Concept Comparison and Analysis Jessica Watts NUR 513 July 2nd, 2012 Coleen Lucas Concept Comparison and Analysis Core concepts are the basis for a theory or model; concepts help in the development of theories. Theorists have developed different models or theories but have common core concepts. This paper will identify the core concept of ‘the role of nursing,’ which two theorists, Dorothea Orem and Virginia Henderson both utilized. We will compare and analyze the concept definitions among both theorists, and discuss the practical use of Orem’s self care theory. Core Concept
The core concept of ‘The role of nursing’ was used in both Dorothea Orem’s self care model and in Virginia Henderson’s nursing care model. Dorothea Orem’s definition of nursing is “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” (Current Nursing, 2010, para. 4). Virginia Henderson’s definition of nursing is “assisting individuals to gain independence in relation to the performance of activities contributing to health or its recovery” (Timetoast, 2011).
Their theories in relation to the concept differ where Orem’s concept requires the patient to have a self deficit and in need of nursing care or support; while Henderson’s concept states that nursing is required regardless if the patient is sick or healthy. The concepts are also similar in the fact that they both support the patient is regaining optimal health. Their concepts are applicable in different nursing settings because the goals of each are the same. Orem’s Self Care Theory—Metaparadigms
Within Orem’s self care theory, there are five metaparadigms: nursing, health, environment, human being, and nursing client. Orem views nursing as an art, a helping service, and a technology. Orem’s definition of nursing is “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” (Current Nursing, 2010, para. 3). Orem encompasses the patient’s, the physician’s, and the nurse’s perspective of the patient’s health condition.
Her goal of nursing is to make the patient and members of the patient’s family capable of meeting the patient’s self care needs, maintain an optimal state of health, to regain previous state of health after an illness or disease, and to decrease the effects of a chronic illness. Orem uses the terms ‘health’ and ‘healthy’ to describe living things ; “it is when they are structurally and functionally whole or sound, in conjunction, with physiological and psycho-physiological mechanisms and a material structure in relation to and interacting with other human beings” (Current Nursing, 2010, para. ). Orem’s environment is the elements, conditions, and components within the environment. According to Orem a human being “has the capacity to reflect, symbolize and use symbols; a unity that can function biologically, symbolically, and socially” (Current Nursing, 2010, para. 5). A nursing client is a human being who has health related or derived issues that cause them to be incapable of continuous and complete self care; they are the focus, only when their self care needs exceed their self care capabilities. Theory of Self Care
Orem’s definition of self care is the “practice of activities that the individual initiates and performs on their own behalf to maintain life, health, and well being” (Current Nursing, 2010, para. 12). The human ability to engage in self care is determined by age, developmental state, life experience, social and cultural orientation, health, and available resources. Orem describes three self care requisites; universal self care requisites, developmental self care requisites, and health deviation of self care; all are directed towards the provision of self care.
Universal self care requisites are the maintenance, provision, balance, prevention, and promotion of human functioning. “Developmental self care requisites are associated with developmental processes derived from a condition or associated with an event” (Current Nursing, 2010, para. 14), for example adjusting to a new job or adjusting to bodily changes, such as menopause. Health deviation self care is required in conditions of illness, disease, or injury. Health deviation is seeking, securing, modifying, learning, and effectively carrying out medically prescribed measures. Theory of Self Care Deficit
Orem’s theory of self care deficit specifies when nursing is needed. “Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care” (Current Nursing, 2010, para. 16). Orem’s created five methods of helping; which are acting for and doing for others, guiding others, supporting one another, providing an environment that promotes personal development, and teaching one another. Theory of Nursing Systems Orem describes how the patients self care needs will be meet by the nurse, patient, or both in her theory of nursing systems. The design and elements of a nursing system defines the scope of nursing responsibility in health care situations, defines general and specific roles of nurses and patients, and defines reasons for nurses’ relationship with patients” (Current Nursing, 2010, para. 17). Orem recognized that members of the health profession usually develop specialized technologies. “A technology is systematized information about a process or a method for affecting some desired result through deliberate practical endeavors, with or without use of materials or instruments” (Current Nursing, 2010, para. 17).
Concept of Orem’s Theory Orem interrelates concepts in such a way, that it creates a different perspective of a particular phenomenon. Orem’s theory is logical, simple, and generalizable; and is a basis to test hypotheses. “It contributes to and assists in increasing the general body of knowledge within the discipline through the research implemented to validate them” (Current Nursing, 2010, para. 21). According to Orem, her theory in Current Nursing, 2010, can be used by practitioners to guide and improve their practice and it must be consistent with other validated theories, principles, and laws. Major
Assumptions, Strengths, and Limitations According to Current Nursing, 2010; some major assumptions of Orem’s theory are: people should be self-reliant and responsible for their own care and their family; people are distinct individuals; nursing is a form of action and interaction between two or more people; successfully meeting universal and developmental self care requisites is an important component of primary care prevention; knowledge of potential health problems is necessary for promoting self care behaviors; and self care and dependent care are behaviors learned within a socio- cultural context.
Some strengths to Orem’s theory, according to Current Nursing, 2010; are: it provides a comprehensive base to nursing practice; it has utility for professional nursing in the areas of nursing practice, education, administration, and research; specifies when nursing is needed; and Orem’s self care approach is contemporary with the concepts of health promotion and health maintenance today. As with any theory there are always limitations to its use; Orem’s theory’s major limitation is that her theory is illness oriented and only calls for nursing care when there is an illness present. Global health care needs, as identified by clinicians or patients/consumers, are addressed through the generation of research evidence that is effective, but also feasible, appropriate and meaningful to specific populations, cultures and settings” (The Joanna Briggs Institute, 2011). Concepts are the bases for a theory or model and aide the development of theories. The common concept discussed in this paper was the role of nursing, which is common and essential to Orem and Henderson’s theory.
Orem believed that a patient needed to have a self deficit for nursing care while Henderson believed in nursing care whether the patient was healthy or ill. While each theorist had different definitions of the role of nursing, both had the same concept of nursing care. “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings.
Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles” (Definition of Nursing, 2010). Orem’s self care model demonstrated the role of nursing in caring for an individual with a self care deficit and/or illness. Nursing interventions help individuals regain optimal health and well-being.
References Current Nursing. (2010). Dorothea Orem’s Theory. Retrieved from http://currentnursing. com/nursing_theory/self_care_deficit_theory. html Definition of Nursing. (2010). Retrieved from http://www. icn. ch/about-icn/icn-definition-of-nursing/ Timetoast. (2011). Breif history of Nursing. Retrieved from http://www. timetoast. com/timelines/22792 The Joanna Briggs Institute . (2011). Retrieved from http://www. joannabriggs. edu. au/JBI%20Approach