Introduction
A theory is integral in nursing because it enables nurses to conceptualize their duties and perform them systematically. Essentially, a nursing theory comprises concepts, ideas, principles, models, assumptions, and propositions, which elucidate a given phenomenon in nursing. Given that nursing practice involves diverse activities, a nursing theory acts as a guide, which describes and explains the interrelationships among these activities. Long-term experience in sub-acute care environment has enabled me to understand and apply different nursing theories. As sub-acute care offers comprehensive care, it enhances self-care abilities of patients with acute illnesses or injuries. The experience of helping patients in sub-acute care environment to gain self-care abilities entailed the application of Dorothea Orem’s self-care deficit theory of nursing. The theory of self-care deficit by Dorothea Orem holds that patients have innate abilities for self-care, which nurses identify and optimize (O’shaughnessy, 2014). In this case, the selected nursing theory is Dorothea Orem’s self-care deficit theory, which is effective in empowering patients to attain self-care abilities. Therefore, in describing the application of Orem’s self-care deficit theory of nursing, this essay examines the importance of the theory, offers a summary of the selected theory, explains the views of the theory on the specialization of nursing education , and eventually concludes the application of the theory.
Importance of the Theory
Since nursing aims at improving the quality of lives of patients, Orem’s theory of self-care deficit is important to nursing because it promotes self-care. According to O’shaughnessy (2014), Orem’s theory of self-care deficit holds that patients have innate abilities, which become deficient during sickness, and thus, nurses optimize these abilities when providing nursing care. Fundamentally, the theory supports nursing care by reinforcing self-care interventions, which are central in the recovery of patients. Hashemi et al. (2014) state that Orem’s theory of self-care deficit offers conceptual framework that guides nurses in running self-care programs or applying different forms of nursing systems. Therefore, the nursing theory is important because it promotes self-care by offering an effective conceptual framework that enhances quality of nursing care.
The theory of self-care deficit is important in nursing because it enables nurses to assess the deficit of innate self-care abilities of patients, which make them perform their self-care activities. Nurses need to undertake keen assessment of patients’ health status and progress over time so that they can understand their needs. The assessment enables nurses to have a comprehensive understanding of their patients so that they can offer customized care that is commensurate with their self-care inabilities. Deficit of self-care usually occurs when self-care abilities of patients are unable to meet the demands for self-care. O’shaughnessy (2014) states the existence of self-care deficit requires nurses to facilitate patients to recover the deficit and perform activities of self-care. Therefore, self-care deficit theory is significant for it enables nurses to ascertain the needs of patients, tailor their nursing care, and assist them to attain self-care. Fundamentally, the nature of tailored nursing care is dependent on the ascertained needs of patients.
Summary of Dorothea Orem’s Self-Care Deficit Theory
The name of the selected theory is self-care deficit theory by Dorothea Orem. The first reason for selecting the theory is that it is applicable in the provision of nursing care in chronic, acute, and sub-acute healthcare environments. Since patients with chronic or acute conditions have deficits in self-care abilities, the theory recognizes these deficits and offers nurses with a conceptual framework of improving self-care. The theory of self-care deficit enables nurses to design and implement customized care plans that meet diverse needs of patients (Hashemi et al., 2014). Consequently, nursing care effectively improves self-care abilities and quality of life among patients. The second reason for selecting the theory is that it recognizes the innate self-care abilities of patients. O’shaughnessy (2014) argues that self-care deficit theory recognizes that patients have innate abilities for self-care, which require nurses to identify and optimize when offering nursing care. The extent of deficit determines the nature of nursing care that patients require, and thus, making customization of nursing care possible. The third reason for selecting the theory is that it allows assessment of patients’ progress over time. Continual assessment of patients’ deficits in abilities for self-care enables nurses to monitor the progress of patients and adjust interventions to obtain optimal outcomes of nursing care (O’shaughnessy, 2014). Hence, self-care deficit theory is helpful in monitoring progress of patients and adjusting interventions to achieve optimal nursing outcomes.
The purposes of self-care deficit theory are to assess the needs of patients, customize nursing care, and monitor progress of patients in response to nursing care. In the aspect of assessing the needs of patients, the theory is applicable in identifying deficits, which prevent patients from attaining the status of undertaking self-care activities. Self-care deficit theory postulates that deficits in innate abilities for self-care prevent patients from performing activities of self-care (O’shaughnessy, 2014). Thus, identification of deficits is integral in the customization of nursing care, which is the second purpose of self-care deficit theory. Understanding of the needs of patients in self-care enables nurses to decide if they can employ wholly compensatory, partly compensatory, or supportive-educative nursing systems in the provision of nursing care (Hashemi et al. 2014). After assessing the needs of patients and customizing nursing care, nurses also apply self-care deficit theory in monitoring how patients progress so that they can optimize the interventions.
