Self-care Deficit Theory Of Nursing Research Articles

The application of the self-care deficit nursing theory in adolescents with cystic fibrosis: A randomized controlled study

PurposeThe present study evaluates the effects of the application of Self-Care Deficit Nursing Theory (SCDNT) on the self-care knowledge and skills in adolescents with Cystic Fibrosis. Design and methodsThis randomized controlled study included 30 adolescents who were equally divided into the intervention and control groups. The data were collected by using the Sociodemographic Data Form and the Self-Care Knowledge and Skills Evaluation Forms for Adolescents with Cystic Fibrosis. A total of seven home visits were conducted with the adolescents in the intervention group, during which individualized care plans were applied based on the Self-Care Deficit Nursing Theory. The self-care needs of the adolescents in the control group were identified based on data collected during two home visits conducted at the onset of the study and after 4.5 months. ResultsAs a result of the application of nursing interventions based on the SCDNT, a statistically significant increase was noted in the self-care knowledge and skills of the adolescents in the intervention group (p < 0.05). Additionally, after the interventions based on SCDNT, the need of adolescents for nursing interventions decreased significantly over time in all adolescents in the intervention group (p < 0.05). ConclusionsThe application of nursing interventions based on the SCDNT was effective in enhancing the self-care knowledge and skills of adolescents with Cystic Fibrosis. Practice implicationsNurses can benefit from Orem's Self-Care Deficit Nursing Theory in the design and application of the individualized care of adolescents with Cystic Fibrosis to improve their self-care practices.

Utilization of Orem's Self-Care Deficit Nursing Theory in Self-Care Among Older Korean Immigrants With Diabetes in the United States.

Background: Diabetes is a chronic illness and increasing among older populations. Self-care is a critical element in managing diabetes. Orem's Self-Care Deficit Nursing Theory (SCDNT) has been used and applied in nursing to explain significant self-care concepts. Although older Korean immigrants are marginalized in maintaining optimal health status and accessing adequate health services, related studies are still lacking. Utilization of Orem's SCDNT allows nurses to better understand associated factors in self-care among older Korean immigrants with diabetes. Purpose: The first aim is to explain the significant concepts of SCDNT. The second aim is to examine basic conditioning factors on self-care among older Korean immigrants with diabetes based on Orem's SCDNT. Methods: Each concept and structure of Orem's SCDNT was described with a table and figure. The 10 basic conditioning factors in self-care among older Korean immigrants with diabetes were investigated based on the previous literature and discussed in terms of Orem's SCDNT. Results: By exploring the 10 basic conditioning factors among older Korean immigrants, nurses can identify related factors in the self-care of this minority immigrant group and initiate the development of culturally tailored and age-specific nursing interventions. Implications for Nursing Practice: This study provides an understanding of related self-care factors among older Korean immigrants with diabetes. Additionally, the findings will help nurses to develop customized effective interventions and implement appropriate diabetes care for this minority group.

Orem's nursing self-care deficit theory: A theoretical analysis focusing on its philosophical and sociological foundation.

The self-care deficit nursing theory (SCDNT) advocated by Dorothea E. Orem is widely known and used in nursing practice worldwide. However, its broader philosophical and sociological context is often ignored. The theoretical analysis of Orem's SCDNT reported in this article focuses on four aspects of the theory: its essential structure/core values, affirmation of nursing as a practical science, philosophical foundations, and the sociological context surrounding its development. By interpreting the SCDNT from a philosophical and sociological viewpoint, it can be concluded that Orem established human-to-human nursing as a science premised on the existence of human beings as the central value of the theory. Moreover, Orem emphasized that the human-to-human relationship necessarily precedes the nurse-patient interface. The new interpretation and evaluation perspectives presented in this report may further the understanding of Orem's SCDNT. Moreover, they highlight the multifaceted aspects of nursing practice and role of person-to-person relationships as the basis of the SCDNT.

Orem's Self-Care Deficit Nursing Theory: Relevance and Need for Refinement.

The purpose of this article is to highlight the relevance of Orem's Self-Care Deficit Nursing Theory (SCDNT) in contemporary and future practice, explicitly within the global self-care movement and interprofessional healthcare. The authors discuss the relevance and important strengths within Orem's nursing theory and recommend theoretical refinement within the context of significant societal and healthcare transformation. The constructs of global people-centered care and population health, with related social determinants of health, are identified as critical areas for development if SCDNT is to have continued relevance for nursing practice. Implications for theoretical thinking and nursing education are recommended.

