The Orem Nursing Deficit Theory
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Dorothy Orem was born in 1914 in Baltimore in the United States of America, where her future into the medical fraternity took shape at providence hospital, where she attained her diploma. She then proceeded for a bachelor and masters degree at the catholic university of America, with the award of 1945, as she acquired her master’s in nursing. Her participation in the nursing fraternity as a private nurse, a staff nurse and nursing educator earned her an honorary doctorate degree in science in the year 1976. Her theory first took to the limelight of the nursing fraternity in 1971, with similar editions being published in 1980, while the recent publication in 2001. Her death in 2007 was a sign of an icon of good service in the medical fraternity, where her works will be used by generations to come.
The self-care deficit nursing theory or the Orem model of nursing is the view of assisting the patient to synthesize primary care. The philosophy behind the theory lies in the fact that a patient is more responsive to the healing process especially if it is care for oneself. The recovery process can be harnessed holistically if the patients provide care primarily for themselves. Orem identified the self-care requisites or essential tools for self-healing processes, which are categorically classified as universal, developmental and health deviation requisites. The universal requisites are the basic needs that everyone is entitled to while the developmental requisites are needs that become essential due to maturity and change in developmental levels in life. On the other hand, the health requisites are determinants of the condition of the patient through monitoring of health deviations and determination of the requirements depending on the situation (Anderson, 2001).
According to Orem (1985), the theorem also takes into account the evaluation of categories of technology; where according to Orem, technology is the evaluation of a desired result through some form of practice without the necessity to use hardware and software programs. This implies that the categories of technology depend on easily available resources like the human intellect. For instance, the interpersonal technology aims at the social association with the patient through allowing communication with providence of the basic needs. On the other hand, the regulatory technology is a view of all the determinants of growth, which aims at improving the life of humankind (Orem, 1985).
The thinking of Orem in synthesis of the self-care deficit theorem falls into the level of meta-theory in that it presents the overall perspective of the nursing fraternity, and encompasses the grand theory, the practice theory and the middle range theory. The revelation of the theory stipulates that it is an insight into self care of the patient with proactive consequences in administration of the practices in the theory, which is a globally renowned perspective. This implies that Orem based the argument of the stipulations in the self-care deficit theory upon the notion that this is a global perspective akin to the related field of nursing. The theory also encompasses the grand theory as comprises a self-nurturing system, which is currently considered a broader perspective of the nursing discipline (Anderson, 2001).
Moreover, it lies in the middle range theory of nursing, which can be characterized as a research, whose findings may give lead to a nursing practice that improves the health of the people. It can be exemplified by the fact that self is a form of experiment, where the prevalence of basic needs, including the technological categories, like the social category, against other cases could give comparison in order to depict the most suitable results. Another reason why this theory is described as experimental is, the forces of application that revolve around the theory and its components form a positive outcome. On the other hand, the Orem theory also lays within the jurisdiction the level of practice where it stipulates prevalence of best outcomes from the identification of simple practices in the phenomenon Fawcett (2000), reiterates that the nursing theory of self-deficit care by Orem is a theory in itself from the way Orem synthesized the hypothesis. The phenomenon is depicted through an inspiration behind formulation. Formulation of the theorem was accomplished through comparison with solving a complex puzzle. This puzzle is what helped in aiding the wordings. The synthesis of the components of the puzzle into interlocking ideas gave the preview of the picture, just like the conjugation of interrelated wordings make up the theory. The interpretation of meaning in the theory also justifies the theorization of ideas since meaning of phrases change with translation in language. This can be compared to graphical analysis, where coverage of the focal point depends on the three coordinate axes. It is evident that different lines in graphs may have different Cartesian coordinates built with the same deviation in slope (Fawcett, 2000).
tThe entire words can be paraphrased into other forms especially if translated from the original language without distortion of the meaning, this can be applicable in both the nursing and the self-deficit theorems . It designates that the relationships that characterize the theory are observable while the structures, which totally depend on the human intellect, are synonymous. Just like the graphical representation, the Cartesian coordinate system provides the focal points of the line, while the gradient of the line is always synonymous, which must be calculated using the focal points. In real analysis, the self deficit theory is a stipulation of observable characters, while its structure is what is synonymous. Consequently, the structure of the theory depends on personal interpretation, which involves services like primary care lie in actions, which depend on intellectual convictions and understanding of the practice.
