Orem’s Self-Care Deficit Theory is discussed in a nursing article on continence care. The objective of the article is to advocate for client care that is unidirectional. The application of theory-based nursing provides value-based guidance and a framework for further research (Bernier, 2002).
In an applicable case study there is a 30 year old Caucasian woman (L.R.), who is also English speaking. L.R.’s current health orientation, family characteristics, and environmental characteristics are relatively normative. She applies appropriate hygiene, health habits, and dental care. L.R. is operating suitably for her developmental stage (Bernier, 2002).
The application of Orem’s Theory is understood in reviewing L.R.’s past health deviation of Self-Care Requisites. During a recent physical examination she complained that her urinary incontinence (UI) was upsetting her. As a result she required suitable medical support. Another identified need includes L.R.’s desire to improve her pathological condition. Her preference was to address UI immediately to avoid deteriorating symptoms (Bernier, 2002).
Additionally, L.R. understands that incontinence symptomatology will worsen if the issue is not addressed immediately. Presently she does not show indication of depression associated with UI symptoms. Finally, although UI is not life-threatening, left untreated it can diminish the quality of life (Bernier, 2002).
Orem’s three theories include self-care, self-care deficit, and nursing system. The continence nurse effectively applies Orem’s theory to assess L.R.’s condition and develop a plan of care. The relevant plan of care includes diagnosis, goals, determination of client and nurse responsibilities, and evaluation (Bernier, 2002).
The three nursing diagnosis all requested supportive educative services. Chronologically, obtaining information related to urinary incontinence, understanding the relevant exertional activities, and gaining a normal self-concept are recommended. The client is responsible for actively listening to the information on causes, types and treatment of UI. The client is also responsible for utilizing the obtained health information for appropriate behaviors including pelvic floor exercises. Maintaining bladder diaries enable the client and the nurse to monitor progress (Bernier, 2002).
The nursing responsibilities include the provision of an appropriate educational setting and encouraging the client to complete the recommended plan of care. Follow-up appointments enable the nurse and healthcare staff, to ensure UI symptoms are properly monitored and managed (Bernier, 2002).
In summation it is important to understand that nurses and patients must work jointly to achieve self-care. Critical social and interpersonal technologies include relevant communication, coordination, and the maintenance of therapeutic relations (Nursing Faculty UCC, n.d.). In analysis Orem’s theory of universal self-care requisites were mostly met, except the complete control of bladder functions. In analyzing the theory of self-care deficit the results were insufficient. A gap remains in continence care treatment. Within the field of nursing, overcoming stress associated with urinary incontinence requires further research and application (Bernier, 2002).
When analyzing the theory of nursing system, there are three prognoses’ that are possible. Those include wholly compensatory, partly compensatory, and supportive-educative. In the case of L.R. the appropriate diagnosis would be supportive-educative. Although, the patient still needs to overcome UI associated with stress they are healthy enough to apply self-care (Bernier, 2002).
Bernier, F. (2002, December). Applying Orem's Self-Care Deficit Theory of Nursing. Urologic Nursing, 22(6), 384-394.
Nursing Faculty UCC. (n.d.). Dorothea Orem's Nursing Theory. Retrieved from http://faculty.ucc.edu/nursing-gervase/Orem%5B1%5D.pps
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