Orem 's Basic Conditioning Factors Essay

Orem focuses on nursing as a deliberate human action and notes that all individuals can benefit from nursing when they have health-derived or health-related limitations for engaging in self-care or the care of dependent others (Gunther, 2016). The nurse chooses deliberate actions from nursing systems to bring about desirable conditions in persons. The goal of nursing is to move a patient toward responsible self care or to meet existing healthcare needs of those who have health care deficits (Gunther, 2016). Orem expects people to be responsible for themselves and to seek help when they cannot maintain therapeutic self-care or dependent-care (Fawcett, 2003).

Dorothea Orem is known as one of the foremost nursing theorists. She is credited with the development of a nursing grand theory, the self-care deficit nursing theory (SCDNT). The beginning of her career can be traced back to Washington, D.C. in the mid 1930’s. Though she was a Baltimore, Maryland native, Orem pursued her nursing education at Catholic University of America (CUA) in Washington, D.C., graduating with baccalaureate and Master’s degrees in 1939 and 1945 respectively. Following her education, Orem held many job positions across multiple nursing disciplines, including working as a private nurse, nurse educator, administrator, director, and private contractor (McEwen & Wills, 2011).

In essence, the role played by the nurse is to increase and facilitate the self-care abilities and level of the individual patient (Smith & Parker, 2015). As such, self-care is neither reflexive nor instinctive. Instead, it is either performed rationally or intentionally in response to an already known need. Based on this Orem's theory, rational response is learned through communication and interpersonal relations. Orem asserts that self-care agency can also be defined as the power to take action (Caruso, Cisar & Pipe, 2008). It is a complex capability developed to enable maturing adolescents and adults to recognize, identify, and understand various factors to be managed or controlled so as to decide about, develop, and perform realistic care measures. The capability discussed above is strongly dependent on culture-related values and lifelong experiences.

While many people may believe that learning is just a natural response that all animals are capable of, there is actually a more complex explanation on how we learn the things we do in order to survive in the world. Classical conditioning and operant conditioning are both basic forms of learning, they have the word conditioning in common. Conditioning is the acquisition of specific patterns of behavior in the presence of well-defined stimuli.

The nursing process does not merely treat the patient as a physical body, but rather treats the patient holistically. The central philosophy of Dorothea Orem's self-care deficit nursing theory "is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they're able" (Dorothea Orem, 2012, Nursing Theory). However, although self-care may be the core of Orem's theory, the decision to engage in self-care must be facilitated by the patient's social and physical environment, of which the family can play a critical role in shaping.

While learning to drive a car, I have experienced the elements of classical conditioning. Conditioned stimulus was a car that rapidly stopped in front of me.

Dorothea Orem's self-care deficit theory was born while Dorothea Orem (1917-2007) was working in the Department of Health Education and Welfare (HEW) as a curriculum consultant. At this time in the history of the profession, nursing was just emerging as a unique academic discipline. Orem's theory was designed to answer the fundamental question: What is nursing? Orem defined nursing as a way of realizing every patient's desire to engage in self-care in a manner to "sustain life and health, recover from disease or injury and cope" with the consequences of major health events and daily life (El-Kader n.d.). Major assumptions of the theory include that "people should be self-reliant and responsible for their own care and others in their family needing care" (Dorothea Orem's self-care deficit theory, 2012, Current Nursing). Fundamentally, nursing and the nursing process is designed to enhance self-care and to address deficits in self-care.

Orem’s theory of self care deficit specifies when nursing is needed. “Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care” (Current Nursing, 2010, para. 16). Orem’s created five methods of helping; which are acting for and doing for others, guiding others, supporting one another, providing an environment that promotes personal development, and teaching one another.

The purpose of this paper will be to explain the components of Dorothea Orem’s self-care deficit theory, the current significance of the theory, and the application of this particular nursing theory. A nursing theory is an explanation of a division of nursing that “describes, explains, predicts, or prescribes” that particular division. (Perry, Potter, Stockert, & Hall, 2013, p. 41). Orem developed her personal theory, the self-care deficit theory, to assess a patient’s ability to perform vital daily tasks and how it affected the patient’s. (Hartweg & Pickens, 2016). This theory is a grand theory, which means it can be used in almost all areas of nursing. There are five components or methods that compose this theory that nurses will practice when working with a patient who needs to reach the self-care deficit. (Edney, Jaime, & Young, 2016). It is used today and has been included in several studies that have proven it to be effective in shortening hospital visits when used on critically ill patients. (Hohdorf, 2010). This particular theory has helped advance nursing practice since Orem’s first publication.

Orem’s Self-Care Theory lays the foundation to measure self-care maintenance, management, and confidence. The framework of Orem’s theory contributes an optimistic patient view to their own personal healthcare and the goal of nurses, and the independent function of their patients. The identification of nursing as a science and an art are identified as well as its boundaries, and serve as unique contributions to nursing. The research that Orem completed was designed to measure self-care deficits and the quality of life to help determine the correlation between both (Seed & Torkelson, 2012).

Basic Conditioning Factors Mr. Morris has at least four basic conditioning factors present affecting his condition. First, at age 75, it decreases his chances of full recovery if his physical and psychological abilities continue to decline. Second, because of his health state, having been newly diagnosed with congestive heart failure decreases his ability to perform activities of daily living. Aggravating his conditions are the symptoms of CHF, which are edema on his legs as evidenced by not being able to make more than six steps from his porch and shortness of breath, which could be manifested by his increasing fatigue.

Many different factors can affect these abilities and must be considered by nurses when providing comprehensive care. She referred to this new thought process as the Self-care Deficit Theory of Nursing, which also is known as the Orem Model of Nursing. Orem published the basis for this theory in her book Nursing: Concepts of Practice in 1971. The Self-care Deficit Theory of Nursing earned Orem much acclaim and respect within the medical world. She became a lead theorist in nursing education and practice for the rest of her career. Her book, Nursing: Concepts of Practice, is still widely read today as it enters into its sixth edition. Wayne,

Dorothea Orem’s self-care nursing philosophy encourages patient autonomy and gives patients a voice. Consequently, it increases patient responsibility and participation in their care. It provides nurses with a solid foundation to give patients’ self-sufficiency and control in caring for themselves. The self-care model is achieved when patients transform from dependent, unreceptive patients to active, engaged

Dorothea Orem created the self-care theory in 1959 and continued to build upon her theory until 2001. The purpose of Orem’s theory was to define nursing, discuss the relationship among the nurse and the patient, and to promote a clear understanding of the scope of nursing (Taylor, Self-Care Deficit Theory of Nursing, 2006). Today, Orem’s theory is widely known and is utilized in nursing curriculum, as well as continuing education topics for healthcare providers.

ENVIRONMENT Context where self-care occurs. Can hinder or support self-care activities. Includes the family, work, community, health care system. Person (client/patient) self-care deficits are the result of environmental situations. HEALTH Promoted by adequate self-care Major areas for "self-care" patient education Maintaining health Enhancing health Includes: exercise & physical fitness nutrition and weight control stress management maintenance of social support systems environmental control