,TFN/NCM REVIEWER advanced practice guides began to be

recognized as theory.
History of Nursing Theory-History of
professional nursing began with Florence Fawcett’s- seminal proposal of four global
Nightingale. nursing concepts as a nursing
-Develop a body of specialized knowledge metaparadigm served as an organizing
on which to base nursing practice. structure for existing nursing frameworks
-Strong emphasis on practice and worked and introduced a way of organizing
throughout the century toward the individual theoretical works in meaningful
development of nursing as a profession. structure.
Curriculum Era-Address the question of Classification of nursing models as
what contents a nurse should study to learn paradigms within metaparadigm concepts
how to be a nurse. are ff:
-Emphasis was on what courses nursing Person
students should take, with the goal of Environment
arriving at a standardized curriculum. Health
Nursing
Research Emphasis Era-Focused on the
research process and the long-range goal of Emphasis shifted from learning about the
acquiring substantive knowledge to guide theorist to use of the theoretical works to
nursing practice. The need to do Research generate:
in order to seek higher education began in Research questions
this Research Emphasis Era. Research Guide practice
courses were included in nursing curricula Organize curricula
Graduate Education Era-Developed in Theory development emerged as a process
tandem with the research era. Master’s and product of professional scholarship
degree programs in nursing emerged to and growth and sought higher education
meet the public need for specialized clinical among:
nursing practice. Nurse leaders
Included concepts in: Administrators
Concept development Educators
Nursing models Practitioners
Early nursing theorist
Fitzpatrick and Whall (1983)- had said,
Knowledge development process
“Nursing is on the brink of an exciting new
Theory Era-A natural outgrowth of the era”
research and graduate education eras.
Theory Utilization Era-Emphasis shifted to
Emphasis on theory development and
theory application in nursing practice,
testing. Accelerated as early works
research, education and administration.
developed as frameworks for curricula and
Restored balance between research and
practice for knowledge development in the
discipline of nursing. Emphasis to produce SCIENCE-From the latin “scientia” meaning
evidence for quality professional practice. knowledge.
A systematically organized body of
knowledge about a particular subject .
Is performing the process of observation,
description, experimental, investigation and
theoretical explanation of natural
phenomenon.
KNOWLEDGE-general awareness,
understanding or possession of information,
facts, ideas, truths or principles.
Information, skills and expertise acquired by
a person through various experiences or
SIGNIFICANCE OF NURSING THEORY through formal/informal learning.
DISCIPLINE- refers to a branch of education, SOURCES OF KNOWLEDGE
a department of learning, or domain of
knowledge TRADITIONAL - nursing practice which is
passed down from generation to generation
PROFESSION- refers to a specialized field of
practice, founded upon the theoretical AUTHORITATIVE - is an idea by a person of
structure of the science or knowledge of the authority which is perceived as true
discipline and accompanying practice because of his or her expertise.
abilities. SCIENTIFIC - knowledge came from a
Significance For The Discipline-This scientific method through research
emphasis led into theory development era THEORY-Is an organized system of accepted
that moved nursing toward the goal knowledge that is composed of concepts,
developing nursing knowledge to guide propositions, definitions and assumptions
nursing practice. The discipline and the intended to explain a set of fact, event or
profession are inextricably linked and phenomena.
failure to recognize and separate them from
each other anchors nursing in a vocational CONCEPT-idea, belief, view, notion,
rather than a professional view. thought, perception, impression.
Are building blocks of theories
Forms of basis in recognizing nursing as
discipline: ABSTRACT CONCEPT- are indirectly
a. Knowledge of person observed.
b. Health - it is independent on time and place.
c. Environment Examples are love, care and freedom.

