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Orems Theory - Mexican American Family

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Mexican American Family

The concept of self care has come to the forefront of healthcare management. It continues to present itself as an important part of health preservation, prevention and disease management, especially for culturally diverse families today. Orem states that self care develops throughout the life course, and behavior reflects an individual's group connection with habits, beliefs, and practices that constitute their cultural way of life (Becker, Gates, & Newsom, 2004). The Mexican American family that discussed in this paper is an example of how to apply Orem's self-care theory.

Orem's Theory


During the early 1940s and 1950s, the nursing profession focused on carrying out physicians' orders while providing basic patient care. The influences focused on conceptual models of nursing from other disciplines, such as medicine, sociology, and psychology. Nonetheless, the nursing profession lacked structure until the development of Orem's theory that describes self-care, the self-care deficit, and the nursing system in the 1950s (Clarke, Allison, Beriglia & Taylor, 2009).


Orem worked by consistently studying, developing, and redefining her conceptual framework for over 20 years between 1950 and 1970. She shaped the development of the theory form her professional background by working with numerous nurses at the Indiana State Board of Health (Clarke et al., 2009). Her quest to identify the concept of nursing lead her to ask questions regarding what nurses actually do, why nurses do what they do, and the results of their actions. According to Clarke et al. (2009), she published six editions of her work in a book entitled "Nursing: Concept of Practice." Her hard work improved the nursing profession by providing a general theory that enriched the nursing practice, research, administration, and nursing school curricula around the world.

Influential factors

Orem's work led her to use non-nursing theories and philosophies, unlike other nursing theories, thus widening the perspective beyond such traditional mind sets. Orem paralleled Florence Nightingale's philosophy that nursing was more than just carrying out orders for the physician. In fact, nursing philosophy frames the scientific view that the development of the nursing process develops from a logical body of scientific-based evidence (Clarke et al., 2009). However, Orem's theory is unique because she does credit any influential factor beyond her own knowledge, experience, and research

Major concerns

Unfortunately, not everyone accepted her work because she relentlessly pushed the nursing profession beyond a medical practice into the world of science. Some questioned the usefulness of her theory because of the inability to address such issues as power or control. However, Orem refutes such opposition to point that this is a general theory that will fit into any nursing scenario (Clarke et al., 2009).

Others complained that the entire theory is so complex that it is difficult to understand

and apply. Nonetheless, she viewed the acts of nursing as knowledge-driven toward a defined proper objective (Theofanidis & Fountouki, 2008). This knowledge helps in establishing a plan of care that focused on the needs of the patient. The theory defines how much self-care the patient requires and the ability of the nurse to render such care.

Contribution to Nursing

Orem's self-care deficit theory has significantly contributed to nursing knowledge. In fact, this theory identifies the focus of nursing practice (Pearson, 2008). The theory is believed to be directly applicable to the nursing profession as it clearly describes in what nurses do (Fitzpatrick & Whall, 2005). The role of the nurse is to promote independence and provide care for those others. Furthermore, universities and health care organizations have widely adopted Orem's theory and have used it as their curriculum focus and practice model (Pearson, 2008). The self-care deficit nursing theory has been used in combination with many other theories to contribute to the development of various health promotion models. This contribution is exemplified further by Latham and Cavillo's (2007) work with Hispanic adults with Type two diabetes.

Basic Concepts

Orem's self-care deficit nursing theory is a grand theory because it includes the four major paradigm concepts of person, environment, health and nurse. In her theory, Orem identifies additional concepts relevant to nursing practice. These concepts are self-care, self-care requisite, self-care agent, and nursing systems. Orem's concept of self-care explains that all persons have self-care needs and they also have the right to meet those needs (Pearson, 2008). In times of illness, certain self-care needs for the individual to meet which creates a self-care requisite. Orem identified three types of self-care requisites (Pearson, 2008). Universal self-care requisites include activities such as oxygenation, sleep, socialization and elimination; whereas developmental requisites occur with a life change or during a change in life cycle stages. Finally, health deviation requisites occur with illness or disability.

When an individual cannot meet their self-care needs or develops a self-care requisite, the self-care agency steps in. The self-care agency can include the individual, family, or friends. This group of people serves to meet the self-care needs of the individual until he or she can perform independently. Inclusion of a nurse in the group would create a nursing agency. Orem describes three nursing systems that define the role of the nursing agency: wholly compensatory, partly compensatory, and supportive educative (Fitzpatrick & Whall, 2005). A wholly compensatory nursing system is used when the patient is incapable of acting on his or her own behalf, thus requiring the agency to perform all self-care needs. A partly compensatory system is used for patients with varying limitations. Finally, a supportive educative system assists the patient who can act on his or her own behalf but requires additional knowledge and or support (Fitzpatrick & Whall, 2005).

Applying Orem's Theory

The self-care theory is applied to the nursing process by assessing the condition of the patient, identification of patient needs, resolution of the patient needs, and evaluation of the implementation (Nursing Theories, 2012). The nursing process is a method to decide why a



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