Dothea Orem Self-Care Theory

Dorothea Orem's Self-Care Theory This page was last updated on February 4, 2012 INTRODUCTION †¢Theorist : Dorothea Orem (1914-2007) †¢Born 1914 in Baltimore, US †¢Earned her diploma at Providence Hospital – Washington, DC †¢1939 – BSN Ed. , Catholic University of America †¢1945 – MSN Ed. , Catholic University of America †¢She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant. †¢Received honorary Doctor of Science degree in 1976. †¢Theory was first published in Nursing: Concepts of Practice in 1971, second in 1980, in 1995, and 2001.MAJOR ASSUMPTIONS †¢People should be self-reliant and responsible for their own care and others in their family needing care †¢People are distinct individuals †¢Nursing is a form of action – interaction between two or more persons †¢Successfully meeting universal and development self-care requisites is an important compon ent of primary care prevention and ill health †¢A person’s knowledge of potential health problems is necessary for promoting self-care behaviors †¢Self care and dependent care are behaviors learned within a socio-cultural context DEFINITIONS OF DOMAIN CONCEPTSNursing – is art, a helping service, and a technology †¢Actions deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments †¢Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective †¢Goal of nursing – to render the patient or members of his family capable of meeting the patient’s self care needs †¢To maintain a state of health To regain normal or near normal state of health in the event of disease or injury †¢To stabilize ,control ,or minimize the effects of chronic poor health or disability Health – health and healthy are terms used to describe living things †¦ †¢It is when they are structurally and functionally whole or sound †¦ wholeness or integrity. .includes that which makes a person human,†¦operating in conjunction with physiological and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beings Environment environment components are enthronement factors, enthronement elements, conditions, and developed environment Human being – has the capacity to reflect, symbolize and use symbols †¢Conceptualized as a total being with universal, developmental needs and capable of continuous self care †¢A unity that can function biologically, symbolically and socially Nursing client †¢A human being who has â€Å"health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in ineffective / incomple te care. A human being is the focus of nursing only when a self –care requisites exceeds self care capabilities Nursing problem †¢deficits in universal, developmental, and health derived or health related conditions Nursing process †¢a system to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of care Nursing therapeutics †¢deliberate, systematic and purposeful action, OREM’S GENERAL THEORY OF NURSING Orem’s general theory of nursing in three related parts:- †¢Theory of self care Theory of self care deficit †¢Theory of nursing system A. Theory of Self Care This theory Includes: †¢Self care – practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being †¢Self care agency – is a human ability which is â€Å"the ability for engaging in self care† -conditioned by age developmental state, life experience sociocultural orientation health and available resources †¢Therapeutic self care demand – â€Å"totality of self care actions to be performed for some uration in order to meet self care requisites by using valid methods and related sets of operations and actions† †¢Self care requisites – action directed towards provision of self care. 3 categories of self care requisites are- oUniversal self care requisites oDevelopmental self care requisites oHealth deviation self care requisites 1. Universal self care requisites †¢Associated with life processes and the maintenance of the integrity of human structure and functioning †¢Common to all , ADL †¢Identifies these requisites as: oMaintenance of sufficient intake of air ,water, food Provision of care assoc with elimination process oBalance between activity and rest, between solitude and social interaction oPrevention of hazards to human life well being and oPromotion of human functioning 2. Developmental sel f care requisites †¢Associated with developmental processes/ derived from a condition†¦. Or associated with an event oE. g. adjusting to a new job oadjusting to body changes 3. Health deviation self care †¢Required in conditions of illness, injury, or disease . these include:– †¢Seeking and securing appropriate medical assistance Being aware of and attending to the effects and results of pathologic conditions †¢Effectively carrying out medically prescribed measures †¢Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care †¢Learning to live with effects of pathologic conditions B. Theory of self care deficit †¢Specifies when nursing is needed †¢Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care.Orem identifies 5 methods of helping: oActing for and doing for others o Guiding others oSupporting another oProviding an environment promoting personal development in relation to meet future demands oTeaching another C. Theory of Nursing Systems †¢Describes how the patient’s self care needs will be met by the nurse , the patient, or both †¢Identifies 3 classifications of nursing system to meet the self care requisites of the patient:- †¢Wholly compensatory system †¢Partly compensatory system †¢Supportive – educative system †¢Design and elements of nursing system define Scope of nursing responsibility in health care situations †¢General and specific roles of nurses and patients †¢Reasons for nurses’ relationship with patients and †¢Orem recognized that specialized technologies are usually developed by members of the health profession †¢A technology is systematized information about a process or a method for affecting some desired result through deliberate practical endeavor, with or w ithout use of materials or instruments. Categories of technologies 