TERMINOLOGIES
CONCRETE CONCEPT- are directly observed. THEORIES MUST BE LOGICAL IN NATURE
Specific to time and place (LOGIC – an orderly reasoning)-
Examples are nurse, mother, chair Interrelationships of concepts must be
sequential and consistently used within the
PROPOSITION-Statements that explains the
theory
relationships of different concepts.
EXAMPLE THEORIES SHOULD BE SIMPLE BUT
Children don’t want to stay in the hospital GENERALLY BROAD IN NATURE
because of their fear of injections. Parsimonious – simple terms that
describes, explains, or predicts a wide range
DEFINITION-Is composed of various
of phenomena
descriptions which convey a general
meaning and reduces the vagueness in THEORY CAN BE THE SOURCE OF
understanding a set of concepts. HYPOTHESES THAT CAN BE TESTED FOR IT
TO BE ELABORATED
ASSUMPTION-Is a statement that specifies
the relationship or connection of factual THEORIES CONTRIBUTE IN ENRICHING THE
concepts or phenomena. GENERAL BODY OF KNOWLEDGE
Example THROUGH THE STUDIES IMPLEMENTED TO
All patients who are not able to take good VALIDATE THEM
care of themselves need nurses.
THEORIES CAN BE USED BY
PHENOMENON-a fact or occurrence that PRACTITIONERS TO DIRECT OR ENHANCE
can be observed THEIR PRACTICE
something notable; excites people’s interest
THEORIES MUST BE CONSISTENT WITH
and curiosity
OTHER VALIDATED THEORIES, LAWS, AND
PHILOSOPHY-A statement of beliefs and PRINCIPLES BUT WILL LEAVE OPEN
values about human beings and their world. UNANSWERED QUESTIONS THAT NEED TO
Is concerned with the purpose of human BE TESTED
life, the nature of being and reality, the
TYPES OF THEORIES
theory and limits of knowledge.
DESCRIPTIVE or Factor Isolating Theories -
THEORY
to know the properties and workings of a
CHARACTERISTICS OF A THEORY discipline. Do not explain the relationship of
concepts.
THEORY CAN CORRELATE CONCEPTS IN
Ex. Filipino nursing practices like using
SUCH A WAY AS TO GENERATE A
herbal medicines and other alternative
DIFFERENT WAY OF LOOKING AT A
treatment.
CERTAIN FACT OR PHENOMENON
EXAMPLE EXPLANATORY - or factor relating theories -
The relationship between self-care deficit to examine how properties relate and thus
and nursing affect the discipline
Ex. A research study about the factors PERSON - refers to the recipient of nursing
affecting newborns in failing to thrive care, including physical, spiritual,
psychological, socio-cultural components
PREDICTIVE or situation relating theories -
to calculate relationships between ENVIRONMENT- refers to all internal and
properties and how they occur external conditions and circumstances, and
Ex. effects of unsanitary environment on influences affecting the person
the recovery of post operative patients
HEALTH- refers to the degree of wellness or
PRESCRIPTIVE or situation producing illness experienced by the person
theories - to identify under which
NURSING - refers to the actions,
conditions relationships occur
characteristics, and attributes of the
Ex. explaining the difference in nsg.
individual providing the nursing care
management in the ER in relieving anxiety
COMPONENTS OF A THEORY
CONTEXT-Resembles environment to which
nursing act takes place
CONTENT-Subject of the theory
PROCESS-Method by which nurse acts in
using nursing theory
NURSING THEORY-The term given to the
body of knowledge used to support nursing
practice. A group of related concepts that THE IMPORTANCE OF NURSING THEORY
derive from the nursing models
Helps to decide what nurses know and
NURSING PARADIGM-are patterns or what nurses need to know
models used to show a clear relationship
among the existing theoretical works in Theory analyzes and explains what nurses
nursing do

