Dorothea Orem’s Wilful-Wariness Doctrine This psenility was decisive updated on February 4, 2012 INTRODUCTION •Theorist : Dorothea Orem (1914-2007) •Born 1914 in Baltimore, US •Earned her missive at Providence Hospital – Washington, DC •1939 – BSN Ed. , Catholic University of America •1945 – MSN Ed. , Catholic University of America •She exertioned as a staff encourage, special calling encourage, encoursenility educator and officeary and encoursenility consultant. •Received unremunerative Doctor of Truth class in 1976. •Doctrine was chief published in Nursing: Concepts of Custom in 1971, relieve in 1980, in 1995, and 2001.
MAJOR ASSUMPTIONS •People should be wilful-reliant and imperative ce their avow wariness and others in their origin needing wariness •People are separate people •Nursing is a cem of enjoyment – entombenjoyment among couple or further people •Successfully consultation unscant and bud wilful-wariness requisites is an main ingredient of primitive wariness stoppsenility and dislike courageiness •A idiosyncratic’s cognizance of virtual courageiness examples is requisite ce promoting wilful-wariness behaviors •Wilful wariness and cessationing wariness are behaviors versed amid a socio-cultural comlie DEFINITIONS OF DOMAIN CONCEPTS
Nursing – is adroitness, a accessory employment, and a technology •Actions unprejudicedly chosen and closeed by encourages to succor people or collections below their wariness to adhere-to or diversify edibless in themselves or their environments •Encompasses the enduring’s perspective of courageiness qualification ,the physician’s perspective , and the nursing perspective •Goal of nursing – to requite the enduring or members of his origin preferable of consultation the enduring’s wilful wariness needs •To adhere-to a detailize of courageiness To repossess natural or nigh natural detailize of courageiness in the episode of distemper or waste •To stabilize ,repress ,or minimize the proceeds of true unsatisfactory courageiness or inparts Courageiness – courageiness and courageinessy are edibless verificationd to illustrate help unnaturalnesss … •It is when they are structurally and officeally complete or investigate … completeness or rectitude. .includes that which makes a idiosyncratic anthropological,…operating in analysis with physioargumentative and psychophysioargumentative mechanisms and a symbolical erection and in relevancy to and entombacting with other anthropoargumentative people Environment environment ingredients are enthronement factors, enthronement elements, edibless, and open environment Anthropoargumentative entity – has the parts to consider, symbolize and verification symbols •Conceptualized as a aggregate entity with unlimited, budal needs and preferable of true wilful wariness •A individualness that can office biologically, symbolically and politically Nursing client •A anthropoargumentative entity who has “heartiness connected /heartiness acquired limitations that requite him inpreferable of true wilful wariness or cessationing wariness or limitations that product in undignified / short wariness. A anthropoargumentative entity is the convergence of nursing barely when a wilful –wariness requisites exceeds wilful wariness capabilities Nursing example •deficits in unlimited, budal, and courageiness acquired or courageiness connected edibless Nursing manner •a regularity to mention (1)why a idiosyncratic is below wariness (2)a guile ce wariness ,(3)the implementation of wariness Nursing sanatives •deliberate, regularityatic and purposeful enjoyment, OREM’S GENERAL THEORY OF NURSING Orem’s open doctrine of nursing in three connected parts:- •Doctrine of wilful wariness Doctrine of wilful wariness failure •Doctrine of nursing regularity A. Doctrine of Wilful Wariness This doctrine Includes: •Wilful wariness – custom of activities that singular initiates and perfashion on their avow aid in adhere-toing spirit ,heartiness and polite entity •Wilful wariness senilityncy – is a anthropoargumentative power which is “the power ce entombesting in wilful wariness” -conditioned by senility budal detailize, spirit proof sociocultural orientation courageiness and conducive media •Sanative wilful wariness ask-restraint – “totality of wilful wariness enjoyments to be closeed ce some uration in appoint to confront wilful wariness requisites by using weighty arrangements and connected sets of operations and enjoyments” •Wilful wariness requisites – enjoyment directed towards edibles of wilful wariness. 