications of nursing system to meet the self care requisites of the patient:- 1.Wholly compensatory system 2.Partly compensatory system 3.Supportive – educative system
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  Orem’s Theory andNursing Process  Orem’s approach to the nursing process presents a method to determine the self care deficits and then to define the roles of person or nurse to meet the self care demands.  The steps within the approach are considered to be the technical component of the nursing process.  Orem emphasizes that the technological component "must be coordinated with interpersonal and social processes within nursing situations  Comparison of Orem’s Nursing Process and the Nursing Process  Nursing Process  Assessment  Nursing diagnosis  Plans with scientific rationale  Implementation  evaluation  Orem’s Nursing. Process  Diagnosis and prescription ;determine why nursing is needed. analyze and interpret –make judgment regarding care  Design of a nursing system and plan for delivery of care  Production and management of nursing systems
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  Step 1-collect datain six areas:-  The person’s health status  The physician’s perspective of the person’s health status  The person’s perspective of his or her health  The health goals within the context of life history ,life style, and health status  The person’s requirements for self care  The person’s capacity to perform self care Step 2  Nurse designs a system that is wholly or partly compensatory or supportive-educative.  The 2 actions are:-  Bringing out a good organization of the components of patients’ therapeutic self care demands  Selection of combination of ways of helping that will be effective and efficient in compensating for/ overcoming patient’s self care deficits Step 3  Nurse assists the patient or family in self care matters to achieve identified and described health and health related results ..collecting evidence in evaluating results achieved against results specified in the nursing system design  Actions are directed by etiology component of nursing diagnosis  evaluation
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  Orem’sworkand thecharacteristicsof atheory  Theories can interrelate concepts in such a way as to create a different way of looking at a particular phenomenon  Theories must be logical in nature  Theories must be relatively simple yet generalizable  Theories are the basis for hypothesis that can be tested  Theories contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them  Theories can be used by the practitioners to guide and improve their practice  Theories must be consistent with other validated theories ,laws and principles TheoryTesting  Orem’s theory has been used as the basis for the development of research instruments to assist researchers in using the theory  A self care questionnaire was developed and tested by Moore(1995) for the special purpose of measuring the self care practice of children and adolescents  The theory has been used as a conceptual framework in assoc. degree programs (Fenner 1979) also in many nursing schools
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  Strengths  It Providesa comprehensive base to nursing practice  It has utility for professional nursing in the areas of nursing practice nursing curricula nursing education administration ,and nursing research  Specifies when nursing is needed  Also includes continuing education as part of the professional component of nursing education  Her self care approach is contemporary with the concepts of health promotion and health maintenance  Expanded her focus of individual self care to include multiperson units Limitations  In general system theory a system is viewed as a single whole thing while Orem defines a system as a single whole ,thing  Health is often viewed as dynamic and ever changing .Orem’s visual presentation of the boxed nursing systems implies three static conditions of health  Appears that the theory is illness oriented rather with no indication of its use in wellness settings
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  Summary  Orem’s generaltheory of nursing is composed of three constructs .Throughout her work ,she interprets the concepts of human beings, health, nursing and society .and has defined 3 steps of nursing process  It has a broad scope in clinical practice and to lesser extent in research ,education and administration
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  ANY QUESTIONS………….???
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  THANK YOU