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DOROTHEA OREMs SELFCARE-DEFICIT THEORY

Each individual has the ability to perform self-care, and are responsible for
their health and the health of their dependents. Self-care is "the practice of
activities that individuals initiate and perform on their own behalf in
maintaining life, health, and well-being".
Orem's initial definition of nursing's concern included "man's need for selfcare action and the provision and management of it on a continuous basis in
order to sustain life and health, recover from disease or injury, and cope with
their effects".
Orem's Self-Care Model describes a structure wherein the nurse assists the
client, where needed, to maintain an adequate level of self-care. The degree
of nursing care and intervention depends on the degree to which the client is
able (or unable) to meet self-care needs

Orem's theory is made up of 3 related theories:


1. Theory of Self-Care
2. Theory of Self-Care Deficit
3. Theory of Nursing Systems

A. Theory of Self-care
This theory focuses on the performance or practice of activities that
individuals can initiate and perform on their own behalf to maintain life,
health and well-being. One of the most important consideration under this
theory are the self-care requisites which are the categories of self-care needs
that an individual must be able to accomplish.
Universal self-care requisites are associated with life processes and the
maintenance of the integrity of human structure and functioning. This
includes the ADLs of an individual.

In my clients case, he was still able to do usual activities like eating,


drinking, and urinating. However, due to the impact of the accident and his
sustained injuries, some of his activities were disrupted like bathing and
dressing by himself. He also complained that he couldnt sleep well because
of the pain hes experiencing. His usual activities were also interrupted. He
couldnt even walk outside of his room because hes feeling dizzy and weak.

B. Theory of Self-care Deficit


This theory delineates when nursing is needed. Orem identified 5 methods of
helping for us nurses:

Acting for and doing for others

Guiding others

Supporting another

Providing an environment promoting personal development in relation


to meet future demands

Teaching another

In my case, I would prefer using the method of supporting another. Acting


and doing for my client would only prevent his independence. This method
might totally incapacitate my client and would make him feel useless
considering that hes an active individual before he met the accident.
Guiding or teaching him or simply providing him an setting for development
may help him in a way that it doesnt overrule his independence but due to
my clients injuries, he would still need actual assistance doing some of his
ADLs.
Supporting my client through helping him accomplish his tasks and not
simply doing things for him will not only help my client complete his
activities but maintain his independence as well. This method shall aid him
go through his current condition without losing his sense of autonomy over
himself.

C. Theory of Nursing System


This describes how the patients self-care needs will be met both by the
patient and the nurse. It may also refer to the extent of intervening a nurse
may have to do in managing her clients condition. This is categorized into
three:
1. Wholly compensatory system
2. Partially compensatory system
3. Supportive educative system
In my patients case, Partially compensatory system must be utilized.
This is because my patient isnt fully dependent when it comes to his selfcare needs. He can still manage to do some of his activities and just seeks
for certain nursing assistance.

PERSONAL and SOCIAL HISTORY


According to Mr. F.C he is an out-going and adventurous type of person. This
is reflected on his present job as a manager of a company in ________.
He is a work-oriented individual. He always keeps himself busy at work and
merely rests. He was actually a self-supporting student way back on his college
years.
Apart from his remarkably hectic schedule, Mr. F.C said that he makes sure
that he is still an active Christian. He always finds time to attend Mass during
Sundays and participate in religious events like fiestas.
According to his wife who stayed with him in the hospital, Mr. F.C isnt just an
industrious person but a friendly and jolly individual. He loves to attend social
gatherings and join his friends whenever they have gimmicks.
Mr. FC also mentioned that he doesnt smoke nor a drinks alcohol. He only
drinks during parties or gatherings.

Although he can still do some of his ADLs like eating and brushing his teeth,
moreover, after sustaining injuries from the accident, Mr. C.F. said that he finds it
difficult doing some activities like clothing himself because he has trouble moving
his upper extremities. He couldnt walk to the CR by himself too because he feels
dizzy standing for too long. He most of the time seeks for assistance from his wife.
He also mentioned that he cant sleep soundly at night because of the pain he feels
on his clavicle.
According to Mr. F.C. he felt like his world was shaken after the accident. He
felt so weak and incapacitated. Because he is an active person, he mentioned that
staying in the hospital makes him feel worn out.