Dorothea Orem (1914-2007)|
INTRODUCTION * One of foremost nursing theorists. * Born 1914 in Baltimore. * Earned her diploma at Providence Hospital – Washington, DC * 1939 – BSN Ed., Catholic University of America * 1945 – MSN Ed., Catholic University of America * Involved in nursing practice, nursing service, and nursing education * During her professional career, she worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant * Received honorary Doctor of Science degree in 1976 * Published first formal articulation of her ideas in Nursing: Concepts of Practice in 197, second in 1980, and in 1995.DEVELOPMENT OF THEORY * 1949-1957 Orem worked for the Division of Hospital and Institutional Services of the Indiana State Board of Health. * Her goal was to upgrade the quality of nursing in general hospitals throughout the state. During this time she developed her definition of nursing practice. * 1959 Orem subsequently served as acting dean of the school of Nursing and as an assistant professor of nursing education at CUA. She continued to develop her concept of nursing and self care during this time. * Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980, 1985, 1991, 1995, and 2001.MAJOR ASSUMPTIONS * People should be self-reliant and responsible for their own care and others in their family needing care * People are distinct individuals * Nursing is a form of action – interaction between two or more persons * Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health * A person’s knowledge of potential health problems is necessary for promoting self-care behaviors * Self care and dependent care are behaviors learned within a socio-cultural contextDEFINITIONS OF DOMAIN CONCEPTSNursing – is art, a helping service, and a technology * Actions deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments * Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective * Goal of nursing – to render the patient or members of his family capable of meeting the patient’s self care needs * To maintain a state of health * To regain normal or near normal state of health in the event of disease or injury * To stabilize ,control ,or minimize the effects of chronic poor health or disabilityHealth – health and healthy are terms used to describe living things … * It is when they are structurally and functionally whole or sound … wholeness or integrity. .includes that which makes a person human,…operating in conjunction with physiological and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beingsEnvironment * environment components are enthronement factors, enthronement elements, conditions, and developed environment Human being – has the capacity to reflect, symbolize and use symbols * Conceptualized as a total being with universal, developmental needs and capable of continuous self care * A unity that can function biologically, symbolically and sociallyNursing client * A human being who has "health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in ineffective / incomplete care. * A human being is the focus of nursing only when a self –care requisites exceeds self care capabilities Nursing problem * deficits in universal, developmental, and health derived or health related conditionsNursing process * a system to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of careNursing therapeutics * deliberate, systematic and purposeful action OREM’S...