Children with cancer and their parents: self-care and dependent-care practices

In this qualitative study the self-care practices of children with cancer and the dependent-care practices of their parents were examined. These practices were organized according to self-care requisites presented in Orem's theory of self-care. The intent of this examination was to determine the competency of participants, identify where self-care deficits occurred, and decide what nursing interventions were needed. A purposive sample of 9 children and 18 parents were interviewed to determine their experiences with cancer. Content analysis was conducted using a deductive approach to code and analyze the data according to Orem's universal, developmental, and health-deviation self-care requisites. NVivo qualitative analysis software was employed for data analysis. The findings of this study revealed that participants were competent agents, performing many practices in the areas of universal and developmental self-care requisites. Participants performed far fewer practices regarding health-deviation self-care requisites and interferences with development, however, indicating a need for supportive-educative nursing interventions in these areas. Future research should examine participants' operations and specific nursing interventions to support those operations.     

Predictors of self-care in adolescents with cystic fibrosis: a test of Orem's theories of self-care and self-care deficit

Pediatric nurses often struggle to find ways to encourage adolescents with cystic fibrosis (CF) to engage in self-care that is essential to their health and life. A study of predictors of self-care was conducted to provide a stronger evidence base for nursing practice with these youth. Orem's theories of self-care and self-care deficit were tested to explain and predict the universal and health deviation self-care of 123 adolescents with CF. Four dimensions of self-care agency emerged as predictors of universal self-care, two of which were also predictive of health deviation self-care. Seventy percent of the variance or change in universal self-care scores and 40% of health deviation self-care variance were explained. Clarification and extension of Orem's theories were also an important outcome. Development of nursing interventions designed to strengthen predictors of universal and health deviation-specific self-care identified in this research holds the potential to improve length and quality of life for adolescents with CF.     

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.     

An empirical test of a self-care model of women's responses to battering

A model of women's responses to battering was constructed based on Orem's theory of self-care deficit and on empirical and clinical observations. The model proposed that the age, educational level, and cultural influences as basic conditioning factors would all be directly related to relational conflict, which would be negatively related to self-care agency (as a mediator) and indirectly related to both outcomes of health and well-being. Using simultaneous structural equation modeling with specification searching, a modified model was derived that eliminated the mediation path but supported direct effects of both abuse and self-care agency on health. The derived model was found to be only a borderline fit with the data, probably due to measurement problems, lack of inclusion of important variables, and small sample size (N = 117). However, there was support for several of the relationships deduced from and/or congruent with Orem's theory.     

将Orem自理理论用于多发性骨髓瘤患者的护理

本介绍了应用Orem自理理论指导多发性骨髓瘤合并自发性骨折患的护理，使患的病情得到了较快的恢复。同时，介绍Orem自理理论的主要概念，应用Orem自理理论对个案进行评估的过程以及护理计划的制定和护理措施的实施，并提出了Orem自理理论在我国应用的优点与不足。     

奥瑞姆自护理论在临床护理应用中的研究进展

本文阐述奥瑞姆自护理论的主要概念与内容,同时回顾分析其近年来在国内外应用最广泛的内科护理、外科护理、妇产儿科护理和精神科护理这4个科室涉及的典型研究的应用情况,也将从奥瑞姆自护理论在我国护理领域应用的延展性、影响性进行思考,为其在护理领域继续发展提供依据。     

A comparative analysis of Orem's self-care model and Peplau's interpersonal theory

The process of choosing a nursing model or theory to guide one's clinical practice, curriculum development or theoretical framework for research can be facilitated by analysis of and comparison of existing theories, with each other and then with one's personal philosophies This paper summarizes the major concepts and assumptions of Dorothea Orem's self-care model and Hildegard Peplau's interpersonal theory, and then compares the two for similarities and differences in their origins of theory development, meanings related to nursing metaparadigm concepts, logical adequacy, usefulness and generalizability, parsimony and testability     

Self-care requirements for activity and rest: an Orem nursing focus

According to Orem's self-care deficit nursing theory, helping people to maintain a balance between activity and rest (a universal self-care requisite) is a legitimate concern of nursing. The meaning of activity and rest, the requirements and potential measures for meeting this self-care requisite, and factors that might influence the process are explored. Criteria for determining a need for nursing, guides for a nursing clinical assessment, and guides for nursing action are suggested as potential ways to assist persons to meet the action demands associated with this self-care requisite.     