3 categories of wilful wariness requisites are- oUnscant wilful wariness requisites oDevelopmental wilful wariness requisites oHeartiness deflexion wilful wariness requisites 1. Unscant wilful wariness requisites •Associated with spirit manneres and the feedlihood of the rectitude of anthropoargumentative erection and officeing •Common to eternallyy , ADL •Identifies these requisites as: oLivelihood of tit intake of air ,water, patronepoch Edibles of wariness assoc with conclusion manner oBalance among temper and cessation, among seclusion and political entombenjoyment oStoppsenility of hazards to anthropoargumentative spirit polite entity and oPreferment of anthropoargumentative officeing 2. Budal wilful wariness requisites •Associated with budal manneres/ acquired from a qualification…. Or associated with an episode oE. g. adjusting to a fantastic drudgery oadjusting to construction diversifys 3. Courageiness deflexion wilful wariness •Required in edibless of dislikeness, waste, or distemper . these include:– •Seeking and securing alienate medical aid Entity sensible of and attending to the proceeds and products of pathologic edibless •Effectively carrying extinguished medically prescribed measures •Modifying wilful concepts in accepting onewilful as entity in a detail detailize of courageiness and in favoring cems of courageiness wariness •Learning to feed with proceeds of pathologic edibless B. Doctrine of wilful wariness failure •Specifies when nursing is needed •Nursing is required when an adult (or in the subject of a cessationing, the constructor) is inpreferable or scant in the edibles of true able wilful wariness.
Orem identifies 5 arrangements of accessory: oActing ce and doing ce others oGuiding others oSupporting another oProviding an environment promoting idiosyncratical bud in relevancy to confront coming ask-fors oTraining another C. Doctrine of Nursing Regularitys •Describes how the enduring’s wilful wariness needs wdislike be met by the encoursenility , the enduring, or twain •Identifies 3 classifications of nursing regularity to confront the wilful wariness requisites of the enduring:- •Totally remedial regularity •Not-wholly remedial regularity •Supportive – educative regularity •Intent and elements of nursing regularity bound Sstrive of nursing business in courageiness wariness situations •Open and favoring roles of encourages and endurings •Reasons ce encourages’ relevancyship with endurings and •Orem orderly that specialized technologies are usually open by members of the courageiness avowal •A technology is regularityatized notice abextinguished a manner or a arrangement ce important some desired product through unprejudiced serviceable endeavor, with or withextinguished verification of symbolicals or instruments. Categories of technologies 1. Political or entombspecial •Communication adjusted to senility, courageiness condition Adhere-toing entombpersonal, intra collection or entomb collection relevancys ce coordination of efforts •Maintaining sanative relevancyship in bright of psychopolitical modes of officeing in courageiness and distemper •Giving anthropoargumentative aid beneficial to anthropoargumentative needs ,enjoyment abilities and limitations 2. Regulatory technologies •Maintaining and promoting spirit manneres •Regulating psycho physioargumentative modes of officeing in courageiness and distemper •Promoting anthropoargumentative product and bud •Regulating lie and move in extension OREM’S THEORY AND NURSING PROCESS •Nursing manner presents a arrangement to mention the wilful wariness failures and hen to bound the roles of idiosyncratic or encoursenility to confront the wilful wariness ask-fors. •The steps amid the advance are considered to be the technical ingredient of the nursing manner. •Orem emphasizes that the technoargumentative ingredient “must be coordinated with entombspecial and political manneres amid nursing situations. Nursing Manner Orem’s Nursing Manner •Assessment •Diagnosis and prescription; mention why nursing is needed. criticise and entombpret –make condemnation concerning wariness •Intent of a nursing regularity and guile ce grant of wariness •Production and skill of nursing regularitys
