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Orem's Self-Care Deficit Theory: A Comprehensive Exploration in Nursing Practice

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Orem's Self-Care Deficit Theory: A Comprehensive Exploration in Nursing

Practice

Introduction to the Theory of Interpersonal Relations

Orem’s Self-Care Deficit Theory (SCDT) is a grand theory proposed for conducting

professional nursing practice. This theory was chosen because the model incorporates a process

view of the interdependence between patient decision-making and the nurse's action in a system

shifting toward patient preference in caring (Tanaka, 2022). Self-care has become even more

vital in current nursing practice (Tanaka, 2022). Patient autonomy is now included as a critical

measure, especially given the prevalence of chronic illnesses that demand patient regulation.

Personally, in my practice as a nurse, I have used Orem’s Self-Care Deficit Theory in

order to analyze the needs of a specific patient and create a patient care plan that is suitable

specifically for that patient. As suggested by Tanaka (2022), self-care deficiencies could be

evaluated in terms of the overall and specific patient requirements, along with their actual

departures, individual care plans, and educative or environmental changes that might be held

valuable to encourage more decision-making independence. Such goals may involve educating

the patient on his or her disease, diet, and medications and establishing goals that will foster the

patient's improved health.

Synthesized Method of Theory Evaluation

Theory Description

Scope of Theory

The Self-Care Deficit Theory (SCDT) by Orem is a highly developed theory that

incorporates the various aspects of self-care and the role of the practice in nursing. The range of
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the theory includes evaluating an individual’s self-care capacity, areas of self-care that require

enhancement, and intervention strategies that can be employed to enhance a patient’s ability to

meet their needs. It is suitable for use in acute care, chronic care, rehabilitation, and community

health settings to underscore the importance of patient-centeredness in attaining value-based

healthcare outcomes.

Purpose of Theory

The primary purpose of Orem’s theory is to serve nursing practice, thus supporting the

concept of self-care. The theory focuses on helping individuals become self-reliant in caring for

their health through performing self-care tasks and seeking help from nursing professionals when

they cannot manage their self-care needs.

Origins of Theory

Orem’s SCDT began in the 50s and early 60s when Dorothea Orem observed that other

nursing theories failed to capture the patient’s involvement in care adequately. Orem’s education

informed the theory and her practical experience as a nurse and a nursing educator. She realized

a need for a theory encompassing nursing practice and included the patient’s aspect in

maintaining health.

Major Concepts

1. Self-care: The practice of activities that individuals initiate and perform on their behalf to

maintain life, health, and well-being.

2. Self-Care Deficit: This occurs when an individual cannot perform self-care activities due

to limitations or health conditions, resulting in nursing intervention.

3. Nursing Systems: Frameworks that guide nursing actions based on the level of self-care

support required.
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Major Theoretical Propositions

1. People can manage themselves and have the desire to do that if they know how important it

is.

2. Nursing becomes required when people have self-care needs, which provide a barrier to

the overall well-being of a person.

3. Nursing impacts or practical approaches often strengthen clients’ self-care skills and

minimize self-care gaps, thus enhancing health standards.

4. Nursing care outcomes are the extent to which the recipients can fulfill self-care needs

independently.

Major Assumptions

1. Universal Need for Self-Care: All individuals have a fundamental need for self-care to

maintain health and well-being.

2. Patient Capability: Individuals can learn and perform self-care, given appropriate

education and support.

3. Role of Nursing: Nursing is essential for helping individuals who cannot fully meet their

self-care needs due to illness or disability.

4. Health as a Continuum: Health is a continuum where individuals can progress toward

optimal health through effective self-care practices.

Context for Use

Self-care demand theory, promoted by Orem, is also helpful in practice in clinical

settings, as well as in chronic ailments, rehabilitation, and other areas of community health. In

clinical settings, the theory can help nurses identify the patient's self-care level and design a

unique treatment plan that addresses the zone of altered self-care. In the case of chronic illnesses,
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including diabetes or hypertension, the theory helps the nurses teach patients about measures to

lead healthy lives. This theory can also be used in rehabilitation settings as patients will be

encouraged to engage in activities that help them achieve independence, thus allowing them to

recover fully.

Theory Analysis

Content Analysis

The content of Orem's Self-Care Deficit Theory is built around three primary concepts:

self-care, self-care deficit, and nursing systems. According to McEwen and Wills (2023), self-

care comprises the processes that people undertake and are responsible for undertaking on their

own for their health. Self-care deficit is when people cannot provide self-care because they do

not know how, are physically incapable, or do not have sufficient helpers. Finally, nursing

systems are the structures and processes nurses employ to assist patients in meeting their self-

care needs.

Structural Analysis

From Orem’s Self-Care Theory analysis, the structure is logically harmonized, the

elements are clear, and they are in harmony, each substantiating the theory. The theory is based

on postulates about human beings, health, and nursing, which are the premises upon which

the theory's propositions rest. The significant assumptions include the view that people are

assumed to be capable of self-care, self-care is deemed necessary for health, and nursing is

needed when gaps in self-care capacity are found. The precise structures of the theory make it

easier for the nurses to implement them because they will enable a systematic way of evaluating

the patient’s needs and taking the necessary actions.

