The structure of self-care in a group of elderly people

According to Orem's self-care deficit theory of nursing, the structure of self-care consists of self-care agency balanced by therapeutic self-care demand. Different conditioning factors constitute these two constructs. The aim of this study was to investigate through secondary analysis the structure of self-care in a group of elderly. Data were originally collected from a total of 125 randomly chosen elderly individuals (65+ years of age) in Sweden by means of a mailed questionnaire. Confirmatory factor analysis was used to show that self-care agency was totally and significantly balanced against therapeutic self-care demand and explained by five conditioning factors.     

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.     

Self-care agency as a function of patient-environmental factors among nursing home residents

The relationship between environmental and personal factors on self-appraised self-care agency of nursing home residents was examined. Data were collected from 83 nursing home residents in relation to self-care abilities, environmental constraints, and selected demographic factors. Race and previous occupation were related to self-care agency with residents who were black or previously self-employed evidencing higher scores. In addition, residents who viewed the home as overly restrictive or fostering dependence had lower perceptions of their self-care abilities. The results are discussed in terms of Orem's theory of self-care, social learning theory, and implications for restructuring care within nursing homes.     

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.     

运用Orem自理理论缓解宫颈癌患者癌症相关疲劳的研究

目的了解癌症相关疲劳对宫颈癌患者的影响,采用有效的护理干预缓解患者的疲劳。方法将133例宫颈癌患者随机分为干预组67例和对照组66例。对照组实施常规护理,干预组运用Orem自理理论,实施系统的护理干预。采用简短疲劳评估表、生活质量量表、癌症相关疲劳有关因素评估表,对两组患者进行比较。结果干预组癌症相关疲劳缓解程度明显高于对照组,疲劳程度明显减轻,生活质量明显提高。结论运用Orem自理理论对宫颈癌患者进行护理干预,有利于缓解患者的疲劳,提高生活质量。     

Self-care agency: conceptualizations and operationalizations

This article traces the interactive process between theory and research as it has been used to clarify the concept of self-care agency, a key concept in Orem's model of nursing. Theoretical constructions of self-care agency that have emerged in the work of Orem and the Nursing Development Conference Group are reviewed. Operational measures of self-care agency are described, particularly with regard to their underlying theoretical formulations. Factorial structures for some self-care agency instruments are related to the components of self-care agency in Orem's most recent conceptualization. Dimensions of self-care agency that are consistently supported by research studies of this phenomenon are identified.     

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.     

Testing Orem's Self-Care Agency and Basic Conditioning Factors in a Chinese community undergoing haemodialysis

This paper reports results of tests of Orem's Self-Care Agency and Basic Conditioning Factors in a Chinese community undergoing haemodialysis measured by the modified Chinese version of the ASA scale. Eighty-six patients from one major city of China, Tianjin, all of whom had end stage renal disease and were undergoing haemodialysis formed the sample of the study. The research instrument employed in the study was the modified version of the Appraisal of Self-care Agency Scale, developed for use with patients undergoing haemodialysis. The levels of self-care agency of the patients were identified with respect to the findings of the study. The relationships between the self-care agency and basic conditioning factors were investigated by the use of Spearman Rank Correlation Coefficients and the relationships were statistically supported by the findings of this research.     

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。     

Self-care agency and self-care practice of adolescents

The purposes of this study were threefold: (a) to describe self-care agency, (b) to describe self-care practice, and (c) to describe the relationship between self-care agency and self-care practice in adolescents. The usefulness of Orem's Self-Care Deficit Nursing Theory (SCDNT) with adolescents also was evaluated. Participants in this study included 173 adolescents, 14 to 19 years of age. Data were collected in classroom settings in two diverse high schools. Denyes Self Care Agency Instrument-90 and Denyes Self-Care Practice Instrument-90 were administered. Results revealed the presence of self-care agency and self-care practice. Although self-care practice was lower than self-care agency, a significant positive correlation was found between the two concepts. The lower self-care practice scores, as compared with the self-care agency scores, suggest that characteristic adolescent behaviors may or may not interfere with self-care practice. The results of this study support the usefulness of Orem's SCDNT with adolescent populations and identify the critical need for further research examining self-care in adolescents.     

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。     

Orem自理理论在减轻肿瘤患者化疗副作用的应用研究

目的 探讨Orem自理理论在减轻肿瘤患者化疗副作用方面的应用.方法 将100例肿瘤化疗患者随机分为实验组和对照组各50例.实验组采用Orem自理理论构建的护理模式,对照组进行常规护理.化疗结束3 d后,采用欧洲癌症患者生命质量测定量表EORTC QLQ-C30评价护理效果.结果 实验组总体健康状况明显高于对照组;在功能领域方面,实验组的躯体、认知、情绪和社会功能明显高于对照组;在症状领域方面,实验组的疲劳、恶心、呕吐明显低于对照组;在特异性项目方面,实验组的失眠、便秘明显低于对照组,食欲好于对照组,差异均有统计学意义.结论 应用Orem自理理论能减轻肿瘤患者化疗后副作用,提高患者的生活质量.     

