Dorothea Orem’s Self-Care Deficit Nursing Theory

Hartweg, D. L., & Metcalfe, S. A. (2022). Orem’s self-care deficit nursing theory: Relevance and need for refinement. Nursing Science Quarterly, 35(1), 70-76. Web.

Health care faces serious challenges – inequality in access to services, increased spending, pandemic, and other factors. It is also transforming, people’s self-care becomes critical, and Orem’s self-care deficit nursing theory (SCDNT) has several strengths to improve health care in the context of such transformations. The concept of self-care is becoming widely influential and promising, and SCDNT is significantly consistent with its increasing value. The term implies the ability of people to maintain their health and prevent diseases without the help of medical institutions. Such an approach can reduce the burden on health care systems, and SCDNT defines the role of a nurse in the new realities. Within the theory, the patient and medical services provider are partners in care for health. The strengths of SCDNT, such as a focus on well-being and people’s right to make decisions about their care, are consistent with global trends and may therefore be a theoretical framework for health care development.

Highlighting the relevance of SCDNT within today’s health realities, the authors also emphasize some possible refinement. The role of nurses is expanding – they do not just care for patients but embrace much more responsibilities. These professionals also develop partnerships with other providers, community representatives, and leaders. Working with the society also provides them with a role in health policy and shifts the focus to prevention, supporting health rather than first aid. SCDNT can be a strong foundation for developing nurse knowledge and education in the described settings. The authors believe that improving and using SCDNT will help change medical practice and make it fairer and more effective. The new environment makes nurses aware of the social and health system’s complexity and makes them act as mediators between specialists and society. Thus, SCDNT helps define the role of nurses in healthcare when self-care and interdisciplinary collaboration become predominant trends.

Malekzadeh, J., Amouzeshi, Z., & Mazlom, S. R. (2018). A quasi‐experimental study of the effect of teaching Orem’s self‐care model on nursing students’ clinical performance and patient satisfaction. Nursing Open, 5(3), 370-375. Web.

Clinical training is a critical part of nursing specialist preparation, but productivity is often reduced at this stage, and resistance to innovation arises. The article’s authors argue that SCDNT can provide a more appropriate theoretical framework for the curriculum and address emerging issues. Following the theory, a nurse uses supportive educational, compensatory, or partially compensatory systems depending on the ability of patients to care for themselves. The authors believe that such an approach could increase patient satisfaction and promote effective nurse training. To test their hypothesis, they conducted a quasi-experimental study of the effect of SCDNT on student performance in the clinic and patients’ subsequent evaluation of the quality of the services.

The study design suggested the participation of students, divided into two groups. Researchers performed additional training based on SCDNT in the intervention group. The educational session focused on the nursing process and was shorter in time in the control group. Before and after the intervention, researchers tested students’ awareness of Orem’s theory through a questionnaire. After training, the groups practiced in a clinical setting where they cared for various patients. The authors observed and evaluated student performance and interviewed participants and patients about service satisfaction. Researchers performed data analysis with SPSS 16 software, and the authors used Fisher extract, chi-squared, two-way ANOVA, and other tests for variables.

The analysis results showed that the clinical effectiveness of the SCDNT-based intervention group was significantly higher. A noticeable improvement was observed in the communicative skills of these students. At the same time, the difference in patient satisfaction levels was not statistically significant between groups. However, the difference in several evaluation directions was still in favor of the effectiveness of SCDNT. The authors believe that more extended learning based on Orem’s theory will have a more significant result. Thus, the study supports the benefit of SCDNT for nurse education and patient care.

Yip J. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s self-care deficit nursing theory. SAGE Open Nursing, 7, 1-7. Web.

The study’s author draws attention to the gap in the existing literature and studies regarding SCDNT – they provide a theoretical framework but do not provide practice guidance. To fill the gap, the researcher conducts a case study involving monitoring the work of a nurse applying SCDNT in primary care circumstances. This theory provides several specific actions a specialist should do within the practice – diagnosis, prescription, treatment, and case management. They are part of a dynamic process and will be effective when the patient’s needs are considered. It is crucial to determine precisely how these principles are applied in practice, not only in theory. Therefore, the theory assumes several basic constructions, which must be evaluated when studying the case. They include patients’ dispositions and abilities, basic conditioning factors, the environment, self-care requisites, which means actions necessary to achieve well-being, and the capacity of the patients to take care of themselves.

In the practice case reviewed by the author, the nurse analyzed the necessary constructions to understand the patient better. In particular, it is possible to identify a person’s interest in taking care of their health and understanding the current state. Within the framework of SCDNT, nurses must make sure that patients have understood and accepted their condition to determine measures to ensure effective self-care in the future. At the same time, in the case considered by the study’s author, the patient was not strongly concerned about his health but had the goal of reducing symptoms, which helped focus on creating a care plan. The nurse was also able to offer necessary prescriptions and coordinate the case management with the patient’s interested face-wife. Analyzing the case, the author concludes that SCDNT is an appropriate theoretical framework for nursing practice, even in primary care settings. The theory helped the specialist understand the patient’s capabilities and needs and provided a systematic approach to care.