TFN 6

• Dorothea Orem's Self-Care Deficit Model


  Nursing is a helping profession of assisting patients overcome or compensate for their health-associated limitations and engaging in actions to regulate their own functioning and development or that of their dependents
• Orem's Self-Care Deficit Model


  • The model is a collection of three interrelated theories: nursing systems, self-care, and self-care deficit
  • The focus is to enhance the person's ability for self-care and this also extends to the care of dependents
  • A person's self-care deficits are the result of environmental situations
  • Theoretical sources - philosophical system of moderate realism
• Three systems within Orem's model

  • Wholly Compensatory System - nurse provides total care
  • Partially Compensatory System - nurse & patient share responsibility for care
  • Supportive-Educative System - client has primary responsibility for personal health, with nurse acting as a consultant
• Wholly Compensatory System


  • Accomplishes patient's therapeutic self-care
  • Compensates for the patient's inability to engage in self-care
  • Supports and protects the patient
• Partially Compensatory System


  • Performs some self-care measures
  • Regulates self-care agency
  • Accepts care and assistance from nurse
• Supportive-Educative System


  • Accomplishes self-care
  • Regulates the exercise and development of self-care agency
• The basic premise of Orem's model is that individuals can take responsibility for their health and the health of others
• When an individual is unable to meet his own self-care requisites, a self-care deficit occurs
• It is the duty and obligation of the professional nurse to recognize and identify these deficits in order to define a support modality or intervention
• Self-care


  The practice of activities that maturing and mature individuals initiate and perform, within time periods, on their behalf to ensure maintaining life, healthful functioning, continuing personal development, and well-being
• Self-care requisites


  • Universal self-care requisites - those needs that all people have; include air, water, food, elimination, activity and rest, solitude and social interaction, hazard prevention, and promotion of normal functioning
  • Developmental self-care requisites - those needs that relate to the development of the individual; include conditions that promote development, engagement in self-development, and prevention of or overcoming effects of human conditions and life situations that can adversely affect human development
  • Health deviation requisites - those needs that arise as a result of a patient's condition; include all pathologic conditions or disorders which include defects, deformities, and disabilities. These require medical intervention and management
• Therapeutic self-care demand


  The totality of nursing care measures important at certain times or over a period of time for meeting all of the individual's known self-care requisites
• Nursing agency


  The developed capabilities of nurses that empower them to meet the therapeutic self-care demands of the patient
• Self-care agency


  A complex acquired ability of mature & maturing individuals to know & meet their continuing requirements for deliberate & purposive action to regulate their own human functioning and development
• Dependent-care agent


  A maturing adolescent who accepts and fulfills the responsibility to know and meet the therapeutic self-care demand of significant others who are socially dependent on them
• Nursing systems


  Series and sequences of deliberate practical actions of nurses performed at times
• Nursing systems are action systems formed by nurses through the exercise of their nursing agency for persons with health-derived or health-associated limitations in self-care or dependent care
• Self-care is a regulatory function by man. It is deliberate and is performed by the person himself or have them performed by another person or them in order to maintain life, health, development, and well-being
• Nursing


  An art through which the practitioner of nursing gives specialized assistance to persons with disabilities, making more than ordinary assistance necessary to meet self-care needs. The nurse also intelligently participates in the medical care the individual receives from the physician
• Person


  Humans are defined as "men, women, and children cared for either singly or as social units" and are the "material object" of nurses and others who provide direct care
• Health


  Being structurally and functionally whole or sound. Also, health is a state that encompasses both the health of individuals and groups, and human health is the ability to reflect on oneself, symbolize experience, and communicate with others
• Environment


  Includes the physical, chemical, and biological features, as well as the family, culture, and community
• The emphasis in Orem's model is on education and supportive measures, highlighting the importance of health teachings in clinical nursing
• Imogene King's Interacting Systems Framework and Goal Attainment Theory


  Nursing is an observable behavior found in the health care systems in society that aims to help individuals maintain their health so they can function in their roles
• Imogene King's Interacting Systems Framework


  • Emphasizes the importance of the interaction between the nurse and patients
  • Views this interaction as an open system which is in constant interaction with a variety of environmental factors
  • There are three interrelated systems: personal systems, interpersonal system, and social system
• Imogene King's Goal Attainment Theory is a middle-range theory that is the product of developments from her first Interacting Systems Framework
• 8 propositions related to Imogene King's Goal Attainment Theory

  • If perceptual accuracy is present in the nurse-client interactions, then transactions will occur
  • If a nurse and client make transactions, then goals will be attained
  • If goals are attained, then satisfaction will occur
  • If goals are attained, then effective nursing care will occur
  • If transactions are made in nurse-client interactions, then growth and development will be enhanced
  • If role expectations and role performance as perceived by nurse and client are congruent, then transactions will result
  • If role conflict is experienced by nurse and client or both, then stress in nurse-relationship interactions will occur
  • If nurses with special knowledge and skills communicate appropriate information to clients, then mutual goal setting and goal attainment will occur
• Perception


  A process in which data obtained through the senses and from memory are organized, interpreted, and transformed
• Stress


  An ever changing condition in which an individual, through environmental interaction, seeks to keep equilibrium to support growth and development and activity
• The self


  Made up of thoughts and feelings related to one's awareness of being a person separate from others and influencing one's view of who and what he or she is
• Growth and development


  Processes in people's lives through which they move from potential for achievement to actualization of self
• Body image


  Includes both the way one perceives one's body and others' reactions to one's appearance
• Space


  The physical area known as territory and by the behaviors of those who occupy it
• Interactions


  Observable behaviors of two or more persons in mutual presence
• Communication

  Verbal and non-verbal, situational, perceptual, transactional, irreversible, or moving forward in time, personal, and dynamic
• Transactions


  A series of exchanges between human beings and the environment that include observable behaviors that seek to reach goals of worth to the participants
• Role


  Characterized by reciprocity in that a person may be a giver at one time and a taker at another time, with the relationship between two or more individuals who are functioning in two or more roles that are learned social, complex, and situational
• Authority


  The active, reciprocal process of transaction in which the actors' experience, understanding, and values influence the meaning, legitimacy and acceptance of those in organizational positions associated with authority
• Status


  The relationship of one's place in a group to others in the group or of a group to other groups
• Decision-making


  A changing and orderly process through which choices related to goals are made among toward the goal