PENGEMBANGAN FORMAT PENGKAJIAN BERDASARKAN

TEORI KEPERAWATAN

Ghulam AhmadNIM. 2151140003

Description TheoriesThe Self-Care or Self-Care Deficit Theory of Nursing is composed of three interrelated theories: • (1) the theory of self-care, • (2) the self-care deficit theory, and • (3) the theory of nursing systems

Orem’s theory defined Nursing as “The act of assisting others in the provision and management of self-care to maintain or improve human functioning at home level of effectiveness.”

It focuses on each individual’s ability to perform self-care, defined as “the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being.”

AssumptionsThe assumptions of Dorothea Orem’s Self-Care Theory are: • In order to stay alive and remain functional, humans engage in constant

communication and connect among themselves and their environment. • The power to act deliberately is exercised to identify needs and to make

needed judgments. • Mature human beings experience privations in the form of action in care

of self and others involving making life-sustaining and function-regulating actions.

• Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify needs for, and make inputs into, self and others.

• Groups of human beings with structured relationships cluster tasks and allocate responsibilities for providing care to group members.

Self Care

• Self-care is the performance or practice of activities that individuals initiate and perform on their own behalf to maintain life, health and well-being.

Self-care Deficit

• Self-care Deficit delineates when nursing is needed.

• Nursing is required when an adult (or in the case of a dependent, the parent or guardian) is incapable of or limited in the provision of continuous effective self-care.

Nursing System

• Nursing System is the product of a series of relations between the persons: legitimate nurse and legitimate client.

• This system is activated when the client’s therapeutic self-care demand exceeds available self-care agency, leading to the need for nursing.

Self-care Requisites

• Self-care Requisites or requirements can be defined as actions directed toward the provision of self-care. It is presented in three categories:– Universal self-care requisites – Developmental self-care requisites– Health deviation self-care requisites

Universal self-care requisitesAssociated with life processes and the maintenance of the integrity of human structure and functioning.

• The maintenance of a sufficient intake of air• The maintenance of a sufficient intake of water• The maintenance of a sufficient intake of food• The provision of care associated with elimination process and excrements• The maintenance of a balance between activity and rest• The maintenance of a balance between solitude and social interaction• The prevention of hazards to human life, human functioning, and human well-

being• The promotion of human functioning and development within social groups in

accord with human potential, known human limitations, and the human desire to be normal

Developmental self-care requisites

• Developmental self-care requisites are “either specialized expressions of universal self-care requisites that have been particularized for developmental processes or they are new requisites derived from a condition or associated with an event.”

Health deviation self-care requisites

• Health deviation self-care requisites are required in conditions of illness, injury, or disease or may result from medical measures required to diagnose and correct the condition.

Wholly compensatory nursing system

• This is represented by a situation in which the individual is unable “to engage in those self-care actions requiring self-directed and controlled ambulation and manipulative movement or the medical prescription to refrain from such activity… Persons with these limitations are socially dependent on others for their continued existence and well-being.”

• Example: care of a new born, care of client recovering from surgery in a post-anesthesia care unit

Partial compensatory nursing system

• This is represented by a situation in which “both nurse and perform care measures or other actions involving manipulative tasks or ambulation… [Either] the patient or the nurse may have the major role in the performance of care measures.”

• Example: Nurse can assist postoperative client to ambulate, Nurse can bring a meal tray for client who can feed himself

Supportive-educative system

• This is also known as supportive-developmental system, the person “is able to perform or can and should learn to perform required measures of externally or internally oriented therapeutic self-care but cannot do so without assistance.”

• Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies.

Orem’s Theory and The Nursing Process

• The Nursing Process presents a method in determining self-care deficits and to define the roles of persons or nurse to meet the self-care demands.

STEP 1 : ASSESMENT

Collect Data in Six Areas• The person’s health status• The physician’s perspective of the person’s health

status• The person’s perspective of his or health health• The health goals within the context of life history,

lifestyle, and health status.• The person’s requirements for self-care• The person’s capacity to perform self-care

STEP 2 : Nursing Diagnosis & Plans

• The nurse designs a system that is wholly or partly compensatory or supportive-educative.

• The two actions are: (1) Bringing out a good organization of the

components of patients’ therapeutic self-care demands.

(2) Selection of combination of ways of helping that will be effective and efficient in compensating for/overcoming patient’s self-care deficits.

Step 3 : Implementation & Evaluation

• Nurse assists the patient or family in self-care matters to achieve identified and described health and health-related results.

• Collecting evidence in evaluating results achieved against results specified in the nursing system design.

• Actions are directed by etiology component of nursing diagnosis.

• Orem’s theory is relatively simple, but generalizable to apply to a wide variety of patients. It explains the terms self-care, nursing systems, and self-care deficit which are very essential to students who plan to start their career in nursing.

• Moreover, this theory signifies that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they’re able. This theory is particularly used in rehabilitation and primary care or other settings in which patients are encouraged to be independent.

• Though this theory greatly influences every patient’s independence, the definition of self-care cannot be directly applied to those who needs complete care or assistance with self-care activities such as the infants and the aged.

END