Chosen theory – Dorothea Orem: Pioneer of the Self-Care Nursing Theory
Write a report on the chosen theorist/theory that includes the following:
1. Explanation of how patient outcomes could be used to determine the success of the theory’s implementation.
2. Contrast between present practice and what would take place if the theory were guiding the practice.
Theorist Identification and Rationale
The implementation of self-care theory by Dorothea Orem is necessary so as to promote patient outcomes. The theory was first published in 1971. One of the major assumptions of the theory is that people ought to be self-reliant and responsible for care of others needing care and for their own care (Current Nursing, 2021). The rationale for selection of this theory is that there is need to improve self-care abilities of patients given the shortage of healthcare providers in hospitals. Self-care is most suitable for use in rehabilitation settings after a patient has received care from nurses and physicians (Gonzalo, 2021). The purpose of this paper is to discuss the impact of self-care theory on patient care and to reflect on the current practice.
Self-care theory is classified as a grand nursing theory. The classification implies that the theory covers a wide scope with utilization of general concepts, which are applicable to all instances of nursing (Gonzalo, 2021).
Theory Assumptions, Concepts, and Propositions
Assumptions of the self-care theory include maintenance of common communication and interpersonal relationship to stay alive and remain functional; power of patients to act deliberately; that mature individuals experience privations; and human agency can be reflected in self-care (Gonzalo, 2021). Self-care theory is composed of three interrelate theories including the self-care deficit theory, the theory of self-care, and the theory of nursing systems. A major preposition is that a patient can practice or perform self-care activities to maintain their wellbeing, life, and health (Gonzalo, 2021).
Examples of application of self-care theory include use of the theory in Kusnanto et al.’s (2018) study among individuals with systemic lupus erythematosus. On average self-care theory improved self-care operation by 17.53%, self-care agency by 19.93%, and quality of life by 12.19% (Kusnanto et al., 2018). Another example is that Borji, Otaghi, and Kazembeigi (2017), demonstrated that self-care theory can be used to improve the quality of life among patients with type II diabetes.
Theory Application Hypothesis and Examples
Self-care abilities make patients or their family members to be effective in management of their condition or status at home (American Sentinel College of Nursing, 2021). For example, some conditions such as diabetes and wound dressing can be managed at home. Besides, patients can effectively manage their medications at home (Current Nursing, 2021).
Plan for integration include re-education and re-training of healthcare providers on how to implement or apply self-care principles and concepts at all levels of care. After training, the hospital administration should monitor and assess the success of its implementation. Patient outcomes should also be evaluated upon utilization of the model in practice (Current Nursing, 2021).
Improvement in patient outcome that can be observed with the use of the model include maintenance of effective respiration; proper hydration; achieved state of normalcy; maintenance of health status, and effective management of disease process. Other outcomes include improved adherence to medication regimen and improved awareness of various problems. Self-care theory can also help the patients to adjust and cope with changes (Current Nursing, 2021). Self-care can help reduce the level of fatigue among patients and improve quality of care (Yuk, 2021).
Present Practice Versus Theory-Guided Practice
The current practice is heavily reliant on the action and care provided by healthcare team on improvement of patient outcomes. The current practice does not recognize the impact of patient self-care on overall healthcare outcomes (Current Nursing, 2021). Selfcare theory implementation in the healthcare organization would enable patient to monitor their conditions and seek as well as secure appropriate medical assistance when in need. The patients should be able to regulate or attend to the discomforting or deleterious effects of prescribed medical measures. The child patients should learn to live with their pathologic conditions. Besides, patients should be able to learn to live with the effects of treatment and diagnostic measures, which can help to promote continued personal development (Gonzalo, 2021).
Patients and/or family members can self-care and self-manage their conditions or disease. Self-care has various advantages on patient care increase improved medication adherence, quality and safety of care. The current organization should implement concepts borrowed for self-care theory to improve patient outcomes and reduce over dependence on healthcare staff.
American Sentinel College of Nursing. (2021). Self-care. https://www.americansentinel.edu/blog/2020/07/11/dorothea-orem-pioneer-of-the-self-care-nursing-theory/
Borji, M., Otaghi, M., & Kazembeigi, S. (2017). The Impact of Orem’s Self-Care Model on the Quality of Life in Patients With Type II Diabetes. Biomed Pharmacol J, 10(1). http://biomedpharmajournal.org/?p=13576
Current Nursing. (2021). Nursing theories. https://www.currentnursing.com/nursing_theory/self_care_deficit_theory.html
Gonzalo, A. (March 05, 2021). Dorothea Orem: self-care deficit theory. https://nurseslabs.com/dorothea-orems-self-care-theory/
Kusnanto, K., Sari, N. P. W., Harmayetty, H., Efendi, F., & Gunawan, J. (2018). Self-care model application to improve self-care agency, self-care activities, and quality of life in patients with systemic lupus erythematosus. Journal of Taibah University Medical Sciences, 13(5), 472-478. https://doi.org/10.1016/j.jtumed.2018.07.002
Yuk, J. Y. C. (2021). Theory-based Advanced Nursing Practice: A practice update on the application of Orem’s self-care deficit nursing theory. SAGE Open Nursing, 7. https://journals.sagepub.com/doi/full/10.1177/23779608211011993