Family health assessment — an integrated approach

The author discusses the development of a family assessment guide which combines family systems theory and Orem's self-care nursing framework. The rationale for integrating these two approaches is presented, based on the argument that a family conceptual framework or nursing framework alone cannot provide adequate guidelines for family nursing in the community. The family is viewed as a system with structure and function. Orem's self-care requirements are incorporated into the functions of the family. Five major assessment categories are discussed: environmental data; family structure; family function – meeting self-care requisites of family members; family function – adapting to change; and family perception of health situation. Data to be collected within each category is outlined, as well as the rationale for its inclusion in terms of its relevance for nursing of families in community health nursing.     

Power, self-care and health in women living in urban squatter settlements in Karachi, Pakistan: a test of Orem''s theory

This was a study of health in women living in urban squatter settlements in Karachi, Pakistan. The study grew out of the author's concern for the generally poor health status of Pakistani women. Orem's nursing theory was selected to examine health in these women. The purpose of the study was to examine relationships among basic conditioning factors, self-care agency (specifically, perception of power as a foundational capability of self-care agency and the enabling capabilities of self-care agency), self-care, and selected health outcomes of Pakistani women. Four hypotheses were developed and tested. They were that in a group of Pakistani women: (1) perception of power as a foundational capability and enabling capabilities of self-care agency and self-care will be related to selected basic conditioning factors; (2) perception of power, as a foundational capability of self-care agency, will be directly and positively related to enabling capabilities of self-care agency; (3) perception of power as a foundational capability and enabling capabilities of self-care agency will have a direct and positive relationship with self-care; and (4) self-care will be related to selected health outcomes. Hypotheses one, two and three were supported. Findings indicate that the basic conditioning factors, socioeconomic variables, ethnicity and roles, were predictive of perception of power, enabling capabilities of self-care agency, self-care and health. Hypothesis four was not supported; basic conditioning factors had more influence on health than self-care.     

孕妇自理行为与自然分娩关系的对比研究

目的 探讨Orem自理理论在女性怀孕期间应用的可行性,为孕妇掌握更好的自我护理技巧提供护理措施,以达到优生优育的效果.方法 对确诊怀孕孕妇选取80例,随机分为观察组与对照组,每组40例,观察组进行常规管理及卫生指导的基础上运用Orem自理理论进行自理行为跟踪指导,对照组则按常规进行孕妇管理及卫生指导直到分娩,观察两组产妇自然分娩的数量.结果 孕妇适时的自理行为对胎儿的自然分娩起到较好的效果,观察组的阴道分娩数量明显高于对照组(P＜0.05).结论 Orem的自理模式对指导孕妇受孕期间的自我护理行为具有良好的促进作用.     

Development of the "Whittener Activity Catalog of Self-Care in Venous Ulcer"

Poor rates of healing and high rates of re-ulceration are characteristic of venous leg ulcer. The performing of special health-deviation self-care is important for the successful treatment and prevention of this chronic disease. This study aimed to validate a newly designed instrument for the measurement of specific self-care. The "Wittener Aktivit?tenkatalog der Selbstpflege bei ven?s bedingten offenen Beinen" (WAS-VOB) (a catalogue containing self-care activities for venous leg ulcer) was conceptualized on the basis of Orem's theory and on pathophysiological processes. The items were created by using patient interviews (n = 20) and a literature review. An analysis of the reliability was used to reduce the raw scale. The quality of the WAS-VOB was assessed for face-validity (n = 6), feasibility (n = 8), test-retest-reliability (n = 60) and the internal consistency (n = 234). The involvement of patients was based on an informed consent. The WAS-VOB is a self-describing instrument, includes 59 self-care activities and describes those in eight scales which deal with "general compression", "wearing compression bandages", "wearing compression hosiery", "mobility", "temperature", "overload of the venous system", "prevention of skin damage" and "wound healing". The WAS-VOB is practicable and has good psycho-metric characteristics. The test-retest-coefficient (Kendall's tau b) is 0.58, Cronbach's alpha 0.72. The instrument WAS-VOB is suitable for the assessment of self-care deficits.     

