Oremís Theory of Self Care Deficit
Self - Care Model
†††††††††††† Oremís metaparadigm includes the following concepts; Person, Health, Nursing and Environment.
∑ Person:† An individual with physical and emotional requirements for the maintenance of health and well being.
∑ Health: ďStructural and functional soundness and wholeness of the individualĒ (Hartweg, p. 44).
∑ Nursing: The acts of a specially trained and able individual to help a person or multiple people deal with actual or potential self care deficits.
∑ Environment: Patients surroundings which may affect their ability to perform their self care activities.
†††††††††††† Orem has developed a concept of nursing that places emphasis on the personís need for self care-those activities that an individual practices for the purpose of maintaining life, health, and well being.† It is the concern of nursing to provide for and promote the personís self care actions in an attempt to promote life and health and to assist him to recover from disease and injury or to cope with their effects (Alligood & Tomey, p. 255).† The need for nursing exists when an adult is unable to satisfactorily meet his self care requisites.
†††††††††††† Nursing is responsible for assisting the person to overcome those circumstances that interfere with self care that cause self care limitations and deficits.† There are three broad categories of self care requisites: universal, developmental, and those related to health deviation.† Universal self care requisites are those that are required of all individuals to maintain integrated human functioning.† Developmental self care requisites are those that occur as a result of developmental processes or of conditions that can affect human development.† Health deviation self care requisites are those that occur as a result of disease, injury, disfigurement, disability, or medical diagnoses and treatment and that† require that changes be made in the personís routine of self care depending on the nature and extent of the requisites.† Self care activity is purposeful, deliberate action that is goal directed, self initiated, and self directed and is affected by the personís values and goals. When it is effective, it promotes the structural integrity, functioning, and development of the
person (Hartweg, p. 8, 20, 21).
†††††††††††† Orem identifies three systems of nursing activities that are designed to meet the individualís self care requirements; according to the extent to which self care action is disrupted: the wholly compensatory system, the partly compensatory system, and the supportive-educative (developmental) system.† The wholly compensatory system is used when the person is unable to assume an active role in his care and the nurse assists him by acting for and doing for him.† The partly compensatory system is used when the nurse and the patient participate in accomplishing therapeutic self care actions.† The major responsibility for the performance of these actions may be assumed by the nurse or by the patient, depending on the patientís actual or medically prescribed limitations, his knowledge and skills, and his psychologic readiness to accomplish such activities.† The supportive-educative system is used when the patient is capable of performing, or learning to perform, those measures that are necessary to accomplish his self care requisites but for which he needs assistance in the form of support, guidance, provision of a developmental environment, and teaching (Hartweg, p.22, 24, 27, 29).
†††††††††††† As the health status of the patient changes, his needs for nursing activity may demand a change in nursing system that is appropriate to meet his needs.† Such a conceptual model of nursing can serve as a framework for guiding and directing nursing care.† Currently, the framework is used within various nursing education and nursing service settings.