Experience of the patient's success in facing post-stroke urinary incontinence: the patient's perspective

Abstract Objective Post-stroke urinary incontinence (UI) is one of the sequelae of stroke. This situation affects all aspects of the patient's life – physically, psychologically, socially, and spiritually. This study aimed to investigate the experience of patients’ success in facing a post-stroke UI. Methods A qualitative study using the Rapid Assessment Procedure (RAP) approach was used in this study. Informants were selected using purposive sampling. In-depth interviews with as many as 8 patients who had recovered from post-stroke UI and living in the greater area of Southeast Sulawesi (Indonesia) were conducted. In-depth interviews were also conducted with 8 caregivers and 2 nurses. Data were analyzed using a thematic analysis approach and interpretation of data was based on Humanbecoming theory and Self-care deficit theory of nursing. Results Five successful things the patients experienced during post-stroke UI were identified. The five successes were as follows: they provided information to get to know and understand post-stroke UI, followed the procedures to overcome post-stroke UI, conducted self-control exercises and stayed motivated, performed daily activities independently according to ability, and made use of family support and peers’ attention. Conclusions These findings indicated that persistence, belief, independence, and social support (family and peer) made patients to successfully face their post-stroke UI and improved their quality of life. These findings also became the basis for developing a post-stroke UI management model based on Humanbecoming theory and Self-care deficit theory of nursing.

Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem's Self-Care Deficit Nursing Theory

IntroductionMany researchers have commended the self-care deficit nursing theory (SCDNT) developed by Orem as a means of improving patients' health outcomes through nurses' contributions. However, experimental research has investigated specific aspects of SCDNT, such as self-care agency and self-care requisites, rather than how the construct is practiced and understood as a whole. The current research presents a case study in which an advanced practice nurse (APN) used SCDNT-led practice within a primary healthcare setting that illustrates how the theory is applied to case management.MethodsA case study was conducted by observing an APN during her work in the asthma clinic of a public hospital in Hong Kong. A comparison was made between the case management of the APN under observation with the nursing processes stipulated by the SCDNT across four key operations: diagnostic, prescriptive, treatment or regulatory, and case management.ConclusionDuring the observed consultation, the APN applied the four key operations. In SCDNT, the role of the APN is to apply practical nursing knowledge by determining how a patient can best undertake self-care within the circumstances of their living arrangements and support facilities. The case study also demonstrated that SCDNT-based nursing practice has strengths and limitations in a primary healthcare setting. The study concluded that Orem's SCDNT serves as an appropriate theoretical framework for nursing practice within primary healthcare settings. One practical consequence of using SCDNT is that it enables APNs to use nurse-sensitive indicators when evaluating their clinical practice. This study offers a practice update to increase the accountability of nursing practice for nurse-led healthcare services.

Impact of Training Based on Orem's Theory on Self-Care Agency and Quality of Life in Patients With Coronary Artery Disease.

ABSTRACTBackgroundCoronary artery disease (CAD) is a primary cause of death worldwide. CAD negatively affects individuals because it reduces their functional skills and self-care abilities and disrupts quality of life.PurposeThis study was designed to assess the impact of a training program based on Orem's self-care deficit nursing theory (SCDNT) on self-care abilities and quality of life in patients with CAD.MethodsThis study was conducted using a randomized, controlled, pretest/posttest experimental design. One hundred two patients with CAD were divided evenly into either the intervention or control group, with sample randomization based on gender, age, low-density lipoprotein cholesterol level, and Self-Care Agency Scale scores. For both groups, interviews were conducted in two sessions held, respectively, at the hospital and at home. Study data were collected using the patient information form, Self-Care Agency Scale, MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew), Quality of Life Questionnaire (15D), and training booklet.ResultsA highly significant difference was found between the two groups in terms of the average posttest scores on the Self-Care Agency Scale, MacNew, and 15D. For the intervention group, the posttest scores on the Self-Care Agency Scale, MacNew, and 15D were significantly higher than the pretest scores, whereas average pretest and posttest scores on these measures were similar for the control group.ConclusionsThe training program developed in this study based on Orem's SCDNT improved self-care agency as well as disease-specific and overall quality of life in patients with CAD. Nurses should pay attention to the CAD-related educational level of patients when teaching them how to live with their disease. Moreover, nurses should use Orem's SCDNT to strengthen the self-care agency of these patients to increase quality of life and the effectiveness of related education efforts. Finally, medical institutions and governments should develop appropriate education policies for patients at risk of CAD and for those with CAD.

Addressing Physical Health Needs of Individuals With Schizophrenia Using Orem's Theory.