The key concepts of self-care deficit theory are self-care deficit, self-care, and nursing agency, which interrelate in the nursing environment. The concept of self-care deficit implies that patients have deficits in self-care abilities that hinder them from performing activities of self-care. Comparatively, the concept of self-care holds that patients have innate abilities for self-care, which nurses can optimize in nursing care. These two concepts interrelate as nurses identify self-care deficits among patients and facilitate self-care by providing customized nursing care. Nurses comprise nursing agency as they facilitate attainment and optimization of self-care abilities among patients (O’shaughnessy, 2014). These concepts of the theory interrelate in nursing and effectively address issues of healthcare that lie in nursing, person, and health, which are some of the nursing metaparadigms. In addressing metaparadigm of nursing, self-care deficit theory requires nurses to assess needs of patients, customize their care, and monitor their progress accordingly. The theory also examines metaparadigm of a person because it holds that patients have innate self-care abilities. Ultimately, in the metaparadigm of health, the theory recognizes the existence of diverse patients’ needs, which require different degrees of nursing care.
Views of Self-Care Deficit Theory on a Specialization
Orem’s self-care deficit theory views nursing education as an integral aspect of nursing because it equips nurses with knowledge and skills, which are essential in improving the quality of nursing care. Fundamentally, the basis of the theory is that nurses can assess the needs of patients, identify deficits in self-care abilities, customize nursing care, and continually monitor the progress of patients while optimizing nursing care. The basis of the theory encapsulates nursing education because it defines the roles and duties of nurses in nursing as a profession in terms of empirical knowledge and conceptual knowledge (Queiros, Vidinha, & Filho, 2014). Orem’s self-care deficit theory views self-care as health-deviation, developmental, and universal requisites. Moreover, the theory views nursing education as a complex of wholly compensatory care, partly compensatory care, and supportive-educative care, which self-care deficit, self-care, and nursing agency determine. The classification of nursing care indicates that the self-care deficit theory views nursing education as integrated parts. Queiros et al. (2014) explain that self-care deficit theory views nursing education as a practical science, which require nurses to apply scientific knowledge, empirical experience, and conceptual framework in the provision of nursing care. Hence, the views of the self-care deficit theory on nursing education have significantly shaped nursing care.
The first example of the view of self-care deficit theory on nursing education is the application of self-care deficit theory in promoting home peritoneal dialysis among the elderly patients. Customized nursing care of supportive-educative system allows nurses to teach patients on how to perform peritoneal dialysis at home. Given that patients have innate abilities for self-care, the application of supportive-educative nursing system in promoting patients to undertake peritoneal dialysis at home has proved to be effective among the elderly population. According to O’shaughnessy (2014), the application of self-care deficit theory in peritoneal dialysis among the elderly significantly enhances quality of life, autonomy, self-worth, and self-care. Thus, the theory boosts nursing education because it provides nurses with novel knowledge and skills, which they can apply in promoting home dialysis.
The application of self-care deficit theory in improving quality of care among patients with burns is the second example of the theory’s view on nursing education. Patients with burns usually have significant deficits of self-care, and hence, nurses need to offer appropriate nursing care, which promote self-care abilities. For nurses to offer appropriate nursing care, they design and apply self-care programs that meet the unique needs of patients. Hashemi et al. (2014) report that the application of self-care deficit theory in designing and implementing self-care program improved quality of life of patients with burns from 73.33% to 98.12% within the period of two months. In this view, it is evident that self-care deficit theory is important in nursing education because it optimizes nursing care among patients with burns and improves quality of life.
Conclusion
In nursing, theories play a central role in the delivery of nursing care because they enable nurses to conceptualize their practices and perform them in a systematic manner. The nursing theory of self-care deficit by Dorothea Orem is important to the nursing profession because it promotes self-care abilities of patients in acute and sub-acute care environments. The main concepts of self-care deficit theory are self-care deficit, self-care, and nursing agency, which interrelate in promoting self-care abilities among patients and shaping metaparadigm concepts of nursing, namely, person, nursing, and health. Essentially, the purposes of self-care deficit theory are to assess the needs of patients, customize nursing care, and monitor progress of patients in response to the administered nursing care. Regarding how self-care deficit theory views the specialization of nursing education, self-care programs for home dialysis among the elderly patients and quality of life among patients with burns are two practical applications of the theory in promoting nursing care.
References
Hashemi, F., Dolatabad, F., Yektatalab, S., Ayaz, M., Zare, N., & Mansouri, P. (2014). Effect of Orem Self-Care Program on the Life of Qaulity of Burn Patients Referred to Ghotb-al-Dine-Shirazi Burn Center, Shiraz, Iran: A Randomized Control Trial. International Journal of Community Based Nursing and Midwifery, 2(1), 40-50.
O’shaughnessy, M. (2014). Application of Dorothy Orem’s Theory of Self-Care to the Elderly Patient on Peritoneal Dialysis. Nephrology Nursing Journal, 41(5), 495-498.
Queiros, P., Vidinha, T., & Filho, A. (2014). Self-care: Orem’s Theoretical Contribution of the Nursing Discipline and Profession. Reference Journal of Nursing, 4(3), 157-173.