1. Social or interpersonal †¢Communication adjusted to age, health status Maintaining interpersonal, intra group or inter group relations for coordination of efforts †¢Maintaining therapeutic relationship in light of psychosocial modes of functioning in health and disease †¢Giving human assistance adapted to human needs ,action abilities and limitations 2. Regulatory technologies †¢Maintaining and promoting life processes †¢Regulating psycho physiological modes of functioning in health and disease †¢Promoting human growth and development †¢Regulating position and movement in space OREM’S THEORY AND NURSING PROCESS †¢Nursing process presents a method to determine the self care deficits and hen to define the roles of person or nurse to meet the self care demands. †¢The steps within the approach are considered to be the technical component of the nursing process. †¢Orem emphasizes that the technological component â€Å"must be coordinated with interpersonal and social processes within nursing situations. Nursing Process Orem’s Nursing Process †¢Assessment †¢Diagnosis and prescription; determine why nursing is needed. analyze and interpret –make judgment regarding care †¢Design of a nursing system and plan for delivery of care †¢Production and management of nursing systemsStep 1-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 her health †¢The health goals within the context of life history ,life style, and health status †¢The person’s requirements for self care †¢The person’s capacity to perform self care †¢Nursing diagnosis †¢Plans with scientific rationaleStep 2 †¢Nurse designs a system that is wholly or partly compe nsatory or supportive-educative. †¢The 2 actions are:- Bringing out a good organization of the components of patients’ therapeutic self care demands †¢Selection of combination of ways of helping that will be effective and efficient in compensating for/ overcoming patient’s self care deficits †¢Implementation †¢evaluationStep 3 †¢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 †¢evaluationApplication of Orem’s theory to nursing process Therapeutic self care demandAdequacy of self care agencyNursing diagnosisMethods of helping Air Maintain effective respiration Water No problem Food maintain sufficient intakeInadequate Adequate InadequatePotential for impaired respiratory status P F fluid imbalance Actual nutritional deficit r/t nauseaGuiding & directing Teaching Providing physical support Hazards Prevent spouse abuse Promotion of normalcyInadequate InadequateP/F injury A/d in environment Shared housingPersonal development Guiding & directing Guiding & directingMaintain developmental environment Support  ¬ed normalcy in environment Prevent /manage dev threatInadequate InadequateActual delay in normal dev. R/T early parenthood Level of education Dev deficit r/t loss of reproductive organsGuiding & directing Providing psy support Providing physical, psy support Maintenance of health status Management of disease process Inadequate InadequateP/F contd. alterations in health status P/F UTIGuiding & directing, teaching Guiding & directing, teaching Adherence to med regimen Awareness of potential problemsInadequate InadequateP/F ? dherence in self catheterization & OPD RT Actual deficit in awareness of advisability of HRT & RT effectsteaching teaching Adjust to los s of reproductive ability & dev healthy view of illness Adjust life style to cope with change Inadequate InadequateActual threat to self image Actual self deficit in planning for future needs Providing psy support Guiding & directing OREM’S WORK AND THE CHARACTERISTICS OF A THEORY †¢Orem's theory ointerrelate concepts in such a way as to create a different way of looking at a particular phenomenon ois logical in nature. ois relatively simple yet generalizable ois basis for hypothesis that can be tested contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them ocan be used by the practitioners to guide and improve their practice omust be consistent with other validated theories ,laws and principles Strengths †¢Provides a comprehensive base to nursing practice †¢It has utility for professional nursing in the areas of nursing practice nursing curricula ,nursing education administrat ion ,and nursing research †¢Specifies when nursing is needed †¢Her self-care approach is contemporary with the concepts of health promotion and health maintenance Limitations In general system theory a system is viewed as a single whole thing while Orem defines a system as a single whole, thing. †¢Health is often viewed as dynamic and ever changing. †¢The theory is illness oriented. RESEARCH ON OREM'S THEORY 1. Self-care requirements for activity and rest: an Orem nursing focus 2. Nursing diagnoses in patients after heart catheterization–contribution of Orem 3. Self-care–the contribution of nursing sciences to health care 4. Self-care: a foundational science 5. Orem's self-care deficit nursing theory: its philosophic foundation and the state of the science 6. Dorothea E. Orem: thoughts on her theory . Orem's theory in practice. Hospice nursing care 8. Solving the Orem mystery: an educational strategy 9. Orem's family evaluation REFERENCES †¢Ore m, D. E. (1991). Nursing: Concepts of practice (4th ed. ). St. Louis, MO: Mosby-Year Book Inc. †¢Taylor, S. G. (2006). Dorthea E. Orem: Self-care deficit theory of nursing. In A. M. †¢Tomey, A. & Alligood, M. (2002). Significance of theory for nursing as a discipline and profession. Nursing Theorists and their work. Mosby, St. Louis, Missouri, United States of America. †¢Whelan, E. G. (1984). Analysis and application of Dorothea Orem’s Self-care Practuce Model.Retrieved October 31, 2006. †¢George B. Julia , Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange. †¢Wills M. Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins. †¢Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott. †¢Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott. †¢Potter A P atricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.

