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Importance of Dorothea Orems theory to nursing
Importance of Dorothea Orems theory to nursing
Orem theory nursing
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Dorthea Elizabeth Orem’s Nursing Theory as it Applies to Patients With End Stage Renal Disease and Hemodialysis Treatment
According to the Healthy People Database, in 2010 the aging population was estimated at 40 million, this number is expected rise to nearly 70 million by the year 2030 (National Center for Health Statistics, 2000). At the forefront of health concerns for this aging population will be the intervention, management and treatment of chronic diseases. This increase in both this specific population as well as the required medical care will place a significant amount of stress on an already distressed healthcare system, which in turn will affect the availability of recourses and costs. Including patients in their self care with strategic health promotion such as encouragement and education geared towards specific socioeconomic groups will be more cost effective and beneficial in the management of chronic disease. Studies indicate that patients involved in self management of disease processes often have better patient outcomes.
Obesity has become a very critical problem in the United States. According to the Centers for Disease Control and Prevention (CDC, 2011) in the past two decades there has been an increasingly dramatic increase in obesity seen within the United States. Evidence from research indicate a strong correlation between being over-weight or obese with incidences of coronary heart disease, type 2 diabetes, hypertension and cancers increases (CDC, 2011). A major complication associated with diabetes is the occurrence of nephropathy which can lead to end stage renal disease (ESRD).
Complications related to diabetes and nephropathy are said to account for 50% of new cases of end stage renal disease (...
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... M.A. (2006). Applications of Dorthea Orem's self care deficit nursing theory. In M.E. Parker (Ed.) (2006). Nursing theory and nursing practice (2nd ed., pp. 149-155). Philadelphia: EA. Davis Company.
Kuther, N. (2001). Improving compliance in dialysis patients: Does anything work. Seminars in Dialysis, 14(5), 324-327.
National Center for Health Statistics. (2000). Healthy people data 2010. Retrieved July 1, 2009, from http://www.healthypeople.gov/ data/data2010.htm
Orem, D.E. (1995). Nursing: Concepts of practice (5th ed.). New York: McGraw Hill.
Quinan, P. (2007). Control and coping for individuals with end stage renal disease on hemodialysis: A position paper. CANNT Journal, 17(3), 77-84.
United States Renal Data System (USRDS). (2008). Annual data report: Incidence and prevalence. Retrieved July 8, 2009, from http://www.usrds.org/2008/pdf/V2-02-2008.pdf
The nephrologist has to deduce the major cause of the disease in the individual so that he or she can know the approach to apply in treating the ailment. According to the National Kidney Foundation (2016), the considerations made are the potential risks that expose the patient to chronic kidney disease. The major risks are other conditions in the body such as diabetes, hypertension and pregnancy. The age and weight of the individual also influence the treatment and diagnosis of the disease in the patient. Chronic kidney disease mostly affects individuals over the age of 60 years thus the diagnosis approach developed mostly suits them. If the disease is found in a child, the diagnosis and treatment approach changes since the dosage especially in prescription will change. Weight is another factor that is considered in the diagnosis and treatment of the condition. Obese individuals are at a higher risk of developing diabetes, which is a cause of the disease. The other factors considered in the treatment of the disease is the stage of the disease in the individual whether it is at mild, moderate or advanced
The purpose of this paper is to inform the reader how Dorethea Orem’s nursing theory has been used in research. Orem begin developing her theory in the 1950’s, a time when most nursing conceptual models were based on other disciplines such as medicine, psychology and/or sociology (Fawcett, 2000). Orem’s theory is a three-part theory of self-care. The three theories that make up the general theory are: Self-Care, Self-Care Deficit, and Nursing Systems. The Self-Care theory states that adults deliberately learn and perform actions to direct their survival, quality of life, and well-being. Self-Care Deficit theory states that nursing is required because of the inability to perform self-care as the result of limitations. Nursing Systems theory is the product of nursing in nursing system(s) by which nurses use the nursing process to help individuals meet their self-care requisites and build their self-care or dependent-care capabilities. These three theories form the overall Self-Care Deficit Theory. (Alligood & Tomey, 2001)
The editorial explains that diabetes mellitus is the leading cause of irreversible renal failure, known more commonly as End Stage Renal Disease (ESRD). Diabetes mellitus can cause nerve, vascular and other problems that can result in limb amputation and blindness. There are two types of diabetes: long-duration, non-insulin dependent (type 2) and insulin-dependent (type 1). Type 1 seems to attract the most attention from Physicians and the media. Many of those that suffer from type 1 are children and young adults.
This entails that the professional nurse provide not only ordinary but extraordinary care and support to make it possible for these individuals to achieve their requirements for self-care. Furthermore, the professional nurse judiciously and collaboratively partakes in the individual’s health care provided by the medical doctor. Dorthea Orem understood that individuals possess the natural capability of self-care, and nurses have a duty to place emphasis on enhancing that capability. Nurses who deliver direct care can support these capabilities by offering learning opportunities and teaching methods that enhance self-care activities, therefore contributing a positive and encouraging influence on the individuals and caregivers quality of
Latent diabetic vascular complications are a hallmark of the disease and known to significantly affect the cardiovascular and renal systems. Atherosclerosis is the main reason for decreased life expectancy in patients with diabetes, whereas diabetic nephropathy and retinopathy are the largest contributors to end-stage renal disease and blindness, respectively (37, 56). Current therapy is aimed at managing blood glucose concentrations and increasing insulin resistance. Thus, vascular complication mitigation includes: blood glucose monitoring and lowering, which decreases the risk of nephropathy and retinopathy. Antihypertensive medicine is also utilized to decrease the risk of cardiovascular disease, nephropathy, and retinopathy (15, 26). As well, hypertension is closely associated with stroke and pulmonary edema. Despite these advances, diabetes complications and their treatments are aimed at abating symptoms in an effort to improve physiological function.
