Introduction
During the COVID-19 pandemic, the quality and concepts of care have dramatically changed. It was important to re-evaluate current nursing trends and obligations in nursing homes and other medical facilities in a short period. The lack of healthcare providers turns out to be one of the most evident challenges in the long-term care sector (McGilton et al., 2022). Nurses have to work hard and share their knowledge and skills in cooperating with people who need extended care in treating severe illnesses and disabilities. Today, many nursing, borrowed, and interdisciplinary theories can be applied in long-term care practice. Orem’s Self-Care Deficit Nursing Theory (SCDNT) aims at improving care quality and supporting patients who are limited or unable to provide self-care. Implementing Orem’s approach in long-term care nursing is a simple and logical opportunity for nurses to help patients, promote recovery, increase life quality, and maintain education.
Origin
Dorothea Orem was a well-known American nursing theorist who developed and constantly improved her model of nursing for more than 40 years. Her intention was to clarify why people needed nursing in general, what expectations patients developed, and what nurses could do as healthcare practitioners. Self-care is the major concept of her nursing theory that covers the activities in which people should be engaged to preserve and restore their health (Khademian et al., 2020). Orem (as cited in Hartweg & Metcalfe, 2022) explained self-care as “the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being” (p. 71). It is not enough to provide nurses with detailed guides and knowledge bases to complete their functions and cooperate with patients. The chosen theory originates from the idea of empowering patients and their families to encourage self-care.
Meaning and Scope
The meaning of SCDNT is rather clear and definite to underline the importance of patient recovery through self-care and cooperation with nurses. Orem’s approach is highly applicable in various clinical settings because of the possibility of improving patient health by making them independent and more confident in their contributions (Ali, 2018). Orem wanted to show that every individual could be self-reliant and self-care agents to perform certain activities. Nursing, in its turn, is a cooperation between a nurse and a patient, and this form of action promotes awareness of health problems and behaviors. Orem’s theory creates a structure in a complex healthcare system and determines the role of nurses from a disciplinary perspective (Hartweg & Metcalfe, 2022). Thus, nurses with different practical experiences may apply this approach to help their patients create safe clinical environments.
Logical Adequacy
Self-care deficit is a condition when a person is not able to perform daily activities and functions due to health problems or other physiological or mental disabilities related to age or recovery procedures. Orem’s theory is created to solve this problem and demonstrate what nurses might do to predict the negative outcomes of such a deficit. Certain steps should be taken to initiate a care process, including gathering information about the patient, identifying the patient’s needs and care goals, and developing strategies depending on the offered background (Hartweg & Metcalfe, 2022; Khademian et al., 2020). This theory shows adequacy and logic by addressing the main stages of nursing care and patient-nurse cooperation in a hospital.
Usefulness and Simplicity
In terms of its usefulness, Orem’s theory does not include complex steps and concepts. The role of this model is to show nurses what care aspects are vital for patients in a particular situation. At the same time, nurses should not complete all tasks on their own and invite patients to participate in some activities. There are several universal rules of self-care like intake of fresh air, food, and water, rest, and social interactions (McEwen & Wills, as cited in Ali, 2018). Developmental and health deviation requirements that depend on the current condition of the patient include medical assistance, therapeutic interventions, and regular checkups. Orem’s model represents a clear guide for nurses and patients to develop their relationships and mind self-care as an integral element.
Generalizability
Due to its simplicity and systematization, SCDNT remains generalizable and can be applied to various clinical settings where patients follow certain care rules. Self-care deficit may be observed in any patient who is challenged by a physical or mental health condition. On the one hand, Orem’s theory is effective for nurses in understanding what kind of help they should offer to their clients. On the other hand, the same principles may be followed by patients and their families to improve their well-being. Thus, generalizability is explained through the theory’s humanistic and holistic approach to care, with recovery as its main legitimate outcome (Hartweg & Metcalfe, 2022). Nurses from all care settings are free to use Orem’s ideas and initiate their relationships with patients.
Testability
One of the ways to check the credibility and effectiveness of Orem’s theory is to discuss its testability. In fact, there are no specific tests or scales to be applied. However, it is possible to compare care outcomes in patients who followed self-care principles and education during their treatment with those who have no or limited explanation of self-care basics. For example, nurses and patients may be asked about major self-care principles and abilities they need to develop in a caring process. Nurses from long-term care settings are responsible for strengthening staff skills and competencies in working with complex patients (McGilton et al., 2022). Thus, it is correct to say that SCDNT is highly testable and can be measured by various criteria and characteristics.
Theory in Nursing Practice: Example and Rationale
Orem’s theory can be used in long-term care units to support the patient’s independence and dignity in treatment. Some people are not ready to accept their disability and or temporary injury, and they suffer from depression, post-traumatic stress disorder, or other mental complications. Nurses need to identify their major needs and explain how to continue living and dealing with their problems. Orem proves the importance of guiding and supporting other people and providing information and conditions to promote personal development. For example, a patient who survived a physical assault and needs to undergo long-term treatment should remember basic food, water, and air intake, follow hygiene requirements, and communicate with the staff. The rationale for this approach is to ensure that a nurse practitioner supports and cooperates with the patient to underline his/her dignity and future improvements.
Conclusion
Long-term care is not always easy and simple for nurses and patients, and the application of Orem’s self-deficit care theory is a unique opportunity to simplify some treatment aspects. Despite their injuries, diseases, and traumas, it is important to prove that individuals must perform certain activities on their behalf to maintain life functioning. Communication, education, and cooperation are the major elements in the chosen theory. Nurses should not do everything instead of their patients but ensure that people participate in their care process and address self-care issues properly.
References
Ali, B. H. I. (2018). Application of Orem self care deficit theory on psychiatric patient. Annals of Nursing and Practice, 5(1), 1-3. 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.
Khademian, Z., Ara, F. K., & Gholamzadeh, S. (2020). The effect of self care education based on orem’s nursing theory on quality of life and self-efficacy in patients with hypertension: A quasi-experimental study. International Journal of Community Based Nursing and Midwifery, 8(2), 140-149. Web.
McGilton, K. S., Bowers, B. J., & Resnick, B. (2022). The future includes nurse practitioner models of care in the long-term care sector. Journal of the American Medical Directors Association, 23(2), 197-200. Web.