Pakistan Tourism Essay

Dented with political crisis and economic instability Pakistan has been unable to promote its tourism industry to the world. This does not mean that Pakistan is not a tourism destination. From scenic landscapes to a diverse culture, Pakistan has tremendous potential in terms of tourism. Before the economic crisis struck the world and when the economic and political climate of the country was stable, Pakistan received more than 500,000 tourists. From the ruins of civilizations such as Moenjodaro, Taxila and Harappa to the peaks of the Himalayan hill stations which stand at above 7000ft, Pakistan has lots to offer. Lahore, the second largest city is the cultural and fashion hub of Pakistan. The Lahore fort, Badshahi Mosque, Shalimar Gardens and the Tomb of Jahangir are key Mughal architectural icons of the city. The Travel and Tourism Competitiveness Report published by the World Economic Forum ranked Pakistan as one of the top 25 tourist destinations due to its abundance of World Heritage sites such as Moenjodaro, Taxila, Buddhist ruins of Takht-i-Bahi, monuments of Thatta, Fort and Shalimar Gardens and the Rohtas Fort (www. tourism. gov. pk ). K2, the world’s second highest mountain attracts numerous mountain climbers from across the globe each year. The northern part of Pakistan boasts a large amount of forts and ancient architecture such as the Chitral and Hunza valley also known for their scenic beauty. Other peaks such as Nanga Parbat and Rakaposhi are also renowned and are supported by remote resorts which provide an ideal summer get away for tourists (Rehmat Karim Baig, 2005). The country also hosts various festivals and fairs that are aimed at attracting tourists. The ski resorts in the northern part have annual skiing championships. Moreover, paragliding shows, the cholistan jeep rally, Kalash festival, Silk Route festival and Polo Festivals are held regularly. Trekking, Skiing, rafting, hunting, mountain and desert jeep safaris, fishing, bird watching and camel safaris are some unique experiences Pakistan has to offer in terms of adventure tourism. With a classic topography including towering mountains, narrow passes and beautiful glaciers the country is heaven for the adventure centered tourists (www. pakistan4ever. com). Pakistan also offers spiritual tourism for various religions and ethnicities such as Buddhists and Sikhs form neighboring countries. The Indus Valley gave rise to various civilizations and gained fame throughout the world. Sport tourism is also a major attraction. The Shandur Polo Festival is the most attracting sports festival for both local and foreign tourists. Other sports include white water rafting, rock climbing, angling and mountain biking (Mujahida Noreen, 2002). Tours and Packages are easily accessible for tourists which include day trips to heritage sites, city trips, summer and winter packages. Apart from the hill stations and culturally diverse landscape, Pakistani cities of Lahore, Islamabad and Karachi are an adventure in themselves. From the lively shopping districts of Karachi to the scrumptious meals in Lahore, each city has its specialty. Pakistani tourists on the other hand are major contributors to the tourism revenue. The northern hill stations of Ayubia and Nathiagali are renowned for there scenic beauty, tranquility and adventures. Lahore is the fashion capital of Pakistan and offers numerous shopping and food service facilities. The ‘Food Street’ in Lahore is most renowned because of its delicacies. Tourism in Pakistan is endless, with so much to offer, the country is a haven for tourists of all kinds. Visit Pakistan and you will never regret it (Government of Pakistan, UNDP, and WTO, 2000). References 1. Mujahida Noreen. (2002). Tourism in Pakistan. Univeristy of Michigan: National Institute of Pakistan Studies. 2. Pakistan Tourism Development Corporation. Retrieved May 10, 2010, from www. tourism. gov. pk 3. Pakistan Travel and Tourism Guide. Retrieved May 10, 2010, from www. pakistan4ever. com 4. Rehmat Karim Baig, (2005). â€Å"Mountaineering and Tourism Promotion in Chitral†, proceeding Report -Seminars on Mountain Tourism, pp. 31-3. 5. Government of Pakistan, UNDP, and WTO. (2000). Tourism Master Plan-Pakistan, Madrid.

