Since the recognition of nursing back in the 19th century, professionals have been pooling their efforts in order to define some of the basic theoretical foundations of the profession. As a result, the existence of significantly diverse nursing theories makes it challenging for a practitioner to decide on the most appropriate approach to nursing care. Thus, it is of crucial importance to provide a critical analysis of the most widespread theories to define their positive and negative implications for the setting. The aim of the following presentation is to provide a brief overview of Dorothea Orem’s self-care nursing theory. Moreover, the theoretical data will be compared with the evidence-based concept application to evaluate the overall approach’s efficiency.
At the beginning of the 20th century, the idea of defining the nurse’s area of responsibility and proficiency were some of the primary research tasks. Thus, Dorothea Orem, being a professional nurse herself, outlined the correlation between nursing and the self-care of the patients. According to the scholarly data, self-care in Orem’s interpretation stands for the patient’s ability to perform actions aimed at maintaining a healthy lifestyle (Khademian et al., 2020). The nurses, in their turn, do not perceive patients as people with limited abilities, providing healthcare assistance when explicitly required by the patient. As a result, the approaches to nursing were divided into the three major systems regarding the extent to which help and education are required.
When speaking of Orem’s theory overview, it is of crucial importance to mention the existence of the three subsequent theories within the framework aimed at describing the patterns of patients’ requirements for assistance. Thus, according to the self-care theoretical framework, patients are capable of performing activities without external help. The theory of self-care deficit, in its turn, presupposes nurses’ participation in the process by helping patients with basic health-maintaining activities (Khademian et al., 2020). The last theory concerns the question of the nursing system applied to a specific communicative situation. Hence, it may be outlined that the theory itself is quite relevant in the context of modern healthcare.
In order to demonstrate the efficacy of the following framework, qualitative data on the subject should be analyzed. A prime example of the theory’s success was found in the study conducted by Malekzadeh et al. (2018), which aimed at defining the qualitative difference between nursing students learning Orem’s self-care approach and those learning routine nursing processes. The following quasi-experimental study included 66 nursing students, half of which were learning the fundamentals of Orem’s nursing theory prior to working with patients (Malekzadeh et al., 2018). As a result, the intervention group has shown considerably better results during nursing practice.
Theory & Conceptual Model
When speaking of the conceptual framework, it is necessary to outline some of the major variables that influence the way self-care theory works in an actual environment. To begin with, the self-care nursing framework encompasses such universal concepts as nursing, health, environment, and humans, as these notions are crucial in terms of healthcare efficacy. Besides these notions, the theory encompasses the concept of self-care demand, self-care agency, nursing agency, self-care proper, and deficit (Gligor & Domnariu, 2020). In fact, the theory of self-care contributes a lot to the conceptual model, as it defines the working frameworks of cooperation between self-care and nursing.
Theory & Metaparadigms
Orem’s nursing theory is deeply preoccupied with the positive outcomes for the community as well as for each individual patient. According to the researchers, the theory of self-care manages to tackle every aspect of the nursing metaparadigm, including environment, people, nursing, and health (Gligor & Domnariu, 2020). This fact may be justified by the representation of the conceptual framework above, as it pays attention to the patient as a human being influenced by various environmental factors, whereas nursing becomes a paradigm that helps address this influence when required.
Evidence-Based Examples: # 1
The examples concerning the evidence-based practice justification primarily concern the manifestation of the influence scope self-care deficit theory has on the practice efficiency. Hence, the first example is correlated with the elderly care for patients undergoing hip replacement theory (Yan et al., 2017). The study itself is quasi-experimental, encompassing the observation of 76 elderly patients undergoing and recovering from a complicated surgery. The aforementioned sample was equally divided into the intervention and control groups, where the latter received conventional medical assistance throughout the process (Yan et al., 2017). The results of the experiment revealed that the patients from the intervention group had a lower complication risk and a higher satisfaction rate, proving the idea of self-care theory efficiency.
Evidence-Based Examples: # 2
Another relevant example concerns a study involving women living with rheumatoid arthritis. Considering the fact that this disease is a severe condition that limits the patient’s movement due to excruciating pain, it becomes evident that nursing intervention is inevitable. Using the methodology of a clinical trial, Saeedifar et al. (2018) chose a sample of 60 female patients with rheumatoid arthritis. After undergoing treatment, the participants were asked to fill in the questionnaire and assess their pain level on a numeric scale. The results showed that the patients in the intervention group were suffering less from the pain (Saeedifar et al., 2018). Hence, it may be concluded that the self-care deficit nursing practice is a valuable approach to pain management.
Evidence-Based Examples: # 3
Finally, the last evidence-based example is related to a long-term mental condition. Ahmed et al. (n.d.) conducted research aimed at defining the scope to which the self-care nursing systems would be able to assist school-age children with autistic spectrum disorder (ASD) and their parents. The sample of the study constituted 36 participants claiming to have ASD-related self-care issues. Prior to the intervention, parents stated that the major challenge was a lack of proper training and education on how to communicate with their children. The results revealed that the self-care nursing model implementation contributed to the parents’ understanding and kids’ ability to perform some basic self-care activities (Ahmed et al., n.d.). Hence, it may be concluded that self-care nursing has a beneficial effect on the vast majority of nursing practice cases, including rehabilitation and education.
Nursing remains to be one of the most challenging aspects of healthcare when it comes to the identification of the scope of responsibility and practice approach. The aim of the following presentation was to analyze one of the most notorious theoretical approaches to the nursing practice. Thus, as far as Dorothea Orem’s self-care nursing theory is concerned, it may be concluded that the framework is a multifunctional and efficient intervention tool. The approach is especially applicable to the processes of patient education and rehabilitation. The future implications of the research may concern an exhaustive assessment of the evidence-based data in order to reclaim the value of self-care nursing in the modern healthcare paradigm.
Ahmed, H. M., Mohammed, R. E., & Ibrahim, S. R. (n.d.). Effect of Orem self-care model on school-age children and teenagers with autism and their parents. Web.
Gligor, L., & Domnariu, C. D. (2020). Patient care approach using nursing theories-comparative analysis of Orem’s self-care deficit theory and Henderson’s model. Acta Medica Transilvanica, 25(2), 11-14. Web.
Khademian, Z., Kazemi Ara, F., & Gholamzadeh, S. (2020). The effect of self care education based on Orem’s nursing theory on quality of life and self-efficacy in patients with hypertension: a quasi-experimental study. International Journal of Community Based Nursing and Midwifery, 8(2), 140–149. Web.
Malekzadeh, J., Amouzeshi, Z., & Mazlom, S. R. (2018). A quasi‐experimental study of the effect of teaching Orem’s self‐care model on nursing students’ clinical performance and patient satisfaction. Nursing Open, 5(3), 370-375. Web.
Saeedifar, E. S., Memarian, R., Fatahi, S., & Ghelichkhani, F. (2018). Use of the Orem self-care model on pain relief in women with rheumatoid arthritis: a randomized trial. Electronic Physician, 10(6), 6884. Web.
Yan, H. U. A. N. G., Jie, Z. H. U., & Chuanli, Y. A. N. G. (2017). Application of Orem self-care theory in elderly patients undergoing total hip replacement surgery. Chinese Journal of Integrative Nursing, 3(5), 108.