People with schizophrenia have increased morbidity and mortality rates associated with poor physical health that requires a holistic and comprehensive nursing approach. Dorothy Orem's self-care deficit nursing theory (SCDNT) has made a substantive contribution to nursing by focusing on people as whole entities who engage with their environment to sustain health. We offer an expanded view of the SCDNT by showing how it is a useful framework for nurses to integrate interpretive, empirical, and critical theoretical perspectives for addressing both the physical and mental health needs for people with schizophrenia. Understanding patient needs through different theoretical lenses will help nurses integrate high-quality, evidence-based care with patients' realities, needs, and values while considering the influence of the broader sociopolitical context. We demonstrate how the SCDNT allows nurses incorporate a critical perspective for critiquing the influence of societal barriers on individual's health and advocate for initiatives to address the complex sociopolitical, economic, and contextual factors that affect the physical well-being of individuals with schizophrenia.

Spirituality Self-Care Practices as a Mediator between Quality of Life and Depression

The purpose of this study was to develop a midrange theory, building on Orem’s self-care deficit nursing theory (SCDNT) to include constructs of religion, spirituality, and spiritual self‑care practices. This mid-range theory, White’s theory of spirituality and spiritual self-care (WTSSSC), was developed and tested as part of a larger study of African American patients with heart failure (HF). The aim of the study was to determine if spiritual self-care practices were mediating the relationship between depression and quality of life for African Americans diagnosed with heart failure. Participants in this study included 142 African Americans diagnosed with HF who were recruited at the clinic where they were being treated. Four instruments were used to measure spiritual self-care practices (White’s Spiritual Self-Care Practice Scale (WSPSCPC)), depression symptomology (Patient Health Questionnaire-9 (PHQ-9)), quality of life (World Health Organization QOL (WHOQOL-Bref)), and personal characteristics. Results of the analysis were statistically significant, indicating that spirituality self-care practices were mediating the relationship between depression and quality of life for African American individuals diagnosed with HF. As the population ages and chronic illness becomes more common, nurses need to promote the use of spirituality self-care practices to help patients maintain their well-being.

Beginning the Recovery Journey in Acute Psychiatric Care: Using Concepts from Orem's Self-Care Deficit Nursing Theory

A national agenda has been established for mental health systems to move toward a recovery model of care. Recovery principles are embedded in the foundations of nursing science and practice. Orem's Self-Care Deficit Nursing Theory (SCDNT) is in alignment with the ideals of recovery and can provide a structure for changing cultures on inpatient psychiatric units. SCDNT can guide research activities that link a patient's self-care abilities to improved recovery model outcomes. This paradigm shift is an opportunity for psychiatric nursing to return to its roots and deliver care that is patient-centered and conducive to recovering from mental illness.

Self-Care Demands of Persons Living With an Implantable Left-Ventricular Assist Device

Heart failure (HF) is a growing public health problem affecting approximately 23 million people worldwide. Treatment options for advanced HF patients have moved beyond pharmacologic therapy to include left-ventricular assist devices (LVADs). Patients with an LVAD must manage a complex regimen of care. This article proposes the use of self-care deficit nursing theory (SCDNT) as a framework to identify and organize the care needs of patients with an LVAD from a nursing perspective. Within SCDNT, self-care refers to actions designed to meet self-care requisites to achieve regulatory goals. When formalized, self-care requisites have two components: the general action to be taken and a "factor" to be controlled. The reformulation of health-deviation self-care requisites common to LVAD patients are presented and may serve as an exemplar for other technology-assisted living situations. The strengths and limitations of using the SCDNT for patients with such complex needs, as well as implications for clinical practice, research, and advancement of nursing science, are examined.

Conceptual analysis of self-care agency

The concept of self- care agency was developed by Orem (1980) as a component of Self-Care Deficit Nursing Theory (SCD-NT). Since its development, self-care agency concept has been applied widely in the discipline of nursing to determine the relationship between self-care agency and other concepts of the Orem SCD-NT in various populations. In this paper, the author analyzes the concept of self-care agency using Wilson’s Conceptual Analysis Method as modified by Walker &amp; Avant (1995). In particular, the use of the self-care agency concept is considered as it relates to conditioning factors, self-care actions, and specific outcomes in nursing research and practice.

Conceptual analysis of self-care agency

The concept of self- care agency was developed by Orem (1980) as a component of Self-Care Defi cit Nursing Theory (SCD-NT). Since its development, self-care agency concept has been applied widely in the discipline of nursing to determine the relationship between self-care agency and other concepts of the Orem SCDNT in various populations. In this paper, the author analyzes the concept of self-care agency using Wilson’s Conceptual Analysis Method as modifi ed by Walker & Avant (1995). In particular, the use of the self-care agency concept is considered as it relates to conditioning factors, self-care actions, and specifi c outcomes in nursing research and practice. Descriptors: Self care.

Living with serious mental illness: the desire for normalcy.

