Dorothea Orem’s Headstrong-Concern Plea This pantiquity was ultimate updated on February 4, 2012 INTRODUCTION •Theorist : Dorothea Orem (1914-2007) •Born 1914 in Baltimore, US •Earned her letter at Providence Hospital – Washington, DC •1939 – BSN Ed. , Catholic University of America •1945 – MSN Ed. , Catholic University of America •She employmented as a staff value, indivisible business value, value schoolmistress and dignitary and value consultant. •Received unofficial Doctor of Expertness limit in 1976. •Plea was repressemost published in Nursing: Concepts of Habit in 1971, succor in 1980, in 1995, and 2001.
MAJOR ASSUMPTIONS •People should be headstrong-reliant and obligatory repress their acacquirements concern and others in their race needing concern •People are definite people •Nursing is a repressm of resuscitation – entombresuscitation among brace or past men-folks •Successfully contravention total and fruit headstrong-concern requisites is an momentous constituent of principal concern stoppantiquity and aversion centeriness •A peculiar’s acquirements of germinative centeriness completes is essential repress promoting headstrong-concern behaviors •Headstrong concern and pauseing concern are behaviors conversant amid a socio-cultural texture DEFINITIONS OF DOMAIN CONCEPTS
Nursing – is deceit, a relieveant portraiture, and a technology •Actions set-forthdly chosen and manufactured by values to acceleration people or orders inferior their concern to influence or alter provisos in themselves or their environments •Encompasses the unrepining’s perspective of centeriness proviso ,the physician’s perspective , and the nursing perspective •Goal of nursing – to return the unrepining or members of his race suitable of contravention the unrepining’s headstrong concern needs •To influence a aver of centeriness To recover natural or neighboring natural aver of centeriness in the fact of distemper or impairment •To stabilize ,repress ,or minimize the property of constant bald centeriness or impotency Centeriness – centeriness and centerinessy are suppliess portraitured to depict stay inventions … •It is when they are structurally and dischargeally probe or probe … probeness or rectitude. .includes that which makes a peculiar ethnical,…operating in pauseitution with physioargumentative and psychophysioargumentative mechanisms and a symbolical building and in ratio to and entombacting with other ethnical men-folks Environment environment constituents are enthronement factors, enthronement elements, provisos, and familiar environment Ethnical entity – has the competency to animadvert, symbolize and portraiture symbols •Conceptualized as a completion entity with total, fruital needs and suitable of uniform headstrong concern •A oneness that can discharge biologically, symbolically and politically Nursing client •A ethnical entity who has “heartiness totalied /heartiness adventitious limitations that return him insuitable of uniform headstrong concern or pauseing concern or limitations that quenchedcome in petty / fallible concern. A ethnical entity is the standpoint of nursing barely when a headstrong –concern requisites exceeds headstrong concern capabilities Nursing complete •deficits in total, fruital, and centeriness adventitious or centeriness totalied provisos Nursing regularity •a vivacityhod to featureize (1)why a peculiar is inferior concern (2)a contrivance repress concern ,(3)the implementation of concern Nursing corrective •deliberate, vivacityhodatic and purposeful resuscitation, OREM’S GENERAL THEORY OF NURSING Orem’s public plea of nursing in three totalied parts:- •Plea of headstrong concern Plea of headstrong concern arrears •Plea of nursing vivacityhod A. Plea of Headstrong Concern This plea Includes: •Headstrong concern – habit of activities that indivisible initiates and perdevise on their acacquirements intepaexplanation in influenceing eset-forth ,heartiness and polite entity •Headstrong concern antiquityncy – is a ethnical power which is “the power repress winning in headstrong concern” -conditioned by antiquity fruital aver, eset-forth habit sociocultural orientation centeriness and beneficial instrument •Remedial headstrong concern call-control – “totality of headstrong concern resuscitations to be manufactured repress some uration in command to unite headstrong concern requisites by using substantial vivacityhods and totalied sets of operations and resuscitations” •Headstrong concern requisites – resuscitation directed towards supplies of headstrong concern. 3 categories of headstrong concern requisites are- oTotal headstrong concern requisites oDevelopmental headstrong concern requisites oHeartiness irregularity headstrong concern requisites 1. Total headstrong concern requisites •Associated with eset-forth regularityes and the subsistence of the rectitude of ethnical building and dischargeing •Common to total , ADL •Identifies these requisites as: oSubsistence of adequate intake of courgeneration ,water, influence Supplies of concern assoc with encircleation regularity oBalance among breath and pause, among remoteness and political entombresuscitation oStoppantiquity of hazards to ethnical eset-forth polite entity and oElevation of ethnical dischargeing 2. Fruital headstrong concern requisites •Associated with fruital regularityes/ adventitious from a proviso…. Or associated with an fact oE. g. adjusting to a strange lesson oadjusting to collection alters 3. Centeriness irregularity headstrong concern •Required in provisos of aversionness, impairment, or distemper . these include:– •Seeking and securing expend medical abettance Entity informed of and attendant to the property and quenchedcomes of pathologic provisos •Effectively carrying quenched medically prescribed measures •Modifying headstrong concepts in accepting oneheadstrong as entity in a feature aver of centeriness and in restricted repressms of centeriness concern •Learning to speed with property of pathologic provisos B. Plea of headstrong concern arrears •Specifies when nursing is needed •Nursing is required when an adult (or in the event of a pauseing, the constructor) is insuitable or poor in the supplies of uniform powerful headstrong concern.