On the other hand, this theory connects research in the aspect of its stipulations. The general phenomenon that the theory carries is a form of abstract information, which reignited research into the knowledge of the ideology lying behind the conviction of the mind of the theorist, who is Orem in this case. Research is evident in translations to other languages without distortion of the initial meaning. It is a common practic that when information is passed over from one generation to the next, a distortion of meaning occurs due to the slight changes in interpretation between the mediator and the recipient. This necessitates a research into the original ideology, which might be through synthesis of the puzzle method used in formulation and helps to keep the original meaning of the theory with the consequent viability of the theorem even after the demise of the theorist. The judgmental aspect also requires to be studied before a theory becomes respectable. The study involves evaluation of the evidence based on nursing and the consequent implications, while coherency with the expected outcome justifies the consideration of the theory as a nursing one (Soderhamn & Cliffordson, 2001).
The above implies that without research into the aspects affecting the humankind, there would be jeopardy to the entire system of formulation of the theory, which in real essence shows how void the theory would be. In the formulation of the Orem model of nursing, the theorist had a prior knowledge of the patient situation without self-care. Moreover, the theorist should have been inspired by high rates of infection due to poor disease management practices of the patients. This led to the evaluation of modes, which could incorporate patients as primary sources of the healing and preventive processes.
McLaughlin (1999), emphasizes that the theory is a practice in the sense that it has directions for use, just like the prescription of medicine. The matter is self-explanatory in that from the wordings of the theory and patient primary care impact on the subsequent health measures. The theory, as well as the practice, incorporates the self-care, the deficit self care and the nursing systems, which work hand in hand for the well-being of the patient. The analysis of self-care practices involves the ability to instill self-care practices that keep the self-health in good condition. The latter depends on factors like age and family background. Though,in some cases these factors may not be applicable, for instance, to the underage, who do not have prior knowledge of their rights as far as health is concerned. Moreover, family background forms the culture that determines uptake of self-care steps and its consequent practices (McLaughlin, 1999).
On the other hand, the theorem as a practice involves the deficit care as a practice of the theorem, which involves a partly or wholly compensative program or educative practices deliberated by the nurse to the patient. Self-deficit practice involves expertise work ,diagnosis and treatment of the disease. The partly compensatory practice involves activation of the natural immune system into fighting against the disease, while the wholly compensatory program involves steps that might lead to total change in the immune system, for instance blood transfusion, while the educative practice comes about during prescription of curative measures like the use of drugs. Consequently, the practice of nursing systems forms the involvement of the professional ethics and the code of conduct in the nursing fraternity. It stipulates how the patient care practices should be carried out for effective healing processes. This spans from the process patient healing to practices aimed at the prevention of death.
The abovementioned shows that the understanding of the nursing theorem by Orem is relevant pertaining to the nursing goals, which is my field of practice. The major focus of the nursing practice is geared towards attaining a sustainable society. A sustainable society is one, which flourishes on the healthy well being of the individuals. Moreover, a sustainable society finds solutions to health problems on its own. The mode of attaining this balance of self-sustainability is the factor underpinning the work of Orem in the synthesis of the nursing theorem. The practical application of the theorem into fulfilling the nursing goals is varied, with the basic being health promotion, which has different impacts on the physical and physiological processes of human beings.
Firstly, the nursing theorem is essential in promotion of health through diversification in the definition of disease prevention. The theory defines disease prevention as a practice that should be patient centered (Orem, 1997). This process of engagement of patients in disease prevention has resulted in more social collaboration between the practitioners and the patients. The factor is contributory to the increased abilities of detection of new modes of infection since it helps in opening up to disease diagnostic processes. For instance, the prevalence rates of diagnosis of stigma associated diseases, such as; AIDS has increased due to the buildup of the confidence in the patients since they form part of the preventive forces. Consequently, awareness in patients over preference to preventive than curative measures has increased.
Secondly, the goal of health promotion has changed the interaction with the environment. The description of health promotion in relation to the environment is a step that works towards changing the environment into habitable forms. It derives from the fact that the environment determines prevalence rates of diseases; moreover, adaptation of the environment to suit a healthy living reduces chance of vulnerability to new forms of infections. This practice is essential in determining the rate of prevalence of diseases and the suitability of the environment to health. Just like other nursing theorem, the Orem theory does not fall short of declaration of participatory health initiatives. These health initiatives, which span from curative to preventive, involve shaping of the environment and elimination of disease causing organisms. Teaching the preventive practices is the form of initiating the involvement of the society into health reform measures.(Orem, 1997).
On the other hand, the theorem is aiding in achievement of the nursing goals through improving on the proficiency of the evidence based in nursing. Such kind of research helps nursing students to attain understanding of the nursing profession. The role of the medical practitioners living with the Orem’s work of nursing theory is to execute the self-deficit, which involves prescription of curative methods and teaching on the prevenntive modes. This practical participation by the medical practitioners goes a long way towards increasing the proficiency in the health related matters. Moreover, increasing the general understanding of the nursing field is vital. This increase in proficiency is the major goal of the nursing practice, which culminates in health promotion.