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My Observation Of Unsupervised Adolescent - 1990 Words

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I had no idea what they were and, as a new graduate, was too timid

The Airplane Game free essay sample

When we were younger and on vacation, my sisters and I often grew bored inside our hotel rooms, so we fashioned a game we dubbed â€Å"The Airplane Game†. The hotel bathtub was the airplane, magazine subscription cards were the money, and the beds were the duty free shops. My eldest sister was always the air hostess in charge of our departure, while my other sister and I were the ditzy passengers. The plane would be boarding yet we’d stop by the beds to purchase sweets, losing track of time whilst analysing the Skittles section. Just as the airplane was leaving, we’d make it to the bathroom. Unfortunately for us it would be racing down the tarmac as we’d be entering, leaving us with a foot outside the tub, assuring our death. By this time we’d all be breathless with laughter. This game never seemed to lose its power to entertain. We will write a custom essay sample on The Airplane Game or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Years went by and we outgrew â€Å"The Airplane Game†, but the misty memories remained. As it often happens with time gone by, things changed. My father was presented with the opportunity to work in a foreign country and my sisters moved to boarding school and college. My family’s structure began to disintegrate, ultimately crumbling with my parent’s separation. For my freshman and sophomore year of high school I was consumed by my parent’s divorce. I became careless and unfocused, my academics took a backseat, and occupying my thoughts with diverting nonsense became a full-time job. I embodied the ditzy passenger unable to board the plane in an appropriate fashion, losing track of what was important through meaningless distractions. This changed the summer following my sophomore year when I attended Pratt Institute’s Pre-College program. The experience allowed me to interact with people with personalities far different from the ones I was used to and unveiled a world of possibilities I never knew existed. Involving myself with diverse perspectives and backgrounds made me realize that I was not only well off, but what I deemed problems were merely difficulties I would eventually overcome. Sure my parents weren’t together and change was imminent, but it was something I needed, something that encouraged me to step out of my comfort zone. I thereafter decided to strive in every aspect. I grew to not only enjoy my classes, but the process of learning. I joined clubs, continued playing the piano, and improved my French through three summers spent in France. I became more confident in my writing and ultimately had poetry published. Over the years I’ve come to the realization that â€Å"The Airplane Game† was much more than a way to pass the time; it now seems like a harbinger of the future. Carelessness breeds insecurity, especially when planning for the imminent. I may have taken off with a leg outside the plane, but these past two years have taught me that with effort and determination, I can always pull myself back in.

