Orems Self-Care Deficit Nursing Theory

Orems Self-Care Deficit Nursing Theory (SCDNT)

Original Source Impetus was to define content for practical nursing curricula for Department of Health, Education, and Welfare References Parsons structure of social action and von Bertalanfys system theory Ontology

moderate realism

Focus person as agent

Source: McEwen & Wills (2007)

SCDNT Paradigmatic Origins

Needs Theory (Henderson, 1966)
Functional Theory (Abdellah, Beland, Martin, & Matheney, 1961) Uniqueness of Orems theory individual is capable of engaging in own self-care

Orem credits reflection on own practice & others for theory beginnings
Source: Meleis (1997)

SCDNT Overview
Relationship between self-care agency and therapeutic

self-care demands, distinguishing self-care deficit from dependent care (Romeo & Devereaux, 2006) Composed of 3 nested theories:
Self-care
Self-care deficit Nursing systems

Relationship between the 3 theories: The theory nursing systems subsumes the theory of self-care deficit, which subsumes the theory of self-care (Orem, 1991, p. 66)

SCDNT Overview
Based on 4 concepts Self-care

Activities an individual performs independently throughout life to promote & maintain well-being

Self-care agency Individuals ability to perform self-care activities Self-care requisites Measures or actions to provide self-care Therapeutic self-care demand Self-care activities required to meet self-care requisites

Source: Berman, Snyder, Kozier & Erb (2008)

SCDNT Overview
Self-care deficit results when the self-care agency can not

meet self-care demands Explains when nursing care is needed Explains how people can be assisted through 5 methods of helping:
Acting or doing for Guiding Teaching Supporting Providing an environment to promote the persons abilities to

meet current & future demands

Orems 3 Types of Nursing Systems

Wholly compensatory
Required when one cannot control/monitor their environment Nurse accomplishes patients therapeutic self-care

Partly compensatory

activities Nurse and patient work together to meet patients self-care needs Supportive-educative Required when one needs to learn to perform self-care activities & needs assistance to do so Patient provides necessary self-care and nurse supports/educates client in development of self-care agency
Sources: Berman, Snyder, Kozier & Erb (2008) Meleis (1997)

Required when one is unable to perform some but not all self-care

SCDNT and Research

Jenny, J. (1991). Self-care deficit theory and nursing diagnosis: A test of conceptual fit. Journal of Nursing Education, 30(5), 227-232. Kumar, C. P. (2007). Application of Orems self-care deficit theory and standardized nursing languages in a case study of a woman with diabetes. International Journal of Nursing Terminologies and Classifications, 18(3), 103- 110. Moore, J. B. (1993). Predictors of childrens self-care performance: Testing the theory of self-care deficit. Scholarly Inquiry for Nursing Practice, 7(3), 199-212.

SCDNT Applied to Nursing Practice

Burks, K. J. (1999). A nursing practice model for chronic

illness. Rehabilitation Nursing, 24(5), 197-200. Frey, M. A. & Fox, M. A. (1990). Assessing and teaching self-care to youths with diabetes mellitus. Pediatric Nursing, 16, 597-800. Geden, E. A., Sang-Arun, I., & Taylor, S. (2001). Self-care deficit nursing theory and the nurse practitioners practice. Nursing Science Quarterly, 14(1), 29. Harrison-Raines, K. (1993). Nursing and self-care theory applied to utilization review: Concepts and cases. American Journal of Medical Quality, 8(4), 197-199.

Application of SCDNT To My Practice

As a nurse educator, I can use SCDNT to help students

identify when patients should receive help to meet their heath care needs. In addition, this theory identifies to what degree the client needs help. I believe in allowing an individual to do what they can for themselves and to support those efforts the best I can. Finally, SCDNT identifies the concept of educating clients, an important role of the professional nurse.

Application of SCDNT to my nursing profession

As a Registered Nurse Case Manager is use Orems Self

Care Deficit Nursing Theory while assisting patients and families in discharge planning. I am able to provide education and the tools needed to allow the patient to care for themselves. Families are incorporated in the teaching and are willing to learn how to assist or allow the patient to care for themselves. SCDNT describes the professional nurse as an educator but also how to provide the knowledge that will allow the patient to care for themselves.