Research Paper on Orem's Self-Care Deficit Nursing Theory: Enhancing Well-Being at Home

Introduction

Dorothea Orem is a nurse theorist who developed the Self-Care Deficit Nursing Theory, otherwise referred to as the Orem Model of Nursing. The main reason for selecting the theorist for analysis in this paper is the fact that she assisted others by delivering and managing self-care in a bid to sustain and develop the overall well-being of humans at the home level (Gonzalo, 2014). Importantly, the theory centers on the ability of every person to conduct self-care, which Gonzalo (2014) defined as the processes where people tend to initiate and perform actions that aim at maintaining life, well-being, and excellent health. Therefore, this paper focuses on Dorothea Orem by giving a brief background of her life and analyzing the Orem Model of Nursing.

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Background

Dorothea Orem was born in the year 1914 in the region of Baltimore, Maryland (Gonzalo, 2014). Her father worked at a construction site while the theorist's mother was a homemaker. Orem schooled at Seton High School in Baltimore and graduated in the year 1931 (Gonzalo, 2014). She acquired her diploma in nursing in the year 1934 (Gonzalo, 2014). Her desire to study prompted her to enroll in the Catholic University of America for her bachelor's degree, which she acquired in the year 1939 and later her masters in nursing education in the year 1945 (Gonzalo, 2014). Orem has an extricated career in nursing. As Gonzalo (2014) indicated, the theorist was given her honorary doctorates of science from two universities in the years 1976 and 1980, respectively. Some of the factors that influenced Orem's development of the theory are the situations wherein patients are encouraged to bring out the best within despite their prolonged illnesses. Mainly, this is prevalent in rehabilitation settings. On such occasions, patients tend to be independent after receiving care from doctors and nurses. Orem developed the theory between the years 1951 and 2001 (Gonzalo, 2014). According to Gonzalo (2014), the Orem Model of Nursing is one of the renowned nursing theories that cover a variety of general concepts that could be applied to all facets of nursing.

Analysis

Origin of the Model

Importantly, nursing was a field dependent on medicine during its early stages. At the time, nurses were people who obliged by the orders and responsibilities assigned to them by doctors. As years passed, innovative nursing professionals such as Dorothea Orem played a substantial role in developing the nursing profession, further leading to its worldwide recognition. More so, the developments attracted respect for the people in the job. Notably, the theory first appeared in the year 1971 (Gonzalo, 2014).

Historically, the 20th century, particularly the period after the Second World War, was characterized by a significant reduction in the overall number of nurses. The lowered number could be attributed to the fact that most nurses who were involved in the treatment of soldiers and victims of the war abandoned their duties due to the traumatic experiences endured at the time. As such, the number of nurses was significantly low when compared to the patients in need of help, especially in countries such as the United States. Such factors may have prompted Orem to develop her theory of self-care where patients could take care of themselves and avoid over-reliance on medical personnel. Moreover, Orem had her bachelor's and master's degree at the time. The theory appeared when she released her first book titled, "Nursing: Concepts of Practice." At this time, Orem worked as a curriculum consultant. Orem believed that people could conduct self-care. Besides, she insisted that nursing should focus on the ability to foster self-care among patients. The ideas of the model were based on the unique experiences of their personal nursing career, observations, logic and metaphysics, resource utilization, and the abilities to reflect and question.

Unique Focus of the Model

The unique aspect of the Self-Care Deficit Theory by Orem is that it implies that nursing practices and assistances are not always required. In some situations, individuals could conduct self-care to manage their injuries and conditions. According to Wong, Ip, Choi, and Lam (2015), the theory specifies when nursing aid is needed. Primarily, nursing is required in instances where a person is vulnerable or limited in the processes of providing prolonged and operative self-care. Besides, unlike other theories of nursing, Dorothea Orem provides some techniques of self-care that include acting on behalf of others.

Content

Importantly, the theory defines a person as a self-reliant person with the capacity to reflect. More so, human beings are different from others based on how they reflect upon themselves and surrounding, symbolize their experiences, and use of symbolic creations while thinking, communication and in their actions. Wong et al. (2015) indicated that Orem further indicated that humans were total beings with powers and developmental needs and could do self-care and care for the well-being of other people. In addition to that, the supposition defined a nursing client as a human behind with a health-related condition and deviations that render them incapable of continued self-care hence leading to incomplete care. Primarily, this means that an individual seeking health care, based on the theory, should be in no ability to conduct self-care measures. Thus, nursing applies in instances where self-care requisites tend to exceed the capabilities of an individual to perform self-care.

