Dorothea Orem

 Dorothea Orem

Date of Birth: 

Born in Baltimore, Maryland in 1914.  

Education: 

Orem started her nursing career atProvidence Hospital School of Nursing in Washington D.C., where she received a diploma of nursing in the early 1930’s. Dorothea Orem later completed her Bachelor of Science in Nursing in the Catholic University of America in 1939 and in 1946, she received her Master of Science degree in Nursing Education from the same university. 

A Glimpse of Orem’s Accomplishments and Contributions:

• Dorothea Orem as a member of a curriculum subcommittee at Catholic University recognized the need to continue in developing a conceptualization of nursing.

• Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980, 1985, 1991, 1995, and 2001.

• Nursing: Concepts of Practice was the original publication of the conceptual framework (Orem, 1971)

• 1949-1957 Orem worked for the Division of Hospital and Institutional Services of the Indiana State Board of Health. Her objective was to improve the quality of nursing in general hospitals and she was able develop the definition of nursing by this time

• 1958-1960 she help publish "Guidelines for Developing Curricula for the Education of Practical Nurses" in 1959.

• Washington D.C. in 1957, Orem further developed her ideas, first as a consultant in the Office of Education where her task was to improve the nursing component of a vocational nursing curriculum.

• Orem’s ideas were further formalized after her participation in the Nursing Development Conference Group (NDCG), the two were committed to the development of structured nursing knowledge and to nursing as a practice discipline” (Hartweg, 1995)

• Continues to develop her theory after her retirement in 1984

• Dr. Orem continues to be active in theory development. She completed the 6th edition of Nursing: Concepts of Practice, published by Mosby in January 2001.

Publication:

Nursing Concepts of Practice

Textbook presents the development of nursing theory and illustrates its relevance to nursing practice. Discusses the foundations of nursing as a field of knowledge and practice and provides an approach to 'knowing and thinking nursing.' Contains five new chapters and three revised chapters. Previous edition: c1995. 

Hardcover: 542 pages 

Publisher: C.V. Mosby; 6th edition (January 15, 2001) 

ISBN: 032300864X 

  

Concepts:

Nursing – is art, a helping service, and a technology

• Actions deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments
• Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective
• Goal of nursing – to render the patient or members of his family capable of meeting the patient’s self care needs
• To maintain a state of health
• To regain normal or near normal state of health in the event of disease or injury
• To stabilize ,control ,or minimize the effects of chronic poor health or disability

Health – health and healthy are terms used to describe living things …

• It is when they are structurally and functionally whole or sound … wholeness or integrity. .includes that which makes a person human,…operating in conjunction with physiological and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beings

Environment

• environment components are enthronement factors, enthronement elements, conditions, and developed environment

Human being – has the capacity to reflect, symbolize and use symbols

• Conceptualized as a total being with universal, developmental needs and capable of continuous self care
• A unity that can function biologically, symbolically and socially

MAJOR ASSUMPTIONS:

• People should be self-reliant and responsible for their own care and others in their family needing care
• People are distinct individuals
• Nursing is a form of action – interaction between two or more persons
• Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health
• A person’s knowledge of potential health problems is necessary for promoting self-care behaviors
• Self care and dependent care are behaviors learned within a socio-cultural context

Theoretical Assertion: 

Dorothea Orem's Self Care Deficit Theory encompasses all aspect relating to the patient's health, nursing and all the factors that affect which.

The concepts discussed revolve mainly around self care. It is the patient's ability to care for himself and his dependents as well as others as dictated by the environment he lives in that determines health or the need for assistance in maintaining health. On the other hand, the society plays the major role into regulating the nursing care process as to when nursing care is needed and when and how the nursing system is implemented. It is also the environment and the society that directly affect the nurse-patient relationship and self care agency, which are all interconnected into achieving, restoring, and maintaining health.

As shown in the figure below, health can be achieved if the person has knowledge and resources to perform self care activities to meet self care deficits. On the other side, self care deficit results when self care agency (ability to perform self-care) is not adequate to meet the known self care demand and/or the failure to meet the health care requisites (Kozier et.al, 2002) This then warrants the need for nursing intervention through the nursing system, which in turn is empowered by the nurse-patient relationship. The end result of all of this is the maintenance, restoration, or preservation of health. 

Created By: Cheska Uvero