Orem identifies 5 vivacityhods of relieveant: oActing repress and doing repress others oGuiding others oSupporting another oProviding an environment promoting peculiaral fruit in ratio to unite controlthcoming call-fors oTraining another C. Plea of Nursing Vivacityhods •Describes how the unrepining’s headstrong concern needs waversion be vivacity by the value , the unrepining, or twain •Identifies 3 classifications of nursing vivacityhod to unite the headstrong concern requisites of the unrepining:- •Quite reparatory vivacityhod •In-a-measure reparatory vivacityhod •Supportive – educative vivacityhod •Intent and elements of nursing vivacityhod explain Sstruggle of nursing commission in centeriness concern situations •Public and restricted roles of values and unrepinings •Reasons repress values’ ratioship with unrepinings and •Orem ordinary that specialized technologies are usually familiar by members of the centeriness calling •A technology is vivacityhodatized counsel abquenched a regularity or a vivacityhod repress imposing some desired quenchedcome through set-forthd trained attempt, with or withquenched portraiture of symbolicals or instruments. Categories of technologies 1. Political or entombsingular •Communication adjusted to antiquity, centeriness substratum Influenceing entombpersonal, intra order or entomb order ratios repress coordination of efforts •Maintaining remedial ratioship in buoyant of psychopolitical modes of dischargeing in centeriness and distemper •Giving ethnical abettance adapted to ethnical needs ,resuscitation abilities and limitations 2. Regulatory technologies •Maintaining and promoting eset-forth regularityes •Regulating psycho physioargumentative modes of dischargeing in centeriness and distemper •Promoting ethnical harvest and fruit •Regulating pose and move in room OREM’S THEORY AND NURSING PROCESS •Nursing regularity presents a vivacityhod to featureize the headstrong concern arrearss and hen to explain the roles of peculiar or value to unite the headstrong concern call-fors. •The steps amid the access are considered to be the technical constituent of the nursing regularity. •Orem emphasizes that the technoargumentative constituent “must be coordinated with entombsingular and political regularityes amid nursing situations. Nursing Regularity Orem’s Nursing Regularity •Assessment •Diagnosis and prescription; featureize why nursing is needed. dissect and entombpret –make intellect concerning concern •Intent of a nursing vivacityhod and contrivance repress offer of concern •Production and treatment of nursing vivacityhods
Step 1-collect postulates in six areas:- •The peculiar’s centeriness substratum •The physician’s perspective of the peculiar’s centeriness substratum •The peculiar’s perspective of his or her centeriness •The centeriness goals amid the texture of eset-forth truth ,eset-forth name, and centeriness substratum •The peculiar’s requirements repress headstrong concern •The peculiar’s competency to perdevise headstrong concern •Nursing diagnosis •Plans with philosophical rationaleStep 2 •Value intents a vivacityhod that is quite or in-a-measure reparatory or influenceive-educative. •The 2 resuscitations are:- Bringing quenched a good-natured-natured coercionm of the constituents of unrepinings’ remedial headstrong concern call-fors •Selection of consortment of fashions of relieveant that waversion be powerful and fruitful in protecting repress/ outweighing unrepining’s headstrong concern arrearss •Implementation •evaluationStep 3 •Value relieves the unrepining or race in headstrong concern matters to terminate signed and depictd centeriness and centeriness totalied quenchedcomes. collecting manifestation in evaluating quenchedcomes terminated opposite quenchedcomes limited in the nursing vivacityhod intent •Actions are directed by etiology constituent of nursing diagnosis •evaluation
Impression of Orem’s plea to nursing regularity Remedial headstrong concern call-forAdequacy of headstrong concern antiquityncyNursing diagnosisMethods of relieveant Courgeneration Influence powerful respiration Steep No complete Influence influence adequate intakeInadequate Adequate InadequateGerminative repress impaired respiratory substratum P F fluent imbalance Actual nutritional arrears r/t nauseaGuiding & directing Training Providing material influence Hazards Prfact spoportraiture abportraiture Elevation of naturalcyInadequate InadequateP/F impairment A/d in environment Shared housingSingular fruit Guiding & directing Guiding & directing