The theory is also relevant in the attainment of the nursing goals through ensuring that the whole client participates. In this case, the definition of the word health signifies a whole. A whole in its turn signifies the society, community and the family at large. The health concerns have shifted within societies from the conventional individual participation to a whole body that makes up the ecosystem. Application of the nursing theorem and especially the self-care deficit theorem ensures that the change policy measures are taken up on a universal basis. The theory provides stipulation of the roles and functions performing which, every individual spanning from the patient to the practitioner, and within the whole society, could give lead to a healthy environment (Heath, 1998).
Furthermore, the theory is also relevant to attainment of the nursing goals through variation in analysis in the nursing professional and decision-making processes. The relevance is based on the fact that the medical practitioners are acquainted with tools that require proper analysis of the consequences before incorporation and experimentation. For instance, before configuring on a new mode of treatment, there must be analysis and proof that the current curative program is not viable for prescription of an alternative, this implies that the fiduciary rights stipulated in the theorem and its practice could aid in the right mode of decision-making. Moreover, it is a criterion of creation of awareness among patients over the need for sound decision-making processes. Overly, this theorem is essential in achievement of the nursing goals since the stipulations are achievable. It gives room for research into new modes of overcoming infections, and finally, leads to a healthy society.
The theory is applicable in the present day as it helps the patients to attain the required quality of healthcare on their own. The explanation lies in that it depicts the meaning of the Orem theorem that synthesizes the need for patient participation. Moreover, it is a form of utilization of the effort vested by patients in their own care management practices. This is a cost effective mode of healthcare, which gives preference to prevention than cure. In addition, it reduces chances of vulnerability since all the forces of causative agents would be minimal. The theorem could also be applicable in research of new curative forms to new infections (Hussey & Gilliland, 1989).
It is also applicable in shaping evidence based in nursing. The form of understanding of the principles of the theorem creates knowledge, thus, sharpening the skills of practitioners, to understand the medical fraternity better. Consequently, it has the influence on the proficiency of the practitioners through understanding of models related to teaching in nursing. Moreover, the theorem is a tool for shaping performance in the medical fraternity. Thus, essential in environmental conservation, since the forces of rehabilitation of health go hand in hand with a healthy environment. The theorem is applicable in sustainability of the environment since participatory leadership forms the force of correction to the environment in order to bring conformity with the stipulations of the theorem.
The theorem could be a tool for future application in increasing life expectancy, reducing death rates and minimizing human vulnerability to causative agents. The fact is determined by practicing the stipulations of the theory, which may result in adherence to self-healthy programs and eliminate prevalence rates of diseases. Moreover, participation of the medical practitioners would increase proficiency in tackling new forms of infection. This would mean that all avenues of disease infection would be sealed with no resultant diseases, which would impact forces of long life like mortality rate and life expectancy. Therefore, the theorem is the factor determining existence of life, and it is necessary to involve it in the health management systems. Overly, the theorem will be the tool of shaping competence in terms of health among societies (National Work Group on Literacy and Health, 1998).
Conclusively, Orem is an advocate of sound health since her research and consequent revelation of the self-care deficit theorem, which ensures patient participation through being proactive on personal care. This theorem is essential since it also gives the deficit part, which ensures the practitioner part, who should give direction to diagnostic measures and consequent treatment. The theorem is a tool for research in that its stipulations allow evaluation of outcomes against the said practices. This implies that the practice involved in evaluation of the theory was based on the factors affecting the health fraternity, which reveals a positive outcome. The theorem is essential in defining health promotion as it incorporates the medical practitioners and all other stakeholders in the medical fraternity and influences shaping of the participants’ proficiency (National Work Group on Literacy and Health, 1998).
For instance, involvement of the patients in their own care ensures prevalence of self-health measures, which might be cheaper than the curative measures. The basic application of the theorem in the modern world is through initiating research and evidence based in nursing, which is essential in understanding the medical nursing fraternity. Moreover, this may be helpful to generations to come, as it would be the source of elimination of deaths, and the factor determining the demographics of health, such as life expectancy and mortality rate. Consequently, it signifies that acting in accordance with the stipulations of the theorem could give lead to a society free from diseases. Therefore, it is relevant to put into practice the self-care deficit-nursing theorem to ensure that the society is proactive in terms of providence of its own health, which would be an honor to the noble work of Orem (Hussey & Gilliland, 1989).
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