1. How Dorothea Orem theory led to nursing actions that have made important differences to patients.
The Dorothea Orem Theory is a general theory on nursing which focused on three concepts, namely, the theory of self care, the theory of self care deficit and the theory of nursing system. Patients benefitted from the Orem’s general theory of nursing because it paved the way for changes in the nursing actions. In Orem’s theory of self-care, Orem espoused the idea that an individual can initiate and perform activities that will benefit his health and well-being. With this theory, patients do not solely rely on nurses or healthcare practitioners to improve their wellness. They take the initiative to do things which they can manage to do themselves. The theory of self-care makes patients realize that they have the capacity to make themselves healthy and assist others as well, to achieve optimum health. Since this theory includes detailing the eight elements of universal self care, namely, “air, water, food, elimination, activity and rest, solitude and social interactions, prevention of harm and promotion of normality”, patients become more aware of the requisites for good health (Bruce, et al, 2007, p. 19). Because nursing actions involves educating patients about activities which promote wellness, patients gain much from the change.
On the other hand, in Orem’s theory of self care deficit, the need for a nurse is identified. This theory helps patients determine when they need the assistance from a nurse. If this deficit is pinpointed by the nurse, then the nurse is able to focus his attention on such need. The patient is then cared for in activities which he cannot perform.
In the theory of nursing systems, the nurse will perform the self-care needs of an individual depending on the different modalities (Bruce, et al, 2007). Depending on the level of involvment of the patient, the appropriate support modality will be applied (Bruce, et al , 2007).
Orem’s theory has paved the way to a more encompassing role for nurses. Their roles are specified as to whether they will act or do something for the patient; guide, teach or direct another person in helping someone achieve wellness; provide physical and psychological support; and provide a supportive environment in order for the patient to meet his needs today and in the future. The varied roles of a nurse affect the patients positively because they too feel that they have a responsibility for their well-being. The inspiration and support that they get from the nurses encourages them to live healthy.
The Orem theory has given a whole new perspective on the nursing process, which resulted in patients gaining a new perspective too on their health and wellness issues. The interaction between the nurse and the patient becomes more pronounced. The patient realizes that the nurse is a partner in the assessment, planning and implementation of his care.
2. Examples of how the Dorothea Orem theory is utilized with family health and guiding the nursing process.
One example of how the Orem theory is utilized as a guide with family health and in the nursing process is when a patient in unable to have a baby or is barren, the nurse can provide psychological support to the patient or offer advice as to the various options available to her.
Another example is when a nurse educates a diabetic patient about getting his blood sugar reading using chemstrips, if the results are questionable (Bruce, et al, 2007). The nurse can interview the patient how he does the readings. She can thus determine whether the patient is doing the procedure incorrectly. The nurse can then instruct the patient the right way of getting the readings. Furthermore, if the nurse by talking with the wife of the patient, learns that the diet being given by the wife is not appropriate for a diabetic person, the nurse can give nutritional counselling to the wife or suggest that they avail of the nutritional services of the hospital (Bruce, et al, 2007).
Another area where the Orem theory serves as a guide to the nursing process is in the assessment of the patient. The nurse has to first determine the health status of the individual. Furthermore, the nurse has to know what is the person’s capacity for health care and what are the areas where there is a self-care deficit. A knowledge of the lifestyle of the person, his diet and medical history are essential information that should be assessed by the nurse.
For stroke victims, nurses guided by the Orem theory can help educate the care giver of the stroke patient. The nurse can assess the needs of the patient. Moreover, the nurse is in a position to determine what activities can be done by the patient on his own and which ones would require the assistance of a caregiver.
References
Bruce, E., Gagnon, C., Gendron, N., Puteris, L., & Tamblyn, A. (2007). Dorothea Orem's theory of self care. Retrieved from slideshare.net: http://www.slideshare.net/jben501/dorothea-orem-theory
Currentnursing.com. (2012, February 4). Dorothea Orem's self-care theory. Retrieved from currentnursing.com: http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
El-Kader, N. A. (n.d.). Self-care deficit theory Dorothea Orem. Retrieved from ocw.up.edu.ps: http://ocw.up.edu.ps/repositories/pdf-archive/New%20orem%20theory.pdf