Consequently, health, as defined by Orem in her theory, is a state of well-being and excellent health. Dorothea Orem acknowledged the fact that health is a social responsibility. In a bid to maintain the well-being and unique health of the society, nursing was introduced. According to Wong et al. (2015), Orem, in her theory, implied that nursing is a community service activity. The actions performed by a nurse aim at maintaining and improving health conditions, which is a service aimed at helping other people. With all these explanations, it is worth noting that the Orem's Model of Nursing indicates that the role of a nurse and a nursing client are complementary since they both work towards achieving self-care. Another critical factor concerning the theory is that nurses assist people who cannot meet some of their self-care needs. All these concepts of the argument can be summarized in the model below.

Figure 1. Orem's Self-Care Theory (Gonzalo, 2014).

Evaluation

Explication of Origins

The philosophy of the Self-Care Deficit Nursing Theory by Orem is based on the wish of the patients to care for themselves and realism influences. Importantly, Orem's self-care theoretical framework is based on philosophical, scientific, and theoretical knowledge of human behavior. According to Oliveira-Kumakura et al. (2019), philosophical claims are stated in the form of presupposition, premises, and assumptions. It is worth noting that Orem claimed that philosophy is essential since it helps people to think about things, but does not inform on the subject matter.

Consequently, the theory acknowledges the influence of other scholars. Considering that Orem released the approach through her publication, she cited the works of different scholars. They include; Aristotle Thomas Aquinas et al. (1953), J. Macmurray (1957), M. B.Arnold (1960), M. Black (1962), B.J.F Lonergan (1958), T. Kotarbinksi (1965), and R. Harre (1965), to mention a few. In addition to that, Orem is keen to acknowledge the influence of the Nursing Development Conference and her study group as well.

Comprehensiveness of Content

According to Bender (2018), the four meta-paradigms of nursing are person, health, environment, and nursing. Importantly, the meta-paradigm of a person often entails the patient who receives care. Some of the factors that could be included in this meta-paradigm are the spirituality of a person, culture, friends, and family. Environment, on the other hand, could be internal or external. Mainly, the environment often entails the interactions between a patient and the visitors or the surroundings. The meta-paradigm of health includes the quality and well-being of a patient, which also entails the access of a patient to health services.

Notably, Orem's Self-Care Deficit Nursing Theory applies all the four meta-paradigms of nursing, considering that it focuses on self-care, which is the ability of a patient to provide self-care health practices to maintain their well-being. In the second edition of Dorothea Orem's book, she indicated that nursing is made possible by the existence of nurses, which shows the inclusion of the nursing meta-paradigm in theory (Bender, 2018). Orem claims that nursing is a service that involves helping humans. More so, nursing practice is derived from activities aimed at assisting people under their care to maintain or change some of the conditions in the environment. Thus, this shows the connection of the theory with the meta-paradigm of environment. Self-care, as described by Orem, could be done by persons through their actions and under the guidance of a nurse in situations where persons have health-related complications (Pudlo, Bionat, Park, & Bhimaraj, 2017). From this, it is clear that the theory encompasses all the four meta-paradigms of nursing.

Additionally, Dorothea Orem's model is sufficient enough to guide nursing research, education, and practice. Researchers can use the contents of the theory to study the benefits of self-care practices on health further. Also, studies on the best diseases and conditions that could be managed easily through self-care measures could be analyzed (Malekzadeh, Amouzeshi, & Mazlom, 2018). Those benefits and findings could be taught in schools and encouraged in communities. Thus, this implies that Dorothea Orem's Self-Care Deficit Nursing Theory is broad enough to encourage further and continued research.

Logical Congruence

Orem's Model of Nursing represents a reciprocal relationship. Primarily, this means that nurses do their part and conduct their role in assisting patients. In contrast, nursing clients hold self-care practices that are inclusive of measures such as taking the prescribed medications and avoiding particular prohibited food in a bid to maintain and preserve their health (Malekzadeh et al., 2018). In addition to that, the content of the theory is logically corresponding to the author's philosophical claims. At the same time, the thinking of the theorists is mostly influenced by an array of perspectives and resources in the discipline.

Generation of Theory

The first theory deduced from the model is the Self-Care Deficit Theory that proposes the need for self-care practices and measures that could be conducted at home by a patient or through the aid of a group of people. The second theory that can be deduced from the model is the Middle-range theory of relating factors that proposes the need or self-care measures for patients battling with heart diseases among other illnesses. The other argument that emerged is the middle range theory of self-examination, where patients manage their conditions by avoiding some foodstuffs and managing their requirements as well.

Legitimacy

The model can easily be applied in daily routines and activities. Patients with heart diseases, for instance, could practice self-care measures that include regular exercises and weight management, avoidance of foods with high cholesterol levels, and avoiding strenuous activities. Such practices could help in improving the health conditions of such patients, which shows that self-care practice, as proposed by Orem,...