This article describes the desire for normalcy as experienced by 6 men and 13 women with serious mental illness based on secondary analysis of data from two previous qualitative studies. Original data were collected by structured and semi-structured interviews, and thematic analysis was done. Major categories of desire for normalcy are having normal things and experiences; doing meaningful activities; and being well, safe, free, and independent. Self-care actions to promote and maintain normalcy are identified, and finding are discussed in relation to Orem's self-care deficit theory of nursing. Implications for nursing theory, research, and practice are addressed.

Physical Abuse, Social Support, Self-Care, and Pregnancy Outcomes of Older Adolescents

ObjectiveTo evaluate the relationships between physical abuse, social support, self-care agency and practices, and pregnancy outcome for older adolescent mothers and infants. DesignPredictive-correlational design based on Orem’s Self-Care Deficit Theory of Nursing and featuring a prospective cohort analysis. Prenatal interviews and medical record review after delivery were both used as data sources. Setting:Public prenatal clinics. Participants:Pregnant adolescents who were at least 18 years of age at the time of the prenatal interview and no more than 19 years of age at conception. Complete data were available for 139 participants. Main Outcome Measures:Infant birth weight, pregnancy complications. Results:Twenty-two percent (n=30) of the adolescents in this sample reported that they experienced physical abuse during their pregnancy. Abused pregnant adolescents gave birth to infants with significantly lower birth weights (M=3,144g) than did adolescent mothers who were not abused (M=3,310g) (t=1.99; p=.025). The interaction effect of abuse and the social support factors of shelter and family help, self-care agency, household size, and prenatal care were significant predictors of infant birth weight. Abused adolescents had significantly more previous miscarriages, substance use, and triage visits during their pregnancies. Conclusions:Identification of abused adolescents and their social resources during pregnancy may enhance prediction of infants at high risk and provide opportunities for intervention.

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.

The relationship of self-concept and self-care in children with cancer.

The purposes of this descriptive study were to examine the relationships between self-concept and (a) self-care, (b) dependent-care, and (c) basic conditioning factors for children with cancer, and to compare the self-concept of children on- and off-therapy. The theoretical framework was Orem's self-care deficit theory of nursing. The sample consisted of 74 children with cancer and their mothers. Results showed small but significant correlations between variables, providing some evidence that if children had higher self-concept scores they performed more self-care activities and received more dependent-care from their mothers. The self-concept scores of the on- and off-therapy groups were not significantly different. This study supports Orem's theory and reinforces the need to promote positive self-concept.

The relationship of self-concept and self-care in children with cancer

The purposes of this descriptive study were to examine the relationships between self-concept and (a) self-care, (b) dependent-care, and (c) basic conditioning factors for children with cancer, and to compare the self-concept of children on- and off-therapy. The theoretical framework was Orem's self-care deficit theory of nursing. The sample consisted of 74 children with cancer and their mothers. Results showed small but significant correlations between variables, providing some evidence that if children had higher self-concept scores they performed more self-care activities and received more dependent-care from their mothers. The self-concept scores of the on- and off-therapy groups were not significantly different. This study supports Orem's theory and reinforces the need to promote positive self-concept.

Use of theory to guide nurses in the design of health messages for children.

To be effective, presentation of health messages for development of self-care agency must be age and developmentally appropriate. Blending cognitive development theories with selected foundational capabilities and dispositions from Self-Care Deficit Nursing Theory (SCDNT) has resulted in five concrete factors for successfully designing and delivering health messages for optimal learning in children. The capacity to learn requires perception, attention, play, communication, and memory. Actual evidence of learning about healthy choices by elementary school-aged children is illustrated. Indications of successes and deficiencies in design and delivery of health promotion messages during a school health fair are presented.

Testing Orem's theory with Mexican Americans.

To examine an ethnographic study using evaluation criteria for theory-testing through verification of personal experience. Ten theory-verification criteria developed by Silva and Sorrel (1992) for inductive methods of inquiry. A 1995 ethnographic study conducted with Mexican Americans and conceptualized within Orem's Self-Care Deficit Theory of Nursing. Twenty Mexican American key informants were from 13 families. Primary data sources were focused observations and a series of ethnographic interviews. The study, purposes, methods, selected findings, confirmability and credibility of study findings, and relevance to Orem's theory are presented in the context of each criterion. The purpose, design, analysis, and examination of results of the 1995 study sufficiently meet the 10 formative criteria. Because this study can be considered an example of theory verification research, findings are relevant to the development of Orem's theory. Through the use of theory-verification criteria, inductive methods of research can be used to test or verify theory. The testing of nursing theory with diverse populations is an important direction for continued theory development. Use of evaluation criteria can serve as a template for inclusion of diverse perspectives.