METAPARADIGMS-Greek “Meta”- with; Better patient care, enhanced professional

“Paradeigma”- pattern status for nurses and improved
Main concepts encompassing the subject communication between nurses
matter and the scope of discipline Guides nursing research and nursing
Organizing conceptual or philosophical education
framework of a discipline or profession
It defines and describes relationships PURPOSES OF NURSING THEORY
among major ideas and values EDUCATION
THE METAPARADIGM OF NURSING: RESEARCH
CLINICAL PRACTICE
PURPOSES OF NURSING THEORY openness, pattern, pandimensioal,
integrality, reasonancy, and helicy
NURSING RESEARCH-Offers framework for
respectively.
generating knowledge and new ideas. Assist
in the discovery of knowledge in a specific ENERGY FIELDS -it is the inevitable part of
field of study. life.
CLINICAL PRACTICE-Assist nurses to OPENNESS- there is no boundary or barrier
describe, explain, and predict everyday that can flow of energy between human
experiences. Serve to guide assessment, and environment which leads to the
implementation and evaluation of nursing continuous movement or matter of energy.
care.
PATTERN- is the distinguishing character of
NURSING EDUCATION-Provide a general the energy field.
focus for curriculum design.
PANDIMENTIONAL-undeviating field which
Guide curricular decision-making process.
is not constricted by space or time, it is an
infinite domain without boundary.
HOMEODYNAMICS- refers to the balance
between the dynamic life process and
environment.
PRINCIPLES OF INTEGRALITY- Energy fields
are dynamic and constantly interact with
the human and environment, which affect
our environment and vice versa.
PRINCIPLES OF REASONANCY-is an ordered
RELATIONSHIPS BETWEEN arrangement of rhythm characterizing both
Theory & Research-Research validates & human field and environmental field.
modifies theory. Theory stimulates
PRINCIPLES OF HELIECY- any minute change
exploration
in the environment which leads to ripple
Theory & Practice-Theory guides practice.
effect, results in a larger changes in other
Theory provides insights about nursing
field.
practice situations. Practice shapes theory.
Research & Practice-Research develops METAPARADIGM IN NURSING
practice PERSON-a unitary human being is open
systems which continuously interact with
MARTHA ROGER SCIENCE OF UNITARY
environment.
HUMAN BEING-theory of science of unitary
human beings is mainly focusing on the four ENVIRONMENT-it includes the entire
concepts and three principles of energy field other than person.
homeodynamic that are energy fields,
HEALTH-not clearly defined by Roger. It is empowering, encouraging etc. depending
determined by the interaction between on the client’s condition and needs.
energy fields, human and environment.
EVALUATION- is done by repeating the
Bad interaction or misplacing of the energy
pattern appraisal after the mutual
leads to illness.
patterning to determine the extents of
NURSING-is both science and art. It dissonance and harmony.
constantly maintains the energy field which
Philosophy and Science of Caring by
is conductive for patient.
Margaret Jean Watson
APPLICATION OF SUBH
Born in Southern West Virginia
CLINICAL PRACTICE-nursing action is always 1964 – BSN in Colorado
focused on unitary human being and 1966 – MS in Psychiatric – Mental Health
change the energy field between human Nsg
and environment. 1973 – PhD in Educational Psychology
-nursing interventions include all the
PERSON-Human being to be valued, cared
noninvasive actions.
for, respected, nurtured, understood and
NURSING EDUCATION-emphasis should be assisted. Must be viewed according to the
given on the understanding of the patient client’s development & the conflicts arising
and self, energy field and environment. in this development.
-Training should lay more focus on teaching
ENVIRONMENT-Defined as society with all
noninvasive modalities.
its influences. It provides the values that
NURSING RESEARCH-Rogerian theory has determine how one should behave and
been used in many research works and has what goals one should strive toward.
always been found testable and applicable Encompasses social, cultural & spiritual
in research. aspect.
NURSING PROCESS ACCORDING TO SUBH HEALTH-Refers to unity & harmony with in
the mind, body & soul.
PATTERN APPRAISAL- it is an inclusive
