Spirituality and spiritual self-care: expanding self-care deficit nursing theory

The authors propose an integration of the concepts of spirituality and spiritual self-care within Orem's self-care deficit nursing theory as a critical step in theory development. Theoretical clarity is needed to understand the contributions of spirituality to health and well-being. Spirituality is the beliefs persons hold related to their subjective sense of existential connectedness including beliefs that reflect relationships with others, acknowledge a higher power, recognize an individual's place in the world, and lead to spiritual practices. Spiritual self-care is the set of spiritually-based practices in which people engage to promote continued personal development and well-being in health and illness.     

Impact of role-sets on implementing self-care theory with children.

Child health nurses' perceptions about their role-relationships (role-sets) to both their patients and parents of their patients may have contributed to the lack of literature on hospital nursing of children within Orem's Self-Care Nursing Theory. These perceptions and their impact are examined historically within three 20th century periods.     

A situation-specific theory of heart failure self-care

Heart failure, a common syndrome in developed countries worldwide, is associated with poor quality of life, frequent rehospitalizations, and early death. Self-care is essential to improving outcomes in this patient population. The purpose of this article is to describe a situation-specific theory of heart failure self-care in which self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability (maintenance) and the response to symptoms when they occur (management). Self-care maintenance is further defined to encompass routine symptom monitoring and treatment adherence. Self-care management is characterized as a process initiated by symptom recognition and evaluation, which stimulates the use of self-care treatments and treatment evaluation. Confidence in self-care is thought to moderate and/or mediate the effect of self-care on various outcomes. Four propositions were derived from the self-care of heart failure conceptual model: (1) symptom recognition is the key to successful self-care management; (2) self-care is better in patients with more knowledge, skill, experience, and compatible values; (3) confidence moderates the relationship between self-care and outcomes; and (4) confidence mediates the relationship between self-care and outcomes. These propositions were tested and supported using data obtained in previous research. Support of these propositions provides early evidence for this situation-specific theory of heart failure self-care.     

Orem自护理论在直肠癌切除术后的应用

目的:探讨Orem自护理论在直肠癌切除术后运用的可行性,为患者掌握更好的自我护理技巧提供干预措施。方法:将自护理论的三种基本护理方法应用于42例直肠癌切除术后患者,根据患者不同阶段的自理需求,提供完全补偿、部分补偿和辅助—教育等系统的护理,鼓励其主动参与自我护理。结果:40例患者术后恢复良好,出院后能够自理日常生活,心态良好。结论:Orem自护理论应用于直肠癌切除术后具有可行性。     

A theory of dependent-care: a corollary theory to Orem's theory of self-care

Dependent-care has its origins in people's requirements for regulatory care. The foundations for dependent-care are found in the ability of individuals to provide their required care. First introduced as a corollary to self-care, this work emerged through a process of reading and discussion. Models that support the theory of dependent-care are identified. Premises are stated. There is elaboration of the conceptualizations representing the work that has been done. There are still elements that need further development, such as specifying the enabling abilities of dependent-care agency and verifying and formalizing the various elements presented.     

A middle-range theory of self-care of chronic illness

Nearly 50% of adults have one or more chronic illnesses. Self-care is considered essential in the management of chronic illness, but the elements of self-care in this context have not been specified in a middle-range theory. This article describes a middle-range theory of self-care that addresses the process of maintaining health with health promoting practices within the context of the management required of a chronic illness. The key concepts include self-care maintenance, self-care monitoring, and self-care management. Assumptions and propositions of the theory are specified. Factors influencing self-care including experience, skill, motivation, culture, confidence, habits, function, cognition, support from others, and access to care are described.     

自理理论在临床护理中的应用进展

回顾了自理理论的产生及其发展背景,介绍了自理理论对临床护理理念的影响及其在临床护理实践中应用现状,提出自理理论应用于临床护理所带来的伦理问题。     

自理理论在临床护理中的应用进展

回顾了自理理论的产生及其发展背景，介绍了自理理论对临床护理理念的影响及其在临床护理实践中应用现状，提出自理理论应用于临床护理所带来的伦理问题。     

Orem自护理论在自然分娩过程中的应用

目的：探讨Orem自护理论在自然分娩过程中的应用效果。方法：在我院住院分娩的单胎头位、孕足月、无妊娠合并症和并发症的初产妇155例,对照组71例予以常规护理,观察组84例在此基础上运用Orem自护理论进行护理干预。观察两组的分娩方式;第一、第二产程的疼痛程度;自理能力。结果：观察组第一、第二产程的疼痛程度、自理能力与对照组比较,具有显著性差异（P〈0.01）。结论：运用Orem自护理论可减轻自然分娩过程的中疼痛,提高产妇的自理能力。     