Development of an instrument to measure mothers' performance of self-care activities for children

One who performs self-care activities for another is known as a dependent care agent, according to Orem. Attempts to study mothers' performance of self-care activities for children have been impeded by the lack of an instrument with which to measure dependent care agent performance. Findings based on a sample of 475 women indicate that the Dependent Care Agent (DCA) questionnaire developed in this study had a coefficient alpha of .91, with item-total correlations ranging from .27 to .63. Although Orem's expected dimensions of universal, developmental, and health deviation requisites were not represented in the factor analysis, individual requisites for self-care were clearly present.     

An interpretation of family within Orem's general theory of nursing

This article offers an interpretation of family from the perspective of Orem's theory of nursing. The family is conceptualized within this theory from three perspectives: (a) as a factor that conditions an individual's requirements for care and ability to provide care for self; (b) as a dependent-care unit; and (c) as a unit of service. The meaning of these perspectives to the nurse is examined. The different assessment questions are identified. The family is seen as having functions related to the members' development of self-care agency and the establishment of appropriate dependent care systems in such a way as to promote the health of the entire family.     

Families dealing with stroke desire information about self-care needs.

As hospital lengths of stay have decreased, healthcare professionals have less opportunity to fully educate stroke patients and their families regarding self-care before the patient is discharged home. Consequently, families often need continuing education provided to them in outpatient settings. The purpose of this study was to identify the self-care needs about which people dealing with stroke most frequently want information. Twenty-four people responded to a survey that listed 48 self-care needs structured within Orem's universal self-care requisites (USCRs). The top five self-care needs about which information was desired were: preventing falls; maintaining adequate nutrition; staying active; managing stress; and dealing with emotional and mood changes. These needs correlated with several of Orem's USCRs. By keeping these needs in mind, healthcare professionals can develop better educational materials and provide more pertinent information to stroke patients and their families during homecare or office visits, support group meetings, or via the Internet.     

Complex health problems. Clinically assessing self-management abilities

Assessment of self-care abilities by staff nurses is critical to planning post-hospitalization care. Assessment instruments must be comprehensive and yet usable by busy nurses. Orem's three categories of self-care deficits (universal, developmental, and therapeutic) provided a basis for the development of a Self-Management Inventory.     

Universal self-care requisites as identified by homeless elderly men

1. Given the current economic climate, the number of homeless persons, and the nature of their needs, nurses must be prepared to facilitate movement of all homeless persons toward self-care. 2. Nurses can contribute to the self-care of homeless elderly men by recognizing and eliciting requisites, associated actions, and nursing interventions that reinforce meeting of needs. 3. Study results support Orem's proposition that universal self-care requisites are common to all individuals regardless of age, sex, developmental level, health state, or internal or external conditions. 4. A number of participant's statements used to formulate themes suggested a relationship to more than one category of universal self-care requisites, which suggests that the categories are not mutually exclusive.     

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.     

Comparison of two theorists on care: Orem and Leininger

Dorothea Orem and Madeleine Leininger are two nursing scholars who are contributing significantly to the body of nursing knowledge. This paper contrasts their backgrounds, the origins of their theories, their views of the nature of nursing, use of theory development strategies, and contributions to nursing science. The concepts of Leininger's care and Orem's self-care will be compared as these relate to their theories with the examination of similarities and differences.