Orem自理理论在减轻肿瘤患者化疗副作用的应用研究

目的探讨Orem自理理论在减轻肿瘤患者化疗副作用方面的应用。方法将100例肿瘤化疗患者随机分为实验组和对照组各50例。实验组采用Orem自理理论构建的护理模式,对照组进行常规护理。化疗结束3d后,采用欧洲癌症患者生命质量测定量表EORTC QLQ-C30评价护理效果。结果实验组总体健康状况明显高于对照组;在功能领域方面,实验组的躯体、认知、情绪和社会功能明显高于对照组;在症状领域方面,实验组的疲劳、恶心、呕吐明显低于对照组;在特异性项目方面,实验组的失眠、便秘明显低于对照组,食欲好于对照组,差异均有统计学意义。结论应用Orem自理理论能减轻肿瘤患者化疗后副作用,提高患者的生活质量。     

Using a self-care framework for continuing education in gerontological nursing

Orem's (1985) Self-Care Deficit Nursing Theory (S-CDNT) was used as a framework for an 8-day continuing education course in gerontological nursing provided nine times throughout Missouri. Through the use of case studies, major elements of the theory were not only introduced, but also were related to practice by speakers who focused on self-care abilities and limitations, as well as self-care demands and agency. Evaluation data from each of the locations demonstrated a significant increase in participants' knowledge scores from pre- to posttest (p less than .0001) using the Sign Rank Test. Participants perceived a substantial increase in both knowledge of theory-based gerontological nursing and theory-based practice. Follow-up evaluations after 6 months suggested that the use of S-CDNT as a framework for gerontological nursing content had a lasting impact on the development of a strong nursing perspective and on more positive attitudes toward gerontological nursing.     

优质护理在脑卒中患者中的应用效果探讨

目的 探讨优质护理在脑卒中患者中的应用效果。方法 将2017年1月至2017年12月在我院接受治疗的首发脑卒中患者110例纳入课题研究,采用随机对照表法分为观察组（55例）和对照组（55例）,分别接受优质护理干预和常规护理干预,比较两组患者的神经功能缺损程度、肢体运动功能、焦虑情况、自我护理能力、生活质量和护理满意度。结果 干预后,观察组患者的经功能缺损程度、肢体运动功能、焦虑情况、自我护理能力、生活质量和护理满意度均显著优于对照组患者（P<0.05）。结论 优质护理服务有助于降低脑卒中患者神经功能缺损程度,改善患者的焦虑情况和肢体运动功能,提高患者的自我护理能力和生活质量,值得临床推广。     

Frequency of and indications for wholly compensatory nursing care related to enteral food intake: a secondary analysis of the Belgium National Nursing Minimum Data Set

This study describes the frequency of and indications used for total feeding assistance and tube feeding in a national representative sample of Belgian hospital patients (n = 421 314). Data from the 1990 national minimum nursing data registration was used. Orem's self-care model was used to describe and categorize types of nursing care and related indications. The scope of wholly compensatory nursing care was limited to total feeding assistance and tube feeding. This type of nursing care is indicated when self-care agency is undeveloped or cannot be used and when self-care demands are significantly increased. Based on review of the literature, hypotheses to indicate nursing care were formulated and tested. Wholly compensatory nursing care related to enteral food intake is given to 14.4% of the total patient population in Belgian hospitals. If self-care demand increases due to malnutrition, then this is an indication for total feeding assistance. If self-care agency decreases due to blindness, mental retardation, disorientation or upper extremity dysfunction, then this is also an indication for total feeding assistance. If self-care agency decreases due to impaired chewing, then this is an indication for tube feeding. This study has generated the first representative national nursing statistics about total feeding assistance and tube feeding in hospitals.     

A Swedish Version of the Appraisal of Self-Care Agency (ASA) Scale

The “Appraisal of Self-care Agency” scale (the ASA scale) is designed to measure self-care agency in accordance with Orem's self-care deficit theory of nursing. The aim of this study was to obtain a reliable Swedish version of the ASA scale by measuring the internal consistency. ASA-A for self-appraisal and ASA-B for appraisal of another were tested with a convenience sample of 52 elderly in-patients and 53 caregivers in six geriatric care units. Cronbach's alpha reliability coefficient was 0.59 for the ASA-A scores, 0.77 for ASA-B scores obtained by caregivers comprising different professions, and 0.87 for scores obtained by registered nurses. Further testing of both validity and reliability is needed if this version of the scale is to be used in nursing research and practice.     

Nursing agency: the link between practical nursing science and nursing practice

The relationship of nursing science and nursing practice has been the topic of numerous discussions over the past decades. According to Orem, nursing science is a practical science, meaning that knowledge is developed for the sake of nursing practice. Within Orem's self-care deficit nursing theory, the concept of nursing agency links nursing science and nursing practice. Nursing agency refers to the power or ability of the nurse to design and produce systems of care. The relationship of practical nursing science, nursing practice, and nursing agency is examined in this article. Suggestions for further work related to nursing agency are provided.     

Environment: a perspective of the self-care deficit nursing theory

In this column the author presents an examination of Orem's conceptualization of environment as a metaparadigm concept, the role of environment in the theoretical structure of the self-care deficit nursing theory, and the creation of a developmental environment as one of the ways of helping another. Suggestions for further work related to the conceptualization of environment and the organization of existent knowledge are provided. Application of the concept of nursing agency and the environmental factor of healthcare system illustrate the utility of self-care deficit nursing theory in relation to the recommendations for changes in nursing education and for redesign of the healthcare system.