Functional Analysis

The functional concept relates to the manifestation of the concepts in the framework of

Orem’s theory in practice, research, and teaching. The theory asserts choice in health self-

management, outlines the circumstances that result in self-care deprivation, and anticipates the

possibility of nursing action to address those conditions and help patients restore choice in health

self-management. Applying Orem’s self-care theory within practice involves sections where the

patient is taught about managing disease, interpersonal communication support, and links to

assets that improve self-care management.

Practical Relevance and Applicability

Orem’s Self-Care Deficit Theory implies emerging trends in healthcare facilities,

focusing on patient care outcomes associated with self-care Deficit Theory. The theory promotes

the interpersonal nursing model, where the nurses deliver care involving physical, emotional, and

social aspects of health. Orem’s model incorporates the contemporary approaches of nursing

practice where the patient is encouraged to participate in self-care.

Theory Evaluation

Contribution to the Discipline’s Knowledge Base

Self-care deficit theory is essential to nursing knowledge as it offers a roadmap of how

and why self-care impacts healthcare results. The theory defines terms such as self-care, self-care

deficit, and nursing system, which gives the theory a system for assessing the patient’s needs and

an approach to the nursing intervention. This conceptual clarity helps form nursing curricula,

research, and evidence-based practice frameworks, thereby advancing the body of knowledge in

the nursing field.

Effectiveness in Directing Nursing Practice and Interventions

Orem SCDT, in a way, keenly orients nursing practice by assessing patients' self-care

competency and any shortages thereof. The theory gives nurses the means of understanding the

needs of specific patients, planning how to address these needs, and assessing the results of the

intervention. It also enhances a systematic manner of enjoying one-on-one care throughout

managing patients’ health conditions. Several quantitative studies exploring self-care

interventions based on Orem’s theory stressed enhanced client outcomes as more compliance

with prescribed care regimens and increased quality of life.

Evaluation of Favorable Outcomes

Issues of interest in evaluating Orem’s theory include its effects on the patients. Previous

studies revealed that the programs developed from Orem’s self-care model have positive

outcomes in treating clients in different facilities. For instance, in treating chronic diseases,

supported clients develop self-care skills, which result in better health outcomes, fewer relapses,

and improved quality of life. One aspect of Orem’s theory is self-care, which allows a patient to

play an active part in managing her condition, essential in preventing chronic disease.

Strengths and Limitations of the Theory

However, like any theory, the Self-Care Deficit Theory developed by Orem also has

drawbacks. A well-defined conceptual framework informs this and directs the nursing

assessments and interventions. This clarity is essential in ensuring nurses' training promotes self-

care evaluation deficits and how best they could be filled. However, one limitation is that the

theory may downplay the complexities of health experiences by emphasizing the agency's role at

the individual level. It fails to integrate influences of socio-economic factors, culture, and
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healthcare system constraints, which may affect a patient’s ability to self-care. This gap implies

the need to establish other frameworks related to the determinants of health as well.

Conclusion and Implications for Nursing Practice

The theory stimulates potentially beneficial nursing actions because it targets self-care

that can significantly contribute to a better state of health. This theory provides nurses with a

solid theoretical foundation for conceptualizing the importance of self-care in managing health.

Still, it also has shortcomings and brings to the nurses' attention the impact of the environment

on the patient’s health. As nursing practice advances, applying Orem’s Self-care Nursing Theory

with the inclusion of the social determinants of health will improve patient outcomes among

culturally diverse clients.

Personal Reflection

In doing theory analysis when studying nursing theory, I have discovered that the theory

analysis criteria are essential in developing my understanding of nursing practice. The

requirements presented by McEwen & Wills permit the methodical assessment of the theories,

thus allowing me to objectively evaluate the usefulness of these theories ‘in the real world.’ In

my working practice, using such criteria has allowed me to define what theories should be

considered or not for nursing concerning my case and the needs of my patients.

With the help of Orem’s theory, I can improve my practice by applying patient-

empowering practices based on research findings. I have learned that the process of analysis of

theory makes me more knowledgeable about how the theory helps me in patient care and

improves patient outcomes through clinical decision-making. Such reflection enables a greater

understanding of nursing theory's value in improving the standards and position of such

a profession.
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As a result, the criteria for theory analysis have helped inform my nursing practice. They

have helped me establish specific guidelines that assess the relevance and applicability of

different nursing theories, resulting in better decision-making in my nursing practice. I adhere to

the following noble goals and objectives in my nursing practice. Self-care or caring for the self is

critical when attending to patients since it boosts patient satisfaction. This journey through theory

analysis enriches my nursing knowledge. It strengthens my values in bringing the best quality of

evidence-based care to those people and communities I work with.

References

McEwen, M., & Wills, E. M. (2023). Theoretical basis for nursing (6th ed.). Wolters Kluwer.

Tanaka, M. (2022). Orem’s nursing self‐care deficit theory: A theoretical analysis focusing on its

philosophical and sociological foundation. Nursing Forum, 57(3), 480–485.

https://doi.org/10.1111/nuf.12696