assessment of human and environment NURSING-Providing holistic health care. A
energy fields, its organization of energy human science of people & human health-
field, and identification of areas of illness experiences that are mediated by
dissonance. professional, personal, scientific, aesthetic
-Nurses validate the entire appraisal along & ethical human care transactions
with the client.
MUTUAL PATTERNING-it is the mutual
interaction between the client and the
nurse. Patterning can be done by suggesting
the various alternatives, educating,
Watson’s 10 Carative Factors Promotion of interpersonal teaching-
learning- Gives a client maximum health
Forming humanistic-altruistic value
control because it provides information &
system-Occurs early in life but can be
alternatives. Distinguishes caring from
greatly influenced by nursing educators.
curing by assigning responsibility for health
Can be accomplished by examining one’s
to the client. Enables a client to provide
views, beliefs, & interactions with various
self-care, determine personal needs &
cultures as well as personal growth
provide opportunities for their personal
experiences Provides satisfaction through
growth.
giving & extending oneself.
Provision for supportive, protective &
Instillation of faith-hope- Describes the
corrective mental, physical, sociocultural
nurse’s role in developing effective nurse-
& spiritual environment- Involves
patient interrelationships& in promoting
assessing & facilitating a client’s coping
wellness.
abilities to support & protect mental &
Cultivating sensitivity to self and others- physical well-being.
The recognition of feelings leads to self-
Assisting with gratification of human
actualization through self-acceptance for
needs- Addresses the needs of both the
both the nurse & the patient. As Nurses
nurse & the client. Requires meeting lower-
acknowledge their sensitivity & feelings,
order needs before attaining higher-order
they become more genuine, authentic &
needs.
sensitive to others.
Allowance for existential -
Development of a helping-trust
phenomenological forces- Permits one to
relationship-Establishes rapport & caring
understand people from the way things
Helps promote expression of positive &
appear to them; their experiences shape
negative feelings. Is accomplished through
their individual perceptions. Leads to better
congruence, empathy, nonpossesive
understanding of oneself & of others.
warmth, & effective communication.
FLORENCE NIGHTINGALE: Environmental
Promotion & acceptance of the expression
Theory
of positive & negative feelings- Involves
sharing of feelings. Includes being prepared 1851 – trained in nursing (Kaiserwerth,
for negative as well as positive feelings. Germany)
Pioneered the concept of formal education
Systematic use of the scientific problem-
solving method for decision making- is November 1854-Nightingale reorganized
important for research, defining the patient care
discipline & developing a scientific
4077 soldiers died on her first winter in
knowledge base for nursing. Brings
Scutari
scientific, problem-solving approach to
nursing care. March 1855 – Britain sends Sanitary
Commission to Scutari
War finished in 1856 environment which then causes STRESS.
Involves communication with the person,
1860- Saint Thomas' Hospital in London.
about the person, and about other people
Nightingale School and Home for Nurses
Social Environment- Involves collecting
In 1860, Nightingale published Notes on
data about illness and disease prevention.
Nursing. Considered the first “nursing
Consists of a person’s home or hospital
theorist”. Information on her theory has
room, as well as the total community that
been obtained through interpretation of
affects the patient’s specific environment.
her writings
Stress free surroundings
Bedridden in 1896
5 Major Components of a Healthful
Chronic Fatigue Syndrome
Environment
Pioneered in the field of Hospital Planning
Died in August 13, 1910 1. Proper ventilation
2. Adequate light
Nightingale’s Nursing Theory
3. Sufficient warmth
Theory basis: the inter-relationship of a 4. Control of noise
healthful environment with nursing 5. Control of effluvia
(noxious odors)
External influences and conditions can
prevent, suppress, or contribute to disease Nightingale’s 13 Canons:
or death
 Ventilation and warming
Theory goal: Nurses help patients retain  Health of Houses
