Overview and Guiding Propositions Described in the Theory
Heart failure is a condition that is frequently characterized by cognitive impairment. Thus, it can negatively influence the ability of patients to provide the necessary self-care. Therefore, one of the nursing theories applicable to this research on heart failure is Dorothea Orem’s Self-Care Deficit Theory. The theory comprises some smaller theories such as the theory of self-care, the theory of dependent-care, the theory of self-care deficit, and the theory of nursing systems.
Self-care includes the set of activities initiated and performed by individuals “in the interest of maintaining life, healthful functioning, continuing personal development, and well-being by meeting known requisites for functional and developmental regulations” (Alligood, 2014, p. 244). Dependent care is provided to an individual unable to perform self-care due to health conditions or age factors. Self-care deficit develops when therapeutic self-care demands and the ability to perform self-care do not coincide. Finally, nursing systems are series of nursing actions to provide coordination with patient care to meet therapeutic demands.
The guiding proposition of self-care deficit theory is the statement that self-care deficit develops in case a patient or his family are not able to provide effective care. Consequently, these demands can be provided by a nurse. According to Orem (as cited in Alligood, 2014, p. 246), the patient is the focus of care provided by a nurse. The patient’s health condition is under the impact of the environment. All those components make up a metaparadigm of the self-care deficit theory.
Application of the Theory to the Project’s Focus
The focus of the project is expressed in the purpose of the research. It is formulated to investigate the effectiveness of meaningful interactions between nurses and patients during the pre-discharge period along with the provision of further caregiving. Self-care deficit theory is applicable to the objectives of this project. It should be mentioned that self-care in heart failure is a complex process.
It comprises preventive practices such as dietary restrictions, symptoms’ management, and making decisions about the need for professional care in conditions of a healthcare facility (Hajduk et al., 2013). Patients with heart failure frequently are not able to perform self-care interventions, which leads to the development of self-care deficit and the necessity to involve care from outside, either performed by the patient relatives or professional nurses. In fact, this inability creates the concept of dependent care.
Another link of the project focus to self-care deficit theory is that the lack of care has a negative impact on the patient’s condition, thus increasing the risk of rehospitalizations. Therefore, there is a need for effective pre-discharge education interventions that can improve self-care and prevent its deficit. Moreover, nursing systems as a part of self-care deficit theory can be used for patients with heart failure. Since these systems presuppose sequences of actions directed at the patient’s well-being, they can be implemented to guide nurse interventions for heart failure patients.
On the whole, self-care deficit theory can be used as a basis for the theoretical framework of this project. It correlates with the necessity of effective care for heart failure patients and reflects the situation when these patients are not able to perform self-care activities due to cognitive impairment developed as the result of the disease. In addition, the theory focuses on the importance of a nurse’s role in the process of care, which is important for heart failure patients.
References
Alligood, M.R. (Ed.). (2014). Nursing theorists and their work. St. Luis, MS: Elsevier Mosby.
Hajduk, A. M., Lemon, S. C., McManus, D. D., Lessard, D. M., Gurwitz, J. H., Spencer, F. A., … Saczynski, J. S. (2013). Cognitive impairment and self-care in heart failure. Clinical Research, 5, 407-416.