OREM’S SELF CARE DEFICIT NURSING THEORY Janet Secrest, PhD; RN University of Tennessee at Chattanooga

Objectives At the end of this PP, you will be able to: 1. Explain the three theories in Orem’s SCDNT 2. State the self care requisites 3. State the Basic Conditioning Factors 4. Identify the Power Components 5. Explain the relationship between the BCF, PC, and SCR 6. Use an analogy to explain Nursing Systems 7. Relate Nursing Process to SCDNT

3 THEORIES Theory of Self Care Theory of Self Care Deficit Theory of Nursing System

Theory 1: Theory of Self Care Is the person able to meet health related self-care requisites? or asked another way Is there a need for nursing care?

Self Care Requisites (3) Universal Developmental Health deviation

Self-Care Requisites Influenced by Basic Conditioning Factors Power Components

Solitude/social activity Universal Self Care Requisites (8) Air Water Food Elimination Activity/rest Solitude/social activity Prevention hazards Promotion well being Normalcy Orem, 2001, pp. 225-227

Orem’s Developmental Stages Intrauterine Adulthood Neonatal Infancy Childhood Adolescence Pregnancy Orem, 2001, pp. 225-227

Developmental self care requisites 1. promote and/or engage development For example . . .

2. overcome interferences with development educational deprivation problems of social adaptation failures of healthy individuation loss of relatives, friends, associates, possessions

After the hurricane

2. overcome interferences with development abrupt change of residence status associated problems poor health or disability oppressive living conditions terminal illness/impending death

Health deviation self care requisites (6) 1. Seeking medical assistance 2. Being aware of, attending to effects, results path condition 3. Effectively carrying out prescribed treatment measures

Health deviation self care requisites (6) 4. Being aware of, attending to, regulating discomforting effects of medical care performed, prescribed by MD

Health deviation self care requisites (6) Modifying self-concept in accepting oneself as in a state of health Learning to live w/effects that promotes personal development

From the ParaOlympics

Basic Conditioning Factors

Priority Basic Conditioning Factors Age Developmental state Orem state Erikson, Piaget Health state Nursing history Physical examination Supporting laboratory data

Power Components Motivation

(Theory 1) Theory of Self Care Nursing History Basic Conditioning Factors 2. Power Components 3. S-C Requisites a) Universal b) Developmental c) Health Deviation

Assess for each self care requisite therapeutic abilities demands What is the patient’s ability to meet, for example, USCR: air What are the therapeutic demands on air? versus

Assess each self care requisite USCR: Air self care therapeutic abilities demands What is the patient’s ability to meet, for example, USCR: air What are the therapeutic demands on air? versus Ability meets demand

Self care ability compromised increased therapeutic demand Assess for each self care requisite self care abilities USCR: Air therapeutic demands Self care ability compromised and increased therapeutic demand

(Theory 2) Theory of Self-Care Deficit There IS need for nursing S-c abilities < therapeutic demands therapeutic demands >s-c abilities

(Theory 3) Theory of Nursing System Systems formed by nurses that compensate for those in need of nursing . . . i.e., unable to meet health related S-C requisites

Nursing System Wholly compensatory Partially compensatory Supportive educative (developmental)

*analogy by Hilda Horton

Bicycle for two analogy The nurse is in the back seat Wholly compensatory: Nurse only pedals Partially compensatory: Nurse pedals, patient pedals Supportive-educative: Patient only pedals, nurse provides guidance

Theory of self care Traditional Orem Assessment Diagnosis

Diagnosis Assess self care requisites, basic conditioning factors, power components 2. Analyze data 3. Formulate self care deficit statement (s) (nursing diagnosis)

Theory of self care deficit Traditional Orem Planning Prescription

Prescription 1. State particularized self care requisite statement [goal statement] 2. State step by step interventions that lead patient to meet particularized self care requisite statement (goal), leading to self care agency for that self care requisite.

Theory of nursing system Traditional Orem Implementation Evaluation Regulation Control

Control = evaluation Regulation, Control Carrying out the prescription—how does the pt respond? Is this appropriate? Control--appraisal process--the progress toward the goal or outcome of self care agency Control = evaluation

Orem’s Nursing Process Diagnosis Prescription Regulation Control

Objectives At the end of this PP, you will be able to: 1. Explain the three theories in Orem’s SCDNT 2. State the self care requisites 3. State the Basic Conditioning Factors 4. Identify the Power Components 5. Explain the relationship between the BCF, PC, and SCR 6. Use an analogy to explain Nursing Systems 7. Relate Nursing Process to SCDNT

Outcome: Self care agency