Analysis and Application of Dorothea Orem's Self-Care Practice Model Elaine Gilligan Whelan, RNC, MA, MSN
Curriculum design in nursing education has become an increasingly sophisticated process throughout the past decade. "Theories" of nursing have emerged, and have become the basis for various curricula models. One model which is relevant to nursing education, practice and research, is that of Dorothea Orem. Nurse educators are constantly bombarded with material regardmg various nursing "theories." Each nurse educator would benefit by having some familiarity with the models of the major theorists of our day. Dorothea Orem s theory is the basis for numerous curricula across the country. Since curriculum design and redesign affords faculty the opportunity to pursue alternative approaches to the present blueprint of their academic program, material must be succinctly presented which affords one an overview of such theories as that of Orem. This paper is an attempt to address that need.
James (1968). Following this analysis of the model, a clinical example of the application of the model is presented. Analysis Philosophical Assumptions: Orem has presented the following assumptions about the nature of man, the nature of nursing, and the interactions between man and environment. Regarding the nature of man, Orem sees man as responsible for his own self-care in relation to his health. She also sees man as responsible for others who are dependent upon him (children, the sick and the elderly). Thirdly, she believes man has the right to choose or not to choose in relation to his health (Orem, 1980, pp. 1-33). For Orem, nursing is viewed as a human service which is valued in many social groups. Nursing is considered to be a mode of helping, wherein the focus of nursing is the individual's self-care action. Nursing intervention is necessary, within Orem's framework, in order to sustain life and health, to facilitate recovery from disease or injury and to help individuals cope with the effects of such threats to their self-care abilities. In order to perform in the role of nurse, an individual requires specialized knowledge, skills, and attitudes. Since the nurse engages in activities described as "a complex form of deliberate action," Orem believes that nurses must be familiar with the technological and moral aspects of decisions which affect lives, health and welfare (Orem, 1980, pp. 1-33). In terms of the interactions between man and environment, man is viewed conceptually as an open-system, i.e., a biopsychosocial being who has universal self-care requisites which are affected by age, developmental factors and health deviation experiences. The self-care "theory" presents nurse-patient relationships in an ecological context in which "human systems are formed from the interpenetrations of psychosocial and technological human systems" (Orem, 1980, p. 33). Interactions between man and nursing are determined by the needs of the patient, whose experience of self-care deficits, serves to legitimize the mutual roles. System Components: The goals of Orem's Self-Care 'Theory" are: 1) the satisfaction of universal self-care requisites; VOL. 23, NO. 8, OCTOBER 1984
In this age of multitudinous "theories" of nursing, upon which various curricula models are based, it is helpful to be able to glean the essence of a theory without necessarily having to expend a great deal of time and energy doing so. Since time is a precious commodity, especially for those engaged in nursing education, it is often useful to read a paper which analyzes, evaluates and demonstrates application of a given nursing "theory." Such exposure might then provide faculty with at least an elementary familiarity with a given theory, which might subsequently be entertained as a model for a curriculum change. This paper includes an analysis of Dorothea Orem's SelfCare Model, using the criteria for analysis suggested in the writings of such...
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