Module 3: Orem’s Self-Care Deficit Nursing Theory – Flashcards
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List the 3 main theories within the *self-care deficit nursing theory*.
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1. The theory of *self-care* 2. The theory of *self-care deficit* 3. The theory of *nursing systems*
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What are the 3 central concepts in the *theory of self-care*?
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1. Self-care 2. Self-care requisites 3. Self-care agency
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Self-care
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The practice of activities that individuals initiate and perform on their own behalf in maintaining life, health and well being
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TRUE or FALSE: Self-care cannot develop.
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True
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Dependent care
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The care that is provided to a person who is unable to perform the self-care needed to maintain life and well-being
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TRUE or FALSE: Self-care cannot be performed if abilities could not develop, or became inoperable.
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True
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Self-care agency
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An ability to engage in self-care that develops from childhood, reaches maturity in adulthood, and declines with old age.
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In the self-care agency pyramid what are the 3 tiers?
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1. *Capabilities* for specific self-care 2. *Power component* necessary for general self-care 3. Foundational *capabilities and dispositions* necessary for deliberate action
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In the first tier of the self-care agency pyramid, what are the *3 abilities for specific self-care*?
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1. *Determine* what *needs* to be done to regulate one's health 2. *Judge and decided* what to do from the info that has been obtained 3. *Actually perform* the self-care actions
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Motivation to engage in self-care and empowering capabilities is an example of what part of the self-care agency pyramid?
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Power components
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Give examples of *foundational capabilities and dispositions necessary for deliberate action*.
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-ability to work -to regulate position -movement of body -awareness of one's abilities
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Dependent-care Agency
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The acquired ability of a person to know and meet the therapeutic self-care demand of the dependent person
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What are the *3 self-care requisites*?
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1. Universal -all humans throughout all stages of life cycles 2. Developmental -2 types: maturational and situational 3. Health - deviation -for individuals who are ill, injured or disabled
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In the self-care requisite "developmental", explain the difference between *maturational and situational self-care*.
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*Maturational*: related to universals, but adjusted for age or developmental stage (eg. needs for food and interaction in adulthood are different from those of a neonate) *Situational*: Prevents of overcomes effects of life events or experiences that can impact human development (eg. tragedy of death, change of residence, experiences related to social conditions like educational deprivation)
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What are the *8 universal self-care requisites*?
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1. Maintenance of a sufficient intake of *air*. 2. Maintenance of a sufficient intake of *food*. 3. Maintenance of a sufficient intake of *water*. 4. Provision of care associated with *elemination* processes and excrements. 5.Maintenance of balance between *activity and rest* 6.Maintenance of balance between *solitude and social interaction*. 7.*Prevention of hazards* to human life, human functioning, and human well-being. 8. Promotion of human functioning and development within *social groups* in accordance with human potential, known human limitations, and the human desire *to be normal*.
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What are the 3 *developmental self-care requisites*?
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1. Provision of conditions that promote development 2. Engagement in self-development 3. Prevention of or overcoming effects of human conditions and life situations that can adversely affect human development
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A person deliberately drinks a quantity of water to maintain a sufficient intake of water. This is an example of what?
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Basic self-care requisite
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What is a similarity between self-care and dependent-care?
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-they are both performed "purposively" (not instinctive, but performed rationally)
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According to the *theory of self-care deficit*, when and why do people require the health service nursing?
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From time to time when individuals are affected by limitations that do not allow them to meet their self-care needs
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What is the main idea of *theory of nursing system*?
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Nurses have abilities that they use to determine if nursing help is necessary or "legitimate"
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Explain the *process of the theory of nursing system*.
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1. Determine existing or potential deficit relationship between abilities and demands for action (eg. health of an individual) 2. If deficit exits, design a plan -identify what is to be done and by whom (the nure, the pt, the family member) 3. Increase pt's capabilities to meet a need, or requisite, or to decrease the demand
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In basic nursing systems, identify the nurses actions in the *Wholly compensatory system*.
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-accomplishes pt's therapeutic self-care -compensate for pt's inability to engage in self-care -supports and protects pt
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In basic nursing systems, identify the nurses actions in the *Partly compensatory system*.
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-perform some self-care measures for pt -compensate for self-care limitation of pt -assist pt as required -perform some self-care measures -regulate self-care agency
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In basic nursing systems, identify the *patients* actions in the *Partly compensatory system*.
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- perform some self-care measures -regulate self-care agency -accept care and assistance from nurse
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In basic nursing systems, identify the nurses action in the *supportive-education system*
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-regulates the exercise and development of self-care agency
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In basic nursing system, identify the *patient* action in the *supportive-education system*.
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-accomplishes self-care -regulates the exercise and development of self-care agency
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What is the difference between self-care activities and actions?
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The timely dimension: self-care *activities* are actions that are just carried out (or were just carried out), whereas self-care requisites circumscribe intended *actions* that should be or must be carried out.
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Explain the patient's view about nursing in relation to Orem's theory.
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Orem described humans who have a self-care deficit and who are not able to adequately meet their self-care demands as "legitimate" pts.
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What is the *overall aim of nursing*?
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-helping humans in maintaining structural, functional integrity and well-being during the road to independence -If independence not possible: nurses should support relatives or others to assume responsibility for the self-care of the pt
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TRUE or FALSE: Nursing is a intellectual, diagnostic process and complementary method.
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True: It complements actions of humans (or their relatives) who are not able to perform the necessary self-care
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What is the main thesis of Orem's theory?
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At times human beings are are not able to perform actions that promote or maintain life, health and well-being. Nursing has the responsibility to compensate for these deficits with the aim to assist these human beings (or their relatives) to regain these abilities (as much as possible).
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Explain the *worldview* of Orem's theory.
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-humans are rational, problem oriented beings who want to satisfy their needs -nature consists of universal pattern (norms) -social reality is defined by roles related to different social positions (responsibilities and obligations)
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Is Orem's theory normative or descriptive?
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Normative: it defines on what nurses should focus (eg. for whom nurses should care)
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What are some challenges to Orem's theory?
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-The theory neglects mental, psychological or social adaptations necessary for humans confronting serious illness, impairment or disability -Does not account for nursing care situations in which self-care deficit is not the core problem: suffering, pain or mourning
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What are the *two central criticisms* to Orem's SCDNT?
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-The concept of action is limited and is extremely problematic due to the system theoretical frame of the theory construction -The practical consequences promote an expertocratic exertion of power of nurses over patients
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According to Parsons' how is action understood?
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A selection against the backdrop of goals, means and situational contexts whereby this selection is lead by societal norms. -limited to instrumental action
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Explain 2 outcomes of Parson's model following Orem's.
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-a conception of action that is primary oriented toward the individual actions are not directed towards communicative understanding -the singular orientation of action is caught in a utilitarian concept of action it is difficult to perceive how one can get from 'unit acts' to 'social acts'.
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System Theoretical Frame
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*System theoretical frame*: the basic unit of a social system is the individual, but it is embedded in role pattern and institutional structures.