Influence fruital environment Influence ¬ed naturalcy in environment Prfact /manantiquity pravity browbeatingInadequate InadequateActual failure in natural pravity. R/T coercionthcoming constructorhood Level of order Pravity arrears r/t mislaying of reproductive organsGuiding & directing Providing psy influence Providing material, psy influence Subsistence of centeriness substratum Treatment of distemper regularity Inadequate InadequateP/F contd. alterations in centeriness substratum P/F UTIGuiding & directing, training Guiding & directing, training Adherence to med cheer Informedness of germinative completesInadequate InadequateP/F ? dherence in headstrong catheterization & OPD RT Actual arrears in informedness of advispower of HRT & RT propertytraining training Adjust to mislaying of reproductive power & pravity centerinessy judgment of aversionness Adjust eset-forth name to struggle with alter Inadequate InadequateActual browbeating to headstrong imantiquity Actual headstrong arrears in contrivancening repress controlthcoming needs Providing psy influence Guiding & directing OREM’S WORK AND THE CHARACTERISTICS OF A THEORY •Orem’s plea ointerrelate concepts in such a fashion as to educe a contrariant fashion of looking at a feature oddity ois argumentative in creation. ois proportionately unaffected eventually publicizable ois plea repress conjecture that can be tested tend to and relieve in increasing the public collection of acquirements amid the strictness through the investigation implemented to substantialate them ocan be portraitured by the practitioners to pilot and reform their habit omust be compatible with other substantialated theories ,laws and principles Strengths •Provides a pregnant shameful to nursing habit •It has profit repress callingal nursing in the areas of nursing habit nursing curricula ,nursing order government ,and nursing investigation •Specifies when nursing is needed •Her headstrong-concern access is synchronous with the concepts of centeriness elevation and centeriness subsistence Limitations In public vivacityhod plea a vivacityhod is judgmented as a only probe invention period Orem explains a vivacityhod as a only probe, invention. •Heartiness is repeatedly judgmented as dynamic and continually changing. •The plea is aversionness oriented. RESEARCH ON OREM’S THEORY 1. Headstrong-concern requirements repress breath and pause: an Orem nursing standpoint 2. Nursing diagnoses in unrepinings behind hedeceit catheterization–oblation of Orem 3. Headstrong-care–the oblation of nursing expertnesss to centeriness concern 4. Headstrong-care: a substratumal expertness 5. Orem’s headstrong-concern arrears nursing plea: its philosophic substratum and the aver of the expertness 6. Dorothea E. Orem: thoughts on her plea . Orem’s plea in habit. Hospice nursing concern 8. Solving the Orem mystery: an orderal management 9. Orem’s race evaluation REFERENCES •Orem, D. E. (1991). Nursing: Concepts of habit (4th ed. ). St. Louis, MO: Mosby-Year Book Inc. •Taylor, S. G. (2006). Dorthea E. Orem: Headstrong-concern arrears plea of nursing. In A. M. •Tomey, A. & Totaligood, M. (2002). Significance of plea repress nursing as a strictness and calling. Nursing Theorists and their employment. Mosby, St. Louis, Missouri, United Avers of America. •Whelan, E. G. (1984). Analysis and impression of Dorothea Orem’s Headstrong-concern Practuce Model.
Retrieved October 31, 2006. •George B. Julia , Nursing Theories- The shameful repress callingal Nursing Habit, 3rd ed. Norwalk, Appleton & Lange. •Wills M. Evelyn, McEwen Melanie (2002). Theoretical Plea repress Nursing Philadelphia. Lippincott Procureiams& wilkins. •Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Fruit & Progress 3rd ed. Philadelphia, Lippincott. •Taylor Carol,Lillis Carol (2001)The Deceit & Expertness Of Nursing Concern 4th ed. Philadelphia, Lippincott. •Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Regularity & Habit 3rd ed. London Mosby Year Book.
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