their own vitality by meeting their basic  Petty management
needs through control of the environment  Observation of the Sick
 Personal Cleanliness
Nursing’s Focus: control of the
environment for individuals, families & the  Light
community  Cleanliness of Rooms
 Bed and Bedding
Three Types of Environments  Taking Food
Physical Environment- Consists of physical  What food
elements where the patient is being  Noise
treated. Affects all other aspects of the  Chattering Hopes and Advices
environment. Cleanliness of environment  Variety
relates directly to disease prevention and Metaparadigm in Nursing
patient mortality. Ventilation, warmth,
cleanliness, light, noise and drainage. PERSON-The patient, a human being acted
upon by a nurse or affected by the
Psychological Environment- Providing a environment who has reparative powers.
positive stress-free surrounding. Can be Recovery is within the patient’s power as
affected by a negative physical
long as safe environment for recuperation 10. Sick and well are governed by the
exists. same laws of health.
11. The nurse should be observant and
ENVIRONMENT-Comprises the external
confidential.
conditions and forces that affect one’s life
and development. Everything from person’s
food to a nurse’s verbal and nonverbal
GOAL ATTAINMENT THEORY
interactions with the person. IMOGENE
KING
HEALTH- Maintaining well-being by using a Background
person’s powers to the fullest extent;  youngest of 3 children, born in 1923
disease is viewed as a reparative process  St. John's Hospital School of
instituted by nature. Maintained by Nursing in St. Louis, Missouri (1945)
controlling environmental factors to
prevent disease; nurse helps the person  St. Louis University
through the healing process. - BS in Nursing Education (1948) MS
NURSING:-Aims to provide fresh air, light, in Nursing (1957)
warmth, cleanliness, quiet and proper diet; > Teachers College, Columbia
facilitates a person’s reparative by ensuring University,
the best possible environment; influences New York: - EdD (1961)
the environment to affect health. - Postdoctoral study in research
design, statistics, and computers.
NIGHTINGALE’S ASSUMPTION  Expertise:
1. Nursing is separate from medicine. Adult medical-surgical nursing
2. Nurses should be trained.  Experiences:
3. The environment is important in a. administrator, an educator, and a
nursing. practitioner
4. The disease process is not Nursing Metaparadigm
important to nursing.
5. Nursing should support the PERSON
environment to assist the patient in -Individuals are spiritual being
healing. -have the capacity to think, know,
6. Research should be utilized through make choices & select alternative
observation and empirics to define courses of action
the nursing discipline… -have the ability through their
7. Nursing is both an empirical science language & other symbols to record
and an art. their history & preserve their culture
8. Nursing’s concern is with the - open system in transaction with the
person in the environment. environment
9. The person is interacting with the - unique & holistic, are of intrinsic
environment. worth & are capable of rational
 thinking & decision making in most > Is an act wherein the nurse interacts &
situations communicates with the client
- Individuals differ in their needs, >The nurse helps the client identify the
wants & goals existing health condition, exploring &
agreeing on activities that promote health
3 fundamental health needs >The goal of the nurse in King’s theory is to
of human beings help the client maintain health through
 Need for health information health promotion & maintenance,
 Need for care for illness prevention restoration & caring for the sick & dying
 Need for total care when a person
GOAL ATTAINMENT THEORY
doesn’t have the capacity to help
themselves King's Goal Attainment Theory
>Involves the nurse and the patient
HEALTH mutually communicating information,
>Is a dynamic state in the life cycle; establishing goals, and taking action to
illness is an interference in the life obtain goals.
cycle
>Implies continuous adjustment to >Two people who are usually strangers
stress in the internal and external come together in a health care organization
environments, using personal to help or to be helped to a mutual state of
resources to achieve optimal daily health.
living
Central focus of the theory

