OREM S THEORY.pptx
- 1. DOROTHEA OREM’S SELF CARE THEORY Ms. Shalini Abraham , Associate Professor DYPUSON
- 2. ABOUT OREM…… Theorist : Dorothea Orem (1914-2007) Born 1914 in Baltimore, US Earned her diploma at Providence Hospital –Washington 1939 – BSN Ed., Catholic University of America 1945 – MSN Ed., Catholic University of America She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant. Received honorary Doctor of Science degree in 1976.
- 3. People are distinct individuals Self care and dependent care are behaviors learned within a socio- cultural context Person’s knowledge of potential health problems is necessary for promoting self-care behaviors Self-care requisites is an important component of primary care prevention and ill health People should be self-reliant and responsible for their own care ASSUMPTIONS
- 4. OREM’S GENERAL THEORY OF NURSING Theory of self care Theory of self care deficit Theory of nursing system
- 7. practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being
- 8. 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
- 9. "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"
- 10. Action directed towards provision of self care. 3 categories of self care requisites are- Universal self care requisites Developmental self care requisites Health deviation self care requisites
- 12. 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 personal development in relation to meet future demands Teaching another
- 14. WHOLLY COMPENSATORY SYSTEM PARTLY COMPENSATORY SYSTEM SUPPORTIVE-EDUCATIVE SYSTEM
- 17. 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.
- 18. Nursing Process Orem’s Nursing Process Assessment collect data in 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
- 19. Nursing Process Orem’s Nursing Process Nursing diagnosis Plans with scientific rationale 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
- 20. Nursing Process Orem’s Nursing Process Implementation evaluation 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
- 21. Application of Orem’s theory to nursing process
- 22. NURSE ACTION Accomplish the patient’s Therapeutic care Compensates for patient ability in self care Supports and protect the patient WHOLLY COMPENSATORY SYSTEM PATIENT ACTION LIMITED
- 23. NURSE ACTION/ PATIENT ACTION Performs Care Compensates and regulate the ability in self care Assists and accepts the care PARTLY COMPENSATORY SYSTEM
- 24. ACCOMPLISH SELF CARE REGULATES THE EXERCISES AND GET GUIDANCE NURSE ACTION PATIENT ACTION
- 25. EXAMPLE WITH SCENARIO &APPLICATION OF THEORY 1. MEDICAL PROBLEM AND PLAN Physician’s perspective of the condition: Diagnosed with pancreatitis and is on the following treatment: IV fluid NS 8 hourly NPM Continuous gastric drainage Inj. Paracetamol 1gm IV TDS Inj. Voveran 75 mg IM SOS Inj. Pan 40 mg IV OD Inj. Pipzo 4.5 gm IV BD Inj. Metronidazole 500mg IV TDS Inj. Fortwin 1amp IM HS Inj. Calmpose 1amp Im HS Medical Diagnosis: peptic perforation with peritonitis Medical Treatment: Medication and restriction in oral intake Surgical treatment: Repair of perforation is done under general anesthesia
- 26. Therapeutic self care demand: deficient area: pain control Adequacy of self care agency: inadequate Nursing diagnosis Ineffective pain control related to presence of surgical wound in abdomen Outcome: Improved pain control Achieve and maintain a reduction in the pain Goal: To reduce pain Design of the nursing system: Acting or doing , supportive and educative
- 27. Method of helping: Guidance: Ask the client to report the intensity, location, severity, associated and aggravating factors. Support: Administer analgesics Provide diversion and psychological support to the patient Teaching: Teach the non – pharmacological method to the patient once the pain is a little reduced.
- 28. Implementation Assessed the pain along with its location, characteristics, duration, frequency, quality, intensity. Patient is kept NPM to control pain. Continuous nasogastric drainage is provided for gastric decompression. Non-pharmacological techniques(guided imagery) are taught to the client to perform to reduce pain. Inj. Voveran 75mg is administered IM Inj. Paracetamol 1 gm is administered IV support provided. Evaluation Patient explained slight reduction in pain and demonstrated to perform pain relieving non- pharmacological measures.
- 29. STRENGTHS OF THEORY Provides a 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 Her self-care approach is contemporary with the concepts of health promotion and health maintenance
- 30. LIMITATIONS OF THEORY 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. The theory is illness oriented.