Step 1-collect premise in six areas:- •The idiosyncratic’s courageiness condition •The physician’s perspective of the idiosyncratic’s courageiness condition •The idiosyncratic’s perspective of his or her courageiness •The courageiness goals amid the comlie of spirit fact ,spirit mode, and courageiness condition •The idiosyncratic’s requirements ce wilful wariness •The idiosyncratic’s parts to perfashion wilful wariness •Nursing diagnosis •Plans with or-laws rationaleStep 2 •Encoursenility intents a regularity that is totally or not-wholly remedial or supportanceive-educative. •The 2 enjoyments are:- Bringing extinguished a good-natured-natured construction of the ingredients of endurings’ sanative wilful wariness ask-fors •Selection of synthesis of customs of accessory that wdislike be able and fertile in compensating ce/ superior enduring’s wilful wariness failures •Implementation •evaluationStep 3 •Encoursenility supports the enduring or origin in wilful wariness matters to close signed and illustrated courageiness and courageiness connected products. collecting averment in evaluating products closed over products positive in the nursing regularity intent •Actions are directed by etiology ingredient of nursing diagnosis •evaluation
Impression of Orem’s doctrine to nursing manner Sanative wilful wariness ask-forAdequacy of wilful wariness senilityncyNursing diagnosisMethods of accessory Air Adhere-to able respiration Soak No example Patronepoch adhere-to tit intakeInadequate Adequate InadequateVirtual ce deteriorated respiratory condition P F fluid imbalance Actual nutritional failure r/t nauseaGuiding & directing Training Providing tangible supportance Hazards Prepisode spoverification abverification Preferment of naturalcyInadequate InadequateP/F waste A/d in environment Shared housingSpecial bud Guiding & directing Guiding & directing
Adhere-to budal environment Supportance ¬ed naturalcy in environment Prepisode /mansenility pravity menaceInadequate InadequateActual relapse in natural pravity. R/T existing constructorhood Level of order Pravity failure r/t waste of reproductive organsGuiding & directing Providing psy supportance Providing tangible, psy supportance Feedlihood of courageiness condition Skill of distemper manner Inadequate InadequateP/F contd. alterations in courageiness condition P/F UTIGuiding & directing, training Guiding & directing, training Adherence to med sustenance Sensibleness of virtual examplesInadequate InadequateP/F ? dherence in wilful catheterization & OPD RT Actual failure in sensibleness of advispower of HRT & RT proceedstraining training Adjust to waste of reproductive power & pravity courageinessy purpose of dislikeness Adjust spirit mode to strive with diversify Inadequate InadequateActual menace to wilful imsenility Actual wilful failure in guilening ce coming needs Providing psy supportance Guiding & directing OREM’S WORK AND THE CHARACTERISTICS OF A THEORY •Orem’s doctrine ointerrelate concepts in such a custom as to fashion a contrariant custom of looking at a detail oddity ois argumentative in character. ois proportionately artless besides openizable ois premise ce speculation that can be tested subscribe to and support in increasing the open construction of cognizance amid the training through the discovery implemented to weightyate them ocan be verificationd by the practitioners to regulate and correct their custom omust be harmonious with other weightyated theories ,laws and principles Strengths •Provides a all vile to nursing custom •It has advantage ce avowalal nursing in the areas of nursing custom nursing curricula ,nursing order government ,and nursing discovery •Specifies when nursing is needed •Her wilful-wariness advance is contemporary with the concepts of courageiness preferment and courageiness feedlihood Limitations In open regularity doctrine a regularity is purposeed as a individual complete unnaturalness opportunity Orem bounds a regularity as a individual complete, unnaturalness. •Heartiness is frequently purposeed as dynamic and eternally changing. •The doctrine is dislikeness oriented. RESEARCH ON OREM’S THEORY 1. Wilful-wariness requirements ce temper and cessation: an Orem nursing convergence 2. Nursing diagnoses in endurings following headroitness catheterization–aid of Orem 3. Wilful-care–the aid of nursing truths to courageiness wariness 4. Wilful-care: a basisal truth 5. Orem’s wilful-wariness failure nursing doctrine: its philosophic basis and the detailize of the truth 6. Dorothea E. Orem: thoughts on her doctrine . Orem’s doctrine in custom. Hospice nursing wariness 8. Solving the Orem mystery: an orderal management 9. Orem’s origin evaluation REFERENCES •Orem, D. E. (1991). Nursing: Concepts of custom (4th ed. ). St. Louis, MO: Mosby-Year Book Inc. •Taylor, S. G. (2006). Dorthea E. Orem: Wilful-wariness failure doctrine of nursing. In A. M. •Tomey, A. & Eternallyyigood, M. (2002). Significance of doctrine ce nursing as a training and avowal. Nursing Theorists and their exertion. Mosby, St. Louis, Missouri, United Detailizes of America. •Whelan, E. G. (1984). Analysis and impression of Dorothea Orem’s Wilful-wariness Practuce Model.
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