Environment Focus:
  man as a dynamic human being whose
>The process of balance involving perceptions of objects, persons, and events
internal & external interactions influence his behavior, social interaction,
inside the social system and health
>Interpreted from the general
She proposes three basic premises;
systems theory as an open system
man is:
with permeable boundaries that
1. A reactive being
allow the exchange of matter,
2. A time oriented being
energy, and information
3. A social being
>Man as a reactive being is aware of other
things; persons and events in the
environment

Nursing >Man as a time-oriented being is

influenced by time orientation.
Each person is influenced by his past c. Growth and Development--involves all
actions. the changes that occur (cellular,
molecular, and behavioral). These
Man as a social being has a continuous
change are usually orderly and
exchange with persons in the environment.
predictable, but may vary with
Language is a social link and facilitates individuals.
interpersonal communication.
D. Body Image--The way a person perceive
3 Interacting systems of the theory: their body and the reaction of others to
their body. Body image is subjective and
1. PERSONAL SYSTEM
changes as the person changes physically or
2. INTERPERSONAL SYSTEM emotionally.
 
3. SOCIAL SYSTEM
E. Space--is the immediate physical territory
occupied by the person and person's
behavior.
 
F. Time--is the order of events and their
relationship to each other.

INTERPERSONAL SYSTEMS
>Two or more interacting individuals.
>How the nurse interrelates with a
co-worker or patient, particularly in a
nurse-patient relationship
PERSONAL SYSTEM
Concepts of Interpersonal system:
 INDIVIDUALS
A. Interaction – any situation wherein the
 It is how the nurse views & nurse relates & deals with a patient
integrates self based from personal
B. Communication – refers to the
goals & beliefs
transmission of information from one
Concepts of Personal system person to another; either directly or
indirectly
a. The Individual's Perception- the
person's representation of reality and it C. Transaction – refers to the interaction
is unique to each individual between a person & the environment
for the purpose of goal attainment
b. Self--The person's subjective
environment, values, ideas, attitudes, D. Role – refers to the expected behaviors
and commitment. of a person in a specific position & to
 the rules that govern the position & D. Status – refers to the position occupied
affect interaction between two or more by a person in a group or the position
persons occupied by a group in relation to other
E. Stress – refers to an exchange of groups in an organization; it is
energy, either positive or negative accomplished by certain duties,
between a person & the environment; privileges & obligations
F. Stressors – Events that produce stress E. Decision Making – results from
developing & acting on perceived
choices for goal attainment
SOCIAL SYSTEM
>Composed of larger group of 6 CHARACTERISTICS OF MAN
individuals with common interests or 1. The ability to perceive – perceptions
goals. will influence behavior and thus life and
>How the nurse interacts with co- health.
workers, superiors, subordinates & 2. The ability to think – thinking is based
the client environment in general upon the inquiring mind of man.
example: 3. The ability to feel- have emotions.
1. families, religious groups, schools,
4. The ability to perceive – perceptions
workplaces, and peer groups will influence behavior and thus life and
A social system comprises the: health.
1.social roles
5. The ability to think – thinking is based
2.behaviors upon the inquiring mind of man.
3. practices
6. The ability to feel- have emotions.
Concepts of Social System
Propositions of King’s Goal Attainment
A. Organization – refers to a group of Theory
people with similar interest who have
prescribed roles & positions & who use 1. If perceptual accuracy is present In
resources to achieve personal & nurse-client interactions,
organizational goals transactions will occur.

B. Authority – refers to the observable 2. If nurse & client make transactions,

behavior of providing guidance & order goals will be attained
& being responsible for actions 3. If goals are attained, satisfactions
C. Power – is characterized by the ability will occur
to use resources for goal achievement; 4. If goals are attained, effective
also a means by which one or more nursing care will occur
persons can influence others
 5. If transactions are made in nurse-  1958-1960 curriculum consultant
client interactions, growth &
 1959 – “Guides for developing the
development will be enhanced
curricula for the Education of
6. If role expectations & role Practical Nurses” was published
performance as perceived by nurse
- 1971 – “Nursing Concepts of
& client are congruent, transactions
Practice” which is Orem’s first book
will occur
was published.1980,1995.
7. If role conflict is experienced by the -died in June 22 ,2007 at age 92.
nurse & client or both, stress in
 Orem’s theory addresses client’s
nurse-client interactions will occur
self-care needs
8. If nurses with special knowledge &
 It is defined as Goal-oriented
skills communicate appropriate
activities that are set towards
information to clients, mutual goal
generating interest in the part of the
setting & goal attainment will occur
client to maintain life & health
Self-Care Deficit Nursing Theory development