Planning For Management Information System Essays -

Planning for Management Information System Planning for Management Information System The biggest challenge and most critical success factor in reengineering projects are persuading the people within the organization to cooperate. When you begin to computerize a legacy system considers the advantages; reduced clerical cost, quicker processing time and improved customer service. Everyone knows that the computer capabilities alone make life a lot easier for all managers. The advantage of time and accuracy spread over the lifespan of the information system means improved long-term vision and focus for top, middle and lower managers. A management information system (MIS) focus is on information that management needs to prepare its job. This task becomes much more difficult when the major players have a tradition of high independence, are often confrontational to management, and are irreplaceable independent contractors. CIO's in major business organizations face exactly this situation; further complicated by the fact that the reengineering effort is crucial to the continued existence of the organization. Such discussion has driven the software industry to focus attention on software specifically designed to support the team approach essential to most service and customer oriented organizations. The importance of teamwork can not be over emphasize in achieving overall organizational goals, and the need to capture and manage an organization's knowledge base remain crucial. This teamwork enables the organization to achieve and sustain competitive advantage in their business. In considering the framework for an information system (IS) each level operational, tactical and strategic planning requires different IS. At the operational planning system, the IS collect, validate and record transactional data relating to acquisition or disbursement of resources. The data for account receivable and payables, payrolls, inventory level, shipping data, printed invoice and cash receipts recorded as they occur. The operational-level IS characteristic are repetitive, predictable, emphasizes the past and detailed in nature just to name a few. The focus of the operational system is the daily tasks performed at the user level. The operational level manager uses this data to check every day tasks, i.e. ordering, shipping, inventory control, the essence of the business processes. The second level in the framework is the tactical system. This system provide middle-level managers with information to monitor and control operation while allocating their resources efficiently. The data is summarized, aggregated, or analyzed with a wide range of reports, i.e., summary, exception and ah hoc reports. The tactical information system differs from operational information system in the basic purpose: operational support the execution of tasks and a tactical information system supports a manager control over those tasks under their area of supervision as well as the allocation of resources to meet the company objectives set by top management. The data input and the information produced as outputs differ from the type of data involved, tactical characteristics are periodic in nature, with unexpected findings, comparative in nature with both internal and external sources. The tactical information system purpose and the regularity of report produced within the information system are drastically different from an operational system. The third level in the framework is strategic planning, designed to provide top managers with information that assist them in making long-range planning decisions for the business. The different in strategic and tactical are not always clear, because both types of information systems may use some of the same data, you might say that the systems sometimes overlap with the difference being in the data that the system uses. Typically, top management uses strategic planning system to forecast long-range company objectives. The characteristics are ah hoc basis, unstructured format, external source, and subjectivity, summary and predictive in nature. A MIS provides information for effective planning and tactical decision making, which is the foundation of operational level data system. A tactical planning system provides middle-level management with the ability to monitor and control resources. The tactical information system does not support the execution of operational tasks, but allow managers visibility over the operation. Information systems are costly, to deploy and maintain, yet the maximization of economic value of IS in the long-run balance out over the initial set-up cost. The right software products enable teams of people to integrate their knowledge, work processes and applications to achieve improved business effectiveness. It has been suggested that the implementation of such technologies is more difficult and yields more unintended consequences than is typically acknowledged. First, how such technologies are used reflect the effects. Second, how these technologies are likely used when alternative tools co-exist, meaning predictability is difficult from technological characteristics. Third, because people use groupware with other people, one person's choices about how to use groupware may have consequences for other group members, user satisfaction. The measurement for an effective MIS must be the users; usage