Orem model of nursing
Encyclopedia
The self-care deficit nursing theory is a grand nursing theory
that was developed between 1959 and 2001 by Dorothea Orem
. It is also known as the Orem model of nursing. It is particularly used in rehabilitation
and primary care
settings where the patient is encouraged to be as independent
as possible.
is based upon the philosophy that all "patients wish to care for themselves". They can recover more quickly and holistically if they are allowed to perform their own self-cares to the best of their ability.
to determine these deficits, and define a support modality.
The nurse is encouraged to assign a support modality to each of the self-care requisites.
'J' is a 50-year-old male who has just been diagnosed with type-two diabetes mellitus. He has a history of hypertension, and is a chronic smoker, smoking around 30 cigarettes daily.
Nursing theory
Nursing theory is the term given to the body of knowledge that is used to define or explain various aspects of the profession of nursing.-Grand nursing theories:...
that was developed between 1959 and 2001 by Dorothea Orem
Dorothea Orem
Dorothea Elizabeth Orem , born in Baltimore, Maryland, was a nursing theorist and creator of the Self-Care Deficit Nursing Theory , also known as the Orem model of nursing....
. It is also known as the Orem model of nursing. It is particularly used in rehabilitation
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
and primary care
Primary care
Primary care is the term for the health services by providers who act as the principal point of consultation for patients within a health care system...
settings where the patient is encouraged to be as independent
Independent living
Independent living, as seen by its advocates, is a philosophy, a way of looking at disability and society, and a worldwide movement of people with disabilities working for self-determination, self-respect and equal opportunities...
as possible.
Central philosophy
The nursing theoryNursing theory
Nursing theory is the term given to the body of knowledge that is used to define or explain various aspects of the profession of nursing.-Grand nursing theories:...
is based upon the philosophy that all "patients wish to care for themselves". They can recover more quickly and holistically if they are allowed to perform their own self-cares to the best of their ability.
Self-care requisites
Self-care requisites are groups of needs or requirements that Orem identified. They are classified as either:- Universal self-care requisites - those needs that all people have
- Developmental self-care requisites - 1. maturational: progress toward higher level of maturation. 2. situational: prevention of deleterious effects related to development.
- Health deviation requisites - those needs that arise as a result of a patient's condition
Self-care deficits
When an individual is very unable to meet their own self-care requisites, a "self-care deficit" occurs. It is the job of the Registered NurseRegistered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
to determine these deficits, and define a support modality.
Support modalities
Nurses are encouraged to rate their patient's dependencies or each of the self-care deficits on the following scale:- Total Compensation
- Partial Compensation
- Educative/Supportive
Universal Self-Care Requisites (SCRs)
The Universal self-care requisites that all or health are:- Air
- Water
- Food
- Elimination
- Activity and Rest
- Solitude and Social Interaction
- Hazard Prevention
- Promotion of Normality
The nurse is encouraged to assign a support modality to each of the self-care requisites.
Example nursing assessment
This patient is entirely fictitious and any likeness to any person, alive or dead, is purely coincidental.'J' is a 50-year-old male who has just been diagnosed with type-two diabetes mellitus. He has a history of hypertension, and is a chronic smoker, smoking around 30 cigarettes daily.
- AIR: Educative/Supportive - Provide education on the risks associated with smokingTobacco smokingTobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...
particularly for the diabetic patient. - WATER: Educative/Supportive - Ensure access to adequate hydration - risk of polydipsiaPolydipsiaPolydipsia is a medical symptom in which the patient displays excessive thirst. The word derives from the Greek πολυδιψία, which is derived from πολύς + δίψα...
due to hyperglycaemiaHyperglycemiaHyperglycemia or Hyperglycæmia, or high blood sugar, is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a glucose level higher than 13.5mmol/l , but symptoms may not start to become noticeable until even higher values such as 15-20 mmol/l...
. - FOOD: Partial Compensation - Education and provision of a diet that is suitable for his new diagnosis of diabetes, blood sugarBlood sugarThe blood sugar concentration or blood glucose level is the amount of glucose present in the blood of a human or animal. Normally in mammals, the body maintains the blood glucose level at a reference range between about 3.6 and 5.8 mM , or 64.8 and 104.4 mg/dL...
monitoring after meals. - ELIMINATION: Educative/Supportive - May require monitoring.
- ACTIVITY AND REST: Educative/Supportive - Educate patient as to the benefits of cardiovascular exercise, especially for the diabetic
- SOLITUDE AND SOCIAL INTERACTION: Partial Compensation - Nurses may provide social interaction as hospital admission will cause change is social behaviour and interactions.
- HAZARD PREVENTION: Partial Compensation - Nurses will need to educate regarding the medication that he may be taking, and administer this medication initially. Particularly relevant if J is taking insulinInsulinInsulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....
injectionInjection (medicine)An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...
s. - PROMOTE NORMALITY: Partial Compensation - Nurses will need to facilitate a return to normal lifestyle. This will involve advocating for the patient in a multi-disciplinary team, in order to achieve a medication regimeRegimeThe word regime refers to a set of conditions, most often of a political nature.-Politics:...
that will fit with the patient's life.