Dorothea Elizabeth Orem  The theory is aimed towards making

the clients perform self-care
Credentials and Background activities in order to live
 Born on 1914 in Baltimore, Maryland independently

 Began her nursing education at METAPARADIGM

Providence Hospital School of Nursing in  PERSON
Washington,DC
– Defined as the patient- a being who
 1939 – she earned her BSN education at functions biologically, symbolically &
the Catholic University of America socially & who has the potential for
 1946 – earned her M.S.N. from learning & development
Catholic University of America.
 her nursing experiences – Is an individual subject to the forces of
included nature, with a capacity for self-
a. operating room nursing, knowledge, who can engage in
deliberate action, interpret experiences
b. private duty nursing (home &
hospital), & perform beneficial actions

c. hospital staff nursing on pediatric – Is an individual who can learn to meet

and adult medical and surgical units, self-care requisites; if for some reason,
d. evening supervisor in the E.R. the person cannot learn self-care
e. biological science teacher measures, others must provide the care
  HEALTH Major Concepts & Definitions
– Orem supports the WHO’s definition of 1.Self – Care
health as “the state of physical, mental, 2.Self – Care Requisites
and social well-being and not merely the Universal Self-Care
absence of disease or infirmity”. Requisites
– Consists of physical, psychological, Developmental Self – Care
interpersonal & social aspects; Requisites
according to Orem, these aspects are Health Deviation Self Care
inseparable
Requisites
– Includes promotion & maintenance of 3.Therapeutic Self – Care
health, treatment of illness & Demand
prevention of complications
4.Self-Care Agency
ENVIRONMENT
Consists of environmental factors,
 Agent
environmental elements, environmental  Dependent-Care Agent
conditions (external physical & psychosocial
surroundings) & developmental b.Self-Care Deficit
environment (promotion of personal
development through motivation to  Nursing Agency
establish appropriate goals & to adjust  Nursing Design
behavior to meet these goals; includes
formation of or change in attitudes & c.Nursing System
values, creativity, self-concept & physical
development)  Helping Methods

 NURSING Self-care deficit theory as a general

theory is composed of 3 related
– helping clients to establish or identify
ways to perform self-care activities. theories:

– Nursing actions are geared towards the 1. THE THEORY OF SELF-CARE

independence of the client. - Describes why & how people
– Nursing is a human service-its focus is care for themselves
on persons with inabilities to maintain Self- Care : refers to those activities
continuous provision of healthcare.
an individual performs independently
- Nursing is based on values
throughout life to promote &
maintain personal well-being
Self- Care agency: the complex 3. Maintenance of sufficient intake
acquired ability of mature & maturing of water.
persons to know & meet their
4. Provision of care associated with
continuing requirements for
elimination.
deliberate, purposive action to
regulate their own functioning & 5. Maintenance of balance between
development activity and rest.
- consists of two agents: An agent 6. Maintenance of balance between
(individual who is engage in meeting solitude and social interaction.
the need of a person; like bridges
that facilitate what has been done 7. Prevention of hazards to human
and what needs to be done) life, human functioning and
human well-being;
 self-care agent – person who
provides the self-care 8. Promotion of human functioning
and development.
 Dependent care agent – person
other than the individual who B. Developmental Self-care
provides cares requisites
- result from maturation or
Self-care requisites or Self-care associated with conditions or events
needs: are insights of actions or such as adjusting to a change in body
requirements that a person must be image or loss of a spouse
able to meet and perform in order to - they promote processes for life &
achieve well-being. maturation & prevent conditions
Categories of Self-care requisites: deleterious to maturation or those
A. Universal Self-care requisites that lessens those effects
- These are universally set goals that C. Health deviation self-care
must be undertaken in order for an requisites
individual to function in scope of - requisites that result from illness,
healthy living injury or disease or its treatment;
1. Maintenance of sufficient intake they include such actions as seeking
of air. medical assistance, carrying out a
prescribed treatment or learning to
2. Maintenance of sufficient intake
live with the effects of illness or
of food.
treatment
- These health care deviations set standards - helps a person achieve their health care
to which the degree of self-care demand is demand.
needed. Nursing Design: these are professional
functions that must be performed by the
Therapeutic Self-Care Demand >Refers to
nurse in order to meet clients needs
all self-care activities required to meet
- it serves as a guideline of needed &
existing self-care requisites
foreseen results in the production of
>Involves the use of actions to maintain nursing toward the achievement of nursing
health & well-being, each patient’s goals
therapeutic self-care demands varies
throughout life.
3 classifications of Nursing Systems:

