For my nursing model, I have selected Orem’s self-care deficit theory. Orem’s self-care deficit nursing theory (SCDNT or Orem’s model) encompasses three core concepts: self-care, self-care deficit, and the nursing system (Gligor and Domnariu, 2020). Orem’s model defines self-care as actions intentionally performed by individuals to maintain their health and well-being (Hartweg and Metcalfe, 2022). The self-care requirements or requisites specify actions and items in health, development, and well-being necessary for the patient to achieve holistic self-care (Yip, 2021). Hence, the self-care deficit implies that the nursing system is determined by the patient’s care limitations or requirements (Gligor and Domnariu, 2020). Consequently, the SCDNT emphasizes these self-care needs as something a nurse can assess and then fulfill to promote health and well-being (Hartweg and Metcalfe, 2022). The selected nursing model thus emphasizes patients’ circumstances, needs, and actions for self-care.
Analysis and Evaluation
Strengths and Limitations
Orem’s model has a range of strengths and limitations concerning a patient’s assessment. It is helpful since it offers a framework through which nurses can evaluate specific patient needs and identify the most fitting ways to communicate with their patients regarding their health (Yip, 2021). Further, unlike many assessment techniques that focus primarily on the physiological processes, SCDNT allows considering more of the context, including personal characteristics or additional circumstances (Abdelkader and Bawadi, 2019). However, in the SCDNT’s specificity lies its major limitation: it addresses specific aspects of practice rather than approaching the issue conceptually (Yip, 2021). Moreover, Yip (2021) points out weaknesses in Orem’s model interpretation of the relationship between nurses and the community in which they practice since self-care is not the only aspect to consider when assessing a patient’s background. Nonetheless, Orem’s model’s overall approach is sufficiently multifaceted because of its flexibility and tailored approach to patients’ needs.
Despite its limitations, Orem’s model may have applicability for holistic patient evaluation. It offers the required logic, simplicity, and clarity to be used by nurses across primary healthcare settings (Yip, 2021). SCDNT’s usefulness lies in its application in evaluating the needs for lifestyle modification and self-care prescriptions. For instance, SCDNT-based interventions effectively promoted self-care among female patients with hypertension (Nasresabetghadam et al., 2021). Teaching SCDNT’s application to nursing students increases their clinical performance and thus facilitates a more effective assessment and treatment process (Malekzadeh, Amouzeshi, and Mazlom, 2018). Therefore, Orem’s model has the potential to help evaluate patient needs and promote self-care.
Through this model study, I learned that while Orem’s model is applicable across a range of different settings and conditions, it is seemingly underutilized. Abdelkader and Bawadi (2019) note that nursing practice could benefit significantly from utilizing assessment tools grounded in SCDNT. Applying the principles of SCDNT will enable me to care for patients as an integral component of their families and the larger society. I have learned that Orem’s framework focuses on viewing a person’s intentional self-care abilities to maintain life, wellness, and prevent illness.
Nonetheless, there are certain aspects of the holistic approach that the SCDNT does not sufficiently cover. For instance, Orem’s model is limited because it does not cover all aspects of primary care and all potential patient requirements; for instance, it does not clearly define a patient’s family (Yip, 2021). Yip (2021) states that prioritizing family-centered care is vital for a truly holistic approach to primary treatment and assessment. However, this concept may be more important later in the treatment process than throughout the evaluation.
Holistic Assessment Promotion
There is excellent potential for Orem’s theory to change the dynamics of provider-patient interaction. Its emphasis on patients’ deliberate actions to promote self-care allows them to identify and address their own ‘deficit’ individually, depending on the requirements (Gligor and Domnariu, 2020). Moreover, Tanaka (2022) emphasizes that the SCDNT prioritizes the human-to-human connection over the nurse-patient relationship. This approach is fundamental to promoting holistic patient evaluation since it allows one to look beyond the universal set of factors and establish productive communication. Hence, due to its plasticity and attention to patient-specific needs, the SCDNT promotes holistic assessment.
Abdelkader, R.H. and Bawadi, H. (2019) ‘Self-care behavior assessment of fragile school-age children: an application of Orem’s self-care framework’, Global Journal of Health Science, 11(2), pp. 11–19. doi:10.5539/gjhs.v11n2p11.
Gligor, L. and Domnariu, C.D. (2020) ‘Patient care approach using nursing theories – comparative analysis of Orem’s self-care deficit theory and Henderson’s model’, Acta Medica Transilvanica, 25(2), pp. 11–14. doi:10.2478/amtsb-2020-0019.
Hartweg, D.L. and Metcalfe, S.A. (2022) ‘Orem’s self-care deficit nursing theory: relevance and need for refinement’, Nursing Science Quarterly, 35(1), pp. 70–76. doi:10.1177/08943184211051369.
Malekzadeh, J., Amouzeshi, Z. and Mazlom, S.R. (2018) ‘A quasi‐experimental study of the effect of teaching Orem’s self‐care model on nursing students’ clinical performance and patient satisfaction, Nursing Open, 5(3), pp. 370–375. doi:10.1002/nop2.151.
Nasresabetghadam, S. et al. (2021) ‘The effects of Orem’s self-care theory on self-care behaviors among older women with hypertension: a randomized controlled trial’, Nursing and Midwifery Studies, 10(2), pp. 99–106. doi:10.4103/nms.nms_9_20.
Tanaka, M. (2022) ‘Orem’s nursing self‐care deficit theory: a theoretical analysis focusing on its philosophical and sociological foundation’, Nursing Forum, pp. 126–196. doi:10.1111/nuf.12696.
Yip, J.Y.C. (2021) ‘Theory-based advanced nursing practice: a practice update on the application of Orem’s self-care deficit nursing theory, SAGE Open Nursing, 7, pp. 1–9. doi:10.1177/23779608211011993.