Orem[1] by Orem

8/8/2019 Orem[1] by Orem

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Dorothea OremDorothea Orem

Nursing Theory


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Early 1930s - AD from Providence School of

Nursing, Washington,D.C.

1939 BSN completed

1945 - MS in nursing education

1958 - consultant to the Office of Educationwhere she began working on her SELF-CARE

THEORY


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1959 - first published her theory in Guides for

Developing Curricula for the Education ofPractical Nurses (a government publication)

1976 - honorary Doctorate of Science fromGeorgetown University

1999 - last edition of her theory was published


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Orems Definition ofOrems Definition of

NursingNursingNursing is the provision ofself-care which is

therapeutic in sustaining life and health, inrecovering from disease or injury, or coping with

their effects.

Nursing is a service to people, not a derivative of

medicine.

Nursing promotes the goal of patient self-care.


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Orems Nursing ProcessOrems Nursing Process

Consists of3 steps:

Step 1: determine why a patient needs care

Step 2: design a nursing system & plan the

delivery of care

Step 3: management of nursing systems -planning, initiating, & controlling nursing

actions


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Orems General Theory ofOrems General Theory of

NursingNursing

Consists of three related theories

collectively referred to as OremsGeneral Theory of Nursing:

1. Self-care Theory:3 types of self-care requisites

(needs) or categories2. Self-care Deficit Theory:5 Methods ofAssistance

3. Nursing Systems Theory


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Orems SelfOrems Self--care Theorycare Theory

Based on the concepts of:

SELF-CARE SELF-CARE AGENCY

SELF-CARE REQUISITES

THERAPEUTIC SELF-CARE DEMAND


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SelfSelf--care Definitioncare Definition

Self-care comprises those activities

performed independently by an individualto promote and maintain personal well-

being throughout life.


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Orems SelfOrems Self--care Agencycare Agency

Definition: the individuals ability to perform

self-care activities

Consists of TWO agents:

Self-care Agent -person who provides the self-

care

Dependent Care Agent -person other than the

individual who provides the care (such as a parent)


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Orems SelfOrems Self--care Requisitescare Requisites (also(also

called Selfcalled Self--care Needs)care Needs)

Definition: the actions or measures used to provide self-

care

Consists of THREE categories:

Universal - requisites/needs that are common to all

individuals

Developmental - needs resulting from maturation ordevelop due to a condition or event

Health Deviation - needs resulting from illness,

injury & disease or its treatment


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Orems SelfOrems Self--care Deficitcare Deficit

TheoryTheory Is the central focus of Orems Grand Theory of Nursing

Explains when nursing is needed Describes and explains how people can be helped

through nursing

Results when the Self-care Agency (patient) cant meet

her/his self-care needs or administer self-care Nursing meets these self-care needs through five

methods of help


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Five Methods of NursingFive Methods of Nursing

HelpHelp

Acting or doing for

Guiding

Teaching

Supporting

Providing an environment to promote the

patients ability to meet current or future

demands


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Orems Nursing SystemsOrems Nursing Systems

Theory Describes...Theory Describes...

Nursing responsibilities

Roles of the nurse and patient

Rationales for the nurse-patient relationship

Types of actions needed to meet the

patients demands


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Orems Nursing SystemsOrems Nursing Systems

TheoryTheory

Refers to a series of actions a nurse takes to meet

a patients self-care needs Is determined by the patients self-care needs

Is composed of THREE systems:

Wholly compensatory Partly compensatory

Supportive-educative


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Three Nursing SystemsThree Nursing Systems

Wholly Compensatory: a patients self-care

agency is so limited that s/he depends on others

for well-being

Partly Compensatory: a pt can meet some self-

care requisites but needs a nurse to help meet

others Supportive-educative: a pt can meet self-care

requisites but needs help in decision-making,

behavior control, or knowledge acquisition


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Orems Theory & NursingsOrems Theory & Nursings

MetaparadigmMetaparadigm -- PERSONPERSON

The recipient of nursing care

A being who functions biologically, symbolically, and

socially

Has the potential for learning & development

Is subject to the forces of nature

Has a capacity for self-knowledge

Can engage in deliberate actions, interpret experiences,

and perform beneficial actions

Can learn to meet self

-care needs (requisites)


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MetaparadigmMetaparadigm -- PERSONPERSON

Human beings are distinguished from other

living beings by their capacity to:

Reflect upon themselves and their environment

Symbolize what they experience

Use symbolic creations (ideas, words) in thinking,

communicating, and guiding efforts to make things

that are beneficial for themselves and/or for others


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MetaparadigmMetaparadigm -- ENVIRONMENTENVIRONMENT

Environmental Conditions - external physical &

psychosocial surroundings Developmental Environment -promotion of

personal development through motivation to

establish appropriate goals & to adjust behavior

to meet those goals

Can positively or negatively impact a persons

ability to provide self-care


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MetaparadigmMetaparadigm -- NURSINGNURSING

A service geared towards helping the self and

others Is required when self-care demands exceed a

patients self-care ability (agency)

Promotes the patient as a self-care agent Has several components


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Components ofComponents ofNURSINGNURSING

NURSING ART: the theoretical base of nursing and

other disciplines such as sciences, art, humanities

NURSING PRUDENCE: the quality that enables the

nurse to seek advice in new or difficult situations, to

make correct judgements, to decide to act in a particular

manner, and/or to act NURSING SERVICE: a helping service

NURSING AGENCY: the ability of the RN


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MetaparadigmMetaparadigm -- NURSINGNURSING ROLE THEORY: the role of the nurse & patient are

complementary as they work together to achieve self-

care SPECIAL TECHNOLOGIES:

Social & Interpersonal technologies -communicating, coordinating, establishing &

maintaining therapeutic relations, renderingassistance

Regulatory technologies - maintaining andpromoting life processes, growth/development, and

psycho-physiologic modes of functioning


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MetaparadigmMetaparadigm -- HEALTHHEALTH

Supports health promotion and health

maintenance Supports the premises of holistic health in that

both RN and patient promote the individuals

responsibility for self care


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Orems Key Contribution ToOrems Key Contribution To

NursingNursing

The continued evolution of original

ideas to further delineate nursingpractice, functions, self-care needs, and

nursing systems based on research.

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Orem[1] by Orem