2. THE THEORY OF SELF-CARE DEFICIT-  Each system describes nursing

which describes & explains why people can responsibilities, roles of the nurse &
be helped through nursing patient , rationales for the nurse-patient
Self-care deficit: arises when the self-care relationship & types of actions needed
agency cannot meet self-care requisites to meet the patient’s self-care agency &
therapeutic self-care demand
Helping Methods:
1. A wholly compensatory nursing system
1. Acting or doing for another - is used when a patient’s self-care
2. Guiding and directing agency is so limited that the patient
depends on others for well-being
3. Providing physical or psychological 2. A partly compensatory nursing system -
support is used when a patient can meet some
4. Teaching self-care requisites but needs a nurse to
help meet others
5. Providing and maintaining an - the nurse & the patient play major
environment that supports personal roles in performing self-care
development
3. Supportive – Educative Nursing System
3.THEORY OF NURSING SYSTEMS-- - is used when a patient can meet self-
describes and explains relationships that care requisites but needs assistance
must be brought about & maintained for with decision making , behavior control
nursing to be produced or knowledge acquisition skills
- refers to the series of actions a nurse takes
to meet a patient’s self-care requisites
Major Assumptions

Nursing Agency: set of established 1. Human beings require continuous,

capabilities of a nurse who can legitimately deliberate inputs to themselves and
perform activities of care for a client. their environments to remain alive and
function in accordance with natural
human endowments.
2. Human agency, the power to act theory as the basis for structuring
deliberately, is exercised in the form of practice is found in descriptions of
care for self and others in identifying nurse-managed clinics at John Hopkins
needs and making needed inputs. Hospital in 1973.
3. Mature human beings experience Research articles on the use of SCDNT or
privations in the form of limitations for components in clinical practice include
action in care for self and others
A. Teaching self-care to individuals with
involving and making of life sustaining
DM,ESRD, hemodialysis, peritoneal
and function-regulating inputs.
dialysis, renal transplant
4. Human agency is exercised in B. Pain assessment
discovering, developing, and
C. Cardiac research
transmitting ways and means to identify
needs and make inputs to self and d. Oncology – focus cancer prevention, self-
others. care after being diagnosed with
malignancies.
5. Groups of human beings with structured
relationship cluster tasks and allocate e. Psychiatry etc..
responsibilities for providing care to
 Education
group members who experience
“Guides for Developing Curriculum for
privations for making required,
the Education of Practical Nurses”
deliberate input to self and others.
a. Orem worked on a book
“Foundations of Nursing Practice”
(Morris Harvey College)
Research
a. First instrument to measure the
exercise of Self-care agency (ESCA) was
published in 1979

2. Theory of Self-Care deficit

3. Theory of Self-Care

Acceptance by the Nursing

Community
 Practice
>The first documented use of Orem’s