Introduction
This presentation explores the application of a nursing theory, Dorothea Orem’s Self-care Deficit theory, on an area of concern within advanced nursing practice. The issue selected for this assignment is the non-compliance of patients with chronic conditions with treatment regimens recommended by health professionals. The slide deck begins with detailed explanations of Dorothea Orem’s Self-care Deficit theory and the area of concern, followed by an application of the theory to the problem.
Dorothea Orem’s Self-care Deficit Theory
Dorothea Orem’s self-care deficit theory focuses on the patient’s ability to care for themselves through initiating and performing health activities to maintain well-being, life, and health. It encompasses three other theories, including self-care, self-care deficit, and nursing systems. It relies on five assumptions, which are the need for humans to connect and communicate constantly with their environment and that identifying needs and making judgments require deliberate action (Hartweg & Metcalfe, 2022). There is an assumption that adults experience privations regarding life sustenance and functional regulatory acts of self and others, a human agency develops, discovers, and transmits self-care ability in others and self, and groups arrange tasks through structured relationships to offer care to members. Orem’s theory follows the format of other nursing theories by defining key concepts, specifically self-care theory: nursing, humans, environment, health self-care, and self-care agency. It identifies conditioning factors for self-care, such as gender, culture, age, healthcare system, family, environment, lifestyle, resources, health, and developmental states (Hartweg & Metcalfe, 2022). A deficit is created when adults need nursing interventions due to the lack of or limited ability to continuously and effectively care for themselves. According to Orem, universal and health deviation self-care requirements are based on basic human processes and are necessary during illnesses, respectively (Hartweg & Metcalfe, 2022). Nurses can support patients by acting for others, guiding and supporting them, teaching, and providing an enabling environment for self-care.
The area of advanced nursing selected for Orem’s theory is chronic illnesses management because there is a need for long-term care. There are three steps in the nursing intervention process: assessing the patient’s self-care ability and needs, diagnosis and design of the care plan, and implementing and evaluating the effectiveness of the care plan (Hartweg & Metcalfe, 2022). In chronic illness management, nurses must intervene when chronically ill patients cannot maintain sufficient self-care to sustain health and life or cope with their condition. Although Orem’s theory acknowledges the dynamic nature of health, it does not consider the patients’ emotional needs (Hartweg & Metcalfe, 2022). Since self-care is essential for improving health outcomes for a chronic condition, the theory is at the center of the advanced nursing area.
Chronic Illnesses Management: Noncompliance With Treatment Regimens
Non-compliance with treatment regimens is an issue in managing chronic health conditions. As patients refuse to adhere to given treatment plans, disability cases are rising, healthcare costs are increasing, mortality and hospitalization rates are growing, and they are at higher risk of reporting severe cases of Covid19 (Hernández et al., 2019). The burden of chronic conditions is increasing at an alarming rate, with 60% of Americans living with at least one such illness (Halter et al., 2021). Therefore, chronic illnesses and non-compliance have negative effects on the mentioned health outcomes.
Theory Application to Issue of Concern
Orem’s theory has a direct application to noncompliance with treatment regimens, as it is part of self-care. When applying the theory, nurses can follow the steps provided by Orem. During the assessment, nurses gather data on the patient’s health status, physician’s and patient’s views, health goals, self-care requirements, and ability to care for themselves (Hernández et al., 2019). In the second step of diagnosis and designing care plans, nurses create wholly, supportive-educative, or partly compensatory regimens, identify self-care demand components, and combine various helping methods to efficiently and effectively fill self-care deficits (Hernández et al., 2019). When implementing care plans, nurses must work with the patients and their families to improve self-care while evaluating the efficacy of the plan.
The practice-based framework for supporting compliance with treatment regimens among chronically ill patients relies on the three steps of Orem’s theory. In the initial step, nurses must gather information surrounding the patient’s non-compliance behavior, including personal reasons, disease-related issues, treatment plan concerns, socioeconomic factors, and health provider problems (Lerch & Thrane, 2019). In the second step, nurses are to design a care plan that incorporates several helping methods depending on the identified causes of non-compliance. Finally, nursing staff implement the plan and regularly evaluate its effectiveness in facilitating compliance with treatment regimens.
Conclusion
Orem’s theory provides three steps to form the framework for supporting compliance with treatment regimens among patients with chronic health conditions. My nursing philosophy is empowering each patient to proactively manage their health condition. Orem’s theory is in line with this philosophy as it also emphasizes self-care practices among patients and guides nurses on the process of interventions aimed at enhancing self-care.
References
Hacker, K. A., Briss, P. A., Richardson, L., Wright, J., & Petersen, R. (2021). Peer reviewed: COVID-19 and chronic disease: The impact now and in the future. Preventing Chronic Disease, 18. Web.
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.
Hernández, Y. N., Pacheco, J. A. C., & Sánchez, M. A. (2019). Dorothea E. Orem’s self-care deficit theory’s adaptation to people with diabetes mellitus and complicated neuropathic ulcer. Revista Cubana de Enfermería, 35(1), 1-13.
Lerch, m. F., & Thrane, S. E. (2019). Adolescents with chronic illness and the transition to self-management: A systematic review. Journal of Adolescence, 72, 152-161. Web.