Nursing: Patient and Self-care Deficit

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Applying Dorothea Orem's Self-Care Deficit Theory To Practice

Dorothea Orem developed her self-care deficit theory of nursing under three interrelated theories known as the theory of self-care, theory of self-care deficit, and theory of nursing systems. Each of these theories explains concepts of basic conditioning factors to support her general theory. Orem’s theory suggests that all individuals have a need for self-care action on a continuous basis. When self-care can no longer be performed due to injury or illness the patient develops a self-care deficit and requires the assistance of the nurse to provide quality and quantity healthcare. Orem’s interrelated theories can be applied to day to day practice on the stroke unit.

The theory of self-care is the patient’s ability to perform their own self-care needs to maintain life, health, and well-being. Basic conditioning factors of self-care include age, gender, developmental state and environmental factors to name a few. Stroke patients may lose their entire ability to provide self-care depending on where the stroke occurred. Basic things such as eating or even speaking may be affected. One of the first steps taken on the floor is a bedside swallow evaluation. This is very important because it determines if oral nutrition or medications can be given. Swallowing problems can increase risk of morbidity and mortality, as well as risk of aspiration pneumonia where food or fluids pass into the airway (Morris, 2009). Patients may be unable to receive necessary treatment if they have the inability to swallow and collaboration with the doctor is needed to determine whether or not other routes for nutrition or medication administration may be used.

The theory of self-care deficit is the main element of Orem’s general theory. The self-care-deficit theory is acquired when individuals are unable to perform basic needs to sustain health, life and well-being. Stroke patients may only be able to use one arm, or one...
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