This article describes the choices for treatment: hemodialysis, peritoneal dialysis, and kidney transplantation. It gives the pros and cons of each. It also discusses diet and paying for treatment. It gives tips for working with your doctor, nurses, and others who make up your health care team. It provides a list of groups that offer information and services to kidney patients. It also lists magazines, books, and brochures that you can read for more information about treatment.
In the elderly population, there are several healthcare deficits noted, the issue is when these patients are abandon by nurses due to work environment issues such as staff shortage, assignment acuity disagreements, and etc. As stated, health care deficits most often affect the elderly population, but it can affect anyone that have a debilitating disease or trauma. I have over three years of nursing experience working in a nursing home, so I am very familiar with self- care deficits in the elderly population. When dealing with the elderly population I integrate the Dorothea Orem’s Self –Care Deficit Theory into my practice to address the issue at hand. What is the Dorothea Orem’s Self-Care Deficit Theory? Dorothea Orem’s Self-Care Deficit Theory is a grand
The nursing theories that are currently in place in the emergency room to promote professional growth and development are vital; however, there are other nursing theories that could be implemented to help improve professional growth and development. A theory that should be implemented to more effectively promote professional growth and development is Orem’s theory of self-care deficit. Orem’s theory is considered a “realistic reflection on nursing practice” (McEwen & Wills, 2014, p. 146). If the nurse is not taking care of him or herself, “stress [can] accumulate [and the] nurse can … become angry, exhausted, depressed, and sleepless” (Ruff & Hoffman, 2016, p. 8). By the nurse having these feelings he or she is not able to take care of him
Her theory explains how an individual can achieve or maintain a healthy state using self-care, directly or through the help of a nurse. When an individual becomes unable to provide care for themselves, the nurse would be responsible for providing the assistance needed. However, if the person is fully capable of providing their own basic self-care, the nurse’s role would then be come supporter/education of that self-care. Stated on the Nursing Theory Webpage Self Care Deficit Theory, “Orem 's theory is comprised of three related parts: (1) theory of self-care, (2) theory of self-care deficit, and (3) theory of nursing system” (Self care deficit theory,
There are many diseases in the world that affect patient’s life. WOH has mentioned that chronic conditions might lead to disability in the future which leads to spend a lot of money to treat patients (WHO, 2005). Chronic condition has been defined as “health problems that require ongoing management over a period of years or decades, and include: diabetes, heart disease, asthma, chronic obstructive pulmonary Disease (COPD), cancer, HIV/AIDS, depression, and physical disabilities. To control chronic diseases and prevent patients from getting worse, all health professional and patients should be aware about self management. Therefore, this assignment will explain that ‘Self-management is an important component of effective management of people with chronic conditions and implant current self management models in health care can help to improve the quality of outcomes for patients and health care system.
Renal replacement therapy (aka dialysis) is often required in patient with acute or chronic kidney disease (CKD) to facilitate the removal of undesirable waste products from the body. In the US more than 10% (more than 20 million) of adults may have CKD.1 Chances of having CKD increase after age 50 yrs and is most common among adults older than 70 yrs. Approximately 5%-6% Intensive care unit (ICU) patients have acute renal failure during their ICU stay.2
Virginia Henderson developed the nursing need theory, which focuses on increasing the patient’s independence to speed up the recovery process (Alligood and Tomey, 2009). This is where my theory begins to connect with hers. Our main duty as nurses is to provide care for the patient while they are unable to care for themselves and facilitate them to be the best individual they can be. For this reason nursing is both a science and an art. It is a science in that nurses must understand the disease processes that are affecting the patient’s health, they must also practice based on evidence that is defended by science, and know how to operate equipment and machines. However, it is an art because it requires unique care for each patient, and each nurse is going to provide care in a slightly different way. The nurse is responsible for following the health care providers plan of care, but the nurse provides the creativity that provides the individualized care. The ultimate goal of nursing is to provide care to facilitate the patient in retaining or maintaining their maximal level of
The Registered Nurses Association of Ontario (RNAO) (2009) reported, “an estimated two million Canadians have kidney disease or are at risk for it” (p. 17). According to Porth (2011) and the Kidney Foundatoin of Canada (n.d.c), chronic kidney disease (CKD) has several different causes that combined cause a loss in renal function over 3 months or more, resulting in kidney failure, and its progression is classified into five stages. The two main causes for CKD are diabetes and hypertension (HTN) (National Kidney Foundation, 2012a). Practical nurses caring for adults with chronic kidney disease must consider the importance to their practices and to the adults and their families and the care and education needed to assist the adult and family.
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).
Chronic Kidney Disease. Mayo Foundation for Medical Education and Research, 2014. Web. 20 May 2014.