Dorothea Orem’s theory of Self-Care Deficit was developed and introduced in 1971 (Denyes et al., 2001). It is a grand nursing theory that defines nursing as an act of assisting others in becoming autonomous and independent in their own care, thus improving the human functioning at adequate levels of effectiveness (Denyes et al., 2001). The purpose of a nurse, was, thus, defined as an enabler for patients to practice self-care. Orem defined such a concept as a series of acts performed by the patient voluntarily, with the scope of maintaining life, health, and well-being (Denyes et al., 2001). Orem’s theory of self-care deficit can be applied to a multitude of areas and provides an overarching framework for researchers to rely on when addressing concrete and measurable issues.
Major concepts of Orem’s model of nursing are as follows (Denyes et al., 2001):
- Nursing: A practice, service, or technology, as well as actions deliberately selected by nurses with the end goal of rendering the patient capable of meeting their own self-care needs.
- Health: Functional, spiritual, and physiological wholeness, which is used to characterize the patient.
- Environment: A conglomerate of enthronement factors, elements, and conditions that may affect the patient and the nurse during nursing and everyday activity.
- Human Being: A biological unity that can interact with the environment on a physical, social, and emotional level, and is capable of self-care.
- Nursing client: A human being with health-related limitations that may render them incapable of self-care.
- Nursing Problem: A deficit in one of the key conditions specified above, which is typically health or development-related.
- Nursing Process: A process during which a plan of care is developed and implemented, with the purpose of benefitting the patient.
Orem’s theory of care features relationship statements, which are as follows (Denyes et al., 2001):
- The primary responsibility for the maintenance of one’s own care and those of their family needing care lies upon individual human being.
- Nursing can only occur as a result of interaction between the nurse and the patient.
- Primary care seeks to successfully meet self-care requisites as means of preventing poor health.
- In order to prevent potential health problems from occurring, the patients must know about them.
- Self-care and dependency are learned behaviors heavily influenced by socio-cultural contexts.
Evaluation of Usefulness of the Theory to the Chosen Topic
Orem’s theory of self-care is very useful in the scope of the chosen topic, which is antenatal education on obesity to reduce the risk of obesity in pregnancy and associated complications in women who recently achieved pregnancy. In the scope of the proposed intervention, it focuses on patient autonomy, which is required in preventing weight issues outside the hospital. Orem’s assumption that the illness comes from a self-care deficit is applicable to obesity in pregnant or post-partum women, as the weight gain is often the result of increased dietary intake, lack of self-control, and lack of dieting knowledge (Denyes et al., 2001; Phillips, 2014).
Examples of Theory Concepts and Statements Relating to the Chosen Theory
The concepts and relationship statements that relate to the chosen subject are the concepts of nursing (nurses providing information to patients), the primary responsibility of a human being to maintain one’s own health, and the use of knowledge to counteract potential problems before they occur (Phillips, 2014). The theory correctly identifies the patient as the only person capable of constantly having control over their own activities, which is something a nurse cannot do (Phillips, 2014). The knowledge of how to properly control one’s weight during or after pregnancy will empower these efforts and give them structure and form, thus dramatically increasing their efficiency (Phillips, 2014). The role of the nurse in such a position is to be able to provide theoretical and practical knowledge, guiding the patient on their way to self-reliance.
The appropriate interventions to address the clinical challenge include educational and practical interventions, which could be measured by knowledge retention and post-factum increases/decreases in obesity (Phillips, 2014). The increases or decreases in weight shall be measured using BMI, whereas knowledge gains will be estimated using a grading rubric. Orem’s theory of care is applicable to the chosen clinical challenge as it seeks to enhance the capacity of a patient to avoid pregnancy-related obesity. The purpose of these interventions is to give the patients the tools for efficient self-care, thus falling within Orem’s scope of practice (Denyes et al., 2001).
For example, educational intervention aimed at informing women during or shortly after pregnancy will warn them about the potential of gaining weight, the reasons for such occurrences, and what could be done to prevent such outcomes. The practical part would involve assembling appropriate dieting, calculating and reducing calorie intake, and performing exercises that are not threatening the health and well-being of women after pregnancy, which are still recovering from various complications associated with the condition (Phillips, 2014). Many educational and preventive interventions utilize Orem’s theory of self-care deficit as an overarching framework. It is assumed that if patients know about the problem and the means of overcoming it, they will be successful in doing so on their own or with nurse help (Phillips, 2014).
Denyes, M. J., Orem, D. E., & Bekel, G. (2001). Self-care: A foundational science. Nursing Science Quarterly, 14(1), 48-54.
Phillips, T. M. (2014). Exploration of theoretical models: Postpartum weight retention in African American adolescents. Nursing Science Quarterly, 27(4), 308-314.