自理学说应用于骨折病人护理的效果评价

目的 评价自理学说在骨折病人护理中的应用效果。方法 在骨科病房中运用自理理论实施护理：完全补偿性护理；部分补偿性护理；支持教育（情感支持，信息支持）。通过发放问卷调查表评价自理学说应用前后效果。结果 自理学说在骨折病人护理应用前后效果比较，经χ^2检验有明显差异（P＜0.01)。结论 认为自理学说在骨折病人护理中的应用，提高了骨折病人的自我概念水平、生活自理能力，使病人产生自信心。     

以Orem自理理论为框架的护理干预对前列腺增生患者自护能力的影响

目的探讨以Orem自理理论为框架的护理干预对前列腺增生（BPH）患者围手术期自护能力的影响。方法采用方便取样方法选取BPH患者128例,随机分为对照组和观察组各64例。对照组患者接受常规护理和健康教育,观察组在常规护理的基础上接受以Orem自理理论为框架的护理干预。采用自我护理能力测定量表（ESCA）评价患者的自护能力并比较两组患者术后膀胱痉挛的发生率。结果观察组患者自我护理能力、自护责任感、自我护理技能、健康知识水平得分分别（131．624-15．73）,（28．31±5．14）,（35．15±2．89）,（45．27±3．15）分,均高于对照组患者（109．214-19．89）,（21．53±7．18）,（26．19±5．36）,（38．17-4-4．10）分,差异具有统计学意义（t分别为4．316,-7．241,-8．676,-9．140;P〈0．05或P〈0．01）。观察组术后膀胱痉挛的发生率低于对照组,两组比较差异具有统计学意义（9．4％比23．4％;x^2=4．743,P〈0．05）。结论以Orem自理理论为框架的护理干预能够提高BPH患者的自护能力,降低膀胱痉挛的发生率,增加患者的主观幸福感,促进患者康复。     

奥瑞姆自护理论在经外周静脉置入中心静脉导管维护中的应用

[目的]提高病人的自护能力、降低并发症发生率。[方法]以奥瑞姆自护理论为指导,在留置经外周静脉置入中心静脉导管（PICC）不同时期应用不同的护理系统对151例留置PICC病人进行管道维护。[结果]院内：置管初期发生机械性静脉炎23例,穿刺口出血13例,发生静脉血栓拔管2例,敷料过敏1例;院外：穿刺口感染2例,敷料过敏6例,导管破损3例,导管脱出5例,发生静脉血栓拔管1例,堵管2例。[结论]应用奥瑞姆的自护理论于PICC维护中,能够充分发挥护士对病人的全面评估能力以及病人的主观能动性,改善和提高病人的自护能力,减少PICC并发症的发生。     

Evaluation of education materials using Orem's self-care deficit theory

This article presents Orem's self-care deficit nursing theory as the conceptual framework in the development, design, selection, and evaluation of appropriate written patient education materials for patients with low literacy skills. The model, which includes essential evaluation factors used in literacy research, offers nurses and other professionals a more comprehensive means to judge the suitability of health information and instructional materials. Nurses have a critical role in educating consumers and their families and for providing patients with useful information that will influence their decision-making and participation in care.     

运用自护理论 减轻产后乳房胀痛

目的探讨减轻产后乳房胀痛的方法.方法将100例正常经阴道分娩的足月初产妇,随机分成两个组,对常规50例,自护组50例.两组实施相同的健康教育,常规组以帮产妇做、随时指导为主;自护组实施自护理论的辅助教育系统,教会产妇预防和减轻产后乳房胀痛的相关措施.观察两组产后乳房硬度及胀痛情况.结果两组产妇产后乳房硬度及胀痛经统计学处理(秩和检验),P＜0.01,有显著性差异.结论运用自护理论指导产妇产后乳房护理,能明显减轻产后乳房胀痛,值得推广.     

Understanding homeless adults by testing the theory of self-care

This article explicates, within a sample of homeless adults, the relationship between self-care agency, self-care, and well-being, while controlling for select basic conditioning factors. Self-care is found to explain 30% of the variance in current well-being. Self-esteem and affect balance, along with the power components of self-care agency, are found to explain 25% of the variance in self-care and, together with select basic conditioning factors, to explain 54% of its variance. Affect is proposed as an energy disposition, a dimension of self-care agency. Recommendations are made to strengthen the homeless individual's self-care agency.     

Health promotion self-care within Orem''s general theory of nursing

The growing emphasis on health promotion by society and the increasing utilization of Orem's general theory of nursing to guide practice, education and research create a need to clarify health promotion activity within the model. The concept of health promotion self-care is developed after an analysis of statements by Pender and Orem for their logical congruence. Further in-depth analysis of Orem's model facilitates the placement of the new concept within its current structure. The potential strength of the model for guiding health promotion practice is discussed, as well as areas for needed development.